Standard DMS Records

The following records are automatically available:



Alert Messages
You can use this record to store alert messages that will display in specified functions when a patient account is selected using Patient Look-up.

The Alert Messages summary screen shows the date the record was originally entered, the contents of the alert message, the user who last added or modified the record and the date and time of the modification for each record.



If you select an existing record, the data currently stored for that record displays.



If you click Add in the Action Column on the Alert Messages summary screen to add a new record, you need to type a date in the Date dialog box.



Data Field Information
Prompt Response Req Len
NOTES Type the alert message that you want displayed when a patient account is selected. 60*4
All Functions If you want this alert to display when a patient is selected using Patient Look-up in all functions, select this checkbox.   1
Patient If you want this alert to display when a patient is selected in the Patient functions, select this check box.   1
Limited Schedule If you want this alert to display when a patient is selected using Patient Look-up in the Schedule functions, select this check box.   1
Expanded Schedule If you want this alert to display when a patient is selected using Patient Look-up in the schedule function,select this check box.   1
Transactions If you want this alert to display when a patient is selected using Patient Look-up in the Transactions functions, select this checkbox.   1
Billing If you want this alert to display when a patient is selected using Patient Look-up in the Billing functions, select this checkbox.   1
Collections If you want this alert to display when a patient is selected using Patient Look-up in the Collections functions, select this checkbox.   1
Managed Care If you want this alert to display when a patient is selected using Patient Look-up in the Managed Care functions, select this checkbox.   1
Rx Management If you want this alert to display when a patient is selected using Patient Look-up in the Rx Management functions, select this checkbox.   1
System If you want this alert to display when a patient is selected using Patient Look-up in the System functions, select this checkbox.   1

The Alert Message dialog box displays in the functions you select. The date the alert was originally entered appears after each entry.



Allergy Record:
You can use this record to store information about any allergies the patient may have.

The Allergy Record summary screen shows the code and name of the allergy, the date it was first observed, any comments/allergic reaction and an end date to represent the date that the allergic reaction ended. To select a record, click anywhere on a row containing the allergy information.



If you select an existing record, the data currently stored for that record displays.



Click Add in the Action Column on the Allergy Record summary screen to start a new record. Click Delete in the lower-right corner of the screen to delete an existing record.

Data Field Information
Prompt Response Req Len
Allergy Type the code you want or select from the Allergy list. 1
Date First Recorded/Observed Type the date you want or click the calendar icon to select a date.   10
Comments/Reaction Type any comments or description of the allergic reaction.   50
End Date Type the date you want or click the calendar icon to select a date. This date represents the date that the patient no longer has the allergic reaction.   10


Contact Information:
You can use this record to store additional contact information for the patient. For example, an emergency contact person, spouse's employer, or school information.



Data Field Information
Prompt Response Req Len
Contact Name Type the primary contacts first and last name.   35
Address Line One Type the address for this contact.   35
Two Type any additional address information.   35
Zip Code Type the five digit zip code or the zip-plus-four, including the dash, for this contact.   10
City Type the city for this contact.   15
State Code Type the two digit state code for this contact.   3
Home Phone Type the phone number for this contact, if different from the patient's.   20
Work Phone Type the work phone number for this contact.   20
Cell Phone Type the cell or other phone number for this contact.   20
Relationship Type the relationship of this contact to the patient.   35
Secondary Contact Type the secondary contacts first and last name.   35
Address Line One Type the address for this contact.   35
Address Line Two Type any additional address information.   35
Zip Code Type the five digit zip code or the zip-plus-four, including the dash for this contact.   10
City Type the city for this contact.   15
State Code Type the two dig it state code for this contact.   3
Home Phone Type the phone number for this contact, if different from the patient's.   20
Work Phone Type the work phone number for this contact.   20
Cell Phone Type the cell or other phone number for this contact.   20
Relationship Type the relationship of this contact to the patient.   35

Click Validate Address to convert the address entered into the standard United States Postal Service format. The Address Line One will be converted; the information in Address Line Two (if standard) moves up to the end of Address Line One; the Zip Code is converted to Zip+4 and the City and State are converted based on the Zip Code. If a standard match cannot be found, messages display to explain. If you disagree with the converted address, you can change it back and save it without the validation changes. These changes will prevent claims from being rejected or added to the Exception report due to an invalid address or state code.


