No. | Control Name | Type | Description |
1 | Find Patient | text field | Patient information used to search for a patient.Default value: empty.User can type it manually (e.g. a part of patient name, Member ID, Patient ID) and press Enter key or they can select it from the list which opens by pressing […] button. Patient details load to Patient details tab. |
2 | Patient ID | text field | Patient unique identifier.Default value: empty.Patient ID is not editable, it is assigned with new patient saving. |
3 | Payer ID | text field | Insurance company which pays the claim.Default value: empty. Format: code: company name. User can type it manually (e.g. a code) and press Enter key or they can select it from the list which opens by pressing […] button. |
4 | TPA ID | text field | Third-party administrator that processes the claim.Default value: empty. Format: code: company name. User can type it manually (e.g. a code) and press Enter key or they can select it from the list which opens by pressing […] button. |
5 | Member ID | text field | Patient insurance card for the specified payer.Default value: empty. |
6 | Cover Plan | drop-down | Cover plan for the specified payer.Default value: empty.When user sets Payer, Cover Plan drop-down fills automatically with custom values for this payer. User can select a plan from the list or type another one – new plan will be added to the list. |
7 | First Name | text field | Patient first name.Default value: empty. |
8 | Last Name | text field | Patient last name.Default value: empty. |
9 | Gender | drop-down list | Patient gender.Default value: empty.Possible values: Male, Female. |
10 | Birth Date | date picker | Patient birth date.Default value: empty. |
11 | Emirates ID | drop-down list | Patient Emirates ID.Default value: Unknown status, without a card.Possible values:- National without a card;- Expatriate resident without a card;- Not national, not expatriate resident without a card;- Unknown status, without a card |
12 | Nationality | text field | Patient nationality.Default value: empty.Format: nationality: country. User can type it manually (e.g. a code) and press Enter key or they can select it from the list which opens by pressing […] button. |
13 | Mobile | text field | Patient mobile number.Default value: empty. |
14 | Work Tel. | text field | Patient work phone number.Default value: empty. |
15 | Home Tel. | text field | Patient home phone number.Default value: empty. |
16 | Address | text field | Patient address or addresses.Default value: empty. |