QuadraMed CPR Insurance Payor Profile Table Reference€¦ · QuadraMed® CPR Insurance Payor Profile Table Reference iv QuadraMed Corporation 20 - Expiration Date Data Element 5.4.0

QuadraMed® CPRInsurance Payor Profile

Table Reference

Client Support

Government Program Support

WarningThe laboratory information system module of the QuadraMed CPR (QCPR) product is not designed for, nor is it intended for use in, a blood banking establishment. QuadraMed does not support, and disclaims any liability for, any use of the QCPR product for such purpose. This means that the intended use of QCPR does not include any blood banking functions whatsoever, which functions include by way of example, but are in no way limited to, the following:

Documentation – Including pre-transfusion testing (i.e., readings), outcome of testing (i.e., interpretations), transfusion of blood products, computer assisted evaluation of data, and unit number and blood type as they relate to any of the above documentations.

Inventory tracking units

Labels for blood products

Converting antibody/transfusion history card information

Donor processing

In no event will QuadraMed or any person or company acting on its behalf be liable for any direct, indirect, special, incidental, or consequential damages, loss (including, without limitation, loss of profit), or personal injury arising from the supply or use of QCPR to perform the above mentioned or any other blood banking functions or to support a blood banking establishment, or arising from the supply or use of any accompanying hardware and written materials for the purposes of supporting the above mentioned or any other blood banking functions.

Any questions regarding the use of QCPR should be directed to QCPR Customer Support.

QuadraMed Corporation Proprietary StatementThis material constitutes proprietary and trade secret information of the QuadraMed Corporation, and shall not be disclosed to any third party, nor used by the recipient except under the terms and conditions prescribed by the QuadraMed Corporation.

The trademarks, service marks, and logos of QuadraMed Corporation and others used herein are the property of QuadraMed or their respective owners.

QuadraMed Corporation Copyright StatementThis material is also protected by Federal Copyright Law and is not to be copied or reproduced in any form, using any medium, without the prior written authorization of the QuadraMed Corporation. However, the QuadraMed Corporation allows the printing of the Adobe Acrobat PDF files for the purposes of client training and reference.

Contents copyright © 2011 QuadraMed Corporation. All rights reserved.

Phone: 877.823.7263

E-Mail: [email protected]

Technical Support:

Phone: 800.257.0512


Application Training Support:

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Software and PDFs of guides and other documentation are available for download on the client support website. CDs and printed materials are available for purchase. See http://www.quadramed.com/customer_service for more information.

QuadraMed Corporation iii

Revision List

The following list provides the most current revision number and date for each chapter in this manual.

CHAPTERREVISION NUMBER

DATE

01 - Insurance/Payor Profile Table, ^rt(“ipp”) 5.5.8 6/93

02 - Address Data Element 5.4.10 1/93

03 - Assignment of Benefits Data Element 5.4.0 11/92

04 - Authorization Approved Length of Stay Data Element 5.4.0 11/92

05 - Authorization Date/Time of Date Element 5.4.0 11/92

06 - Authorization Person Talked To Data Element 5.4.0 11/92

07 - Authorization Source Data Element 5.4.0 11/92

08 - Authorization Status Data Element 5.4.0 11/92

09 - Comment Data Element 5.4.0 11/92

10 - Copay Data Element 5.4.0 11/92

11 - Date 1 Data Element 5.4.0 11/92




15 - Dialysis Provider Data Element 5.4.0 11/92

16 - Dialysis Type Data Element 5.4.0 11/92

17- Effective Date 1 Data Element 5.4.0 11/92

18 - Effective Date 2 Data Element 5.4.0 11/92

19 - Effective Date 3 Data Element 5.4.0 11/92

QuadraMed® CPR Insurance Payor Profile Table Reference

iv QuadraMed Corporation

20 - Expiration Date Data Element 5.4.0 11/92

21 - Explanation Code Data Element 5.4.0 11/92

22 - Financial Class Data Element 5.4.0 11/92

23 - Formatted Entry 1 Data Element 5.4.0 11/92










33 - Free-Text Insurance/Payor Name Data Element 5.4.0 11/92

34 - Generic Choose Data Element 5.5.4 5/93

35 - Generic Date/Time Data Element 5.5.4 5/93

36 - Generic Employee Name Data Element 5.5.8 6/93

37 - Generic Formatted Entry Data Element 5.5.8 6/93

38- Generic Free-Text Data Element 5.5.8 6/93

39 - Generic Hard-Coded Select Screen Data Element 5.5.8 6/93

40 - Generic Multimedia Data Element 4.3.0 7/05

41 - Generic Name Data Element 5.5.8 6/93

42 - Generic Other Facility Data Element 5.7.22 7/94

43 - Generic Selection Screen/Tree Data Element 5.5.8 6/93

44 - Generic Table Selection Data Element 5.7.22 7/94

45 - Generic Telephone Data Element 5.5.8 6/93

46 - Group Number Data Element 5.4.0 11/92

47 - Insurance Verified Data Element 5.4.0 11/92

48 - Military Base Data Element 5.4.0 11/92


DATE

QuadraMed Corporation v

49 - Military Branch of Service Data Element 5.4.0 11/92

50 - Military Rank Data Element 5.4.0 11/92

51 - Military Reason Data Element 5.4.0 11/92

52 - Military Status Data Element 5.4.0 11/92

53 - Other Facility Data Element 5.4.0 11/92

54 - Other Facility Stay End Date Data Element 5.4.0 11/92

55 - Other Facility Stay Start Date Data Element 5.4.0 11/92

56 - Payor Number Data Element 5.7.22 7/94

57 - Plan Number Data Element 5.4.0 11/92

58 - Pre-Auth Data Element 5.4.4 12/92

59 - Pre-Auth Number Data Element 5.4.0 11/92

60 - Pre-Auth Second Opinion Flag Data Element 5.4.0 11/92

61 - Proration Plan Number Data Element 5.5.4 5/93

62 - Release of Information Data Element 5.4.0 11/92

63 - Require Verification Data Element 5.4.0 11/92

64 - Review Agency Contact Person Data Element 5.4.0 11/92

65 - Review Agency Data Element 5.4.0 11/92

66 - Secondary Numbers Data Element 5.8.22 4/95

67 - Send Verification Data Element 5.0.0 05/06

68 - Signature Date Data Element 5.4.0 11/92

69 - Subscriber Address Data Element 5.4.10 1/93

70 - Subscriber Birthdate Data Element 5.4.4 12/92

71 - Subscriber Day Telephone Data Element 5.4.4 12/92

72 - Subscriber Driver’s License Data Element 5.4.4 12/92

73 - Subscriber Employee ID Data Element 5.4.4 12/92

74 - Subscriber Employer Address Data Element 5.4.10 1/93

75 - Subscriber Employer Branch Data Element 5.4.4 12/92

76 - Subscriber Employer Comment Data Element 5.4.4 12/92

77 - Subscriber Employer Contact Data Element 5.4.4 12/92


DATE


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78 - Subscriber Employer Data Element 5.4.4 12/92

79 - Subscriber Employer Telephone Data Element 5.4.4 12/92

80 - Subscriber Employment Status Data Element 5.4.4 12/92

81 - Subscriber Home Telephone Data Element 5.4.4 12/92

82 - Subscriber Name Data Element 5.7.30 9/94

83 - Subscriber Occupation Data Element 5.4.4 12/92

84 - Subscriber Relationship Data Element 5.4.4 12/92

85 - Subscriber Sex Data Element 5.4.4 12/92

86 - Subscriber Social Security Number Data Element 5.4.4 12/92

87 - Telephone Data Element 5.4.0 11/92


DATE

Copyright © 2011 QuadraMed Corporation

Table of Contents

Revision List . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iii

Chapter 1 Insurance/Payor Profile Table, ^rt("ipp")

Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1Table Attributes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1Table Builder Definition Screen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Active? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3Profile Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3Profile Short Name. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Parameter Definitions Level . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4Screen Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Screen Driver Type. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4Screen Driver Level . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Data Elements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Data Element Definition Screen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6Expressions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Edit Security Expr. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7Display Security Expr . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7Allowed Security Expr . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8Required Expr . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Chapter 2 Address Data Element

Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11Data Element Attributes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11Description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12Constants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

Message Modifier. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12Address Collection Screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13


viii QuadraMed Corporation

Chapter 3 Assignment of Benefits Data Element

Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15Data Element Attributes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15Description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16Constants. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

Prompt . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16Face Sheet. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16Values . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17Message Modifier. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17Display Text . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

Chapter 4 Authorization Approved Length of Stay Data Element


Message Modifier. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

Chapter 5 Authorization Date/Time of Data Element



Chapter 6 Authorization Person Talked To Data Element



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QuadraMed Corporation ix

Chapter 7 Authorization Source Data Element



Chapter 8 Authorization Status Data Element



Chapter 9 Comment Data Element


Message Modifier. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32Length . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32

Chapter 10 Copay Data Element




x QuadraMed Corporation

Chapter 11 Date 1 Data Element


Message Modifier. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37Days In Past. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37Days In Future . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37










Table of Contents

QuadraMed Corporation xi

Days In Past. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49Days In Future . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49

Chapter 15 Dialysis Provider Data Element



Chapter 16 Dialysis Type Data Element


Prompt . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54Face Sheet. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54Values . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55Message Modifier. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55Display Text . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55

Chapter 17 Effective Date 1 Data Element




Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61Data Element Attributes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61


xii QuadraMed Corporation

Description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62Constants. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63

Message Modifier. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63Effective Date 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63Days In Past. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63Days In Future . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64




Chapter 20 Expiration Date Data Element



Chapter 21 Explanation Code Data Element



Table of Contents

QuadraMed Corporation xiii

Chapter 22 Financial Class Data Element



Chapter 23 Formatted Entry 1 Data Element


Message Modifier. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78Display Type . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79Display Format(s). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79Display Maximum Length. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79Length . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80Verification Expression. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80



Message Modifier. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82Display Type . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83Display Format(s). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83Display Maximum Length. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83Length . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84Verification Expression. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84


Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85Data Element Attributes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85


xiv QuadraMed Corporation

Description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86Constants. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86

Message Modifier. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86Display Type . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87Display Format(s). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87Display Maximum Length. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87Length . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88Verification Expression . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88








Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97Data Element Attributes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97Description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98

Table of Contents

QuadraMed Corporation xv

Constants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98Message Modifier. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98Display Type . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99Display Format(s). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99Display Maximum Length. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99Length . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100Verification Expression. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100


Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101Data Element Attributes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101Description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 102Constants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 102

Message Modifier. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 102Display Type . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103Display Format(s). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103Display Maximum Length. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103Length . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104Verification Expression. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104



Message Modifier. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106Display Type . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107Display Format(s). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107Display Maximum Length. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107Length . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108Verification Expression. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108




xvi QuadraMed Corporation

Message Modifier. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110Display Type . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111Display Format(s). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111Display Maximum Length. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111Length . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112Verification Expression . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112


Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113Data Element Attributes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113Description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114Constants. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114


Chapter 33 Free-Text Insurance/Payor Name Data Element


Message Modifier. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 118

Chapter 34 Generic Choose Data Element


Prompt . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120Choose Values. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121Storage Reference. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 122

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Chapter 35 Generic Date/Time Data Element


Message Modifier. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126Allow Approximate? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126Storage Reference. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126

Chapter 36 Generic Employee Name Data Element


Message Modifier. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 130Employee Type(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131Display Type . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131Storage Reference. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131

Chapter 37 Generic Formatted Entry Data Element


Message Modifier. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135Display Type . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 136Display Format(s). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 136Display Maximum Length. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 136Length . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137Check Digit Type . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137Verification Expression. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 138Storage Reference. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 138

Chapter 38 Generic Free-Text Data Element

Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139


xviii QuadraMed Corporation

Data Element Attributes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139Description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139Constants. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 140

Message Modifier. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 140Length . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 140Storage Reference. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141

Chapter 39 Generic Hard-Coded Select Screen Data Element


Message Modifier. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 144Hard-Coded Values . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 144Storage Reference. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 145

Chapter 40 Generic Multimedia Data Element

Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147Data Element Attributes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147Description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 148Capture/Edit Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 150Field Display Format . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151Printing Images Using Chart Review Print Routine. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151Printing Images Using the HTML Printer Server and HTML Reports . . . . . . . . . . . . . . . . . . . . . . . . . 152Constants. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 152

Storage Reference. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 152Multimedia Definition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 153Multimedia Type. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 153Multimedia Server Type(s). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 154Multimedia Catalogue Object(s). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 156Display Format. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 156Allow Annotation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157Initial Annotation Tool . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157Multimedia Rubber Stamp(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 158Additional Object Data String. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 159Additional Generated Data String . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 160Suppress Printing?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 160Image Print Size. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161

Expressions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161

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Chapter 41 Generic Name Data Element


Message Modifier. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 164Length . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165Storage Reference. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165

Chapter 42 Generic Other Facility Data Element


Message Modifier. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 169Storage Reference. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 169Address Collection Screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 169Use Partial Name Match? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 170

Expressions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 170

Chapter 43 Generic Selection Screen/Tree Data Element


Message Modifier. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 174Screen Type/Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 174Window Preference . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 175Multi-Select? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 175Allow Free-Text? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 176Storage Reference. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 176

Chapter 44 Generic Table Selection Data Element

Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 177


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Message Modifier. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 179Selection Table . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 179Selection Group . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 179Window Preference . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 180Multi-Select? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 180Allow Free-Text? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 181Allow Partial Name?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 181Storage Reference. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 182

Expressions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 182

Chapter 45 Generic Telephone Data Element


Message Modifier. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 184Storage Reference. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 184

Chapter 46 Group Number Data Element



Chapter 47 Insurance Verified Data Element

Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 189Data Element Attributes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 189

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Description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 190Constants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 190

Prompt . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 190Face Sheet. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 190Values . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 191Message Modifier. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 191Display Text . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 192

Chapter 48 Military Base Data Element


Message Modifier. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 194Length . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 194

Chapter 49 Military Branch of Service Data Element



Chapter 50 Military Rank Data Element



Chapter 51 Military Reason Data Element

Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 199


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Chapter 52 Military Status Data Element



Chapter 53 Other Facility Data Element



Chapter 54 Other Facility Stay End Date Data Element


Message Modifier. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 207Days In Past. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 207Days In Future . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 207

Chapter 55 Other Facility Stay Start Date Data Element

Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 209Data Element Attributes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 209

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Description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 209Constants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211

Message Modifier. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211Days In Past. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211Days In Future . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211

Chapter 56 Payor Number Data Element



Expressions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 214

Chapter 57 Plan Number Data Element


Message Modifier. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 218Display Type . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 219Display Format(s). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 219Length . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 219Display Maximum Length. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 220Verification Expression. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 220

Chapter 58 Pre-Auth Data Element




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Chapter 59 Pre-Auth Number Data Element


Message Modifier. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 224Display Type . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 225Display Format(s). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 225Length . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 225Display Maximum Length. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 226Verification Expression . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 226

Chapter 60 Pre-Auth Second Opinion Flag Data Element



Chapter 61 Proration Plan Number Data Element


Message Modifier. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 233Display Type . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 233Display Format(s). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 234Display Maximum Length. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 234Length . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 234Verification Expression . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 235Low Range. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 235High Range . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 235

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Chapter 62 Release of Information Data Element



Chapter 63 Require Verification Data Element



Chapter 64 Review Agency Contact Person Data Element


Message Modifier. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 246Face Sheet. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 246

Chapter 65 Review Agency Data Element

Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 247Data Element Attributes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 247


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Description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 247Constants. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 248

Message Modifier. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 248Face Sheet. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 248

Chapter 66 Secondary Numbers Data Element


Message Modifier. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 251Secondary Number Type/Secondary Number Type(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 252Allow Duplicate Secondary Number(s)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 252Allow Edit of Secondary Number(s)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 253Manual Number Entry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 253

Expressions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 253

Chapter 67 Send Verification Data Element

Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 255Data Element Attributes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 256Description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 256Manual Verification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 256

Card Reader Verification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 256

Scan Insurance Card . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 257Manual Override . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 257Verification Interface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 258Visit Insurance Processing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 260Streamlined Newborn Admission . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 260

Visit Add . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 262Visit Conversion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 262Visit Edit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 262

Constants. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 262Timeout Management Queue(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 262Interface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 263Verification Start Method . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 263Card Reader Parameters. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 264Field Delimiter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 264

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Card Capture Parameters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 264Card Reader Parameters Section . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 265

Ins/Payor DE Pointer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 265Card Location. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 265Override Previous Data? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 266

Manual Start Information Section . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 266Message Modifier. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 266Format(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 267Display Name. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 267Required Status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 267

Chapter 68 Signature Date Data Element



Chapter 69 Subscriber Address Data Element


Message Modifier. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 274Address Collection Screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 274Street Address Length . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 275City Length . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 275County Length . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 275State Length. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 276Country Length. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 276Mailing Code Length . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 277

Chapter 70 Subscriber Birthdate Data Element

Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 279Data Element Attributes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 279Description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 280


xxviii QuadraMed Corporation

Date and time . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 281Constants. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 282


Chapter 71 Subscriber Day Telephone Data Element



Chapter 72 Subscriber Driver's License Data Element



Chapter 73 Subscriber Employee ID Data Element



Chapter 74 Subscriber Employer Address Data Element

Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 291

Table of Contents

QuadraMed Corporation xxix

Data Element Attributes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 291Description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 291Constants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 292

Message Modifier. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 292Address Collection Screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 293

Chapter 75 Subscriber Employer Branch Data Element



Chapter 76 Subscriber Employer Comment Data Element



Chapter 77 Subscriber Employer Contact Data Element



Chapter 78 Subscriber Employer Data Element



xxx QuadraMed Corporation

Constants. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 305Message Modifier. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 305Length . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 305Address Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 305

Chapter 79 Subscriber Employer Telephone Data Element



Chapter 80 Subscriber Employment Status Data Element



Chapter 81 Subscriber Home Telephone Data Element



Chapter 82 Subscriber Name Data Element



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QuadraMed Corporation xxxi

Guarantor Modifier . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 316Guarantor Modifier Character . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 317Same As Data To Exclude. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 317Length . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 318

Expressions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 318

Chapter 83 Subscriber Occupation Data Element



Chapter 84 Subscriber Relationship Data Element



Chapter 85 Subscriber Sex Data Element



Chapter 86 Subscriber Social Security Number Data Element



xxxii QuadraMed Corporation

Constants. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 328Message Modifier. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 328

Chapter 87 Telephone Data Element



Index of Selected Fields . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 331

QuadraMed Corporation 1

Chapter 1

Insurance/Payor Profile Table, ^rt("ipp")

OverviewThe Insurance/Payor Profile Table, ^rt("ipp"), is used to define the insurance screen sequences that collects insurance-specific information. A different screen sequence can be defined for each insurance/payor.

Table AttributesTable Relationship Links TO Menu Functions FROM ^rt("ipp"):

None

Links TO other Tables FROM ^rt("ipp"):Insurance/Payor Table, ^rt("ip")

Links FROM other Tables TO ^rt("ipp"):None

Facility Specific? No

Database Standards The Database Standards used to build/validate this table are located in Registration/Visit Screens Database Standards in the Database Standards Table Reference.

Table Organization The Insurance/Payor Profile Table, ^rt("ipp"), is a multiple-level screen driver table. It is composed of the following levels:

Profile Name

Parameter Definitions

Screen Driver

Once the Insurance/Payor Profile Table, ^rt("ipp") is accessed, the System prompts for a partial name. After a partial name is entered, the System displays a list of matching Insurance/Payor Profile Options, if any. The following processing options are available:

EditAddDelete


2 QuadraMed Corporation

Selecting an option to edit displays the information for the Profile Name level. This information can be edited by choosing (E) Edit or the Screen Driver level can be accessed by pressing the ENTER key.

When adding a new option, the information for the Profile Name level must be defined and accepted before the Screen Driver level can be accessed.

After the Profile Name level is defined, the System displays the list of previously defined Screen Sequence Options, if any. The following processing options are available:

EditBuildDeleteInsertMove

Selecting an option to edit causes the System to display the Screen Driver level. The Parameter Definitions level can be accessed by choosing the param processing option from the Screen Driver level. When inserting a new option, the Parameter Definitions level must be defined and accepted before the Screen Driver level can be accessed. The following processing options are available:

EditColorDeleteHeadingInsertMoveParam

For a complete description of rebuilding screens, see the screen drivers chapter in the Introduction to QuadraMed® CPR Tables manual.

The usual Edit, Add, and Delete processing options are available.

Department Usage Admitting/RegistrationAdmitting/registration uses these screens to enter/display all insurance/payor (or third party payor) information for a patient.

Admitting/registration can define generic fields to capture specialized information (Example: over income amounts for Medicaid eligibility).

Utilization ManagementUtilization management uses these screens to enter/display pre-authorization information.



Table Builder Definition ScreenThe following fields display on the Table Builder Definitions Screen for the Profile Name level:

Active?

Purpose Defines whether this option displays for selection in menu functions and in other tables.

Input Yes/No

Defaults to yes

System Use Yes – Indicates the option is available. The option displays for selection in menu functions and in other tables.

No – Indicates the option is inactive. The option displays in dim text in the table and does not display for selection in menu functions or other tables.

Impact ofChange

Edits and additions are effective immediately.

Profile Name

Purpose Defines the name of the screen sequence.

Input Free-text

Greater than 40 characters is impractical for display purposes

Required

System Use Displays this name for selection in the Insurance/Payor Table, ^rt("ip"), Screen Profile field.

Impact ofChange


Profile Short Name

Purpose Defines the screen sequence name in abbreviated terms.

Input Free-text

10 character limit

Required

System Use Currently not used

Impact ofChange

None



Parameter Definitions LevelThe following fields display on the Table Builder Definitions Screen for the Parameter Definitions level:

Screen Driver TypeDefines whether the screen driver is a vertical or horizontal screen driver. The System defaults to horizontal. This field cannot be edited.

Screen Driver LevelThis level is a horizontal screen driver.

Data ElementsThe following data elements can be inserted on any Insurance/Payor Profile Table, ^rt("ipp"), Screen Driver:

Address

Assignment of Benefits

Authorization Approved Length of Stay

Authorization Date/Time of

Authorization Person Talked To

Authorization Source

Authorization Status

Comment

Copay

Screen Name

Purpose Defines the name of the screen.

Input Free-text

50 character limit

Required

System Use Displays this screen name for selection when defining insurance information during visit processing.

Impact ofChange




Date 1

Date 2

Date 3

Date 4

Dialysis Provider

Dialysis Type

Effective Date 1

Effective Date 2

Effective Date 3

Expiration Date

Explanation Code

Financial Class

Formatted Entry 1

Formatted Entry 10

Formatted Entry 2

Formatted Entry 3

Formatted Entry 4

Formatted Entry 5

Formatted Entry 6

Formatted Entry 7

Formatted Entry 8

Formatted Entry 9

Free-Text Insurance/Payor Name

Generic Choose

Generic Date/Time

Generic Employee Name

Generic Formatted Entry

Generic Free-Text

Generic Hard-Coded Select Screen

Generic Multimedia

Generic Other Facility

Generic Selection Screen/Tree

Generic Table Selection

Generic Telephone

Group Number

Insurance Verified

Military Base

Military Branch of Service

Military Rank

Military Reason

Military Status

Other Facility

Other Facility Stay End Date

Other Facility Stay Start Date

Payor Number

Plan Number

Pre-Auth

Pre-Auth Number

Pre-Auth Second Opinion Flag

Proration Plan Number

Release of Information

Require Verification

Review Agency

Review Agency Contact Person

Secondary Numbers



Data Element Definition ScreenThe following fields display on all the Insurance/Payor Profile Table, ^rt("ipp"), Data Element Definition Screens:

Send Verification

Signature Date

Subscriber Address

Subscriber Birthdate

Subscriber Day Telephone

Subscriber Driver's License

Subscriber Employee ID

Subscriber Employer

Subscriber Employer Address

Subscriber Employer Branch

Subscriber Employer Comment

Subscriber Employer Contact

Subscriber Employer Telephone

Subscriber Employment Status

Subscriber Home Telephone

Subscriber Name

Subscriber Occupation

Subscriber Relationship

Subscriber Sex

Subscriber Social Security Number

Telephone

FIELD DESCRIPTION

Field Name Identifies the name of the field that displays on the screen driver.

Data Width Defines the width of the line(s) in which the entered data displays.

# Lines Defines the number of lines in which the data displays.

Archive? Defines whether data is stored in an archive (audit trail) event.

Required? Defines whether the field is required during data entry. Whether a field is required can also be defined in a data element dependency.

Edit Only? Defines whether the data element field is skipped in the fill and blank fill modes.

Constants Defines the specification of processing parameters for the data element field being defined, such as input limits, formats, and the transaction line. The fields that display are unique to each data element.



ExpressionsThe following fields display when the Expressions field is accessed:

Edit Security Expr

Purpose Defines an expression that determines whether the data element field can be edited by the user. This security check is in addition to any hard-coded checks in the data element.

Input Report Writer expression editor

This field is defined with a boolean (true/false) expression.

System Use Evaluates the expression defined in this field when the screen driver is accessed. The expression also is evaluated any time a field referenced in the expression is edited.

When the expression evaluates as true, the data element field can be edited on the user side.

In QuadraMed Computerized Patient Records (QuadraMed CPR), (character mode), when the expression evaluates as false, the selection number and data for the data element field are starred out (***), making the field inaccessible.

In Ultiview or Javaview, when the expression evaluates as false, the option number button displays in dim text, indicating the option is not accessible.

Impact of Change

Changes are not reflected on the user side until the screen containing the data element is rebuilt.

