What is a Philips Remote INR Form and How is it Used?

Definition & Meaning of Philips Remote INR Form

The Philips Remote INR form is an essential document used in the Remote INR Self-Testing Program, which allows patients to monitor their International Normalized Ratio (INR) levels from home. This form is crucial for patients who are prescribed anticoagulant therapy, particularly those on Warfarin, as it facilitates their enrollment in a program that supports self-testing using the CoaguChek Vantus system. The form serves multiple purposes, including acting as a physician's order and verifying insurance coverage for the necessary equipment and supplies.

By using the Philips Remote INR form, patients can take control of their health management, reduce the need for frequent lab visits, and ensure they are consistently monitoring their INR levels, which is vital for safe anticoagulant therapy.

How to Use the Philips Remote INR Form

Using the Philips Remote INR form involves several key steps that ensure patients can effectively enroll in the Remote INR program and receive the necessary support. The process typically includes:

• Initial Consultation: Patients must first consult with their healthcare provider, who will determine if they are suitable candidates for home INR testing.
• Form Completion: After receiving the form, patients fill it out with necessary personal and medical information, including their anticoagulant therapy details.
• Submission: The completed form is submitted to the Remote INR team, which will initiate the enrollment process.
• Insurance Verification: The team will contact the patient’s insurance provider to confirm coverage for the CoaguChek Vantus system.
• Training: Once approved, patients will receive training on how to use the testing system and ongoing support as needed.

How to Obtain the Philips Remote INR Form

Patients can obtain the Philips Remote INR form through various channels. The most common methods include:

• Healthcare Provider: Patients can request the form directly from their physician during a consultation.
• Philips Official Website: The form may be available for download from the Philips Ambulatory Monitoring and Diagnostics website.
• Remote INR Team: Patients can contact the Remote INR support team at the designated phone number, such as, to request the form.

Steps to Complete the Philips Remote INR Form

Completing the Philips Remote INR form requires careful attention to detail to ensure accuracy and compliance. The steps include:

• Personal Information: Fill in personal details, including name, address, and contact information.
• Medical History: Provide relevant medical history, including current medications and any previous INR testing.
• Physician Information: Include the name and contact details of the prescribing physician.
• Signature: Sign and date the form to authorize the submission and confirm understanding of the program.

Why Use the Philips Remote INR Form

The Philips Remote INR form is beneficial for several reasons:

• Convenience: It allows patients to test their INR levels at home, reducing the need for frequent lab visits.
• Empowerment: Patients gain more control over their anticoagulant therapy, leading to better health outcomes.
• Insurance Support: The form helps verify insurance coverage, ensuring patients are aware of potential out-of-pocket costs.

Who Typically Uses the Philips Remote INR Form

The Philips Remote INR form is primarily used by patients who:

• Are prescribed anticoagulant medications, particularly Warfarin.
• Have been on anticoagulant therapy for an extended period, typically over 90 days.
• Possess the cognitive ability and resources to perform self-testing safely.

Important Terms Related to Philips Remote INR

Understanding key terms related to the Philips Remote INR form can enhance comprehension of the process:

• INR: International Normalized Ratio, a measure of blood coagulation.
• Anticoagulant Therapy: Treatment aimed at preventing blood clots.
• CoaguChek Vantus: The device used for self-testing INR levels.

Legal Use of the Philips Remote INR Form

The Philips Remote INR form is legally recognized as a physician's order for home INR testing. It must be completed accurately to ensure compliance with healthcare regulations. Key legal aspects include:

• Patient Authorization: The patient's signature on the form authorizes the use of their information for insurance verification and program enrollment.
• Insurance Compliance: The form must meet the requirements set by insurance providers to ensure coverage for the testing system.