Get Oh Kettering Health Network Central Scheduling One Step Form 2018-2025

The OH Kettering Health Network Central Scheduling One Step Form is a crucial document for scheduling various medical services. This guide will provide you with step-by-step instructions to complete the form online effectively.

Follow the steps to easily complete the form online.

1. Click the ‘Get Form’ button to obtain the form. This action will allow you to access the document within an editing interface.
2. Fill in the patient's name exactly as it appears on their identification documents. This ensures accurate scheduling and identification.
3. Enter the date of birth (DOB) in the required format. This information is essential for medical records.
4. Select your preferred method of contact by checking the corresponding box for home, work, or email.
5. Provide the social security number (SSN) of the patient, which is necessary for insurance purposes.
6. Specify the ICD10 codes and written diagnosis(es) if applicable. This information is important for medical billing.
7. Indicate the patient's sex by selecting the appropriate option, either male or female.
8. If precertification is required, enter the precertification number in the designated field.
9. Fill in the patient's insurance details and the expiration date of the insurance plan.
10. Add any special notes or instructions in the 'Special notes / etc.' section.
11. If precertification is not required, provide your initials to confirm this.
12. Complete the section for lab services by selecting necessary tests, noting whether additional requirements such as contrast are needed.
13. Fill in the required radiology and nuclear medicine sections as relevant, indicating specific procedures and modalities.
14. Sign the form providing your physician signature and include their name and address for reference.
15. After completing the form, you can save changes, download a copy, print it, or share it as needed.

Complete your forms online to ensure accurate and efficient scheduling!