Display Security Expr

Purpose Defines an expression that determines whether the data element field can be accessed on the screen driver on the user side. This security check is in addition to any hard-coded display checks in the data element.


This field is defined with a boolean (true/false) expression.


When the expression evaluates as true, the data element field displays on the user side.

In QuadraMed CPR (character mode), when the expression evaluates as false, the selection number and data area for the data element field are starred out (***), making the field inaccessible.

In Ultiview or Javaview, when the expression evaluates as false, the option number button displays in dim text, indicating the option is not accessible.

Impact of Change




Allowed Security Expr

Purpose Defines an expression that determines whether data can be entered into the data element field, and whether previously defined data is cleared when data cannot be entered. When allowed security fails, the field cannot be accessed and the System clears any data defined in the field.


This subfield is defined with a boolean (true/false) expression

System Use Evaluates the expression defined in this subfield when the screen driver is accessed. The expression is also evaluated any time a field referenced in the expression is edited.

When the expression evaluates as true, data can be entered into the data element field, and the System does not clear the data if, subsequently, the field cannot be accessed. Therefore, if any data is changed which allows the field to be accessed, the previously defined data redisplays in the data element field.

When the expression evaluates as false, data cannot be entered into the data element field, and the System clears the data if, subsequently, the field cannot be accessed. Therefore, if any data is changed which allows the field to be accessed, either the default value displays, if defined, or the field displays empty.

Impact ofChange


Required Expr

Purpose Defines an expression that determines whether the data element field is required. This status is in addition to any hard-coded checks in the data element.



This field is defined with an expression that results in one of the following values:

0 (not required) – Indicates the data element field is not required. The screen driver can be accepted as complete without entering data into the data element field.

1 (accept required) – Indicates the data element field is accept required. The screen driver cannot be accepted as complete or partial without entering data into the data element field. The selection number for an accept required field displays in a bright box to indicate the field must be defined.

2 (process required) – Indicates the data element field is process required. The screen driver can be accepted as partial, but not complete, without entering data into the data element field. The selection number for a process required field displays in a bright box to indicate the field must be defined.



If the Data Element Definition Screen, Required? field can be defined for the data element as well as this field, the System uses the most restrictive definition. For example, if the Required? field is defined as process required and this expression indicates the field is not required (that is, a value of 0), the field is process required when the screen driver is accessed on the user side.

Impact of Change


Required Expr (Continued)




Chapter 2

Address Data Element

OverviewThe Address data element is used to create a field that allows the address of the insurance/payor to be entered during insurance processing.

Data Element AttributesData Element Relationship

Links TO other Tables FROM Address data element:


Links FROM other Tables TO Address data element:

Address Collection Driver Table, ^rt("ad")

Variations The Address data element consists of the following variations:

Display Only

This variation indicates the address is a display only field. The information that displays cannot be edited. The following field displays for the Display Only variation when the Constants field is accessed:

Address Collection ScreenEntered - City/State Only

This variation indicates the System only defaults the city and state information. When this variation is being defined, the System creates two data element fields on the screen driver, one for the city and another for the state. The following field displays for the Entered - City/State Only variation when the Constants field is accessed:

Message Modifier



DescriptionOnce a field that has been created from the Address data element is accessed, the System automatically defaults the information defined in the Insurance/Payor Table, ^rt("ip"), Address field. Depending on the variation selected, this information can be viewed, accepted, or edited.

ConstantsThe following fields can display when the Constants field is accessed:

Entered - Standard

This variation displays the Address Collection Screen for definition when the field created from this data element is accessed during insurance processing. The following fields display for the Entered - Standard variation when the Constants field is accessed:

Message ModifierAddress Collection ScreenEntered - State Only

This variation indicates the System only defaults the state information. There are no constants defined for this variation.

Rebuilding Screens Changes are not reflected on the user's side until the screen containing the data element is rebuilt.

Message Modifier

Purpose Defines the text that displays as the transaction line when this data element field is accessed. In some instances, the message modifier also provides a header to a selection list.

Input Free-text


Required

System Use Displays this text as the transaction line when the field created from this data element is accessed.

Impact ofChange

Changes are not reflected on the user's side until the screen containing the data element is rebuilt.

Chapter 2 Address Data Element


Address Collection Screen

Purpose Defines the Address Collection Screen that displays to collect the address on the user's side.

Input Single selection

Links from the Address Collection Driver Table, ^rt("ad")

System Use Displays this Address Collection Screen when the field created from this data element is selected during insurance processing.

When a screen is not defined in this field, the System displays the screen defined in the System Parameter Table, ^%z, Reg/ADT System Parameters subfile, Facility-specific level, Miscellaneous Data Screen, Address Collection Driver field.

For a complete description of address screens, see Chapter 1, Address Collection Driver Table, ^rt("ad") in the Address Collection Driver Table Reference.

Impact ofChange





Chapter 3

Assignment of Benefits Data Element

OverviewThe Assignment of Benefits data element is used to create a field that defines whether the patient has authorized the insurance company to pay the hospital for services rendered (that is, assign the benefits to the hospital).


Links TO other Tables FROM Address data element:


Links FROM other Tables TO Address data element:

Face Sheet Table, ^nt("fs")

Variations The Assignment of Benefits data element consists of the following variations:

Choose – This variation indicates to the System that the options display in the transaction line defined in the Prompt Constants field. The following fields display for the Choose variation when the Constants field is accessed:

PromptFace SheetValuesScreen – This variation indicates to the System that the options display as a selection on a screen. The following fields display for the Screen variation when the Constants field is accessed:

Message ModifierFace SheetDisplay Text




DescriptionOnce a field that has been created from the Assignment of Benefits data element is accessed, the System, depending on the variation selected, either prompts for a status to be chosen or displays a list of options and prompts for one to be selected.

The information that defaults into this data element field is a result of the assignment of benefits calculation.


Prompt

Purpose Defines the transaction line that displays when this data element is selected during insurance processing.

Input Free-text beginning with the verb Choose.

Each choose value must be included in the prompt. For example, if the following values are defined:

The transaction line (prompt) should be defined as:

Choose no assignment(N) or assignment(Y)

System Use Displays this transaction line when the data element is selected during insurance processing

Impact ofChange


Face Sheet

Purpose Defines the face sheet data element into which information is passed.

Input Partial name match

Single selection

Links from the Face Sheet Table, ^nt("fs"), Categories/Data Elements subfile

System Use Stores this value in the face sheet data element, replacing the previously stored results.

VALUE DISPLAY TEXT MEANING

N No assignment no assignment of benefits

Y Assignment assignment of benefits

Chapter 3 Assignment of Benefits Data Element


Impact ofChange


Values

Purpose Defines the character values that are accepted as input.

Input Value – Defines an allowable choice. Only one alphabetic character can be entered, and each value must have a unique letter. The System automatically capitalizes lower case letters.

Display text – Defines the text associated with the defined value. This is a free-text entry.

Meaning – Hard-coded text associated with the value and display text.

System Use When a value is chosen from the transaction line, the System displays the defined display text for that value.

Impact ofChange


Message Modifier


Input Free-text


Required


Impact ofChange


Display Text


Input Display text – Defines the text that displays for selection. This is a free-text entry.

Meaning – Hard-coded text associated with the display text.

(M) Move

Face Sheet (Continued)



System Use When a value is selected from the screen, the System displays the information defined as the display text for that value.

(M) Move – Allows the order of the display text to be changed.

Impact ofChange


Display Text (Continued)


Chapter 4

Authorization Approved Length of Stay Data Element

OverviewThe Authorization Approved Length of Stay data element is used to create an insurance field that allows the number of days (length of stay) that has been approved for the visit by the patient's insurance company to be defined.

Data Element Attributes

DescriptionOnce a field that has been created from the Authorization Approved Length of Stay data element is accessed, the System prompts for a length of stay to be entered. The System only accepts the entry of an integer.

Data Element Relationship

Links TO other Tables FROM Authorization Approved Length of Stay data element:


Links FROM other Tables TO Authorization Approved Length of Stay data element:

None

Variations None




ConstantsThe following field displays when the Constants field is accessed:

Message Modifier


Input Free-text


Required


Impact ofChange



Chapter 5

Authorization Date/Time of Data Element

OverviewThe Authorization Date/Time of data element is used to create a field that allows the entry of the date or date and time that pre-authorization was obtained for the patient's visit.


DescriptionOnce a field that has been created from the Authorization Date/Time of data element is accessed, the QuadraMed CPR System prompts for a date or date/time to be entered. The System allows the date to be entered in the following ways:

t (today) – Displays the current System date.

t +/- (offset) – Displays the current System date plus/minus a valid offset. QuadraMed CPR accepts the following offsets:

number(n) – Indicates the offset is a number of days (Example: t-1 is yesterday, based on the current System date).

nw – Indicates the offset is a number of weeks (Example: t-3w is 3 weeks ago).


Links TO other Tables FROM Authorization Date/Time of data element:


Links FROM other Tables TO Authorization Date/Time of data element:

None

Variations None




nm – Indicates the offset is a number of months (Example: If today is 9 August 90, then t-3m is May 1990).

ny – Indicates the offset is a number of years (Example: If today is 9 August 89, then t-2y is 1987).

The format in which the System accepts dates is determined by the System Parameter Table, ^%z, General Parameters level, Date Parsing field. The Date Parsing Options, along with their defined formats, are as follows:

U.S.A.

Month-Day-Year in one of the following formats:

mm-dd-yy

mm/dd/yy

dd mmm yy

dd mmm yyyy

Month-Year in one of the following formats:

mm/yy

mm-yy

mmm yyyy

Year as yyyy

When a month is defined with a three character format (that is, mmm), the input is alphabetic characters. When the month is defined with a two-character format (that is, mm), the input is numeric.

Canada – Canadian parsing interprets the first number of an unformatted date string as a day rather than as a month.

International – Currently not used.

QuadraMed CPR allows a date and time to be entered in the following ways:

n (now) – Current System date and time.

t (today) – Current System date. A t can be entered by itself or followed by a time (Example: t 0700 is today at 0700).

Date and time – All the previously identified date formats are acceptable with the following time formats:

As a 24-hour time (Example: 1300 for 1:00 pm)

As hh:mm am/pm (Example: 11:15 pm)

Chapter 5 Authorization Date/Time of Data Element


n - (offset) – Current System date minus an allowed offset. QuadraMed CPR accepts the following offsets:

number (n) – Indicates the offset is a number of minutes (Example: n-30 is 30 minutes ago).

nh – Indicates the offset is a number of hours (Example: n-2h is 2 hours ago).

The System evaluates each entered time for the proper format. When an unrecognized format is entered, the System displays an error message.


Message Modifier


Input Free-text


Required


Impact ofChange





Chapter 6

Authorization Person Talked To Data Element

OverviewThe Authorization Person Talked To data element is used to create an insurance field that allows the name of the person representing the third party payor, who authorized the patient's visit, to be entered.


DescriptionOnce a field that has been created from the Authorization Person Talked To data element is accessed, the System prompts for a name to be entered. This is a free-text field.


Links TO other Tables FROM Authorization Person Talked To data element:


Links FROM other Tables TO Authorization Person Talked To data element:

None

Variations None





Message Modifier


Input Free-text


Required


Impact ofChange



Chapter 7

Authorization Source Data Element

OverviewThe Authorization Source data element is used to create a field that defines the source from which the pre-authorization was given.


DescriptionOnce a field that has been created from the Authorization Source data element is accessed, the System displays a list of Pre-Authorization Source Options and prompts for one to be selected, or for free-text to be entered. Pre-Authorization Source Options are defined in the Pre-Authorization Source Table, ^rt("pa").


Links TO other Tables FROM Authorization Source data element:


Links FROM other Tables TO Authorization Source data element:

None

Variations None





Message Modifier


Input Free-text


Required


Impact ofChange



Chapter 8

Authorization Status Data Element

OverviewThe Authorization Status data element is used to create a field that defines the current status of pre-authorization for an insurance.Users who perform pre-authorization processing update the status of their work during processing.


DescriptionOnce a field that has been created from the Authorization Status data element is accessed, the System displays a list of Status Options and prompts for one to be selected. The System defaults the pre-authorization status of unprocessed. This option can be accepted when the pre-authorization verification process has not started or changed to partial or complete. These options are hard-coded.

When the pre-authorization status is changed to partial or complete, the System displays the status on the Insurance Summary Screen, in parentheses, next to the insurance's pre-authorization requirement.


Links TO other Tables FROM Authorization Status data element:


Links FROM other Tables TO Authorization Status data element:

None

Variations None





Message Modifier


Input Free-text


Required


Impact ofChange



Chapter 9

Comment Data Element

OverviewThe Comment data element is used to create a field that allows free-text information about the insurance to be entered.


DescriptionOnce a field that has been created from the Comment data element is accessed, the System prompts for information to be entered.


Links TO other Tables FROM Comment data element:


Links FROM other Tables TO Comment data element:

None

Variations None




ConstantsThe following fields display when the Constants field is accessed:

Message Modifier


Input Free-text


Required


Impact ofChange


Length

Purpose Defines the maximum number of characters that can be entered into this field.

Input Integer

System Use When defined, the System places the end of line symbol (|) at the end of the data element field input area to mark the maximum number of characters that can be entered.

When left blank, there is no limit for entering characters into the data element field.

Impact ofChange



Chapter 10

Copay Data Element

OverviewThe Copay data element is used to create an insurance field that defines the subscriber's copayment information. This field can be used to define the specific amount of the copayment (Example: $5.00), the percentage amount of the copayment (Example: 30 %), or that the patient does not have a copayment (Example: None or No copayment).


DescriptionOnce a field that has been created from the Copay data element is accessed, the System prompts for the copayment information to be entered. This is a free-text field.


Links TO other Tables FROM Copay data element:


Links FROM other Tables TO Copay data element:

None

Variations None





Message Modifier


Input Free-text


Required


Impact ofChange



Chapter 11

Date 1 Data Element

OverviewThe Date 1 data element is used to create an insurance field that collects a date.


DescriptionOnce a field that has been created from the Date 1 data element is accessed, the System prompts for a date to be entered. The System accepts the following date formats:


t +/- offset – Displays the current System date plus or minus a valid offset. The System accepts the following offsets:

(n) number – Indicates the offset is a number of days, indicated by n. For example, t+1 is tomorrow and t-1 is yesterday.

nw – Indicates the offset is a number of weeks, indicated by n. For example, t+3w is three weeks or 21 days in the future.


Links TO other Tables FROM Date 1 data element:


Links FROM other Tables TO Date 1 data element:

None

Variations None




nm – Indicates the offset is a number of months, indicated by n. When the date offset is a month, only the month and year display. For example, when the current System date is 17 December 91, t+3m is March 1992.

ny – Indicates the offset is a number of years, indicated by n. When the offset is a year, only the year displays. For example, when the current System date is 17 December 91, t+2y is 1993.

Acceptable date formats are determined by the System Parameter Table, ^%z, General Parameters level, Date Parsing field. Depending on the Date Parsing Option selected, the System accepts the date in the following formats:

U.S.A.

The month (m), day (d), and year (y) can be defined in the following formats:

mm-dd-yy

mm/dd/yy

dd mmm yy

dd mmm yyyy

The month and year can be defined in the following formats:

mm/yy

mm-yy

mmm yyyy

The year can be defined as yyyy.

When a month is defined in a three character format (that is, mmm), the input is alphabetic characters. When the month is defined in a two character format (that is, mm), the input is numeric.

Canada – Canadian date parsing interprets the first number of an unformatted date string as a day rather than a month.





Message Modifier


Input Free-text


Required


Impact ofChange


Days In Past

Purpose Defines the number of days, in the past, the System accepts for a date.

Input Integer

Defaults to No limit

System Use When a past date is entered into this data element field, the System checks the entered date against the current System date minus the number of days defined in this field. When the date is previous to the current System date minus the number of days defined in this field, the System displays an error message and prompts for another date.

For example, if today is 31 October 1992, and this field is defined as 2, the System does not accept a date prior to 29 October 1992.

No limit – Indicates that any past date is accepted.

Impact ofChange


Days In Future

Purpose Defines the number of days, in the future, the System accepts for a date.

Input Integer




System Use When a future date is entered into this data element field, the System checks the entered date against the current System date plus the number of days defined in this field. When the date is greater than the current System date plus the number of days defined in this field, the System displays an error message and prompts for another date.

For example, if today is 31 October 1992, and this field is defined as 2, the System does not accept a date greater than (that is, into the future) 02 November 1992.

No limit – Indicates that any future date is accepted.

Impact ofChange


Days In Future (Continued)


Chapter 12

Date 2 Data Element












None

Variations None







U.S.A.


mm-dd-yy

mm/dd/yy

dd mmm yy

dd mmm yyyy


mm/yy

mm-yy

mmm yyyy








Message Modifier


Input Free-text


Required


Impact ofChange


Days In Past


Input Integer





Impact ofChange


Days In Future


Input Integer







Impact ofChange




Chapter 13

Date 3 Data Element












None

Variations None







U.S.A.


mm-dd-yy

mm/dd/yy

dd mmm yy

dd mmm yyyy


mm/yy

mm-yy

mmm yyyy








Message Modifier


Input Free-text


Required


Impact ofChange


Days In Past


Input Integer





Impact ofChange


Days In Future


Input Integer







Impact ofChange




Chapter 14

Date 4 Data Element












None

Variations None







U.S.A.


mm-dd-yy

mm/dd/yy

dd mmm yy

dd mmm yyyy


mm/yy

mm-yy

mmm yyyy








Message Modifier


Input Free-text


Required


Impact ofChange


Days In Past


Input Integer





Impact ofChange


Days In Future


Input Integer




System Use When a future date is entered into thisdata element field, the System checks the entered date against the current System date plus the number of days defined in this field. When the date is greater than the current System date plus the number of days defined in this field, the System displays an error message and prompts for another date.



Impact ofChange




Chapter 15

Dialysis Provider Data Element

OverviewThe Dialysis Provider data element is used to create a field that defines the patient's dialysis provider facility.


DescriptionOnce a field that has been created from the Dialysis Provider data element is accessed, the System prompts for a partial name to be entered.

Once a partial name is entered, the System displays a list of matching options and prompts for one to be selected. The options that display are defined in the Other Facility Table, ^rt("of").


Links TO other Tables FROM Dialysis Provider data element:


Links FROM other Tables TO Dialysis Provider data element:

None

Variations None





Message Modifier


Input Free-text


Required


Impact ofChange



Chapter 16

Dialysis Type Data Element

OverviewThe Dialysis Type data element is used to create a field that defines the type of dialysis provided to the patient (that is, hemodialysis or peritoneal). This field is starred out ( ** ), making it inaccessible, until the field created from the Dialysis Type data element is defined.


Links TO other Tables FROM Dialysis Type data element:


Links FROM other Tables TO Dialysis Type data element:


Variations The Dialysis Type data element consists of the following variations:

Choose

This variation indicates to the System that the options display in the transaction line defined in the Prompt Constants field. The following fields display for the Choose variation when the Constants field is accessed:

PromptFace SheetValuesScreen

This variation indicates to the System that the options display as a selection screen. The following fields display for the Screen variation when the Constants field is accessed:





DescriptionOnce a field that has been created from the Dialysis Type data element is accessed, the System, depending on the variation selected, either prompts for a type to be chosen or displays a list of options and prompts for one to be selected.


Prompt



Each choose value must be included in the prompt. For example, if the following values are defined::


Choose hemodialysis (H) or peritoneal (P)

System Use Displays this transaction line when the data element is selected during insurance processing.

Impact ofChange


Face Sheet



Single selection



Impact ofChange



H Hemodialysis Hemodialysis

P Peritoneal Peritoneal Dialysis

Chapter 16 Dialysis Type Data Element


Values



Display Text – Defines the text associated with the defined value. This is a free-text entry.



Impact ofChange


Message Modifier


Input Free-text


Required


Impact ofChange


Display Text


Input Display Text – Defines the text that displays for selection. This is a free-text entry.


(M) Move





Impact ofChange




Chapter 17

Effective Date 1 Data Element

OverviewThe Effective Date 1 data element is used to create a field that defines the start (effective) date of the subscriber's primary insurance coverage.


DescriptionOnce a field that has been created from the Effective Date 1 data element is accessed, the System prompts for an effective date to be entered. The System accepts the following date formats:

"t"(today) – Displays the current System date.

"t" +/- offset – Displays the current System date plus or minus a valid offset. The System accepts the following offsets:




Links TO other Tables FROM Effective Date 1 data element:


Links FROM other Tables TO Effective Date 1 data element:

None

Variations None







U.S.A.


mm-dd-yy

mm/dd/yy

dd mmm yy

dd mmm yyyy


mm/yy

mm-yy

mmm yyyy







ConstantsMessage Modifier


Input Free-text


Required


Impact ofChange


Days In Past


Input Integer




No limit – The System accepts all past dates.

Impact ofChange


Days In Future

Purpose Defines the number of days in the future that will be accepted for a date entry.

Input Integer





For example, if today is 31 October 1992, and this field is defined as 2, the System does not accept a date greater than 02 November 1992.

Compares the entered date against the number defined in this field. When the entered date exceeds this number, the System displays an error message and prompts for another date to be entered.

No limit – The System accepts all future dates.

Impact ofChange




Chapter 18


OverviewThe Effective Date 2 data element is used to create a field that defines the start (effective) date of the subscriber's secondary insurance coverage.





None

Variations The Effective Date 2 data element consists of the following variations:

Allow Copy From Effective Date 1 – This variation allows the date defined in the Effective Date 1 data element field to be copied into this data element field. The following fields display for the Allow Copy From Effective Date 1 variation when the Constants field is accessed:

Message ModifierEffective Date 1Days In PastDays In FutureStandard – This variation causes the System to prompt for a date to be entered; the date defined in the Effective Date 1 data element field cannot be copied. The following fields display for the Standard variation when the Constants field is accessed:

Message ModifierDays In PastDays In Future












U.S.A.


mm-dd-yy

mm/dd/yy

dd mmm yy

dd mmm yyyy


mm/yy

mm-yy

mmm yyyy









Input Free-text


Required


Impact ofChange


Effective Date 1

Purpose Defines the text that displays as part of the message modifier.

Input Free text

Greater than 35 characters is impractical for display purposes.

Required

System Use Displays this text in place of the <effective date 1> section of the message modifier.

Impact ofChange


Days In Past

Purpose Defines the number of days in the past the System accepts for a date.

Input Integer







Impact ofChange


Days In Future


Input Integer



For example, if today is 31 October 1992, and this field is defined as 2, the System does not accept a date later than 02 November 1992.


Impact ofChange


Days In Past (Continued)


Chapter 19


OverviewThe Effective Date 3 data element is used to create a field that defines the start (effective) date of the subscriber's tertiary insurance coverage.











None

Variations None







U.S.A.


mm-dd-yy

mm/dd/yy

dd mmm yy

dd mmm yyyy


mm/yy

mm-yy

mmm yyyy









Input Free-text


Required


Impact ofChange


Days In Past

Purpose Defines the number of days in the past that will be accepted for a date entry.

Input Integer





Impact ofChange


Days In Future


Input Integer







Impact ofChange




Chapter 20

Expiration Date Data Element

OverviewThe Expiration Date data element is used to create an insurance field that collects the expiration date of the subscriber's insurance coverage.


DescriptionOnce a field that has been created from the Expiration Date data element is accessed, the System prompts for a date to be entered. The System accepts the following date formats:






Links TO other Tables FROM Expiration Date data element:


Links FROM other Tables TO Expiration Date data element:

None

Variations None







U.S.A.


mm-dd-yy

mm/dd/yy

dd mmm yy

dd mmm yyyy


mm/yy

mm-yy

mmm yyyy





Chapter 20 Expiration Date Data Element



Message Modifier


Input Free-text


Required


Impact ofChange


Days In Past


Input Integer





Impact ofChange


Days In Future


Input Integer







Impact ofChange




Chapter 21

Explanation Code Data Element

OverviewThe Explanation Code data element is used to create a field that allows an explanation code to be defined during insurance processing. Explanation codes are used in the UB-82 Billing Code System to provide standard data collection and billing practices for third party payment processing.

For example, the explanation code can provide a breakdown of the location in which a CAT Scan is given (Example: E1 – Head, E2 – Spine). The explanation code can also be used to indicate the medical necessity of an emergency room service (Example: When an emergency room service is based on medical necessity, Blue Cross requires that a certain code be used. Some of the codes are as follows: A1 – Acute illness, patient admitted; A2 – Acute illness, patient not admitted).


DescriptionOnce a field that has been created from the Explanation Code data element is accessed, the System displays a list of Explanation Code Options and prompts for one to be selected. Explanation Code Options are defined in the Explanation Code Table, ^rt("ex").


Links TO other Tables FROM Explanation Code data element:


Links FROM other Tables TO Explanation Code data element:

None

Variations None





Message Modifier


Input Free-text


Required


Impact ofChange



Chapter 22

Financial Class Data Element

OverviewThe Financial Class data element is used to create a field that defines the patient's financial class for a particular visit. A financial class is the category a patient is placed into based on the party responsible for reimbursing the hospital for services rendered during a visit.


DescriptionOnce a field that has been created from the Financial Class data element is accessed, the System, depending on the variation selected, can display a list of Financial Class Options and prompt for one to be selected.

The information that defaults into this data element field is a result of the financial class calculation.


Links TO other Tables FROM Financial Class data element:


Links FROM other Tables TO Financial Class data element:

None

Variations The Financial Class data element consists of the following variations:

Display Only – This variation only allows the data element to be viewed. There are no constants defined for this variation.

