Physician Summary -
| Physician | Start Transaction | In Progress | Action Needed | PA Needed | BV/PA Failed | Ready To Treat | Grand Total |
|---|
Appointment List -
| Appt Date | Phys/Location | Patient Name | Payers | Last Injection | Next Injection | Raised Drug | Action |
|---|
Patient Gender *
Drug *
Primary Diagnosis Code *
Secondary Diagnosis Code
Tertiary Diagnosis Code
Other Diagnosis Codes
Visual Acuity
OD
/
OS
/
Matched *
ID
Name
Relation
DOB
Gender
Matched
ID
Name
Relation
DOB
Gender
Matched
ID
Name
Relation
DOB
Gender
Payers
Primary *
Drug *
Eye *
Effective
Expiration
Status *
Notes
clear
Secondary *
Drug *
Eye *
Effective
Expiration
Status *
Notes
clear
Tertiary *
Drug *
Eye *
Effective
Expiration
Status *
Notes
Prior Authorization using RetinaOS is temporarily disabled for maintenance. In the interim, you can submit Prior Authorizations manually.
Patient Gender *
Drug *
Primary Diagnosis Code *
Secondary Diagnosis Code
Tertiary Diagnosis Code
Other Diagnosis Codes
Visual Acuity
OD
/
OS
/
Payer
ID
Name
Relation
DOB
Gender
Payers
Primary *
Drug *
Eye *
Effective
Expiration
Status *
Notes
clear
Secondary *
Drug *
Eye *
Effective
Expiration
Status *
Notes
clear
Tertiary *
Drug *
Eye *
Effective
Expiration
Status *
Notes
Under Development