Get the free 4704 CT Imaging Transmittal Worksheet v1.0 6.30.14.doc

ACRID 4704 Detection of Early Lung Cancer Among Military Personnel Study 2 (DECAMP2):Screening of Patients with Early Stage Lung Cancer or at High Risk for Developing Lung CancerPlace Label Here Institution

How to fill out 4704 ct imaging transmittal

How to fill out 4704 ct imaging transmittal

1. Start by filling out the top section of the form, which includes the name and address of the sender (your contact information).
2. Next, fill in the receiver's name, address, and contact information in the designated fields.
3. Provide the necessary details of the CT imaging transmittal, such as the date of transmission, the patient's name, date of birth, and medical record number.
4. Indicate the type of imaging being transmitted (CT scan in this case) and provide any additional relevant information, such as the reason for the transmission or any special instructions.
5. Complete the section for billing and payment, including the method of payment and any applicable insurance information.
6. Sign and date the form to authenticate the transmission.
7. Make a copy of the completed form for your records and send the original to the intended recipient.
8. Keep track of the transmission by noting the date it was sent and any other relevant details.
9. Follow up with the recipient to ensure that the transmission was received and processed.

Who needs 4704 ct imaging transmittal?

1. The 4704 CT imaging transmittal form is typically needed by healthcare professionals or facilities that are transmitting CT imaging scans or related information to another party.
2. This form ensures proper documentation and communication between parties involved in the diagnostic or treatment process. It may be required by hospitals, clinics, radiology centers, or other healthcare providers.

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What is 4704 ct imaging transmittal?

4704 ct imaging transmittal is a form used to transmit CT imaging records to the appropriate healthcare providers or facilities.

Who is required to file 4704 ct imaging transmittal?

Healthcare providers or facilities that perform CT imaging procedures are required to file 4704 ct imaging transmittal.

How to fill out 4704 ct imaging transmittal?

To fill out 4704 ct imaging transmittal, you need to provide information such as patient details, imaging procedure details, referring physician information, and date of the procedure.

What is the purpose of 4704 ct imaging transmittal?

The purpose of 4704 ct imaging transmittal is to ensure the proper transfer of CT imaging records for the continuity of patient care.

What information must be reported on 4704 ct imaging transmittal?

Information such as patient demographics, imaging procedure details, referring physician information, and date of the procedure must be reported on 4704 ct imaging transmittal.