Standard – This variation allows the data element to be edited. The following field displays for the Standard variation when the Constants field is accessed:

Message Modifier





Message Modifier


Input Free-text


Required


Impact ofChange



Chapter 23

Formatted Entry 1 Data Element

OverviewThe Formatted Entry 1 data element is used to create a field for collecting data that must be entered in a specific format (Example: A passport number, district number, or grant number). The format can be a specific sequence of alpha characters, numbers, and punctuation.


Although this data element is still supported, the Generic Formatted Entry data element should be used instead of this data element.


Links TO other Tables FROM Formatted Entry 1 data element:


Links FROM other Tables TO Formatted Entry 1 data element:

None

Variations The Formatted Entry 1 data element consists of the following variations:

Expand – When the Display Type Constants field is defined as format, displays an XP icon at the bottom of the screen. Pressing the EXPD key causes the System to display the format defined in the Display Format(s) Constants field. Though multiple formats can be defined, only one entry is allowed per data element field.

The following fields can display for the Expand variation:

Message ModifierDisplay TypeDisplay Format(s)Display Maximum Length



DescriptionOnce a field that has been created from the Formatted Entry 1 data element is accessed, the System prompts for data to be entered. Once data has been entered, the System checks the entered data against the defined format. When the entered format is invalid, the System displays an error message.


LengthVerification ExpressionNo Expand – When the Display Type Constants field is defined as format, displays the format defined in the Display Format(s) Constants field. Though multiple formats can be defined, only one entry is allowed per data element field. The following fields can display for the No Expand variation:

Message ModifierDisplay TypeDisplay Format(s)Display Maximum LengthLengthVerification Expression


Message Modifier


Input Free-text


Required


Impact ofChange




Display Type

Purpose Defines how the data element is to be entered.

Input (F) Format

(L) Length

Defaults to Format

System Use (F) Format – Displays the format defined in the Display Format(s) field when the data element is accessed. Displays the following additional fields for definition:

Display Format(s)Display Maximum Length

(L) Length – Displays the end of line symbol (|) at the end of the data element field to mark the maximum number of characters that can be entered. Displays the Length field for definition.

Impact ofChange


Display Format(s)

Purpose Defines the valid formats.

Input Add/Delete Editor

When adding or editing a format, the following information must be used:

A – Defines the alphabetic characters used in the format.

9 – Defines the numbers used in the format.Punctuation marks – Defines a punctuation mark as itself.

For example, when the format is defined as AA-999, a valid entry is CD-123.

System Use Compares the entered data against the defined format and displays an error message when the entered data is in an invalid format.

Impact ofChange


Display Maximum Length

Purpose Defines whether the maximum length of the formatted entry is displayed.

Input Yes/No

Defaults to No



System Use Yes – Displays the end of line symbol (|) at the end of the data element field to mark the maximum number of characters that can be entered. Displays the length of the longest format specified.

No – Does not display the end of line symbol.

Impact ofChange

Changes are not reflected on the user's side until the screen containing this data element is rebuilt.

Length


Input Integer



Impact ofChange


Verification Expression

Purpose Defines a more specific format check, such as numbers must start with a specific number or set of numbers (Example: 12 or 1812).

Input Mumps code/operations (that is, !,|, $s)

Data values (that is, 1812, A1812)

System Use Evaluates/performs the defined expression. When the expression returns a false value, the number was entered into the System inaccurately and an error message displays.

Impact ofChange


Display Maximum Length (Continued)


Chapter 24









None


Expand – When the Display Type Constants field is defined as format, displays an XP icon at the bottom of the screen. Pressing the EXPD key causes the System to display the format defined in the Display Format(s) Constants field. Though multiple formats can be defined, only one entry is allowed per data element field. The following fields can display for the Expand variation:


Message ModifierDisplay Type





Display Format(s)Display Maximum LengthLengthVerification ExpressionNo Expand – When the Display Type Constants field is defined as format, displays the format defined in the Display Format(s) Constants field. Though multiple formats can be defined, only one entry is allowed per data element field. The following fields can display for the No Expand variation:



Message Modifier


Input Free-text


Required


Impact ofChange




Display Type


Input (F) Format

(L) Length

Defaults to format




Impact ofChange


Display Format(s)

Purpose Defines the valid format.




9 – Defines the numbers used in the format.

Punctuation marks – Defines a punctuation mark as itself.



Impact ofChange




Input Yes/No

Defaults to no



System Use Yes – Displays the end of line symbol ( | ) at the end of the data element field to mark the maximum number of characters that can be entered. Displays the length of the longest format specified.


Impact ofChange


Length


Input Integer



Impact ofChange







Impact ofChange




Chapter 25









None


Expand – When the Display Type Constants field is defined as format, displays an XP icon at the bottom of the screen. Pressing the EXPD key causes the System to display the format defined in the Display Format(s) Constants field. Though multiple formats can be defined, only one entry is allowed per data element field.The following fields can display for the Expand variation:






No Expand – When the Display Type Constants field is defined as format, displays the format defined in the Display Format(s) Constants field. Though multiple formats can be defined, only one entry is allowed per data element field. The following fields can display for the No Expand variation:



Message Modifier


Input Free-text


Required


Impact ofChange




Display Type


Input (F) Format

(L) Length

Defaults to format




Impact ofChange


Display Format(s)









Impact ofChange




Input Yes/No

Defaults to no





Impact ofChange


Length


Input Integer



Impact ofChange







Impact ofChange




Chapter 26









None


Expand – When the Display Type Constants field is defined as format, displays an XP icon at the bottom of the screen. Pressing the EXPD key causes the System to display the format defined in the Display Format(s) Constants field. Though multiple formats can be defined, only one entry is allowed per data element field.










Message Modifier


Input Free-text


Required


Impact ofChange




Display Type


Input (F) Format

(L) Length

Defaults to format




Impact ofChange


Display Format(s)









Impact ofChange




Input Yes/No

Defaults to no



.



Impact ofChange


Length


Input Integer



Impact ofChange







Impact ofChange




Chapter 27









None











Message Modifier


Input Free-text


Required


Impact ofChange




Display Type


Input (F) Format

(L) Length

Defaults to format



(L) Length – Displays the end of line symbol ( | ) at the end of the data element field to mark the maximum number of characters that can be entered. Displays the Length field for definition.

Impact ofChange


Display Format(s)









Impact ofChange




Input Yes/No

Defaults to no





Impact ofChange


Length


Input Integer



Impact ofChange







Impact ofChange




Chapter 28









None











Message Modifier


Input Free-text


Required


Impact ofChange




Display Type


Input (F) Format

(L) Length

Defaults to format




Impact ofChange


Display Format(s)









Impact ofChange




Input Yes/No

Defaults to no





Impact ofChange


Length


Input Integer



Impact ofChange







Impact ofChange




Chapter 29









None











Message Modifier


Input Free-text


Required


Impact ofChange




Display Type


Input (F) Format

(L) Length

Defaults to format




Impact ofChange


Display Format(s)









Impact ofChange




Input Yes/No

Defaults to no





Impact ofChange


Length


Input Integer



Impact ofChange







Impact ofChange




Chapter 30









None











Message Modifier


Input Free-text


Required


Impact ofChange




Display Type


Input (F) Format

(L) Length

Defaults to format




Impact ofChange


Display Format(s)









Impact ofChange




Input Yes/No

Defaults to no





Impact ofChange


Length


Input Integer



Impact ofChange







Impact ofChange




Chapter 31









None











Message Modifier


Input Free-text


Required


Impact ofChange




Display Type


Input (F) Format

(L) Length

Defaults to format




Impact ofChange


Display Format(s)









Impact ofChange




Input Yes/No

Defaults to no





Impact ofChange


Length


Input Integer



Impact ofChange







Impact ofChange




Chapter 32









None











Message Modifier


Input Free-text


Required


Impact ofChange




Display Type


Input (F) Format

(L) Length

Defaults to format




Impact ofChange


Display Format(s)

Purpose Defines the valid formats.








Impact ofChange




Input Yes/No

Defaults to no





Impact ofChange


Length


Input Integer



Impact ofChange







Impact ofChange




Chapter 33

Free-Text Insurance/Payor Name Data Element

OverviewThe Free-Text Insurance/Payor Name data element is used to create an insurance field that allows a free-text insurance/payor name to be entered. This data element field is used for those occasions when admitting/registration needs to add an insurance to the patient's record and the insurance name is not defined in the Insurance/Payor Table, ^rt("ip").


DescriptionOnce a field that has been created from the Free-Text Insurance/Payor Name data element is accessed, the System prompts for a name to be entered. The name is entered as free-text.


Links TO other Tables FROM Free-Text Insurance/Payor Name data element:


Links FROM other Tables TO Free-Text Insurance/Payor Name data element:

None

Variations None





Message Modifier


Input Free-text


Required


Impact ofChange



Chapter 34

Generic Choose Data Element

OverviewThe Generic Choose data element is used to create a field whose data must be internally coded. Choose data elements present the user with a defined set of options that are embedded within the transaction line. Each option is associated with an alphabetic character. The alphabetic character is entered to choose the associated option. This data element can also be used to create a field that accepts a yes/no answer. The Generic Choose data element is to be used only when the other non-generic data elements within the insurance/payor data dictionary do not apply.


DescriptionOnce a field that has been created from the Generic Choose data element is accessed, the QuadraMed CPR System displays the transaction line defined in the Prompt Constants field and prompts the user to choose an option.


Links TO other Tables FROM Generic Choose data element:


Links FROM other Tables TO Generic Choose data element:

Generic Insurance/Payor Data Element Table, ^rt("gi")

Variations None




The entry of the alphabetic character associated with the desired option causes the option to be recorded. The System can copy forward generic insurance data from a previous visit into the current visit when the following conditions are met:

The insurance is copied forward during one of the following processes:

Adding a new visit

Copying a previous visit into a new visit

Changing visit types during a visit add

Converting a visit

The field created from this data element has information defined.

The Generic Insurance/Payor Data Element Table, ^rt("gi"), Copy Data Forward? field is defined as yes for the option defined in the Storage Reference Constants field of this data element.


Prompt


Input Free-text beginning with the verb Choose

Each choose value must be included in the prompt. For example, if the following choose values are defined:


Choose alpha(A) or beta(B)

Alternatively, when the choose values are defined for a Yes/No field:

VALUE INTERNAL DISPLAY TEXT

A 1 alpha

B 2 beta

VALUE INTERNAL DISPLAY TEXT

N 0 no

Y 1 yes

Chapter 34 Generic Choose Data Element



Patient located? no

The no default occurred because the n value is defined as 0.

Required


Impact ofChange


Choose Values

Purpose Defines the character value accepted as input.


When adding or editing a value, the System prompts for the following:

Value

Alphabetic character

Each alphabetic character must be unique

Internal value

Integer

Each internal value must be unique

Display text

Free-text

Required

System Use Value – Determines the alphabetic character used to define an allowable option. The user can enter the selection letter as either upper or lower case. The System upshifts all lower case entries.

Internal value – Determines the value associated with the option being defined. When the internal value for an option is defined as 0, the System displays that option as the default value. Typically, in Yes/No fields, the no response is defined as the default value.

Display text – Determines the text associated with the choose value that displays in the transaction line and in the field created from this data element.

Impact ofChange


Prompt (Continued)



Storage Reference

Purpose Defines the location in which the information defined in this data element is stored.


Links from the Generic Insurance/Payor Data Element Table, ^rt("gi")

Required

System Use Determines the storage location where the choose data is stored.

Impact ofChange



Chapter 35

Generic Date/Time Data Element

OverviewThe Generic Date/Time data element is used to create a field that allows the entry of a date and/or time during insurance processing. This data element is to be used only when the other non-generic date/time data elements within the insurance/payor data dictionary do not apply.


Links TO other Tables FROM Generic Date/Time data element:


Links FROM other Tables TO Generic Date/Time data element:


Variations The Generic Date/Time data element consists of the following variations:

Date – This variation only accepts entry of a date. The System does not allow a time to be entered. The following fields display for the Date variation when the Constants field is accessed:

Message ModifierAllow Approximate?Storage ReferenceDate/Time – This variation accepts the entry of a date and time. The following fields display for the Date/Time variation when the Constants field is accessed:

Message ModifierAllow Approximate?Storage Reference



DescriptionOnce a field that has been created from the Generic Date/Time data element is accessed, the QuadraMed CPR System, depending on the variation selected, prompts for either a date and/or a time to be entered. The System allows the date to be entered in the following formats:


t +/- (offset) – Displays the current System date plus/minus a valid offset. QuadraMed CPR accepts the following offsets:

number(n) – Indicates the offset is a number of days (Example: t-1 is yesterday, based on the current System date).

nw – Indicates the offset is a number of weeks (Example: t-3w is 3 weeks ago).

nm – Indicates the offset is a number of months (Example: If today is 9 August 92, then t-3m is 9 May 1992).

ny – Indicates the offset is a number of years (Example: If today is 9 August 93, then t-2y is 9 August 1991).

The format in which the System accepts dates is determined by the System Parameter Table, ^%z, General Parameters level, Date Parsing field. The date parsing options, along with their defined formats, are as follows:

U.S.A.

Month-Day-Year in one of the following formats:

mm-dd-yy

mm/dd/yy

dd mmm yy

dd mmm yyyy

Month-Year in one of the following formats:

mm/yy

mm-yy

Time – This variation only allows entry of a time. The System does not allow a date to be entered. The following fields display for the Time variation when the Constants field is accessed:

Message ModifierAllow Approximate?Storage Reference




mmm yyyy

Year as yyyy

When approximate dates are allowed, any of the U.S.A. formats can be prefixed by a tilde (~) to indicate an approximate date. For example, ~June 1991.

When a month is defined with a three character format (that is, mmm), the input is alphabetic characters (Example: Dec). When the month is defined with a two character format (that is, mm), the input is numeric (Example:12).

Canada – Canadian parsing interprets the first number of an unformatted date string as a day rather than as a month.


QuadraMed CPR allows a date and time to be entered in the following formats:


t (today) – Current System date. A t can be entered followed by a time (Example: t 0700 is today at 0700).

Date and time – All the previously identified date formats are acceptable with the following time formats:

As a 24-hour time (Example: 1300 for 1 pm)

As hh:mm am/pm (Example: 11:15 pm)

n - (offset) – Current System date minus an allowed offset. QuadraMed CPR accepts the following offsets:

number (n) – Indicates the offset is a number of minutes (Example: n-30 is 30 minutes ago).

nh – Indicates the offset is a number of hours (Example: n-2h is 2 hours ago).


The System can copy forward generic insurance data from a previous visit into the current visit when the following conditions are met:


Adding a new visit



Converting a visit



The field created from this data element has information defined. The Generic Insurance/Payor Data Element Table, ^rt("gi"), Copy Data Forward? field is defined as yes for the option defined in the Storage Reference Constants field of this data element.


Message Modifier


Input Free-text


Required


Impact ofChange


Allow Approximate?

Purpose Defines whether the System allows an approximate date/time to be entered.

Input Yes/No

Defaults to no

System Use Yes – Indicates an approximate date/time can be entered, prefixed by a tilde (~).

No – Indicates the System does not recognize an approximate date/time.

Impact ofChange


Storage Reference




Required



System Use Determines where the date/time entered into this data element field is stored.

Impact ofChange


Storage Reference (Continued)




Chapter 36

Generic Employee Name Data Element

OverviewThe Generic Employee Name data element is used to create a field that allows an employee to be defined. This data element is to be used only when the other non-generic data elements within the insurance/payor data dictionary do not apply.


Links TO other Tables FROM Generic Employee Name data element:


Links FROM other Tables TO Generic Employee Name data element:


Variations The Generic Employee Name data element consists of the following variations:

Multiple Employees – This variation allows more than one employee to be selected during insurance processing. The number of employees that display is limited to the number of lines specified in the Data Element Definition Screen, # Lines field. The following fields display for the Multiple Employees variation when the Constants field is accessed:

Message ModifierEmployee Type(s)Display TypeStorage ReferenceSingle Employee – This variation allows only one employee to be selected during insurance processing. The following fields display for the Single Employee variation when the Constants field is accessed:

Message ModifierEmployee Type(s)Display TypeStorage Reference




DescriptionOnce a field that has been created from the Generic Employee Name data element is accessed, the System prompts for an employee ID to be entered. The EXPD key can be pressed to select the employee by department, specialty, type, group, or ID type. Only those employees with the same employee type as defined in the Employee Type(s) Constants field of this data element display for selection.



Adding a new visit



Converting a visit




Message Modifier


Input Free-text


Required


Impact ofChange


Chapter 36 Generic Employee Name Data Element


Employee Type(s)

Purpose Defines the type of employee or employees that displays for selection when this data element is selected.

Input Facility-specific

Add/Delete Editor

Multiple selection

Links from the Employee Type Table, âet("et")

System Use Determines the type of employee that displays for selection when this data element is accessed during insurance processing.

When not defined, all employees types can be selected.

Impact ofChange


Display Type

Purpose Defines the information that displays for the identified employee.

Input Single selection from the following hard-coded options:

Name/title

Name/title,specialty,admitting privileges

Number,name/title,job title,department

Name/title,department/section

Name/title,group,specialty,beeper

Required

System Use Determines the information that displays for the identified employee.

Impact ofChange


Storage Reference




Required



System Use Determines where the employee name(s) defined in this data element field is stored.

Impact ofChange


Storage Reference (Continued)


Chapter 37

Generic Formatted Entry Data Element

OverviewThe Generic Formatted Entry data element is used to create a field for collecting data that must be entered in a specific format (Example: passport number, district number, grant number, and so on). The format can be a specific sequence of alpha characters, numbers, and/or punctuation. This data element is to be used only when the other non-generic data elements within the insurance/payor data dictionary do not apply.


Although, the Formatted Entry (1-10) data elements are still supported, this data element should be used instead of the Formatted Entry (1-10) data elements.


Links TO other Tables FROM Generic Formatted Entry data element:


Links FROM other Tables TO Generic Formatted Entry data element:


Variations The Generic Formatted Entry data element consists of the following variations:

Expand – When the Display Type Constants field is defined as format, displays an expand icon at the bottom of the screen. Pressing the EXPD key causes the System to display the format defined in the Display Format(s) Constants field. Though multiple formats can be defined, only one entry is allowed per data element field.


Message ModifierDisplay TypeDisplay Format(s)Display Maximum Length



LengthCheck Digit TypeVerification ExpressionStorage ReferenceExpand Add/Delete – When the Display Type Constants field is defined as format, displays an expand icon at the bottom of the screen. Pressing the EXPD key causes the System to display the format defined in the Display Format(s) Constants field. Multiple entries are allowed per data element field.

The following fields can display for the Expand Add/Delete variation:

Message ModifierDisplay TypeDisplay Format(s)Display Maximum LengthLengthCheck Digit TypeVerification ExpressionStorage ReferenceNo Expand – When the Display Type Constants field is defined as format, displays the format defined in the Display Format(s) Constants field. Though multiple formats can be defined, only one entry is allowed per data element field.

The following fields can display for the No Expand variation:

Message ModifierDisplay TypeDisplay Format(s)Display Maximum LengthLengthCheck Digit TypeVerification ExpressionStorage ReferenceNo Expand Add/Delete – When the Display Type Constants field is defined as format, displays the format defined in the Display Format(s) Constants field. Multiple entries are allowed.

The following fields can display for the No Expand Add/Delete variation:

Message ModifierDisplay TypeDisplay Format(s)Display Maximum LengthLengthCheck Digit TypeVerification ExpressionStorage Reference



DescriptionOnce a field that has been created from the Generic Formatted Entry data element is accessed, the System prompts for data to be entered. Once data has been entered, the System checks the entered data against the defined format. When the entered format is invalid, the System displays an error message.



Adding a new visit



Converting a visit





Message Modifier


Input Free-text


Required


Impact ofChange




Display Type

Purpose Defines how information is to be entered into the data element field.

Input (F) Format

(L) Length

Defaults to format

System Use (F) Format – Displays the format defined in the Display Format(s) field when the data element is accessed or the XP key is pressed. Displays the following additional fields for definition:


(L) Length – Displays the end of line symbol ( | ) at the end of the data element field to mark the maximum number of free-text characters that can be entered. Displays the Length field for definition.

Impact ofChange


Display Format(s)



When adding or editing a format, the following characters must be used:






Impact ofChange



Purpose Defines whether the maximum length of the formatted entry displays.

Input Yes/No

Defaults to no





Impact ofChange


Length


Input Integer



Impact ofChange


Check Digit Type

Purpose Defines the algorithm that determines the check digit. Check digits are redundant digits added to an input value for error detection.

Input (T) Mod 10

(E) Mod 11

(N) No check digit

Defaults to no

System Use (T) Mod 10 – Indicates a Modulus 10 check digit method is used to determine whether the number was entered into the System accurately.

(E) Mod 11 – Indicates a Modulus 11 check digit method is used to determine whether the number was entered into the System accurately.

(N) No check digit – Indicates no check is to be performed on input to the data element field.

Impact ofChange








For a complete description of calculations/expressions, see Chapter 5, Calculations/Expressions in the Introduction to CPR Tables.

Data values (Example: 1812, A1812)

System Use Evaluates the defined expression. When the expression returns a false value, the number was entered into the System inaccurately and an error message displays.

Impact ofChange


Storage Reference




Required

System Use Determines where the formatted data defined in this data element field is stored.

Impact ofChange



Chapter 38

Generic Free-Text Data Element

OverviewThe Generic Free-Text data element is used to create a field that collects comments and/or other unformatted data. The information can be entered using any alphabetic, numeric, or punctuation characters. This data element is to be used only when the other non-generic data elements within the insurance/payor data dictionary do not apply.


DescriptionOnce a field that has been created from the Generic Free-Text data element is accessed, the System prompts for free-text entry of data. The System accepts up to 1023 characters of data.



Adding a new visit



Links TO other Tables FROM Generic Free-Text data element:


Links FROM other Tables TO Generic Free-Text data element:


Variations None





Converting a visit




Message Modifier


Input Free-text


Required


Impact ofChange


Length


Input Integer



Impact ofChange


Chapter 38 Generic Free-Text Data Element


Storage Reference




Required

System Use Determines where the free-text information defined in this data element field is stored.

Impact ofChange





Chapter 39

Generic Hard-Coded Select Screen Data Element

OverviewThe Generic Hard-Coded Select Screen data element is used to collect data from a selection screen. This data element type should be used only when a small number of options (that is, 2-6) are defined for selection and the selected option needs to be coded for use elsewhere in the System (Example: A calculation). This data element is to be used only when the other non-generic data elements within the insurance/payor data dictionary do not apply.


DescriptionOnce a field that has been created from the Generic Hard-Coded Select Screen data element is accessed, the QuadraMed CPR System displays a list of options. These options are defined in the Hard-Coded Values Constants field of this data element. The System prompts for an option to be selected.


Links TO other Tables FROM Generic Hard-Coded Select Screen data element:


Links FROM other Tables TO Generic Hard-Coded Select Screen data element:


Variations None






Adding a new visit



Converting a visit





Input Free-text


Required


Impact ofChange


Hard-Coded Values

Purpose Defines the list of options to be selected for data entry.

Input Insert/Delete Editor

When inserting an option, the following information must be defined:

Internal value

IntegerDisplay text

Free-text

Required

Chapter 39 Generic Hard-Coded Select Screen Data Element


System Use Internal value – Uses this value for various inclusion and billing calculations.

Display text – Determines the text that displays in the field created from this data element when the option is selected.

Impact ofChange


Storage Reference




Required

System Use Determines where the option selected from the hard-coded selection screen is stored.

Impact ofChange


Hard-Coded Values (Continued)




Chapter 40

Generic Multimedia Data Element

OverviewThe Generic Multimedia data element is used to create a field that allows non-textual data (that is, multimedia objects) to be integrated into the QuadraMed CPR computer-based patient record. Care providers can acquire (capture), render (view), and edit (add, delete, and annotate) multimedia data when accessing the field created from this data element.


Links TO other Tables FROM the Generic Multimedia data element:


Links FROM other Tables TO the Generic Multimedia data element:

Generic Insurance/Payor Data Element Table, ^rt(“gi”)Multimedia Object Catalogue Table, ^mmt(“oc”)Multimedia Rubber Stamp Table, ^mmt(“rs”)Multimedia Server Type Table, ^mmt(“st”)Multimedia Type Table, ^mmt(“t”)

Links FROM the Hierarchical Filing Structure (HFS)

Required Status The required status for this data element is database-defined in the Insurance/Payor Profile Table, ̂ rt(“ipp”), Data Element Definition Screen, Required? field, as well as in the Required Expr Expressions field.

NOTE: When both the Required? field and a required expression are defined, the System uses the most restrictive required status.

Variations None

Rebuilding Screens Changes are not reflected on the user side until the screen containing this data element is rebuilt.



DescriptionWhen the field created from this data element is accessed, the System enables one of the following processes to occur:

The Media Manager Client (that is, a computerized digital data capture, rendering and editing application), can be initiated to process multimedia data.

The Image Manager (Server-based) application (that is, a computerized digital data capture, rendering and annotation system) can be initiated to process multimedia data.

A third-party image management client can be initiated to process multimedia data.

In addition to the above configuration, the following additional requirements must be met to process multimedia data from the Media Manager client application in QuadraMed CPR as shown below:

The workstation must have OMCjE (OpenMEd Capture javaExpress)™ 4.1.2 or greater installed. This is required to acquire, edit, or view multimedia objects.

