PATIENT APPOINTMENT AND SCHEDULING REFERENCE MANUAL
Transcription
PATIENT APPOINTMENT AND SCHEDULING REFERENCE MANUAL
SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 PATIENT APPOINTMENT AND SCHEDULING REFERENCE MANUAL Copyright 1996 SAIC License is granted under Contract DAHC94-88-D-0005 and the provisions of DFAR 52.227-7013 (May 1987) to the U.S. Government and third parties under its employ to reproduce this document, in whole or in part, for Government purposes only . Submitted in Response to Contract DAHC94-88-D-0005, CDRL Item B047 For: U.S. Army Information System Section & Acquisition Agency and Composite Health Care System Program Office By: Science Applications International Corporation (SAIC) Health Care Technology Sector (HCTS) 10260 Campus Point Drive, San Diego, CA 92121 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 LIST OF EFFECTIVE PAGES Reference copyright on title page. • This document includes the specific pages cited below. • The “Date” column indicates the date carried in the header of the subject page, thereby identifying the current issue of each page in this document. • If change pages are issued, insert as specified in the change notice. Dispose of superseded pages in accordance with applicable regulations. Date Page Number 29 Jul 1996 Title page (i) 29 Jul 1996 ii —vii 29 Jul 1996 1-1 — 1-12 29 Jul 1996 2-1 — 2-114 29 Jul 1996 3-1 — 3-36 29 Jul 1996 4-1 — 4-211 29 Jul 1996 5-1 — 5-51 29 Jul 1996 6-1 — 6-459 ii SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 RECORD OF CHANGE This record is maintained throughout the life of the document; each published update is recorded. A Change Package (re-issue of changed pages only) carries change bars in the page margins to identify differences from the preceding issue. Due to the scope of change that necessitates a Revision (re-issue of entire document), a Revision does not carry change bars. Issue Date Summary Description Alpha Draft 06 May 1996 Initial draft submittal. CHCS-4.5 Final 29 Jul 1996 CHCS-4.51 Initial submittal. iii Reference Data SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 PATIENT APPOINTMENT AND SCHEDULING REFERENCE MANUAL Table of Contents Section Page INTRODUCTION TO THE REFERENCE MANUAL ............................. vi Section 1 Subsystem Overview ............................................................................... 1-1 Table 1. File Access Codes for Common, PAS, and MCP Files ............. Table 2. PAS and MCP Security Keys .................................................... 1-6 1-8 Section 2 Menu Diagrams & Definitions .............................................................. 2-1 PAS System Menu Diagram.................................................................... Scheduling Supervisor Menu Diagram................................................... Scheduling Supervisor Menu Definitions ............................................... Clerk Scheduling Menu Diagram ........................................................... Clerk Scheduling Menu Definitions........................................................ Emergency Room Menu Diagram ........................................................... Emergency Room Menu Definitions ....................................................... Managed Care Program Menu Diagram ................................................ Managed Care Program Menu Definitions............................................. 2-16 2-17 2-20 2-40 2-41 2-48 2-49 2-54 2-64 Section 3 Procedure Flowcharts ............................................................................ 3-1 BOOK APPOINTMENTS FOR A SINGLE PATIENT .......................... BOOK APPOINTMENTS FOR MULTIPLE PATIENTS (SINGLE CLINIC) ................................................................................ BOOK APPOINTMENTS FOR A FAMILY ............................................ OVERBOOK AN APPOINTMENT SLOT .............................................. MODIFY AN APPOINTMENT SLOT .................................................... CREATE A PROVIDER SCHEDULE .................................................... WAIT LIST PROCESSING ..................................................................... CANCEL APPOINTMENT SLOTS BY FACILITY ............................... MODIFY PROVIDER SCHEDULES ...................................................... CREATE DAILY PROVIDER TEMPLATE ............................................ CREATE WEEKLY PROVIDER TEMPLATE ....................................... EDIT A CLINIC PROFILE ...................................................................... CHECK-IN PATIENT(S) ......................................................................... iv 3-2 3-3 3-4 3-5 3-6 3-7 3-8 3-9 3-10 3-11 3-12 3-13 3-14 Table of Contents SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 PATIENT APPOINTMENT AND SCHEDULING REFERENCE MANUAL Table of Contents (continued) Section Page END-OF-DAY PROCESSING ................................................................. ADD/MODIFY/DELETE WAIT LIST REQUEST .................................. APPOINTMENT CANCELLATION BY PATIENT ............................... CHECK-OUT EMERGENCY ROOM PATIENT .................................... UPDATE EMERGENCY ROOM PATIENT DATA ............................... CHECK-OUT/RECHARGE PATIENT MEDICAL RECORD ................ ENROLL AN ACTIVE-DUTY PATIENT INTO THE MCP .................. ENROLL A FAMILY MEMBER INTO MCP ......................................... AUTO ENROLL AN ACTIVE-DUTY PATIENT INTO MCP ................ ASSIGN AN EXCEPTION PROVIDER TO AN MCP PATIENT .......... REASSIGN A FAMILY TO A NEW PCM .............................................. REASSIGN A PCM’S PATIENTS TO ONE OR MULTIPLE NEW PCMS .......................................................................................... BOOK AN APPOINTMENT FOR AN ENROLLED PATIENT WITH AN ASSIGNED PCM ................................................................ BOOK AN APPOINTMENT FOR AN ENROLLED PATIENT WITH A PROVIDER ............................................................................ BOOK AN APPOINTMENT FOR A NON-ENROLLED PATIENT WITH A PROVIDER ............................................................................ BOOK AN APPOINTMENT FOR A CASE MANAGEMENT PATIENT WITH AN EXCEPTION PROVIDER ................................ GENERATE A NON-AVAILABILITY STATEMENT ........................... ENTER A NEW PLACE OF CARE ......................................................... CREATE A PROVIDER GROUP ............................................................ ASSIGN A UNIT IDENTIFICATION CODE (UIC) TO A PCM ........... 3-15 3-16 3-17 3-18 3-19 3-20 3-21 3-23 3-25 3-26 3-27 3-28 3-29 3-30 3-31 3-32 3-33 3-34 3-35 3-36 Section 4 Quick Reference Guides ......................................................................... 4-1 Section 5 Subsystem Glossary................................................................................. 5-1 Section 6 Sample Output Reports .......................................................................... 6-1 MCP ............................................................................................................. 6-229 v Table of Contents SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 INTRODUCTION TO THE REFERENCE MANUAL The subsystem-specific Reference Manual is designed to help you during CHCS training classes and at the workcenter as you become familiar with CHCS. You can use the information in this manual to: • Review what you learned in your functionality training • Become familiar with other options included in your subsystem • Provide detailed on-the-job quick references The subsystem Reference Manual contains the following sections: Section 1. Subsystem Overview Section 2. Menu Diagrams & Definitions This section contains menu diagrams for the entire subsystem, and definitions of every menu option in the diagrams. The first part of this section is the Option Finder, where every menu option in the subsystem is listed alphabetically by option name (not synonym). The page number where the option definition is found is listed at the right margin, opposite the option name. A diagram of the main subsystem menu immediately follows the Option Finder. Beginning on the page following this diagram, options on the main subsystem menu are briefly defined in the order they appear on the menu. Options on the main subsystem menu that lead to additional menus are also diagrammed to show all menu layers. On a separate page, associated option definitions immediately follow each main option diagram, also in the order they appear on the successive menus. Section 3. Procedure Flowcharts Flowcharts are a visual representation of the steps required to complete a procedure. vi Introduction SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Section 4. Quick Reference Guides This section contains “at a glance” information, including option or action definitions, screen displays, entry path, and other “need to know” information, for commonly used options and actions. Most of the guides are specific to the subsystem; however, some of the guides in each Reference Manual apply to all subsystems. The titles of these common Quick Reference Guides all begin with “CHCS.” The guides are displayed sideways on the paper so that the sites can have the guides bound into a pocket-size quick reference for users. Section 5. Subsystem Glossary This section contains CHCS and subsystem terminology and definitions. The terms are arranged alphabetically for easy reference. Section 6. Sample Output Reports This section contains sample copies of subsystem reports. You may want to refer students to this section during class as you discuss the various reports available. • END vii Introduction SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 PATIENT APPOINTMENT AND SCHEDULING REFERENCE MANUAL Section 1 Subsystem Overview 1-1 Subsystem Overview SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 PATIENT APPOINTMENT AND SCHEDULING REFERENCE MANUAL Section 1. Subsystem Overview CHCS provides functionality in nine subsystems. This is the software that most medical treatment facility (MTF) personnel use on a daily basis as they perform patient care and administrative activities. A description of the Patient Appointment and Scheduling (PAS) subsystem follows. PATIENT APPOINTMENT AND SCHEDULING (PAS) PAS software is used by scheduling supervisors who use the PAS Subsystem to add and maintain clinic, provider, and appointment type profile information. Processing provider schedules is simplified by templates that can quickly create the needed schedules. The transfer of schedules between providers in a clinic can be performed automatically and any schedule conflicts are displayed to the user for resolution. When new schedules are created, Wait List requests can be processed automatically, including generation of mailers notifying the patients of the booked appointments, or interactively recording the results of the attempted phone contact and any booked appointment. Booking personnel use PAS functions in the performance of their daily tasks to search for single or multiple appointments in one or more clinics; to cancel and reschedule appointments, and enter Wait List requests. Patient appointment information, (past, present, or future) can be quickly displayed and printed when needed. The Front Desk personnel use various options to check-in patients, process Wait List requests, and maintain the End-Of-Day Processing Report. Emergency Room (ER) personnel use PAS functionality to enter and update ER encounters. Rapid entry of patients not registered can be performed, and the patient data can be easily updated as necessary. Encounter forms (SF558) can be printed automatically or on demand. PAS personnel use CHCS to automate collecting data for the generation and printing of rosters, management reports, operational reports, and workload statistics. 1-2 Subsystem Overview SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 MANAGED CARE PROGRAM (MCP) MCP software is an automated program that helps MTFs manage information for MCP network providers and their subcontractors. MCP allows health care finders (HCFs), health benefits advisors, MTF booking clerks, and MTF supervisors to search for the most cost-effective source of speciality care regardless of whether the patient is enrolled in the MCP. When searching for specialty care, the MCP simultaneously searches for both MTF and civilian providers in the network. MCP then displays a list of providers, grouped by discount rate, from which a selection can be made. MCP personnel can maintain system files and tables that support MCP; create and maintain information to support the provider network and other MCP management reports and outputs; perform patient enrollment processing; manage appointment referrals, perform provider searches, and book appointments with specialists in the provider network for both enrolled and non-enrolled patients; book appointments for enrolled patients with their primary care manager; and issue non-availability statements (NASs) and care authorizations. MENU ASSIGNMENTS Prior to activation of the PAS subsystem, users must be assigned their access and verify codes, menus, File Manager (FileMan) access codes, and security keys. PAS Primary Menu Assignments All users are assigned a primary menu. When the user logs on to the system, this menu displays. Some PAS users can be assigned the PAS System Menu [SD PAS MAIN MENU] as their primary menu, while others are assigned a different primary menu depending on their function within the clinic. The PAS System Menu gives access to all supervisor and clerk functionality and should be limited to supervisors. The following guidelines are used for assigning menus to PAS users: User Menu PAS Supervisors SD PAS SUPER PAS Clerk SD CLERK MENU PAS Supervisors and Clerks SD PAS MAIN MENU Emergency (ER) Personnel SD EMERGENCY ROOM MAIN MENU 1-3 Subsystem Overview SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 MCP Menu Assignments The following guidelines, FileMan access codes, and security keys are used for assigning menus to MCP users: – MCP File and Table (F/T) Point of Contact (POC) Primary Menu Option: Secondary Menu Options: FileMan Access Codes: Security Keys: – Systems Manager Menu (EVE) #SsA CPZ MCP CPZ NET CPZ FILE CPZ AGRMOD DOD DATABASE ADMIN DOD F-T MANAGEMENT DOD REACTIVATE DOD MEPRS SYSTEM DOD MEPRS SD MCP F/T POC - Systems Manager Menu (EVE) Restricted Primary Menu Option: Secondary Menu Options: FileMan Access Codes: Security Keys: Managed Care Program Menu [MCP MAIN MENU] Menu Management Menu [XUMAINT] User Management Menu [XUSER] Database Administration Menu [DOD DB MENU] #SsA CPZ MCP CPZ NET CPZ FILE CPZ AGRMOD CPZ AD HOC/DIOUT DOD DATABASE ADMIN DOD F-T MANAGEMENT DOD REACTIVATE DOD MEPRS SYSTEM DOD MEPRS SD 1-4 Subsystem Overview SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 – MCP HCFs Primary Menu Option: Secondary Menu Options: FileMan Access Codes: Clinic Access (PAS Booking Keys): Managed Care Program Menu [MCP MAIN MENU] End-of-Day Processing/Editing [SD EOD EDITING] Operational Reports Menu [SD OPER REPORTS] &s Security Keys:CPZ MCP CPZ CASE CPZ NAS CPZ PCM LABEL SD (BOOKING AUTHORITY) SD (CHANGE AUTHORITY) SD (OVERBOOK AUTHORITY) FILEMAN ACCESS Some files and some fields within the files are protected with FileMan access security. The user must have one of the file access codes assigned in the User file record to be able to perform the read, write, delete, copy, or learn as you go (LAYGO) of the file. Each subsystem within CHCS has specific FileMan access codes. Generally, uppercase codes specify supervisor access and usually permit both read and write access. Lowercase codes specify standard user access and usually permit read-only access. Each subsystem defines the use of the related code. Table 1 lists the Common, PAS, and MCP files and the associated FileMan access codes needed to read, write, or LAYGO into each file. Note that only one of the codes specified is needed for access. After a FileMan access code has been added or edited, the user must perform a restart session to update the user account. 1-5 Subsystem Overview SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Table 1. File Access Codes for Common, PAS, and MCP Files File # File Name Access Read Write LAYGO # # Common Files 40.8 Medical Center Division S 45.7 Department and Service # # 8119 MEPRS Codes # # 5.8002 Zip Code #^ #^ 40.5 Holiday # # 44 Hospital Location Ss Ss 7 Provider Class # # 3.1 Title # # 3 User # # 6 Provider #P #P 8111 Unit Ship ID # # Ss @ PAS Files 44.5 Appointment Type Ss S 44.6 PAS Profile Template Ss S S Aa Aa MCP Files 8064 Insurance Company 8561 MCP Assignment Reason Ss S S 8564 MCP Disenrollment Reason Ss S S 8560 MCP Form Text S S S 39.4 Embosser Format #DdSs #DS #DS FM-00398-1 1-6 Subsystem Overview SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Table 1. File Access Codes for Common, PAS, and MCP Files (continued) File # File Name Access Read Write LAYGO 8555 MCP Office Ss Ss Ss 8556 MCP HCF Ss Ss Ss 8577 MCP Zip Code Combination Ss Ss Ss 8566 MCP Facility Type Ss S Ss 8583 NAS Issuing Officer S S S 8576 MCP Provider Specialty Type Ss S S 8568 Professional Category Ss S S 8569 Military Status Ss S S 8550 MCP Provider Group Ss S 8553 MCP Place of Care Ss S 78551 MCP Provider Ss S S 8570 MCP Appointment Refusal S @ @ 8578 MCP Parameters S S S 8579 MCP Unit PCM Ss Ss @ FM-00398-2 1-7 Subsystem Overview SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 SECURITY KEYS Table 2 briefly describes the PAS and MCP security keys. Table 2. PAS and MCP Security Keys Security Key Description PAS Security Keys SDCL1 Security key for supervisors at the clinic level. Assign to supervisors who are the only ones allowed to book a particular appointment type (if set up with clinic appointment types) or perform End-of-Day Processing more than seven days in the past. This key can be given to the appointment types at the clinic level. SDCL2 Security key for senior/lead clerks at the clinic level. This key does not restrict or control any PAS options at this time. SDCL3 Security key for general clerks at the clinic level. This key does not restrict or control any PAS options at this time. SDEROOM Allows holders access to the Emergency Room primary menu [SD EMERGENCY ROOM MAIN MENU]. Assign to all ER personnel who require access to perform ER functions in CHCS. SDHCP1 Security key for supervisors at the provider level. Assign to supervisors who need the capability to edit End-of-Day processing more than seven days in the past. SDHCP2 Security key for senior/lead clerks at the provider level. This key does not restrict or control any PAS options at this time. SDHCP3 Security key for general clerks at the provider level. This key does not restrict or control any PAS options at this time. FM-00399-1 1-8 Subsystem Overview SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Table 2. PAS and MCP Security Keys (continued) Security Key Description SDZ PAS FILE-TABLE MAINT Allows holders access to the PAS File/Table Maintenance Menu. Assign to those supervisors who need to activate and inactivate providers in clinics; create new clinics; enter/edit Medical Expense and Performance Reporting System (MEPRS) codes/cost pools, method of transit codes, outpatient disposition codes, schedule modification reasons, trackable entity codes, wait list priorities; and enter/edit, view, and print PAS mailers. SD ARCHIVE Locks the Archive Patient Date option on the PAS Menu. (Note: Do not assign this security key to any users as the archive functions are still under development.) This key does not restrict or control any PAS options at this time. SDZ RESTRICTED VIEW Allows holders to set restricted clinics and to give other users access to them. (Note: Do not assign this security key to any users as the restricted view functions are still under development.) This key does not restrict or control any PAS options at this time. MCP Security Keys CPZ MCP Allows holders to access the Managed Care Program Menu [MCP MAIN MENU] on the PAS Main Menu [SD PAS MAIN MENU]. All HCFs and MCP File and Table POCs should be assigned this key. CPZ NET Locks the Provider Network Management Menu [MCP NET MAINTAIN MENU] option on the Managed Care Program Menu [MCP MAIN MENU]. MCP File and Table POCs should be assigned this key. CPZ FILE Locks the File and Table for MCP Menu [MCP FILE TABLE MAINT MENU] on the Managed Care Program Menu [MCP MAIN MENU]. MCP File and Table POCs should be assigned this key. FM-00399-2 1-9 Subsystem Overview SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Table 2. PAS and MCP Security Keys (continued) Security Key Description CPZ AGRMOD Allows holders to access the Modify Group Agreement Effective Date [MCP AGREEMENT MODIFICATION] option on the Provider Network Management Menu [MCP NET MAINTAIN MENU]. This is a central processing unit (CPU)-intensive option and should only be assigned to a few select MCP File and Table POCs. CPZ AGREEMENT Locks the Agreement Type Enter/Edit [MCP AGREEMENT TYPE ENTER EDIT] option on the Provider Network File/Table Maintenance Menu [MCP HCP NET FILE MAINT MENU]. Allows users with the CPZ FILE security key to edit the agreement types for the MTF. This key should only be assigned to a few select MCP File and Table POCs. CPZ OHI Allows PAS users to enter other health insurance (OHI) via the PAS Demographics Display Action Bar. CPZ CASE Allows holders to enter/edit case managers (nonnetwork providers/exception providers) for patients. PAS users who hold the CPZ OHI security key in addition to this key have the capability to add case managers via the OHI option on the Demographics Display screen. CPZ NAS Locks the Interactive NAS Processing Menu [MCP NAS MAIN MENU] option on the Managed Care Program Menu [MCP MAIN MENU]. This option allows users to enter non-availability statements (NASs). CPZ PCM BATCH Locks the Batch PCM Reassignment [MCP BATCH PCM REASSIGNMENT] option from the Managed Care Program Menu [MCP MAIN MENU]. This is a CPU-intensive task that should be restricted to selected personnel. CPZ AD HOC Allows holders within the MCP module to access Print, Search, and Inquire File Entries options. FM-00399-3 1-10 Subsystem Overview SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Table 2. PAS and MCP Security Keys (continued) Security Key Description CPZ LABEL Allows holders to generate provider labels, and mailing labels for individual patients or by family (batch). CPZ ZIP Allows holders to override a patient's residential zip code if that zip code has been defined as being outside the enrollment (catchment) area for the site. CPZ PARAMETER Allows holders access to the MCP Parameters file. Allows the site to set restrictions on enrollment mix and zip codes, and to determine if the site is going to run in Local Empanelment Mode or Full Enrollment Mode. Additional Security Keys DOD DATABASE ADMIN Locks the Database Administration Menu [DOD DB ADMIN] option on the Core Application Menu [EXOCHORIA]. Assign to MCP File and Table POCs in order to access the MEPRS System Menu [DOD MEPRS SYSTEM MENU] and the Common Files and Tables Management Menu [DOD F-T BUILD MAIN MENU]. DOD F-T MANAGEMENT Locks the Common Files and Tables Management Menu [DOD F-T BUILD MAIN MENU] option on the Database Administration Menu [DOD DB ADMIN]. Assign to MCP File and Table POCs in order to access the Provider File Enter/Edit [DOD PROVIDER EDIT] option and Inactivate/Reactivate File Entries [DOD REACTIVATION] option. DOD REACTIVATE Locks the Inactivate/Reactivate File Entries [DOD REACTIVATION] option on the Common Files and Tables Maintenance Menu [DOD MAINTAIN F-T]. This is a very powerful option that should be closely monitored. It is primarily needed for MCP File and Table POCs that maintain the Civilian Provider Network. FM-00399-4 1-11 Subsystem Overview SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Table 2. PAS and MCP Security Keys (continued) Security Key Description DOD MEPRS SYSTEM Locks the MEPRS System Menu [DOD MEPRS SYSTEM MENU] option on the Database Administration Menu [DOD DB ADMIN]. Allows holders to inquire to four-digit MEPRS codes. DOD MEPRS SD Locks the Site Definable MEPRS Table Maintenance [DOD MEPRS SD TABLE MAT] option on the Workload Files Maintenance Menu [DOD MEPRS MAINTAIN F-T MENU]. The user who holds this key must also hold the DOD MEPRS SYSTEM key. Assign this key to the MCP File and Table POCs responsible for building the generic MEPRS codes for the MCP catchment area. The codes must be built under the Defense Medical Information Systems (DMIS) ID and GROUP ID associated with the MCP division. This is accomplished by building the codes while signed on to the MCP division. FM-00399-5 PAS Security Keys The PAS subsystem allows PAS supervisory personnel to control which scheduling clerks can book a slot for specified appointment types (Booking Authority), overbook according to a particular appointment type (Overbook Authority), or have the authorization to change, join, or split specified appointment types (Appointment Change Authority). These can be controlled either at the clinic level or provider level by using seven pre-assigned PAS security keys that are sent out with the PAS package for basic security access control (SDCL1-SDHCP3). The site can set up more elaborate security schemes by creating its own set of security keys. Selected PAS clinic personnel also need security keys to access some Medical Record Tracking (MRT) functions. END 1-12 Subsystem Overview SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 PATIENT APPOINTMENT AND SCHEDULING REFERENCE MANUAL Section 2 Menu Diagrams & Definitions 2-1 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 PATIENT APPOINTMENT AND SCHEDULING REFERENCE MANUAL Section 2. Menu Diagrams & Definitions Menu Definitions Index Title Page Activate/Inactivate Clinic Provider (AFIL) ...................................... 2-35 Activity Date and ER Clinic Edit (AER)........................................... 2-50 AD Family Member by Unit Enrollment Roster (1) ........................ 2-73, 2-83 Ad Hoc Report Menu (AHOC) ........................................................... 2-34 Ad Hoc Report Menu (AMCP) ........................................................... 2-113 Address Label for Patient (APAL) .................................................... 2-80 Agreement Data Changes (AGDC) ................................................... 2-112 Agreement Reports Menu (AMRM) .................................................. 2-104 Agreement Type Referral Summary (1) ........................................... 2-65, 2-87 Alphabetic Enrollment Roster by Service (2) ................................... 2-74, 2-83 Appointment Order Processing (AOP).............................................. 2-42 Appointment Referral Booking (AHCF) ........................................... 2-64 Appointment Type Enter/Edit (APRO) ............................................. 2-21 Appointment Type List (5) ................................................................ 2-22 Appointment Utilization Report (1) .................................................. 2-29 Assign PAS Primary Clinic Location (AUSR) .................................. 2-38 Assignment Reports Menu (APCM).................................................. 2-99 Audit Trail for Provider Network Menu (AUDI).............................. 2-112 Available PCM Capacity by Provider Group (1)............................... 2-79, 2-93 Available Schedule Monitor Bulletin (1) .......................................... 2-37 Aviation Medicine Report (2)............................................................. 2-37 Batch Enroll Active Duty (BENR) .................................................... 2-70 Batch PCM Reassignment (BPCM) .................................................. 2-100 2-2 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Menu Definitions Index (continued) Title Page Batch PCM Reassignment Menu (BMCP)........................................ 2-98 Batch Reports & Utilities Menu (BRPT) .......................................... 2-37 Book Appointments (BOK) ................................................................ 2-41 Branch of Service Summary Report (BNAS).................................... 2-101 Call No-Show Report (1) .................................................................... 2-25, 2-44 Cancel a Request (CAN) .................................................................... 2-47, 2-98 Cancellation by Facility (CMSC)....................................................... 2-25 Cancellation by Patient (CBP) .......................................................... 2-41 Cancellation by Patient (CMCP) ....................................................... 2-81 Cancellation Processing (Mail/Phone) (CNOT) ................................ 2-33, 2-42 Case Management Program Enrollment Roster (3) ........................ 2-74, 2-83 Catchment Area Zip Code Enter/Edit (CAZC) ................................. 2-110 Change Division of a Clinic (3).......................................................... 2-37 Change in Eligibility Enrollment Roster (4) .................................... 2-75, 2-84 Check-out & Patient Instructions (CER) .......................................... 2-49 Clean Up Appointment Global (4)..................................................... 2-37 Clean Up DMIS ID Update (CLUP).................................................. 2-109 Clerk Scheduling Menu ..................................................................... 2-41 Clerk Workload Recap Report (2) ..................................................... 2-30 Clerk Workload Report (3)................................................................. 2-30 Clinic Profile Edit (CPRO)................................................................. 2-20 Clinic Profile List (3).......................................................................... 2-22 Clinic Schedule Summary (2) ............................................................ 2-44 Clinic Workload Report (1) ................................................................ 2-51 Clinic Workload Report (4) ................................................................ 2-30 Command Facility Workload Recap Report (5) ................................ 2-31 2-3 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Menu Definitions Index (continued) Title Page Command Security Program Report (5) ........................................... 2-37 Conditional Enrollment Processing (CENR) .................................... 2-68 Consolidated OR Provider Roster (One Clinic) (1) ........................... 2-33 Consolidated OR Provider Roster (One Clinic) (3) ........................... 2-44 Consolidated Roster (ALL Clinics) (2) .............................................. 2-33 Correct Patient Data Menu (CPAT).................................................. 2-39 Create a New Clinic (CFIL)............................................................... 2-35 Create Schedules (CSCH).................................................................. 2-23 Create/Edit Daily Template (CTEM) ................................................ 2-23 Daily Outpatient Encounter Forms (Clin/Prov/Indv) (4) ................. 2-45 Daily Outpatient Encounter Forms (Division/All) (2)...................... 2-26 DEERS Eligibility Request (2) .......................................................... 2-52 DEERS Eligibility Request (DRDM)................................................. 2-43, 2-96 DEERS/Enrollment Maintenance Reports Menu (DEMR).............. 2-95 DEERS/Enrollment Maintenance Reports Menu (DRPM).............. 2-69 Default PCM/UIC Report (6) ............................................................. 2-80, 2-94 Delete Potential Candidate List (DBER).......................................... 2-71 Delete Template (DTEM) .................................................................. 2-23 Delinquent End-of-Day Processing Report (1) ................................. 2-26 Department and Service File Enter/Edit (DEPT) ............................ 2-111 Discount Provider Agreement Roster (1) .......................................... 2-90 Discount Provider Agreement Roster (4) .......................................... 2-105 Discrepancy Avoidance Report (3) .................................................... 2-106 Disenrollees for Period by Reason Code (5) ..................................... 2-75, 2-84 Disenrollment (DENR) ...................................................................... 2-68 Disenrollment Reason Enter/Edit (DISE) ........................................ 2-107 2-4 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Menu Definitions Index (continued) Title Page Disenrollment Summary by Reason (1) ........................................... 2-77, 2-86 Display Patient Appointments (DMCP) ........................................... 2-81 Display Patient Appointments (DPA)............................................... 2-41 Display Request (DIS) ....................................................................... 2-47, 2-98 Disposition Processing (DER)............................................................ 2-50 Division Profile Edit (DPRO) ............................................................ 2-20 Division Profile List (2)...................................................................... 2-22 Edit a Request (EDI).......................................................................... 2-47, 2-98 Emergency Room Clinic Profile Edit (1) ........................................... 2-21, 2-51 Emergency Room Clinic Profile List (6)............................................ 2-22 Emergency Room Menu ..................................................................... 2-49 Emergency Room Profiles Menu (EER) ............................................ 2-50 Emergency Room Profiles Menu (EPRO) ......................................... 2-21 Emergency Room Provider Profile Edit (2) ...................................... 2-51 Emergency Room Provider Profile List (7) ....................................... 2-22 End-of-Day Processing/Editing (2) .................................................... 2-51 End-of-Day Processing/Editing (EOD).............................................. 2-42 Enrollee DMIS ID Update (DMIS).................................................... 2-109 Enrollee Entitlement Discrepancy Report (10) ................................ 2-77, 2-85 Enrollee Lockout Override Reason Enter/Edit (LORE)................... 2-108 Enrollee/Patient Assignment Notification (ERPT) .......................... 2-99 Enrollment Block Reason Enter/Edit (EBRE).................................. 2-108 Enrollment Enter/Edit (EENR)......................................................... 2-68 Enrollment File/Table Maintenance Menu (ETAB)......................... 2-107 Enrollment Processing Menu (EMCP).............................................. 2-68 Enrollment Reports Menu (ERME) .................................................. 2-81 2-5 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Menu Definitions Index (continued) Title Page Enrollment Reports Menu (ERPM)................................................... 2-72 Enrollment Roster by PCM (2) .......................................................... 2-79, 2-93 Enrollment Roster Exception Conditions (6).................................... 2-75, 2-84 Enrollment Rosters Menu (ROST) .................................................... 2-73, 2-82 Enrollment Summaries Menu (SUMM) ........................................... 2-77, 2-86 Enrollment Summary Report (2) ..................................................... 2-77, 2-86 Enrollment/Disenrollment Discrepancy Report (2).......................... 2-70, 2-95 Enter Network Appointment Refusals (EHCF) ............................... 2-65 Enter/Edit MEPRS Codes/COST POOL Codes (EFIL) .................... 2-35 Enter/Edit PAS Mailers (EML) ......................................................... 2-36 Expiration Date Provider Agreement Roster (2).............................. 2-90 Expiration Date Provider Agreement Roster (5).............................. 2-105 Facility Cancellation Statistical Report (6) ...................................... 2-31 Facility File/Table Maintenance Menu (FTAB) ............................... 2-109 Facility Profile Edit (FPRO) .............................................................. 2-20 Facility Profile List (1)....................................................................... 2-22 Facility Type Enter/Edit (FACI) ....................................................... 2-110 Family Batch Enrollment Labels Build Utility (1) ......................... 2-72, 2-82 Family Batch Enrollment Labels Menu (LABL) .............................. 2-72, 2-81 Family Batch Enrollment Labels Print Utility (2) .......................... 2-73, 2-82 Family PCM Reassignment (FPCM)................................................. 2-100 File/Table for MCP Menu (FMCP) .................................................... 2-107 File/Table Maintenance Menu (FILE) .............................................. 2-35 Former Patient Name (3) .................................................................. 2-52 Former Patient Name (FPAT)........................................................... 2-39 Freeze/Release Schedules (FMSC).................................................... 2-24 2-6 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Menu Definitions Index (continued) Title Page Frozen Slot Monitor Bulletin (6) ....................................................... 2-38 Full ER Encounter (FER) .................................................................. 2-50 Full Registration (1)........................................................................... 2-52 Generate Embossed Card (4)............................................................. 2-52 Generate Embossed Card (GRDM) ................................................... 2-43, 2-96 Group Data Changes (GPDC) ........................................................... 2-113 Group Enter/Edit (GROU)................................................................. 2-111 Group Management Reports Menu (GMRM) ................................... 2-103 Group Member Roster (1) .................................................................. 2-103 Group Member Roster (3) .................................................................. 2-91 Group Profile/Agreements Enter/Edit (GNET) ................................ 2-102 Hard Copy of Registration Form (5) ................................................. 2-52 Hard Copy of Registration Form (HRDM)........................................ 2-44, 2-96 Health Care Finder Menu (HMCP) .................................................. 2-64 Health Care Finder Reports Menu (HRPT) ..................................... 2-87 Health Care Finder Reports Menu (RHCF) ..................................... 2-65 Identify Duplicate Patients (IDP) ..................................................... 2-39 Identify Potential Active Duty Candidates (IBER).......................... 2-70 Image Tracking (I) ............................................................................. 2-46, 2-97 Incomplete Patient Address Report (3) ............................................ 2-73, 2-82 Incomplete Provider Address Report (3)........................................... 2-90 Individual Patient Check-In (IPC).................................................... 2-41 Individual Provider Profile/Agreements Enter/Edit (INET) ........... 2-103 Information Desk Display (6) ............................................................ 2-52 Initial and Follow-up Clinic Visit Report (7) .................................... 2-31 Inpatient Ward Roster for Today (3)................................................. 