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Imaging Services 801 Green Valley Road Greensboro, NC 27408 APPLICATION FOR MAMMOGRAPHY SCHOLARSHIP Please check all that apply: I have a CURRENT Health serve, Guilford Co. Community Care (orange),
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Ensure you have all the necessary information and documents ready, such as the patient's personal details, medical history, and insurance information.
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Begin by completing the top section of the form, which usually asks for the patient's name, date of birth, contact information, and reason for the imaging service.
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Provide any additional information requested, such as referring physician details, preferred appointment date, or any special instructions.
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Proceed to the insurance section, where you will need to input the patient's insurance information, including the policy number, group number, and any prior authorization details if applicable.
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Who needs imaging services 801 green:

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Patients who have been referred by their healthcare provider for diagnostic imaging procedures, such as X-rays, CT scans, MRIs, or ultrasounds, may require imaging services 801 green.
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Imaging services 801 green refer to a specific form used for reporting imaging services provided at location 801.
Healthcare providers, medical facilities, and imaging centers are required to file imaging services 801 green.
To fill out imaging services 801 green, you must provide detailed information about the imaging services provided, including CPT codes, patient information, and dates of service.
The purpose of imaging services 801 green is to accurately report and track imaging services provided at location 801 for billing and record-keeping purposes.
On imaging services 801 green, you must report CPT codes, patient demographics, referring physician information, and dates of service.
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