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  • Aim Preauthorization/rqi Request Fax Form

Get Aim Preauthorization/rqi Request Fax Form

AN IMAGING MANAGEMENT PREAUTH/RQI DEPARTMENT www.americanimaging.net FAX #: 800-610-0050 FROM: Contact Person Phone #: Fax #: Subscriber (Insurance Holder) and Patient Information Patient Name: Subscriber Name: Last:___________________________ First:________________________ Last :___________________________First:_______________________________ ID #: (include alpha prefix)___________________________________ DOB:________/________/__________ SSN:____________________________________________.

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How to fill out the AIM Preauthorization/RQI Request Fax Form online

Completing the AIM Preauthorization/RQI Request Fax Form online is essential for ensuring a smooth preauthorization process. This guide will walk you through each section of the form, providing clear and concise instructions to make your experience as efficient as possible.

Follow the steps to complete the AIM Preauthorization/RQI Request Fax Form

  1. Click the ‘Get Form’ button to obtain the form and open it in your preferred editor.
  2. Begin by filling out the 'To' section, including the name of the American Imaging Management Preauth/RQI Department and their fax number (800-610-0050).
  3. In the 'From' section, provide the contact information of the person submitting the request, including their name, phone number, and fax number.
  4. Proceed to the 'Subscriber and Patient Information' section. Provide the patient's name, the subscriber's name, their identification number (ID #), date of birth, and social security number. Indicate the relationship to the subscriber and the patient's sex.
  5. Fill in the health plan details, such as the health plan name, group number, and the product type (e.g., PPO, POS, HMO, or other).
  6. Complete the 'Referring Physician Information' section by entering the name of the physician ordering the exam.
  7. In the 'Provider Information' section, supply the name of the facility where the service will be provided, its contact details, and specialty.
  8. Address the 'Procedure(s) Information' section by listing the dates of procedures, the associated procedure names, and CPT codes if available.
  9. Move to the 'Clinical Information' section and provide a detailed account of the patient's diagnosis or symptoms, including their duration, frequency, and intensity.
  10. Answer the questions regarding the physician's suspicions, treatment history, previous relevant testing, and injury-related queries.
  11. Review all entered information for accuracy.
  12. Once completed, save the changes, then download, print, or share the form as needed.

Complete your AIM Preauthorization/RQI Request Fax Form online today to ensure a swift and efficient preauthorization process.

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Questions & Answers

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The fax number for Carelon pre-authorization is crucial for submitting your AIM Preauthorization/RQI Request Fax Form effectively. By using the designated fax line, you can avoid any setbacks in processing your authorizations. Ensuring the use of the correct number will save you time and enhance communication with Carelon.

For any communications with Carelon, including submitting the AIM Preauthorization/RQI Request Fax Form, it's important to have the correct fax number. Having this information ensures that your requests are processed without delay. Always double-check the fax number before sending to improve your chances of a quick response.

For submitting your AIM Preauthorization/RQI Request Fax Form to eviCore, make sure to confirm the fax number listed specifically for the services you require. eviCore handles a range of authorization types, so using the correct fax number is crucial. You can find this information on eviCore’s website or support portal, ensuring your requests are handled in a timely manner.

If you're referring to the fax associated with 833-389-4172, it is important to clarify its purpose in the context of your AIM Preauthorization/RQI Request Fax Form. This number typically serves as a central point for various service requests. Always double-check the appropriate context and authorization requirements linked to this fax number.

Submitting a prior authorization to Carelon involves completing the AIM Preauthorization/RQI Request Fax Form correctly. After filling out the form, fax it to the number provided by Carelon for your specific situation. Make sure you include all necessary information and documentation for your request to be processed efficiently.

When it comes to United Healthcare authorization, you will need the correct fax number to send your AIM Preauthorization/RQI Request Fax Form. This number can often vary based on the specific service or type of treatment. Always verify the correct fax number on the United Healthcare website or by contacting their provider support team for confirmation.

To submit a Carelon preauthorization request, utilize the AIM Preauthorization/RQI Request Fax Form and ensure you send it to the specific fax number provided by Carelon. This information is often available on their official site or through customer service. Accurate submission is key to prompt approval and processing of your request.

If you have a fax document to send to the number 833 389 4172, ensure it is relevant to the AIM Preauthorization/RQI Request Fax Form or other related inquiries. Always verify that you are sending your documents to the right number to prevent miscommunication. Using the correct details will help streamline your request's handling.

To complete the credentialing process with Carelon, you will need to send your documents using the AIM Preauthorization/RQI Request Fax Form. The correct fax number should be checked directly with Carelon's credentialing department or on their website for the most accurate information. This step is essential for ensuring proper processing of your application.

If you are looking to submit a prior authorization request for Carelon, remember to use the AIM Preauthorization/RQI Request Fax Form and send it to the designated fax number provided by Carelon. This information can often be found on their user-friendly website, or you can reach out to their support team for assistance.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
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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