2-34 2-7 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Menu Definitions Index (continued) Title Page Inpatient Ward Roster for Today (5)................................................. 2-45 Inquire to File Entries (IDHC).......................................................... 2-114 Inquire to File Entries (IHOC).......................................................... 2-34 Insurance Company Enter/Edit (INSU) ........................................... 2-107 Interactive DEERS Eligibility Request (IENR) ............................... 2-69 Interactive NAS Processing Menu (IMCP)....................................... 2-100 JCAHO Control Register Print (JER)............................................... 2-50 John Doe Registration (7) .................................................................. 2-52 Labels for Providers Menu (LABM) .................................................. 2-89 List File Attributes (LDHC) .............................................................. 2-114 List File Attributes (LHOC) .............................................................. 2-35 List PAS Users (LUSR) ..................................................................... 2-39 List Profiles Menu (LPRO) ................................................................ 2-21 Maintain/Cancel Schedules Menu (MSCH)...................................... 2-24 Managed Care Program Menu .......................................................... 2-64 Management Reports Menu (MER) .................................................. 2-51 Management Reports Menu (MGRM) .............................................. 2-25 MCP Conditional Enrollment Roster (1) .......................................... 2-69, 2-95 MCP DEERS Ineligibility Report (3) ................................................ 2-70, 2-95 MCP Division Profile Edit (DIVI) ..................................................... 2-109 MCP Embosser Attribute Enter/Edit (EMBA) ................................. 2-108 MCP Embosser Cards Enter/Edit (EMBC)....................................... 2-108 MCP Embosser Type Enter/Edit (EMBT) ........................................ 2-108 MCP Enrollment Form (MEFM) ....................................................... 2-80 MCP Forms Text Enter/Edit (FORM)............................................... 2-107 MCP Health Care Finder Profile Enter/Edit (HEAL)...................... 2-110 2-8 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Menu Definitions Index (continued) Title Page MCP Office Enter/Edit (OFFI) .......................................................... 2-109 MCP Parameters Profile Enter/Edit (PARA) ................................... 2-110 MCP Place of Care Report (1)............................................................ 2-92 Medical Records Tracking (MRT) ..................................................... 2-46, 2-97 Merge/Transfer Patient Data (MPAT).............................................. 2-39 Method of Transit Enter/Edit (MFIL)............................................... 2-36 Military No-Show Report (7) ............................................................. 2-38 Military Status Enter/Edit (MILI) .................................................... 2-112 Mini Registration (8).......................................................................... 2-53 Mini Registration (MRDM) ............................................................... 2-44, 2-96 Miscellaneous Network Reports Menu (MMRM) ............................. 2-106 Miscellaneous Reports Menu (MMGR) ............................................. 2-25 Modify Group Agreement Effective Date (MNET) ........................... 2-107 Modify/Add/Delete Schedules (MMSC)............................................. 2-25 Monthly Statistical Report (8)........................................................... 2-31 Multiple Check-In by Default (MCD) ............................................... 2-42 NAS Issuing Officer Enter/Edit (ISSO) ............................................ 2-110 NAS Statistical Report (NNAS) ........................................................ 2-101 Network Provider Reports Menu (NPRM) ....................................... 2-89 New ER Patient Enter (NER) ........................................................... 2-49 Next Available Appointment Report (9) ........................................... 2-32 Non-Availability Statement Processing (NNAS) ............................. 2-100 Non-Enrolled Booking (NHCF) ......................................................... 2-65 Non-Enrolled Booking (NMCP)......................................................... 2-67 No-Show Processing (Mail/Phone) (NNOT) ...................................... 2-33, 2-43 No-Show Statistical Report (10)........................................................ 2-32 2-9 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Menu Definitions Index (continued) Title Page Notify Patients Menu (Cancel, No-Show, Wait List) (NOT)............ 2-42 Notify Patients Menu (Cancel, No-Show, Wait List) (NOTP) ......... 2-32 OHI Enrollment Summary (3) ......................................................... 2-78, 2-86 Open Schedules (OSCH) .................................................................... 2-23 Operational Reports Menu (ORM) .................................................... 2-44 Operational Rosters & Displays Menu (ORDM) .............................. 2-33 Outpatient Disposition Enter/Edit (OFIL) ....................................... 2-36 Outpatient Disposition Roster (6) ..................................................... 2-45 Output Products (OHCF)................................................................... 2-65 Outputs & Enrollment Maintenance Reports Menu (OENR) ......... 2-69 Outputs & Management Reports Menu (OMCP) ............................. 2-81 Outputs & Network Management Reports Menu (ONET) .............. 2-103 PAS DEERS Ineligibility Report (4) ................................................. 2-34, 2-70, 2-95 PAS DEERS Inquiries (8).................................................................. 2-38 PAS Mailer Menu (PFIL)................................................................... 2-36 PAS Weekly Data Clean Up (9)......................................................... 2-38 Patient Cancellation Statistical Report (11) .................................... 2-32 Patient Category Enrollment Summary (4) ..................................... 2-78, 2-87 Patient Check-Out (PCO) .................................................................. 2-47, 2-98 Patient Registration Report (3) ......................................................... 2-26 Patient Visit Summary Report (7) .................................................... 2-45 PCM Activity Report (3) .................................................................... 2-79, 2-93 PCM Activity Report (4) .................................................................... 2-66, 2-88 PCM Assignment Change Roster by Reason (4) .............................. 2-79, 2-34 PCM Assignment Change Summary (5) ........................................... 2-80, 2-94 PCM Assignment Reason Enter/Edit (PCMA) ................................. 2-107 2-10 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Menu Definitions Index (continued) Title Page PCM Booking (PHCF)........................................................................ 2-64 PCM Enrollment Mix Discrepancy Report (5).................................. 2-104 PCM Enrollment Mix Discrepancy Report (8).................................. 2-94 PCM Enrollment Mix Discrepancy Statistical Summary (4) .......... 2-104 PCM Enrollment Mix Discrepancy Statistical Summary (7) .......... 2-94 PCM Reassignment Report (RRPT) .................................................. 2-99 PCM Reports Menu (PRPM) ............................................................. 2-78 PCM Reports Menu (PRPT) .............................................................. 2-93 Place of Care Data Changes (LCDC) ................................................ 2-113 Place of Care Enter/Edit (PLAC) ...................................................... 2-111 Primary Provider Report (4).............................................................. 2-26 Print Batch Enrollment Report (PBER) ........................................... 2-71 Print Clinic/Provider Schedules (PSCH) .......................................... 2-24 Print Daily/Weekly Template (PTEM) ............................................. 2-23 Print File Entries (PDHC)................................................................. 2-114 Print File Entries (PHOC)................................................................. 2-34 Print PAS Mailer Notices (10)........................................................... 2-38 Print PAS Mailers (PML) .................................................................. 2-36 Print PAS User (PUSR) ..................................................................... 2-39 Print Patient Address Label (LHCF) ................................................ 2-67 Print/Display Enrollment History (PENR)....................................... 2-69 Print/Display Provider Roster (5) ..................................................... 2-34 Print/Display Provider Roster (8) ..................................................... 2-45 Problem Avoidance Report (2)........................................................... 2-26 Problem Avoidance Reports Menu (PMGR) ..................................... 2-26 Problem, Procedure & Diagnosis Enter/Edit (PER)......................... 2-49 2-11 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Menu Definitions Index (continued) Title Page Professional Category Enter/Edit (PROF)........................................ 2-112 Profiles Menu (PROF)........................................................................ 2-20 Provider Agreement Detail Report (3) .............................................. 2-92 Provider Alphabetic Agreement Roster (1)....................................... 2-104 Provider Alphabetic Agreement Roster (4)....................................... 2-91 Provider Assignment Notification (PRPT) ....................................... 2-99 Provider Batch Address Labels - Build Utility (1) ........................... 2-89, 2-106 Provider Batch Address Labels - Print Utility (2)............................ 2-89, 2-106 Provider Change (PMSC) .................................................................. 2-24 Provider Data Changes (PRDC)........................................................ 2-113 Provider Enter/Edit (PROV).............................................................. 2-111 Provider Group Report (2) ................................................................. 2-92, 2-103 Provider List by Specialty (3) ............................................................ 2-104 Provider List by Specialty (5) ............................................................ 2-91 Provider Network File/Table Maintenance Menu (PTAB) .............. 2-111 Provider Network List (3).................................................................. 2-66, 2-88 Provider Network Management Menu (PMCP) ............................... 2-102 Provider Patient Workload Report (5) .............................................. 2-67, 2-88 Provider Profile Enter/Edit (PPRO).................................................. 2-20 Provider Profile List (4) ..................................................................... 2-22 Provider Roster (ALL Clinics) (6)...................................................... 2-34 Provider Rosters Menu (PROM) ....................................................... 2-90 Provider Schedule Summary (9) ....................................................... 2-45 Reactivate MCP Enrollment (RACT)................................................ 2-111 Reason for Issue by Patient Category Report (PNAS) ..................... 2-101 Reason for Issue Summary Report (SNAS) ...................................... 2-101 2-12 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Menu Definitions Index (continued) Title Page Re-Charge Records (RCR) ................................................................. 2-46, 2-97 Reciprocal Disenrollment by Reason Roster (7) .............................. 2-76, 2-84 Reciprocal Disenrollment Discrepancy Report (8) .......................... 2-76, 2-85 Reciprocal Disenrollment Processing (RENR) ................................. 2-68 Refused Appointments Report (6) ..................................................... 2-67, 2-89 Registration & DEERS Menu (RDM) ............................................... 2-43 Registration & DEERS Menu (RREG) ............................................. 2-96 Registration Menu (RER) .................................................................. 2-51 Registration Menu (RMCP) ............................................................... 2-96 Repeat No-Show & Strong Notice Processing (RNOT) .................... 2-33, 2-43 Replicate Daily Template (RTEM).................................................... 2-23 Replicate Schedules (RSCH) ............................................................. 2-24 Reports for NAS (RNAS) ................................................................... 2-101 Reports for Provider Menu (RPTM) .................................................. 2-92 Request a Record (9) .......................................................................... 2-53 Request a Record (QUE) .................................................................... 2-47, 2-97 Schedule Deficiencies Report ............................................................ 2-28 Schedule Deficiency Monitor Report (3) ........................................... 2-28 Schedule Modification Reason Enter/Edit (SFIL) ............................ 2-36 Schedule Problem Avoidance Report (11)......................................... 2-38 Schedules Menu (SCHE) ................................................................... 2-23 Scheduling Supervisor Menu ............................................................ 2-20 Search File Entries (SDHC) .............................................................. 2-114 Search File Entries (SHOC) .............................................................. 2-35 SF558 Print (SER) ............................................................................. 2-49 Short Record Inquiry (INQ)............................................................... 2-47, 2-98 2-13 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Menu Definitions Index (continued) Title Page Specialty Provider Agreement Roster (2) ......................................... 2-105 Specialty Provider Agreement Roster (6) ......................................... 2-91 Specialty Provider Agreement Summary (3).................................... 2-105 Specialty Provider Agreement Summary (4).................................... 2-92 Specialty Type Enter/Edit (SPEC) .................................................... 2-112 Specialty Type Referral Summary (2) .............................................. 2-66, 2-87 Statistical & Workload Reports Menu (SMGR) ............................... 2-29 Stuff Security Keys for Clinic/Provider (SPRO) ............................... 2-21 Templates Menu (TEMP) .................................................................. 2-22 Track & Request Medical Records Menu (TREG)............................ 2-97 Track & Request Medical Records Menu (TRM).............................. 2-46 Track User Report (9) ........................................................................ 2-77, 2-85 Trackable Entity (Patient) Add/Delete (TER) .................................. 2-49 Trackable Entity Enter/Edit (TFIL) ................................................. 2-36 Trackable Entity Report (3)............................................................... 2-51 UIC Maintenance Report (URPT)..................................................... 2-99 UIC/PCM Maintenance Enter/Edit (UICP) ...................................... 2-111 Unanswered Telephone Consults Report (10) .................................. 2-46 Unanswered Telephone Consults Report (4) .................................... 2-29 Un-Identify Duplicate Patients (UDP) ............................................. 2-39 Unscheduled Visit (Walk-in, Tel-Con, S-Call) (USV)....................... 2-41 Update Appt History & Encounter Data (UER)............................... 2-49 Update/Print/Enroll Potential AD Candidates (UBER) .................. 2-71 User PAS Menu (USRP) .................................................................... 2-38 View PAS Mailers (VML) .................................................................. 2-36 View Patient Appointment History (VER) ....................................... 2-50 2-14 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Menu Definitions Index (continued) Title Page View Patient DEERS Status (10)...................................................... 2-53 View Patient DEERS Status (VRDM) .............................................. 2-44, 2-96 View Registration Information (11) .................................................. 2-53 Wait List - Automatic Booking Roster (7) ........................................ 2-34 Wait List Hold/Release Schedules (WMSC) ..................................... 2-25 Wait List Management Report (5) .................................................... 2-29 Wait List Priority Enter/Edit (WFIL) ............................................... 2-37 Wait List Processing (Mail/Phone) (WNOT)..................................... 2-33, 2-43 Wait List Requests (WLR)................................................................. 2-43 Wait List Status Report..................................................................... 2-27 Walk In Patients (WER) .................................................................... 2-50 Weekly Template Create/Edit (WTEM)............................................ 2-23 ZIP Code Agreement Roster (6)......................................................... 2-105 ZIP Code Agreement Roster (7)......................................................... 2-91 ZIP Code Combinations Enter/Edit (ZIPC) ...................................... 2-110 2-15 Menu Diagrams & Definitions PATIENT APPOINTMENT AND SCHEDULING SYSTEM MENU DIAGRAM Scheduling Supervisor Menu PAS System Menu Clerk Scheduling Menu 2-16 Emergency Room Menu SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Menu Diagrams & Definitions Managed Care Program Menu PAS SYSTEM MENU DIAGRAMS Scheduling Supervisor Menu PROF TEMP SCHE MGRM NOTP 2-17 Profiles Menu Templates Menu Schedules Menu Management Reports Menu Notify Patients Menu (Cancel, No-Show, Wait List) ORDM Operational Rosters &Displays Menu AHOC Ad Hoc Report Menu FILE File/Table Maintenance Menu BRPT Batch Reports & Utilities Menu USRP User PAS Menu CPAT Correct Patient Data Menu FPRO DPRO CPRO PPRO APRO EPRO SPRO LPRO Facility Profile Edit Division Profile Edit Clinic Profile Edit Provider Profile Enter/Edit Appointment Type Enter/Edit Emergency Room Profiles Menu Stuff Security Keys for Clinic/Provider List Profiles Menu Create/Edit Daily Template Replicate Daily Template Weekly Template Create/Edit Print Daily/Weekly Template Delete Template CSCH OSCH RSCH PSCH MSCH Create Schedules Open Schedules Replicate Schedules Print Clinic/Provider Schedules Maintain/ Cancel Schedules Menu 1 2 3 4 5 Facility Profile List Division Profile List Clinic Profile List Provider Profile List Appointment Type List 6 Emergency Room Clinic Profile List 7 Emergency Room Provider Profile List PMSC Provider Change FMSC Freeze/Release Schedules WMSC Wait List Hold/ Release Schedules CMSC Cancellation by Facility MMSC Modify/Add/ Delete Schedules SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Menu Diagrams & Definitions CTEM RTEM WTEM PTEM DTEM 1 Emergency Room Clinic Profile Edit 2 Emergency Room Provider Profile Edit PAS SYSTEM MENU DIAGRAMS 1 2 Scheduling Supervisor Menu 3 4 PROF TEMP SCHE MGRM NOTP 2-18 Profiles Menu Templates Menu Schedules Menu Management Reports Menu Notify Patients Menu (Cancel, No-Show, Wait List) ORDM Operational Rosters & Displays Menu AHOC Ad Hoc Report Menu FILE File/Table Maintenance Menu BRPT Batch Reports & Utilities Menu USRP User PAS Menu CPAT Correct Patient Data Menu MMGR Miscellaneous Reports Menu PMGR Problem Avoidance Reports Menu SMGR Statistical & Workload Reports Menu 2 3 4 5 Delinquent End-of-Day Processing Report Problem Avoidance Report Schedule Deficiency Monitor Report Unanswered Telephone Consults Report Wait List Management Report 1 2 3 4 5 Appointment Utilization Report Clerk Workload Recap Report Clerk Workload Report Clinic Workload Report Command Facility Workload Recap Report 6 Facility Cancellation Statistical Report 7 Initial and Follow-up Clinic Visit Report 8 Monthly Statistical Report 9 Next Available Appointment Report 10 No-Show Statistical Report 11 Patient Cancellation Statistical Report SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Menu Diagrams & Definitions CNOT Cancellation Processing (Mail/Phone) NNOT No-Show Processing (Mail/Phone) RNOT Repeat No-Show & Strong Notice Processing WNOT Wait List Processing (Mail/Phone) 1 Call No-Show Report Daily Outpatient Encounter Forms (Division/All) Patient Registration Report Primary Provider Report PAS SYSTEM MENU DIAGRAMS 1 Consolidated OR Provider Roster (One Clinic) 2 Consolidated Roster (ALL Clinics) 3 Inpatient Ward Roster for Today 4 PAS DEERS Ineligibility Report 5 Print/Display Provider Roster 6 Provider Roster (ALL Clinics) 7 Wait List - Automatic Booking Roster Scheduling Supervisor Menu PROF TEMP SCHE MGRM NOTP 2-19 ORDM Inquire to File Entries Print File Entries Search File Entries List File Attributes AFIL Activate/Inactivate Clinic Provider Create a New Clinic Enter/Edit MEPRS Codes/ COST POOL Codes Method of Transit Enter/Edit Outpatient Disposition Enter/Edit PAS Mailer Menu Schedule Modification Reason Enter/Edit Trackable Entity Enter/Edit Wait List Priority Enter/Edit CFIL EFIL MFIL OFIL PFIL SFIL TFIL WFIL AUSR Assign PAS Primary Clinic Location LUSR List PAS Users PUSR Print PAS User FPAT IDP MPAT UDP Former Patient Name Identify Duplicate Patients Merge/Transfer Patient Data Un-Identify Duplicate Patients EML VML PML Enter/Edit PAS Mailers View PAS Mailers Print PAS Mailers 1 Available Schedule Monitor Bulletin 2 Aviation Medicine Report 3 Change Division of a Clinic 4 Clean Up Appointment Global 5 Command Security Program Report 6 Frozen Slot Monitor Bulletin 7 Military No-Show Report 8 PAS DEERS Inquiries 9 PAS Weekly Data Clean Up 10 Print PAS Mailer Notices 11 Schedule Problem Avoidance Report SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Menu Diagrams & Definitions AHOC FILE BRPT USRP CPAT Profiles Menu Templates Menu Schedules Menu Management Reports Menu Notify Patients Menu (Cancel, No-Show, Wait List) Operational Rosters & Displays Menu Ad Hoc Report Menu File/Table Maintenance Menu Batch Reports & Utilities Menu User PAS Menu Correct Patient Data Menu IHOC PHOC SHOC LHOC SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 PAS MENU DEFINITIONS Scheduling Supervisor Menu The Scheduling Supervisor Menu is the primary menu for setting patient appointments and schedules, managing the facility profiles, creating master schedule templates, creating provider schedules, processing Wait Lists, and managing reports and utilities. • Profiles Menu (PROF) The Profiles Menu options allow you to create and maintain profile and table information. The profile and table information is established at the facility level and can be modified at the clinic or provider level to suit specific needs. •• Facility Profile Edit (FPRO) The Facility Profile Edit option allows you to set up and edit parameters for facility address, pull products, DEERS eligibility appointment overlap intervals, schedule hold and deletion times, and inactivation periods. •• Division Profile Edit (DPRO) The Division Profile Edit option allows you to set up and edit parameters for a division within the facility. Information defined in the Facility Profile is the default information and can be modified for the specified division. •• Clinic Profile Edit (CPRO) The Clinic Profile Edit option allows you to complete and modify profile data for existing clinics within a division. Wait List processing for the clinic is activated and defined using this option. All appointment types used by providers in the clinic must be defined in the Clinic Profile. New clinics cannot be created using this option. •• Provider Profile Enter/Edit (PPRO) The Provider Profile Enter/Edit option allows you to add new providers to an existing clinic, review and edit profile information for providers currently assigned to the selected clinic, and add or modify appointments for a provider. 2-20 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 •• Appointment Type Enter/Edit (APRO) The Appointment Type Enter/Edit option allows you to add new appointment types to the master list of appointment types, and modify the information for existing appointment types. •• Emergency Room Profiles Menu (EPRO) The Emergency Room Profiles Menu options allow you to complete, modify, and review data for existing emergency room clinics and providers. ••• Emergency Room Clinic Profile Edit (1) The Emergency Room Clinic Profile Edit option allows you to complete and modify profile data for existing Emergency Room clinics within a division. All appointment types used by providers in the Emergency Room clinic must be defined in the Emergency Room Clinic Profile. New Emergency Room locations can be created using the Create a New Clinic option in the File/Table Maintenance Menu. ••• Emergency Room Provider Profile Edit (2) The Emergency Room Provider Profile Edit option allows you to add new providers to an existing Emergency Room clinic, review and edit profile information for providers currently assigned to the selected Emergency Room clinic, and add or modify appointments for an Emergency Room provider. •• Stuff Security Keys for Clinic/Provider (SPRO) The Stuff Security Keys for Clinic/Provider option allows you to restrict the capability to book, change appointments, and overbook authority for a clinic or providers. Setting keys provides security by restricting users without the appropriate keys from booking, overbooking, or modifying (joining or spliting) appointment slots. •• List Profiles Menu (LPRO) The List Profiles Menu options allow you to print profile information for facility, divisions, clinics, providers, appointment types, and emergency rooms. 2-21 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 ••• Facility Profile List (1) The Facility Profile List option allows you to print all profile information for the selected facility. ••• Division Profile List (2) The Division Profile List option allows you to print all profile information for the selected division. ••• Clinic Profile List (3) The Clinic Profile List option allows you to print all profile information for the selected clinic. ••• Provider Profile List (4) The Provider Profile List option allows you to print all profile information for the selected provider. ••• Appointment Type List (5) The Appointment Type List option allows you to print all profile information for the selected appointment type. ••• Emergency Room Clinic Profile List (6) The Emergency Room Clinic Profile List option allows you to print all profile information for the selected Emergency Room clinic. ••• Emergency Room Provider Profile List (7) The Emergency Room Provider Profile List option allows you to print all profile information for a selected Emergency Room provider. • Templates Menu (TEMP) The Templates Menu options allow you to create, edit, replicate, combine, print, and delete provider templates. Templates are created for a provider within a specific clinic and do not contain date, patient, or Wait List information. 2-22 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 •• Create/Edit Daily Template (CTEM) The Create/Edit Daily Template option allows you to generate a provider’s templates for specified days of the week within a specific clinic. •• Replicate Daily Template (RTEM) The Replicate Daily Template option allows you to copy an existing provider template. Templates can be copied for another provider within the same clinic if both providers have identical appointment type information in their profiles. •• Weekly Template Create/Edit (WTEM) The Weekly Template Create/Edit option allows you to assemble a provider’s weekly template from existing daily templates for the same provider. You assemble your weekly template from existing templates. •• Print Daily/Weekly Template (PTEM) The Print Daily/Weekly Template option allows you to print daily and weekly templates for all desired providers within a clinic. •• Delete Template (DTEM) The Delete Template option allows you to delete obsolete daily and weekly templates. • Schedules Menu (SCHE) The Schedules Menu options allow you to create, open, replicate, print, and maintain provider schedules. •• Create Schedules (CSCH) The Create Schedules option allows you to create a provider's schedules with or without templates) for a specific clinic within a specified timeframe. •• Open Schedules (OSCH) The Open Schedules option allows you to open previously created schedules in order to book appointments. 2-23 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 •• Replicate Schedules (RSCH) The Replicate Schedules option allows you to copy an existing schedule for the same provider or to another provider within the same clinic. When copying schedules to other providers in the clinic, the appointment types for each provider are compared and must be identical or the schedule will not be replicated. •• Print Clinic/Provider Schedules (PSCH) The Print Clinic/Provider Schedules option allows you to print schedules for either specified providers or all providers in the selected clinic. •• Maintain/Cancel Schedules Menu (MSCH) The Maintain/Cancel Schedules Menu options allow you to maintain existing schedules. Schedules can be transferred to other providers in the same clinic; schedules can be frozen and released; schedules can be cancelled; slots can be added and deleted in a schedule; and comments and instructions can be deleted, added, or edited for schedule slots. ••• Provider Change (PMSC) The Provider Change option allows you to transfer a provider's schedule to another provider in the same clinic. The schedule is shifted to the new provider after the system has checked to ensure that: 1) the schedule actually exists; 2) that there is no scheduling conflict for the provider receiving the schedule; and 3) that the receiving provider has the same appointment types as the sending provider. If the receiving provider has existing schedules, the transferred schedule will be merged with the provider’s existing schedule. ••• Freeze/Release Schedules (FMSC) The Freeze/Release Schedules option allows you to lock schedules from further booking or release slots that are currently frozen. Schedule slots that are frozen can be automatically released by entering an automatic release date, or manually released using this option. Frozen slots will not be displayed during appointment searches except when the Browse function of the Book Appointments option is being used. 2-24 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 ••• Wait List Hold/Release Schedules (WMSC) The Wait List Hold/Release Schedules option allows you to reserve schedules or slots for Wait List processing, or to release Wait List reserved slots for open booking. ••• Cancellation by Facility (CMSC) The Cancellation by Facility option allows you to cancel open and booked slots or entire schedules at the request of the provider or other facility agency. When canceling booked appointment slots, the system goes directly to the Notify Patients option. The number of patients cancelled, and the reason for the cancellations, are automatically reported in the Facility Cancellation Statistical Report. Appointment slots with a status of Wait cannot be cancelled. ••• Modify/Add/Delete Schedules (MMSC) The Modify/Add/Delete Schedules option allows you to add or delete slots, delete a block of schedules (within a specified date range), change slot appointment type, change number of patients per slot, and enter or edit slot comments. • Management Reports Menu (MGRM) The Management Reports Menu options allow you to generate reports for the efficient management of provider schedules and patient appointments. These management reports are categorized as either Miscellaneous, Problem Avoidance, or Statistical & Workload. •• Miscellaneous Reports Menu (MMGR) The Miscellaneous Reports Menu options allow you to generate the Call No-Show Report, Daily Outpatient Encounter Forms, Patient Registration Report, and the Primary Provider Report. ••• Call No-Show Report (1) The Call No-Show Report option allows you to print a report of all no-show patients with their phone numbers for a specified date. The information provided in this report implements noshow patient follow-up procedures required by the Joint Commission on Accreditation of Health Care Organization (JCAHO). 2-25 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 ••• Daily Outpatient Encounter Forms (Division/All) (2) The Daily Outpatient Encounter Forms (Division/All) option is for all patients with pending booked appointments for all clinics. It allows the user to document all patient encounters on system-generated forms. ••• Patient Registration Report (3) The Patient Registration Report option provides the patient registration count for the facility. This report consists of patient category codes, descriptions, and counts for each category. This is a very complex report and should only be produced after normal duty hours. ••• Primary Provider Report (4) The Primary Provider Report option provides a list of entries in the Primary Provider field in the CHCS Complete Registration option. •• Problem Avoidance Reports Menu (PMGR) The Problem Avoidance Reports Menu options allow you to generate the following reports: Delinquent End-of-Day Processing, Problem Avoidance, Schedule Deficiency Monitor, and Wait List Management. ••• Delinquent End-of-Day Processing Report (1) The Delinquent End-of-Day Processing Report option identifies any booked appointment slots that still have an appointment status of Pending or Missing Providers. It will be printed out by any monthly statistical report option that requires complete end-of-day processing. This report can only be printed for the entire facility; therefore, it should only be requested by supervisory personnel. ••• Problem Avoidance Report (2) The Problem Avoidance Report option addresses situations that could result in lost schedule availability and inadequate notification of schedule change. This report will only print for clinics with deficiencies. 2-26 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 The Problem Avoidance Report is a series of eight linked reports that provide PAS supervisors with a daily summary of potential scheduling problems. This comprehensive report provides PAS supervisors with sufficient information to resolve potential problems. These options do not show up on your screen, but they will be part of the printed 132-column report: •••• Appointment Orders for Inpatients Not Processed Report The Appointment Orders for Inpatients Not Processed Report option provides a list of provider orders entered through the Clinical Subsystem Order Entry module. Although these orders have been entered, they have not been acted upon by a PAS clerk as of the report date. •••• Cancelled Appointment Slots Report The Cancelled Appointment Slots Report option provides a list of all appointment slots cancelled by the facility when the patient has not been notified by mail or phone as of the report date. The report will include the total number of facility cancellations for patients not notified for the specified date range. •••• Frozen Slots Report The Frozen Slots Report option provides a list of all frozen slots that fall within the schedule date and the clinic-defined schedule hold duration (entered in the Schedule Hold Duration Field in the Clinic Profile). This report also tells you which frozen slots are booked and which are open. •••• Wait List Status Report The Wait List Status Report option provides a list of the total number of patients on the Wait List for each clinic and the total number of slots reserved for Wait List processing. 2-27 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 •••• Schedule Deficiencies Report The Schedule Deficiencies Report option provides a summary list of clinics and providers that need schedules. The identity of the clinics and providers is selected by the Schedule Deficiency Monitor function, and is based on parameters entered in the Available Schedule field in the Clinic Profile. •••• Open Schedules Report The Open Schedules Report option provides a summary list of all schedules that have been created for a provider in a clinic, but have not been opened. This summary includes the number of slots not opened. •••• Pending Appointments & Missing Providers Report The Pending Appointments & Missing Providers Report option provides a summary list of all pending appointments and missing providers that must be updated in order to run the Statistical & Workload reports. •••• Wait List Mailer No-Shows Report The Wait List Mailer No-Shows Report option provides a summary list of all Wait List patients who were automatically booked for appointments from the Wait List. After these patients were booked, they were sent a notification mailer; however, they did not show up for their appointment. ••• Schedule Deficiency Monitor Report (3) The Schedule Deficiency Monitor Report option provides a status of schedule availability for each clinic in the facility. The statuses are reported for each provider and show the number of days schedules are required in advance for appointment processing, number of days deficient, and schedule status. This report also notifies the system manager when existing schedules need to be opened. 2-28 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 This report is based upon available schedule parameters entered in the clinic profile. It informs the supervisor that schedules need to be created or opened for providers in specific clinics. An alerting mail message is also sent to the SDSMGR mailgroup. ••• Unanswered Telephone Consults Report (4) The Unanswered Telephone Consults Report option allows you to print unanswered telephone consults by clinic, provider, or patient. Individual sites can set the site parameters to determine the number of days before an unanswered telephone consult becomes “old.” ••• Wait List Management Report (5) The Wait List Management Report option allows you to print or display Wait Lists for a clinic, a division, or the facility. It may be sorted by either Wait List priority, entered date, target date, or patient name. It includes patient name, FMP/SSN, priority type, entered date, target date, number, provider, home and work telephone numbers, and total number of Wait List requests. •• Statistical & Workload Reports Menu (SMGR) The Statistical & Workload Reports Menu options allow you to generate 11 reports: Appointment Utilization Report, Clerk Workload Recap Report, Clerk Workload Report, Clinic Workload Report, Command Facility Workload Recap Report, Facility Cancellation Statistical Report, Initial and Follow-up Clinic Visit Report, Monthly Statistical Report, Next Available Appointment Report, No-Show Statistical Report, and the Patient Cancellation Statistical Report. ••• Appointment Utilization Report (1) The Appointment Utilization Report option measures the planned access and availability of care by tabulating the number of schedule appointment slots created. This report can be run for future dates. A facility can evaluate appointment types and determine which appointment types are not being used so that profiles can be changed. 