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EXAMPLE SHORT REFERRALDate: ___ Referring Provider and NPI: ___ Participants Name: ___DOB: ___Phone#: ___ ___Diabetes Diagnosis: Type 1 Preexisting DM with Pregnancy Type 2 Prediabetes GestationalReferral
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Obtain a copy of the Medicare Provider Manual DOM.
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Read through the manual thoroughly to understand the guidelines and requirements.
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Make sure you have all necessary information and documentation on hand to fill out the manual accurately.
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Complete each section of the manual carefully, following the instructions provided.
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Who needs medicare provider manual dom?

01
Healthcare providers who wish to participate in the Medicare program need the Medicare Provider Manual DOM to understand the rules and regulations set forth by Medicare.
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The Medicare Provider Manual DOM is a document that contains guidelines and instructions for healthcare providers who bill Medicare for services.
All healthcare providers who bill Medicare for services are required to file the Medicare Provider Manual DOM.
Healthcare providers must carefully review the instructions provided in the manual and accurately report all necessary information as required.
The purpose of the Medicare Provider Manual DOM is to ensure that healthcare providers follow the guidelines set by Medicare when billing for services.
The Medicare Provider Manual DOM requires healthcare providers to report information such as patient demographics, services provided, and billing codes.
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