Acelis Connected Health Services In Physician Order Form

Acelis connected health is the leader in home anticoagulation monitoring services and related products.

Acelis connected health services in physician order form.

Get a prescription from your doctor. Care or related services provided by acelis connected health or its agents. This section of the form and any statement on my letterhead attached here has been completed by me or by my employees and reviewed by me. The current location address for acelis connected health services is 6465 national drive livermore california and the contact number is 877 262 4669 and fax number is 925.

The products lists and physician notes and other supporting documentation will be provided to inhealth technologies and or an. At acelis connected health we help individuals manage their health our ecosystem of products and services supports the management of people s health away from hospitals and labs with remote monitoring and connected data solutions. Talk to your doctor click here or call us at 800 504 4032 to find out if you are a good candidate for acelis connected health services. Target inr range to low high acelis connected health will receive test results directly from patient and fax all.

With a focus on engaging the individual in their own care our services center around real time biometric data management certified training and clinical support. Federal usa law restricts these devices to sale by or on the order of a physician. Once you ve been identified as a good candidate for home inr monitoring your doctor will send acelis connected health a prescription. Going to the doctor soon.

Patient information first name m i last name patient phone number s date of birth1 patient email 2. You are also gaining access to acelis connected health s dedicated customer service. Coverage determination is based on specific health plan guidelines. The foregoing information is true.

I authorize medicare and or any other insurance plans under which i am covered to make payment to acelis connected health or its assignee of authorized benefits on my behalf for products or services furnished to me. Review your results history with charts of test values and trends. Acelis connected health services alere home monitoring incorporated is a durable medical equipment medical supplies supplier in livermore california the npi number for acelis connected health services is 1760418370. Order supplies sign in contact.

Alere home monitoring is now acelis connected health. Reporting your results is now easier than ever. View messages and alerts from acelis connected health and your physician stay up to date on test dates office visits medication changes or adjustments track your test results. Report your results on our mobile app download our mobile app for apple.