2-29 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 ••• Clerk Workload Recap Report (2) The Clerk Workload Recap Report option provides statistics on the number of appointments made by each clerk within each clinic. This report is based on the date when the appointment was made, not on the date of the actual appointment; therefore, the totals will not match the Monthly Statistical Report. Since most Unscheduled Visits occur on the day the appointment was made, this report provides a good comparative summary of the unscheduled activity in the clinic, department, and division. A summary of this report is produced as part of the Command Facility Workload Recap Report. ••• Clerk Workload Report (3) The Clerk Workload Report option identifies the work transactions performed by individual clerks, sorted by clinic, for the purpose of assessing productivity. This report is based on the date when the appointment was made, not on the date of the actual appointment; therefore, the totals will not match the Monthly Statistical Report. This report is also based on the clinic in which the appointment was made for the specified date range. Running this report identifies any appointment in the clinic that was made by unauthorized personnel. This report is the same as the Clerk Workload Recap Report except that the Clerk Workload Report reports each day's workload in the specified date range. ••• Clinic Workload Report (4) The Clinic Workload Report is an exact copy of the Dietetics Subsystem Clinic Workload Report, but is available for PAS Emergency Room clinics. This report is an on-demand single clinic, single or multiple Health Care Provider (HCP) version of the Monthly Statistical Report. This report will not print unless all delinquent end-of-day (EOD) processing is complete for the reporting date interval. If EOD processing is not complete, the Delinquent EOD Report will be printed instead of the Clinic Workload Report. The Delinquent EOD Report then prints with a warning that EOD processing is not complete. 2-30 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 ••• Command Facility Workload Recap Report (5) The Command Facility Workload Recap Report option creates a three- or four-page clinic-level summary of the four main monthly statistical reports: Monthly Statistical Report, Facility Cancellation Statistical Report, No-Show Statistical Report, and Patient Cancellation Statistical Report. This report will not print unless all delinquent EOD processing is complete for the reporting date interval. If EOD processing is not complete, the Delinquent EOD Report will print instead of the Command Facility Workload Recap Report with a warning that EOD processing is not complete. ••• Facility Cancellation Statistical Report (6) The Facility Cancellation Statistical Report option provides a list of the total number of appointments cancelled by the facility for each clinic and HCP, and is sorted by reason. A high-level summary of the Count Workload section of this report is produced as part of the Command Facility Workload Recap Report. ••• Initial and Follow-up Clinic Visit Report (7) The Initial and Follow-up Clinic Visit Report option provides a high-level management report of statistics on the number of initial and follow-up visits that occur within the division or group of divisions. Since this report only provides data on clinic visits, the inpatient/outpatient sections of this report are based on the entry of the Kept, S-Call, Tel-Con, and Walk-in appointment statuses for patient visits. Because this report usually contains information for more than one clinic, it cannot be requested or ordered by a clinic. ••• Monthly Statistical Report (8) The Monthly Statistical Report option provides monthly statistics for the clinics and facility. The system calculates inpatient/outpatient workloads for this report based on the Medical Expense and Performance Reporting System (MEPRS) code for the specified clinic. Each clinic is assigned its own unique MEPRS code. 2-31 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 This report will not print unless all delinquent EOD processing is complete for the reporting date interval. If EOD processing is not complete, the Delinquent EOD Report will be printed instead of the Monthly Statistical Report. The Monthly Statistical Report then has to be printed on demand. ••• Next Available Appointment Report (9) The Next Available Appointment Report option provides a list of appointment availability by appointment type and provider within a specific clinic on a given date and time. A summary of this report is part of the Command Facility Workload Recap Report. ••• No-Show Statistical Report (10) The No-Show Statistical Report option provides a profile of noshows by provider, clinic, and facility. There are three parts to this report: 1) a breakdown of no-shows by clinic and provider; 2) a breakdown of no-shows by clinic for the specified date range; 3) all no-shows in alphabetical order. A summary of this report is part of the Command Facility Workload Recap Report. This report will not print unless all delinquent EOD processing is complete for the reporting date interval. If EOD processing is not complete, the Delinquent EOD Report will be printed instead of the No-Show Statistical Report. The No-Show Statistical Report then has to be printed on demand. ••• Patient Cancellation Statistical Report (11) The Patient Cancellation Statistical Report option provides a list of the total number of appointments cancelled by patients for each clinic and HCP, and is sorted by reason. It lists all cancellations and requests to reschedule at a patient’s request. A summary of this report is produced as part of the Command Facility Workload Recap Report. • Notify Patients Menu (Cancel, No-Show, Wait List) (NOTP) The Notify Patients Menu (Cancel, No-Show, Wait List) options allow you to notify patients when their appointments are cancelled by the facility, to follow-up on no-show patients, and to process Wait List requests. 2-32 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 •• Cancellation Processing (Mail/Phone) (CNOT) The Cancellation Processing (Mail/Phone) option allows you to notify patients that their scheduled appointment has been cancelled by the facility. Patients can be notified by mail or phone and rescheduled, or placed on a Wait List. •• No-Show Processing (Mail/Phone) (NNOT) The No-Show Processing (Mail/Phone) option allows you to notify patients by phone of missed appointments, or to generate a mailer to the patient if sufficient mailing information is available. •• Repeat No-Show & Strong Notice Processing (RNOT) The Repeat No-Show & Strong Notice Processing option allows you to generate and send strongly worded reminders to chronic no-show patients. These mailers can be sent only after the No-show Statistical Report has been generated. •• Wait List Processing (Mail/Phone) (WNOT) The Wait List Processing (Mail/Phone) option allows you to notify a patient by phone of an available appointment slot(s) and to book the appointment, or to book the appointment and notify the patient by sending a mailer. • Operational Rosters & Displays Menu (ORDM) The Operational Rosters & Displays Menu options allow you to display or print rosters for individual providers, single clinics, all clinics in the facility, and the DEERS Ineligibility Report. •• Consolidated OR Provider Roster (One Clinic) (1) The Consolidated OR Provider Roster (One Clinic) option allows you to print either of two reports: 1) by specifying an individual provider, a roster printout of only that provider’s appointments is generated; or 2) if no provider is selected, a consolidated roster of the patients for all providers in the selected clinic will be generated. •• Consolidated Roster (ALL Clinics) (2) The Consolidated Roster (ALL Clinics) option allows you to generate rosters for a specified day, and includes all providers for the clinics in chronological order. 2-33 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 •• Inpatient Ward Roster for Today (3) The Inpatient Ward Roster for Today option allows you to print a report of patient data and appointment information for each patient on each ward for today. •• PAS DEERS Ineligibility Report (4) The PAS DEERS Ineligibility Report option allows you to generate a report of all patients whose eligibility was not confirmed by the Defense Enrollment Eligibility Reporting System (DEERS). This report is sorted by Patient Identification (PTID). •• Print/Display Provider Roster (5) The Print/Display Provider Roster option allows you to print or display one provider's roster, for a specific clinic, on a specific day. •• Provider Roster (ALL Clinics) (6) The Provider Roster (ALL Clinics) option allows you to print or display, chronologically, the patients for each provider in a specific clinic, division, or all clinics in the facility. •• Wait List - Automatic Booking Roster (7) The Wait List - Automatic Booking Roster option allows you to automatically book Wait List patients to appointment slots and generate notification mailers of these appointments. • Ad Hoc Report Menu (AHOC) The Ad Hoc Report Menu options allow you to review, search for, and print file entries. The output is in the form of user-defined, special-purpose reports. •• Inquire to File Entries (IHOC) The Inquire to File Entries option allows you to view the data of single or multiple entries in a file. •• Print File Entries (PHOC) The Print File Entries option allows you to display or print selected file entries. 2-34 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 •• Search File Entries (SHOC) The Search File Entries option allows you to search for specified data in a file. •• List File Attributes (LHOC) The List File Attributes option allows you to print out the data dictionary for a specified file. This listing is helpful for programmers, analysts, and others interested in database structures for ad hoc reporting. • File/Table Maintenance Menu (FILE) The File/Table Maintenance Menu options allow you to create a new clinic name in the Hospital Location File, activate/inactivate clinic providers, edit or enter MEPRS and Cost Pool codes for hospital/clinic locations, and edit codes and information in the following tables: Method of Transit, Outpatient Disposition, PAS Mailers, Schedule Modification Reason, Trackable Entity, Wait List Priority. •• Activate/Inactivate Clinic Provider (AFIL) The Activate/Inactivate Clinic Provider option allows you to edit the Inactivation Field in the Hospital Location file, so that a provider who was active in the facility can be inactivated on a specified date in a specified clinic. With this option, you can also reactivate a provider who was previously inactivated. •• Create a New Clinic (CFIL) The Create a New Clinic option allows you to enter a new name in the Hospital Location file, and the location will automatically be assigned a location type of clinic. The new clinic name must exist before the clinic profile can be edited. •• Enter/Edit MEPRS Codes/COST POOL Codes (EFIL) The Enter/Edit MEPRS Codes/COST POOL Codes option allows you to enter either an assigned MEPRS code or a Cost Pool code for a specified clinic. If the MEPRS code is entered, then this code will be displayed at the MEPRS code field on all booking-related screens for each appointment booked for that clinic. If the MEPRS code is not entered, then the Cost Pool code must be entered or the MEPRS code field for each booking-related screen will be blank. 2-35 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 •• Method of Transit Enter/Edit (MFIL) The Method of Transit Enter/Edit option allows you to enter new Method of Transit codes, and edit the existing codes. •• Outpatient Disposition Enter/Edit (OFIL) The Outpatient Disposition Enter/Edit option allows you to enter new Outpatient Disposition codes, and edit existing codes. •• PAS Mailer Menu (PFIL) The PAS Mailer Menu options allow you to edit the facilitycustomized form letters sent out for No-Show, Strong No-Show, and Appointment Cancellation by Facility reasons. ••• Enter/Edit PAS Mailers (EML) The Enter/Edit PAS Mailers option allows the site or File & Table build team to customize the form letters that are sent to patients to notify them of a previously booked appointment, an automatically booked Wait List request, a missed appointment, several missed appointments, or an appointment(s) that has been cancelled by the facility, NoShow Notice, Strong No-Show Notice, or cancellation letter. ••• View PAS Mailers (VML) The View PAS Mailers option allows you to view the return address and the text of PAS mailers. ••• Print PAS Mailers (PML) The Print PAS Mailers option allows an authorized user to print the PAS mailers. •• Schedule Modification Reason Enter/Edit (SFIL) The Schedule Modification Reason Enter/Edit option allows you to enter new schedule modification reasons, or edit existing entries that appear on the Cancellation Statistics Report. •• Trackable Entity Enter/Edit (TFIL) The Trackable Entity Enter/Edit option allows you to enter new trackable entities, or to edit existing entries in the Trackable Entity file. 2-36 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 •• Wait List Priority Enter/Edit (WFIL) The Wait List Priority Enter/Edit option allows you to enter new Wait List Priority codes, or edit the existing codes in the Wait List Priority file. • Batch Reports & Utilities Menu (BRPT) The Batch Reports & Utilities Menu options allow you to create batch utility reports, and run clean-up utility programs. •• Available Schedule Monitor Bulletin (1) The Available Schedule Monitor Bulletin option allows you to generate bulletins to send to members of the SDSMGR mailgroup that indicate those providers needing future schedules to meet the minimum future schedule interval defined in the clinic profile. •• Aviation Medicine Report (2) The Aviation Medicine Report option allows you to generate a report indicating the patients on flying status who were seen the previous day. •• Change Division of a Clinic (3) The Change Division of a Clinic option allows you to notify the schedule supervisor that an option exists for the system manager to change the division of a clinic. •• Clean Up Appointment Global (4) The Clean Up Appointment Global option allows you to kill FileMan cross-references of the ^SDAV global used the previous day to search for appointments, preventing appointment searches for appointments in the past. This utility must be run daily! •• Command Security Program Report (5) The Command Security Program Report option allows you to generate a report indicating all patients listed as members of the three security programs: the Personnel Reliability Program, the Compartmented Security Program, and the Presidential Security Program. 2-37 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 •• Frozen Slot Monitor Bulletin (6) The Frozen Slot Monitor Bulletin option allows you to generate a bulletin to send to the members of the SDSMGR mailgroup that frozen slots currently exist that need to be dispositioned. •• Military No-Show Report (7) The Military No-Show Report option allows you to generate a report of all active duty service members who were no-shows for scheduled appointments. •• PAS DEERS Inquiries (8) The PAS DEERS Inquires option allows you to generate a report of DEERS inquiries for scheduled appointments. •• PAS Weekly Data Clean Up (9) The PAS Weekly Data Clean Up option allows you to delete expired schedules, and expired profiles and templates of inactive providers. •• Print PAS Mailer Notices (10) The Print PAS Mailer Notices option allows you to print all mailer notices in the PAS Mailer Notice file. •• Schedule Problem Avoidance Report (11) The Schedule Problem Avoidance Report option is used to compile data each day for this report so that you can print the report on demand based upon the “snapshot” of the database calculated previously. • User PAS Menu (USRP) The User PAS Menu options allow the supervisor to enter primary location code in the user file, produce reports summarizing data stored in the user file, and display or print user file attributes applicable to PAS. •• Assign PAS Primary Clinic Location (AUSR) The Assign PAS Primary Clinic Location option allows you to assign or change the User Primary Location code. 2-38 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 •• List PAS Users (LUSR) The List PAS Users option allows you to display or print a list of PAS users for a clinic, division, or the facility. •• Print PAS User (PUSR) The Print PAS User option allows you to print or display user data for individual PAS users. • Correct Patient Data Menu (CPAT) The Correct Patient Data Menu options allow you to enter former names of a patient. •• Former Patient Name (FPAT) The Former Patient Name option allows you to create a crossreference file of a patient's former and present names. •• Identify Duplicate Patients (IDP) The Identify Duplicate Patients option allows you to identify a patient as a duplicate of another patient record. Once this has been done, the correct patient record is automatically retrieved. Note that the process of identifying a patient as a duplicate patient must be completed prior to merging the records. •• Merge/Transfer Patient Data (MPAT) The Merge/Transfer Patient Data option allows you to merge duplicate records into one correct record. Only records that have been previously identified as a duplicate record may be merged. The merge process transfers data from the incorrect patient record (duplicate) to the correct patient record. It also places the duplicate record under access control. After the merge process is complete, you cannot access this record. Following the merge process, you may generate an output displaying all data elements that have been merged. Note that the merge process cannot be reversed, so use this option carefully. •• Un-Identify Duplicate Patients (UDP) The Un-Identify Duplicate Patients option allows you to reverse the identification process of a duplicate patient. Use this option when a patient has been incorrectly identified as a duplicate record. 2-39 Menu Diagrams & Definitions PAS SYSTEM MENU DIAGRAMS Clerk Scheduling Menu BOK USV 2-40 CBP DPA IPC MCD AOP EOD NOT ORM TRM * The Record Tracking Application prompts you to choose either Image Tracking or Medical Records Tracking. DRDM GRDM HRDM MRDM VRDM DEERS Eligibility Request Generate Embossed Card Hard Copy of Registration Form Mini Registration View Patient DEERS Status 1 Call No-Show Report 2 Clinic Schedule Summary 3 Consolidated OR Provider Roster (One Clinic) 4 Daily Outpatient Encounter Forms (Clin/Prov/Indv) 5 Inpatient Ward Roster for Today 6 Outpatient Disposition Roster 7 Patient Visit Summary Report 8 Print/Display Provider Roster 9 Provider Schedule Summary 10 Unanswered Telephone Consults Report I MRT Image Tracking Medical Records Tracking RCR QUE CAN DIS EDI PCO INQ Re-Charge Records Request a Record Cancel a Request Display Request Edit a Request Patient Check-Out Short Record Inquiry SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Menu Diagrams & Definitions WLR RDM Book Appointments Unscheduled Visit (Walk-in, Tel-Con, S-Call) Cancellation by Patient Display Patient Appointments Individual Patient Check-In Multiple Check-In by Default Appointment Order Processing End-of-Day Processing/Editing Notify Patients Menu (Cancel, No-Show, Wait List) Wait List Requests Registration & DEERS Menu Operational Reports Menu Track & Request Medical CNOT Cancellation Processing (Mail/Phone) NNOT No-Show Processing (Mail/Phone) RNOT Repeat No-Show & Strong Notice Processing WNOT Wait List Processing (Mail/Phone) SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 PAS MENU DEFINITIONS Clerk Scheduling Menu The Clerk Scheduling Menu is the primary PAS menu for appointment booking, patient check-in, processing appointment cancellations, processing Wait List requests, and ordering operational reports. • Book Appointments (BOK) The Book Appointments option allows you to perform booking actions for a single patient or multiple patients in one or more clinics, and block appointments in a single clinic. Each of these actions can be performed in a single transaction. • Unscheduled Visit (Walk-in, Tel-Con, S-Call) (USV) The Unscheduled Visit option allows you to check-in patients for walk-in visits, telephone consultations, and sick-call. Clinic, appointment type, and patient name are mandatory information during check-in. When the provider is not entered at check-in, the information must be updated during end-of-day processing. • Cancellation by Patient (CBP) The Cancellation by Patient option allows you to cancel an appointment at the patient’s request. Slots cancelled using this option are available for immediate booking of Wait List Requests. Patient name is required information for this option. • Display Patient Appointments (DPA) The Display Patient Appointments option allows you to print or display past and future appointments for an individual (and their family members) registered under the same social security number. • Individual Patient Check-In (IPC) The Individual Patient Check-In option allows you to check-in patients with scheduled appointments. 2-41 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 • Multiple Check-In by Default (MCD) The Multiple Check-In by Default option allows you to simultaneously check-in all patients who kept their scheduled appointments. This option allows you after end-of-day processing has been completed for no-shows and cancellations. • Appointment Order Processing (AOP) The Appointment Order Processing option allows you to transfer orders entered through Order Entry functionality. This option is normally used for patients with an inpatient status. • End-of-Day Processing/Editing (EOD) The End-of-Day Processing/Editing option allows you to edit, modify, or update appointment history data including the status of daily appointments for each clinic and provider. It provides the means by which the computer database is updated to reflect what has really happened in the clinic, and which data is reported in numerous statistical reports. This option allows you to update the appointment status of any patient who was checked in manually. This option allows you to insert all missing providers or to change the Pending appointment status for all appointments in a clinic for one day. The Pending appointment status and missing provider information will cause the Delinquent End-of-Day Processing Report to be generated in lieu of the End-of-Day Processing Report. • Notify Patients Menu (Cancel, No-Show, Wait List) (NOT) The Notify Patients Menu options allow you to notify patients of appointments cancelled by the facility, process No-Show notifications, and process Wait List requests. •• Cancellation Processing (Mail/Phone) (CNOT) The Cancellation Processing option allows you to notify patients of scheduled appointments cancelled by the facility. When notifying a patient by phone, a new appointment may be scheduled immediately if an appointment slot is available. When no appointments are available, a Wait List request can be entered for the patient if the clinic maintains a Wait List. 2-42 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 •• No-Show Processing (Mail/Phone) (NNOT) The No-Show Processing (Mail/Phone) option allows you to notify patients by phone of missed appointments, or to generate a mailer to the patient if sufficient mailing information is available. •• Repeat No-Show & Strong Notice Processing (RNOT) The Repeat No-Show & Strong Notice Processing option allows you to generate and send strongly-worded reminders to chronic no-show patients. These mailers can be sent only after the No-Show Statistical Report has been generated. •• Wait List Processing (Mail/Phone) (WNOT) The Wait List Processing (Mail/Phone) option allows you to either notify a patient by mail of a booked appointment, or to notify a patient with a Wait List request by phone of an available appointment and book the appointment. • Wait List Requests (WLR) The Wait List Request option allows you to add a new Wait List request for a patient to a clinic that has activated the Wait List Activated field in the clinic profile; delete an existing Wait List request, or modify a patient's Wait List request. • Registration & DEERS Menu (RDM) The Registration & DEERS Menu options allow you to change the sponsor’s name for a registered patient, check for DEERS eligibility, generate an embossed card, print a registration form, perform miniregistration, and view a current patient’s DEERS status. •• DEERS Eligibility Request (DRDM) The DEERS Eligibility Request option allows you to conduct a DEERS check for a specific patient. •• Generate Embossed Card (GRDM) The Generate Embossed Card option allows you to print an embossed card containing pertinent patient registration information. 2-43 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 •• Hard Copy of Registration Form (HRDM) The Hard Copy of Registration Form option allows you to print a paper copy of the registration and administration information for a patient. •• Mini Registration (MRDM) The Mini Registration option allows you to register a new patient while booking appointments. •• View Patient DEERS Status (VRDM) The View Patient DEERS Status option allows you to view the status of a registered patient. • Operational Reports Menu (ORM) The Operational Reports Menu options allow you to print reports, rosters and schedule summaries for clinics and providers. The following reports, rosters, and summaries can be generated and printed using this menu: •• Call No-Show Report (1) The Call No-Show Report option allows you to print a report of all noshow patients with their phone numbers for a specified date. The information provided in this report implements no-show patient follow-up procedures required by the Joint Commission on Accreditation of Health Care Organizations (JCAHO). •• Clinic Schedule Summary (2) The Clinic Schedule Summary option allows you to generate and print a clinic schedule summary for past and future dates. This report is a summary for all providers in the specified clinic, and includes a chronological list of each providers slots, the week day, date/time, appointment type, slot status, maximum patients per slot, and current number of patients booked. •• Consolidated OR Provider Roster (One Clinic) (3) The Consolidated OR Provider Roster (One Clinic) option allows you to generate and print either of two rosters: 1) when a provider is specified, a roster of that provider’s appointments will be produced; or 2) when no provider is specified, a consolidated roster of all providers in the specified clinic is produced. If the Print Roster with Open Slots field in the provider profile is set to Yes, the system will print all slots open or booked. 2-44 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 •• Daily Outpatient Encounter Forms (Clin/Prov/Indv) (4) The Daily Outpatient Encounter Forms (Clin/Prov/Indv) option allows you to generate and print an Encounter Form for each existing appointment of the category selected. •• Inpatient Ward Roster for Today (5) The Inpatient Ward Roster for Today option allows you to generate and print Inpatient Ward Rosters for each ward for the date specified. The roster includes appointment time, appointment type, reason for appointment, referred by, clinic, FPM/SSN, sex, provider, comment, registration comment, and date of birth for each patient. •• Outpatient Disposition Roster (6) The Outpatient Disposition Roster option allows you to generate and print a roster of outpatient dispositions for one, multiple, or all providers, clinics, divisions, or groups for a specified date range. For the category selected, you also specify one, multiple, or all patient categories, and one, multiple, or all outpatient dispositions to display. •• Patient Visit Summary Report (7) The Patient Visit Summary Report option allows you to generate and print a patient visit summary for one, multiple, or all clinics, providers, or patients for a specified date range. •• Print/Display Provider Roster (8) The Print/Display Provider Roster option allows you to generate and print the Provider Roster for a provider in a specified clinic on a specific date. The roster includes facility, date/time report generated, date specified, clinic, appointment time, appointment type, DEERS code, reason for appointment, FPM/SSN, sex, provider, comment, home telephone number, work telephone number, comment, and date of birth for each patient. •• Provider Schedule Summary (9) The Provider Schedule Summary option allows you to generate and print a Provider Schedule Summary for past and future dates. This report is a schedule summary for the provider in each clinic assigned, and includes a chronological list of the provider's slots, the week day, date/time, appointment type, slot status, maximum patients per slot, and current number of patients booked. 2-45 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 •• Unanswered Telephone Consults Report (10) The Unanswered Telephone Consults Report option allows you to print unanswered telephone consults by clinic, provider, or patient. Individual sites can set the site parameters to determine the number of days before an unanswered telephone consult becomes “old.” • Track & Request Medical Records Menu (TRM) The Track & Request Medical Records Menu options allow you, as the PAS Clerk, to recharge records to other clinics, and to request records from Medical Records File Rooms. Record Tracking Application The Record Tracking Application allows you to electronically track patient records, whether they are medical records, film folders (radiology records), or records related to Nuclear Medicine. Through the use of this application, you can request patient records, maintain up-to-date information on the location of the record, and be provided significant information for user determination of record availability for charge-out. •• Image Tracking (I) The Image Tracking Menu presents the same functions and options as those for Medical Records Tracking; however, this menu allows you to track radiology records, such as X-ray files. •• Medical Records Tracking (MRT) The Medical Records Tracking option allows you to track inpatient and outpatient medical records throughout the facility. ••• Re-Charge Records (RCR) The Re-Charge Records option allows you to record the transfer of records charged from your own clinic to another clinic. This recharge capability allows record tracking outside of the Medical Records File Room. As an example, a patient’s medical record is checked out to your clinic, the Cardiology Clinic. The patient has just seen a provider in your clinic and takes her medical record to the Surgical Clinic for another scheduled appointment. You, as the Front Desk clerk in the Cardiology Clinic, recharge this patient's medical record to the Surgical Clinic. 2-46 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 ••• Request a Record (QUE) The Request a Record option allows you to enter a request for a medical record from the Medical Record File Room when it was not on the scheduled Pull List for your clinic. Using this option, you can request a patient's medical record for an unanticipated provider review of the patient's medical record or for a patient with an unscheduled appointment. ••• Cancel a Request (CAN) The Cancel a Request option allows you to cancel a previous request for a medical record. You must hold the proper security key access. ••• Display Request (DIS) The Display Request option allows you to display data associated with a specific request for a patient's record. You may access request data for a specific patient by scanning the barcode on a record request label, entering the request number, or entering the patient name. ••• Edit a Request (EDI) The Edit a Request option allows you to access each record request by request number, and allows the user to edit patient demographic and record location information. ••• Patient Check-Out (PCO) The Patient Check-Out option allows you to electronically record the patient as the borrower of their own medical record. ••• Short Record Inquiry (INQ) The Short Record Inquiry option allows you to generate an abbreviated online list of all medical records for a specified patient information. Information includes current borrower, record type, and medical record number. 2-47 Menu Diagrams & Definitions PAS SYSTEM MENU DIAGRAMS Emergency Room Menu 2-48 New ER Patient Enter Problem, Procedure & Diagnosis Enter/Edit Check-out & Patient Instructions Update Appt History & Encounter Data SF 558 Print Trackable Entity (Patient) Add/Delete JCAHO Control Register Print Walk-In Patients View Patient Appointment History Disposition Processing Full ER Encounter Activity Date and ER Clinic Edit Emergency Room Profiles Menu Management Reports Menu Registration Menu 1 2 Emergency Room Clinic Profile Edit Emergency Room Provider Profile Edit 1 2 3 Clinic Workload Report End-of-Day Processing/Editing Trackable Entity Report 1 2 3 4 5 6 7 8 9 10 11 Full Registration DEERS Eligibility Request Former Patient Name Generate Embossed Card Hard Copy of Registration Form Information Desk Display John Doe Registration Mini Registration Request a Record View Patient DEERS Status View Registration Information SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Menu Diagrams & Definitions NER PER CER UER SER TER JER WER VER DER FER AER EER MER RER SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 PAS MENU DEFINITIONS Emergency Room Menu The Emergency Room Menu options are used to enter new patients into an emergency room, check patients out of an emergency room, update patient appointment history and encounter data, print the SF 558 Worksheet, add and delete trackable entities, print the JCAHO Control Registers, and process walk-in patients. • New ER Patient Enter (NER) The New ER Patient Enter option allows you to process a new or previously registered emergency room patient. You can also enter arrival time, chief complaint, appointment type, specify if there is a third party payer, arrival category, or next of kin. • Problem, Procedure & Diagnosis Enter/Edit (PER) The Problem, Procedure & Diagnosis Enter/Edit option allows you to enter or edit diagnosis, problems, procedures, patient's chief complaint, and instructions to the patient related to an existing emergency room visit. • Check-out & Patient Instructions (CER) The Check-out & Patient Instructions option allows you to check-out individual patients and process their patient instructions. • Update Appt History & Encounter Data (UER) The Update Appt History & Encounter Data option allows you to update information in appointment history fields for data entered during new patient emergency room processing. • SF558 Print (SER) The SF558 Print option allows you to print or display the SF 558 Encounter Form Worksheet. • Trackable Entity (Patient) Add/Delete (TER) The Trackable Entity (Patient) Add/Delete option allows you to add trackable entity information or delete existing data. 2-49 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 • JCAHO Control Register Print (JER) The JCAHO Control Register Print option allows you to produce a 132column printout of the JCAHO control register. • Walk In Patients (WER) The Walk In Patients option allows you to check-in a new or previously registered patient. • View Patient Appointment History (VER) The View Patient Appointment History option allows you to display or print past and pending appointments for a patient and family members. • Disposition Processing (DER) The Disposition Processing option allows you to disposition individual or all patients in an emergency room of a specific date. • Full ER Encounter (FER) The Full ER Encounter option allows you to enter or edit data for parameters available in the Check-out & Patient Instructions, Update Appointment History & Encounter Data, and the Problem, Procedure & Diagnosis Enter/Edit options for an individual encounter. • Activity Date and ER Clinic Edit (AER) The Activity Date and ER Clinic Edit option allows you to change the date and/or name of the emergency room clinic for which you wish to enter information. Normally, today’s date allows you as the ER activity date. However, if the system has been down or an encounter must be back-dated, the date of the actual encounter can be entered. • Emergency Room Profiles Menu (EER) The Emergency Room Profile Menu options allow you to edit the Emergency Room Profile for an existing emergency room clinic or provider. 2-50 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 •• Emergency Room Clinic Profile Edit (1) The Emergency Room Clinic Profile Edit option allows you to complete and modify profile data for existing Emergency Room clinics within a division. All appointment types used by providers in the Emergency Room clinic must be defined in the Emergency Room Clinic Profile. New Emergency Room locations can be created using the Create a New Clinic option in the File/Table Maintenance Menu. •• Emergency Room Provider Profile Edit (2) The Emergency Room Provider Profile Edit option allows you to add new providers to an existing Emergency Room clinic, review and edit profile information for providers currently assigned to the selected Emergency Room clinic, and add or modify appointments for an Emergency Room provider. • Management Reports Menu (MER) The Management Reports Menu options allow you to generate a single or multiple provider version of the Monthly Statistical Report or a report of trackable entities. •• Clinic Workload Report (1) The Clinic Workload Report option allows you to generate and print an on-demand, single or multiple provider, version of the PAS Monthly Statistical Report. •• End-of-Day Processing/Editing (2) The End-of-Day Processing/Editing option is defined in the definitions for the Clerk Scheduling Menu. •• Trackable Entity Report (3) The Trackable Entity Report option allows you to generate and print a report of trackable items borrowed from the emergency rooms (i.e., canes, crutches). • Registration Menu (RER) The Registration Menu options allow you to change the sponsor's name for registered patients, check for DEERS eligibility, generate embossed cards, print registration forms, perform mini-registration, and view current patients DEERS status. 2-51 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Note: Definitions for the following registration options are presented in the Clerk Scheduling Menu Definitions: Change Sponsor's Name, DEERS Eligibility Request, Generate Embossed Card, Hard Copy of Registration Form, Mini-Registration, and View Patient DEERS Status. •• Full Registration (1) The Full Registration option allows you to add a new patient into CHCS, enter registration data needed to process the patient, and edit the existing data. •• DEERS Eligibility Request (2) The DEERS Eligibility Request option allows you to conduct a DEERS check for a specific patient. •• Former Patient Name (3) The Former Patient Name option allows you to create a cross reference between a registered patient's current and former name. The cross reference will permit patient file search using the patient's former name. •• Generate Embossed Card (4) The Generate Embossed Card option allows you to print an embossed card containing pertinent patient registration information. •• Hard Copy of Registration Form (5) The Hard Copy of Registration Form option allows you to print a paper copy of the registration and administration information for a patient. •• Information Desk Display (6) The Information Desk Display option allows you to view the following current MTF information for a patient: location, FMP/SSN, rank, ward location, room-bed, and visiting hours. •• John Doe Registration (7) The John Doe Registration option allows you to register a patient whose identity is unknown. The system will assign pseudo registration data until the John Doe registration information can be updated with correct patient information when known. 