Content Comparison

Control Name

Type

Description

Activity Details

Type

drop-down list

Procedure type.

Possible values:

• 3 - CPT code;
• 4 - HCPCS code;
• 5 - Trade Drug code;
• 6 - Dental code;
• 8 - Service code;
• 9 - APR / DRG code.

The latest saved Type will be preselected by default in new requests and e-claims.

Procedure

text field + [...] selection button

Procedure (or activity) from the list of the specified type.

Format: code: description.

The user can type it manually (e.g. a

trade drug code) and press Enter key or they can select it from the list which opens by pressing […] button

.

Yes

Prescription number. Visible for an activity with Type = 5  - Trade Drug code if setting IsRxNumberMandatorySetting = true.

Yes

Fill Counter. Visible for an activity with Type = 5  - Trade Drug code if setting IsRxNumberMandatorySetting = true.

Possible values: >=0, integer.

Ordering Clinician

text

field + [...] selection button

The doctor who ordered a procedure or prescribed a drug.

Format: clinician license: clinician

name (Clinicians list).

The user can type it manually (e.g. a clinician license) and press Enter key or they can select it from the list which opens by pressing […] button. The latest saved Ordering Clinician will be preselected by default in new requests and e-claims.

Ordering Clinician is mandatory if Visit Start Date >= 1-Jun-2014.

Ordering Clinician must be empty if Visit Start Date < 1-Jun-2014.

Performing Clinician

text

field + [...] selection button

The doctor who performed a procedure or dispensed a drug.

Format: clinician license: clinician name

(Clinicians list).

The user can type it manually (e.g. a part of clinician name) and press Enter key or they can select it from the list which opens by pressing […] button. The latest saved Performing Clinician will be preselected by default in new requests and e-claims.

Performing Clinician is optional if Visit Start Date >= 1-Jun-2014.

Performing Clinician is mandatory if Visit Start Date < 1-Jun-2014.

Start Date

date picker

Activity Start Date.

 The latest saved Start Date will be preselected by default in new requests and e-claims.

Possible values: between Start Date and End Date of visit period. If the user changes the visit period and the activity Start Date becomes outside its boundaries, it adjusts to the new value of visit Start Date / End Date.

Quantity

text field

How many items of selected procedure clinician prescribes.

Possible values: 0.0001-999.9999.

Pre-Auth. No

text field

Authorization number

.

Comments

text field

Comments on the activity left by the provider.

Add PDF attachment

link 

On clicking Add PDF attachment link a window opens to search for the necessary file. After the file is selected, the link label changes to View PDF attachment. On clicking View PDF attachment link attached file opens for viewing.

Update observations

link 

On clicking the link Observations form opens where the user can set observations of LOINC or

Text type

.

Price Per One Unit

Discount

text field

Price discount in percent.

Possible values: 0-100%.

Copay

text field

Patient copay in percent.

Possible values: 0-100%.

If the user enters/modifies Copay, Unit Patient Share recalculates: Unit Patient Share = Unit Gross Price x Copay / 100.

If the user modifies Unit Patient Share, Copay value clears.

Deductible

text field

The amount the patient

has to pay out-of-pocket for expenses before the payer will cover the remaining costs.

Gross Price

text field

Gross price for one unit of the procedure.

If the user sets Type = 5 - Trade Drug Code and selects any trade drug in Procedure, Unit Gross Price fills with Price value for this drug but still can be changed to another value.

Patient Share

text field

Patient share for one unit of the procedure.

Unit Patient Share = Unit Gross Price x Copay / 100.

Net Price

text field

Net price for one unit of the procedure.

Unit Net Price = Unit Gross Price - Unit Patient Share.

If the user modifies Net Price, Gross Price adjusts. If the user modifies Gross Price or Patient Share, Net Price adjusts

.

The value-added tax for a procedure in percent.

Possible values: 0-100%.

The value-added tax for a procedure (money value).

VAT Amount =  Unit Net Price x VAT Percent / 100.

Selected Procedures

grid

All procedures for a claim, one procedure per line. 

The grid contains the following columns:

• Code, shows selected value in Procedure;

• Quantity, shows set value in Quantity;

• Gross, calculates as Quantity x Unit Gross Price x (100 - Discount) / 100;

• Net, calculates as Quantity x Unit Net Price x (100 - Discount) / 100;

• Clinician, shows Ordering Clinician.

The grid is not editable.

Add new procedure (Ctrl + N)

link 

On clicking the link

(or pressing Ctrl + N) an empty row adds to the Selected Procedures grid.

Remove this procedure (Ctrl + D)

link 

On clicking the link

(or pressing Ctrl + D) the highlighted row removes from the Selected Procedures grid.

Totals

Total Gross

text field

Total gross price for all procedures (activities) in the claim.

The field is not editable.

Total Patient Share

text field

Total patient share for all procedures (activities) in the claim.

 The field is not editable.

Total Net

text field

Total net price for all procedures (activities) in the claim.

 The field is not editable.