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Christie Clinic 101 West University Ave Champaign, IL 61820 Phone: (217) 3669656 Fax: (217) 3661294 Medical Record Release Authorization Patient Name Maiden Name MAN# Date of Birth Home Phone Cell/Work
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Start by obtaining the necessary forms from the clinic's front desk or website.
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What is christie clinic?
Christie Clinic is a medical practice that provides a wide range of healthcare services to patients in the community.
Who is required to file christie clinic?
Healthcare providers and facilities that have provided services to patients at Christie Clinic are required to file the necessary documentation.
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To fill out Christie Clinic forms, healthcare providers need to include information about the services provided, patient details, and billing information.
What is the purpose of christie clinic?
The purpose of Christie Clinic is to document the healthcare services provided to patients and ensure accurate billing and reimbursement for those services.
What information must be reported on christie clinic?
Information such as patient demographics, diagnosis codes, procedure codes, date of service, and billed amounts must be reported on Christie Clinic forms.
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