An imaging server running OMM (OpenMed Manager) ™ 3.1.15 or greater for storing and managing multimedia objects

A TWAIN compatible image acquisition device (that is, scanner - with or without a document feeder; digital camera; web camera), should be attached to the local computer in order to capture images.

For the Audio multimedia type: a recording application and appropriate hardware are needed for audio acquisition and storage [as an .mp3 or as a .wav file type] to a directory accessible to the workstation. For playback, a sound card/speaker/ application is necessary.

This requires customization of the image server interface.

The following requirements must be met to enable users to process multimedia data:The customer must have version 3.0 or greater of QuadraMed CPR Ultiview Desktop (for the Image Manager and HTML Manager applications) or version 4.1 or greater of the Clinical Desktop (for the Media Manager Client application) implemented. This is required to access the Multimedia data element and to launch the imaging client.The Device Table, âd, Allow Multimedia Edits? field must be defined as yes for the terminal accessing this data element field. This is required in order to cause the field to be selectable for editing, acquiring, or rendering multimedia objects.

The Media Manager functionality is not available in the Ultiview desktop.



For the Video multimedia type: a recording application and appropriate hardware are needed for video acquisition and storage [as an .mpg or as an .avi file type] to a directory accessible to the workstation. For playback, a sound card/speaker/application is necessary for video files with sound.

For the Digital Medical Imaging type: a Digitizer Scanner (high resolution scanner) (DICOM-Compliant) for acquiring clinical images from film.

Once the field created from this data element is accessed, the System display depends on how the Multimedia Definition Constants field, Multimedia Type subfield is defined.

When the Multimedia Type subfield is defined as Scanned/Photographic Imaging, Audio, Digital Medical Imaging, or Video, one of the following can occur:

The Capture/Edit Client can be initiated, and the Client Application Screen can open without an object displayed, when the following conditions are met:

A customer must be licensed to use specific multimedia types in the Media Manager application: Scanned/Photographic Imaging, Audio, Video, Digital Medical Imaging.

The audio, digital medical imaging and video multimedia types apply only to the Media Manager client application.



No multimedia object is defined in the Multimedia Definition Constants field, Multimedia Catalogue Object(s) subfield of this data element.

No multimedia data has been documented (that is, this is a new capture).

The System accesses a server that has been defined to store the multimedia object defined in the Multimedia Definition Constants field, Multimedia Catalogue Object(s) subfield of this data element. Servers are defined in the Multimedia Definition Constants field, Multimedia Server Type(s) subfield of this data element.

The Client Application Screen can be launched in the following modes:

Capture/Edit – Displays during image acquisition or editing (for example, insurance processing).

Render (Display)/Review – Displays during patient or event review. Displays multimedia objects when the field created from this data element is accessed to review multimedia insurance processing data (that is, scanned picture of insurance card).

In QuadraMed CPR Registration/Insurance Processing, the Scanned/Photographic Imaging multimedia type is useful for patient photography for identification, document imaging (for example, scanning consent forms, insurance cards, and so on). The Audio, Video, or Digital Medical Imaging multimedia file types are useful in order, result, and assessment processing. They can only be acquired through file importing and rendered (displayed) in the data element field and cannot be annotated.

Capture/Edit ModeIn Capture/Edit Mode, multimedia data can be captured, edited, and images can be annotated. In addition, annotation can be disabled at the field level.

When no image is defined in the Multimedia Definition Constants field, Multimedia Catalogue Object(s) subfield, the client application is launched without a pre-defined image (that is, a blank screen). The client allows a user to add a new image during insurance processing by importing or by acquisition using a TWAIN compliant device.

When the Multimedia Definition Constants field, Allow Annotation? subfield of this data element is defined as yes, the Capture/Edit Client allows the user to annotate the scanned/photographic image (that is, mark an image with predefined text, symbols: rubber stamps, or by using other annotation tools to specify an area of interest to the care provider). Rubber stamps are defined in the Multimedia Definition Constants field, Multimedia Rubber Stamp(s) subfield.

The Image Manager application allows an initial annotation tool to display as a pre-selected icon on the Annotation toolbar when the Multimedia Definition Constants field, Initial Annotation Tool subfield is defined with an annotation tool option. The user has the option to do one of the following:

Capture and annotate



Capture and not annotate

Not capture and not annotate

Not capture and annotate

After capturing or annotating an image, the image is saved to the server defined in the Multimedia Definition Constants field, Multimedia Server Type(s) subfield of this data element.

Field Display FormatThis data element can be defined to display a thumbnail (that is, miniature) view of the selected image on the order profile for the Scanned/Photographic Imaging multimedia type only, or to display descriptive text in the data element field for all other multimedia types. When the Multimedia Definition Constants field, Display Format subfield is defined as thumbnail, the image defined in the field created from the Multimedia data element displays as a miniature image in the data element field.

A thumbnail can be defined only when the Multimedia Definition Constants field, Multimedia Type subfield is defined with a Scanned/Photographic Imaging multimedia type. The user must be aware that the Data Element Definition Screen of this data element, #Lines field determines the maximum height of the thumbnail image on the profile. The System will always display a thumbnail in correct aspect ratio within the available space.

Printing Images Using Chart Review Print RoutineImages collected by accessing the Media Manager client application in the field created from this data element and associated with a documented event can be printed using the Chart Print routine. The Chart Review Print routine can search for and print data contained in every Multimedia data element, in order. It is necessary to print images for purposes of sharing medical information between providers and other caregivers, as well as in response to request from legal authorities. The Chart Review Print routine can be accessed in the Chart Review menu function by clicking the Print button and pressing the F12 key from an event review screen. The System provides the following print characteristics:

All images from a particular object/event can be excluded. Each item stored in a data element is commonly referred to as an object. Each object can contain multiple images/files. This is based on the definition of the Multimedia Definition Constants field, Suppress Printing? subfield of this data element. When the Suppress Printing? subfield is defined as yes, images collected in this data element field and associated with a documented event are excluded from printing using the Chart Review Print routine. When the Suppress Printing? subfield is defined as no, all images collected in this Multimedia data element field and associated with a documented event are always printed using the Chart Review Print routine.

The printed page displays the data element field number with the words image defined to denote an image is expected to print immediately after the results print.

The System prints the image in order of occurrence, most recent to oldest.



The System prints the image with a header/footer containing the chart print event information.

The System can define the size of the image that displays based on the Multimedia Definition Constants field, Image Print Size subfield.

The print queue to which images are routed for printing is defined in the Area Table, âfa, MM Print Queue field.

Printing Images Using the HTML Printer Server and HTML ReportsUsers can print images captured and stored using the Media Manager client application using the following:

The QuadraMed CPR HTML PrinterServer. The HTML PrinterServer provides the ability for CPR to print HTML reports to printers using an automated process, without requiring user intervention.

A Report Formatter Data Dictionary Table, ârfd, HTML screen driver report. This report allows images to be printed as follows:

Print all of the images for a patient visit or one/multiple specific patient event

Print all of the images for a patient or one/multiple specific patient event


Storage Reference

Purpose Defines the storage location associated with the generic data element.



Required

System Use Determines where the System files the generic data element. All data elements, except the generic data elements, have a pre-defined storage location. Generic data elements are user defined/created. When a new data element is created, a storage location must be defined.

Impact ofChange




Multimedia Definition

Purpose Defines the parameters that collect the information necessary for multimedia objects to be captured, edited, or rendered in this data element field. In addition, these parameters can allow a customer to define data strings that cause the multimedia client to be configured on-the-fly and override the default settings.

A healthcare facility can pass non-object data (that is, employee ID, and so on) to a third-party imaging client, if necessary, through this multimedia definition (this is not supported in the Media Manager application).

Finally, these parameters define whether printing of images collected using the Media Manager client application and documented in the field created from this data element can be printed using the Chart Review Print routine.

Input Displays the following subfields for definition:

Multimedia Type Suppress Printing?Image Print Size

System Use Allows a multimedia object (for example, image) to be captured, annotated (annotations for scanned/photographic images only), or rendered during insurance processing.

Impact ofChange


Multimedia Type

Purpose Defines the multimedia object type associated with this data element.


Links from the Multimedia Type Table, ^mmt(“t”)For the Client-based Media Manager application, the following multimedia types are available for the generic insurance/payor multimedia data element:

Audio

Digital Medical Imaging

Scanned/Photographic Imaging

VideoFor the Server-based Image Manager application, the Scanned/Photographic Imaging multimedia type is available for the generic insurance/payor multimedia data element.

NOTE: Multimedia types for which the customer has no license are unavailable for selection in this subfield.



System Use Determines the type of multimedia object is being acquired/rendered

Determines the menus and toolbars that display in the client application

When this subfield is defined as Audio, causes the following additional subfields to display for definition:

Multimedia Server Type(s)Display FormatAdditional Object Data StringAdditional Generated Data String

When this subfield is defined as Digital Medical Imaging, causes the following additional subfields to display for definition:


When this Constants field is defined as Scanned/Photographic Imaging, causes the following additional subfields to display for definition:

Multimedia Server Type(s)Multimedia Catalogue Object(s)Display FormatAllow Annotation?Additional Object Data StringAdditional Generated Data String?

When this subfield is defined as Video, causes the following additional subfields to display for definition:


Impact ofChange


Multimedia Server Type(s)

Purpose Defines the server type (that is, groups of servers) that store documented multimedia objects. Multiple servers can be defined in order to balance the load when a large number of multimedia objects are stored for a facility. The order of servers in a server type group can be changed, or the order of the server types linked to a data element can be changed to provide load balancing among the available object servers in an enterprise.

Multimedia Type (Continued)



For example, different departments may want to have their own server, (for example, Registration: to store patient identification images-patient photographs, images of patient insurance cards; Nursing: to store images related to patient care; Cardio-pulmonary: to store EKGs, and so on).

This subfield displays only when the Multimedia Type subfield of this data element is defined as Audio, Digital Medical Imaging, Scanned/Photographic Imaging, Video.

Client-Based Media Manager application

For the current client level-based Media Manager application implementation, multiple servers are not supported for a single data element.

Server-Based Image Manager application

Server-based implementations are expected to support multiple servers for a single data element.


Single selection

Links from the Multimedia Server Type Table, ^mmt(“st”)

System Use Stores the object on a specific server based on the following order:

First Server Type (for example, Clinical Image Server)

First Server

Second Server

Third Server

Second Server Type (for example, Medical Image Server)

First Server

Second Server

Third Server

For example, a facility has two server types, Clinical Image Server and Medical Image Server. The System looks first to store the image on the first server type defined Clinical Image Server, and stores the image on the first server.

If the first server is unavailable, the System stores the image on the second server, and so on. If all the servers fail on the Clinical Image Server type, the System goes to the second server type defined, Medical Image Server, and continues searching the servers until it locates one that is available to store the image (that is, first server, second server, and so on).

Impact ofChange


Multimedia Server Type(s) (Continued)



Multimedia Catalogue Object(s)

Purpose Defines the multimedia catalogue object that can default into the client application for editing when this data element field is accessed.

One or more multimedia catalogue objects (that is, Scanned/Photographic Image) can be defaulted into a list of predefined objects (that is, images) that can be selected from within the client application.

Multiple pages can be defined for one image during the same documentation episode. This subfield displays only when the Multimedia Type subfield of this data element is defined as Scanned/Photographic Imaging.


Single selection

Links from the Multimedia Object Catalogue Table, ^mmt(“oc”)NOTE: In order for the object to render properly, the objects defined in this subfield must be of the same type (for example, Scanned/ Photographic Imaging) as defined in the Multimedia Definition Constants field, Multimedia Type subfield.

System Use Can display for the multimedia catalogue object defined in this field for editing or viewing when accessing the field created from this data element during insurance processing

When more than one object is defined, and the client application is in Capture/Edit Mode, the client defaults the object defined first when this data element field is accessed.

In the Image Manager, additional objects can be inserted or other predefined images/pages can be selected using the Image or Page drop-down menu of the Capture/Edit Client.

In the Media Manager, it is recommended to limit the number of catalog objects on one Multimedia data element.

Impact ofChange


Display Format

Purpose Defines the way in which multimedia insurance data displays on the insurance screen.


Text

Free-text


Thumbnail

Defaults to text: definedNOTE: The following multimedia types do not have the option to display as a thumbnail:

AudioDigital Medical ImagingVideo



NOTE: The number of lines defined in the Data Element Definition Screen, #Lines field of this data element determines the available height for display of a thumbnail on the insurance screen. The thumbnail is inserted, in correct aspect ratio, into the available space.

System Use Text – Determines the text that displays in the field created from this data element.

Thumbnail – Displays the thumbnail (that is, miniature image of the multimedia catalogue object) in the field created from this data element.

NOTE: When defining the insurance data to display as a thumbnail image, the user should be aware that a thumbnail display requires access to the object server to display the image. If the server or network is busy, delays or other display issues can be encountered.

Impact ofChange


Allow Annotation?

Purpose Defines whether annotation is available during insurance processing for the object type defined in the Multimedia Definition Constants field, Multimedia Type subfield. Images can be annotated while preserving the underlying, original data. This subfield displays only when the Multimedia Type subfield is defined as Scanned/Photographic Imaging.

Input Yes/No

Defaults to no

System Use Yes – Causes the following annotation functionality to be available in the client application:

Displays the Annotation menu options and Annotation Toolbar for the Image Manager

Displays the Display Annotation Toolbar icon and Annotation Toolbar for the Media Manager

Defining this field as yes causes the following additional subfields to display for definition:

Initial Annotation ToolMultimedia Rubber Stamp(s)

No – Does not allow an object to be annotated within the Capture/Edit Client.

Impact ofChange


Initial Annotation Tool

Purpose Defines the annotation tool that is pre-selected when the Image Manager client application is launched. This field displays only when the Allow Annotation? subfield of this data element is defined as yes.


None

Display Format (Continued)



Select annotation (pointer)

Freehand line (pen)

Highlighter

Straight line

Hollow rectangle

Filled rectangle

Text

Attach-a-note

Rubber stamp

Defaults to none

System Use Displays this annotation tool on the Annotation toolbar in the Image Manager Capture/Edit Client, as a pre-selected icon.

Displays this annotation tool on the Annotation toolbar in the Media Manager Capture/Edit Client.

NOTE: In the Media Manager client application, the initial annotation tool defined in this subfield does not display as a pre-selected icon.

Impact ofChange


Multimedia Rubber Stamp(s)

Purpose Defines the rubber stamp (that is, predefined text or symbols) that is available when the Capture/Edit client application is initiated. A rubber stamp (that is, patient identification number, date/time stamp, arrow, dot, and so on) can be placed on an image as an annotation. This field displays only when the Allow Annotation? subfield of this data element is defined as yes.


Single selection

Links from the Multimedia Rubber Stamp Table, ^mmt(“rs”)

System Use Displays the defined rubber stamp definition for selection when the Annotation toolbar, Rubber Stamp icon is accessed from the Capture/Edit client application.

Impact ofChange


Initial Annotation Tool (Continued)



Additional Object Data String

Purpose Image Manager Server-based application – Defines a user-defined data string that enables the System to configure the way an image within a third-party client application or an image server is handled.

Media Manager Client-based application – This subfield can define scanning operation control for the QuadraMed CPR Media Manager client application that overrides the definition of the Media Manager, File menu, Preferences menu point, TWAIN tab.

Input Free-text

NOTE: The exact format required for the values entered into this field is determined by QuadraMed.

Image Manager Server-based application – The functionality that can be achieved with this field is determined by the application-programming interface that is available for the specific image server or third-party client application.

Depending on the image server software at a given installation of the Image Manager or the Media Manager, this field may not be used at all. This field should be left blank, unless specified by QuadraMed.

Media Manager Client-based application – The scanning operation of the Media Manager client application is controlled by TWAIN settings.

The string defined in this subfield can be used by QuadraMed CPR to pass TWAIN settings to the new Media Manager client application.

The m_extradata string for the Media Manager client application takes the form: <parameter_name>=<value> and uses the ^ character to delimit the pairs.

The string can be prepared as in the following sample:

Image_byte_type=GRAY (8bit)

^x_resolution=120

^y_resolution=120

^select_TWAIN_source=true

^show_device_ui=false

System Use Image Manager Server-based application – Provides a means to pass parameters to an image server or a third-party image client. These parameters enable the System to configure the way an image within a third-party client application or an image server is handled.

Media Manager Client-based application – This subfield can override the following Preferences defined in the Media Manager client application, File menu, Preference menu point:

Image byte type

Default resolutions (that is, horizontal and vertical resolution (dpi))



TWAIN source (that is, the image acquisition device used if the Media Manager client application is not used for image acquisition)

Whether or not the image acquisition device’s user interface displays for configuration to the user

Impact ofChange


Additional Generated Data String

Purpose Defines the means for a healthcare facility to pass non-object data (that is, employee ID, and so on) to a third-party imaging client, if necessary. This subfield displays only when the Multimedia Type Constants field of this data element is defined as Scanned/Photographic Imaging. This subfield is not supported by the Media Manager application.

Input Report Definition

This subfield should be defined with a report using the Report Formatter Hook Table, ârfh, MM Additional Data hook

Links from the Hierarchical Filing Structure (HFS)NOTE: The functionality that can be achieved with this field is determined by the application-programming interface that is available for the specific image server or third-party client application. Depending on the image server software at a given installation of the Image Manager or Media Manager, this field may not be used at all. This field should be left blank, unless specified by QuadraMed.

System Use Provides a way for data not related to a multimedia object to be passed to the object server in a facility. For example, a facility can require data regarding the current user to be captured.

Information such as employee ID, facility ID, Visit ID, and event ID can be passed through the Report Formatter Hook Table, ârfh, MM Additional Data hook to a report through the use of this subfield. The data in the report is returned in similar name=value pairs and is concatenated onto the Additional Object Data string defined in the Additional Object Data String subfield and then passed to the third-party client or server.

Impact ofChange


Suppress Printing?

Purpose Defines whether an image collected in the field created from this data element and associated with a documented event is printed from the Chart Review Print routine.

NOTE: This subfield is used only in conjunction with the Media Manager client application. This functionality is not available in the Image Manager server-based application.

Input Yes/No

Defaults to no

Additional Object Data String (Continued)




System Use Yes – Indicates image collected in the field created from this data element and associated with a documented event are excluded from printing in the Chart Review Print routine.

No – Indicates all image collected in the field created from this data element and associated with a documented event are always printed in the Chart Review Print routine.

NOTE: This does not affect Report Formatter Dictionary Table, ârfd, screen driver reports and screen prints.

Impact ofChange


Image Print Size

Purpose Defines the size of the image that prints from the Chart Review Print routine.

NOTE: This subfield is used only in conjunction with the Media Manager client application. This functionality is not available in the Image Manager server-based application.

Input Integer representing percentage (1-100% Limit) (Defaults to 100%)

System Use Displays the image on the page according to the size defined in this subfield.

NOTE: The image should be defined to allow room for the header (event information) to display.

Impact ofChange


FIELD DESCRIPTION

Edit Security Expr Defines an expression that determines whether the data element field can be edited by the user. This security check is in addition to any hard-coded checks in the data element.

Display Security Expr Defines an expression that determines whether the data element field can be accessed on the screen driver on the user side. This security check is in addition to any hard-coded display checks in the data element.

Allowed Security Expr Defines an expression that determines whether data can be entered into the data element field, and whether previously defined data is cleared when data cannot be entered. When allowed security fails, the field cannot be accessed and the System clears any data defined in the field.

Required Expr Defines an expression that determines whether the data element field is required. This status is in addition to any hard-coded checks in the data element.

Suppress Printing? (Continued)




Chapter 41

Generic Name Data Element

OverviewThe Generic Name data element is used to create a field that allows a name to be entered during insurance processing. This data element is to be used only when the other data elements within the insurance/payor data dictionary do not apply.


Links TO other Tables FROM Generic Name data element:


Links FROM other Tables TO Generic Name data element:


Variations The Generic Name data element consists of the following variations:

Name Without Suffix – This variation does not display the Family Suffix Options during data entry. The following fields display for the Name Without Suffix variation when the Constants field is accessed:

Message ModifierLengthStorage ReferenceStandard – This variation displays the list of Family Suffix Options when the Generic Name is being defined. The following fields display for the Standard variation when the Constants field is accessed:

Message ModifierLengthStorage Reference




DescriptionOnce a field that has been created from the Generic Name data element is accessed, the System prompts for a name to be entered. The name must be entered in the standard name format (that is, Last, First M). Depending on the variation selected, after the name is entered, the System can display a list of Family Suffix Options and prompt for one to be selected. Family Suffix Options are defined in the Family Suffix Table, ^rt("fs").



Adding a new visit



Converting a visit




Message Modifier


Input Free-text


Required


Impact ofChange


Chapter 41 Generic Name Data Element


Length


Input Integer



Impact ofChange


Storage Reference




Required

System Use Determines where the name defined in this data element field is stored.

Impact ofChange





Chapter 42

Generic Other Facility Data Element

OverviewThe Generic Other Facility data element is used to create a field that allows an other facility to be defined during insurance processing. This data element is to be used only when the other data elements within the insurance/payor data dictionary do not apply.


Links TO other Tables FROM the Generic Other Facility data element:


Links FROM other Tables TO the Generic Other Facility data element:

Address Collection Driver Table, ^rt("ad")Generic Insurance/Payor Data Element Table, ^rt("gi")

Required Status The required status for this data element is database-defined in the Insurance/Payor Profile Table, ̂ rt("ipp"), Data Element Definition Screen, Required? field, as well as in the Required Expr Expressions field.


Variations The Generic Other Facility data element consists of the following variations:

Address – This variation displays the name, address, and telephone number of the other facility in the data element field, provided the information is defined in the Other Facility Table, ^rt("of"), and the data element field is defined with enough lines to display this information. When a free-text generic other facility is entered, this variation prompts for a telephone number to be entered or to choose none and then for an address to be defined.

The following fields display for the Address variation when the Constants field is accessed:

Message ModifierStorage Reference



DescriptionOnce a field that has been created from the Generic Other Facility data element is accessed, the System, depending on how the Use Partial Name Match? Constants field of this data element is defined, can prompt for a partial name to be entered or automatically display the list of Other Facility Options. An other facility can be selected or entered as free-text. Other Facility Options are defined in the Other Facility Table, ^rt("of").

When a free-text generic other facility is entered, the System, depending on the variation selected, can prompt to enter a telephone number, or to choose none. The System accepts standard telephone formats. Once a telephone number is entered, or the none option is chosen, the System displays an Address Collection Screen. The screen that displays is defined in the Address Collection Screen Constants field of this data element.



Adding a new visit



Converting a visit



Address Collection ScreenUse Partial Name Match?No Address – This variation displays only the other facility name. The following fields display for the No Address variation when the Constants field is accessed:

Message ModifierStorage ReferenceUse Partial Name Match?





Message Modifier


Input Free-text


Required


Impact ofChange


Storage Reference




Required

System Use Stores the other facility defined in this data element field in the specified location.

Impact ofChange



Purpose Defines the Address Collection Screen that displays to collect the address on the user's side when a free-text other facility is being defined.

This field displays for definition only when the Address variation is defined.






System Use Displays this Address Collection Screen when a free-text other facility is being defined.

The Address Collection Screen displays for definition after the telephone number of the free-text other facility is defined.



Impact ofChange


Use Partial Name Match?

Purpose Defines whether a partial name match is allowed when defining the other facility.

Input Yes/No

Defaults to no

System Use Yes – Indicates the System prompts for a partial name to be entered when this data element field is selected during insurance processing.

No – Indicates a partial name is not accepted as input when defining the other facility.

Impact ofChange


FIELD DESCRIPTION

Default Expr Defines an expression that determines a predefined value entered into the data element field.

Edit Security Expr Defines an expression that determines whether the data element field can be edited by the user.

Display Security Expr Defines an expression that determines whether the data element field can be accessed on the screen driver on the user's side. When display security fails, the selection number and data for the field are starred out.

Address Collection Screen (Continued)



Allowed Security Expr Defines an expression that determines whether data can be entered into the data element field. When allowed security fails, the field cannot be accessed and the System clears any defined data in the field.

Required Expr Defines an expression that determines whether the data element field is required.

FIELD DESCRIPTION




Chapter 43

Generic Selection Screen/Tree Data Element

OverviewThe Generic Selection Screen/Tree data element is used to create a field that accesses a specific selection screen/tree. Selection screens/trees are defined in the Selection Screen/Tree Table, ^nts. This data element is to be used only when the other data elements within the insurance/payor data dictionary do not apply.


DescriptionOnce a field that has been created from the Generic Selection Screen/Tree data element is accessed, the System displays the selection screen or tree defined in the Screen Type/Name Constants field and prompts for an option to be selected.


Links TO other Tables FROM Generic Selection Screen/Tree data element:


Links FROM other Tables TO Generic Selection Screen/Tree data element:

Generic Insurance/Payor Data Element Table, ^rt("gi")Selection Screen/Tree Table, ^nts

Variations None






Adding a new visit



Converting a visit




Message Modifier


Input Free-text


Required


Impact ofChange


Screen Type/Name

Purpose Defines whether the list that displays for selection is a screen or tree, and links a selection screen/tree to this data element.

Input (S) Select screen

(T) Tree

Chapter 43 Generic Selection Screen/Tree Data Element


Partial name match

Single selection

Links from the Selection Screen/Tree Table, ^nts, Result Entry/Assessment subfile

Required

System Use (S) Select screen – Displays the defined selection screen when this data element field is selected.

(T) Tree – Displays the defined selection tree when the data element field is selected.

Impact ofChange


Window Preference

Purpose Defines the amount of screen space allotted to display the selected list.

Input Integer

(E) Entire screen

Defaults to entire screen

System Use Clears the number of lines specified to display the defined list. Lines are counted from the first line above the screen bottom.

