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SPECIALIZED IMAGING NOTIFICATION FORM Please complete ALL information and fax to DAKOTACARE Medical Management-Radiology 605-274-3279. Incomplete forms will be rejected and returned to sender. **This
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How to fill out dakotacare specialized imaging notification
How to fill out dakotacare specialized imaging notification:
01
Start by gathering all the necessary information such as the patient's personal details, insurance information, and the referring physician's information.
02
Ensure that all fields requiring information are filled out accurately, including the reason for the imaging request, type of imaging needed, and any relevant medical history.
03
If there are any supporting documents or medical records that need to be attached, make sure to include them with the notification form.
04
Double-check all the information entered to ensure there are no errors or missing details.
05
Once the form is complete, submit it according to the specified method, whether it be via mail, fax, or online portal.
06
Keep a copy of the completed notification form for your records.
Who needs dakotacare specialized imaging notification:
01
Patients who have been referred by their healthcare provider for specialized imaging procedures.
02
Individuals who are covered under the Dakotacare insurance plan and are seeking coverage for their imaging services.
03
Healthcare providers who need to notify Dakotacare about the imaging services they have ordered for their patients in order to obtain insurance coverage.
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