2-52 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 •• Mini Registration (8) The Mini Registration option allows you to register a new patient while booking appointments. •• Request a Record (9) The Request a Record option allows you to enter a request for existing patient records. Record requests can be for the present or a future date/time. •• View Patient DEERS Status (10) The View Patient DEERS Status option allows you to view the status of a registered patient. •• View Registration Information (11) The View Registration Information option allows you to view all registration information for a patient. This is a view-only option. 2-53 Menu Diagrams & Definitions PAS SYSTEM MENU DIAGRAMS Managed Care Program Menu 2-54 Health Care Finder Menu Non-Enrolled Booking Enrollment Processing Menu Display Patient Appointments Cancellation by Patient Outputs & Management Reports Menu Registration Menu Batch PCM Reassignment Menu Interactive NAS Processing Menu Provider Network Management Menu File/Table for MCP Menu Ad Hoc Report Menu PCM Booking Appointment Referral Booking Non-Enrolled Booking Enter Appointment Refusals Output Products Health Care Finder Reports Menu LHCF Print Patient Address Label 1 2 3 4 5 6 Agreement Type Referral Summary Specialty Type Referral Summary Provider Network List PCM Activity Report Provider Patient Workload Report Refused Appointments Report SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Menu Diagrams & Definitions HMCP NMCP EMCP DMCP CMCP OMCP RMCP BMCP IMCP PMCP FMCP AMCP PHCF AHCF NHCF EHCF OHCF RHCF PAS SYSTEM MENU DIAGRAMS Managed Care Program Menu 2-55 HMCP NMCP EMCP DMCP CMCP OMCP RMCP BMCP IMCP PMCP FMCP AMCP Enrollment Enter/Edit Disenrollment Reciprocal Disenrollment Processing Conditional Enrollment Processing Print/Display Enrollment History Interactive DEERS Eligibility Request Outputs & Enrollment Maintenance Reports Menu BENR Batch Enroll Active Duty DRPM DEERS/Enrollment Maintenance Reports Menu ERPM Enrollment Reports Menu PRPM PCM Reports Menu MEFM MCP Enrollment Form APAL Address Label for Patient 1 2 3 4 MCP Conditional Enrollment Roster Enrollment/Disenrollment Discrepancy Report MCP DEERS Ineligibility Report PAS DEERS Ineligibility Report IBER UBER PBER DBER Identify Potential Active Duty Candidates Update/Print/Enroll Potential AD Candidates Print Batch Enrollment Report Delete Potential Candidate List SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Menu Diagrams & Definitions EENR DENR RENR CENR PENR IENR OENR Health Care Finder Menu Non-Enrolled Booking Enrollment Processing Menu Display Patient Appointments Cancellation by Patient Outputs & Management Reports Menu Registration Menu Batch PCM Reassignment Menu Interactive NAS Processing Menu Provider Network Management Menu File/Table for MCP Menu Ad Hoc Report Menu PAS SYSTEM MENU DIAGRAMS DRPM ERPM PRPM MEFM APAL Managed Care Program Menu 2-56 EENR DENR CENR PENR IENR OENR Health Care Finder Menu Non-Enrolled Booking Enrollment Processing Menu Display Patient Appointments Cancellation by Patient Outputs & Management Reports Menu Registration Menu Batch PCM Reassignment Menu Interactive NAS Processing Menu Provider Network Management Menu File/Table for MCP Menu Ad Hoc Report Menu Enrollment Enter/Edit Disenrollment Conditional Enrollment Processing Print/Display Enrollment History Interactive DEERS Eligibility Request Outputs & Enrollment Maintenance Reports Menu LABL Family Batch Enrollment Labels Menu ROST Enrollment Rosters Menu SUMM Enrollment Summaries Menu 1 2 3 4 Disenrollment Summary by Reason Enrollment Summary Report OHI Enrollment Summary Patient Category Enrollment Summary 1 2 3 4 5 6 7 8 9 10 AD Family Members by Unit Enrollment Roster Alphabetic Enrollment Roster by Service Case Management Program Enrollment Roster Change in Eligibility Enrollment Roster Disenrollees for Period by Reason Code Enrollment Roster Exception Conditions Reciprocal Disenrollment by Reason Roster Reciprocal Disenrollment Discrepancy Report Track User Report Enrollee Entitlement Discrepancy Report 1 2 3 Family Batch Enrollment Labels Build Utility Family Batch Enrollment Labels Print Utility Incomplete Patient Address Report SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Menu Diagrams & Definitions HMCP NMCP EMCP DMCP CMCP OMCP RMCP BMCP IMCP PMCP FMCP AMCP DEERS/Enrollment Maintenance Reports Menu Enrollment Reports Menu PCM Reports Menu MCP Enrollment Form Address Label for Patient PAS SYSTEM MENU DIAGRAMS Managed Care Program Menu 2-57 EENR DENR CENR PENR IENR OENR Health Care Finder Menu Non-Enrolled Booking Enrollment Processing Menu Display Patient Appointments Cancellation by Patient Outputs & Management Reports Menu Registration Menu Batch PCM Reassignment Menu Interactive NAS Processing Menu Provider Network Management Menu File/Table for MCP Menu Ad Hoc Report Menu Enrollment Enter/Edit Disenrollment Conditional Enrollment Processing Print/Display Enrollment History Interactive DEERS Eligibility Request Outputs & Enrollment Maintenance Reports Menu 1 2 3 4 5 6 7 8 Available PCM Capacity by Provider Group Enrollment Roster by PCM PCM Activity Report PCM Assignment Change Roster by Reason PCM Assignment Change Summary Default PCM/UIC Report PCM Enrollment Mix Discrepancy Statistical Summary PCM Enrollment Mix Discrepancy Report SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Menu Diagrams & Definitions HMCP NMCP EMCP DMCP CMCP OMCP RMCP BMCP IMCP PMCP FMCP AMCP DRPM DEERS/Enrollment Maintenance Reports Menu ERPM Enrollment Reports Menu PRPM PCM Reports Menu MEFM MCP Enrollment Form APAL Address Label for Patient PAS SYSTEM MENU DIAGRAMS Managed Care Program Menu HMCP NMCP EMCP DMCP CMCP OMCP 2-58 Health Care Finder Menu Non-Enrolled Booking Enrollment Processing Menu Display Patient Appointments Cancellation by Patient Outputs & Management Reports Menu RMCP Registration Menu BMCP Batch PCM Reassignment Menu IMCP Interactive NAS Processing Menu PMCP Provider Network Management Menu FMCP File/Table for MCP Menu AMCP Ad Hoc Report Menu 1 2 3 4 5 6 Enrollment Reports Menu Health Care Finder Reports Menu Network Provider Reports Menu PCM Reports Menu DEERS/Enrollment Maintenance Reports Menu Agreement Type Referral Summary Specialty Type Referral Summary Provider Network List PCM Activity Report Provider Patient Workload Report Refused Appointments Report 1 2 3 4 Disenrollment Summary by Reason Enrollment Summary Report OHI Enrollment Summary Patient Category Enrollment Summary 1 2 3 4 5 6 7 8 9 10 AD Family Members by Unit Enrollment Roster Alphabetic Enrollment Roster by Service Case Management Program Enrollment Roster Change in Eligibility Enrollment Roster Disenrollees for Period by Reason Code Enrollment Roster Exception Conditions Reciprocal Disenrollment by Reason Roster Reciprocal Disenrollment Discrepancy Report Track User Report Enrollee Entitlement Discrepancy Report 1 2 3 Family Batch Enrollment Labels Build Utility Family Batch Enrollment Labels Print Utility Incomplete Patient Address Report SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Menu Diagrams & Definitions ERME HRPT NPRM PRPT DEMR LABL Family Batch Enrollment Labels Menu ROST Enrollment Rosters Menu SUMM Enrollment Summaries Menu PAS SYSTEM MENU DIAGRAMS Managed Care Program Menu HMCP NMCP EMCP DMCP CMCP OMCP Health Care Finder Menu Non-Enrolled Booking Enrollment Processing Menu Display Patient Appointments Cancellation by Patient Outputs & Management Reports Menu RMCP Registration Menu BMCP Batch PCM Reassignment Menu IMCP Interactive NAS Processing Menu PMCP Provider Network Management Menu FMCP File/Table for MCP Menu AMCP Ad Hoc Report Menu 2-59 1 2 3 4 1 2 3 4 5 6 7 8 Enrollment Reports Menu Health Care Finder Reports Menu Network Provider Reports Menu PCM Reports Menu DEERS/Enrollment Maintenance Reports Menu MCP Conditional Enrollment Roster Enrollment/Disenrollment Discrepancy Report MCP DEERS Ineligibility Report PAS DEERS Ineligibility Report Available PCM Capacity by Provider Group Enrollment Roster by PCM PCM Activity Report PCM Assignment Change Roster by Reason PCM Assignment Change Summary Default PCM/UIC Report PCM Enrollment Mix Discrepancy Statistical Summary PCM Enrollment Mix Discrepancy Report 1 2 3 4 MCP Place of Care Report Provider Group Report Provider Agreement Detail Report Specialty Provider Agreement Summary 1 2 3 4 5 6 7 Discount Provider Agreement Roster Expiration Date Provider Agreement Roster Group Member Roster Provider Alphabetic Agreement Roster Provider List by Specialty Specialty Provider Agreement Roster ZIP Code Agreement Roster 1 2 3 Provider Batch Address Labels - Build Utility Provider Batch Address Labels - Print Utility Incomplete Provider Address Report SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Menu Diagrams & Definitions ERME HRPT NPRM PRPT DEMR LABM Labels for Providers Menu PROM Provider Rosters Menu RPTM Reports for Provider Menu PAS SYSTEM MENU DIAGRAMS Managed Care Program Menu 2-60 HMCP NMCP EMCP DMCP CMCP OMCP RMCP BMCP IMCP PMCP FMCP AMCP Health Care Finder Menu Non-Enrolled Booking Enrollment Processing Menu Display Patient Appointments Cancellation by Patient Outputs & Management Reports Menu Registration Menu Batch PCM Reassignment Menu Interactive NAS Processing Menu Provider Network Management Menu File/Table for MCP Menu Ad Hoc Report Menu DRDM GRDM HRDM MRDM VRDM DEERS Eligibility Request Generate Embossed Card Hard Copy of Registration Form Mini Registration View Patient DEERS Status I MRT Image Tracking Medical Records Tracking * The Record Tracking Application prompts you to choose either Image Tracking or Medical Records Tracking. RCR QUE CAN DIS EDI PCO ING Re-Charge Records Request a Record Cancel a Request Display Request Edit a Request Patient Check-Out Short Record Inquiry SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Menu Diagrams & Definitions RREG Registration & DEERS Menu TREG Track & Request Medical Records Menu* PAS SYSTEM MENU DIAGRAMS Managed Care Program Menu APCM Assignment Reports Menu BPCM Batch PCM Reassignment FPCM Family PCM Reassignment 2-61 HMCP NMCP EMCP DMCP CMCP OMCP RMCP BMCP IMCP PMCP FMCP AMCP Health Care Finder Menu Non-Enrolled Booking Enrollment Processing Menu Display Patient Appointments Cancellation by Patient Outputs & Management Reports Menu Registration Menu Batch PCM Reassignment Menu Interactive NAS Processing Menu Provider Network Management Menu File/Table for MCP Menu Ad Hoc Report Menu ERPT PRPT RRPT URPT Enrollee/Patient Assignment Notification Provider Assignment Notification PCM Reassignment Report UIC Maintenance Report NNAS Non-Availability Statement Processing RNAS Reports for NAS SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Menu Diagrams & Definitions BNAS Branch of Service Summary Report NNAS NAS Statistical Report PNAS Reason for Issue by Patient Category Report SNAS Reason for Issue Summary Report PAS SYSTEM MENU DIAGRAMS Managed Care Program Menu HMCP NMCP EMCP DMCP CMCP OMCP RMCP BMCP IMCP PMCP FMCP AMCP 2-62 GNET INET ONET MNET Health Care Finder Menu Non-Enrolled Booking Enrollment Processing Menu Display Patient Appointments Cancellation by Patient Outputs & Management Reports Menu Registration Menu Batch PCM Reassignment Menu Interactive NAS Processing Menu Provider Network Management Menu File/Table for MCP Menu Ad Hoc Report Menu Group Member Roster Provider Group Report Provider List by Specialty PCM Enrollment Mix Discrepancy Statistical Summary PCM Enrollment Mix Discrepancy Report Group Profile/Agreements Enter/Edit Individual Provider Profile/Agreements Enter/Edit Outputs & Network Management Reports Menu Modify Group Agreement Effective Date Provider Batch Address Labels - Build Utility Provider Batch Address Labels - Print Utility Discrepancy Avoidance Report 1 2 3 4 5 6 Provider Alphabetic Agreement Roster Speciality Provider Agreement Roster Speciality Provider Agreement Summary Discount Provider Agreement Roster Expiration Date Provider Agreement Roster ZIP Code Agreement Roster SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Menu Diagrams & Definitions GMRM Group Management Reports Menu AMRM Agreement Reports Menu MMRM Miscellaneous Network Reports Menu 1 2 3 1 2 3 4 5 PAS SYSTEM MENU DIAGRAMS Managed Care Program Menu HMCP NMCP EMCP DMCP CMCP OMCP RMCP BMCP IMCP PMCP FMCP AMCP 2-63 IDHC PDHC SDHC LDHC Health Care Finder Menu Non-Enrolled Booking Enrollment Processing Menu Display Patient Appointments Cancellation by Patient Outputs & Management Reports Menu Registration Menu Batch PCM Reassignment Menu Interactive NAS Processing Menu Provider Network Management Menu File/Table for MCP Menu Ad Hoc Report Menu Inquire to File Entries Print File Entries Search File Entries List File Attributes Enrollment File/Table Maintenance Menu Facility File/Table Maintenance Menu Provider Network File/Table Maintenance Menu DEPT PLAC PROV GROU SPEC PROF MILI AUDI Department and Service File Enter/Edit Place of Care Enter/Edit Provider Enter/Edit Group Enter/Edit Specialty Type Enter/Edit Professional Category Enter/Edit Military Status Enter/Edit Audit Trail for Provider Network Menu Insurance Company Enter/Edit PCM Assignment Reason Enter/Edit Disenrollment Reason Enter/Edit MCP Forms Text Enter/Edit MCP Embosser Attribute Enter/Edit MCP Embosser Cards Enter/Edit MCP Embosser Type Enter/Edit Enrollment Block Reason Enter/Edit Enrollee Lockout Override Reason Enter/Edit Enrollee DMIS ID Update Clean Up DMIS ID Update DIVI OFFI HEAL ZIPC CAZC FACI ISSO PARA UICP RACT MCP Division Profile Edit MCP Office Enter/Edit MCP Health Care Finder Profile Enter/Edit ZIP Code Combinations Enter/Edit Catchment Area Zip Code Enter/Edit Facility Type Enter/Edit NAS Issuing Officer Enter/Edit MCP Parameters Profile Enter/Edit UIC/PCM Maintenance Enter/Edit Reactivate MCP Enrollment AGDC LCDC GPDC PRDC Agreement Data Changes Place of Care Data Changes Group Data Changes Provider Data Changes SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Menu Diagrams & Definitions ETAB FTAB PTAB INSU PCMA DISE FORM EMBA EMBC EMBT EBRE LORE DMIS CLUP SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Managed Care Program Menu This is the primary menu for the Managed Care Program (MCP). MCP is an automated program that helps MTFs manage information for MCP network providers and their subcontractors. MCP allows you to search for the most costeffective source of specialty care regardless of whether the patient is enrolled in the MCP. When searching for specialty care, the MCP simultaneously searches for both MTF and civilian providers in the network. MCP then displays a list of providers, grouped by discount rate, from which you may choose. From this menu, MCP allows you to maintain system files and tables that support MCP; create and maintain information to support the provider network and other MCP management reports and outputs; perform patient enrollment processing; manage appointment referrals, perform provider searches, and book appointments with specialists in the provider network for both enrolled and nonenrolled patients; book appointments for enrolled patients with their primary care manager; and issue non-availability statements (NASs) and care authorizations. • Health Care Finder Menu (HMCP) The Health Care Finder Menu options allow you to add and modify appointment referrals; conduct provider searches for both enrolled and nonenrolled patients; book appointments with specialists from a network of providers, who work within or outside of the MTF; and generate authorization forms, ID cards, and health care finder reports that support these tasks. •• PCM Booking (PHCF) The PCM Booking option allows you to book appointments for an enrolled patient with the patient’s primary care manager (PCM). PCM booking only processes patients with an MCP status of enrolled. Note that for non-enrolled, pending enrolled, and conditionally enrolled patients, use the Non-Enrolled Booking option. •• Appointment Referral Booking (AHCF) The Appointment Referral Booking option allows you to enter/edit an appointment referral and book appointments for both MCP-enrolled and non-enrolled patients with network providers. Appointments can be cancelled only through the Cancellation by Patient option. Referrals without appointments can be deleted in this option. 2-64 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 •• Non-Enrolled Booking (NHCF) The Non-Enrolled Booking option permits you to book appointments for patients not enrolled in MCP. It also permits you to process patients who are conditionally enrolled or pending enrolled. This option supports both MTF and Non-MTF booking. •• Enter Network Appointment Refusals (EHCF) The Enter Network Appointment Refusals option permits you to enter an appointment refusal from a separate menu option on the Health Care Finder Menu, rather than from the action bar on the NonEnrolled Booking screen. •• Output Products (OHCF) The Output Products option permits you to generate three output products for a specified patient: an enrollment form, membership id, or a patient label. It also permits you to generate two output products for a specified patient and appointment referral: a care authorization form or a provider label. After generating products for one patient, you may select another patient, or quit and exit the option. Note: If you use this option, you should be entered as a health care finder via the Health Care Finder Profile Enter/Edit option. Your record in the system should contain your name, telephone number, and the MCP office to which you are assigned. These fields will print on the care authorization form. •• Health Care Finder Reports Menu (RHCF) The Health Care Finder Reports Menu options allow you to generate information for agreement type referrals, specialty type referrals, the provider network, PCM activity, provider patient workload, and refused appointments. ••• Agreement Type Referral Summary (1) The Agreement Type Referral Summary option allows you to generate/print reports showing the number of referrals that were entered into the system within a selected division during a specified time range. There are two Agreement Type Referral Summary types. The first is sorted by the agreement type of the provider who received the patient care referral. The second is sorted by the 2-65 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 agreement type and then by the specialty of the provider who received the patient care referral. The report additionally shows an overall division total for the number of referrals. Each division is printed on a separate page. ••• Specialty Type Referral Summary (2) The Specialty Type Referral Summary option allows you to produce a Referral Summary by Specialty Type report for selected division(s). This report shows the number of referrals that were entered into the system during a specified date range. This report includes specialty type, provider, professional category, and number of referrals. The report is sorted by the specialty type, and within the specialty type by the provider to whom the patients were referred. The total number of referrals is reported for each provider. Additionally, totals for each specialty type, for the division, as well as for all the referrals entered for the date range specified are generated and shown. ••• Provider Network List (3) The Provider Network List option allows the user to print a report showing provider PCM capacity, assignments, and availability by provider agreement and provider specialty(s) within the agreement. The Provider Network List report is sorted by agreement type, individual provider specialty, place of care zip code, and then provider name. The reports also lists place of care appointment contact, address, and hours of service for each place of care. ••• PCM Activity Report (4) The PCM Activity Report option allows you to print reports showing the current number of enrollees, enrollment capacity, and available enrollment capacity for each PCM; number of emergency room visits; number of referrals made; number of visits with a referral; and number of visits without a referral within the specified date range. You can generate three different reports: the PCM Activity Report by Individual PCM, PCM Activity Report by Provider Group, and PCM Activity Report by Specialty. The PCM 2-66 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Activity Report by Individual PCM is sorted by individual provider, provider group, and provider group agreement. The PCM Activity Report by Provider Group is sorted by individual or group PCM and by agreement type. The PCM Activity Report by Specialty is sorted by individual provider specialty, individual provider, group, and agreement type. ••• Provider Patient Workload Report (5) The Provider Patient Workload Report option allows you to print a report showing outpatient visit activities to MTF providers and the total number of kept visits to MTF providers or provider groups. It also displays outpatient visit activity to non-MTF providers or provider groups and records the total number of booked visits to non-MTF providers or provider groups. In addition, the system reports the total number of different patients in the specified date range. The data is sorted first by agreement type, then by provider or provider group, and then by patient category status. ••• Refused Appointments Report (6) The Refused Appointments Report option allows you to print a report for selected patient(s) for a specified time period who have refused an available MTF or civilian network appointment. It shows the reason for the appointment refusal. This report may be requested either individually by patient name or for all patients. The report is sorted by refusal status and then by patient name when requested for all patients. •• Print Patient Address Label (LHCF) The Print Patient Address Label option allows you to print an address label for one or more patients, provided the patients have complete home or duty addresses. • Non-Enrolled Booking (NMCP) The Non-Enrolled Booking option permits you to book appointments for patients not enrolled in MCP. Non-Enrolled Booking also permits you to process patients who are conditionally enrolled or pending enrolled. This option supports both MTF and Non-MTF booking. 2-67 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 • Enrollment Processing Menu (EMCP) The Enrollment Processing Menu options allow you to verify DEERS eligibility for an MCP patient; enroll a patient into MCP; enroll family members into MCP; assign and modify a PCM for an MCP patient; enter and modify other health insurance (OHI) information; assign an exception provider as a case manager for a patient; and disenroll a patient from MCP. •• Enrollment Enter/Edit (EENR) The Enrollment Enter/Edit option allows you to enroll a patient in MCP and assign a PCM. This option prompts you to enter a patient name, then allows you to enter a new MCP enrollment, or view and edit a current MCP enrollment for a patient. You may both enroll and disenroll a patient, so that one patient may have more than one enrollment record in the system. The system also tracks family relationships of enrolled patients, and permits you to enroll other family members of enrolled patients. After each enrollment or disenrollment, the system sends an enrollment or disenrollment transaction for the Defense Enrollment Eligibility Reporting System (DEERS) as a background process. You may also print PCM place of care information, enter or copy OHI information, or print an encounter form or patient address label. •• Disenrollment (DENR) The Disenrollment option allows you to disenroll patients enrolled in MCP. This option prompts you to enter the name of a patient registered in CHCS, then allows you to disenroll any enrolled members of the patient’s family. •• Reciprocal Disenrollment Processing (RENR) The Reciprocal Disenrollment Processing option allows you to reciprocally disenroll beneficiaries from another facility (the losing facility) without enrolling them in your facility (the gaining facility). •• Conditional Enrollment Processing (CENR) The Conditional Enrollment Processing option allows you to perform DEERS Eligibility checks on conditionally enrolled patients and to cancel their enrollments. You may select individual patients or all conditionally enrolled patients in one specific division, several specific divisions, or all divisions. 2-68 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 •• Print/Display Enrollment History (PENR) The Print/Display Enrollment History option generates a list of the enrollments for a given patient, and allows you to print the enrollment history. •• Interactive DEERS Eligibility Request (IENR) The Interactive DEERS Eligibility Request option allows you to perform a DEERS check on a given patient. You specify the patient name, family member prefix (FMP), sponsor SSN, and patient date of birth (DOB), since these are the main fields by which DEERS identifies the patient. You may specify eligibility start and end dates to determine whether a patient who is currently ineligible in DEERS was eligible at an earlier date. This option, unlike other options that perform DEERS checks, always queries DEERS directly. It does not make use of DEERS data stored in the patient file by DEERS checks performed by other options within the past five days. It also does not store DEERS data in the Patient file for the benefit of other options that check DEERS eligibility. •• Outputs & Enrollment Maintenance Reports Menu (OENR) The Outputs & Enrollment Maintenance Reports Menu options allow you to generate information about DEERS/enrollment maintenance, enrollment, and PCMs. It also allows you to print the MCP enrollment form and address labels for patients. ••• DEERS/Enrollment Maintenance Reports Menu (DRPM) The DEERS/Enrollment Maintenance Reports Menu options allow you to generate information about conditional enrollment, enrollment/disenrollment discrepancies, DEERS ineligible patients from MCP, and DEERS ineligible patients from PAS. •••• MCP Conditional Enrollment Roster (1) The MCP Conditional Enrollment Roster option identifies those patients who received an ineligible response from DEERS and are conditionally enrolled. Data includes patient name, FMP/SSN, DOB, patient category, sponsor rank, home and work phone numbers, enrollment date, address, OHI status, and automatic disenrollment date. 2-69 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 •••• Enrollment/Disenrollment Discrepancy Report (2) The Enrollment/Disenrollment Discrepancy Report option enables you to generate a report for a selected time period listing those patients for whom a DEERS discrepancy response was received for their enrollment or disenrollment transaction. •••• MCP DEERS Ineligibility Report (3) The MCP DEERS Ineligibility Report option allows you to generate a report listing those patients that received an ineligible response from DEERS. •••• PAS DEERS Ineligibility Report (4) The PAS DEERS Ineligibility Report contains a list of those patients who have had a DEERS check performed in the last 24 hours and who have been returned as DEERS ineligible for those eligibility checks that have originated from PAS. This report enables you to produce the DEERS Ineligibility Report either by clinic, division, or group. This report is sorted by patient identification (PTID) and lists all patients who did not meet the DEERS eligibility standards. Data provided includes each patient’s name, FMP/SSN, DOB, date of last DEERS check, date of next appointment, home phone, work phone, clerk scheduler, and current DEERS status. •• Batch Enroll Active Duty (BENR) The Batch Enroll Active Duty option displays only when the CPZ BATCH ENROLL security key is assigned. This menu allows you to batch enroll active-duty beneficiaries into MCP. ••• Identify Potential Active Duty Candidates (IBER) The Identify Potential Active Duty Candidates option allows you to create a Potential Candidate List of active-duty beneficiaries eligible for batch enrollment. This is the first step in the batch enrollment process. The system searches the Patient file for all active-duty beneficiaries who have no MCP history. The system then subdivides these records into two groups: (1) beneficiaries with medical activity (e.g., an order, 2-70 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 admission, appointment, or MCP referral) within a userdefined period, and (2) all candidates. You can either process all candidates, or process only those with medical activity. ••• Update/Print/Enroll Potential AD Candidates (UBER) The Update/Print/Enroll Potential AD Candidates option allows you to subdivide the Potential Candidate List for better manageability. You can create these subsets using the following criteria: UIC (then alphabetically), patient category (then alphabetically), alphabet, and SSN. Once a subset has been identified, you can choose to view the candidates in the subset, print the subset list, update the candidate data, or enroll the subset candidates. Before performing the batch enrollment process, you can update individual or multiple candidate records with new data: UIC, PCM, alternate PCM, enrolling division, and enrollment block flag. Once the eligible (and updated) candidates are identified, you can start the batch enrollment process. ••• Print Batch Enrollment Report (PBER) The Print Batch Enrollment Report option allows you to print the Active Duty Enrollment Report. This report contains two parts: – Part I: Successful Enrollments - This section lists successfully enrolled candidates. It also provides the enrollment date, enrolling division, end enrollment date, and total number of successful enrollments. – Part II: Candidates Unable to be Enrolled - This section lists candidates who were not enrolled. It subdivides candidates by the reason they cannot be enrolled. You can either print each part separately or print them together. Note: The Default PCM/UIC Report is also available to help manage default PCMs. This report, on the PCM Reports Menu, indicates the current assignments of UICs to PCMs. It can be sorted by either UIC or PCM. ••• Delete Potential Candidate List (DBER) The Delete Potential Candidate List option allows you to delete the existing Potential Candidate List file. This option deletes all candidates for all users, and all batch enrollment jobs 2-71 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 currently tasked but not yet completed. If you want to resume batch enrollment, you must rerun the identification process from the beginning. ••• Enrollment Reports Menu (ERPM) The Enrollment Reports Menu options allow you to generate information about active-duty dependents by unit, alphabetic enrollment by service, case management program enrollment, change in eligibility enrollment, disenrollees for period by reason code, disenrollment by reason, enrollment roster exception conditions, OHI enrollment, and patient category enrollment. These options also allow you to create and print labels for families. •••• Family Batch Enrollment Labels Menu (LABL) The Family Batch Enrollment Labels Menu options allow you to build and print family batch enrollment labels for enrolled and nonenrolled patients, and to sort them by unit or location. During the build process, you may define selection criteria. Labels are generated only for patients who meet the criteria and who have complete address information. You may then print these labels either in their entirety or in subsets. You may also print an Incomplete Patient Address Report showing the patients that failed the minimum address requirements. After updating these patients’ addresses, you may print their labels. ••••• Family Batch Enrollment Labels Build Utility (1) The Family Batch Enrollment Labels Build Utility option allows you to create labels for families. You may generate labels for enrolled or nonenrolled patients and have them sorted by unit or location. In addition, you may specify certain selection criteria, which may include patient category group, OHI indicator, expiration within days, and PCM. Labels may be printed with either duty address or home address. Labels are generated only for patients who meet the 2-72 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 criteria specified and who have complete address information for the type of address selected. ••••• Family Batch Enrollment Labels Print Utility (2) The Family Batch Enrollment Labels Print Utility option allows you to print labels which were built using the Family Batch Enrollment Labels Build Utility option. You may print a batch in its entirety or in subsets. Once printed, a label is removed from the batch and cannot be reprinted. ••••• Incomplete Patient Address Report (3) The Incomplete Patient Address Report option allows you to print a listing of patients with incomplete patient address (home or duty) information. This report is generated when a user attempts to print patient address labels, and patients with insufficient address information exist. •••• Enrollment Rosters Menu (ROST) The Enrollment Rosters Menu options allow you to print rosters pertaining to patient enrollment. These rosters include current MCP-enrolled dependents of active-duty enrollees; active enrollees by division and branch of service; active enrollees with case management records by division, and exception providers within the division; active enrollees with pending change of eligibility status; disenrollees by reason code; and enrollees with defined exception conditions. These rosters are normally generated for a specified date range and for selected divisions. ••••• AD Family Member by Unit Enrollment Roster (1) The AD Family Member by Unit Enrollment Roster option allows you to print a list of all current MCP enrollees with a patient 2-73 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 category status of “dependent of active duty.” The report includes sponsor name, SSN, rank, family member name, FMP, DEERS dependent suffix (DDS), DOB, and enrollment date. The report provides subtotals for the number of enrollees by family and Unit ID, and a grand total of all active-duty family members. The report is sorted by the sponsor’s Unit ID and SSN. ••••• Alphabetic Enrollment Roster by Service (2) The Alphabetic Enrollment Roster by Service option enables you to print a roster of enrollees by branch of service for selected division(s). The roster may be printed for one, multiple, or all divisions; and within the selected division(s), by one, multiple, or all branches of service. Data provided includes name, FMP/SSN, DDS, DOB, PCM, sponsor, rank, home and work phone numbers, address, enrollment effective date, exception condition text, OHI status, patient category, and MCP status. ••••• Case Management Program Enrollment Roster (3) The Case Management Program Enrollment Roster option allows you to print an alphabetical list of all currently enrolled beneficiaries who have been identified as Case Management patients in the local MCP network. The reports provides a subtotal for each exception provider, and then a total for all exception providers in a specified division. Data provided includes name, FMP/SSN, DDS, DOB, sponsor rank, home and work phone numbers, address, enrollment effective date, exception condition text, OHI status, patient category, and MCP status. 2-74 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 ••••• Change in Eligibility Enrollment Roster (4) The Change in Eligibility Enrollment Roster option allows you to print a report listing and totaling the number of current MCP enrollees projected to have a change in their eligibility status based on a key eligibility category parameter (for example, beneficiary approaching the age of 65). Authorized users can specify the change-in-eligibility category and the end-of-eligibility date for generating the report. The report subtotals each eligibility category and totals all eligibility categories within a specified division. ••••• Disenrollees for Period by Reason Code (5) The Disenrollees for Period by Reason Code option allows you to print a report listing patients whose disenrollment date falls into a specified date range. You can generate the report for a specific disenrollment reason code and division. The report subtotals disenrollees for each reason code and division, and provides a grand total of disenrollees for the specified date range. Report data includes name, FMP/SSN, DDS, DOB, PCM, sponsor rank, home and work phone numbers, address, OHI status, patient category, and disenrollment date. ••••• Enrollment Roster Exception Conditions (6) The Enrollment Roster Exception Conditions option allows you to print a report alphabetically listing beneficiaries, who are currently enrolled in the MCP, by exception provider with defined exception conditions. The reports subtotals each provider specialty and exception provider, and totals all exception providers within the specified division. 2-75 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 ••••• Reciprocal Disenrollment by Reason Roster (7) The Reciprocal Disenrollment by Reason Roster option allows you to print a report showing only reciprocal disenrollments with the Disenrollment Code of Reciprocally Enrolled/Disenrolled (RED) or Reciprocally Disenrolled (RD). You can select either one or both of the reciprocal disenrollment reasons that you wish to see on the report for a specified date range. This is a wide (132 column) report and may be output to line printers. Note: The Disenrollees for Period by Reason Report option allows you to print all of the other disenrollment reasons, including Remotely Disenrolled (RM). ••••• Reciprocal Disenrollment Discrepancy Report (8) The Reciprocal Disenrollment Discrepancy Report allows you to print a report containing the following discrepancies: Patient Not Enrolled at Losing Facility, and Patient Not Registered/Not Found at Losing Facility. This report must be printed within 14 days; otherwise, it is automatically deleted. You should print the report so that the discrepancies can be resolved. Note: You should print the Disenrollees for Period by Reason Report to list the beneficiaries who were remotely disenrolled. •••• Track User Report (9) The Track User Report allows you to print a report showing MCP enrollment records that have been originated, modified, or had the PCM changed within a specified date range. This report shows the users that originated or modified an enrollment record, or changed the 2-76 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 PCM for an enrollment record. This report may be printed for one, multiple, or all divisions, and within divisions by one, multiple, or all Sponsor SSNs, Patient Category Groups, or Users. •••• Enrollee Entitlement Discrepancy Report (10) The Enrollee Entitlement Discrepancy Report option allows you to print a list of all enrollees with entitlement discrepancies. You select the Enrolling Divisions for the report. You will get a message indicating that it is a complex report and asking if you wish to proceed. •••• Enrollment Summaries Menu (SUMM) The Enrollment Summaries Menu options allow you to generate summary enrollment and disenrollment reports. The disenrollment report shows totals by disenrollment reason within each selected division. The enrollment summary reports show totals by selected categories, such as other health insurance (OHI), patient category status, and primary care manager (PCM). ••••• Disenrollment Summary by Reason (1) The Disenrollment Summary by Reason option allows you to print a report summarizing the number of disenrollees for a specified date range. The report contains a subcount of disenrollees for each reason code, a subtotal for each division, and a grand total for all disenrollees within the specified date range and the specified divisions. ••••• Enrollment Summary Report (2) The Enrollment Summary Report option allows you to print a two-part summary report. The first part contains enrollment summary information for enrollments, disenrollments, reenrollments, families enrolled, admissions, 2-77 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 and number of kept count and noncount appointments by patient category status within a selected date range in the direct care system. The report is subdivided into subcategories based upon sponsor rank for active-duty personnel and active-duty dependents. The second part of the report contains the same information and selection capabilities as the first part, but is reported by PCM. ••••• OHI Enrollment Summary (3) The OHI Enrollment Summary option allows you to print a report listing the number of current enrollees who have active policies with other health insurance companies. An enrollee covered by multiple policies is reported for each insurance company. This report sorts alphabetically by insurance company name. ••••• Patient Category Enrollment Summary (4) The Patient Category Enrollment Summary option allows you to print a report listing the number of current enrollees by their patient category status (i.e., active duty, dependents of active duty, retirees, etc.) The report provides totals for each group, and a grand total for all groups. The last page of the report shows patient category group totals by service. ••• PCM Reports Menu (PRPM) The PCM Reports Menu options allow you to generate information about available PCM capacity by provider group, enrollment by PCM, PCM activity, PCM assignment change by reason, and PCM assignment change summary. 