Patient Information Sheets | Daysheet
PLEASE NOTE: There are two different types of patient information sheets to use: Commercial or Cash patient sheet OR Personal Injury/Worker's Compensation patient sheet.
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Commercial or Cash Patient Sheet
The Commercial or Cash patient information sheet should be used on patients with commercial health insurance, such as BCBS products, Coventry or Humana for example. You may also use this sheet for Medicare, Medicaid, or Cash patients. Cash patients only need to complete the top portion.
Personal Injury/Worker's Compensation Patients
The Personal Injury/Worker's Compensation patient information sheet should be filled out according to the type of patient. If you have a Personal Injury patient, you would indicate which type of insurance your are filing for the patient such as Med-Pay, PIP, or Third-Party Liability. You may also use this sheet for Slip & Fall patients or Settlement Case patients that only have an attorney on file without insurance carrier information.
Daysheet
The Daysheet is used to forward patient services and payment for data entry.
