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Phone 8775896807 Fax 5627662001Date of Request: RETRO DOS ROUTINEURGENTSPECIALIST REFERRAL REQUEST PATIENT INFORMATIONTYPE OR PRINT LEGIBLYName:Member ID:Address:Phone:City, St, Zip:DOB:Requesting
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What is retro dos?
Retro DOS stands for Retroactive Date of Service, it is used in billing to indicate the date on which services were actually rendered.
Who is required to file retro dos?
Healthcare providers and facilities are required to file retro dos to ensure accurate billing and reimbursement.
How to fill out retro dos?
Retro dos can be filled out by entering the correct date of service and relevant billing codes for the services rendered.
What is the purpose of retro dos?
The purpose of retro dos is to accurately document when services were provided in order to facilitate correct billing and reimbursement.
What information must be reported on retro dos?
Information such as the date of service, procedure codes, diagnosis codes, and any relevant modifiers must be reported on retro dos.
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