The space cleared for displaying the list is the space allotted for the message screen itself. The window size should be large enough to display a significant portion of the list, but small enough to minimize the amount of the message screen cleared to display the list.

(E) Entire screen – Clears the entire screen.

Impact ofChange


Multi-Select?

Purpose Defines whether multiple list items can be selected.

Input Yes/No

Defaults to no

Screen Type/Name (Continued)



System Use Yes – Indicates that multiple items, separated by commas, can be selected. When free-text is enabled, the System accepts multiple free-text entries. By convention, when multiple selection is allowed, the descriptor on the transaction line should be suffixed with (s). Free-text is enabled in the Allow Free-Text? Constants field.

No – Indicates only one item can be selected or one free-text entry can be entered.

Impact ofChange


Allow Free-Text?

Purpose Defines whether free-text is allowed in addition to, or in place of, a selection from the list.

Input Yes/No

Defaults to no

System Use Yes – Indicates free-text is allowed in addition to, or in place of, a selection from the list. By convention, when free-text is enable, the message modifier should be suffixed with the phrase or Enter free-text.

No – Indicates a free-text entry is not allowed. The System displays an invalid format error when free-text data is entered.

Impact ofChange


Storage Reference




Required

System Use Determines where an option selected from the selection screen/tree data is stored.

Impact ofChange


Multi-Select? (Continued)


Chapter 44

Generic Table Selection Data Element

OverviewThe Generic Table Selection data element is used to support data entry during insurance processing by the selection of one or more items from a generic table. Generic tables are defined in the Generic Table Table, ^ntt. This data element is to be used only when the other data elements within the insurance/payor data dictionary do not apply.


DescriptionOnce a field that has been created from the Generic Table Selection data element is accessed, the System displays a list of options. The options that display are defined for the selection table defined in the Selection Table Constants field of this data element and linked to the group defined in the Selection Group Constants field of this data element.


Links TO other Tables FROM the Generic Table Selection data element:


Links FROM other Tables TO the Generic Table Selection data element:

Generic Insurance/Payor Data Element Table, ^rt("gi")Generic Table Table, ^ntt


NOTE: When both the Required? field and a required expression are defined, the System Uses the most restrictive required status.

Variations None




Selection tables are defined in the Generic Table Table, ^ntt. A group is defined for an option in the Generic Table Table, ^ntt, Data Elements subfile, Group List field. When the defined table has multiple options, the System displays an expand icon at the bottom of the screen, indicating the EXPD key can be pressed to display all the Data Element Options defined for the selection table, regardless of group.

An option can be selected from either list. When the Allow Partial Name? Constants field of this data element is defined as yes, a partial name or lookup name can also be entered. Lookup names are defined for an option in the Generic Table Table, ^ntt, Data Elements subfile, Lookup Name(s) field. Entries are evaluated by the System as follows:

When the user enters a number, the System attempts to match the entered number with a selection option. When a match is found, the selection's internal code is stored in the System and the corresponding option name displays in the field. When a selection match is not found, the System attempts to match the number with a lookup name, then a partial name. When all checks fail, the System displays an error message.

When the user enters an alphabetic/numeric combination, the System attempts to match a lookup name or partial name, or store the entry as free-text, in that order. An entry is stored as free-text only when the Allow Free-Text? Constants field of this data element is defined as yes.

When the Multi-Select? Constants field of this data element is defined as yes, the System allows multiple entries to be entered/selected. Each entry is evaluated as described above. The System stores either the internal code (when a selection, lookup name, or partial name match is found), or free-text (when no match is found), then processes the next entry.



Adding a new visit



Converting a visit



A numeric entry cannot be interpreted as free-text. Since the System stores the data by internal code, it cannot differentiate between a free-text entry of 10 and an internal code of 10. However, free-text entries can contain numbers, provided one character is non-numeric.




Message Modifier


Input Free-text


Required


Impact ofChange


Selection Table

Purpose Defines the table associated with this data element.


Links from the Generic Table Table, ^ntt

Required

System Use Displays the Data Element Options defined for this table when the field created from this data element is accessed during insurance processing. When no data elements are defined for the linked table, the System displays a No options currently defined! message when the field created from this data element is accessed.

When this field is defined, the System displays the Selection Group Constants field for definition.

Impact ofChange


Selection Group

Purpose Defines the group that determines the data elements that display when the field created from this data element is accessed. This field displays only when the Selection Table Constants field is defined.


Links from the Group Options defined for the selection table defined in the Selection Table Constants field.



Group Options are defined for a selection table in the Generic Table Table, ^ntt, Group Codes subfile.

System Use Determines the data elements that display when the field created from this data element is accessed. The System displays only those data elements defined for the selection table that are linked to this group. A group is defined for the data element in the Generic Table Table, ^ntt, Data Elements subfile, Group List field.

Impact ofChange


Window Preference

Purpose Defines the amount of screen space allotted to display the list of options.

Input Integer

(E) Entire screen

Defaults to entire screen

System Use Displays the list of options in a window the number of lines defined in this field. Lines are counted from the first line above the screen bottom.

The optimal window size is the smallest window that properly displays the list on one screen. However, if the list must be displayed on more than one screen, the window size should be large enough to display a significant portion of the list, but small enough to minimize the message screen cleared to display the list.

(E) Entire screen – Uses the entire screen to display the list. The entire screen is equivalent to a window size of 17 lines.

Impact ofChange


Multi-Select?

Purpose Defines whether multiple options can be selected from the list.

Input Yes/No

Defaults to no

System Use Yes – Allows multiple options to be selected. Each option must be separated by a comma (Example: 1,2). When multiple selections are allowed, the System appends the message modifier with an (s) (Example: Select option(s)).

No – Allows only one option to be selected.

Selection Group (Continued)



Impact ofChange


Allow Free-Text?

Purpose Defines whether free-text data is allowed in addition to, or in place of, a selection from the table.

Input Yes/No

Defaults to no

System Use Yes – Allows free-text data to be entered in addition to or in place of selecting an option from the list. When free-text data is allowed, the System adds a free-text processing option to the transaction line that displays with the list of options.

No – Indicates free-text is not allowed. The System allows only an option to be selected or a partial name or lookup name to be entered.

Impact ofChange


Allow Partial Name?

Purpose Defines whether an option can be identified by a partial name or lookup name.

Input Yes/No

Defaults to no

System Use Yes – Allows an option to be identified by a partial name or lookup name. Lookup names are defined for a data element option in the Generic Table Table, ^ntt, Data Elements subfile, Lookup Name(s) field.

Defining this field as yes causes the System to add a partial name processing option to the transaction line that displays with the list of options.

No – Indicates an option can be identified only by selecting an option from the list or, when the Allow Free-Text? Constants field is defined as yes, by entering free-text.

Impact ofChange


Multi-Select? (Continued)




Storage Reference

Purpose Defines the location in which the information defined in this data element is stored. For a complete description of storage locations, see Chapter 16, Generic Insurance/Payor Data Element Table, ^rt(“gi”) in the Registration/Visit Tables Reference.



Required

System Use Determines where the option selected in the field created from this data element is stored.

Impact ofChange


FIELD DESCRIPTION







Chapter 45

Generic Telephone Data Element

OverviewThe Generic Telephone data element is used to create a field that allows a telephone number to be entered during insurance processing. This data element is to be used only when the other data elements within the insurance/payor data dictionary do not apply.


DescriptionOnce a field that has been created from the Generic Telephone data element is accessed, the System prompts for a telephone number to be entered. QuadraMed CPR accepts standard telephone formats. The System can copy forward generic insurance data from a previous visit into the current visit when the following conditions are met:


Adding a new visit



Converting a visit


Links TO other Tables FROM Generic Telephone data element:


Links FROM other Tables TO Generic Telephone data element:


Variations None







Message Modifier


Input Free-text


Required


Impact ofChange


Storage Reference




Required

System Use Determines where the telephone number defined in this data element field is stored.

Impact ofChange



Chapter 46

Group Number Data Element

OverviewThe Group Number data element is used to create a field that collects the subscriber's group number. The group number is the identification number of the group.


Links TO other Tables FROM Group Number data element:


Links FROM other Tables TO Group Number data element:

None

Variations The Group Number data element consists of the following variations:


Message ModifierDisplay TypeDisplay Format(s)Display Maximum LengthLengthVerification ExpressionNo Expand – When the Display Type Constants field is defined as format, displays the format defined in the Display Format(s) Constants field. Though multiple formats can be defined, only one entry is allowed per data element field.



DescriptionOnce a field that has been created from the Group Number data element is accessed, the System prompts for data to be entered. Once data has been entered, the System checks the entered data against the defined format. When the entered format is invalid, the System displays an error message.


The following fields can display for the No Expand variation:



The System defaults the information into this data element field from the Insurance/Payor Table, ^rt("ip"), Employer Definitions subfile, Group Number level, Insurance Group field, only when the insurance is defined through the Choose employer(E) processing option.

Message Modifier


Input Free-text


Required


Impact ofChange


Chapter 46 Group Number Data Element


Display Type


Input (F) Format

(L) Length

Defaults to format

System Use (F) Format – Displays the format defined in the Display Format(s) field when the data element is accessed.

Displays the following additional fields for definition:



Impact ofChange


Display Format(s)









Displays the format, when defined, in the Insurance/Payor Table, ^rt("ip"), Employer Definitions subfile, Group Number level, Insurance Group field.

Impact ofChange






Input Yes/No

Defaults to no



Impact ofChange

Changes are not reflected on the users side until the screen containing this data element is rebuilt.

Length


Input Integer



Impact ofChange







Impact ofChange

Changes are not reflected on the users side until the screen containing this data element is rebuilt.


Chapter 47

Insurance Verified Data Element

OverviewThe Insurance Verified data element is used to create a field that allows documentation of whether a patient's insurance is accepted or rejected during the insurance verification process.


Links TO other Tables FROM Insurance Verified data element:


Links FROM other Tables TO Insurance Verified data element:


Variations The Insurance Verified data element consists of the following variations:

Choose – This variation indicates to the System that the Insurance Verified Options display in the transaction line defined in the Prompt Constants field. The following fields display for the Choose variation when the Constants field is accessed:

PromptFace SheetValuesScreen – This variation indicates to the System that the Insurance Verified Options display as a selection screen. The following fields display for the Screen variation when the Constants field is accessed:





DescriptionOnce a field that has been created from an Insurance Verified data element is accessed, the System displays verification options and prompts for one to be chosen or selected. Until the verification status is defined, the System defaults to not verified.


Prompt





Choose not verified(N), accepted(A) or rejected(R)

System Use Displays this transaction line when a field created from this data element is accessed during insurance processing.

Impact ofChange


Face Sheet



Single selection



N Not verified not verified

A Accepted verification accepted

R Rejected verification rejected

Chapter 47 Insurance Verified Data Element



Impact ofChange


Values


Input Value – Defines an allowable choice. Only one alphabetic character can be entered, and each value must have a unique letter. The System automatically capitalizes lower-case letters.

Display Text – Defines the text associated with the defined value. This is a free-text entry.


Required

System Use When a value is chosen from the transaction line, the System displays the information defined as the display text for that value.

Impact ofChange


Message Modifier


Input Free-text


Required


Impact ofChange


Face Sheet (Continued)



Display Text




(M) Move

System Use When a field created from the Insurance Verified data element is accessed, the System displays the defined display text on the selection screen.

(M) Move – Allows the order of the display text to be changed. This modified order is reflected in the selection screen that displays to the user.

Impact ofChange



Chapter 48

Military Base Data Element

OverviewThe Military Base data element is used to create an insurance field that defines the military base to which the patient is stationed.


DescriptionOnce a field that has been created from the Military Base data element is accessed, the System displays a list of Military Base Options and prompts for one to be selected, or for free-text to be entered. Military Base Options are defined in the Military Base Table, ^rt("mib").


Links TO other Tables FROM Military Base data element:


Links FROM other Tables TO Military Base data element:

None

Variations None





Message Modifier


Input Free-text


Required


Impact ofChange


Length


Input Integer



Impact ofChange



Chapter 49

Military Branch of Service Data Element

OverviewThe Military Branch of Service data element is used to create an insurance field that defines the military branch of service to which the patient is enlisted.


DescriptionOnce a field that has been created from the Military Branch of Service data element is accessed, the System displays a list of Military Branch of Service Options and prompts for one to be selected. Military Branch of Service Options are defined in the Military Branch of Service Table, ^rt("mit").


Links TO other Tables FROM Military Branch of Service data element:


Links FROM other Tables TO Military Branch of Service data element:

None

Variations None





Message Modifier


Input Free-text


Required


Impact ofChange



Chapter 50

Military Rank Data Element

OverviewThe Military Rank data element is used to create an insurance field that defines the military rank of the patient.


DescriptionOnce a field that has been created from the Military Rank data element is accessed, the System displays a list of Military Rank Options and prompts for one to be selected, or for free-text to be entered. Military Rank Options are defined in the Military Rank Table, ^rt("mir").


Links TO other Tables FROM Military Rank data element:


Links FROM other Tables TO Military Rank data element:

None

Variations None





Message Modifier


Input Free-text


Required


Impact ofChange


Length


Input Integer



Impact ofChange



Chapter 51

Military Reason Data Element

OverviewThe Military Reason data element is used to create an insurance field that defines the reason a non-military hospital was selected for the patient's admission.


DescriptionOnce a field that has been created from the Military Reason data element is accessed, the System displays a list of Military Reason Options and prompts for one to be selected, or for free-text to be entered. Military Reason Options are defined in the Military Reason Table, ^rt("mie").


Links TO other Tables FROM Military Reason data element:


Links FROM other Tables TO Military Reason data element:

None

Variations None





Message Modifier


Input Free-text


Required


Impact ofChange



Chapter 52

Military Status Data Element

OverviewThe Military Status data element is used to create an insurance field that defines the military status of the patient.


DescriptionOnce a field that has been created from the Military Status data element is accessed, the System displays a list of Military Status Options and prompts for one to be selected. Military Status Options are defined in the Military Status Table, ^rt("mis").


Links TO other Tables FROM Military Status data element:


Links FROM other Tables TO Military Status data element:

None

Variations None





Message Modifier


Input Free-text


Required


Impact ofChange



Chapter 53

Other Facility Data Element

OverviewThe Other Facility data element is used to create an insurance field that defines another facility, not on the QuadraMed CPR System, to/from which patients can be transferred.


DescriptionOnce a field that has been created from the Other Facility data element is accessed, the System, depending on the variation selected, displays a list of Other Facility Options and prompts for one to be selected, or for free-text to be entered. Other Facility Options are defined in the Other Facility Table, ^rt("of").


Links TO other Tables FROM Other Facility data element:


Links FROM other Tables TO Other Facility data element:

None

Variations The Other Facility data element consists of the following variations:

Allow Free-Text – This variation causes the or Enter free-text option to be added to the transaction line. The following field displays for the Allow Free-Text variation when the Constants field is accessed:

Message ModifierStandard – This variation does not allow free-text to be entered. The following field displays for the Standard variation when the Constants field is accessed:

Message Modifier





Message Modifier


Input Free-text


Required


Impact ofChange



Chapter 54

Other Facility Stay End Date Data Element

OverviewThe Other Facility Stay End Date data element is used to create a field that defines the date the patient's visit ended at another facility.


DescriptionOnce a field that has been created from the Other Facility Stay End Date data element is accessed, the System prompts for a date to be entered. This data element is starred out ( ), making it inaccessible, until the Other Facility data element is defined. The System accepts the following date formats:





Links TO other Tables FROM Other Facility Stay End Date data element:


Links FROM other Tables TO Other Facility Stay End Date data element:

None

Variations None







Acceptable date formats are determined by the System Parameter Table, ^%z, General Parameters level, Date Parsing field.

Depending on the Date Parsing Option selected, the System accepts the date in the following formats:

U.S.A.


mm-dd-yy

mm/dd/yy

dd mmm yy

dd mmm yyyy


mm/yy

mm-yy

mmm yyyy

The year can be defined as yyyy

When a month is defined in a three character format (i.e., mmm), the input is alphabetic characters. When the month is defined in a two character format (i.e., mm), the input is numeric.



Chapter 54 Other Facility Stay End Date Data Element



Message Modifier


Input Free-text


Required


Impact ofChange


Days In Past


Input Integer





Impact ofChange


Days In Future


Input Integer







Impact ofChange




Chapter 55

Other Facility Stay Start Date Data Element

OverviewThe Other Facility Stay Start Date data element is used to create a field that defines the date the patient's visit began at another facility.


DescriptionOnce a field that has been created from the Other Facility Stay Start Date data element is accessed, the System prompts for a date to be entered. This data element is starred out ( ** ), making it inaccessible, until the Other Facility data element is defined. The System accepts the following date formats:





Links TO other Tables FROM Other Facility Stay End Date data element:


Links FROM other Tables TO Other Facility Stay End Date data element:

None

Variations None








U.S.A.


mm-dd-yy

mm/dd/yy

dd mmm yy

dd mmm yyyy


mm/yy

mm-yy

mmm yyyy

The year can be defined as yyyy




Chapter 55 Other Facility Stay Start Date Data Element



Message Modifier


Input Free-text


Required


Impact ofChange


Days In Past


Input Integer





Impact ofChange


Days In Future


Input Integer







Impact ofChange




Chapter 56

Payor Number Data Element

OverviewThe Payor Number data element is used to create an insurance field that defines the code number of the insurance. The payor number is used by financial systems to identify and report insurance/payors. Financial systems typically identify the insurance/payor by payor number/code instead of by name.


Links TO other Tables FROM the Payor Number data element:


Links FROM other Tables TO the Payor Number data element:

None



Variations The Payor Number data element consists of the following variations:

Display Only – This variation indicates the payor number displays for informational purposes only and cannot be edited. There are no constants for this variation.

Standard – This variation allows the payor number to be edited. The following field displays for the Standard variation when the Constants field is accessed:

Message Modifier




DescriptionOnce a field that has been created from the Payor Number data element is accessed, the System, depending on the variation selected, can display a list of Payor Number Options and prompt for one to be selected. Payor Number Options are defined in the Insurance/Payor Table, ^rt("ip"), Facility Definitions subfile, Miscellaneous level, Visit Specific Data field, Payor Number(s) subfield. When only one payor number is defined in the Payor Number(s) subfield, the System defaults that number into the field created from this data element. When more than one payor number is defined, the System displays a list of Payor Number Options and prompts for one to be selected.



Message Modifier


Input Free-text


Required


Impact ofChange


FIELD DESCRIPTION




Chapter 56 Payor Number Data Element




Edit Check Exprs Defines an ordered list of expressions that determine whether the data entered into the data element field is valid.

FIELD DESCRIPTION




Chapter 57

Plan Number Data Element

OverviewThe Plan Number data element is used to define the patient's plan number. The plan number is associated with the plan of benefits provided by the insurance company.


Links TO other Tables FROM Plan Number data element:


Links FROM other Tables TO Plan Number data element:

None

Variations The Plan Number data element consists of the following variations:

Expand – When the Display Type Constants field is defined as format, displays an expand icon at the bottom of the screen. Pressing the EXPD key causes the System to display the format defined in the Display Format(s) Constants field. Though multiple formats can be defined, only one entry is allowed per data element field. The following fields can display for the Expand variation when the Constants field is accessed:

Message ModifierDisplay TypeDisplay Format(s)LengthDisplay Maximum LengthVerification Expression



DescriptionOnce a field that has been created from the Plan Number data element is accessed, the System, depending on the variation selected, either prompts for data to be entered or an option to be selected.


No Expand – When the Display Type Constants field is defined as format, displays the format defined in Display Format(s) Constants field. Though multiple formats can be defined, only one entry is allowed per data element field. The following fields can display for the No Expand variation when the Constants field is accessed:



The System defaults the information into this data element field from the Insurance/Payor Table, ^rt("ip"), Employer Definitions subfile, Group Number level, Insurance Plan Number field, only when the insurance is defined through the Choose employer(E) processing option.

Message Modifier


Input Free-text


Required


Impact ofChange


Chapter 57 Plan Number Data Element


Display Type


Input (F) Format

(L) Length

Defaults to format

System Use (F) Format – Displays the format defined in the Display Format(s) Constants field when the data element is accessed. Displays the following additional fields for definition:



Impact ofChange


Display Format(s)



When adding or editing a format, the following information can be entered:






Impact ofChange


Length


Input Integer





Impact ofChange



Purpose Defines whether the maximum length of the entry displays.

Input Yes/No

Defaults to no



Impact ofChange




Input ULTIMUMPS™ code/operations (that is, !,|,$s)

For a complete description of ULTIMUMPS™ expressions, see Chapter 5, Calculations/Expressions in the Introduction to CPR Tables.


System Use Evaluates/performs the defined expression. When the expression returns a false value, the number was entered into the System incorrectly and an error message displays.

Impact ofChange


Length (Continued)


Chapter 58

Pre-Auth Data Element

OverviewThe Pre-Auth data element is used to create a field that defines the type of pre-authorization, if any, that is required.


DescriptionOnce a field that has been created from the Pre-Auth data element is accessed, the System, depending on the variation selected, either prompts for a status to be chosen or displays a list of options and prompts for one to be selected. The Pre-Authorization Options that display for selection are hard-coded.


Links TO other Tables FROM Pre-Auth data element:


Links FROM other Tables TO Pre-Auth data element:

None

Variations The Pre-Auth data element consists of the following variations:

Choose – This variation indicates to the System that the options display in the transaction line. The following field displays for the Choose variation when the Constants field is accessed:Message ModifierScreen – This variation indicates to the System that the options display as a selection screen. The following field displays for the Screen variation when the Constants field is accessed:

Message Modifier





Message Modifier


Input Free-text


Required


Impact ofChange



Chapter 59

Pre-Auth Number Data Element

OverviewThe Pre-Auth Number data element is used to define an insurance field that collects the number supplied by the patient's insurance company to confirm the pre-authorization.


Links TO other Tables FROM Pre-Auth Number data element:


Links FROM other Tables TO Pre-Auth Number data element:

None

Variations The Pre-Auth Number data element consists of the following variations:

Expand – When the Display Type Constants field is defined as format, displays an expand icon at the bottom of the screen. Pressing the EXPD key causes the System to display the format defined in the Display Format(s) Constants field. Though multiple formats can be defined, only one entry is allowed per data element field. The following fields can display for the Expand variation when the Constants field is accessed:




DescriptionOnce a field that has been created from the Pre-Auth Number data element is accessed, the System prompts for data to be entered.


No Expand – When the Display Type Constants field is defined as format, displays the format defined in the Display Format(s) Constants field. Though multiple formats can be defined, only one entry is allowed per data element field.

The following fields can display for the No Expand variation when the Constants field is accessed:



Message Modifier


Input Free-text


Required


Impact ofChange


Chapter 59 Pre-Auth Number Data Element


Display Type


Input (F) Format

(L) Length

Defaults to format

System Use (F) Format – Displays the format defined in the Display Format(s) Constants field when the data element is accessed. Displays the following additional fields for definition:



Impact ofChange


Display Format(s)









Impact ofChange


Length


Input Integer





Impact ofChange




Input Yes/No

Defaults to no



Impact ofChange




Input ULTIMUMPS code/operations (that is, !,|,$s)

For a complete description of ULTIMUMPS expressions, see Chapter 5, Calculations/Expressions in the Introduction to CPR Tables.


System Use Evaluates/performs the defined expression. When the expression returns a false value, the number was entered into the System incorrectly and an error message displays.

Impact ofChange


Length (Continued)


Chapter 60

Pre-Auth Second Opinion Flag Data Element

OverviewThe Pre-Auth Second Opinion Flag data element is used to create a field that defines whether the insurance company requires a second opinion before authorizing the patient's visit.


Links TO other Tables FROM Pre-Auth Second Opinion Flag data element:


Links FROM other Tables TO Pre-Auth Second Opinion Flag data element:


Variations The Pre-Auth Second Opinion Flag data element consists of the following variations:


PromptFace SheetValuesScreen – This variation indicates to the System that the options display as a selection screen. The following fields display for the Screen variation when the Constants field is accessed:





DescriptionOnce a field that has been created from the Pre-Auth Second Opinion Flag data element is accessed, the System, depending on the variation selected, either prompts for a status to be chosen or displays a list of options and prompts for one to be selected.


Prompt





Choose no second opinion(N) or second opinion(Y)


Impact ofChange


Face Sheet



Single selection



Impact ofChange



N No no second opinion

Y Yes second opinion

Chapter 60 Pre-Auth Second Opinion Flag Data Element


Values





Required


Impact ofChange


Message Modifier


Input Free-text


Required


Impact ofChange


Display Text




(M) Move

Required





Impact ofChange




Chapter 61

Proration Plan Number Data Element

OverviewThe Proration Plan Number data element is used to create an insurance field that defines the patient's proration plan number. A proration plan number is used by financial systems to identify the benefit plans associated with a third party payor.


Links TO other Tables FROM Proration Plan Number data element:


Links FROM other Tables TO Proration Plan Number data element:

None

Variations The Proration Plan Number data element consists of the following variations:

Expand – When the Display Type Constants field of this data element is defined as format, the System displays an expand icon at the bottom of the screen. Pressing the EXPD key causes the System to display the format defined in the Display Format(s) Constants field of this data element. Though multiple formats can be defined, only one entry is allowed per data element field. The following fields can display for the Expand variation when the Constants field is accessed:




DescriptionOnce a field that has been created from the Proration Plan Number data element is accessed, the System, depending on the variation selected, either prompts for data to be entered or an option to be selected.

