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ORDER FORM IMA, Inc. Imaging Med Advantage S97W13172 Champions Drive Muskegon, WI 53150 pH. 8009407933 FX. 4145251588Return To:(To be filled out by Customer)Date: Manufacturer: Model No.: Bill To:Serial
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Fill in the patient's personal details such as name, date of birth, and contact information.
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Imaging Med Advantage is a specialized program or service that focuses on providing imaging services under Medicare Advantage plans, ensuring patients receive necessary imaging procedures covered by their health plan.
Healthcare providers and facilities that offer imaging services to patients enrolled in Medicare Advantage plans are required to file Imaging Med Advantage.
To fill out Imaging Med Advantage, providers must complete the specific forms provided by Medicare or their respective health plans, including details of the imaging services provided, patient information, and coding as per Medicare guidelines.
The purpose of Imaging Med Advantage is to ensure proper documentation and reimbursement for imaging services rendered to Medicare Advantage beneficiaries, maintaining compliance with regulations and facilitating patient care.
The information reported must include patient demographics, details of the imaging services performed, relevant diagnostic codes, provider identifiers, and any necessary preauthorization details.
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