2-78 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 •••• Available PCM Capacity by Provider Group (1) The Available PCM Capacity by Provider Group option allows you to print reports summarizing overall maximum capacity and patient type capacity, the number of current enrollees, and the remaining capacity for each PCM. You can select one or multiple provider groups for the report. •••• Enrollment Roster by PCM (2) The Enrollment Roster by PCM option allows you to print an enrollment roster by PCM for one, multiple, or all divisions; and within the selected divisions, either by one or more individual PCMs, or one or more provider groups. Report data includes patient name, FMP/SSN, DDS, DOB, sponsor rank, home and work phone numbers, effective dates for enrollment, address, OHI status, patient category, and MCP status. •••• PCM Activity Report (3) The PCM Activity Report option allows you to print reports showing the current number of enrollees; enrollment capacity and available enrollment capacity for each PCM; number of ER visits; number of referrals made; number of visits with a referral; and number of visits without a referral. You can generate three different reports: PCM Activity Report by Individual PCM, PCM Report by Provider Group, and PCM Activity Report by Specialty. The PCM Report by Individual PCM is sorted by individual provider, provider group, and provider group agreement. The PCM Activity Report by Provider Group is sorted by individual or group PCM and by agreement type. The PCM Activity Report by Specialty is sorted by individual provider specialty, individual provider, group, and agreement type. •••• PCM Assignment Change Roster by Reason (4) The PCM Assignment Change Roster by Reason option allows you to print reports listing the current beneficiaries whose PCM assignment was modified within a user-specified date range, or entered with a 2-79 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 specific PCM assignment change reason code. If you do not enter a change reason code, the system lists all beneficiaries who have had a change in PCM during the specified date range. All reports are sorted alphabetically by the assignment change reason code with subtotals for each, and by the losing provider and enrollee name. The report also provides a grand total for all beneficiaries and reasons. •••• PCM Assignment Change Summary (5) The PCM Assignment Change Summary option allows you to print reports summarizing the number of PCM assignment changes for all enrollees that occurred during a user-specified date range. You may specify one, multiple, or all PCMs and assignment change reasons for the report. The report subtotals the number of enrollees changing PCMs for each PCM, and a grand total for all selected PCMs. •••• Default PCM/UIC Report (6) The Default PCM/UIC Report option allows you to print a report listing the association between Unit Identification Codes (UICs) and default PCMs. You can sort the report by UIC or default PCM. ••• MCP Enrollment Form (MEFM) The MCP Enrollment Form option allows you to print an MCP enrollment form for a specified MCP patient. This form includes the enrollment date and ending eligibility/enrollment date; patient name and identifying data; sponsor name and identifying data; PCM and place of care data; insurance company and policy data; and case management involvement. The form additionally displays a site-definable eligibility, benefits, and responsibility statement for the patient; and area for the patient’s signature and date of signing; and an area to indicate the record room for the patient. ••• Address Label for Patient (APAL) The Address Label for Patient option allows you to print an address label for one or more patients. 2-80 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 • Display Patient Appointments (DMCP) The Display Patient Appointments option allows you to display or print a patient’s future or past appointments and Wait List requests, as well as those of other family members registered under the same SSN. It is a quick way to find out which provider saw a patient on a previous visit so that return visits can be scheduled with the same provider for continuity of care. These printouts may be given to patients to remind them of future appointments. Printouts also provide a listing of applicable instructions and appointment type messages. • Cancellation by Patient (CMCP) The Cancellation by Patient option allows you to cancel and reschedule appointments booked through MCP options, such as Appointment Referral Booking, Non-Enrolled Booking, and PCM Booking. The system enables you to enter the patient name and other selection criteria, and then search for all appointments for the patient that meet the search criteria. For each appointment slot, you have the option of cancelling or rescheduling/ cancelling. • Outputs & Management Reports Menu (OMCP) The Outputs & Management Reports Menu options allow you to generate reports for enrollment, health care finder, network provider, PCM, and DEERS/enrollment maintenance. •• Enrollment Reports Menu (ERME) The Enrollment Reports Menu options allow you to generate information about active-duty dependents by unit, alphabetic enrollment by service, case management program enrollment, change in eligibility enrollment, disenrollees for period by reason code, disenrollment by reason, enrollment roster exception conditions, OHI enrollment, and patient category enrollment. These options also allow you to create and print labels for families. ••• Family Batch Enrollment Labels Menu (LABL) The Family Batch Enrollment Labels Menu options allow you to build and print family batch enrollment labels for enrolled and nonenrolled patients, and to sort them by unit or location. During the build process, you may define selection criteria. Labels are generated only for patients who meet the criteria and who have complete address information. You may then print these labels either in their entirety or in subsets. 2-81 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 You may also print an Incomplete Patient Address Report showing the patients that failed the minimum address requirements. After updating these patients’ addresses, you may print their labels. •••• Family Batch Enrollment Labels Build Utility (1) The Family Batch Enrollment Labels Build Utility option allows you to create labels for families. You may generate labels for enrolled or nonenrolled patients and have them sorted by unit or location. In addition, you may specify certain selection criteria, which may include patient category group, OHI indicator, expiration within days, and PCM. Labels may be printed with either duty address or home address. Labels are generated only for patients who meet the criteria specified and who have complete address information for the type of address selected. •••• Family Batch Enrollment Labels Print Utility (2) The Family Batch Enrollment Labels Print Utility option allows you to print labels which were built using the Family Batch Enrollment Labels Build Utility option. You may print a batch in its entirety or in subsets. Once printed, a label is removed from the batch and cannot be reprinted. •••• Incomplete Patient Address Report (3) The Incomplete Patient Address Report option allows you to print a listing of patients with incomplete patient address (home or duty) information. This report is generated when a user attempts to print patient address labels, and patients with insufficient address information exist. ••• Enrollment Rosters Menu (ROST) The Enrollment Rosters Menu options allow you to print rosters pertaining to patient enrollment. These rosters include current MCP-enrolled dependents of active-duty enrollees; active enrollees by division and branch of service; active enrollees with case management records by division, and exception providers within the division; active enrollees with pending change of eligibility status; disenrollees by reason code; and 2-82 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 enrollees with defined exception conditions. These rosters are normally generated for a specified date range and for selected divisions. •••• AD Family Members by Unit Enrollment Roster (1) The AD Family Members by Unit Enrollment Roster option allows you to print a list of all current MCP enrollees with a patient category status of “dependent of active duty.” The report includes sponsor name, SSN, rank, family member name, FMP, DDS, DOB, and enrollment date. The report provides subtotals for the number of enrollees by family and Unit ID, and a grand total of all active-duty family members. The report is sorted by the sponsor’s Unit ID and SSN. •••• Alphabetic Enrollment Roster by Service (2) The Alphabetic Enrollment Roster by Service option enables you to print a roster of enrollees by branch of service for selected division(s). The roster may be printed for one, multiple, or all divisions; and within the selected division(s), by one, multiple, or all branches of service. Data provided includes name, FMP/SSN, DDS, DOB, PCM, sponsor, rank, home and work phone numbers, address, enrollment effective date, exception condition text, OHI status, patient category, and MCP status. •••• Case Management Program Enrollment Roster (3) The Case Management Program Enrollment Roster option allows you to print an alphabetical list of all currently enrolled beneficiaries who have been identified as Case Management patients in the local MCP network. The reports provides a subtotal for each exception provider, and then a total for all exception providers in a specified division. Data provided includes name, FMP/SSN, DDS, DOB, sponsor rank, home and work phone numbers, address, enrollment effective date, exception condition text, OHI status, patient category, and MCP status. 2-83 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 •••• Change in Eligibility Enrollment Roster (4) The Change in Eligibility Enrollment Roster option allows you to print a report listing and totaling the number of current MCP enrollees projected to have a change in their eligibility status based on a key eligibility category parameter (for example, beneficiary approaching the age of 65). Authorized users can specify the change-in-eligibility category and the end-of-eligibility date for generating the report. The report subtotals each eligibility category and totals all eligibility categories within a specified division. •••• Disenrollees for Period by Reason Code (5) The Disenrollees for Period by Reason Code option allows you to print a report listing patients whose disenrollment date falls into a specified date range. You can generate the report for a specific disenrollment reason code and division. The report subtotals disenrollees for each reason code and division, and provides a grand total of disenrollees for the specified date range. Report data includes name, FMP/SSN, DDS, DOB, PCM, sponsor rank, home and work phone numbers, address, OHI status, patient category, and disenrollment date. •••• Enrollment Roster Exception Conditions (6) The Enrollment Roster Exception Conditions option allows you to print a report alphabetically listing beneficiaries, who are currently enrolled in the MCP, by exception provider with defined exception conditions. The reports subtotals each provider specialty and exception provider, and totals all exception providers within the specified division. •••• Reciprocal Disenrollment by Reason Roster (7) The Reciprocal Disenrollment by Reason Roster option allows you to print a report showing only reciprocal disenrollments with the Disenrollment Code of Reciprocally Enrolled/Disenrolled (RED) or Reciprocally Disenrolled (RD). You can select either 2-84 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 one or both of the reciprocal disenrollment reasons that you wish to see on the report for a specified date range. This is a wide (132 column) report and may be output to line printers. Note: The Disenrollees for Period by Reason Report option allows you to print all of the other disenrollment reasons, including Remotely Disenrolled (RM) •••• Reciprocal Disenrollment Discrepancy Report (8) The Reciprocal Disenrollment Discrepancy Report option allows you to print a report containing the following discrepancies: Patient Not Enrolled at Losing Facility, and Patient Not Registered/Not Found at Losing Facility. This report must be printed within 14 days; otherwise, it is automatically deleted. You should print the report so that the discrepancies can be resolved. Note: You should print the Disenrollees for Period by Reason Report to list the beneficiaries who were remotely disenrolled. •••• Track User Report (9) The Track User Report allows you to print a report showing MCP enrollment records that have been originated, modified, or had the PCM changed within a specified date range. This report shows the users that originated or modified an enrollment record, or changed the PCM for an enrollment record. This report may be printed for one, multiple, or all divisions, and within divisions by one, multiple, or all Sponsor SSNs, Patient Category Groups, or Users. •••• Enrollee Entitlement Discrepancy Report (10) The Enrollee Entitlement Discrepancy Report option allows you to print a list of all enrollees with entitlement discrepancies. You select the Enrolling Divisions for the report. You will get 2-85 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 a message indicating that it is a complex report and asking if you wish to proceed. ••• Enrollment Summaries Menu (SUMM) The Enrollment Summaries Menu options allow you to generate summary enrollment and disenrollment reports. The disenrollment report shows totals by disenrollment reason within each selected division. The enrollment summary reports show totals by selected categories, such as other health insurance (OHI), patient category status, and primary care manager (PCM). •••• Disenrollment Summary by Reason (1) The Disenrollment Summary by Reason option allows you to print a report summarizing the number of disenrollees for a specified date range. The report contains a subcount of disenrollees for each reason code, a subtotal for each division, and a grand total for all disenrollees within the specified date range and the specified divisions. •••• Enrollment Summary Report (2) The Enrollment Summary Report option allows you to print a two-part summary report. The first part contains enrollment summary information for enrollments, disenrollments, reenrollments, families enrolled, admissions, and number of kept count and noncount appointments by patient category status within a selected date range in the direct care system. The report is subdivided into subcategories based upon sponsor rank for active-duty personnel and active-duty dependents. The second part of the report contains the same information and selection capabilities as the first part, but is reported by PCM. •••• OHI Enrollment Summary (3) The OHI Enrollment Summary option allows you to print a report listing the number of current enrollees who have active policies with other health insurance 2-86 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 companies. An enrollee covered by multiple policies is reported for each insurance company. This report sorts alphabetically by insurance company name. •••• Patient Category Enrollment Summary (4) The Patient Category Enrollment Summary option allows you to print a report listing the number of current enrollees by their patient category status (i.e., active duty, dependents of active duty, retirees, etc.) The report provides totals for each group, and a grand total for all groups. The last page of the report shows patient category group totals by service. •• Health Care Finder Reports Menu (HRPT) The Health Care Finder Reports Menu options allow you to generate information for agreement type referrals, specialty type referrals, the provider network, PCM activity, provider patient workload, and refused appointments. ••• Agreement Type Referral Summary (1) The Agreement Type Referral Summary option allows you to generate/print reports showing the number of referrals that were entered into the system within a selected division during the specified time range. There are two Agreement Type Referral Summary types. The first is sorted by the agreement type of the provider who received the patient care referral. The second is sorted by the agreement type and then by the specialty of the provider who received the patient care referral. The report also shows an overall division total for the number of referrals. Each division is printed on a separate page. ••• Specialty Type Referral Summary (2) The Specialty Type Referral Summary option allows you to produce a Referral Summary by Specialty Type report for selected division(s). This report shows the number of referrals that were entered into the system during a specified date range. Report data includes specialty type, provider, professional category, and number of referrals. The report is sorted by the specialty type, and within the specialty type, by the provider to whom the patient was referred. The report totals the number of 2-87 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 referrals for each provider. It also totals each specialty type and each division, and includes a grand total for all the referrals entered for the date range specified. ••• Provider Network List (3) The Provider Network List option allows you to print a report showing PCM capacity, assignments, and availability by provider agreement and provider specialties within the agreement. The Provider Network List reports is sorted by agreement type, individual provider specialty, place of care zip code, and then by provider name. The reports also lists place of care appointment contact, address, and hours for each place of care. ••• PCM Activity Report (4) The PCM Activity Report option allows you to print reports showing the current number of enrollees, enrollment capacity, and available enrollment capacity for each PCM; number of ER visits; number of referrals made; number of visits with a referral; and number of visits without a referral. You can generate three different reports: PCM Activity Report by Individual PCM, PCM Activity Report by Provider Group, and PCM Activity Report by Specialty. The PCM Activity Report by Individual PCM is sorted by individual provider, provider group, and provider group agreement. The PCM Activity Report by Provider Group is sorted by individual or group PCM and by agreement type. The PCM Activity Report by Specialty is sorted by individual provider specialty, individual provider, group, and agreement type. ••• Provider Patient Workload Report (5) The Provider Patient Workload Report option allows you to print a report showing outpatient visit activities to MTF providers and the total number of kept visits to MTF providers or provider groups. It also displays outpatient visit activity to non-MTF providers or provider groups and records the total number of booked visits to non-MTF providers or provider groups. In addition, the system reports the total number of different patients in the specified date range. The data is sorted first by agreement type, next by provider or provider group, and then by patient category status. 2-88 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 ••• Refused Appointments Report (6) The Refused Appointments Report option allows you to print a report for a specified time period for selected patient(s) who have refused an available MTF or civilian network appointment, and shows the reason for the appointment refusal. This report may be requested either individually by patient name or for all patients. The report is sorted by refusal status and then by patient name when requested for all patients. •• Network Provider Reports Menu (NPRM) The Network Provider Reports Menu options allow you to generate information about provider groups, providers by specialty, provider agreements, specialty provider agreements, discount provider agreements, expiration date of provider agreements, agreements by zip code, and MCP places of care. You can also print address labels for providers. ••• Labels for Providers Menu (LABM) The Labels for Providers Menu options allow you to build and print provider address labels. During the build process, you may define selection criteria. Labels are generated only for providers who meet the criteria and who have complete address information. You may then print these labels either in their entirety or in subsets. •••• Provider Batch Address Labels - Build Utility (1) The Provider Batch Address Labels - Build Utility option allows you to create address labels for providers. You may generate labels for an individual, multiple, or all providers; all providers by agreement type; all providers by specialty; or all providers whose agreements expire by a specified expiration date. Labels are generated only for providers who meet the criteria specified and who have complete address information. •••• Provider Batch Address Labels - Print Utility (2) The Provider Batch Address Labels - Print Utility option allows you to print labels which were built using 2-89 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 the Provider Batch Address Label Build Utility option.You may print a batch in its entirety or in subsets. Once printed, a label is removed from the batch and cannot be reprinted. •••• Incomplete Provider Address Report (3) The Incomplete Provider Address Report option allows you to print a listing of providers with incomplete address information. This report is generated when a user attempts to build provider address labels, and providers with insufficient information exist. ••• Provider Rosters Menu (PROM) The Provider Rosters Menu options allow you to print rosters pertaining to MCP providers. They include provider agreement discounts; expiration dates for provider agreements; listings of providers by specialties; listings of agreements by zip code; and listings of MCP provider groups, showing MCP providers within the groups, along with the specialties and agreements pertaining to those providers. •••• Discount Provider Agreement Roster (1) The Discount Provider Agreement Roster option allows you to print reports showing all active provider agreements. The report is sorted by agreement, provider type, specialty, and discount percent. Report data includes provider name, provider group, and specialty. •••• Expiration Date Provider Agreement Roster (2) The Expiration Date Provider Agreement Roster allows you to print reports listing and totaling provider agreement types which expire within a user-specified date range for one or more agreement types. The report is sorted by expiration date, provider name, and provider agreement type. Data is totaled by agreement type. 2-90 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 •••• Group Member Roster (3) The Group Member Roster option allows you to print reports listing providers associated with a group, along with their respective specialties for one, multiple, or all provider groups. •••• Provider Alphabetic Agreement Roster (4) The Provider Alphabetic Agreement Roster option allows you to print reports alphabetically, listing providers with current agreements with one or more provider types. Report data includes provider name, specialty, provider group, agreement type, effective stop date, and overall discount rate. The report totals each provider type, and includes a grand total for all provider types and providers. •••• Provider List by Specialty (5) The Provider List by Specialty option allows you to print reports listing providers by provider type and specialty. The report totals providers by specialty, and totals providers by provider type. •••• Specialty Provider Agreement Roster (6) The Specialty Provider Agreement Roster option allows you to print reports listing and totaling provider agreements by specialty, along with a grand total for all providers and specialties. Report data includes specialty, agreement type, provider name, provider group, agreement effective and stop dates, and overall discount rate. •••• ZIP Code Agreement Roster (7) The ZIP Code Agreement Roster option allows you to print reports listing and totaling providers by specialty and zip code. You may request the report for all providers or for PCMs only. The report is sorted by zip code, provider specialty, provider name, provider group, agreement type, and agreement effective date. 2-91 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 ••• Reports for Provider Menu (RPTM) The Reports for Provider Menu options allow you to print detailed information reports for selected MCP places of care and provider groups. You may also print a summary report that showing the number of agreements by provider type, provider specialty, and agreement type. •••• MCP Place of Care Report (1) The MCP Place of Care Report option allows you to print the MCP Place of Care Report for a selected MCP place of care. The reports includes street address, city, state, zip code, appointment contact name, telephone number, place of care hours, directions, and comments. •••• Provider Group Report (2) The Provider Group Report option allows you to print provider group reports by selected provider group(s) and section(s). The group report sections include Group Information, Places of Care, Agreements & Providers, Primary Care Managers, Group Level Exceptions, and Individual Provider Exceptions. Each section requested is printed on separate pages. •••• Provider Agreement Detail Report (3) The Provider Agreement Detail Report option allows you to generate a summary of one, multiple, or all agreements for each provider within a specified group. The report is listed alphabetically by provider name and contains each provider's specialties, dates and types of agreements, the most recent overall discount rates, exceptions, places of care, and billing/payment contact information. •••• Specialty Provider Agreement Summary (4) The Specialty Provider Agreement Summary option allows you to print the Provider Agreement Roster by Specialty Report, which lists the number of agreements by provider type, provider specialty, and agreement type. It totals each agreement type pertaining to a specialty, each specialty pertaining to a provider type, and each provider type. 2-92 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 •• PCM Reports Menu (PRPT) The PCM Reports Menu options allow you to generate information about available PCM capacity by provider group, enrollment by PCM, PCM activity, PCM assignment change by reason, and PCM assignment change summary. ••• Available PCM Capacity by Provider Group (1) The Available PCM Capacity by Provider Group option allows you to print reports summarizing overall maximum capacity and patient type capacity, the number of current enrollees, and the remaining capacity for each PCM. You may select one or multiple provider groups for the report. ••• Enrollment Roster by PCM (2) The Enrollment Roster by PCM option allows you to print an enrollment roster by PCM for one, multiple, or all divisions; and within the selected divisions, either by one or more individual PCMs, or one or more provider groups. Report data includes patient name, FMP/SSN, DDS, DOB, sponsor rank, home and work phone numbers, effective dates for enrollment, address, OHI status, patient category, and MCP status. ••• PCM Activity Report (3) The PCM Activity Report option allows you to print reports showing the current number of enrollees; enrollment capacity and available enrollment capacity for each PCM; number of ER visits; number of referrals made; number of visits with a referral; and number of visits without a referral. You can generate three different reports: PCM Activity Report by Individual PCM, PCM Report by Provider Group, and PCM Activity Report by Specialty. The PCM Report by Individual PCM is sorted by individual provider, provider group, and provider group agreement. The PCM Activity Report by Provider Group is sorted by individual or group PCM and by agreement type. The PCM Activity Report by Specialty is sorted by individual provider specialty, individual provider, group, and agreement type. 2-93 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 ••• PCM Assignment Change Roster by Reason (4) The PCM Assignment Change Roster by Reason option allows you to print reports listing the current beneficiaries whose PCM assignment was modified within a user-specified date range, or entered with a specific PCM assignment change reason code. If you do not enter a change reason code, the system lists all beneficiaries who have had a change in PCM during the specified date range. All reports are sorted alphabetically by the assignment change reason code with subtotals for each, and by the losing provider and enrollee name. The report also provides a grand total for all beneficiaries and reasons. ••• PCM Assignment Change Summary (5) The PCM Assignment Change Summary option allows you to print reports summarizing the number of PCM assignment changes for all enrollees that occurred during a user-specified date range. You may specify one, multiple, or all PCMs and assignment change reasons for the report. The report subtotals the number of enrollees changing PCMs for each PCM, and includes a grand total for all selected PCMs. ••• Default PCM/UIC Report (6) The Default PCM/UIC Report option allows you to print a report listing the association between Unit Identification Codes (UICs) and default PCMs. You can sort the report by UIC or default PCM. ••• PCM Enrollment Mix Discrepancy Statistical Summary (7) The PCM Enrollment Mix Discrepancy Statistical Summary lists PCM Beneficiary Categories which have discrepancies. The discrepancies are identified with an asterisk or flag ("Y"). This report identifies patient loads which include beneficiaries whose age is outside the PCM’s age range preferences or if the PCM Beneficiary Category Capacity is lower than the current assigned patients. ••• PCM Enrollment Mix Discrepancy Report (8) The PCM Enrollment Mix Discrepancy Report includes the statistics from the PCM Enrollment Mix Discrepancy Summary Report and the names of the individual beneficiaries who are currently assigned to PCMs in categories where the number of 2-94 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 assigned beneficiaries exceed the PCMs capacity for that category, or whose age is outside the PCM’s age range preference. You may choose to sort the report by PCM, by MCP Provider Group, or by Beneficiary. •• DEERS/Enrollment Maintenance Reports Menu (DEMR) The DEERS/Enrollment Maintenance Reports Menu options allow you to generate information about conditional enrollment, enrollment/ disenrollment discrepancies, DEERS ineligible patients from MCP, and DEERS ineligible patients from PAS. ••• MCP Conditional Enrollment Roster (1) The MCP Conditional Enrollment Roster option identifies those patients who received an ineligible response from DEERS and are conditionally enrolled. Data includes patient name, FMP/ SSN, DOB, patient category, sponsor rank, home and work phone numbers, enrollment date, address, OHI status, and automatic disenrollment date. ••• Enrollment/Disenrollment Discrepancy Report (2) The Enrollment/Disenrollment Discrepancy Report option allows you to generate a report for a selected time period listing those patients who received a DEERS discrepancy response for their enrollment or disenrollment transaction. ••• MCP DEERS Ineligibility Report (3) The MCP DEERS Ineligibility Report option allows you to generate a report listing those patients who received an ineligible response from DEERS. ••• PAS DEERS Ineligibility Report (4) The PAS DEERS Ineligibility Report option allows you to produce the PAS DEERS Ineligibility Report either by clinic, division, or group. This report lists those patients who have had a DEERS check performed in the last 24 hours and who have been returned as DEERS ineligible for eligibility checks originating from PAS. This report is sorted by Patient Identification (PTID) and lists all patients who did not meet the DEERS eligibility standards. Data includes each patient’s name, FMP/SSN, DOB, date of last 2-95 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 DEERS check, date of next appointment, home phone, work phone, clerk scheduler, and current DEERS status. • Registration Menu (RMCP) For more information on Registration Menu options, refer to the Patient Administration Reference Manual, TC-4.4-0702. •• Registration & DEERS Menu (RREG) The Registration & DEERS Menu options allow you to change the sponsor’s name for a registered patient, check for DEERS eligibility, generate an embossed care, print a registration form, perform miniregistration, and view a current patient’s DEERS status. ••• DEERS Eligibility Request (DRDM) The DEERS Eligibility Request option allows you to conduct a DEERS check for a specific patient. ••• Generate Embossed Card (GRDM) The Generate Embossed Card option allows you to print an embossed card that contains pertinent patient registration information. ••• Hard Copy of Registration Form (HRDM) The Hard Copy of Registration Form option allows you to print a paper copy of the registration and administration information for a patient. ••• Mini Registration (MRDM) The Mini Registration option allows you to register a new patient in the system and enter complete data necessary to process the patient’s registration. This option also allows you to edit an existing patient’s registration data. ••• View Patient DEERS Status (VRDM) The View Patient DEERS Status option allows you to view the DEERS status of a registered patient. 2-96 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 •• Track & Request Medical Records Menu (TREG) The Track & Request Medical Records Menu options allow you to recharge records to other clinics, and to request records from Medical Records File Rooms. Record Tracking Application The Record Tracking Application allows you to electronically track patient records, whether they are medical records, film folders (radiology records), or records related to Nuclear Medicine. Through the use of this application, you can request patient records, maintain up-to-date information on the location of the record, and be provided significant information for user determination of record availability for charge-out. ••• Image Tracking (I) The Image Tracking Menu presents the same functions and options as those for Medical Records Tracking; however, this menu allows you to track radiology records such as X-ray files. ••• Medical Records Tracking (MRT) The Medical Records Tracking option allows you to track inpatient and outpatient medical records throughout the facility. •••• Re-Charge Records (RCR) The Re-Charge Records option allows you to record the transfer of records charged from the file room from one borrower to another. This option is for use with inhouse borrowers only. The system records the new borrower, location/phone, and date/time of re-charge. The system displays this information each time the associated record inquiry is accessed through the Record Tracking System. •••• Request a Record (QUE) The Request a Record option allows you to enter a request for a patient’s record. You can request a single record or multiple records for a patient. You can request the record for the current time, or a date and time in the future. The person/location borrowing the record must be in the Borrower file. 2-97 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 •••• Cancel a Request (CAN) The Cancel a Request option allows you to cancel a previous request. You must hold the proper security key access. •••• Display Request (DIS) The Display Request option allows you to display data associated with a specific request for a patient's record. You may access request data for a specific patient by scanning the barcode on a record request label, entering the request number, or entering the patient name. •••• Edit a Request (EDI) The Edit a Request option allows you to edit data associated with a request for a patient’s record. Only the date/time needed and the requestor can be edited. •••• Patient Check-Out (PCO) The Patient Check-Out option allows you to record a patient as the borrower of the patient’s own record(s). For example, you can use this option for patients carrying their X-rays to an outside HCP. The system records the patient as the borrower of the record, along with the date/time of charge-out, by entering this information into the movement history for the record. •••• Short Record Inquiry (INQ) The Short Record Inquiry option allows you to generate an abbreviated online list of all records for a specified patient. This is the same list that is displayed throughout the Record Tracking package when a patient name is entered. • Batch PCM Reassignment Menu (BMCP) The Batch PCM Reassignment Menu options allow you to reassign a group of enrollees to from a current PCM a new gaining PCM without having to do individual reassignments. You can reassign all patients to one or multiple new PCMs; all patients of the same patient type; or an entire family. 