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  • Oh Kettering Health Network Central Scheduling One Step Form 2016

Get Oh Kettering Health Network Central Scheduling One Step Form 2016-2025

H: W: (check preferred) SSN: C: E-mail: ICD10 Codes & written diagnosis(es): Patient Insurance: Sex: Male Female Precertification #: Exp. Date /Location If Not Required Initials: LAB Basic Metabolic Panel BUN/Urea Nitrogen CBC Complete Blood Count w/ Diff w/o Diff Comprehensive Metabolic Panel Creatinine Blood PT/prothrombin time/INR PTT/Partial Thromboplast Time Anti-Xa Renal Panel TSH (Thyroid S.

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How to fill out the OH Kettering Health Network Central Scheduling One Step Form online

Filling out the OH Kettering Health Network Central Scheduling One Step Form online can streamline your scheduling process. This guide provides detailed instructions to help you successfully complete each section of the form with clarity and confidence.

Follow the steps to fill out the form accurately and efficiently.

  1. Press the ‘Get Form’ button to access the form and open it in your document editor.
  2. Begin by entering the patient's name in the designated field. Ensure that the full legal name is used for accuracy.
  3. Fill in the patient's date of birth (DOB) in the specified format. This information is critical for identification.
  4. Choose a preferred method of contact (Home, Work, or Cell) by checking the appropriate box.
  5. Input the patient's Social Security Number (SSN) in the relevant field. Ensure this is correct to avoid any issues with insurance.
  6. Provide the patient's insurance details, including the name of the insurance provider.
  7. Indicate the patient's sex by checking the corresponding box (Male or Female).
  8. If precertification is required, input the precertification number along with its expiration date.
  9. Select the necessary lab tests by checking the appropriate boxes for each test listed, such as Basic Metabolic Panel or CBC.
  10. Continue to the radiology section. Select any required imaging procedures based on the patient's needs.
  11. In the vascular section, indicate if any vascular examinations are necessary and specify the details.
  12. Complete the nuclear medicine, general, EEG, and pulmonary sections by checking all relevant options.
  13. Ensure that the physician's signature is present. This must be an original or printed signature.
  14. Fill in the physician's name, address, and contact information in the provided fields.
  15. Choose the nearest outpatient facility from the list provided and check the relevant box.
  16. Review all entered information for accuracy and completeness, then save your changes.
  17. Finally, download, print, or share the completed form as needed.

Complete your document online today to ensure a smooth scheduling experience.

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Today, Kettering Health maintains its Seventh-day Adventist Church roots across its healthcare system and is affiliated geographically with the Columbia Union Conference of Seventh-day Adventists, which coordinates the Church's work and healthcare mission in the Mid-Atlantic United States.

Share the Care Billing Customer Service: (866) 319-2981. Outpatient Scheduling Support: (937) 384-4510. Request Medical Records. Office: (937) 762-1200. Fax: (937) 522-8444. Email: releaseofinformation@ketteringhealth.org. Job shadow with us.

Kettering Health Main CampusLocation3535 Southern Blvd., Kettering, Ohio, United StatesOrganizationCare systemPrivateTypeTeaching14 more rows

Kettering Health is a Seventh-day Adventist non-profit health care system headquartered in Kettering, Ohio, that operates fourteen Dayton and Cincinnati area medical centers, Kettering College, and 120 outpatient facilities.

If you have a referral for an appointment, procedure, or test, please call central scheduling at (937) 384-4510.

Identification and Characteristics Name and Address:Kettering Health Main Campus 3535 Southern Boulevard Kettering, OH 45429CMS Certification Number :360079Type of Facility:Short Term Acute CareType of Control:Voluntary Nonprofit, ChurchTotal Staffed Beds:4039 more rows

Our healthcare system features services such as high-quality maternity care, state-of-the-art cancer centers, a leading heart hospital, and cutting-edge brain and spine surgery.

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Fill OH Kettering Health Network Central Scheduling One Step Form

The document is a Central Scheduling One Step Form used for scheduling medical imaging and laboratory services. Request an Appointment. If you have a referral for imaging, labs, or a procedure, please call central scheduling at . As an employee of Kettering Health, you can benefit from pursuing or continuing your education at Kettering College, an entity of Kettering Health Main Campus. Kettering Health is built from many people, places, backgrounds, and perspectives. We're here to help every person lead a full and healthy life. Apply to Front Office Specialist, Medical Scheduler, Medical Representative and more! A small, faith-based healthcare college in Kettering, Ohio offering career-focused medical degrees through traditional and accelerated programs. Program Director: Lyndetta Rotisha Schwartz MD, BA Kettering Med Ctr Internal Med Pgm 6 East 3535 Southern Blvd Kettering, OH 45429. Kettering Health Miamisburg, OH. 2 weeks ago Be among the first 25 applicants.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232