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Co-management transfer of care form - North Cascade Eye Associates 2026
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- Click ‘Get Form’ to open it in the editor.
- Begin by entering the patient's name and date of birth in the designated fields. Ensure accuracy as this information is crucial for identification.
- Fill in the home phone number, Medicare number, and any other insurance details. This section helps streamline billing and insurance processes.
- Specify the date of surgery and select the procedure/lens used. Include diagnosis and CPT codes to provide comprehensive medical information.
- Indicate the co-managing optometrist or ophthalmologist's name along with the dates for post-operative care. This ensures clear communication between healthcare providers.
- Document post-operative uncorrected visual acuity (VA) for both eyes, followed by findings from the post-op exam.
- List any medications prescribed and schedule future post-op visits according to patient needs.
- Finally, ensure that both surgeon and PECP signatures are obtained before faxing back to the Surgery Center using the provided numbers.
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