2-98 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 In addition, a variety of reports are generated as a result of the batch PCM reassignment process. •• Assignment Reports Menu (APCM) The Assignment Reports Menu options allow you to print reports generated as a result of the batch PCM reassignment process: the Enrollee/Patient Assignment Notification, Provider Notification Roster, and PCM Reassignment Report. ••• Enrollee/Patient Assignment Notification (ERPT) The Enrollee/Patient Assignment Notification option allows you to obtain assignment notifications. For a given PCM and a given assignment date, this option generates a form letter for each patient who was assigned to the PCM on or after that date, notifying the patient of the assignment. ••• Provider Assignment Notification (PRPT) The Provider Assignment Notification option allows you to obtain provider assignment notifications. For a given PCM and a given assignment date, this option generates a roster of all patients who were assigned to the PCM on or after that date, notifying the provider of the assignment. You may also obtain a cover letter to the PCM explaining the roster. ••• PCM Reassignment Report (RRPT) The PCM Reassignment Report option allows you to print a report listing the results of a reassignment action. The report has three parts: Patients Reassigned by Gaining PCM, Reassignment Discrepancies, and Appointments Booked With a Prior PCM. The reports listed by this option are created by batch processes started by the Batch PCM Reassignment option. ••• UIC Maintenance Report (URPT) The UIC Maintenance Report option allows you to print a twopart summary report. The first part contains the names of active-duty enrollees whose UIC code has changed since the PCM was assigned. This helps you determine if reassignment of a new PCM is appropriate. If the PCM is the same for a patient’s former and new UIC code, 2-99 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 the patient name is not included on the report. However, when a default PCM has been defined for the patient’s new UIC code, the PCM name and available active-duty capacity is included. The second part of the report contains the names of active-duty enrollees who have invalid UIC codes; i.e., is not a valid entry in the Unit Ship ID file (8111). •• Batch PCM Reassignment (BPCM) The Batch PCM Reassignment option allows you to reassign one PCM’s patients to one or more other PCMs. You enter the name of the current PCM and select the appropriate agreement for that PCM. Then the system prompts you to select either to assign a gaining PCM directly; choose the gaining PCM from those PCMs who meet certain search criteria; choose one or more gaining PCMs from the current PCM’s provider group; or to transfer patients from one place of care to another for the same provider. Following a reassignment, the system generates a mail message informing appropriate personnel of the completion of reassignment, and then produces the PCM Reassignment Report. •• Family PCM Reassignment (FPCM) The Family PCM Reassignment option allows you to reassign one or more members of a family to a new PCM. You enter the name of the patient, and specify which members of the patient’s family are to be reassigned. You may assign a new PCM directly, or specify search criteria and select the new PCM from the list of those who meet the search criteria. If reassigned family members have appointments booked with their prior PCM, a reports of those appointments will be generated. • Interactive NAS Processing Menu (IMCP) The Interactive NAS Processing Menu options allow you to issue, cancel, or print Unconditional Non-Availability Statements (NASs) for CHAMPUSeligible patients who are registered in DEERS; issue, cancel, or print Conditional NASs for CHAMPUS-eligible patients who are not registered in DEERS; and generate NAS Summary reports. •• Non-Availability Statement Processing (NNAS) The Non-Availability Statement Processing option allows you to issue, print, and cancel an NAS in DEERS. A cancelled NAS is not deleted 2-100 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 from DEERS, but can still be queried and printed. An NAS can be accessed either by NAS number or by patient name. This option functions only when DEERS is online. Note: In this option, the system does not permit you to quit a DEERS NAS transaction. Whenever the system queries DEERS for an NAS, it will display the Processing DEERS Request screen. After the request is completed, the system will proceed to the next step in the option. If the transaction results in a discrepancy, the system will display the DEERS NAS Response screen with a discrepancy message. After viewing the message and pressing <Return>, the system will return to the previous action. •• Reports for NAS (RNAS) The Reports for NAS option allows you to generate NAS summary reports. Running the NAS reports requires access to DEERS. ••• Branch of Service Summary Report (BNAS) The Branch of Service Summary Report option allows you to generate a report listing the total number of non-availability statements issued under a given DMIS ID in a given month, broken down by major diagnostic code (MDC) and branch of service. ••• NAS Statistical Report (NNAS) The NAS Statistical Report option allows you to generate a report listing, for a given DMIS ID and for both the current and previous months, the total number of non-availability statements generated, the total number cancelled, and the difference between the two. ••• Reason for Issue by Patient Category Report (PNAS) The Reason for Issue by Patient Category Report option allows you to generate a report listing the total number of nonavailability statements in a given DMIS in a given month for a given reason for issue, broken down by MDC and patient category. ••• Reason for Issue Summary Report (SNAS) The Reason for Issue Summary Report option allows you to generate a report listing the total number of non-availability statements in a given DMIS in a given month, broken down by reason for issue and MDC. 2-101 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 • Provider Network Management Menu (PMCP) The Provider Network Management Menu options allow you to create and maintain provider groups, enter and update network agreements, and maintain provider profile information. •• Group Profile/Agreements Enter/Edit (GNET) The Group Profile/Agreements Enter/Edit option allows you to enter or edit agreement and provider profile data for selected MCP provider groups. You can also inactivate or reactivate places of care and providers using this option. Note: New MCP provider groups must first be created using the File/ Table for MCP Menu options. At least one place of care and one provider must be entered for each MCP provider group. During the adding or editing process for places of care, the system allows you to enter the Clinic Profile Edit option to update clinic profiles for the selected provider group. Upon completion, the system returns you to the Group Profile/Agreements Enter/Edit option to continue processing. The Agreements action allows you to add new group agreements; edit existing group agreements; add or edit PCM enrollment mix data for selected group agreements; add, edit, or delete specialty exception data for group agreements; add, edit, or delete group procedure exceptions; renew an agreement; and terminate group agreements. The Providers action allows you to add a provider to a group; edit the profile of an existing provider; and edit or delete exception data for selected providers. When adding or editing provider profiles, you may enter the Provider Profile Enter/Edit option to update the provider profiles. The system will then return to the Group Profile/Agreements Enter/Edit option to continue processing. When editing exception data, the system allows you to select the agreements in which the selected provider participates; select agreements to edit; select agreements to edit PCM data (enrollment mix); select agreements to edit procedure exception data; and select agreements for which to process specialty exception data. The Inactivate/Reactivate action allows you to inactivate or reactivate an existing place of care for a group or for one or more providers by entering or editing the inactivation date, reactivation date, and reason for inactivation. You can also inactivate a provider 2-102 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 within a group. However, there is no reactivation date for providers. Additionally, this action allows you to print the Discrepancy Avoidance Report. •• Individual Provider Profile/Agreements Enter/Edit (INET) The Individual Provider Profile/Agreements Enter/Edit option allows you to enter or edit individual provider profile and agreement data for selected MCP providers. You can inactivate or reactivate MCP providers or the provider places of care. A provider can also be added as a new member to an existing MCP provider group. During the adding or editing process for the places of care, the system allows you to enter the Provider Profile Enter/Edit option to update provider profiles since no appointments can be booked for the provider until PAS provider profile information is entered. Additionally, you can also print the Discrepancy Avoidance Report when using the Inactivate/Reactivate Place of Care or Provider actions. •• Outputs & Network Management Reports Menu (ONET) The Outputs & Network Management Reports Menu options allow you to generate information relating to provider group management and provider agreements. You can also print address labels for providers and the Discrepancy Avoidance Report. ••• Group Management Reports Menu (GMRM) •••• Group Member Roster (1) The Group Member Roster option allows you to print reports listing providers associated with a group, along with their respective specialties for one, multiple, or all provider groups. •••• Provider Group Report (2) The Provider Group Report option allows you to print provider group reports by selected provider group(s) and section(s). The group report sections include Group Information, Places of Care, Agreements & Providers, Primary Care Managers, Group Level Exceptions, and Individual Provider Exceptions. Each section requested will be printed on separate pages. 2-103 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 •••• Provider List by Specialty (3) The Provider List by Specialty option allows you to print reports listing providers by provider type and specialty. The report totals providers by specialty, and totals providers by provider type. •••• PCM Enrollment Mix Discrepancy Statistical Summary (4) The PCM Enrollment Mix Discrepancy Statistical Summary lists PCM Beneficiary Categories which have discrepancies. The discrepancies are identified with an asterisk or flag ("Y"). This report identifies patient loads which include beneficiaries whose age is outside the PCM’s age range preferences or if the PCM Beneficiary Category Capacity is lower than the current assigned patients. •••• PCM Enrollment Mix Discrepancy Report (5) The PCM Enrollment Mix Discrepancy Report includes the statistics from the PCM Enrollment Mix Discrepancy Summary Report and the names of the individual beneficiaries who are currently assigned to PCMs in categories where the number of assigned beneficiaries exceed the PCMs capacity for that category, or whose age is outside the PCM’s age range preference. You may choose to sort the report by PCM, by MCP Provider Group, or by Beneficiary. ••• Agreement Reports Menu (AMRM) The Agreement Reports Menu options allow you to generate information for provider alphabetic agreements, specialty provider agreements, discount provider agreements, provider agreement expiration dates, and agreements by zip code. •••• Provider Alphabetic Agreement Roster (1) The Provider Alphabetic Agreement Roster option allows you to print reports alphabetically, listing providers with current agreements with one or more provider types. Report data includes provider name, specialty, provider group, agreement type, effective stop date, and overall discount rate. The report totals 2-104 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 each provider type, and includes a grand total for all provider types and providers. •••• Specialty Provider Agreement Roster (2) The Specialty Provider Agreement Roster option allows you to print reports listing and totaling provider agreements by specialty, along with a grand total for all providers and specialties. Report data includes specialty, agreement type, provider name, provider group, agreement effective and stop dates, and overall discount rate. •••• Specialty Provider Agreement Summary (3) The Specialty Provider Agreement Summary option allows you to print the Provider Agreement Roster by Specialty Report, which lists the number of agreements by provider type, provider specialty, and agreement type. Totals are shown for each agreement type pertaining to a specialty, each specialty pertaining to a provider type, and each provider type. •••• Discount Provider Agreement Roster (4) The Discount Provider Agreement Roster option allows you to print reports showing all active provider agreements. The report is sorted by agreement, provider type, specialty, and discount percent. Report data includes provider name, provider group, and specialty. •••• Expiration Date Provider Agreement Roster (5) The Expiration Date Provider Agreement Roster option allows you to print reports listing and totaling provider agreement types which expire within a userspecified date range for one or more agreement types. The report is sorted by expiration date, provider name, and provider agreement type. Data is totaled by agreement type. •••• ZIP Code Agreement Roster (6) The ZIP Code Agreement Roster option allows you to print reports listing and totaling providers by specialty 2-105 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 and zip code. You may request the report for all providers or for PCMs only. The report is sorted by zip code, provider specialty, provider name, provider group, agreement type, and agreement effective date. ••• Miscellaneous Network Reports Menu (MMRM) The Miscellaneous Network Reports Menu options allow you to print address labels for providers and the Discrepancy Avoidance Report. •••• Provider Batch Address Labels - Build Utility (1) The Provider Batch Address Labels - Build Utility option allows you to create address labels for providers. You may generate labels for an individual, multiple, or all providers; all providers by agreement type; all providers by specialty; or all providers whose agreements expire by a specified expiration date. Labels are generate only for providers who meet the criteria specified and who have complete address information. •••• Provider Batch Address Labels - Print Utility (2) The Provider Batch Address Labels - Print Utility option allows you to print labels which were built using the Provider Batch Address Label Build Utility option.You may print a batch in its entirety or in subsets. Once printed, a label is removed from the batch and cannot be reprinted. •••• Discrepancy Avoidance Report (3) The Discrepancy Avoidance Report option allows you to generate a report that informs you, for either a provider or place of care, of the patients, appointments, Wait List requests, and/or provider or place-of-care associations that need to be changed before you may inactivate the provider or place of care. For places of care, the report lists: Patients assigned to providers as primary care managers (PCMs), patients having appointments and referrals to providers, patients having Wait List requests for providers, and providers in each group. 2-106 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 For providers, the report lists: Patients assigned to the provider as a PCM, patients having appointments with and referrals to the provider, patients having Wait List requests for the provider, and places of care for each provider. •• Modify Group Agreement Effective Date (MNET) The Modify Group Agreement Effective Date option allows you to update, change, or review the effective date of existing provider group agreements. Each modification produces an agreement history record. These records are numbered and sorted in chronological order. • File/Table for MCP Menu (FMCP) The File/Table for MCP Menu options allow you to maintain system files and tables that support the MCP. •• Enrollment File/Table Maintenance Menu (ETAB) The Enrollment File/Table Maintenance Menu options allow you to enter/edit MCP enrollment files and tables. ••• Insurance Company Enter/Edit (INSU) The Insurance Company Enter/Edit option allows you to enter/ edit an insurance company record. ••• PCM Assignment Reason Enter/Edit (PCMA) The PCM Assignment Reason Enter/Edit option allows you to enter a new PCM assignment reason for an MTF, or edit the description for an existing PCM assignment reason. ••• Disenrollment Reason Enter/Edit (DISE) The Disenrollment Reason Enter/Edit option allows you to enter a new disenrollment reason code and description, or edit the description for an existing disenrollment reason. ••• MCP Forms Text Enter/Edit (FORM) The MCP Forms Text Enter/Edit option allows you to edit text for an existing Enrollment Form or Care Authorization Form. 2-107 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 ••• MCP Embosser Attribute Enter/Edit (EMBA) The MCP Embosser Attributes Enter/Edit option allows you to associate software attribute codes that are inherent with different embossers without having to hard code the attributes and codes for each type of embosser. The codes can be literal text strings or an interpreted variable such as $C(13) that is sent to the embosser. For more information on embosser type attributes, refer to the Patient Administration Reference Manual, TC-4.4-0702. ••• MCP Embosser Cards Enter/Edit (EMBC) The MCP Embosser Cards Enter/Edit option allows you to define the type of embosser cards that may be generated by the PAD subsystem, and the information to be embossed on each card. This option allows you to build or modify a print template for the card embosser; edit the fields to be displayed on an embosser card; and display or print a sample (test) embosser card. For more information on embosser cards, refer to the Patient Administration Reference Manual, TC-4.4-0702. ••• MCP Embosser Type Enter/Edit (EMBT) The MCP Embosser Type Enter/Edit option allows you to define embosser types. The embosser type is then called from the Emboss Card Format file to tie emboss cards to types of embossers. At run time, the defaults entered in this option will be extracted for use on the emboss card. For more information on embosser cards, refer to the Patient Administration Reference Manual, TC-4.4-0702. ••• Enrollment Block Reason Enter/Edit (EBRE) The Enrollment Block Reason Enter/Edit option allows you to enter a new enrollment block reason code and description, or to view or modify the description for an existing enrollment block reason. ••• Enrollee Lockout Override Reason Enter/Edit (LORE) The Enrollee Lockout Override Reason Enter/Edit option allows you to enter a new enrollee lockout override reason code 2-108 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 and description, or to modify or view the description for an existing enrollee lockout reason ••• Enrollee DMIS ID Update (DMIS) The Enrollee DMIS ID Update option is used to send update enrollment transactions for enrollees in either all or the specified division. This option will result in the DMIS ID of the Enrolling Division being recorded on the patient’s enrollment records on DEERS. ••• Clean Up DMIS ID Update (CLUP) The Clean Up DMIS ID Update option is used to re-set the system in the event that a DMIS ID Update action failed to finish due to a system crash or a TaskMan error. This option will kill the job previously scheduled. It will allow the user to retask the DMIS ID Update action. •• Facility File/Table Maintenance Menu (FTAB) The Facility File/Table Maintenance Menu options allow you to enter or edit MCP facility files and tables. ••• MCP Division Profile Edit (DIVI) The MCP Division Profile Edit option allows you to set up and edit the profiles for the divisions within an MTF, and to determine which of the divisions within the facility is an MCP division, if any. Data in the profile includes the address of the division; time frames for pulling patient records; and schedule hold times (that is, the maximum number of days a schedule or appointment slot may remain frozen before being released for appointment booking). The schedule hold duration specified in the division profile can be overridden by the clinic profile. ••• MCP Office Enter/Edit (OFFI) The MCP Office Enter/Edit option allows you to set up and edit the profiles for the MCP offices. Data in the office profile includes the name of the office supervisor, street address, city, state, zip code, office phone, office location, and office hours. 2-109 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 ••• MCP Health Care Finder Profile Enter/Edit (HEAL) The MCP Health Care Finder Profile Enter/Edit option allows you to set up and edit profiles for MCP health care finders (HCFs). Data in the profile includes the HCF name and phone number, and the MCP office with whom the HCF is associated. ••• ZIP Code Combinations Enter/Edit (ZIPC) The ZIP Code Combinations Enter/Edit option allows you to enter new zip code combinations, and edit or delete existing zip code combinations. Entire zip code combinations, or individual zip codes within a combination, may be entered, edited, or deleted. ••• Catchment Area Zip Code Enter/Edit (CAZC) The Catchment Area Zip Code Enter/Edit option allows you to edit the Provider Network Area and Patient Enroll Area data fields for existing zip codes. These fields define the zip codes as part of the allowable patient or provider network. ••• Facility Type Enter/Edit (FACI) The Facility Type Enter/Edit option allows you to enter a new facility type code and description, or edit a description for an existing facility type. ••• NAS Issuing Officer Enter/Edit (ISSO) The NAS Issuing Officer Enter/Edit option allows you to enter a new NAS issuing officer, or to edit information for an existing NAS issuing officer. For an existing issuing officer, you may edit the title and either the military rank field or the government service rank field. ••• MCP Parameters Profile Enter/Edit (PARA) The MCP Parameters Profile Enter/Edit option allows you to enter or edit MCP parameters. You may specify whether enrollment is to be restricted by residential address, activeduty dependents, retired beneficiaries, or retired dependents. 2-110 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 ••• UIC/PCM Maintenance Enter/Edit (UICP) The UIC/PCM Maintenance Enter/Edit option allows you to enter or edit Unit Identification Code (UIC) assignments to PCMs. A PCM may be selected directly, or by specifying search criteria such as agreement type, specialty, and location. For a given PCM, UICs can be entered, viewed, or deleted. ••• Reactivate MCP Enrollment (RACT) The Reactivate MCP Enrollment option allows you to reactivate the enrollment option if the option was locked during the batch disenrollment process and the job was aborted. •• Provider Network File/Table Maintenance Menu (PTAB) The Provider Network File/Table Maintenance Menu options allow you to enter/edit MCP provider network facility files and tables. ••• Department and Service File Enter/Edit (DEPT) The Department and Service File Enter/Edit option allows you to set up new department or service files, or edit existing department or service files for an MTF. Data in the file includes the department and service name, code, department name (for a department associated with a service), abbreviation, and inactive flag. ••• Place of Care Enter/Edit (PLAC) The Place of Care Enter/Edit option allows you to enter a new place of care and associated file information, or edit the data of an existing place of care. This option also allows you to enter the Clinic Profile Edit option to update the clinic profile. ••• Provider Enter/Edit (PROV) The Provider Enter/Edit option allows you to enter a new provider, or edit information for an existing provider within the MTF. ••• Group Enter/Edit (GROU) The Group Enter/Edit option allows you to enter new MCP provider groups and associated file information to the MTF, or edit the data for an existing provider group. 2-111 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 ••• Specialty Type Enter/Edit (SPEC) The Specialty Type Enter/Edit option allows you to enter new MCP provider specialty types, or edit the data for an existing specialty type. ••• Professional Category Enter/Edit (PROF) The Professional Category Enter/Edit option allows you to enter a new professional category, or edit the category code and description for an existing professional category. ••• Military Status Enter/Edit (MILI) The Military Status Enter/Edit option allows you to enter a new military status code and description, or edit the description for an existing military status. ••• Audit Trail for Provider Network Menu (AUDI) •••• Agreement Data Changes (AGDC) The Agreement Data Changes option allows you to print a report showing changes in agreement data according to the following primary selection criteria: Agreement (type), Group, and Provider. The selection criteria are displayed on the screen as three columns, each with the following choices: One, Multiple, or All. The system displays a variety of different selection criteria and prompts depending on which selection combination you choose. The system requires a selection from the Agreement and Group columns, but not from the Provider column. If you do not make a selection from the Provider column, the system will assume that you do not want to include changes to individual provider agreement in the report. Therefore, the report will include data changes made at the group level only. If you make selection from all three columns, the report will include changes at the individual provider level only. 2-112 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 If you select one agreement, the system will require you to specify a group name, agreement type, and effective date. The system requires that an agreement be associated with one group, and does not allow one agreement to be associated with multiple or all groups. A pick list for exclusive provider agreements display the group effective and stop dates only so you can identify the “mother” agreement for which to report changes. The provider lists with agreements do not include providers who do not participate in the agreements displayed. •••• Place of Care Data Changes (LCDC) The Place of Care Data Changes option allows you to print a report showing changes in places of care. You can specify one, multiple, or all places of care to include in the report. Data elements include Place of Care Name, DMIS ID, Address/Phone Data, and Inactivation/Reactivation date. •••• Group Data Changes (GPDC) The Group Data Changes option allows you to print a report showing changes in provider groups. You can specify one, multiple, or all provider groups to include in the report. •••• Provider Data Changes (PRDC) The Provider Data Changes option allows you to print a report showing changes in provider groups. You can specify one, multiple, or all provider groups to include in the report. • Ad Hoc Report Menu (AMCP) The Ad Hoc Report Menu option provides you with the ability to inquire, print, and search MCP files, as well as information concerning group providers. Refer to FileMan (Version 26.0) Reference Guide, RQMTS-93-103, for complete information on ad hoc reports. 2-113 Menu Diagrams & Definitions SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 •• Inquire to File Entries (IDHC) The Inquire to File Entries option allows you to quickly access the data of a single entry or a few selected entries in a file. •• Print File Entries (PDHC) The Print File Entries option allows you to generate output of data contained within all, or a selected group, of fields within an existing file. The print prompts allow you to vary the output in a number of ways. •• Search File Entries (SDHC) The Search File Entries option allows you to select entries from a file that meet a certain set of criteria. The search involves identifying the file to be searched, describing the search criteria, specifying the logic for the search, and specifying the fields and their order to be printed for each entry selected in the search. •• List File Attributes (LDHC) The List File Attributes option allows you to list attributes of selected files. This option is useful for programmers, analysts, and others interested in database structure. 2-114 Menu Diagrams & Definitions ENDND SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 PATIENT APPOINTMENT AND SCHEDULING REFERENCE MANUAL Section 3 Procedure Flowcharts 3-1 Procedure Flowcharts SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 BOOK APPOINTMENTS FOR A SINGLE PATIENT PAS-00014REF 3-2 Procedure Flowcharts SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 BOOK APPOINTMENTS FOR MULTIPLE PATIENTS (SINGLE CLINIC) PAS-00009REF 3-3 Procedure Flowcharts SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 BOOK APPOINTMENTS FOR A FAMILY PAS-00008REF 3-4 Procedure Flowcharts SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 OVERBOOK AN APPOINTMENT SLOT PAS-00057REF 3-5 Procedure Flowcharts SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 MODIFY AN APPOINTMENT SLOT PAS-00055REF 3-6 Procedure Flowcharts SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 CREATE A PROVIDER SCHEDULE PAS-00023REF 3-7 Procedure Flowcharts SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 WAIT LIST PROCESSING PAS-00045REF 3-8 Procedure Flowcharts SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 CANCEL APPOINTMENT SLOTS BY FACILITY PAS-00016REF 3-9 Procedure Flowcharts SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 MODIFY PROVIDER SCHEDULES PAS-00043REF 3-10 Procedure Flowcharts SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 CREATE DAILY PROVIDER TEMPLATE PAS-00021REF 3-11 Procedure Flowcharts SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 CREATE WEEKLY PROVIDER TEMPLATE PAS-00024REF 3-12 Procedure Flowcharts SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 EDIT A CLINIC PROFILE PAS-00025REF 3-13 Procedure Flowcharts SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 CHECK-IN PATIENT(S) PAS-00017REF 3-14 Procedure Flowcharts SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 END-OF-DAY PROCESSING PAS-00031REF 3-15 Procedure Flowcharts SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 ADD/MODIFY/DELETE WAIT LIST REQUEST PAS-00001REF 3-16 Procedure Flowcharts SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 APPOINTMENT CANCELLATION BY PATIENT PAS-00003REF 3-17 Procedure Flowcharts SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 CHECK-OUT EMERGENCY ROOM PATIENT PAS-00018REF 3-18 Procedure Flowcharts SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 3UPDATE EMERGENCY ROOM PATIENT DATA PAS-00033REF 3-19 Procedure Flowcharts SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 CHECK-OUT/RECHARGE PATIENT MEDICAL RECORD PAS-00019REF 3-20 Procedure Flowcharts SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 ENROLL AN ACTIVE-DUTY PATIENT INTO THE MCP PAS-00026REF 3-21 Procedure Flowcharts SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 ENROLL AN ACTIVE-DUTY PATIENT INTO THE MCP (continued) PAS-00027REF 3-22 Procedure Flowcharts SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 ENROLL A FAMILY MEMBER INTO MCP PAS-00028REF 3-23 Procedure Flowcharts SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 ENROLL A FAMILY MEMBER INTO MCP (continued) PAS-00029REF 3-24 Procedure Flowcharts SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 AUTO ENROLL AN ACTIVE-DUTY PATIENT INTO MCP PAS-00006REF 3-25 Procedure Flowcharts SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 ASSIGN AN EXCEPTION PROVIDER TO AN MCP PATIENT PAS-0004REF 3-26 Procedure Flowcharts SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 REASSIGN A FAMILY TO A NEW PCM PAS-00058REF 3-27 Procedure Flowcharts SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 REASSIGN A PCM’S PATIENTS TO ONE OR MULTIPLE NEW PCMS PAS-00059REF 3-28 Procedure Flowcharts SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 BOOK AN APPOINTMENT FOR AN ENROLLED PATIENT WITH AN ASSIGNED PCM PAS-0007REF 3-29 Procedure Flowcharts SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 BOOK AN APPOINTMENT FOR AN ENROLLED PATIENT WITH A PROVIDER PAS-00011REF 3-30 Procedure Flowcharts SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 BOOK AN APPOINTMENT FOR A NONENROLLED PATIENT WITH A PROVIDER PAS-00012REF 3-31 Procedure Flowcharts SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 BOOK AN APPOINTMENT FOR A CASE MANAGEMENT PATIENT WITH AN EXCEPTION PROVIDER PAS-00010REF 3-32 Procedure Flowcharts SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 GENERATE A NON-AVAILABILITY STATEMENT PAS-00054REF 3-33 Procedure Flowcharts SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 ENTER A NEW PLACE OF CARE PAS-00030REF 3-34 Procedure Flowcharts SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 CREATE A PROVIDER GROUP PAS-00020REF 3-35 Procedure Flowcharts SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 ASSIGN A UNIT IDENTIFICATION CODE (UIC) TO A PCM PAS-00005REF END 3-36 Procedure Flowcharts SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 PATIENT APPOINTMENT AND SCHEDULING REFERENCE MANUAL Section 4 Quick Reference Guides 4-1 Quick Reference Guides SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 PATIENT APPOINTMENT AND SCHEDULING REFERENCE MANUAL Section 4. Quick Reference Guides Index Title Page COMMON ACCESSING HELP. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . BASIC FUNCTION KEYS FOR CHCS . . . . . . . . . . . . . . . . . . . . . . . . . THE LA75 PRINTER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . LOADING PAPER/CHANGING RIBBON FOR LA75 PRINTER SERIES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . LOGGING ON AND LOGGING OFF CHCS . . . . . . . . . . . . . . . . . . . . . MINI REGISTRATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ONLINE USERS MANUAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PRINT A REPORT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . RECHARGE A RECORD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . RECORD TRACKING OVERVIEW . . . . . . . . . . . . . . . . . . . . . . . . . . . . REQUEST A RECORD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . RETRIEVE ALL ARCHIVED DATA FOR A PATIENT . . . . . . . . . . . . . . . . . . . . . . . RETRIEVE ARCHIVED PATIENT DATA BY RECORD TYPE . . . . . SCREEN EDITOR OPTIONS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . SHORT RECORD INQUIRY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . SWITCH DIVISIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . USER-DEFINED KEYS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-6 4-7 4-8 4-9 4-13 4-16 4-18 4-20 4-21 4-22 4-23 4-24 4-25 4-27 4-29 4-30 4-31 PATIENT APPOINTMENT AND SCHEDULING ADD A PATIENT TO THE WAIT LIST . . . . . . . . . . . . . . . . . . . . . . . . . ASSIGN SECURITY KEYS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . BLOCK BOOKING OF A GROUP OF PATIENTS . . . . . . . . . . . . . . . . BOOK A PATIENT INTO MULTIPLE CLINICS . . . . . . . . . . . . . . . . . BOOK APPOINTMENTS FOR A SINGLE PATIENT . . . . . . . . . . . . . BOOK FAMILY MEMBERS INTO DIFFERENT CLINICS ON SAME DAY . . . . . . . . . . . . . . . . . . . . 4-2 4-33 4-37 4-38 4-46 4-54 4-62 Quick Reference Guides SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guide Index (continued) Title Page PATIENT APPOINTMENT AND SCHEDULING (continued) CANCEL APPOINTMENT BY PATIENT . . . . . . . . . . . . . . . . . . . . . . . INTERACTIVE DEERS ELIGIBILITY REQUEST . . . . . . . . . . . . . . . DISPLAY PATIENT APPOINTMENTS . . . . . . . . . . . . . . . . . . . . . . . . EDIT CLINIC PROFILE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . EDIT EMERGENCY ROOM PROFILE . . . . . . . . . . . . . . . . . . . . . . . . . END-OF-DAY PROCESSING. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . GENERATE A PROVIDER ROSTER . . . . . . . . . . . . . . . . . . . . . . . . . . INDIVIDUAL PATIENT CHECK-IN. . . . . . . . . . . . . . . . . . . . . . . . . . . MULTIPLE CHECK-IN BY DEFAULT. . . . . . . . . . . . . . . . . . . . . . . . . PRINT A CLINIC WORKLOAD REPORT. . . . . . . . . . . . . . . . . . . . . . . PRINT AN OUTPATIENT ENCOUNTER FORM (SF600) . . . . . . . . . PRINT WAIT LIST HOLD/RELEASE SCHEDULES. . . . . . . . . . . . . . PROBLEM AVOIDANCE REPORT . . . . . . . . . . . . . . . . . . . . . . . . . . . . PROCESS APPOINTMENT ORDERS. . . . . . . . . . . . . . . . . . . . . . . . . . SCHEDULE CREATION FOR WAIT LIST PROCESSING . . . . . . . . . SPLIT AN APPOINTMENT SLOT AND BOOK ONE OF THE MODIFIED SLOTS . . . . . . . . . . . . . . TELEPHONE CONSULTS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . UNANSWERED TELEPHONE CONSULTS . . . . . . . . . . . . . . . . . . . . THE UNANSWERED TELEPHONE CONSULTS REPORT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . UNSCHEDULED VISITS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-69 4-72 4-74 4-76 4-78 4-80 4-85 4-86 4-88 4-91 4-97 4-98 4-100 4-101 4-107 4-111 4-118 4-121 4-122 4-123 MANAGED CARE PROGRAM ADD AN AGREEMENT EXCEPTION TO A PROVIDER GROUP PROFILE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ADD AN AGREEMENT TO A PROVIDER GROUP PROFILE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . APPOINTMENT REFERRAL BOOKING . . . . . . . . . . . . . . . . . . . . . . . ASSIGN AN EXCEPTION PROVIDER TO AN MCP PATIENT FOR CASE MANAGEMENT. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-3 4-127 4-128 4-129 4-138 Quick Reference Guides SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guide Index (continued) Title Page MANAGED CARE PROGRAM (continued) ASSIGN A PCM TO AN MCP PATIENT . . . . . . . . . . . . . . . . . . . . . . . . AUTO ENROLL A PATIENT INTO THE MCP . . . . . . . . . . . . . . . . . . BATCH PCM REASSIGNMENT PROCESSING . . . . . . . . . . . . . . . . . CHANGE THE PARTICIPATION STATUS OF AN INDIVIDUAL PROVIDER. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CREATE A NEW SET OF ZIP CODE COMBINATIONS. . . . . . . . . . . CREATE A PROVIDER GROUP PROFILE . . . . . . . . . . . . . . . . . . . . . DISENROLL A PATIENT FROM THE MCP . . . . . . . . . . . . . . . . . . . . DOCUMENT A PATIENT CANCELLATION . . . . . . . . . . . . . . . . . . . . DOCUMENT A PATIENT REFUSAL . . . . . . . . . . . . . . . . . . . . . . . . . . EDIT AN INDIVIDUAL PROVIDER PROFILE . . . . . . . . . . . . . . . . . . EDIT TEXT FOR AN MCP FORM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ENROLL A PATIENT INTO THE MCP . . . . . . . . . . . . . . . . . . . . . . . . ENROLL FAMILY MEMBERS INTO THE MCP . . . . . . . . . . . . . . . . . ENTER A NEW MCP OFFICE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ENTER A NEW MILITARY STATUS IN THE MILITARY STATUS FILE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ENTER A NEW PROFESSIONAL CATEGORY IN THE PROFESSIONAL CATEGORY FILE . . . . . . . . . . . . . . . . . . . . . . . ENTER AND EDIT A NEW MCP PROVIDER IN THE PROVIDER FILE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ENTER AND EDIT A NEW NAS ISSUING OFFICER IN THE NAS ISSUING OFFICER FILE . . . . . . . . . . . . . . . . . . . . . . . . . . . ENTER AND EDIT A NEW PLACE OF CARE. . . . . . . . . . . . . . . . . . . ENTER AND EDIT A NEW SERVICE/DEPARTMENT IN THE DEPARTMENT AND SERVICE FILE . . . . . . . . . . . . . . . . . . . . . . ENTER AND EDIT AN MCP HEALTH CARE FINDER IN THE MCP HEALTH CARE FINDER FILE . . . . . . . . . . . . . . . . . . ENTER AND UPDATE INSURANCE COMPANY DATA . . . . . . . . . . ENTER OHI INFORMATION FOR AN MCP PATIENT . . . . . . . . . . . FILE MAINTENANCE CONCEPTS AND DEFINITIONS . . . . . . . . . GENERATE A CARE AUTHORIZATION FORM. . . . . . . . . . . . . . . . . 4-4 4-141 4-143 4-145 4-147 4-148 4-149 4-154 4-156 4-159 4-161 4-162 4-164 4-167 4-170 4-171 4-172 4-173 4-175 4-176 4-180 4-181 4-182 4-183 4-185 4-186 Quick Reference Guides SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guide Index (continued) Title Page MANAGED CARE PROGRAM (continued) GENERATE A NON-AVAILABILITY STATEMENT . . . . . . . . . . . . . . GENERATE AN MCP MEMBERSHIP ID CARD . . . . . . . . . . . . . . . . . INACTIVATE/REACTIVATE AN MCP PROVIDER . . . . . . . . . . . . . . INTERACTIVE NAS PROCESSING . . . . . . . . . . . . . . . . . . . . . . . . . . . NON-ENROLLED BOOKING . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PCM BOOKING. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . TERMINATE AN MCP PROVIDER AGREEMENT . . . . . . . . . . . . . . . 