No Expand – When the Display Type Constants field is defined as format, the System displays the format defined in the Display Format(s) Constants field. Though multiple formats can be defined, only one entry is allowed per data element field.


Message ModifierDisplay TypeDisplay Format(s)Display Maximum LengthLengthVerification ExpressionRange – This variation indicates the entered number(s) must fall within a certain range. The number range is defined in the Low Range and High Range Constants fields.

The following fields display for the Range variation when the Constants field is accessed:

Message ModifierLow RangeHigh RangeSelected – This variation indicates the proration plan number is selected from a list of Proration Plan Number Options. Proration Plan Number Options are defined in the Proration Plan Number Table, ^rt("pp").The System displays the Proration Plan Number Options defined in the Insurance/Payor Table, ^rt("ip"), Insurance/Payor level, Proration Plan(s) field when the Proration Plan Number Table, ^rt("pp"), Visit Type(s) field is defined with the same visit type as the visit being processed.

When the Proration Plan(s) field is not defined, the System displays all Proration Plan Number Options that have the Proration Plan Number Table, ^rt("pp"), Visit Type(s) field defined with the same visit type as the visit being processed. The Message Modifier Constants field displays for the Selected variation when the Constants field is accessed.





Message Modifier


Input Free-text


Required


Impact ofChange


Display Type

Purpose Defines how data can be entered in the field created from this data element.

Input (F) Format

(L) Length

Defaults to format

System Use (F) Format – Displays the format defined in the Display Format(s) Constants field when the data element is accessed or when the EXPD key is pressed.

Displays the following additional fields for definition:


(L) Length – Displays the end of line symbol ( | ) at the end of the data element field to mark the maximum number of free-text characters that can be entered. Displays the Length field for definition.

Impact ofChange




Display Format(s)

Purpose Defines the valid format for entering information into the data element field.








Impact ofChange




Input Yes/No

Defaults to no



Impact ofChange


Length


Input Integer





Impact ofChange




Input ULTIMUMPS code/operations (Example: !,|,$s)

For a complete description of ULTIMUMPS expressions, see Chapter 5, Calculations/Expressions in the Introduction to CPR Tables.


System Use Evaluates the defined expression. When the expression returns a false value, the number was entered into the System incorrectly and an error message displays.

Impact ofChange


Low Range

Purpose Defines the lowest acceptable input value that can be entered into this data element field. This feature is designed to avoid keyed input errors.

Input Integer

Required

System Use Displays an error message when the number entered into the data element field is lower than the defined low range.

Impact ofChange


High Range

Purpose Defines the highest acceptable input value that can be entered into this data element field. This feature is designed to avoid keyed input errors.

Input Integer

Required

Length (Continued)



System Use Displays an error message when the number entered into this data element field is higher than the defined high range.

Impact ofChange


High Range (Continued)


Chapter 62

Release of Information Data Element

OverviewThe Release of Information data element is used to create a field that defines whether information regarding this patient can be released.


Links TO other Tables FROM Release of Information data element:


Links FROM other Tables TO Release of Information data element:


Variations The Release of Information data element consists of the following variations:







DescriptionOnce a field that has been created from the Release of Information data element is accessed, the System, depending on the variation selected, either prompts for a status to be chosen, or displays a list of options and prompts for one to be selected.


Prompt





Choose No release(N) or release(Y) of information


Impact ofChange


Face Sheet



Single selection



Impact ofChange



N N no release of information

Y Y release of information

Chapter 62 Release of Information Data Element


Values





Required


Impact ofChange


Message Modifier


Input Free-text


Required


Impact ofChange


Display Text




(M) Move

Required




(M) Move – Allows the order of the options to be changed.

Impact ofChange




Chapter 63

Require Verification Data Element

OverviewThe Require Verification data element is used to create a field that defines whether the insurance requires verification prior to treatment.


Links TO other Tables FROM Require Verification data element:


Links FROM other Tables TO Require Verification data element:


Variations The Require Verification data element consists of the following variations:







DescriptionOnce a field that has been created from the Require Verification data element is accessed, the System, depending on the variation selected, either prompts for a status to be chosen, or displays a list of options and prompts for one to be selected. The information that defaults into this data element field is a result of the require verification calculation.


Prompt





Choose not required(N) or required(Y)


Impact ofChange


Face Sheet



Single selection



Impact ofChange



N Not required do not require verification

Y Required require verification

Chapter 63 Require Verification Data Element


Values





Required


Impact ofChange


Message Modifier


Input Free-text


Required


Impact ofChange


Display Text




(M) Move

Required




(M) Move – Allows the order of the options to be changed.

Impact ofChange




Chapter 64

Review Agency Contact Person Data Element

OverviewThe Review Agency Contact Person data element is used to create an insurance field that allows the contact person of the review agency to be defined.


DescriptionOnce a field that has been created from the Review Agency Contact Person data element is accessed, the System prompts for a contact person to be identified. The System defaults the review agency contact person defined in the Insurance Review Agency Table, ^rt("ira"), Contact field. This option can be accepted or a free-text contact person can be defined.


Links TO other Tables FROM Review Agency Contact Person data element:


Links FROM other Tables TO Review Agency Contact Person data element:


Variations None


When a free-text contact person is defined, the System treats the field created from this data element as a free-text field. Therefore, if a new review agency is selected from the Insurance Review Agency Table, ^rt("ira"), for the Review Agency data element field, the System does not default the new contact person into this data element field unless this data element field is cleared prior to the selection of the new agency.




Message Modifier


Input Free-text


Required


Impact ofChange


Face Sheet



Single selection



Impact ofChange



Chapter 65

Review Agency Data Element

OverviewThe Review Agency data element is used to create an insurance field that allows a review agency to be defined. A review agency is an outside (that is, non-hospital) agency that is responsible for reviewing healthcare services that are provided to patients who are covered by Medicare or other third parties.


DescriptionOnce a field that has been created from the Review Agency data element is accessed, the System displays a list of Review Agency Options and prompts for one to be selected. The System defaults the review agency defined in the Insurance/Payor Table, ^rt("ip"), Review Agency field. This option can be accepted or another option can be selected. Review Agency Options are defined in the Insurance Review Agency Table, ^rt("ira").


Links TO other Tables FROM Review Agency data element:


Links FROM other Tables TO Review Agency data element:


Variations None





Message Modifier


Input Free-text


Required


Impact ofChange


Face Sheet



Single selection



Impact ofChange



Chapter 66

Secondary Numbers Data Element

OverviewThe Secondary Numbers data element is used to create a field that allows a secondary number to be entered during insurance processing. Secondary numbers associated with an insurance (Example: A Medicaid number) can be used in patient identification to identify a visit for processing.


Links TO other Tables FROM the Secondary Numbers data element:


Links FROM other Tables TO the Secondary Numbers data element:

Visit Secondary Number Table, ^rt("vsn")



Variations The Secondary Numbers data element consists of the following variations:

Multiple Types - Display Only – This variation is a display only variation (that is, it displays a previously created secondary number); it does not allow the assignment of a secondary number. When a secondary number does not exist (that is, has not been defined elsewhere in the System), the number does not display. The number must be assigned elsewhere in the System by a non-display only variation. This variation should be used when the secondary number type variation that assigns the secondary number is a multiple types variation. The following fields display for the Multiple Types - Display Only variation when the Constants field is accessed:

Message ModifierSecondary Number Type(s)



Multiple Types - Expand – This variation causes the System to prompt for the secondary number to be entered. Since this is an expand variation, an expand icon displays at the bottom of the screen. Pressing the EXPD key displays all possible formats. Format Options are defined in the Visit Secondary Number Table, ^rt("vsn"), Display Format(s) field. The following fields display for the Multiple Types - Expand variation when the Constants field is accessed:

Message ModifierSecondary Number Type(s)Allow Duplicate Secondary Number(s)?Allow Edit of Secondary Number(s)?Manual Number EntryMultiple Types - No Expand – This variation is the same as the Multiple Types - Expand variation, except the Format Options automatically display when the System prompts for the number(s) to be entered. The following fields display for the Multiple Types - No Expand variation when the Constants field is accessed:

Message ModifierSecondary Number Type(s)Allow Duplicate Secondary Number(s)?Allow Edit of Secondary Number(s)?Manual Number EntrySingle Type - Display Only – This variation is a display only variation. It is similar to the Multiple Types - Display Only variation, except that it displays only one number. This variation should be used when the secondary number type variation that assigns the secondary number is a single type variation. The following fields display for the Single Type - Display Only variation when the Constants field is accessed:

Message ModifierSecondary Number TypeSingle Type - Expand – This variation causes the System to prompt for the secondary number to be entered. Since this is an expand variation, an expand icon displays at the bottom of the screen. Pressing the EXPD key displays all the possible formats. Format Options are defined in the Visit Secondary Number Table, ^rt("vsn"), Display Format(s) field. The following fields display for the Single Type - Expand variation when the Constants field is accessed:

Message ModifierSecondary Number TypeAllow Duplicate Secondary Number(s)?Allow Edit of Secondary Number(s)?Manual Number EntrySingle Type - No Expand – This variation is the same as the Single Type - Expand variation, except that after the data element is selected, the System prompts for a number to be entered. The Format Options automatically display.



DescriptionOnce a field that has been created from the Secondary Numbers data element is accessed, the System, depending on the variation selected, either automatically displays the secondary number in the data element field or prompts for a number to be entered/selected. When the Multiple Types - No Expand or Single Type - No Expand variation is defined, the System automatically displays all the defined formats. When the Multiple Types - Expand or Single Type - Expand variation is defined, the EXPD key can be pressed to display the formats.

The Secondary Numbers data element can be defined to either display only (that is, not allow editing) or allow the assignment of the secondary number. A facility can define a single secondary number or multiple secondary numbers.


The following fields display for the Single Type - No Expand variation when the Constants field is accessed:

Message ModifierSecondary Number TypeAllow Duplicate Secondary Number(s)?Allow Edit of Secondary Number(s)?Manual Number Entry


Message Modifier


Input Free-text


Required


Impact ofChange




Secondary Number Type/Secondary Number Type(s)

Purpose Defines the secondary number types that is used for the secondary number.

Input For the Secondary Number Type field:

Single selection

Links from the Visit Secondary Number Table, ^rt("vsn")

For the Secondary Number Type(s) field:

Add/Delete Editor

Single selection

Links from the Visit Secondary Number Table, ^rt("vsn")NOTE: The Secondary Number Options that display for selection have the Visit Secondary Number Table, ^rt("vsn"), Auto Assign? field defined as noNOTE: The visit screen that is built with the Insurance/Payor data element used to access the Insurance/Payor Profile Table, ^rt("ipp"), Secondary Numbers data element must have the Secondary Numbers data element, Secondary Number Type(s) Constants field defined with a different secondary number type.

Required

System Use Determines which secondary number type is used for the secondary number.

Impact ofChange


Allow Duplicate Secondary Number(s)?

Purpose Defines whether duplicate secondary numbers are allowed.

Input Yes/No

Defaults to no

System Use Yes – Indicates duplicate secondary numbers are allowed. When duplicate numbers are allowed, and a duplicate number is entered, the System displays the visit with the matching secondary number and prompts to verify the use of the duplicate secondary number.

No – Indicates duplicate secondary numbers are not allowed.

Impact ofChange





Allow Edit of Secondary Number(s)?

Purpose Defines whether the secondary number can be edited after the number has been assigned.

Input Yes/No

Defaults to no

System Use Yes – Indicates the user can select and manually edit the secondary number during a visit edit.

No – Indicates the secondary number cannot be manually edited after assignment.

Impact ofChange


Manual Number Entry

Purpose Defines whether manual number entry is allowed.


At downtime only

Never allow manual entry

Always allow manual entry

Defaults to at downtime only

System Use At downtime only – Indicates manual number entry is allowed only when the System Parameter Table, ^%z, Reg/ADT System Parameters subfile, Facility-specific level, Miscellaneous Data Screen, Allow Recent Downtime Processing? field is defined as yes.

Never allow manual entry – Indicates manual number entry is not allowed.

Always allow manual entry – Indicates manual number entry is always allowed.

Impact ofChange


FIELD DESCRIPTION

Edit Security Expr Defines an expression that determines whether the data element field can be edited by the user. This Expr field displays only when the Expand or No Expand variation is used.




Required Expr Defines an expression that determines whether the data element field is required. This Expr field displays only when the Expand or No Expand variation is used.

FIELD DESCRIPTION


Chapter 67

Send Verification Data Element

OverviewThe Insurance/Payor Profile Table, ^rt(“ipp”), Send Verification data element is used in the following instances:

During the insurance verification process to support communication to a variety of third-party eligibility verification systems, including the ability to swipe a health card for real time insurance verification.

During visit processing, send verification data can be copied forward from the mother’s visit record to the newborn’s visit record.

During the visit insurance verification process to streamline the insurance validation process by retaining or clearing data based upon the individual visit process.

The Send Verification data element provides the ability to verify coverage real-time (electronically) by allowing the user to swipe a health card for insurance verification or perform manual verification by entering data. Insurance verification functionality is extended from inter-job communication (IJC) transactions performed during insurance verification processing to full validation/verification via an interface.

The use of the Send Verification data element provides a cost-effective and time-saving solution to insurance verification for the healthcare facility and patients. Customers can identify and clarify insurance issues before the patient services are rendered. Real time verification allows medical services to be rendered in a timely manner. This enhancement saves the time and expense of tracking patient services and reimbursement.

This requires customized interface work. Please contact Client Support for assistance.




DescriptionOnce the field created from the Send Verification data element is accessed, insurance verification processing is based on the definition of the Verification Start Method Constants field. The Send Verification data element provides the ability to verify coverage real-time (electronically) by allowing the user to swipe a health card for insurance verification or perform manual verification by entering data.

Manual VerificationThe System performs manual insurance verification when the Send Verification data element is accessed during insurance processing and the Verification Start Method Constants field is defined as manual. The System displays a Start Verification? message on the transaction line in the field created from this data element and prompts the user to answer yes or no. Clicking (Y) Yes initiates the interface defined in the Interface Constants field of this data element and starts the insurance verification process. Clicking (N) No stops the insurance verification process and returns the user to the insurance/payor profile screen for the defined insurance.

Card Reader VerificationThe System performs card reader insurance verification when the Send Verification data element is accessed during insurance processing, and the Verification Start Method Constants field is defined as card reader. The System prompts to scan the card or to choose to enter the information manually by clicking (M) Manual Override as shown below.


Links TO other Tables FROM the Send Verification data element:

Insurance/Payor Table, ^rt(“ip”)

Links FROM other Tables TO the Send Verification data element:

Facility Table, âffGeneric Insurance/Payor Data Element Table, ^rt(“gi”)Interface Table, âtiManagement Queue Table, ^rt(“qv”)



Variations None




Clicking Back stops the insurance verification process and returns the user to the insurance/payor screen. The manner in which the card reader performs is defined in the Card Reader Parameters Constants field.

Scan Insurance CardSwiping the insurance card in the card reader initiates the interface defined in the Interface Constants field of this data element.

Manual OverrideClicking (M) Manual Override as shown above from the Send Verification data element field prompts the user to enter data specified in the Card Reader Parameters Constants field, Card Capture Parameters subfield (Manual Start Parameters). The text defined for the transaction line prompt is defined in the Card Reader Parameters Constants field, Card Capture Parameters subfield, Message Modifier sub-subfield.



For example, the user can be prompted to enter the Health Card Number as shown below.

When each required field is completed and OK clicked or ENTER pressed, the entered data loads into the insurance record and the interface defined in the Interface Constants field is initiated.

Verification InterfaceOnce the interface is initiated, an interface processing message appears: Verification in progress.... The interface attempts to establish communication with the insurance vendor verification option defined for the current insurance/payor/facility in the Insurance/Payor Table, ^rt(“ip”), Facility Definitions Subfile, Insurance Verification Vendor field.

When communication is not established, the error message defined for the facility/insurance verification vendor in the Insurance Verification Vendor Table, ^rt(“ipv”), Transmission Error Message field displays.

When communication is established, interface messaging with the insurance verification vendor occurs until there is an error or the communication is completed. The interface obtains and sends the QuadraMed CPR data required by the insurance verification vendor and also receives the insurance verification status and/or other data from the insurance verification vendor.

When the interface communication is completed within the time frame specified in the Insurance Verification Vendor Table, ^rt(“ipv”), Facility Definitions Subfile, Seconds Delay Allowed field, the Verification Status Screen displays with the data to be filed and the user must click OK or press ENTER from that screen to update the information as shown below.



Clicking OK or pressing ENTER files the data on the Verification Status Screen and populates the appropriate fields on the insurance profile screen as shown below. When the add/edit visit transaction is accepted, this information is filed to the visit record.

Clicking the Back button from the Verification Status Screen backs the user out of the Send Verification data element, discards the verification and associated data, and returns the user to the insurance payor/profile screen.

When the interface communication is not completed within the time frame specified in the Insurance Verification Vendor Table, ^rt(“ipv”), Facility Definitions Subfile, Seconds Delay Allowed field, the System displays the text defined in the Timeout Message field.

The user must click OK and the user can continue editing the visit/insurance screen. The data entered to initiate verification is loaded to the visit/insurance fields until the visit is accepted. When the visit is accepted, the data is filed and the visit is routed for follow-up to the management queue defined in the Timeout Management Queue(s) Constants field.



Visit Insurance ProcessingThe Send Verification data element can be utilized during visit processing as follows:

The Newborn Admission menu function can be defined to determine whether Send Verification data is copied forward from the mother’s visit record to the newborn’s visit record.

When adding, editing, or converting a visit, the insurance validation process can be streamlined by retaining or clearing data based upon the individual visit process, ensuring the appropriate insurance verification is performed.

Streamlined Newborn AdmissionThe insurance data automatically copied from the mother’s visit record to the newborn’s visit record can be specified to include send verification data. The ability to configure the type of insurance data eliminates incorrect or unnecessary data existing in the newborn’s visit record. This ensures appropriate data exists in the newborn’s record and expedites reimbursement to the facility for services provided.

After a newborn is registered, the entry of data for a newborn admission has been streamlined. The System can default send verification insurance information for the visit based on the Newborn Admission menu function, Copy Mother Insurance Data push parameter.

The Copy Mother Insurance Data push parameter defines the data from the mother’s visit record that is copied into the equivalent visit data element in the newborn’s visit when the visit is created in the Newborn Admission menu function.



When the Newborn Admission menu function, Copy Mother Insurance Data push parameter, Mark for Copy? prompt for the Send Verification option is defined as yes, the System copies the visit data from the mother’s record into the newborn’s visit. The data copies forward only if it exists in the mother’s record.

When the Newborn Admission menu function, Copy Mother Insurance Data push parameter, Mark for Copy? prompt for the Send Verification option is defined as no, the System does not copy the visit data from the mother’s record into the newborn’s visit. Current algorithms are used to determine whether data defaults.

When the Mark for Copy? prompt for the Send Verification option is defined as no, the System clears the data within the Insurance/Payor Profile Table, ^rt(“ipp”), Send Verification data element and processes as follows:

Empty field processing is invoked when the insurance is copied forward.

Processing within the Insurance/Payor Profile Table, ^rt(“ipp”), Send Verification data element field follows the current workflow for validating insurance through the third-party verification interface.

Once the interface validation message is accepted, any new data is updated within Insurance/Payor Profile Table, ^rt(“ipp”), insurance data element fields and the date/time of validation are included as a suffix to the validation status message displayed in the field created from the Insurance/Payor Profile Table, ^rt(“ipp”), Send Verification data element.

When the mother’s data is not copied into the newborn’s visit, the field created from the Send Verification data element displays Not Sent. The System forces the user through the verification process. Once the interface validation message is accepted, applicable data is updated on the insurance profile screen and the date/time of validation displays as a suffix to the validation message in the field created from the Insurance Payor/Profile Table, ^rt(“ipp”), Send Verification data element.

When the mother’s data is copied forward, the mother’s data populates the Insurance Payor/Profile Table, ̂ rt(“ipp”), Send Verification data element. The System suffixes the verification data with the date and time of the last verification. If the verification occurred on a day other than the current date, the System also prefixes the verification data with Previous.

The send verification data copies forward only when the Mark for Copy? prompt is defined as yes for both the Send Verification and Insurance/Payor options in the Newborn Admission menu function, Copy Mother Insurance Data push parameter. If the Insurance/Payor option does not copy forward, the send verification data does not copy forward regardless of the definition of the Mark for Copy? prompt for this option.



Visit AddWhen adding a new visit, any previous send verification data within the data element is cleared in the field created from the Insurance Payor/Profile Table, ^rt(“ipp”), Send Verification data element during insurance processing. The System displays Not Sent in the data element field. The System forces the user through the verification process. Once the interface validation message is accepted, applicable data is updated on the insurance profile screen and the date/time of validation displays as a suffix to the validation message in the field created from the Send Verification data element.

Visit ConversionWhen a visit is converted using the Visit Type Conversion menu function, previous data within the Insurance Payor/Profile Table, ^rt(“ipp”), Send Verification data element is retained. The System suffixes the verification data with the date and time of the last verification. If the verification occurred on a day other than the current date, the System also prefixes the verification data with Previous.

When verification has not been performed before the conversion, the field created from the data element displays Not Sent. The System forces the user through the verification process. Once the interface validation message is accepted, data is updated on the insurance profile screen and the date/time of validation displays as a suffix to the validation message in the field created from the Send Verification data element.

Visit EditWhen editing a visit, previous data within the Insurance Payor/Profile Table, ^rt(“ipp”), Send Verification data element is retained. The System suffixes the verification data with the date and time of the last verification. If the verification occurred on a day other than the current date, the System also prefixes the verification data with Previous.

When verification has not been performed at visit creation, the field created from the data element displays Not Sent. The user must select the field to perform the verification process. Once the interface validation message is accepted, applicable data is updated on the insurance profile screen and the date/time of validation displays as a suffix to the validation message in the field created from the Send Verification data element.


Timeout Management Queue(s)

Purpose Defines the management queue to which the patient visit is routed when the interface communication is not completed within the time frame specified in the Insurance Verification Vendor Table, ^rt(“ipv”), Facility Definitions Subfile, Seconds Delay Allowed field.




Facility-specific

Single selection of management group option

Links from the Management Queue Table, ^rt(“qv”), Management Queue Group level Single selection of management queue

Links from the Management Queue Table, ^rt(“qv”), Subfile Options level, Management Queue(s) subfile

System Use Routes the patient visit to the management queue defined in this field when communication with the insurance verification vendor system is not completed within the time frame defined in the Insurance Verification Vendor Table, ^rt(“ipv”), Seconds Delay Allowed field.

Impact ofChange


Interface

Purpose Defines the interface option that communicates to an insurance/payor validation system when the field created from this data element is accessed.


Links from the Interface Table, âti

Required

System Use Determines whether current services for the patient are covered by the insurance/payor during registration/visit processing by performing full validation/insurance verification via this interface.l

Impact ofChange


Verification Start Method

Purpose Defines the method used to start communication by the interface.

Input (M) Manual – This is the default.

(C) Card Reader – Causes the Card Reader Parameters field to display for definition.

System Use (M) Manual – Indicates interface communication is started when the user answers yes to the Start Verification? message on the transaction line in the field created from this data element. This is the default.

Timeout Management Queue(s) (Continued)



(C) Card Reader – Indicates interface communication can be started either by a card swipe in a card reader.

Impact ofChange


Card Reader Parameters

Purpose Defines how the data read from the health card is extracted and used with the insurance verification interface and within the QuadraMed CPR application. Displays only when the Verification Start Method field is defined as card reader.

Input Displays the following subfields for definition:

Field DelimiterCard Capture Parameters

System Use Uses the information defined in the Field Delimiter and Card Capture Parameters subfields to determine how data read from the health card is extracted and used with the insurance verification interface.

Impact ofChange


Field Delimiter

Purpose Defines the character that determines where the previous field ends and the next field begins. This field can be defined with one or more free-text characters.

Input Defaults to ^

System Use The System searches for characters defined in this field to parse the string obtained from the card scan into a series of ordered fields.

Impact ofChange


Card Capture Parameters

Purpose Defines the data to be extracted from the card and sent to the interface.


Displays the following subfields for definition:

Card Reader Parameters Section

Verification Start Method (Continued)



Card Reader Parameters Section

Ins/Payor DE PointerCard LocationOverride Previous Data?

Manual Start Information Section

Message Modifier

Format(s)

Display Name

Required Status

System Use Card Reader Parameters Section – Defines the location of the data to be extracted from the card and its mapping to the insurance record.

Manual Start Information Section – Defines parameters for data that must be manually entered when clicking (M) Manual Override.

Impact ofChange


Ins/Payor DE Pointer

Purpose Defines the type of generic insurance/payor data element to which the data is mapped.

Input Single selection from a hard-coded list of generic insurance/payor data elements (currently only Generic Formatted Entry is available).

Single selection from an option from the Generic Insurance/Payor Data Element Table, ^rt(“gi”)

System Use Maps the data read from the health card to the applicable field of the insurance record.

Impact ofChange


Card Location

Purpose Defines the location of the desired data, within the string returned from the health card reader.

Input Enter card field position – Numeric with no range limit.

Enter begin character position – Numeric with no range limit.

Enter end character position – Numeric integer with no range limit, however; the value entered must be greater than the value entered for the beginning character position.

Card Capture Parameters (Continued)



Manual Start Information Section

System Use The position of the field in the string returned from the health card. The System extracts characters from this field that lie within the defined Begin and End character positions and passes the data for use by the interface and mapping to the defined generic insurance/payor data element.

Impact ofChange


Override Previous Data?

