Get Firsthealth Physician Requisition For Outpatient Laboratory Testing 2020-2025

The FirstHealth Physician Requisition for Outpatient Laboratory Testing is an essential document for healthcare providers to request laboratory tests for their patients. This guide offers comprehensive, step-by-step instructions to fill out the form online accurately and efficiently.

Follow the steps to complete the form online effectively.

1. Press the ‘Get Form’ button to access the form and open it in your preferred online editor.
2. Begin by entering the patient's information in the fields specified, including last name, first name, and middle name. Be sure to provide any additional required data such as date of birth and social security number.
3. Fill in the address details, including the city, state, and zip code, ensuring accuracy to avoid issues with processing.
4. Indicate the clinic or outreach site, along with the provider's name and National Provider Identifier (NPI), which are required sections.
5. Select the specimen collection information, including STAT or fasting requirements, and provide the date and time the specimen was collected.
6. Complete the billing information by entering the patient's insurance details, indicating whether Medicare or Medicaid is primary or secondary, and including the relevant ID numbers.
7. Specify the recipient for the results by filling in the contact information for any individuals or clinics that should receive the results via call or fax.
8. In the section for test requests, carefully select the CPT and diagnostic codes for the laboratory tests being ordered, ensuring that all requested tests align with the patient's needs.
9. Review all sections of the form for accuracy and completeness, then save your changes.
10. Once finalized, download, print, or share the completed form as necessary.

Take the next step in your workflow and complete the FirstHealth Physician Requisition for Outpatient Laboratory Testing online today.