4-5 4-189 4-193 4-196 4-197 4-201 4-207 4-211 Quick Reference Guides ACCESSING HELP Accessing Help at Field Prompts on a Screen: CHCS provides help throughout the system. You can use question marks (?, ??, or ???) to access help at any menu, prompt, or field. You can also access the Online Users Manual (OLUM) for more in-depth assistance. Select CLINIC: ? Answer with HOSPITAL LOCATION NAME, or ABBREVIATION, or DESCRIPTION, or SPECIALTY, or MEPRS CODE, or SERVICE. Accessing Help at Menu Prompts: Do you want the entire HOSPITAL LOCATION list? Select MailMan Menu Option: ? 4-6 AML BOP EML GML HML LNM NML QML RML SML Assume another identity as a surrogate Basket Options Edit User Options Group Membership Help Menu List New Messages New Messages and Responses Queued Message Deletion Read a Message Send a Message Sponsor: NEEB, ALTHEA A Personal Data - Privacy Act of 1974 (PL 93-579) ====================================================================== Sponsor Name: NEEB, ALTHEA A Sponsor SSN: 222-33-4561 Sponsor FMP: 20 (SPONSOR) Branch of Service: ARMY Grade/Rank: COLONEL Command Security: ? Station/Unit: 400-ARMY Enter ?? for more options, ??? for brief descriptions, ?OPTION or ?OPTION SYNONYM for online documentation. Select MailMan Menu Option: Sponsor Info MINI1 COMMAND SECURITY Enter a valid COMMAND SECURITY code or name. The patient's level of COMMAND SECURITY. Want list of allowed values? N Quick Reference Guides • Entering ?? displays the Secondary Menu. • Entering ??? displays a brief description of each option on the menu. • Entering ?OPTION or ?OPTION SYNONYM displays the section of the OLUM that discusses that option. Enter OLUM to access the Online Users Manual Menu. (See Quick Reference Guide: Online Users Manual.) • Entering ? displays a brief description of the field. Additional help prompts may display that allow you to access more information. • Pressing <Help> also displays help at any field on a screen. CHCS ACCESSING HELP SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 • Entering ? accesses a message that tells you how to get additional help. BASIC FUNCTION KEYS FOR CHCS 2 1 3 4 5 6 7 8 10 9 11 12 13 14 15 16 F7 F8 F9 F10 F11 ^ X Return Ctrl Lock \ Shift ? / Shift Spacebar 4-7 22 <Hold Screen> <Print Screen> <Set-Up> Caret <^> and Menu Mnemonic 5. <F7> 6. <F8> 7. <F9> 8. <F10> 9. <F11> 10. <Help> 11. <Select> MC-00666 Stops text from scrolling off screen Prints screen to printer with slave cable only Allows user to enter terminal features Moves cursor from field, and accesses a menu option from another menu Moves to bottom of list Moves to top of list Expands order Allows user to abort option Selects all the orders, tasks, etc., seen on screen Provides user with online help Allows user to select text 21 20 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 19 18 Editing Keypad <Insert> <Prev Screen> <Remove> <Next Screen> <PF1> – Backspace/ Delete Key Down-arrow Key Up-arrow Key Backspace/Delete Key <Return> ?? Spacebar – <Return> 17 Numeric Keypad Allows user to insert typed characters Moves to previous screen Erases line and moves cursor to next field Moves to next screen Erases characters to the left of the cursor Moves cursor to the following field/screen Moves cursor to the previous field/screen Erases character-by-character to the left Processes data just entered or exits option/menu Provides user with online help Recalls the last information typed in that field SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides 1. 2. 3. 4. Main Keypad THE LA75 PRINTER FRONT PANEL INDICATOR LIGHTS AND CONTROLS • Power Indicator (A) - This indicator is green, and is illuminated when printer is powered up. • Fault Indicator (B) - The indicator is red, and is illuminated when paper is not loaded or a mechanical problem occurs. • NLQ/LQ (C) - The Near Letter Quality (NLQ) and Letter Quality (LQ) indicators are green. One of these is illuminated if the print quality selected is other than draft. • Ready (D) - This indicator is green. The ready light must be illuminated to print. IF THE PRINTER DOES NOT PRINT, CHECK THE FOLLOWING: • Is the power indicator (A) on the control panel illuminated? 4-8 – Check to see if the printer is plugged in. – Check to see if the power is turned on at the printer and at the power strip (if a power strip or surge protector is being used). • Is the green ready light (D) on the control panel illuminated? • Is the printer hooked up to the terminal? • Is the paper loaded into the printer? MC-00667 This quick reference guide provides the following information: • Understanding the indicator lights and controls on the control panel. • Loading paper from the back of the printer. • Loading paper and card stock from the bottom of the printer. CHCS THE LA75 PRINTER SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides The LA75 series printers are used in most CHCS workcenters. Some locations, such as the Pharmacy, Laboratory, Radiology, and the record rooms, have special printers for labels and bar codes. LOADING PAPER/CHANGING RIBBON FOR LA75 PRINTER SERIES FRONT PANEL INDICATOR LIGHTS AND CONTROLS • RDY Indicator (A) - This indicator is green, and is illuminated when printer is powered up. • Fault Indicator (B) - The indicator is amber, and is illuminated when paper is not loaded or a mechanical problem occurs. • LQ (C) - The Letter Quality (LQ) and Draft indicators are green. One of these is illuminated if the print quality selected is other than draft. IF THE PRINTER DOES NOT PRINT, CHECK THE FOLLOWING: • Is the RDY indicator (A) on the control panel illuminated? – Check to see if the printer is plugged in. – Check to see if the power is turned on at the printer and at the power strip (if a power strip or surge protector is being used). 4-9 • Is the Fault light (B) on the control panel illuminated? • Is the printer hooked up to the terminal? • Is the paper loaded into the printer? LA75 PLUS PRINTER This quick reference guide provides the following information: • Understanding the indicator lights and controls on the control panel. • Loading paper from the back of the printer. • Loading paper and card stock from the bottom of the printer. CHCS LOADING PAPER/CHANGING RIBBON FOR LA75 PRINTER SERIES SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides The LA series printers are used in most CHCS workcenters. Some locations, such as the Pharmacy, Laboratory, Radiology, and the record rooms, have special printers for labels and barcodes. LOADING PAPER/CHANGING RIBBON FOR LA75 PRINTER SERIES (continued) BACK LOADING THE PRINTER BACK LOADING THE PRINTER Loading Continuous-Form Paper Paper is normally loaded in the back of the printer using the following procedure: • Feed paper – Across tractors – Under and around platen •• • Press the paper release lever to tractor mode. Loading Continuous-Form Paper 4-10 CHCS LOADING PAPER/CHANGING RIBBON FOR LA75 PRINTER SERIES SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides • Turn the power switch to the “O” (off) position. • Remove the paper cover and access cover from the top of the printer. • Place the tractor bar in the down position. – Pull the tractor release levers forward. Instructions are posted on the tractor bar. – Push the tractor bar down until it is locked. • Position the left tractor against the tractor stop. – Release both tractor clamps. – Move the left tractor toward the right until it is positioned at the stop. – Relock the left tractor. • Load the continuous-form paper. – Open the tractor doors. – Feed the paper over the paper positioners, across the tractors, then under and around the platen. – Align the pin feed holes in the paper with the tractor pins. – Close the tractor doors. – Adjust the right tractor so that the paper is snug, but not too tight. – Relock the right tractor. – Roll the paper forward until the top of the page is aligned with the bail bar. Pull the bail bar away using the bail bar lever. – Replace the paper cover and the access cover. • Ensure that the printer is ready for printing. – Set the paper release lever toward the front of the printer (tractor mode). – Turn the power switch to the “|” (on) position. LOADING PAPER/CHANGING RIBBON FOR LA75 PRINTER SERIES (continued) BOTTOM LOADING THE PRINTER Loading Card Stock or Continuous-Form Paper • Feed paper – Up and around platen – Across tractors •* BOTTOM LOADING THE PRINTER Loading Card Stock or Continuous-Form Paper Card stock is always loaded into the bottom of the printer. Continuous-form paper can also be loaded into the bottom.Use the following procedure in either case: • Turn the power switch to the “O” (off) position. • Remove the paper cover and access cover from the top of the printer. Note: A printer stand that provides paper access to the paper slot in the bottom of the printer must be used for this setup. • Press the Paper release lever to tractor mode. 4-11 CHCS LOADING PAPER/CHANGING RIBBON FOR LA75 PRINTER SERIES SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides • Place the tractor bar in the up position. – Pull the tractor release levers forward. Instructions are posted on the tractor bar. – Pull the tractor bar up until it is locked. • Position the left tractor against the tractor stop. – Release both tractor clamps. – Move the left tractor to the right until it is positioned at the stop. • Load the card stock or continuous form paper. – Open the tractor doors. – Feed the card stock/paper through the bottom paper access, around the platen, and across the tractors. – Align the pinfeed holes in the paper with the tractor pins. – Close the tractor doors. – Adjust the right tractor so that the paper is snug, but not too tight. – Relock the right tractor. – Roll the paper forward until the top of the page is aligned with the bail bar. – Replace the paper cover and the access cover. • Ensure that the printer is ready for printing. – Set the paper release lever toward the front of the printer (tractor mode). – Turn the power switch to the “|”+ (on) position. LOADING PAPER/CHANGING RIBBON FOR LA75 PRINTER SERIES (continued) CHANGING THE RIBBON CHANGING THE RIBBON • Remove the old ribbon from the printer by pushing the mounting clips outward and lifting the cartridge straight up. • Remove the new ribbon cartridge from the wrapper. • Turn the ribbon adjustment knob in the direction indicated on the cartridge. • Fit the cartridge between the mounting clips on the carriage. Make sure the ribbon fits securely between the printhead and the clear plastic smudge guard. Press the cartridge down until you hear it click into place. Be sure the ribbon is secured on both the left and right sides. • Tighten the ribbon by turning the adjustment knob. 4-12 LOADING PAPER/CHANGING RIBBON FOR LA75 PRINTER SERIES SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides CHCS LOGGING ON AND LOGGING OFF CHCS Access the Logon Prompt: • If the terminal has just been turned on, the screen displays the message, VT[default] Okay. Press <Return> to begin the logon procedure. • If the terminal has timed out, a blinking cursor appears at the lower right corner of the screen. Press <Return> to continue logon procedure. • If a logon prompt doesn’t appear, verify the following: – The terminal is powered on (both plugged in and switched on) – The Hold Screen indicator light is off. If the light is on, press <Hold Screen> to release the screen. (Consider that the indicator light may be burned out.) – The keyboard is connected to the terminal. – The terminal is connected to the wall port. 4-13 • Depending on how your terminal is connected to the system, you may or may not see a prompt for the system service. The name of the CHCS system service at most sites is CHCS. It may also relate to a particular system. LOGGING ON AND LOGGING OFF CHCS SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides CHCS LOGGING ON AND LOGGING OFF CHCS (continued) Log On the CHCS Production System: • You will receive your username, password (optional), and access/verify codes to the CHCS production system after you have completed CHCS training. – Do not share these codes with anyone. – Do not write them down. • To sign on to the production system, respond to the following prompts. (Some prompts may not display.) 4-14 Username: Password: ACCESS CODE: VERIFY CODE: Select DIVISION: Keyboard/Terminal type: • The Username and Password prompts do not appear at terminals tied directly to CHCS. • At PC sites, only the Access Code and Verify Code prompts appear. • Once you are logged on, your assigned primary menu is displayed. The CHCS Administrator can change your primary menu. • You can change your verify code. (See Quick Reference Guide: Edit User Characteristics.) The CHCS Administrator can change your access code. • You can display a list of your allowable divisions. (See Quick Reference Guide: Display User Characteristics.) The CHCS Administrator can add and delete allowable divisions. Log On the CHCS Training System: • During your CHCS training, you will access and use a practice system that provides a sample database. The training system may be accessed using specially designated terminals. • Your presenter will identify the username, password (optional) training area, access and verify codes, and division (optional) that you will use during class. • There is a small difference between signing on to the training system and the production system. In the training system, you see the Training Menu between the Username and Access Code prompts. Your entry on this menu identifies which area (database) you will use during class. Quick Reference Guides Note: When you log on to CHCS (a government computer system) be aware that the government has the legal right to pursue civil/criminal charges against you if you perform an illegal or hostile act on the system. • Access and verify codes do not display on the screen as they are entered. • If you make a mistake when entering your access and verify codes, you may try again. The number of access attempts permitted is determined by your site. After an excessive number of attempts, your terminal will lock up for a set amount of time. Someone at the Help Desk can clear your terminal. • The Division prompt does not appear if your site is not a multidivision site, or if you have a default division. If you commonly work with a particular division, you can set a default division. (See Quick Reference Guides: Edit User Characteristics and Switch Divisions.) CHCS LOGGING ON AND LOGGING OFF CHCS SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 • Depending upon how the CHCS user account is set up at your site, a VMS password may not be required. • Depending on your site parameters, the Keyboard/Terminal type prompt may not appear. If it does, the most common entry is C-VT320 or C-VT420. This is usually the default. Press ? to list other valid entries. LOGGING ON AND LOGGING OFF CHCS (continued) • You can use one of the following Secondary Menu options to log off CHCS: HALT • To sign on to the training system, respond to the following prompts. (Some prompts may not display.) Username: Password: Select AREA: ACCESS CODE: VERIFY CODE: Select DIVISION: Keyboard/Terminal type: • Depending on how the training system is set up at your site, the Password prompt may not appear. 4-15 • At PC sites, only the Access Code and Verify Code prompts appear. • The Division prompt does not appear if the student users are given a default division. Returns to your first logon prompt (usually Username). Returns to the Access Code prompt. Returns to your first logon prompt (usually Username). The next time you log on, the system will ask whether you wish to continue from the menu where you last exited CHCS. RESTART CONTINUE Log Off the CHCS Training System: • Unless your presenter indicates otherwise, exit the training area by using the HALT command. • To exit the training system, enter the following: [Any menu prompt]: HALT Halting at [time] <^> Select Area: <^> then <Return> Log Off the CHCS Production System: • Log off the production system whenever you leave your terminal. This helps to prevent unauthorized access to the system. • You can also enter <^> at your primary menu to log off CHCS. However, you will not be asked to verify the halt. Using <^> to log off is not recommended for that reason. CHCS LOGGING ON AND LOGGING OFF CHCS SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides • You can back off your CHCS primary menu to log off CHCS. Press <Return> at the Primary Menu prompt. The system will prompt you to verify that you wish to halt. If you confirm the halt by pressing <Return> again, you return to your first logon prompt. If you indicate you do not wish to halt, you return to the Primary Menu prompt. MINI REGISTRATION The Mini Registration option allows you to add new patient records to the database or to edit an existing record. A mini registration provides the minimum data necessary to process a patient’s registration. The Mini Registration option includes a DEERS check of the patient’s eligibility for care. You can access the Mini Registration option from several subsystem menus. • To add a new patient, you must have the & FileMan access code. However, you may edit an existing patient registration without that code. • When you access the Mini Registration option, the system prompts you for a patient name and a sponsor name. IMPORTANT! It is critical to identify the patient and sponsor correctly. Small differences in entry of a name, even just including an extra space, can create a duplicate patient entry. 4-16 PLEASE BE CAREFUL. Adding a duplicate patient to the database can have a significant impact on patient safety. • Many ways exist to look up the patient to answer the Patient and Sponsor prompts. (See Quick Reference Guide: Patient Lookup.) Enter ? for help. • Try to display a limited picklist from which you can select the correct patient entry. • PATIENT NAME and SPONSOR NAME: The names are the same if the patient is his or her own sponsor (FMP=20). At the Sponsor Name prompt, press the spacebar, then <Return> to use the same name entered for patient name. • Depending on your entries for patient name and sponsor name, the system determines which of four paths you will take through Mini Registration: – – – – Update an existing patient registration. Add a new patient as own sponsor. Add a new patient with a new sponsor. Add a new patient with an existing sponsor. • In all cases, a DEERS check is performed. (See Quick Reference Guide: DEERS Check.) However, you may see one or more screens depending upon your path through Mini Registration. • You may see one or both of the Initial Information screens. The Patient Initial Information screen displays when a patient is being added to the database as his/her own sponsor, or when the patient has a registered sponsor. The Sponsor Initial Information screen displays when a new sponsor is being added to the database. 1. Enter the first letter of the patient’s last name and the last four digits of the sponsor’s Social Security number. 2. Enter the sponsor’s full Social Security number. 3. Enter the patient’s last name. CHCS MINI REGISTRATION SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides • You should use at least three methods to locate a patient name before adding a new patient to the database: • LASTNAME,FIRSTNAME I: The required format for a patient name uses a comma, but no spaces between the first and last names. There should be no period after the middle initial or following space after the name. MINI REGISTRATION (continued) Enter sponsor and patient names, SSN, FMP, DOB, and patient category code. The most common entries for Patient Category are: Patient Categories USA USN USAF USMC USCG Active Duty Dependent, Active Duty Retired, Length of Service Dependent, Retired A11 A41 A31 A43 N11 N41 N31 N43 F11 F41 F31 F43 M11 M41 M31 M43 • A site can determine whether and which postregistration options follow the Mini Registration option. Possible postregistration options include Print Registration Form, Print Emboss Card, Allergy Information, Print Patient ID Label, and Create Medical Record. C11 C41 C31 C43 Civilian Emergency is K92. Enter ? to display a picklist of all possible patient category codes. 4-17 • The Family Member Selection screen appears when you are entering a patient with an existing sponsor. On this screen, you can select a family member record from which to move demographic data. Position the cursor on a family member name, then press <Return>. • The Mini Registration screen displays when you are adding or editing a patient record. Quick Reference Guides – – – – – – Patient address, including ZIP Home and work phone numbers Outpatient record location Rank Station/unit Organ donor • The system checks for data inconsistencies. Resolving data inconsistences is generally a concern for a full registration rather than a mini registration. CHCS MINI REGISTRATION SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Complete the Mini Registration screen as fully and accurately as possible. Of special importance are: ONLINE USERS MANUAL The Online Users Manual (OLUM) consists of the user instructions for the CHCS basic system, MailMan, ad hoc reporting options of FileMan, and each subsystem. Each subsystem volume provides the menu hierarchy, functional descriptions for each option, step-by-step instructions, and samples of screens and reports. You can select OLUM topics to review by accessing the Index (IND) or the Table of Contents (TOC). MENU PATH: [Any menu option prompt] ➔ OLUM ➔ IND ➔ MMG (for MailMan User Guide) 4-18 ACCESSING MAILMAN MailMan is an option on the CHCS secondary menu. To access MailMan (refer to Sample Screens: MailMan Menu) after you have logged on to the system, perform the following steps: --------------------------------------------------------------------------------------------------------------------------1. From your CHCS primary menu, bring up the secondary menu by entering ??. 2. Enter MAIL. The system displays the MailMan Menu from which you may select an option. + AML BOP Browse Assume Another Identify as a Surrogate Basket Options References Keywords backUp Glossary Help • The IND is a list of subject matter topics arranged in alphabetical order. Search for a topic by using the features on the action bar. • Press <Return> to move between action bars and selection windows. • Use the up-arrow and down-arrow keys to scroll through the entries and place the cursor at the entry of your choice. • Press <Select> to display the OLUM section that contains your chosen topic. • Enter Q at an action bar to return to the OLUM Menu. • Enter F and press <Return>, then enter a letter, letters, or words that you want to find within the IND. • Select Browse. • Select Accessing MailMan. Quit CHCS ONLINE USERS MANUAL SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides MM ONLINE USERS MANUAL INDEX --------------------------------------------------------------------------------------------------------------------------1 Accessing MailMan 2 2 Adding Lines to End of Text 6 3 Assume Another Identity as a Surrogate 2 4 Assume Another Identify as a Surrogate 2.1 5 Basket Rename 2.2.3 6 Basket Options 2 7 Basket Options 2.2 8 Delete 2.2.1 9 List Subjects 2.2.2 10 Statistics 2.3.2 11 Transfer Messages 2.3.1 12 Bold Characters 5 13 Breaking a Line 5 14 Breaking a Line in Two 6 15 Cancelling a MailMan Operation 1.1 16 Copying a Block of Text 5 17 Cutting and Pasting Text 5 --------------------------------------------------------------------------------------------------------------------------Browse Find Glossary Help backUp Quit MM 2 ACCESSING MAILMAN ONLINE USERS MANUAL (continued) MENU PATH: [Any menu option prompt] ➔ OLUM ➔ TOC ➔ MMG (MailMan User Group) 4-19 MM TABLE OF CONTENTS --------------------------------------------------------------------------------------------------------------------------RECORD OF CHANGE (ROC) INTRODUCTION AND OVERVIEW ACCESSING MAILMAN MESSAGE ACTIONS TRANSMIT OPTIONS FILEMAN EDITING OF A MESSAGE PRINTING A MESSAGE NETWORK MAIL MESSAGE APPENDIX A: ACRONYMS AND ABBREVIATIONS SAMPLE SCREENS: SAMPLE SCREENS FOR MAILMAN --------------------------------------------------------------------------------------------------------------------------<F9> = Next level <Select> = Select '?' <Return> = Help <F10> = Previous level <Return> = Action bar Select (V)iew/Select or (Q)uit: V// • Enter Q at an action bar to return to the OLUM Menu. • From within the OLUM from either the IND or the TOC: – Enter K at the action bar to list keywords in that OLUM section. * Select a keyword by using the up-arrow or down-arrow keys to place the cursor next to your keyword choice and press <Select>. – Enter R at the action bar to list references to other parts of your document or other documents. * Also lists screens and reports for that option description. * All references in text are displayed in reverse video. * Select a reference by using the up-arrow or down-arrow keys to place the cursor next to your reference choice and press <Select>. – Enter U at the action bar to backup of the OLUM one level at a time. – Press <Next Screen> to move forward one screen. – Press <Prev Screen> or <^> to back up one screen. – Enter ? from anywhere within the OLUM to get List Processor help. • The TOC corresponds to the menu hierarchy of each subsystem. – To view or select a topic press <Return>. – To move to the next deeper level of the menu hierarchy, place the cursor next to your choice and press <F9>. To back up one level, press <F10>. * Press <Return> to return to the OLUM screen. • Enter ?OPTION NAME at any menu/option selection prompt to go directly to a description of that option. • Enter ??? after an Enter/Edit prompt within any option to go directly to a description of that option. • Press <Return> to move between action bars and selection windows. • Use the up-arrow and down-arrow keys to scroll through the entries and place the cursor at the entry of your choice. • Press <Select> to display the OLUM section that contains your chosen topic. CHCS ONLINE USERS MANUAL SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides • The first screen of the TOC displays the highest menu level in the OLUM volume. PRINT A REPORT CHCS provides a variety of ways to display or print a report. Select the desired display or print choice at the Device prompt. Device: [Site Device] RIGHT MARGIN: 80// Notes: • Information about reports specific to your subsystem will be covered in training classes for that subsystem. The subsystem-specific Reference Manuals contain sample output reports. • When generating reports, you may be prompted to specify a value or range of values. Limit the range of information needed for the report; for example, give a narrower date range. Otherwise, the report may be too long and take excessive system resources to generate. If you specify a long date range, queue the report to compile during a low-use time period. You may produce reports of limited length by specifying date ranges as follows: • A device may be a printer, terminal, queue, or spool. EXAMPLE: • At the Device prompt, enter ? to list available devices. Earliest Date/Time: FIRST// T-2@0900 Latest Date/Time: LAST// T@1000 • To display a report on your terminal screen, enter HOME, <Return>, or 0 (zero). • To print a report interactively, enter a printer name. or 4-20 • To queue a report, enter Q, date/time, and a printer name. Earliest Transaction Date: FIRST// T-7 Latest Date Logged: LAST// T • At the Device prompt, you can specify a shared printer name, or enter SLAVE to identify a printer attached to your terminal. Note: A range of dates or numbers is inclusive. The range includes the values you specify and all the values in between. • To store a report in a VMS spool file, enter SPOOL. EXAMPLE: • A Print Spool file option must be used to print the VMS file. Quick Reference Guides EXAMPLE: DEVICE: HOME;80;24 First: 2 Last: 4 This returns 2, 3, and 4. This entry will send the report to your terminal screen with a right margin of 80, and 24 lines to each page of the report. • The default right margin for many reports is 80 columns. You can enter another right margin, but your printer must be set up to handle right margins greater than 80 (for example, 132 columns). CHCS PRINT A REPORT SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 • Printers have default settings you will use most of the time, but you can customize the print by adding modifiers separated by semicolons. RECHARGE A RECORD This option allows you to check out a patient record to another borrower without checking it into the file room. MEDICAL MENU PATH: RTM ➔ M ➔ CH IMAGE MENU PATH: RTM ➔ I ➔ CH At the record tracking profile screen, select the records to be recharged. If the current borrower field is blank, the record is flagged as Missing and the request will not be completed. An associated borrower can be entered when recharging records. Additional records can be recharged by continuing to enter patient identifiers and selecting records. Records Selected to be 'Recharged' to 'CASEY,BETH' Personal Data - Privacy Act of 1974 (PL-93-579) ----------------------------------------------------------------------------------------Select Records: Deselect choice using the <Select> key. Selections will be processed when you enter a final <Return> 4-21 **** MEDICAL RECORDS TRACKING Profile **** Personal Data - Privacy Act of 1974 (PL 93-579) --------------------------------------------------------------------------------------Name: CARTIER,JOHN (05/347-06-1267) Ward: Birth Date: 02 JAN 1999 Run Date: 02 JAN 2002@0906 --------------------------------------------------------------------------------------Current Borrower -----------------------CALDWELL,LORRAIN Date Charged Phone/Location -------------------- ----------------------19 Nov 2001@1507 555-7917/5129 Quick Reference Guides --------------------------------------------------------------------------------------2 INPATIENT V1 INPATIENT FILE ROOM 31 Aug 2001@1132 555-7247/5229 Date Created: 15 Aug 2001@0800 Reg. #: 2606 Select borrower who is requesting the record. At the recharge screen, enter the patient identifier for the records to be recharged, or wand the records to be recharged with the barcode reader. CHCS RECHARGE A RECORD SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Record Type Vol ---------------------*1 OUTPATIENT V1 RECORD TRACKING OVERVIEW The record tracking option is available to all users on the secondary menu and allows you to access the record tracking functions of the software. The Record Tracking Menu options can be used from the image tracking perspective (film folders) or the medical record tracking perspective (outpatient/ inpatient). The following is an overview of the difference between the two: RECORD TYPES: Radiology Image Tracking Medical Record Tracking MASTER FOLDER Subfolders by type (e.g., chest, bone) INPATIENT (1 volume per inpatient episode.) Borrowers are established in the system set up for record tracking and establish the entities that may borrow records. The borrower may be a provider, a hospital location (such as a clinic, ward, or file room), a medical treatment facility, NONDOD MTF, or other specific locations. For example, a record can be charged to the Cardiology clinic with the associated borrower being Dr. Caldwell. If the system does not recognize the selected borrower, contact the applicable record room to request that the borrower be entered into the system. If the user has FileMan access K, borrowers can LAYGO into the system. 4-22 OUTPATIENT (Multiple volumes created to hold the patient record) RECORD CREATION: INPATIENT When a patient is admitted to the facility. Quick Reference Guides OUTPATIENT When record location is entered through registration options. All of the Record Tracking Menu options are similar and each has an associated quick reference guide. The quick reference guides are written from the medical record perspective. The system asks for borrowers and associated borrowers when you use the Request a Record and Recharge Records options. CHCS RECORD TRACKING OVERVIEW SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 When a patient arrives for an x-ray or when file room workers create a folder. REQUEST A RECORD This option allows you to request a record. File room personnel handle the actual checking in and out of the records. ****MEDICAL RECORDS TRACKING Folders Currently Charged to Borrower**** Personal Data - Privacy Act of 1974 (PL-93-579) =================================================================== Borrower: CALDWELL,LORRAINE Page: 1 Phone/Location: WARD 6B Run Date: 02 JAN 2002@090502 =================================================================== Record Type Vol MEDICAL RECORDS (3) Charged Since... Days Overdue --------------------------------------------------------------------------------OUTPATIENT V1 HAAN,PAUL 26 Oct 2001@1340 67 OUTPATIENT V1 SANTOS,MERVYN 26 Oct 2001@1340 4-23 ****MEDICAL RECORDS TRACKING Profile**** Personal Data - Privacy Act of 1974 (PL-93-579) ======================================================================= Name: CARTIER,JOHN (05/347-06-1267) Birth Date: 02 JAN 1999 Ward: Run Date: 02 JAN 2002@0906 Quick Reference Guides ****Request Profile for OUTPATIENT Vol: 1**** Personal Data - Privacy Act of 1974 (PL-93-579) ====================================================================== Name: CARTIER,JOHN (05/347-06-1267) Birth Date: 02 JAN 1999 Ward: Run Date: 02 JAN 2001@0906 --------------------------------------------------------------------------------------------------------------------------Current: OUTPATIENT FILE Cur Ph: 555-7917 Home: OUTPATIENT Since: 19 Nov 2001@1507 Loc/Rm #: 5129 Hm Ph: 555-7917 ====================================================================== [* pull list request Record Requestor Date Needed Phone/Room# Request No requests • SELECT BORROWER: This is the provider/clinic requesting the record. The first screen displays information regarding records currently checked out to the selected borrower. If set in the Record Tracking parameters, you can update the borrower’s location and phone number. • SELECT RECORD: Enter first initial of last name and last four digits of the Social Security number for the required patient record(s). At the display of the selected patient’s records, select required record(s) using <Select>. The system displays any existing requests for the record or a message that no requests exist. The system automatically assigns a request number. If required, an associated borrower can be entered. • ENTER DATE/TIME RECORD IS NEEDED: The default is NOW, but a future time and date can be entered. This is useful if there are existing requests. If set in the record tracking parameters, the system either prints a record request at your record room, or you may use pull list report CIT ➔ MA to see requests. If you select more than one record for an individual patient, the system processes each record separately so you can enter individual request times and applicable comments. Options on the Request Menu can be used to checkout, cancel, or reprint the requests. Users must have FileMan access K to request a record. CHCS REQUEST A RECORD SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 ========================================================================= Record Type Vol Current Borrower Date Charged Phone/Location -------------------- ------------------------------------------------------------* 1 OUTPATIENT V1 OUTPATIENT FIL 19 Nov 2001@1507 555-7917/5129 ---------------------------------------------------------------------------------------------------------------------------2 INPATIENT V1 INPATIENT FILE RM 31 Aug 2001@1132 555-7247/5229 Date Created: 15 Aug 2001@0800 Reg. #: 2606 MENU PATH: Medical RTM ➔ M ➔ RR Image RTM ➔ I ➔ RR RETRIEVE ALL ARCHIVED DATA FOR A PATIENT The Retrieve All Archived Data for Patient (PAL) option allows you to request a retrieval of all archived data for a patient. To use this option, you must have the associated security keys assigned to you. MENU PATH: Secondary Menu ➔ REA ➔ PAL Note: The Retrieve Archive Data Menu (REA) option is available from most secondary menus, except for User Management (UM) and Menu Management (ME). OPTION PATH: Enter Patient Name ➔ Enter Starting Date ➔ Enter Ending Date ➔ Select F[ull], B[rief], M[ini] or C[ustomized]: B// 4-24 Important: If you do not enter a starting date, you are not prompted for an ending date. Notes: Radiology Records Exam Date Nursing Records Nursing Result Date Clinical Event Records Clinical Event Start Date Dietetics Records User Sig Date for Order All record types User Sig Date for Order (if there was no associated result) • A Full report lists all archived information; a Brief report contains information which is considered to be of prime interest; a Mini report is tailored to the needs of the typical physician; a Customized report allows for custom-tailored report information to be generated. • To view Sensitive Lab test data, you must have the associated security key assigned to you. • Once you have entered your request, a mail message containing the requested archived data will be returned to you within 24 hours. • The retrieved mail message expires according to the timeframe set in the archive site parameters. • The date range you enter is specific to type of data (record type) you want to retrieve. Quick Reference Guides Data of Interest Date of Interest Laboratory Records Specimen Collection Date RX Records Log-in Date IV and UD Records Order Date Admission, Transfer Disposition Records Admission Date Appointment Records Appointment Date CHCS RETRIEVE ALL ARCHIVED DATA FOR A PATIENT SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 • For each of the following Data of Interest, the date range should encompass the following Dates of Interest: RETRIEVE ARCHIVED PATIENT DATA BY RECORD TYPE The Retrieve Archived Patient Data by Record Type (PRT) option allows you to select the type of data you want to retrieve for a patient. To use this option, you must have the associated security keys assigned to you. MENU PATH: Secondary Menu ➔ REA ➔ PRT Note: The Retrieve Archive Data Menu (REA) option is available from most secondary menus, except for User Management (UM) and Menu Management (ME). OPTION PATH: Enter Patient Name ➔ Select record type(s) ➔ Enter Starting Date ➔ Enter Ending Date ➔ Select F[ull], B[rief], M[ini], or C[ustomized]: B// 4-25 Important: If you do not enter a starting date, you are not prompted for an ending date. After you enter the patient name, the following screen information displays: Select Record Categories: Patient: [name] Quick Reference Guides Record Category Notes: • Use the up-arrow and down-arrow keys to move the cursor. Select Clinical Records: Patient: [name] CLINICAL EVENT RECORDS ANCILLARY PROCEDURE RECORDS CONSULT RECORDS DIETETICS RECORDS LABORATORY RECORDS (use EXPAND key for more) NURSING RECORDS PHARMACY RECORDS (use EXPAND key for more) RADIOLOGY RECORDS ADMISSION, TRANSFER, DISPOSITION RECORDS APPOINTMENT RECORDS Clinical Records Notes: • If no information is available for a particular record category, “(No records)” appears after the record category. • Press <F9> (Expand) to view additional Laboratory or Pharmacy records. Laboratory Records Bacteriology Chemistry Mycobacterium Mycology Parasitology Virology Autopsy Bone Marrow Cytology/Gyn Cytology/Non-Gyn Surgical Pathology Pharmacy Records Prescription Unit Dose Intravenous • Press <Select> to select/unselect the record categories for which you want to obtain archived data. • Press <F11> to select all record categories. • Once the record category(s) is selected, press <Return>. CHCS RETRIEVE ARCHIVED PATIENT DATA BY RECORD TYPE SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 PATIENT DEMOGRAPHIC RECORDS CLINICAL RECORDS If you select Clinical Records, the following screen information displays: RETRIEVE ARCHIVED PATIENT DATA BY RECORD TYPE (continued) • Select those records you want to retrieve, then press <Return>. Starting/Ending Date Notes: • The date range you enter is specific to the type of data (record type) you want to retrieve. • For each of the following Data of Interest, the date range should encompass the following Dates of Interest: 4-26 Date of Interest Laboratory Records Specimen Collection Date RX Records Login Date IV and UD Records Order Date Admission, Transfer Disposition Records Admission Date Appointment Records Appointment Date Radiology Records Exam Date Nursing Records Nursing Result Date Clinical Event Records Clinical Event Start Date Dietetics Records User SIG Date for Order All record types User SIG Date for Order (if there was no associated result) • Once you have entered your request, a mail message containing the requested archived data will be returned to you within 24 hours. • The retrieved mail message expires according to the timeframe set in the archive site parameters. • To view Sensitive LAB test data, you must have the associated security key assigned to you. CHCS RETRIEVE ARCHIVED PATIENT DATA BY RECORD TYPE SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides Data of Interest Additional Notes: • A Full report lists all archived information; a Brief report contains information which is considered to be of prime interest. SCREEN EDITOR OPTIONS OPTION KEY ACTION OPTION KEY ACTION Format Text <PF1> <F> Abort <F10> Exits editor, and prompts, Do you want to save this text? Reformats broken lines or uneven text. Forward One Space Right-arrow Backward One Space Left-arrow Moves cursor backward one space. Moves cursor one character to the right. Help <Help> Displays help text. Backspace-Delete Backspace/Delete Deletes one character to the left of the cursor. Insert Line <F17> Inserts blank line above cursor. Bold | ! | text | ! | Bolds text between | ! | symbols. Insert/Typeover <Insert Here> Bottom of Text <F7> Moves cursor down to the line below last line of text. Toggles between insert/ typeover mode. Italics | I | text | I | Italicizes text between | I | symbols. 