Purpose Defines whether any data already input into the mapped insurance/payor field is overridden by entry of new data.

Input Yes/No

Defaults to no

System Use Yes – Overrides any data previously entered into the mapped insurance/payor field.

No – Displays a warning message when the manually entered or scanned data is different than existing data and prompts whether to override existing data.

Impact ofChange


Message Modifier

Purpose Defines the text that displays as the transaction line prompt after clicking (M) Manual Override in the field created from this data element. The (M) Manual Override button displays when the Verification Start Method Constants field is defined as card reader.

Input Free-text

Required

System Use Displays this text as the prompt for entry of data after clicking (M) Manual Override.

Impact ofChange


Card Location (Continued)



Format(s)

Purpose Defines the format in which the data must be entered manually after clicking the (M) Manual Override button.


Enter format (A=letter; 9=number)

Required

System Use Compares the entered data to this defined format and displays an error message when the data does not match this format.

Impact ofChange


Display Name

Purpose Defines the name of the screen driver field on the Manual Override Screen.

Input Free-text

Required

System Use Displays the text defined in this subfield as the name of the screen driver field on the Manual Override Screen.

Impact ofChange


Required Status

Purpose Defines whether the field on the Manual Override Screen is required.

Input (N) Not Required

(R) Required

Defaults to not required

System Use (N) Not Required – Indicates the field on the manual override screen driver is not required. The verification can be initiated if the field is blank.

(R) Required – Indicates the field on the manual override screen driver is required. Data must be defined in the field in order to initiate the verification process.

Impact ofChange





Chapter 68

Signature Date Data Element

OverviewThe Signature Date data element is used to create an insurance field that collects the date on which the hospital obtained the patient's signature, authorizing the hospital to bill the third party for services rendered.


DescriptionOnce a field that has been created from the Signature Date data element is accessed, the System prompts for a date to be entered.


Links TO other Tables FROM the Send Verification data element:

Insurance/Payor Table, ^rt(“ip”)

Links FROM other Tables TO the Send Verification data element:

Facility Table, âff Generic Insurance/Payor Data Element Table, ^rt(“gi”)Interface Table, âtiManagement Queue Table, ^rt(“qv”)



Variations None




The System accepts the following date formats:

t (today) – Current System date.

t+/–offset – Current System date plus or minus a valid offset. The System accepts the following offsets:

x (number) – Indicates the offset is a number of days, indicated by x. For example, t+1 is tomorrow.

xw – Indicates the offset is a number of weeks, indicated by x. For example, t+3w is three weeks or 21 days in the future.

xm – Indicates the offset is a number of months, indicated by x. The date is the same day x months later. For example, when the current System date is 19 July 07, t+3m is October 2007.

xy – Indicates the offset is a number of years, indicated by x.

The date is the same day x years later. For example, when the current System date is 19 July 07, t+2y is 2009.

Acceptable date formats are determined in the System Parameter Table, ^%z, General Parameters level, Date Parsing field. Depending on the date parsing option selected, the System accepts the date in the following formats:

U.S.A.

The month, day and year can be defined in the following formats:

mm-dd-yy

mm/dd/yy

dd mmm yy

dd mmm yyyy


mm/yy

mm-yy

mmm yyyy


When approximate dates are allowed, any of the above formats can be prefixed by a tilde (~) to indicate an approximate date. For example, ~ June 2007.

When a month is defined as a three character format (that is, mmm), the input is an alpha character. When the month is defined as a two character format (that is, mm), the input is numeric.

Chapter 68 Signature Date Data Element


Canada – Canadian parsing interprets the first number of an unformatted date string as a day rather than a month.



Message Modifier


Input Free-text


Required


Impact ofChange





Chapter 69

Subscriber Address Data Element

OverviewThe Subscriber Address data element is used to create a field that allows the residential address of the subscriber to be entered during insurance processing.


DescriptionOnce a field that has been created from the Subscriber Address data element is accessed, the System displays an Address Collection Screen. The Address Collection Screen that displays is defined in the Address Collection Driver Table, ^rt("ad"), and linked to the Address Collection Screen Constants field of this data element.

When the same as patient(P) processing option is chosen while defining the subscriber name, the System defaults the information defined in the Registration Screen Sequence Table, ^rt("rs"), Patient Address data element field into this data element field. After the System defaults this information, the System stars out ( ** ) this data element field, making it inaccessible.


Links TO other Tables FROM Release of Information data element:


Links FROM other Tables TO Release of Information data element:


Variations None




When the same as guarantor? processing option is chosen while defining the subscriber name, the System defaults the information defined in the Guarantor Screen Sequence Table, ^rt("rsg"), Address data element into this data element field. This information can be accepted or edited.

When the other subscriber? processing option is chosen while defining the subscriber name, the System defaults the information defined in the Insurance/Payor Profile Table, ^rt("ipp"), Subscriber Address data element for the other subscriber into this data element field. This information can be accepted or edited.


Message Modifier


Input Free-text


Required


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Impact ofChange




Street Address Length

Purpose Defines the maximum number of characters that can be entered into the field created from the Address Collection Driver Table, ^rt("ad"), Street Address data element, when the field created from this data element is accessed during insurance processing.

Input Integer

System Use When defined, the System places the end of line symbol ( | ) at the end of the Address Collection Driver Table, ^rt("ad"), Street Address data element field to mark the maximum number of characters that can be entered.

When this field is not defined, there is no limit for entering characters into the Address Collection Driver Table, ^rt("ad"), Street Address data element field.

Impact ofChange


City Length

Purpose Defines the maximum number of characters that can be entered into the field created from the Address Collection Driver Table, ^rt("ad"), City data element, when the field created from this data element is accessed during insurance processing.

Input Integer

System Use When defined, the System places the end of line symbol ( | ) at the end of the Address Collection Driver Table, ^rt("ad"), City data element field to mark the maximum number of characters that can be entered.

When this field is not defined, there is no limit for entering characters into the Address Collection Driver Table, ^rt("ad"), City data element field.

Impact ofChange


County Length

Purpose Defines the maximum number of characters that can be entered into the field created from the Address Collection Driver Table, ^rt("ad"), County data element, when the field created from this data element is accessed during insurance processing.

Input Integer

System Use When defined, the System places the end of line symbol ( | ) at the end of the Address Collection Driver Table, ^rt("ad"), County data element field to mark the maximum number of characters that can be entered.



When this field is not defined, there is no limit for entering characters into the Address Collection Driver Table, ^rt("ad"), County data element field.

Impact ofChange


State Length

Purpose Defines the maximum number of characters that can be entered into the field created from the Address Collection Driver Table, ^rt("ad"), State data element, when the field created from this data element is accessed during insurance processing.

Input Integer

System Use When defined, the System places the end of line symbol ( | ) at the end of the Address Collection Driver Table, ^rt("ad"), State data element field to mark the maximum number of characters that can be entered.

When this field is not defined, there is no limit for entering characters into the Address Collection Driver Table, ^rt("ad"), State data element field.

Impact ofChange


Country Length

Purpose Defines the maximum number of characters that can be entered into the field created from the Address Collection Driver Table, ^rt("ad"), Country data element, when the field created from this data element is accessed during insurance processing.

Input Integer

System Use When defined, the System places the end of line symbol ( | ) at the end of the Address Collection Driver Table, ^rt("ad"), Country data element field to mark the maximum number of characters that can be entered.

When this field is not defined, there is no limit for entering characters into the Address Collection Driver Table, ^rt("ad"), Country data element field.

Impact ofChange


County Length (Continued)



Mailing Code Length

Purpose Defines the maximum number of characters that can be entered into the field created from the Address Collection Driver Table, ^rt("ad"), Mailing Code data element, when the field created from this data element is accessed during insurance processing.

Input Integer

System Use When defined, the System places the end of line symbol ( | ) at the end of the Address Collection Driver Table, ^rt("ad"), Mailing Code data element field to mark the maximum number of characters that can be entered.

When this field is not defined, there is no limit for entering characters into the Address Collection Driver Table, ^rt("ad"), Mailing Code data element field.

Impact ofChange





Chapter 70

Subscriber Birthdate Data Element

OverviewThe Subscriber Birthdate data element is used to create a field that allows the subscriber's birthdate to be entered during insurance processing.


Links TO other Tables FROM Subscriber Birthdate data element:


Links FROM other Tables TO Subscriber Birthdate data element:

None

Variations The Subscriber Birthdate data element consists of the following variations:Date – This variation displays the subscriber's birthdate and, in parentheses, the subscriber's age. The System calculates the age based on the birthdate. The following field displays for the Date variation when the Constants field is accessed:

Message ModifierDate-No Age – This variation displays only the subscriber's birthdate. The following field displays for the Date-No Age variation when the Constants field is accessed:

Message ModifierDate/Time – This variation displays the subscriber's birthdate, time, and in parentheses, the subscriber's age. The System calculates the age based on the birthdate. The following field displays for the Date/Time variation when the Constants field is accessed:

Message ModifierDate/Time-No Age – This variation displays the subscriber's birthdate and time. The following field displays for the Date/Time-No Age variation when the Constants field is accessed:

Message Modifier




DescriptionOnce a field that has been created from the Subscriber Birthdate data element is accessed, the QuadraMed CPR System, depending on the variation selected, prompts for either a date or a date and time to be entered. The System allows the date to be entered in the following ways:

t (today) – Current System date.

t+/–offset – Current System date plus or minus a valid offset. The System accepts the following offsets:

x (number) – Indicates the offset is a number of days, indicated by x. For example, t+1 is tomorrow.

xw – Indicates the offset is a number of weeks, indicated by x. For example, t+3w is three weeks or 21 days in the future.

xm – Indicates the offset is a number of months, indicated by x. The date is the same day x months later. For example, when the current System date is 19 July 07, t+3m is October 2007.

xy – Indicates the offset is a number of years, indicated by x. The date is the same day x years later. For example, when the current System date is 19 July 07, t+2y is 2009.

Acceptable date formats are determined in the System Parameter Table, ^%z, General Parameters level, Date Parsing field. Depending on the date parsing option selected, the System accepts the date in the following formats:

U.S.A.

The month, day and year can be defined in the following formats:

mm-dd-yy

mm/dd/yy

dd mmm yy

dd mmm yyyy


mm/yy

mm-yy

mmm yyyy


When approximate dates are allowed, any of the above formats can be prefixed by a tilde (~) to indicate an approximate date. For example, ~ June 2007.

When a month is defined as a three character format (that is, mmm), the input is an alpha character. When the month is defined as a two character format (that is, mm), the input is numeric.

Chapter 70 Subscriber Birthdate Data Element


Canada – Canadian parsing interprets the first number of an unformatted date string as a day rather than a month.


QuadraMed CPR allows a date and time to be entered in the following ways:


t (today) – Current System date. A t can be entered by itself or followed by a time (Example: t 0700 is today at 0700).

Date and timeAll of the previously identified date formats are acceptable with the following time formats:

n (now) with or without a suffix – When now is entered as n, the System defaults the current time. The System accepts the following now suffixes:

n+/–x – Indicates that the offset time is defined in minutes. For example, n+30 is half-hour from now.

n+/–xh – Indicates that the offset time is defined in hours. For example, n+2h is two hours from now.


When the same as patient(P) processing option is chosen while defining the subscriber name, the System defaults the information defined in the Registration Screen Sequence Table, ^rt("rs"), Patient Birthdate data element into this data element field. After the System defaults this information, the System stars out ( ** ) this data element field, making it inaccessible.

When the same as guarantor processing option is chosen while defining the subscriber name, the System defaults the information defined in the Guarantor Screen Sequence Table, ^rt("rsg"), Birthdate data element into this data element field. This information can be accepted or edited.

When the other subscriber processing option is chosen while defining the subscriber name, the System defaults the information defined in the Insurance/Payor Profile Table, ^rt("ipp"), Subscriber Birthdate data element for the other subscriber into this data element field. This information can be accepted or edited.




Message Modifier

Purpose Defines the text that displays as the transaction line prompt after clicking (M) Manual Override in the field created from this data element. The (M) Manual Override button displays when the Verification Start Method Constants field is defined as card reader.

Input Free-text

Required

System Use Displays this text as the prompt for entry of data after clicking (M) Manual Override.

Impact ofChange



Chapter 71

Subscriber Day Telephone Data Element

OverviewThe Subscriber Day Telephone data element is used to create a field that allows the subscriber's daytime telephone number (that is, work telephone number) to be entered during insurance processing.


Links TO other Tables FROM Subscriber Day Telephone data element:


Links FROM other Tables TO Subscriber Day Telephone data element:

None

Variations The Subscriber Day Telephone data element consists of the following variations:

None Option – This variation operates the same as the Standard variation with the addition of or Choose none(N) as a processing option in the transaction line. The following field displays for the None Option variation when the Constants field is accessed:Message ModifierStandard – This variation allows standard telephone formats to be entered. For a complete description of standard telephone formats, see Chapter 4, Standard Data Elements in the Introduction to CPR Tables. The following field displays for the Standard variation when the Constants field is accessed:

Message Modifier




DescriptionOnce a field that has been created from the Subscriber Day Telephone data element is accessed, the System prompts for a telephone number to be entered or for the same as subscriber home phone number(S) processing option to be chosen. When the None Option variation is used, the System also prompts, as part of the transaction line, or Choose none(N). QuadraMed CPR accepts standard telephone formats.

When the same as subscriber home phone number(S) processing option is chosen, the System defaults in the telephone number defined in the Insurance/Payor Profile Table, ^rt("ipp"), Subscriber Home Telephone data element.

When the same as patient(P) processing option is chosen while defining the subscriber name, the System defaults the information defined in the Registration Screen Sequence Table, ^rt("rs"), Patient Day Telephone data element into this data element field. After the System defaults this information, the System stars out ( ** ) this data element field, making it inaccessible.

When the same as guarantor processing option is chosen while defining the subscriber name, the System defaults the information defined in the Guarantor Screen Sequence Table, ^rt("rsg"), Day Telephone data element into this data element field. This information can be accepted or edited.

When the other subscriber processing option is chosen while defining the subscriber name, the System defaults the information defined in the Insurance/Payor Profile Table, ^rt("ipp"), Subscriber Day Telephone data element for the other subscriber into this data element field. This information can be accepted or edited.


Message Modifier


Input Free-text


Required


Impact ofChange



Chapter 72

Subscriber Driver's License Data Element

OverviewThe Subscriber Driver's License data element is used to create a field that allows the subscriber's driver's license number to be entered during insurance processing.


DescriptionOnce a field that has been created from the Subscriber Driver's License data element is accessed, the System prompts for a state to be entered. The EXPD key can be pressed for a list of all the State Options.

When the state is entered without pressing the EXPD key, the System prompts for a license number to be entered and displays the XP icon. A license number can be entered or the EXPD key can be pressed again for a list of the defined formats.

When the EXPD key is pressed for a list of State Options, after a state is selected, the System automatically displays the defined format and prompts for a license number to be entered. When a number is entered that does not match the defined format, an error message displays.


Links TO other Tables FROM Subscriber Driver's License data element:


Links FROM other Tables TO Subscriber Driver's License data element:

None

Variations None




When no format is defined, QuadraMed CPR accepts an entry in any format. After the license number is entered, the System displays the state's initials followed by the license number. State Options are defined in the Country/State/County Table, ^rt("cs"), State level. License number formats are defined in the Country/State/County Table, ^rt("cs"), State level, Driver's License Pattern(s) field.

When the same as patient(P) processing option is chosen while defining the subscriber name, the System defaults the information defined in the Registration Screen Sequence Table, ^rt("rs"), Patient Driver's License data element into this data element field. After the System defaults this information, the System stars out ( ** ) this data element field, making it inaccessible.

When the same as guarantor processing option is chosen while defining the subscriber name, the System defaults the information defined in the Guarantor Screen Sequence Table, ^rt("rsg"), Driver's License data element into this data element field. This information can be accepted or edited.

When the other subscriber processing option is chosen while defining the subscriber name, the System defaults the information defined in the Insurance/Payor Profile Table, ^rt("ipp"), Subscriber Driver's License data element for the other subscriber into this data element field. This information can be accepted or edited.


Message Modifier


Input Free-text


Required


Impact ofChange



Chapter 73

Subscriber Employee ID Data Element

OverviewThe Subscriber Employee ID data element is used to create a field that allows the employee identification number of the subscriber to be entered during insurance processing.


Links TO other Tables FROM Subscriber Employee ID data element:


Links FROM other Tables TO Subscriber Employee ID data element:

None

Variations The Subscriber Employee ID data element consists of the following variations:

Expand – This variation displays an expand icon at the bottom of the screen. When the EXPD key is pressed, the System displays all the formats defined in the Display Format(s) Constants field. The following fields can display for the Expand variation when the Constants field is accessed:

Message ModifierDisplay TypeLengthDisplay Format(s)Display Maximum LengthVerification ExpressionNo Expand – This variation automatically displays the defined formats when the field created from this data element is accessed.



DescriptionOnce a field that has been created from the Subscriber Employee ID data element is accessed, the System, depending on the variation selected, either displays a list of format options and/or prompts for an identification number to be entered. When the format options do not automatically display, the System displays the XP icon at the bottom of the screen. Pressing the EXPD key causes the format options to display.

When the same as patient(P) processing option is chosen while defining the subscriber name, the System defaults the information defined in the Registration Screen Sequence Table, ^rt("rs"), Patient Employee ID data element into this data element field. After the System defaults this information, the System stars out ( ** ) this data element field, making it inaccessible. When the same as guarantor processing option is chosen while defining the subscriber name, the System defaults the information defined in the Guarantor Screen Sequence Table, ^rt("rsg"), Employee ID data element into this data element field. This information can be accepted or edited. When the other subscriber processing option is chosen while defining the subscriber name, the System defaults the information defined in the Insurance/Payor Profile Table, ^rt("ipp"), Subscriber Employee ID data element for the other subscriber into this data element field. This information can be accepted or edited.



Message ModifierDisplay TypeLengthDisplay Format(s)Display Maximum LengthVerification Expression


Message Modifier


Input Free-text


Required

Chapter 73 Subscriber Employee ID Data Element



Impact ofChange


Display Type

Purpose Defines the type of check that will be performed on the data entered into this data element field.

Input (F) Format

(L) Length

Defaults to format

System Use (F) Format – Indicates how the characters must be arranged to be accepted as input. Displays the following additional fields for definition:


(L) Length – Displays a bar (|) at the end of the transaction line, indicating the maximum number of characters that can be entered. Displays the Length field for definition.

Impact ofChange


Display Format(s)

Purpose Defines the specific format allowed for this data element.


Formatted entry

Accepts A’s or 9’s only

A – Defines an alphabetic character

9 – Defines a numerical digit

For example, an acceptable entry for an AA999 format would be CD234.

System Use Checks each number entered against the defined format. When the number does not match, displays a warning message.

When no format is defined, the System does not perform any checks on the entered data.

Impact ofChange


Message Modifier (Continued)




Purpose Defines whether the maximum length of the formatted entry should be displayed when the field created from this data element is selected during insurance processing.

Input Yes/No

Defaults to no

System Use Yes – Displays the end of line symbol (|) at the end of the data element field to mark the maximum number of characters that can be entered.


Impact ofChange


Length


Input Integer



Impact ofChange



Purpose Defines a more specific format check (Example: The number must start with a specific set of numbers, such as 12 or 1812).

Input Mumps code/operations (Example: !, |, $s, and so on)


System Use Evaluates/performs the defined expression. When the expression returns a false value, the number was entered incorrectly and an error messages displays.

Impact ofChange



Chapter 74

Subscriber Employer Address Data Element

OverviewThe Subscriber Employer Address data element is used to create a field that allows the subscriber's employer address to be entered during insurance processing.


DescriptionOnce a field that has been created from the Subscriber Employer Address data element is accessed, the System either automatically defaults the subscriber's employer address or displays an Address Collection Screen.

The Address Collection Screen that displays is defined in the Address Collection Driver Table, ^rt("ad"), and linked to the Address Collection Screen Constants field of this data element.When no entry is made into the field created from the Subscriber Employer data element, the System stars out ( ** ) this field, making it inaccessible.


Links TO other Tables FROM Subscriber Employer Address data element:


Links FROM other Tables TO Subscriber Employer Address data element:


Variations None




When the Subscriber Employer data element is defined, this data element field can be defined as follows:

Automatically defaulted by the System when the information for the Subscriber Employer data element is selected from the Employer Table, ^rt("em"). When the address is defined in the Employer Table, ^rt("em"), Employer level, Address field, the System defaults the employer address into this field. After the System defaults this information, it stars out ( ** ) this data element field, making it inaccessible.

Automatically defaulted by the System when the information for the Subscriber Branch data element is selected from the Employer Table, ^rt("em"). When the address is defined in the Employer Table, ^rt("em"), Branch level, Address field, the System defaults the branch address into this field. The branch address overrides the employer address. After the System defaults this information, it stars out ( ** ) this data element field, making it inaccessible.

Free-text entry of the address.

When the same as patient(P) processing option is chosen while defining the subscriber name, the System defaults the information defined in the Registration Screen Sequence Table, ^rt("rs"), Patient Employer Address data element into this data element field. After the System defaults this information, the System stars out ( ** ) this data element field, making it inaccessible. When the same as guarantor? processing option is chosen while defining the subscriber name, the System defaults the information defined in the Guarantor Screen Sequence Table, ^rt("rsg"), Employer Address data element field into this data element field. This information can be accepted or edited.

When the other subscriber? processing option is chosen while defining the subscriber name, the System defaults the information defined in the Insurance/Payor Profile Table, ^rt("ipp"), Subscriber Employer Address data element field for the other subscriber into this data element field. This information can be accepted or edited.


Message Modifier


Input Free-text


Required

Chapter 74 Subscriber Employer Address Data Element



Impact ofChange









Impact ofChange






Chapter 75

Subscriber Employer Branch Data Element

OverviewThe Subscriber Employer Branch data element is used to create a field that allows the subscriber's employer branch to be entered during insurance processing.


Links TO other Tables FROM Subscriber Employer Branch data element:


Links FROM other Tables TO Subscriber Employer Branch data element:

None

Variations The Subscriber Employer Branch data element consists of the following variations:

Free-Text Only – This variation indicates to the System that the entry will be free-text. The System does not display any Branch Options for selection. The following field displays for the Free-Text Only variation when the Constants field is accessed:

Message ModifierStandard – This variation indicates to the System that the entry will be either free-text or a selection from the Branch Options. The System displays a list of Branch Options for selection as well as prompts for free-text to be entered. The following field displays for the Standard variation when the Constants field is accessed:

Message Modifier




DescriptionOnce the field that has been created from the Subscriber Employer Branch data element is accessed, the System, depending on the variation selected, either prompts for an employer branch, a partial name, or free-text to be entered. Branch Options are defined in the Employer Table, ^rt("em").

When no entry is made into the field created from the Subscriber Employer data element, QuadraMed CPR stars out ( ** ) this field, making it inaccessible. When a Branch Option is selected, the System automatically fills in the following data element fields with branch information, provided the information is defined in the Employer Table, ^rt("em"), Branch level:




When the same as patient(P) processing option is chosen while defining the subscriber name, the System defaults the information defined in the Registration Screen Sequence Table, ^rt("rs"), Patient Employer Branch data element into this data element field. After the System defaults this information, the System stars out ( ** ) this data element field, making it inaccessible. When the same as guarantor processing option is chosen while defining the subscriber name, the System defaults the information defined in the Guarantor Screen Sequence Table, ̂ rt("rsg"), Employer Branch data element into this data element field. This information can be accepted or edited.

When the other subscriber processing option is chosen while defining the subscriber name, the System defaults the information defined in the Insurance/Payor Profile Table, ^rt("ipp"), Subscriber Employer Branch data element for the other subscriber into this data element field. This information can be accepted or edited.


Message Modifier


Input Free-text


Required

Chapter 75 Subscriber Employer Branch Data Element



Impact ofChange






Chapter 76

Subscriber Employer Comment Data Element

OverviewThe Subscriber Employer Comment data element is used to create a field that allows a free-text comment about the subscriber's employer to be entered during insurance processing.


DescriptionOnce a field that has been created from the Subscriber Employer Comment data element is accessed, the System prompts for a comment to be entered. When no entry is made into the field created from the Subscriber Employer data element, QuadraMed CPR stars out ( ** ) this field, making it inaccessible.

When the same as patient(P) processing option is chosen while defining the subscriber name, the System defaults the information defined in the Registration Screen Sequence Table, ^rt("rs"), Patient Employer Comment data element into this data element field. After the System defaults this information, the System stars out ( ** ) this data element field, making it inaccessible.


Links TO other Tables FROM Subscriber Employer Comment data element:


Links FROM other Tables TO Subscriber Employer Comment data element:

None

Variations None




When the same as guarantor processing option is chosen while defining the subscriber name, the System defaults the information defined in the Guarantor Screen Sequence Table, ^rt("rsg"), Employer Comment data element into this data element field. This information can be accepted or edited.

When the other subscriber processing option is chosen while defining the subscriber name, the System defaults the information defined in the Insurance/Payor Profile Table, ^rt("ipp"), Subscriber Employer Comment data element for the other subscriber into this data element field. This information can be accepted or edited.


Message Modifier


Input Free-text


Required


Impact ofChange



Chapter 77

Subscriber Employer Contact Data Element

OverviewThe Subscriber Employer Contact data element is used to create a field that allows the subscriber's employer contact to be entered during insurance processing.


DescriptionOnce a field that has been created from the Subscriber Employer Contact data element is accessed, the System prompts for a contact to be entered. When no entry is made into the field created from the Subscriber Employer data element, QuadraMed CPR stars out ( ** ) this field, making it inaccessible.

