Patient Details

No.

Control Name

Type

Description

1

Find patient

text field

Patient information used to search for a patient. Default value: empty. The 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

The insurance company that 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

The 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

Insurance plan

drop-down

Cover plan for the specified payer.Default value: empty.When the user sets Payer, Cover Plan drop-down fills automatically with custom values for this payer. Users can select a plan from the list or type another one – a 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.