Cpap order 2025

1. Click ‘Get Form’ to open the CPAP order in the editor.
2. Begin by filling in the referral details, including the Referral Name and Address, along with the Contact Name, Phone Number, and Fax Number.
3. Next, enter the Patient's information: Name, Address, Date of Birth (DOB), Phone Numbers, Email, and Policy Number.
4. Indicate the Insurance provider and Diagnosis. For OSA diagnosis, fill in the AHI value as needed.
5. Select any secondary diagnoses that apply from the provided options.
6. Specify the Equipment Order Status by selecting whether this is for a New Patient or a Change/Renewal/Discontinue of an existing order.
7. In the PAP Equipment Ordered section, check off any equipment required and fill in specific pressure settings and ramp times as necessary.
8. Complete sections for Patient Interface preferences and Accessories needed for optimal use.
9. Finally, ensure that a Physician Signature is included along with their printed name and NPI number before submitting your form.

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