Get the free Imaging Services Forms - MSU Health Care
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PET/CT
Referral Form 5173535053 (Ext 1)
Fax 5174324394
www.rad.msu.edu
Tax ID 386005984
NPI 1891747614MSU Clinical Center, Ste D100 (Wing)
840 Service Rd, East Lansing, MI 48824Patient Name ___ DOB
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How to fill out imaging services forms
How to fill out imaging services forms
01
Gather all necessary information such as personal details, insurance information, and medical history.
02
Ensure you have the appropriate imaging request from your healthcare provider.
03
Fill out the form accurately and completely, double-checking for any errors.
04
Submit the completed form to the imaging services department either in person or electronically.
Who needs imaging services forms?
01
Individuals who require medical imaging such as X-rays, MRIs, CT scans, or ultrasounds.
02
Healthcare providers who are requesting imaging services for their patients.
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What is imaging services forms?
Imaging services forms are documents used to report imaging services provided by healthcare facilities.
Who is required to file imaging services forms?
Healthcare facilities that provide imaging services are required to file imaging services forms.
How to fill out imaging services forms?
Imaging services forms can be filled out manually or electronically, following the instructions provided by the relevant regulatory body.
What is the purpose of imaging services forms?
The purpose of imaging services forms is to track and report the imaging services provided by healthcare facilities.
What information must be reported on imaging services forms?
Imaging services forms typically require information such as the type of imaging service provided, the date of service, and the patient's information.
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