MPowerHealth - Scheduling a Procedure

NORMAL BUSINESS HOURS:
(CST) 8:00 AM to 5:00 PM Mon – Fri

For Scheduling outside of normal business hours and Holidays, Emergency Cases, and Start Time Changes:

ON CALL SCHEDULING LINE:
210-269-7108

PLEASE ATTACH A COPY OF THE PATIENT'S DEMOGRAPHIC SHEET AND A COPY OF THEIR INSURANCE CARD

SERVICES REQUESTED:

Intraoperative Monitoring

Physician Assist

Requestor

Referring/Operating Physician

This is a...

New Appointment

Re-Schedule

Update Requested Services

Facility (Full Facility Name - type a few characters to search)

Previous Surgery Date

Surgery Date

Surgery Time

Facility City

Facility State

Estimated Duration

Specialty

Patient

First Name

Middle Initial

Last Name

DOB

Demo Sheet

H&P

Case Information

Procedure Type

Procedure Levels

Choose Diagnosis Codes

Tap or double-click to select a code

Chosen Diagnosis Codes

Self Pay?

Insurance Card - Front

Insurance Card - Back

Insurance Carrier

Group Number

Policy Number

Scheduler

Scheduler's Name

Scheduler's Phone

Scheduler's Email

Confirm

Physician's Signature File

Please only upload image files.

Date