Procedure Details tab

Control Name

Type

Description

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 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 claims.

Ordering clinician is mandatory if Encounter start >= 1-Jun-2014. Ordering clinician must be empty if Encounter start < 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 claims.

Performing clinician is optional if Encounter start >= 1-Jun-2014. Performing clinician is mandatory if Encounter start < 1-Jun-2014.

Start date

date picker

Activity start date. The latest saved Start Date will be preselected by default in new requests and claims.

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

Quantity

text field

How many items of selected procedure clinician prescribes.

Possible values: 0.0001-999.9999.

Add PDF attachment

link 

On clicking Add PDF attachment 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 Update observations Observations form opens where the user can set observations of LOINC or Text type. For a sent request (that cannot be edited) the link name is View observations.

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, then Patient share recalculates: Patient share = Gross price x Copay / 100.

If the user modifies Patient share, Copay value clears.

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, 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.

Patient share = Gross price x Copay / 100.

Net price

text field

Net price for one unit of the procedure.

Net price = Gross price - Patient share.

If the user modifies Net price, then Gross price adjusts. If the user modifies Gross price or Patient share, then Net price adjusts.

Selected procedures

grid

All procedures for a request, 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 Gross price x (100 - Discount) / 100;
• Net, calculates as Quantity x 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.

Total gross (requested)

text field

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

Total patient share (requested)

text field

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

Total net (requested)

text field

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

Denial code as per the payer reply.

Format: denial code - denial description