Family Income Data:
This record is for Community Health Centers only. You can use this record to utilize a sliding fee schedule based on a familys income level. This record must exist for the UDS Reporting. If you select to compile UDS reports for a certain grant, the reports include only the patients who have a Family Income Data record. Then, depending on which grant you pick, only certain patients will pull into the reports based on the data entered in this Family Income Data record.

The Family Income Data summary screen shows the date the record was originally entered, the Record number, the user who last added or modified the record and the date and time of the modification for each record.



If you select an existing record, the data currently stored for that record displays.



If you click Add in the Action Column on the Summary screen to add a new record, you need to type a date in the Date dialog box. Click Delete in the lower-right corner of the screen to delete an existing record.



Data Field Information
Prompt Response Req Len
Family Members Type the number of individuals in this family. 2
Payroll Frequency Select the payroll frequency from the Payroll Frequency list.   1
Payroll Amount$ Type the amount of each payroll.   10
Annual Income$ Type the annual income of the family. This field will default with the annual income based on the amounts you typed in the Payroll Frequency and Payroll Amount fields.   10
Review Date Type the date you want to review this data or click the calendar icon to select a date. The Review Date allows you to track which patients need to have their income reviewed. This Review Date shows as an Alert on the patients account thirty days prior to the actual date entered. This alerts the clinic if this patient makes an appointment or comes in for services. Updated financial information can be obtained at that time. 10
Migrant/Seasonal Program For UDS Reporting, select the Migrant/Seasonal worker status option.   1
Homeless Program For UDS Reporting, select the homeless status from the Homeless Program list.   1
Public Housing Program If this family is enrolled in a Public Housing Program, select this check box.   1
School Based Program If this family is enrolled in a School Based Program, select this check box.   1
Medical Fee $ Some clinics have minimum amounts they want collected even if the family is at 100% poverty level. If your practice varies its flat fees by family, type the flat fee amount for medical services for this family, if applicable. (If your practice charges the same flat fee for everyone, type the flat fee in the Medical Fee $ field in the UDS Integration function {Reports, UDS Reports}).

These fields also depend on how you chose to set up the order hierarchy with the Nominal Fee $ field in the Type of Service Table and in the Procedure Code Table at the time of installation.		   10
Percentage After you save and go back into the Family Income Data screen, this field defaults with the amount stored in the Disc Percent field in Maintain Income Based Fees (Tables, Fee Schedule Table), based on where the Annual Income$ falls within the Min Income and Max Income range.   5
Dental Fee $ Some clinics have minimum amounts they want collected even if the family is at 100% poverty level. If your practice varies its flat fees by family, type the flat fee amount for dental services for this family, if applicable. (If your practice charges the same flat fee for everyone, type the flat fee in the Dental Fee $ field in the UDS Integration function {Reports, UDS Reports}).

These fields also depend on how you chose to set up the order hierarchy with the Nominal Fee $ field in the Type of Service Table and in the Procedure Code Table at the time of installation.		   10
Denied Discount If the patient's income is undeclared, select this check box.   1
Veteran If a family member is a veteran, select this check box.   1
Poverty Level If you want to force this patient into a poverty level, A for highest level.   1


If you complete the Family Income Data record for a patient account and type a date in the Review Date field, the Alerts dialog box displays, indicating the Review Date, each time you access the patient's account.



HIPAA Information:
You can use this record to store the information HIPAA requires your practice to maintain.



Data Field Information
Prompt Response Req Len
Date Notice of Privacy Practices signed Type the date the patient signed this document or click the calendar icon to select a date.   10
Date Disclosure of Health Info signed Type the date the patient signed this document or click the calendar icon to select a date.   10
Exclusions/Alerts Type any additional information needed regarding this patient pertaining to HIPAA regulations. If you type anything in this field, the Alerts dialog box will display, indicating the HIPAA Alert, each time you access the patient's account.   50*4
PHI Release: Name Type the individual's name the patient has indicated to release/deny access to their Private Health Information (PHI).   20
Release/Deny: Select the option applicable for this individual.   1
Identifier: Mothers Maiden Name Type the maiden name of the patient's mother. Every Identifier field is provided for you to capture information that may be used to confirm your patient's identity prior to disclosing their health information.   15
Identifier: City of Birth Type the patient's city of birth.   15
Identifier: Favorite Color Type the patient's favorite color.   15
Identifier: Optional Type any additional identifier text applicable.   15
Identifier: Optional Type any additional identifier text applicable.   15

If you complete the HIPAA record for a patient account and type anything in the Alerts/Exclusions field, the Alerts dialog box displays, indicating the HIPAA Alert, each time you access the patient's account.



