Cardionet 1007 Manual De Usuario

8

PATIENT ENROLLMENT

The Patient Enrollment Form is located in the CardioNet Patient
Enrollment and Management System (PEMS). The client can access the
CardioNet Patient Enrollment and Management System application at

www.cardionet.com.

 This is a secure and restricted website and the user

is required to be enrolled as a CardioNet client. Forms are also available
from the CardioNet Patient Service Center. If you are not a CardioNet
registered user, please contact the Patient Service Center.

Login

Password

Please enter your username and password to log in.

Username

After you have entered your user name and password, click the log in
button on your screen. You now have access to the CardioNet Patient
Enrollment and Management System. The name of the client, physician
or practice should appear on the upper left of the PEMS application.
You may also refer to the CardioNet 

Quick Start Guide for instructions

on enrolling a patient.

Using the CardioNet navigational tree on the left side, click on
Documents and Forms. A document tab will open with a list of
applicable forms. Click on 

Patient Enrollment Form (MON300) and print

a copy. Follow the same process and procedure for 

Patient Prescription

Form (MON302). Each form must be completed to enroll a patient on
CardioNet’s service.

The Patient Enrollment Form includes patient demographics,
emergency information, primary and secondary insurance, patient
waiver and assignment of benefits. Using this form please input all the
appropriate information in the fields listed. In addition to any insurance
information that is listed on the form, please provide CardioNet with a
copy (front and back) of the patient’s insurance card.

The patient’s signature is required on all enrollment forms prior to
submitting to CardioNet.