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BEACON RADIOLOGY
IMAGING Services Schedule please call 5746477700
Please faxes this side only to 5746472200
*Exams Requiring Special Preparation
(see back)Patient Name (last, first)Bordering PhysicianChief
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How to fill out radiology imaging services forms
How to fill out radiology imaging services forms
01
Gather all necessary information such as patient's personal details, insurance information, ordering physician's details, and reason for the imaging study.
02
Fill out the patient demographics section accurately with patient's name, date of birth, address, and contact information.
03
Provide details of the insurance coverage including policy number, group number, and subscriber information.
04
Include ordering physician's name, NPI number, and signature on the form.
05
Specify the type of imaging study required, date of study, and any special instructions or considerations.
Who needs radiology imaging services forms?
01
Patients who require radiology imaging services for diagnostic purposes.
02
Healthcare providers or facilities ordering imaging studies for their patients.
03
Insurance companies processing claims for radiology imaging services.
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What is radiology imaging services forms?
Radiology imaging services forms are documents used to report details of radiology imaging services provided by healthcare facilities.
Who is required to file radiology imaging services forms?
Healthcare facilities that provide radiology imaging services are required to file radiology imaging services forms.
How to fill out radiology imaging services forms?
Radiology imaging services forms can be filled out by entering the required information such as the type of service provided, date of service, and patient information.
What is the purpose of radiology imaging services forms?
The purpose of radiology imaging services forms is to accurately report and track radiology imaging services provided by healthcare facilities.
What information must be reported on radiology imaging services forms?
Information such as the type of service provided, date of service, patient information, and healthcare facility details must be reported on radiology imaging services forms.
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