Cardionet 1007 Manual De Usuario
9
The
Patient Prescription Form includes the patient name, prescribing
physician, physician group name, and duration of monitoring requested,
diagnosis and ICD-9 code. Using this form input all the appropriate
information in the fields listed. The prescribing physician is required
to sign the CardioNet Patient Prescription Form prior to enrolling
the patient.
diagnosis and ICD-9 code. Using this form input all the appropriate
information in the fields listed. The prescribing physician is required
to sign the CardioNet Patient Prescription Form prior to enrolling
the patient.
Please fax both completed forms, including a copy of the patient’s
insurance card to the CardioNet Patient Service Center.
insurance card to the CardioNet Patient Service Center.
The enrollment information will be entered into the CardioNet patient
database; the patient’s insurance carrier will be contacted for
preauthorization as required, upon approval, the delivery of the
CardioNet System will be scheduled as soon as possible.
database; the patient’s insurance carrier will be contacted for
preauthorization as required, upon approval, the delivery of the
CardioNet System will be scheduled as soon as possible.
Please see “Sample Forms and Reports” section of this manual for
examples of reports and forms.
examples of reports and forms.