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Get Aim Preauthorization/rqi Request Fax Form
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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
- Click the ‘Get Form’ button to obtain the form and open it in your preferred editor.
- 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).
- In the 'From' section, provide the contact information of the person submitting the request, including their name, phone number, and fax number.
- 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.
- 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).
- Complete the 'Referring Physician Information' section by entering the name of the physician ordering the exam.
- In the 'Provider Information' section, supply the name of the facility where the service will be provided, its contact details, and specialty.
- Address the 'Procedure(s) Information' section by listing the dates of procedures, the associated procedure names, and CPT codes if available.
- Move to the 'Clinical Information' section and provide a detailed account of the patient's diagnosis or symptoms, including their duration, frequency, and intensity.
- Answer the questions regarding the physician's suspicions, treatment history, previous relevant testing, and injury-related queries.
- Review all entered information for accuracy.
- 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.
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.
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