When the Subscriber Employer data element is defined, this data element field can be defined as follows:


Links TO other Tables FROM Subscriber Employer Contact data element:


Links FROM other Tables TO Subscriber Employer Contact data element:

None

Variations None




Automatically filled-in by the System when the information for the Subscriber Employer data element is selected from the Employer Table, ^rt("em"). When the contact is defined in the Employer Table, ^rt("em"), Employer level, Contact Name field, the System defaults the subscriber employer contact into this field.

Automatically filled-in by the System when the information for the Subscriber Branch data element is selected from the Employer Table, ^rt("em"). When the contact is defined in the Employer Table, ^rt("em"), Branch level, Contact Name field, the System defaults the subscriber employer contact into this field.

Free-text entry of the contact.

When the same as patient(P) processing option is chosen while defining the subscriber name, the System defaults the information defined in the Registration Screen Sequence Table, ^rt("rs"), Patient Employer Contact data element into this data element field. After the System defaults this information, the System stars out ( ** ) this data element field, making it inaccessible. When the same as guarantor processing option is chosen while defining the subscriber name, the System defaults the information defined in the Guarantor Screen Sequence Table, ^rt("rsg"), Employer Contact data element into this data element field. This information can be accepted or edited. When the other subscriber processing option is chosen while defining the subscriber name, the System defaults the information defined in the Insurance/Payor Profile Table, ^rt("ipp"), Subscriber Employer Contact data element for the other subscriber into this data element field. This information can be accepted or edited.


Message Modifier


Input Free-text


Required


Impact ofChange



Chapter 78

Subscriber Employer Data Element

OverviewThe Subscriber Employer data element is used to create a field that allows the subscriber's employer to be entered during the insurance process.


Links TO other Tables FROM Subscriber Employer data element:


Links FROM other Tables TO Subscriber Employer data element:

None

Variations The Subscriber Employer data element consists of the following variations:

Free-Text Only – This variation indicates to the System that the entry will be free-text. The System does not display any Employer Options for selection. The following fields display for the Free-Text Only variation when the Constants field is accessed:

Message ModifierLengthStandard – This variation indicates to the System that the entry will be either free-text or a selection from the Employer Options. The System displays a list of Employer Options for selection as well as prompts for free-text to be entered. The following fields display for the Standard variation when the Constants field is accessed:

Message ModifierLengthAddress Display




DescriptionOnce a field that has been created from the Subscriber Employer data element is accessed, the System, depending on the variation selected, either prompts for an employer, a partial name, or free-text to be entered. Entry of a partial name causes the System to display a list of Employer Options. Employer Options are defined in the Employer Table, ^rt("em").

The Subscriber Employer data element is starred out ( ** ), making it inaccessible, until the Subscriber Employment Status data element field is defined as active. An employment status is considered active when the Employment Status Table, ^rt("ems"), Active Employment? field is defined as yes for the selected employment status option.

The following data element fields are starred out ( ** ), making them inaccessible, until the Subscriber Employer data element is defined:







When an Employer Option is selected from the Employer Table, ^rt("em"), the System automatically fills in the following data element fields, provided the information is defined in the Employer Table, ^rt("em"):




When the same as patient(P) processing option is chosen while defining the subscriber name, the System defaults the information defined in the Registration Screen Sequence Table, ^rt("rs"), Patient Employer data element into this data element field. After the System defaults this information, the System stars out ( ** ) this data element field, making it inaccessible.

When the same as guarantor processing option is chosen while defining the subscriber name, the System defaults the information defined in the Guarantor Screen Sequence Table, ^rt("rsg"), Employer data element into this data element field. This information can be accepted or edited.

When the other subscriber processing option is chosen while defining the subscriber name, the System defaults the information defined in the Insurance/Payor Profile Table, ^rt("ipp"), Subscriber Employer data element for the other subscriber into this data element field. This information can be accepted or edited.

Chapter 78 Subscriber Employer Data Element



Message Modifier


Input Free-text


Required


Impact ofChange


Length


Input Integer



Impact ofChange


Address Display

Purpose Defines the address that displays in the Subscriber Employer Address data element field.

Input (L) Location Address

(B) Billing Address

Defaults to location address



System Use (L) Location Address – The System displays the information defined in the Employer Table, ^rt("em"), Employer level, Address field, as the subscriber employer's address.

(B) Billing Address – The System displays the information defined in the Employer Table, ^rt("em"), Employer level, Billing Address field, as the subscriber employer's address.

Impact ofChange


Address Display (Continued)


Chapter 79

Subscriber Employer Telephone Data Element

OverviewThe Subscriber Employer Telephone data element is used to create a field that allows the subscriber's employer telephone number to be entered during insurance processing.


DescriptionOnce a field that has been created from the Subscriber Employer Telephone data element is accessed, the System prompts for the telephone number to be entered. QuadraMed CPR accepts standard telephone formats.

When no entry is made into the field created from the Subscriber Employer data element, QuadraMed CPR stars out ( ** ) this field, making it inaccessible.


Links TO other Tables FROM Subscriber Employer Telephone data element:


Links FROM other Tables TO Subscriber Employer Telephone data element:

None

Variations None




When the Subscriber Employer data element is defined, this field can be defined as follows:

Automatically filled-in by the System when the information for the Subscriber Employer data element is selected from the Employer Table, ^rt("em"). When the telephone number is defined in the Employer Table, ^rt("em"), Employer level, Telephone field, the System defaults the subscriber employer telephone number into this field.

Automatically filled-in by the System when the information for the Subscriber Branch data element is selected from the Employer Table, ^rt("em"). When the telephone number is defined in the Employer Table, ^rt("em"), Branch level, Telephone field, the System defaults the branch telephone number into this field. The branch telephone number overrides the Employer level, Telephone field.

Free-text entry of the telephone number.

When the same as patient(P) processing option is chosen while defining the subscriber name, the System defaults the information defined in the Registration Screen Sequence Table, ^rt("rs"), Patient Employer Telephone data element into this data element field. After the System defaults this information, the System stars out ( ** ) this data element field, making it inaccessible. When the same as guarantor processing option is chosen while defining the subscriber name, the System defaults the information defined in the Guarantor Screen Sequence Table, ^rt("rsg"), Employer Telephone data element into this data element field. This information can be accepted or edited. When the other subscriber processing option is chosen while defining the subscriber name, the System defaults the information defined in the Insurance/Payor Profile Table, ^rt("ipp"), Subscriber Employer Telephone data element for the other subscriber into this data element field. This information can be accepted or edited.


Message Modifier


Input Free-text


Required


Impact ofChange



Chapter 80

Subscriber Employment Status Data Element

OverviewThe Subscriber Employment Status data element is used to create a field that allows the employment status of the subscriber to be entered during insurance processing.


DescriptionOnce a field that has been created from the Subscriber Employment Status data element is accessed, the System displays a list of Employment Status Options and prompts for one to be selected. Employment Status Options are defined in the Employment Status Table, ^rt("ems").

When an option is selected that is not considered an active employment status, QuadraMed CPR stars out (**) the following data element fields, making them inaccessible:


Subscriber Employer



Links TO other Tables FROM Subscriber Employer Status data element:


Links FROM other Tables TO Subscriber Employer Status data element:

None

Variations None








An employment status option is considered active when the Employment Status Table, ^rt("ems"), Active Employment? field is defined as yes.

When the same as patient(P) processing option is chosen while defining the subscriber name, the System defaults the information defined in the Registration Screen Sequence Table, ^rt("rs"), Patient Employment Status data element into this data element field. After the System defaults this information, the System stars out ( ** ) this data element field, making it inaccessible. When the same as guarantor processing option is chosen while defining the subscriber name, the System defaults the information defined in the Guarantor Screen Sequence Table, ^rt("rsg"), Employment Status data element into this data element field. This information can be accepted or edited. When the other subscriber processing option is chosen while defining the subscriber name, the System defaults the information defined in the Insurance/Payor Profile Table, ^rt("ipp"), Subscriber Employment Status data element for the other subscriber into this data element field. This information can be accepted or edited.


Message Modifier


Input Free-text


Required


Impact ofChange



Chapter 81

Subscriber Home Telephone Data Element

OverviewThe Subscriber Home Telephone data element is used to create a field that allows the subscriber's home telephone number to be entered during insurance processing.


Links TO other Tables FROM Subscriber Employer Telephone data element:


Links FROM other Tables TO Subscriber Employer Telephone data element:

None

Variations The Subscriber Home Telephone data element consists of the following variations:

None Option – This variation operates the same as the Standard variation with the addition of or Choose none (N) as a processing option in the transaction line. The following field displays for the None Option variation when the Constants field is accessed:

Message ModifierStandard – This variation allows standard telephone formats to be entered. For a complete description of standard telephone formats, see Chapter 4, Standard Data Elements in the Introduction to CPR Tables. The following field displays for the Standard variation when the Constants field is accessed:

Message Modifier




DescriptionOnce a field that has been created from the Subscriber Home Telephone data element is accessed, the System prompts for a telephone number to be entered. When the None Option variation is used, the System also prompts, as part of the transaction line, or Choose none(N). QuadraMed CPR accepts standard telephone formats.

When the same as patient(P) processing option is chosen while defining the subscriber name, the System defaults the information defined in the Registration Screen Sequence Table, ^rt("rs"), Patient Home Telephone data element into this data element field. After the System defaults this information, the System stars out ( ** ) this data element field, making it inaccessible. When the same as guarantor processing option is chosen while defining the subscriber name, the System defaults the information defined in the Guarantor Screen Sequence Table, ^rt("rsg"), Home Telephone data element into this data element field. This information can be accepted or edited. When the other subscriber processing option is chosen while defining the subscriber name, the System defaults the information defined in the Insurance/Payor Profile Table, ^rt("ipp"), Subscriber Home Telephone data element for the other subscriber into this data element field. This information can be accepted or edited.


Message Modifier


Input Free-text


Required


Impact ofChange



Chapter 82

Subscriber Name Data Element

OverviewThe Subscriber Name data element is used to create a field that allows the name of the person holding the insurance policy to be identified.


Links TO other Tables FROM the Subscriber Name data element:


Links FROM other Tables TO the Subscriber Name data element:

None



Variations The Subscriber Name data element consists of the following variations:

Name without suffix – This variation does not display the Family Suffix Options during data entry. The following fields display for the Name without suffix variation when the Constants field is accessed:

Message ModifierGuarantor ModifierGuarantor Modifier CharacterSame As Data To ExcludeLengthStandard – This variation displays the list of Family Suffix Options when the subscriber name is being defined. The following fields display for the Standard variation when the Constants field is accessed:

Message ModifierGuarantor Modifier



DescriptionOnce a field that has been created from the Subscriber Name data element is accessed, the System prompts for a name to be entered, or to choose same as patient, guarantor, or other subscriber. When a name is entered, it must be entered in the standard person format (i.e., Last,First M). Depending on the variation selected, after the name is entered, the System can display a list of Family Suffix Options. Family Suffix Options are defined in the Family Suffix Table, ^rt("fs").

When the same as patient processing option is chosen, the System defaults the following Registration Screen Sequence Table, ^rt("rs"), patient data element information into the corresponding Insurance/Payor Profile Table, ^rt("ipp"), subscriber data element.

Guarantor Modifier CharacterSame As Data To ExcludeLength


REGISTRATION SCREEN SEQUENCE TABLE, ^RT("RS"), DATA ELEMENT

INSURANCE/PAYOR PROFILE TABLE, ^RT("IPP"), DATA ELEMENT

Employer Subscriber Employer

Employer Address Subscriber Employer Address

Employer Branch Subscriber Employer Branch

Employer Comment Subscriber Employer Comment

Employer Contact Subscriber Employer Contact

Employer Telephone Subscriber Employer Telephone

Patient Name Subscriber Name

Patient Address Subscriber Address

Patient Birthdate Subscriber Birthdate

Patient Day Telephone Subscriber Day Telephone

Patient Driver's License Subscriber Driver's License

Patient Employee ID Subscriber Employee ID

Patient Employment Status Subscriber Employment Status

Patient Home Telephone Subscriber Home Telephone

Patient Occupation Subscriber Occupation



When the same as <guarantor modifier> processing option is chosen, the System defaults the following Guarantor Screen Sequence Table, ^rt("rsg"), guarantor data element information into the corresponding Insurance/Payor Profile Table, ^rt("ipp"), subscriber data element.

Patient Sex Subscriber Sex

Patient Social Security # Subscriber Social Security Number

After the System defaults the patient information into the corresponding subscriber data element field, the System stars out ( ** ) all fields created from the subscriber data elements, except the Subscriber Name data element, making them inaccessible.

GUARANTOR SCREEN SEQUENCE TABLE,^RT("RSG"), DATA ELEMENT


Name Subscriber Name

Address Subscriber Address

Birthdate Subscriber Birthdate

Day Telephone Subscriber Day Telephone

Driver's License Subscriber Driver's License

Employee ID Subscriber Employee ID

Employer Subscriber Employer

Employer Address Subscriber Employer Address

Employer Branch Subscriber Employer Branch

Employer Comment Subscriber Employer Comment

Employer Contact Subscriber Employer Contact

Employer Telephone Subscriber Employer Telephone

Employment Status Subscriber Employment Status

Home Telephone Subscriber Home Telephone

Occupation Subscriber Occupation

Relationship Subscriber Relationship

Sex Subscriber Sex

Social Security # Subscriber Social Security Number

REGISTRATION SCREEN SEQUENCE TABLE, ^RT("RS"), DATA ELEMENT




When the other subscriber processing option is chosen, the System displays a list of Other Subscriber Options and prompts for one to be selected. When more than one insurance is defined for a visit, the System displays the subscribers defined for those other insurances as Other Subscriber Options. When an other subscriber is chosen, the System defaults all the other subscriber information into the corresponding data element fields. This information can be accepted or edited.


When the field created from the Visit Type Table, ^rt("vt"), Guarantor data element is defined as same as patient employer, the System suppresses the same as patient guarantor processing option from displaying in this data element field.

Message Modifier


Input Free-text


Required


Impact ofChange


Guarantor Modifier

Purpose Defines the transaction line option that allows the default of guarantor data as subscriber data.

Input Free-text

Greater than 15 characters is impractical for display purposes.

Required

System Use Displays this text as part of the transaction line when the field created from this data element is accessed.

Impact ofChange




Guarantor Modifier Character

Purpose Defines the character that is associated with the guarantor modifier.

Input Free-text

1 character limit

Required

System Use Displays this character on the transaction line, in parentheses, after the text defined in the Guarantor Modifier Constants field.

For example, if the Guarantor Modifier Constants field is defined as guarantor and this Constants field is defined as g, the transaction line would display Choose guarantor(g).

Impact ofChange


Same As Data To Exclude

Purpose Defines which data elements are not to be copied when the field created from the this data element is defined as same as patient.

Input Multiple selection from the following hard-coded options:

Address

Birthdate

Day Telephone Number

Death Date/Time

Driver's License

Employee ID

Employer

Employer Address

Employer Branch

Employer Comment

Employer Contact

Employer Telephone Number

Employment Status

Home Telephone Number

Mailing Address

Name

Occupation

Relationship

Sex

Social Security Number




System Use Excludes the selected options from being copied when the field created from this data element is defined as same as patient.

Impact ofChange


Length


Input Integer



Impact ofChange


FIELD DESCRIPTION






Same As Data To Exclude (Continued)


Chapter 83

Subscriber Occupation Data Element

OverviewThe Subscriber Occupation data element is used to create a field that allows the subscriber's occupation to be entered during insurance processing.


Links TO other Tables FROM Subscriber Occupation data element:


Links FROM other Tables TO Subscriber Occupation data element:

None

Variations The Subscriber Occupation data element consists of the following variations:

Free-Text Only – This variation indicates to the System that the entry is free-text. The following fields display for the Free-Text Only variation when the Constants field is accessed:

Message ModifierLengthStandard – This variation indicates to the System that the entry is either free-text or a selection from the Occupation Options. The following fields display for the Standard variation when the Constants field is accessed:

Message ModifierLength




DescriptionOnce a field that has been created from the Subscriber Occupation data element is accessed, the System, depending on the variation selected, either prompts for the entry of a partial name or an occupation.

When a partial name is entered, the System displays a list of matching Occupation Options and prompts for one to be selected, or for free-text to be entered. Occupation Options are defined in the Occupation Table, ^rt("oc"). When the same as patient(P) processing option is chosen while defining the subscriber name, the System defaults the information defined in the Registration Screen Sequence Table, ^rt("rs"), Patient Occupation data element into this data element field. After the System defaults this information, the System stars out ( ** ) this data element field, making it inaccessible.

When the same as guarantor processing option is chosen while defining the subscriber name, the System defaults the information defined in the Guarantor Screen Sequence Table, ^rt("rsg"), Occupation data element into this data element field. This information can be accepted or edited. When the other subscriber processing option is chosen while defining the subscriber name, the System defaults the information defined in the Insurance/Payor Profile Table, ^rt("ipp"), Subscriber Occupation data element for the other subscriber into this data element field. This information can be accepted or edited.


Message Modifier


Input Free-text


Required


Impact ofChange


Length


Input Integer

Chapter 83 Subscriber Occupation Data Element




Impact ofChange


Length (Continued)




Chapter 84

Subscriber Relationship Data Element

OverviewThe Subscriber Relationship data element is used to create a field that allows the entry of the subscriber's relationship to the patient during insurance processing.


DescriptionOnce a field that has been created from the Subscriber Relationship data element is accessed, the System displays a list of Relationship Options and prompts for one to be selected. Relationship Options are defined in the Relationship Table, ^rt("rl").

When the same as patient(P) processing option is chosen while defining the subscriber name, the System defaults self into this data element field. After the System defaults this information, the System stars out ( ** ) this data element field, making it inaccessible.


Links TO other Tables FROM Subscriber Relationship data element:


Links FROM other Tables TO Subscriber Relationship data element:

None

Variations None




When the same as guarantor processing option is chosen while defining the subscriber name, the System defaults the information defined in the Guarantor Screen Sequence Table, ^rt("rsg"), Relationship data element into this data element field. This information can be accepted or edited. When the other subscriber processing option is chosen while defining the subscriber name, the System defaults the information defined in the Insurance/Payor Profile Table, ^rt("ipp"), Subscriber Relationship data element for the other subscriber into this data element field. This information can be accepted or edited.


Message Modifier


Input Free-text


Required


Impact ofChange



Chapter 85

Subscriber Sex Data Element

OverviewThe Subscriber Sex data element is used to create a field that allows the subscriber's sex to be entered during insurance processing.


DescriptionOnce a field that has been created from the Subscriber Sex data element is accessed, the System prompts for the subscriber's sex to be chosen (i.e., M Male, F Female, or U Unknown).

When the same as patient(P) processing option is chosen while defining the subscriber name, the System defaults the information defined in the Registration Screen Sequence Table, ^rt("rs"), Patient Sex data element into this data element field. After the System defaults this information, the System stars out ( ** ) this data element field, making it inaccessible. When the same as guarantor processing option is chosen while defining the subscriber name, the System defaults the information defined in the Guarantor Screen Sequence Table, ^rt("rsg"), Sex data element into this data element field. This information can be accepted or edited.


Links TO other Tables FROM Subscriber Sex data element:


Links FROM other Tables TO Subscriber Sex data element:

None

Variations None




When the other subscriber processing option is chosen while defining the subscriber name, the System defaults the information defined in the Insurance/Payor Profile Table, ^rt("ipp"), Subscriber Sex data element for the other subscriber into this data element field. This information can be accepted or edited.


Message Modifier


Input Free-text


Required


Impact ofChange



Chapter 86

Subscriber Social Security Number Data Element

OverviewThe Subscriber Social Security Number data element is used to create a field that allows the subscriber's social security number to be entered during insurance processing.


DescriptionOnce a field that has been created from the Subscriber Social Security Number data element is accessed, the System prompts for the subscriber's social security number to be entered. The format of the social security number is hard-coded (that is, 999-99-9999).

When the same as patient (P) processing option is chosen while defining the subscriber name, the System defaults the information defined in the Registration Screen Sequence Table, ^rt("rs"), Patient Social Security Number data element into this data element field. After the System defaults this information, the System stars out ( ** ) this data element field, making it inaccessible.


Links TO other Tables FROM Subscriber Social Security Number data element:


Links FROM other Tables TO Subscriber Social Security Number data element:

None

Variations None




When the same as guarantor processing option is chosen while defining the subscriber name, the System defaults the information defined in the Guarantor Screen Sequence Table, ^rt("rsg"), Social Security Number data element into this data element field. This information can be accepted or edited. When the other subscriber processing option is chosen while defining the subscriber name, the System defaults the information defined in the Insurance/Payor Profile Table, ^rt("ipp"), Subscriber Social Security Number data element for the other subscriber into this data element field. This information can be accepted or edited.


Message Modifier


Input Free-text


Required


Impact ofChange



Chapter 87

Telephone Data Element

OverviewThe Telephone data element is used to create a field that allows the insurance/payor telephone number to be defined.


DescriptionOnce a field that has been created from the Telephone data element is accessed, the System automatically defaults the telephone number defined in the Insurance/Payor Table, ^rt("ip"), Telephone field.


Links TO other Tables FROM Telephone data element:


Links FROM other Tables TO Telephone data element:

None

Variations The Telephone data element consists of the following variations:

Display Only – This variation indicates the telephone number is a display only field. The information that displays cannot be edited. There are no constants defined for this data element.

Entered – This variation allows standard telephone formats to be entered. For a complete description of standard telephone formats, see Chapter 4, Standard Data Elements in the Introduction to CPR Tables. The following field displays for the Entered variation when the Constants field is accessed:

Message Modifier




When this data element field is defined with the Display Only variation, the field created from this data element cannot be edited. When this data element field is defined with the Entered variation, the default information can be accepted or edited. QuadraMed CPR accepts standard telephone formats.


Message Modifier


Input Free-text


Required


Impact ofChange



Index of Selected Fields

AAdditional Generated Data String 160Additional Object Data String 159Address Collection Screen 13, 169, 274, 293Address Display 305Allow Annotation? 157Allow Approximate? 126Allow Duplicate Secondary Number(s)? 252Allow Edit of Secondary Number(s)? 253Allow Free-Text? 176, 181Allow Partial Name? 181Allowed Security Expr 8, 161, 171, 182, 215, 318

CCard Capture Parameters 264Card Location 265Card Reader Parameters 264Check Digit Type 137Choose Values 121City Length 275Country 276Country Length 276County Length 275

DDays In Future 37, 41, 45, 49, 59, 64, 67, 71, 207, 211Days In Past 37, 41, 45, 49, 59, 63, 67, 71, 207, 211Display Format 156Display Format(s) 79, 83, 87, 91, 95, 99, 103, 107, 111,

115, 136, 187, 219, 225, 234, 289Display Maximum Length 79, 83, 87, 91, 95, 99, 103,

107, 111, 115, 136, 188, 220, 226, 234, 290Display Name 267Display Security Expr 7, 161, 170, 182, 214, 254, 318Display Text 17, 55, 192, 239, 243Display Type 79, 83, 87, 91, 95, 99, 103, 107, 111,

115, 131, 136, 187, 219, 225, 233, 289

EEdit Security Expr 7, 161, 170, 182, 214, 253, 318Effective Date 1 63Employee Type(s) 131

FField Delimiter 264Format(s) 267

GGuarantor Modifier 316Guarantor Modifier Character 317

HHard-Coded Values 144High Range 235

IImage Print Size 161Initial Annotation Tool 157Ins/Payor DE Pointer 265Interface 263

LLow Range 235

MMailing Code Length 277Manual Number Entry 253Message Modifier 12, 17, 20, 23, 26, 28, 30, 32, 34, 37,

41, 45, 49, 52, 55, 59, 63, 67, 71, 74, 76, 78, 82, 86, 90, 94, 98, 102, 106, 110, 114, 118, 126, 130, 135, 140, 144, 164, 169, 174, 179, 184, 186, 191, 194, 196, 198, 200, 202, 204, 207, 211, 214, 218, 222, 224, 229, 233, 239, 243, 246, 248, 251, 271, 274,



284, 286, 288, 292, 296, 300, 302, 305, 308, 310, 312, 316, 320, 324, 326, 328, 330

Multimedia Catalogue Object(s) 156Multimedia Definition 153Multimedia Rubber Stamp(s) 158Multimedia Server Type(s) 154Multimedia Type 153Multi-Select? 175, 180

OOverride Previous Data? 266

PProfile Name 3Profile Short Name 3Prompt 16, 54, 120, 190, 228, 238, 242

RRequired Expr 8, 161, 171, 182, 215, 254, 318Required Status 267Revision List iii

SSame As Data To Exclude 317Screen Name 4Screen Type/Name 174Secondary Number Type/Secondary Number

Type(s) 252Selection Group 179Selection Table 179State Length 276Storage Reference 122, 126, 131, 138, 141, 145, 152,

165, 169, 182, 184Storage Reference (Continued) 176Street Address Length 275Suppress Printing? 160

TTimeout Management Queue(s) 262

UUse Partial Name Match? 170

VValues 17, 55, 191, 229, 239, 243Verification Expression 80, 84, 88, 92, 96, 100, 104,

108, 112, 116, 138, 188, 220, 226, 235, 290Verification Start Method 263

WWindow Preference 175, 180

Documents

QuadraMed CPR Insurance Payor Profile Table Reference€¦ · QuadraMed® CPR Insurance Payor Profile Table Reference iv QuadraMed Corporation 20 - Expiration Date Data Element 5.4.0