SYMMETRY FORMS

SYMMETRY FORMS

Hello! 

Please read this ticket in its entirety, and reply with any questions or concerns you may have. This is a VITAL and necessary form of communication between our offices, so it is important we are all on the same page.

      I have attached some new and updated forms for your office to communicate with Symmetry. Because we strive for efficiency, yet we do not want the front desk to be overwhelmed and want the office to focus on patient care, we combined quite a few different forms into one for ease of use.

  • The first new form is the PATIENT INFO SHEET. This form has sections for various types of information. Depending on the type of patient visit you receive, will also determine what portions of the form to fill out. Here are some guidelines to help you fill out the form correctly -- to help us from having to go back and forth for information -- and to make sure the claim goes out correct.                                                                                                                                                       
  • The next most important form is the new FAX COVER SHEET. This must accompany ALL faxes and Sharefiles to Symmetry. Our system for sorting relies on the cover sheet, and there must be a cover sheet for EACH TYPE of information sent. If you are sending us EOB's and patient payments, you can send them all at once, however you will need one cover sheet for EOBS and another for patient payments. 

  • The next form is the RELEASE FROM ACCIDENT form. This is only used for Auto/PI/WC patients who are released from treatment by the doctor. This would accompany any letters to insurance companies written by the doctor to notify them of the release. We maintain this for our records. 

  •  The last form is the ORTHOTICS ORDER FORM. If your office fits patients with Orthotics, you would use this form to communicate with us that a patient needs a claim produced for orthotics. After you have verified the patients eligibility and contacted the insurance company for an authorization, you would simply fill out this form and submit to us. We can them create a claim right away.


Please take time to look over these forms. These forms will be updated from time to time, however we think this new format will keep information clean and in one place. 


Thank you!

The Symmetry Team
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