Hospitalization
You can use this record to store information about any inpatient hospital visits for the patient.

The Hospitalization summary screen shows the Record Number, the Description of the hospitalization and the Admit and Discharge Dates.


If you select an existing record, the data currently stored for that record displays.



Click Add in the Action Column on the Hospitalization summary screen to start a new record. Click Delete in the lower-right corner of the screen to delete an existing record.

Data Field Information
Prompt Response Req Len
Date Admitted Type the date the patient was admitted to the hospital or click the calendar icon to select a date. 10
Date Discharged Type the date the patient was discharged from the hospital or click the calendar icon to select a date.   10
Hospital Type the hospital location code or select a code from the Hospital list. The only codes displayed in the list are inpatient or outpatient location codes that contain an equivalent location code of twenty-one (21), twenty-two (22), thirty-one (31), fifty-one (51), or sixty-one (61) in the Location Code Table. 5
Floor # Type the hospital floor number assigned to this patient.   10
Room # Type the hospital room number assigned to this patient.   10
Reason for Admit Type the reason the patient was admitted to the hospital.   50*5
MRN Type the Medical Record Number assigned by the hospital for this patient. This field is primarily used by CGM webMOBILE.   20
Hospital Note Type any applicable hospital note text.   50*5

Insurance Notes:
You can use this record to store notes regarding claims and communication with insurance companies. You should utilize the INOTES record if you are using the Insurance Collections Module to track payments from insurance companies.

The Insurance Notes summary screen shows the Date of Service, the contents of the note, the user who last added or modified the record and the date and time of the modification for each record.



If you select an existing record, the data currently stored for that record displays.



If you click Add in the Action Column on the Insurance Notes summary screen to add a new record, you need to type the date of service and the insurance note in the Add Notes dialog box. Click Delete in the lower-right corner of the screen to delete an existing record.



Data Field Information
Prompt Response Req Len
Date of Service Type the date of service or click the calendar icon to select a date. 10
Note Type any applicable note text.   10
 
When an INOTE has been added for a date of service and you point to the transaction on the patient's Transaction History screen, the attached INOTE displays.



Notes:
You can use this record to store general notes on the patient's account.

(NOTE: If you add any notes in the Collections module in the Work Accounts function using the Add a Note function on the Action Column, they are automatically stored and displayed as part of this DMS Notes record.)

The Notes summary screen shows the date the record was originally entered, the contents of the note, the user who last added or modified the record and the date and time of the modification for each record.


If you select an existing record, the data currently stored for that record displays.

If you click Add in the Action Column on the Notes summary screen to add a new record, you need to type the date and the note in the Add Notes dialog box. Click Delete in the lower-right corner of the screen to delete an existing record.

Data Field Information

 

UB-92 Information - Part 1:
You can use this record to enter and store details for the UB claims. For information on UB setup, see UB Setup Information.

The UB-92 Information Part 1 summary screen shows the date the record was originally entered, the record number, the user who last added or modified the record and the date and time of the modification for each record.

If you select an existing record, the data currently stored for that record displays.

Click Add in the Action Column on the UB-92 Information Part 1 summary screen to start a new record. Click Delete in the lower-right corner of the screen to delete an existing record.

UB-92 Information - Part 2:
You can use this record to enter and store details for the UB claims. For information on UB setup, see UB Setup Information.

The UB-92 Information Part 2 summary screen shows the date the record was originally entered, the record number, the user who last added or modified the record and the date and time of the modification for each record.

If you select an existing record, the data currently stored for that record displays. Click Delete in the lower-right corner of the screen to delete an existing record.

Click Add in the Action Column on the UB-92 Information Part 2 summary screen to start a new record.


Custom Form
You can use these custom records to store information based on the custom forms you create with the Form Generator function. These forms display with Custom next to the Description.



The screen that displays when you select a custom form depends on the Storage Strategy you selected when creating the form in the Form Generator. The Storage Strategy cannot be changed after the form is created; you would need to create a new form.