Diagnostic Requisition

            The Diagnostic Requisition Module provides the user with the opportunity to order and track diagnostic requisitions. Through the module, you can either generate a DWC Form RFA(Request for Authorization) or a Diagnostic Requisition Referral document. The users are also provided with the ability to select the rendering provider that will fulfill the referral.

How to add Diagnostic Requisition?

• Click Diagnostic Requisition on the left-side panel. 

• Click Add Diagnostic Requisition in the upper right corner. 

• Select the referring examiner, claimant, and claim number. Click Save & Next.

• Add the information in the field, Referring Examiner's Diagnosis, Diagnostics to order, and the Diagnostic Study Procedures as required. Click Save & Next.

•   Add in the appointment details, such as selecting who will perform the diagnostic procedure. In this dropdown, there will be four options. selecting     
• Referring Examiner - The examiner requesting this procedure. 

• Internal Organization Examiner - An examiner within simplexam application. All the other examiners added to the application will be listed here to choose from. 

• Diagnostic Procedure Vendor - The request is outsourced to a vendor to perform the procedure. We can select a vendor from the dropdown given by Simplexam, or you can add any vendor according to your requirement. Once this information is entered, the data will be saved and used for future requests.

• Other Examiner - Choose this option if this request is sent to an examiner outside the application. Once this information is entered, the data will be saved and used for future requests. Click Save & Close.

• A diagnostic request has been successfully created. You can generate & download the RFA & referral document at the end of the page in the document section. 

• Example of the RFA of diagnostic requisition.

• Example of Referral Document.