4-27 <PF1> <X> Breaks text line at cursor. <F9> Inserts predefined text. Last Window on Screen <PF1> Down-arrow Cut and Paste <PF1> <C> Moves text block to holding buffer. (See Mark Text.) Moves text in buffer to cursor position. Moves cursor to last field on the screen. Leave Field/Line <Return> Delete Block of Text <F13> Deletes paragraph, entire document, or text block. (See Mark Text.) While in Insert Off mode, moves cursor to next line or field. Leave Text <PF1> <Return> Moves cursor to the next field on the screen. Delete Character <F14> Deletes character that cursor is on. Margin Setting <PF1> <M> Delete Field <Remove> Deletes line that cursor is on. Sets left and right text margins. Margins apply from cursor to bottom of text. Delete Line <F18> Deletes line that cursor is on. Mark Text <Select> Marks beginning and ending of text block. Delete Word <PF4> Deletes word that cursor is on. Move Block of Text <F12> Erase to End <PF1> <Delete> Deletes text from cursor to end of line. Moves text block to another position. (See Mark Text.) CHCS SCREEN EDITOR OPTIONS SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides Break Line Canned Text SCREEN EDITOR OPTIONS (continued) OPTION KEY ACTION Reverse Video |~| text |~| Displays text between [~] symbols in reverse video. Search Text <Find> Searches text for a specified string, in a paragraph, entire document or text block. (See Mark Text.) Spell Check <PF1> <S> Scans text for spelling errors, in a paragraph, entire document or text block. (See Mark Text.) (See also Quick Reference Guide: Spell Checker.) 4-28 KEY ACTION Next Field/Line Down-arrow Moves cursor down one line. Next Page <PF1> Right-arrow Moves cursor to next page. Next Screen <Next Screen> Moves cursor to next screen. Next Word <PF2> Moves cursor to next word. Previous Field/Line Up-arrow Moves cursor up one line. Previous Page <PF1> Left-arrow Moves cursor to previous page. Previous Screen <Prev Screen> Moves cursor to previous screen. Previous Word <PF3> Moves cursor to previous word. Tab <Tab> Inserts five spaces at cursor. Print Screen to Another Device <F19> Prints screen to a specified device. (See Quick Reference Guide: Printing a Report.) Top of Screen <F6> Moves cursor to top of screen. Top of Text <F8> Refreshes display and places cursor at top of text. Overstrike |-| text |-| Overstrikes text between [-] symbols. Transfer from another Field <PF1> <T> Transfers entry from the same file. Refresh Screen <F20> Clears screen and redisplays text. Underscore |_| text |_| Underlines text between [_] symbols. Repeat Block of Text <F11> Copies text block to another position. (See Mark Text.) Replace Replaces a character string with another string, for a paragraph, entire document, or text block. (See Mark Text.) <PF1> <R> CHCS SCREEN EDITOR OPTIONS SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides OPTION SHORT RECORD INQUIRY This option allows you to quickly view all records or folders associated with a patient, their current location, and borrower. If more details are required, you can contact the file room personnel to provide detailed movement history. MEDICAL MENU PATH: RTM ➔ M ➔ IN IMAGE MENU PATH: RTM ➔ I ➔ IN 4-29 ***MEDICAL RECORDS TRACKING Profile *** Personal Data - Privacy Act of 1974 (PL 93-579) ====================================================================== Name: CARTIER, JOHN (05/347-06-1267) Birth Date: 02 JAN 1999 Ward: Run Date: 02 JAN 2002@09061 ====================================================================== Record Type Vol Current Borrower Date Charged Phone/Location ---------------------------------------------------------------- ----------------------*1 OUTPATIENT V1 CASEY,BEN 19 Nov 2001@1507 555-7917/5129 -------------------------------------------------------------------------------------------------------------------------2 INPATIENT V1 INPATIENT 31 Aug 2001@1132 555-7247/5229 FILE ROOM Date Created: 15 Aug 2001@0800 Reg. #: 2606 • Enter an identifier for the patient you want to review. Quick Reference Guides CHCS SHORT RECORD INQUIRY SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 • The screen is view only. SWITCH DIVISIONS The Switch Divisions option allows you to change your current division to another of your allowable divisions. This option is on every user’s Secondary Menu so it can be selected at any menu prompt. MENU PATH: Secondary Menu ➔ DIV • You can review your current division and the list of your allowable divisions. (See Quick Reference Guide: Display User Characteristics.) • The Switch Divisions option allows you to manipulate and review data for another MTF division. • Switching your current division does not affect your default division. The next time you log on, your current division will be set at the default division. When you select the option, the following displays: You are currently signed on Division: [division]. Select DIVISION: [division] You are now signed onto Division: [division]. • If a MTF is a multidivision site, then CHCS can: 4-30 – Track information for the divisions, workcenters, and work elements within the entire site. – Limit a user’s access to division-specific information to predetermined allowable divisions. • All the divisions that you can work with are your allowable divisions. The CHCS Administrator can modify your list of allowable divisions. • If you tend to work with a particular division, you can make it your default division. (See Quick Reference Guide: Edit User Characteristics.) If you have a default division, you are not prompted for a current division when you log on. Every time you log on, your current division is set at the default division. • If you do not have a default division, you must enter a current division when you log on. (See Quick Reference Guide: Logging On and Logging Off CHCS.) CHCS SWITCH DIVISIONS SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides • When you log on, the system must know on which of your allowable divisions you are currently working. This is your current division. USER-DEFINED KEYS The User-Defined Key (UDK) Management Menu option is located on the Secondary Menu in CHCS. You can program UDKs to play back a sequence of keystrokes. These keys are attached to your access and verify codes, so they can be used from terminal to terminal. SL LL EL CL EU Show UDK Library Load UDK Library Edit UDK Library Copy UDK Library Edit UDK User Profile Select UDK Management Menu Option: EL *** UDK Library Edit*** 4-31 Select UDK LIBRARY NAME: SAMPLER Are you adding 'SAMPLER' as a new UDK LIBRARY? Y UDK Library Edit UDK LIBRARY: SAMPLER UDK LIBRARY: SAMPLER UDK Macro Edit UDK: ?? Macro: Enter a number from 6 to 20 to indicate which UDK you want to edit. Use 15 for the <Help> key and 16 for the <Do> key. Current UDK macro definitions: F6 ;SETCRORDER SETCRESC[23~CRYCR F7 RCRCRCRNCRLABCRCRCRCR F8 DOCCREDRCRSCCR4HCRCRCR F9 F10 F11 F13 F14 F15 F16 F17 F18 F19 F20 Quick Reference Guides Want to edit macros (Y/N): Y CHCS USER-DEFINED KEYS SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 NAME: SAMPLER EDITOR: CARTIER,ROBIN USAGE: PUBLIC EDITABLE: NOT EDITABLE USER-DEFINED KEYS (continued) Notes: • In order for your library to remain loaded after you leave the system, you must enter the library into your UDK User Profile and establish it as a default library: • The definable keys are <Shift> <F6> through <Shift> <F20>. UDK Library User: CARTIER,ROBIN • On the UDK Macro Edit screen: – Enter the number of the function key you wish to program, e.g., 6 (not F[n]). – Enter a macro of the exact steps you would use for anything you enter into the system frequently. – Insert control characters in a macro by using the special UDK Library loaded for the macro editor. For example, press <Shift> <F13> to insert a <Return> key stroke. 4-32 <F6> = Insert <F7> = Remove <F8> = Select <F9> = Prev Screen <F10> = Next Screen <F11> = Escape <F12> = F7 <F13> = Return UDK USER EDIT Select UDK Library: UDK Library: SAMPLER UDK Library: Default UDK Library: SAMPLER • If you wish to delete a UDK Library and it is listed as your default UDK Library, you must first delete it as your default from your UDK User Profile. <F14> = F11 <F15> = PF1 <F16> = Do <F17> = Cursor Up <F18> = Cursor Down <F19> = Cursor Left <F20> = Cursor Right Quick Reference Guides – Approximately 400 keystrokes can be stored in each library. (Users may have multiple libraries.) • To engage the UDK, press <Shift-F[n]> • Use the Copy UDK Library (CL) menu option to copy other public libraries. CHCS USER-DEFINED KEYS SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 – Help is available by pressing <Help> at the Macro prompt. ADD A PATIENT TO THE WAIT LIST The Wait List Request option allows you to add, delete, or modify a wait list request for a patient for a specific clinic, appointment type, and provider. The Wait List field in the clinic profile must be activated. MENU PATH: PAS System Menu ➔ Clerk Scheduling Menu ➔ WLR OPTION PATH: SELECT (P)atient ➔ COMPLETE mini registration (optional) ➔ SELECT (A)dd ➔ COMPLETE Wait List process ➔ FILE request WAIT LIST REQUEST Patient: Clinic PAS 000 FMP/SSN: Type Prio Wait # Date In Target Date Provider ================================================================================= 4-33 ================================================================================= Select (P)atient, or (Q)uit: P// <Return> Select Patient Name: Select Patient Name: SCOTT,ALLAN A Quick Reference Guides PAS ADD A PATIENT TO THE WAIT LIST SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 20/600-60-6504 22 Apr 1975 M A02 OK? YES// ADD A PATIENT TO THE WAIT LIST (continued) WAIT LIST REQUEST Patient: SCOTT,ALLAN A DEMOGRAPHICS DISPLAY Name: Patient Category: Patient Type: MCP Status: ACV: Direct Care: SCOTT,ALLAN A USA AD OFFICER FMP/SSN: DDS: Sex: DOB/Age: A-ACTIVE DUTY/CCP ENROLLED DMIS ID: ELIGIBLE Medicare: 20/600-60-6504 MALE 22 Apr 1975/26Y 6015 NOT ELIGIBLE PAS 902 FMP/SSN: 20/600-60-6504 Clinic Type Prio Wait # Date In Target Date Provider ====================================================================== ACARDI NEW 6 092.00000955 20 Jun 2001 21 Jun 2001 ADDAMS,HENRY ACAST NEW 6 093.00000956 20 Jun 2001 21 Jun 2001 AGENT,BARRY T ====================================================================== Select (P)atient, (A)dd, (D)elete, (M)odify, or (Q)uit: A =================================================================================== Sponsor Name: SCOTT,ALLAN A Rank: FIRST LIEUTENANT 4-34 Station/Unit: SAOASA FINANCE MGMT DSN: Home Address: 123 ELM ST. City: SAN DIEGO State: CALIFORNIA Zip Code: 92122 Home Phone: 222-2345 Duty Phone: 222-1234 Work Phone: 222-1234 Registration Comment: Last Registration Date: Outpatient Record Room: MEDICAL RECORDS FILE ROOM MCP Enroll Date: 21 Jun 2001 End Enroll Date: 21 Jun 2002 Primary Care Manager: PCM Phone: 202 361-4241 Primary OHI: Case Mgmt: NO ======================================================================= Select (F)ull, (M)ini, (N)ew Patient, (C)ontinue, or (Q)uit DEMO: C// <Return> ADD A PATIENT TO THE WAIT LIST SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides PAS ADD A PATIENT TO THE WAIT LIST (continued) Patient Appointment: SCOTT,ALLAN A Patient Appointment: SCOTT,ALLAN A SD WAIT LIST ADD SD WAIT LIST ADD Patient: SCOTT,ALLAN A FMP/SSN: 20/600-60-6504 Home Phone: 222-2345 Work Phone: 222-1234 Street: 123 ELM ST. Zip Code: 92122 City: SAN DIEGO State: CALIFORNIA ======================================================================= Clinic: CAST CLINIC /DIVA Type: RET Provider: CALHOUN,CRAIG M Wait List Priority: 6 Requested Start Time: 0001 Requested Stop Time: 2400 Days of Week: Wait List Target Date: 22 Jun 2001 Wait List Comment: Reason for Appointment: Patient: SCOTT,ALLAN A FMP/SSN: 20/600-60-6504 Home Phone: 222-2345 Work Phone: 222-1234 Street: 123 ELM ST. Zip Code: 92122 City: SAN DIEGO State: CALIFORNIA ===================================================================== Clinic: CAST CLINIC /DIVA Type: RET Provider: CALHOUN,CRAIG M Wait List Priority: 6 Requested Start Time: 0001 Requested Stop Time: 2400 Days of Week: M TU W TH F Wait List Target Date: 22 Jun 2001 Wait List Comment: Reason for Appointment: CAST GOT WET. REPLACE 4-35 Select acceptable days of the week with an X. Press spacebar to remove an entry. Enter <^> to accept all entries. Use the <Return> and/or backspace keys to position the cursor on a specific day. M: X TU: X W: X TH: X F: X SA: SU: <^> ADD A PATIENT TO THE WAIT LIST SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides PAS ADD A PATIENT TO THE WAIT LIST (continued) Patient Appointment: SCOTT,ALLAN A SD WAIT LIST ADD Patient: SCOTT,ALLAN A FMP/SSN: 20/600-60-6504 Home Phone: 222-2345 Work Phone: 222-1234 Street: 123 ELM ST. Zip Code: 92122 City: SAN DIEGO State: CALIFORNIA ======================================================================= Clinic: CAST CLINIC /DIVA Type: RET Provider: CALHOUN,CRAIG M Wait List Priority: 6 Requested Start Time: 0001 Requested Stop Time: 2400 Days of Week: M TU W TH F Wait List Target Date: 22 Jun 2001 Wait List Comment: Reason for Appointment: CAST GOT WET. REPLACE __________________________________________________________________________ 4-36 This patient has other Wait List requests for this clinic. OK to File? Y Patient: SCOTT,ALLAN A Notes: • Brackets [ ] indicate variable data. • Clinic and appointment type are required fields for wait list requests. • Requested START time and STOP time and Days of the Week makes the search for appointment slots much easier. During (A)utomatic Wait List booking, the system can then find an exact match according to the patient's request. • Provider name may or may not be required to make the Wait List Request. This is dependent on whether YES is entered in the Wait List Provider Mandatory field in the clinic profile. • Patients can also be added to the Wait Lists through the Book (BOK) Appointments option. • Wait list priority of 2 is the default for active-duty patients, and 6 is the default for nonactive-duty patients. This default can be changed as needed based on entries in the Wait List Priority file. ADD WAIT LIST REQUEST PAS 902 FMP/SSN: 20/600-60-6504 ACARDI ACAST ACAST NEW NEW RET 6 6 6 092.00000955 20 Jun 2001 092.00000956 20 Jun 2001 092.00000957 21 Jun 2001 21 Jun 2001 ADDAMS,HENRY 21 Jun 2001 AGENT,BARRY T 22 Jun 2001 CALHOUN,CRAIG ====================Wait List count for clinic ACAST is now 6===================== Select (P)atient, (A)dd, (D)elete, (M)odify, or (Q)uit: Q PAS ADD A PATIENT TO THE WAIT LIST SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides Clinic Type Prio Wait # Date In Target Date Provider ======================================================================= ASSIGN SECURITY KEYS The Stuff Security Keys for Clinic/Provider option allows you to restrict the capability to book, change appointments, and overbook authority for a clinic or providers. Setting keys provides security by restricting users without the appropriate keys from booking, overbooking, or modifying (joining/splitting/ changing appointment types) appointment slots. MENU PATH: PAS System Menu ➔ Scheduling Supervisor Menu ➔ PROF ➔ SPRO After you access this option, the following prompts display: Assign security key(s) to (C)linic or (P)rovider(s) profile(s)? C// P or <Return> Select Security Key for Overbooking: [key] Select Security Key for Appointment Change Authority: [key] Select Security Key for Booking Authority: [key] • The three preassigned security keys for the clinic level are: SDCL1 supervisory; SDCL2 lead clerks; and SDCL3 clerks. • The three preassigned security keys for the provider level are: SDHCP1 supervisory; SDHCP2 lead clerks; and SDHCP3 clerks. • Sites can set up their own security keys. For example: SD ACARDI B for booking authority; SD ACARDI C for appointment change authority; and SD ACARDI O for overbooking. • If you are stuffing keys by clinic, you are not prompted for a provider at the SELECT provider prompt. 4-37 • Once security keys have been assigned to a provider or clinic, they can only be changed by either restuffing them through this option, or by going into the Provider or Clinic Profile and changing them. Notes: • Brackets [ ] indicate variable data for these fields. • Restriction is done by appointment type only. • If no security keys have been indicated, the system checks the Clinic Profile. If different security keys are assigned in these fields at both the clinic and provider level, the keys assigned at the Clinic level are overridden by the security keys set in the Provider Profile. PAS ASSIGN SECURITY KEYS SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides • The system checks the Provider and Clinic Profiles to determine any restrictions for the three booking authorities (book, overbook, and appointment type (join/split). BLOCK BOOKING OF A GROUP OF PATIENTS This action allows you to book a block of appointments in a single clinic on one or more days for a group of patients. MENU PATH: PAS System Menu ➔ Clerk Scheduling Menu ➔ BOK BOOKING SEARCH CRITERIA Patient: Clinic: Provider: Time Range: 0001 to 2400 Dates: 21 Jun 2001 to 02 Aug 2001 FMP/SSN: Appt. Type: Service: Duration: Days of Week: ======================================================================== 4-38 ======================================================================== Select (C)hange Search Criteria, (B)rowse, (W)ait List Add, (M)ultiple Clinic, (F)amily, or (Q)uit: C// <Return> BOOKING SEARCH CRITERIA Patient: Clinic: Provider: Time Range: 0001 to 2400 Dates: 21 Jun 2001 to 02 Aug 2001 FMP/SSN: Appt. Type: Service: Duration: Days of Week: ======================================================================== Appointment Type * Provider * Clinic * Dates Patient Time Range Days of Week Duration + Service ======================================================================== Use <Select> to select Search Criteria to be changed <Return> Select Clinic: ACARDI Select Provider: CALDWELL OK? YES// Start Date: 15 Aug 2001 Stop Date: 22 Aug 2001 PAS BLOCK BOOKING OF A GROUP OF PATIENTS SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides Note: Clinic, Provider or Specialty allows Block Booking Independent of one another. BLOCK BOOKING OF A GROUP OF PATIENTS (continued) BOOKING SEARCH CRITERIA Patient: Clinic: CARDIOLOGY/DIVA Provider: CALDWELL,LORRAINE Time Range: 0001 to 2400 Dates: 15 Aug 2001 to 22 Aug 2001 FMP/SSN: Appt. Type: 4-39 Service: Duration: Days of Week: M TU W TH F ====================================================================== Appointment Type * Provider * Clinic * Dates Patient Time Range Days of Week Duration + Service ====================================================================== Select (C)hange Search Criteria, (B)rowse, (S)ingle Patient, (W)ait List Add, (T)el-Consult, (M)ultiple Clinic, B(1)ock, (F)amily, or (Q)uit: S// L __________________________________________________________________________ Patient: Clinic: CARDIOLOGY/DIVA Provider: CALDWELL,LORRAINE Time Range: 0001 to 2400 Dates: 15 Aug 2001 to 22 Aug 2001 FMP/SSN: Appt. Type: Service: Duration: Days of Week: M TU W TH F ====================================================================== + WED 0900 22 Aug 01 MULTI 3/0 WED 1000 22 Aug 01 MULTI 3/0 WED 1100 22 Aug 01 MULTI 3/0 WED 1200 22 Aug 01 MULTI 3/0 WED 1300 22 Aug 01 MULTI 3/0 WED 1400 22 Aug 01 MULTI 3/0 WED 1500 22 Aug 01 MULTI 3/0 WED 1600 22 Aug 01 MULTI 3/0 + WED 1700 22 Aug 01 MULTI 3/0 ====================================================================== Use <Select> to select appointment(s) to be booked FILE APPOINTMENT Quick Reference Guides Patient: FMP/SSN: Clinic: CARDIOLOGY CLINIC/DIVA Appt. Type: Provider: CALDWELL,LORRAINE Service: Time Range: 0001 to 2400 Duration: Dates: 15 Aug 2001 to 22 Aug 2001 Days of Week: ====================================================================== WED 0730 22 Aug 01 NEW 1/0 WED 0900 22 Aug 01 RET 1/0 WED 1000 22 Aug 01 RET 1/0 Select PATIENT NAME: PAS BLOCK BOOKING OF A GROUP OF PATIENTS SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Searching . . . SINGLE PATIENT BOOKING BLOCK BOOKING OF A GROUP OF PATIENTS (continued) FILE APPOINTMENT Patient: Clinic: CARDIOLOGY CLINIC/DIVA Provider: CALDWELL,LORRAINE C Time Range: 0001 to 2400 Dates: 15 Aug 2001 to 22 Aug 2001 FMP/SSN: Appt. Type: Service: Duration: Days of Week: ====================================================================== WED 1700 22 Aug 01 MULTI 3/0 4-40 ============================ Select Slot #1 of 1 ============================ Select Patient Name: SANDERS,ALLAN A 20/600-60-6501 16 Mar 1975 M A03 OK? YES// SINGLE PATIENT BOOKING DEMOGRAPHICS DISPLAY Patient: FMP/SSN: Clinic: CARDIOLOGY CLINIC/DIVA Appt. Type: Name: SANDERS,ALLAN A Provider: CALDWELL,LORRAINE C Specialty: FMP/SSN: 20/600-60-6501 Patient Category: USA AD OFFICER DDS: Time Range: 0001 to 2400 Duration: Patient Dates: 15 Aug 2001Type: to 22 Aug 2001 Days of Week: Sex: MALE MCP Status: DOB/Age: 16 Mar 1975/26Y ========================================================================= + WED 0900 22 ACV: Aug 90 MULTI 3/0 DMIS ID: WED 1000 22Care: Aug ELIGIBLE 90 MULTI 3/0 Direct Medicare: NOT ELIGIBLE WED 1100 22 Aug 90 MULTI 3/0 ================================================================================== WED Sponsor 1200 22Name: Aug SANDERS,ALLAN 90 MULTI 3/0 A Rank: CAPTAIN WED 1300 22 Aug 90 MULTI 3/0 Station Unit: 400-ARMY DSN: WED 1400 22 Aug 90 MULTI 3/0 ST 3/0 WED Home 1500 Address: 22 Aug 123 01 ELM MULTI DIEGO 3/0 State: CALIFORNIA WED 1600 22 City: Aug SAN 90 MULTI Home Phone: 222-2345 * WED 1700 Zip22Code: Aug 92122 90 MULTI 3/0 ========================================================================= Duty Phone: 222-1234 Work Phone: 222-1234 UseRegistration <Select> toComment: select appointment(s) to be booked Last Registration Date: 21 Jun 2001@1246 Outpatient Record Room: MCP Enroll Date: End Enroll Date: Primary Care Manager: PCM Phone: Primary OHI: Case Mgmt: ================================================================================== Select (F)ull, (M)ini, (N)ew Patient, (C)ontinue, or (Q)uit DEMO: C// <Return> BLOCK BOOKING OF A GROUP OF PATIENTS SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides PAS BLOCK BOOKING OF A GROUP OF PATIENTS (continued) PATIENT APPOINTMENT: SANDERS,ALLAN WED 1700 22 Aug 01 MULTI FILE APPOINTMENT Patient: SANDERS,ALLAN A Clinic: CARDIOLOGY CLINIC/DIVA Clinic Phone: 202 427-4181 Provider: CALDWELL,LORRAINE C Time Range: 0001 to 2400 Dates: 15 Aug 2001 to 22 Aug 2001 FMP/SSN: 20/600-60-6501 Appt. Type: Service: Duration: Days of Week: ================================================================================== WED 1700 22 Aug 01 MULTI FILE APPOINTMENT 3/0 ACARDI No reminder notice will be sent. Clinic Message: Clinic/Appt. Type Instructions: Provider Message: Provider/Appt. Type Instructions: Arrival Message: 10 minutes Registration Comment: 3/0 MEPRS Code: BACA Requesting Service: Referred By: Send Reminder Notice: YES Appointment Comment: Reason for Appointment: ================================= Select Slot #1 of 1 ================================= Select (D)elete/Print appointment orders/Wait List requests, (B)ook appt, (S)kip appt, (V)iew, or (Q)uit File Appointment: B// <Return> 4-41 ASK FOR HELP = HELP SCREEN EXIT = F10 __________________________________________________________________________ PAS BLOCK BOOKING OF A GROUP OF PATIENTS SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides MEPRS Code: <Return> Requesting Service: Referred By: <Return> Send Reminder Notice: <Return> Appointment Comment: <Return> Reason for Appointment: <Return> <Return> BLOCK BOOKING OF A GROUP OF PATIENTS (continued) Remind Patient of other appointments/Wait List request? Yes// N Appointment booked . . . FILE APPOINTMENT Patient: Clinic: CARDIOLOGY CLINIC/DIVA Clinic phone: 202 427-4181 Provider: CALDWELL,LORRAINE C Time Range: 0001 to 2400 Dates: 15 Aug 2001 to 22 Aug 2001 FMP/SSN: Appt. Type: Service: Duration: Days of Week: ================================================================================== 4-42 WED 1700 22 Aug 01 MULTI 3/1 ============================ Select Slot #1 of 1 ============================ Select Patient Name: 20/600-60-6502 20/600-60-6502 19 May 1975 M A02 OK? YES// DEMOGRAPHICS DISPLAY Name: Patient Category: Patient Type: MCP Status: ACV: Direct Care: SAWYER,ALLAN A USA AD OFFICER CCP/ACTIVE DUTY ENROLLED FMP/SSN: DDS: Sex: DOB/Age: A-ACTIVE DUTY/CCP ENROLLED DMIS ID: ELIGIBLE Medicare: 20/600-60-6502 MALE 19 May 1964/26Y 6015 NOT ELIGIBLE ================================================================================= Sponsor Name: Station/Unit: Home Address: City: ZIP Code: Duty Phone: Registration Comment: Last Registration Date: Outpatient Record Room: MCP Enroll Date: Primary Care Manager: Primary OHI: SAWYER,ALLAN A 400-ARMY 123 ELM ST. MAYSVILLE 28555 222-1234 21 Jun 2001 ENRICO,FRANK M Rank: FIRST LIEUTENANT DSN: State: NORTH CAROLI Home Phone: 919-743-2112 Work Phone: 222-1234 End Enroll Date: 21 Jun 2001 PCM Phone: 202 271-5852 Case Mgmt: NO ================================================================================= Select (F)ull, (M)ini, (N)ew Patient, (C)ontinue, or (Q)uit DEMO: C// <Return> BLOCK BOOKING OF A GROUP OF PATIENTS SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides PAS BLOCK BOOKING OF A GROUP OF PATIENTS (continued) PATIENT APPOINTMENT: SAWYER,ALLAN WED 1700 22 Aug 01 MULTI FILE APPOINTMENT Patient: SAWYER,ALLAN Clinic: CARDIOLOGY CLINIC/DIVA Provider: CALDWELL,LORRAINE C Time Range: 0001 to 2400 Dates: 15 Aug 2001 to 22 Aug 2001 FMP/SSN: 20/600-60-6502 Appt. Type: Service: Duration: Days of Week: ========================================================== WED 1700 22 Aug 01 MULTI 3/1 FILE APPOINTMENT 3/0 ACARDI No reminder notice will be sent. Clinic Message: Clinic/Appt. Type Instructions: Provider Message: Provider/Appt. Type Instructions: Arrival Message: 10 minutes Registration Comment: MEPRS Code: BACA Requesting Service: Referred By: Send Reminder Notice: YES Appointment Comment: Reason for Appointment: 4-43 ============================ Select Slot #1 of 1============================= Select (B)ook appt, (S)kip appt, (V)iew, or (Q)uit File Appointment: B ASK FOR HELP = HELP SCREEN EXIT = F10 __________________________________________________________________________ Remind Patient of other appointments/Wait List request? Yes// N Appointment booked . . . PAS BLOCK BOOKING OF A GROUP OF PATIENTS SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides MEPRS Code: <Return> Requesting Service: Referred By: Send Reminder Notice: <Return> Appointment Comment: REQUIRES A W/C Reason for Appointment: <Return> <Return> BLOCK BOOKING OF A GROUP OF PATIENTS (continued) FILE APPOINTMENT Patient: SAWYER,ALLAN FMP/SSN: 20/600-60-6502 Clinic: CARDIOLOGY CLINIC/DIVA Appt. Type: Clinic phone: 202 427-4181 Provider: CALDWELL,LORRAINE C Service: Time Range: 0001 to 2400 Duration: Dates: 15 Aug 2001 to 22 Aug 2001 Days of Week: ======================================================================= WED 1700 22 Aug 01 MULTI 3/2 4-44 ============================ Select Slot #1 of 1============================= Select Patient Name: SCHMIDT,ALLAN 20/600-60-6503 1 Oct 1975 M A02 OK? YES// DEMOGRAPHICS DISPLAY Name: SCHMIDT,ALLAN FMP/SSN: 20/600-60-6503 Patient Category: USA AD OFFICER DDS: Patient Type: CCP/ACTIVE DUTY Sex: MALE 1975 MCP Status: ENROLLED DOB/Age: 01 Oct 1975/25Y ACV: A-ACTIVE DUTY/CCP ENROLLED DMIS ID: 6015 Direct Care: ELIGIBLE Medicare: NOT ELIGIBLE =========================================================== Sponsor Name: SCHMIDT, ALLAN A Rank: CAPTAIN Station/Unit: 300-NAVY DSN: Home Address: 123 ELM ST. City: SAN DIEGO State: CALIFORNIA ZIP Code: 92122 Home Phone: 222-2345 Duty Phone: 222-1234 Work Phone: 222-1234 Registration Comment: Last Registration Date: Outpatient Record Room: MEDICAL RECORDS FILE ROOM MCP Enroll Date: 21 Jun 2001 End Enroll Date: 21 Jun 2002 Primary Care Manager: EMERALD,FRANK M PCM Phone: 202 271-5850 Primary OHI: Case Mgmt: NO =========================================================== Select (F)ull, (M)ini, (N)ew Patient, (C)ontinue, or (Q)uit DEMO: C// <Return> FILE APPOINTMENT ============================ Select Slot #1 of 1============================= Select (B)ook appt, (S)kip appt, (V)iew, or (Q)uit File Appointment: B// <Return> PAS BLOCK BOOKING OF A GROUP OF PATIENTS SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides Patient: SCHMIDT,ALLAN FMP/SSN: 20/600-60-6503 Clinic: CARDIOLOGY CLINIC/DIVA Appt. Type: Clinic phone: 202 427-4181 Provider: CALDWELL,LORRAINE C Service: Time Range: 0001 to 2400 Duration: Dates: 15 Aug 2001 to 22 Aug 2001 Days of Week: ========================================================== WED 1700 22 Aug 01 MULTI 3/2 BLOCK BOOKING OF A GROUP OF PATIENTS (continued) PATIENT APPOINTMENT: SCHMIDT,ALLAN A WED 1700 22 Aug 01 MULTI FILE APPOINTMENT 3/2 ACARDI No reminder notice will be sent. Clinic Message: Clinic/Appt. Type Instructions: Provider Message: Provider/Appt. Type Instructions: Arrival Message: 10 minutes Registration Comment: 4-45 MEPRS Code: BACA Requesting Service: Referred By: Send Reminder Notice: NO Appointment Comment: Reason for Appointment: BOOKING SEARCH CRITERIA Patient: Clinic: CARDIOLOGY CLINIC/DIVA Provider: CALDWELL,LORRAINE C. Time Range: 0001 to 2400 Dates: 15 Aug 2001 to 22 Aug 2001 FMP/SSN: Appt. Type: Service: Duration: Days of Week: ======================================================================= ======================================================================= Select (C)hange Search Criteria, (B)rowse, (S)ingle Patient, (W)ait List Add, (M)ultiple Clinic, B(1)ock, (F)amily, or (Q)uit: S// Q Notes: • Block booking allows you to book several patients into a multiple slot appointment at the same time or to book a series of patients into selected single appointment slots. ASK FOR HELP = HELP SCREEN EXIT = F10 ______________________________________________________________________________________ • New patients can be registered as their appointments are booked. • Registered patients can have their existing demographic data updated as their appointments are booked. Remind Patient of other appointments/Wait List request? Yes// N Appointment booked . . . PAS BLOCK BOOKING OF A GROUP OF PATIENTS SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides MEPRS Code: <Return> Requesting Service: Referred By: Send Reminder Notice: Y Appointment Comment: <Return> Reason for Appointment: <Return> <Return> • Both new and registered patients can be booked using this action. BOOK A PATIENT INTO MULTIPLE CLINICS This action allows you to book one or more appointments in one or more clinics on one or more days for one patient. MENU PATH: PAS System Menu ➔ Clerk Scheduling Menu ➔ BOK BOOKING SEARCH CRITERIA Patient: FMP/SSN: Clinic: Appt. Type: Clinic phone: Provider: Service: Time Range: 0001 to 2400 Duration: Dates: 21 Jun 01 to 02 Aug 01 Days of Week: ====================================================================== BOOKING SEARCH CRITERIA 4-46 Patient: FMP/SSN: Clinic: Appt. Type: Clinic phone: Provider: Service: Time Range: 0001 to 2400 Duration: Dates: 30 Jul 2001 to 6 Aug 2001 Days of Week: TH ======================================================================= + Provider Clinic * Dates Patient Time Range * Days of Week Duration Service Default Search Criteria ======================================================================= Use <Select> to select SEARCH CRITERIA to be changed ______________________________________________________________________________________ ====================================================================== Select (C)hange Search Criteria, (B)rowse, (S)ingle Patient, (W)ait List Add, (T)el-Consult, (M)ultiple Clinic, B(l)ock, (F)amily, or (Q)uit: M Select acceptable days of the week with an "X". Press spacebar to remove an entry. Enter <^> to accept all entries. Use the Return and/or Backspace keys to position the cursor on a specific day. M: X TU: X W: X TH: X F: X SA: SU: <Return> PAS BOOK A PATIENT INTO MULTIPLE CLINICS SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides Search Multiple Clinics for same day Match? NO// <Return> <Return> Start Date: (Today’s Date)// 12 Oct 2001 Stop Date: (Six weeks from Start Date)// 13 Oct 2001 BOOK A PATIENT INTO MULTIPLE CLINICS (continued) MULTIPLE CLINIC DIFFERENT DAY SEARCH CRITERIA BOOKING SEARCH CRITERIA 4-47 Patient: FMP/SSN: Clinic: Appt. Type: Clinic phone: Provider: Service: Time Range: 0001 to 2400 Duration: Dates: 12 Oct 2001 to 13 Oct 2001 Days of Week: M T W TH F ======================================================================= +* Provider * Clinic Dates Patient Time Range Days of Week Duration Service * Default Search Criteria ======================================================================= ======================================================================= Select (C)hange Search Criteria, (P)lace appointments on Scratchpad, or (Q)uit Multiple Clinic: P// <Return> ______________________________________________________________________________________ Searching... 157742958 Quick Reference Guides Do you want the current criteria selections to be saved as your Default Selection Criteria? Yes// <Return> PAS BOOK A PATIENT INTO MULTIPLE CLINICS SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Select Clinic: ACARDI Select Provider: CALDWELL,LORRAINE C OK? Yes// <Return> Patient: FMP/SSN: Clinic: CARDIOLOGY CLINIC/DIVA Appt. Type: Clinic phone: Provider: CALDWELL,LORRAINE Service: Time Range: 0001 to 2400 Duration: Dates: 12 Oct 2001 to 13 Oct 2001 Days of Week: M TU W TH F ======================================================================= BOOK A PATIENT INTO MULTIPLE CLINICS (continued) MULTIPLE CLINIC DIFFERENT DAY SEARCH CRITERIA 4-48 Patient: FMP/SSN: Clinic: CARDIOLOGY CLINIC/DIV A Appt. Type: Clinic phone: 202 427-4181 Provider: CALDWELL,LORRAINE C Service: Time Range: 0001 to 2400 Duration: Dates: 12 Oct 2001 to 13 Oct 2001 Days of Week: M TU W TH F ======================================================================== FRI 0700 12 Oct 01 NEW 1/0 ARCADI * FRI 0800 12 Oct 01 NEW 1/0 ARCADI FRI 0830 12 Oct 01 RET 1/0 ARCADI FRI 0 900 12 Oct 01 RET 1/0 ARCADI FRI 0930 12 Oct 01 RET 1/0 ARCADI FRI 1000 12 Oct 01 RET 1/0 ARCADI FRI 1030 12 Oct 01 RET 1/0 ARCADI FRI 1100 12 Oct 01 RET 1/0 ARCADI + FRI 1200 12 Oct 01 LUNCH 1/0 ARCADI ======================================================================== Use <Select> to select appointment(s) to be booked _____________________________________________________________________________ Press <Return> to activate selection(s). MULTIPLE CLINIC DIFFERENT DAY SEARCH CRITERIA Patient: Clinic: CARDIOLOGY CLINIC/DIV A Clinic phone: 202 427-4181 Provider: CALDWELL,LORRAINE Time Range: 0001 to 2400 Dates: 12 Oct 2001 to 13 Oct 2001 FMP/SSN: Appt. Type: Service: Duration: Days of Week: M TU W TH F ======================================================================== Appointment Type * Provider * Clinic Dates Patient Time Range Days of Week Duration + Service ======================================================================== Use <Select> to select SEARCH CRITERIA to be changed _____________________________________________________________________________ <Return> Select Clinic: ACAST Select Provider: CALHOUN ===================== Scratchpad contains 1 Appointments ====================== Select (C)hange Search Criteria, (P)lace appointments on Scratchpad, (F)ile appointments from Scratchpad, or (Q)uit MULTIPLE CLINIC: C// <Return> PAS BOOK A PATIENT INTO MULTIPLE CLINICS SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides MULTIPLE CLINIC DIFFERENT DAY SEARCH CRITERIA Patient: FMP/SSN: Clinic: CARDIOLOGY Appt. Type: Provider: CALDWELL,LORRAINE Specialty: Time Range: 0001 to 2400 Duration: Dates: 12 Oct 2001 to 13 Oct 2001 Days of Week: M TU W TH F ======================================================================== FRI 0800 12 Oct 01 NEW 1/0 ACARDI BOOK A PATIENT INTO MULTIPLE CLINICS (continued) MULTIPLE CLINIC DIFFERENT DAY SEARCH CRITERIA Patient: FMP/SSN: Clinic: CAST CLINIC/DIV A Appt. Type: Clinic phone: 202 427-4181 Provider: CALHOUN Service: Time Range: 0001 to 2400 Duration: Dates: 12 Oct 2001 to 13 Oct 2001 Days of Week: M TU W TH F ======================================================================== FRI 0800 12 Oct 01 NEW 1/0 ACARDI ===================== Scratchpad contains 1 Appointment ====================== Select (C)hange Search Criteria, (P)lace appointments on ‘SCRATCHPAD’, (F)ile appointments from ‘SCRATCHPAD’, or (Q)uit MULTIPLE CLINIC: C// P MULTIPLE CLINIC DIFFERENT DAY SEARCH CRITERIA 4-49 Patient: FMP/SSN: Clinic: CAST CLINIC/DIV A Appt. Type: Clinic Phone: 202 427-4281 Provider: CALHOUN Service: Time Range: 0001 to 2400 Duration: Dates: 12 Oct 2001 to 13 Oct 2001 Days of Week: M TU W TH F ======================================================================== * FRI 0700 12 Oct 01 NEW 1/0 ACAST FRI 0730 12 Oct 01 NEW 1/0 ACAST FRI 0800 12 Oct 01 NEW 1/0 ACAST FRI 090 0 12 Oct 01 NEW 1/0 ACAST FRI 0930 12 Oct 01 NEW 1/0 ACAST FRI 1000 12 Oct 01 NEW 1/0 ACAST FRI 1030 12 Oct 01 NEW 1/0 ACAST FRI 1100 12 Oct 01 NEW 1/0 ACAST + FRI 1130 12 Oct 01 NEW 1/0 ACAST ======================================================================== Use <Select> to select appointment(s) to be booked _____________________________________________________________________________ <Return> BOOK A PATIENT INTO MULTIPLE CLINICS SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides PAS BOOK A PATIENT INTO MULTIPLE CLINICS (continued) MULTIPLE CLINIC DIFFERENT DAY SEARCH CRITERIA Patient: FMP/SSN: Clinic: CAST CLINIC/DIVA Appt. Type: Clinic Phone: 202 427-4281 Provider: CALHOUN Service: Time Range: 0001 to 2400 Duration: Dates: 12 Oct 2001 to 13 Oct 2001 Days of Week: M TU W TH F ======================================================================== FRI 0700 12 Oct 01 NEW 1/0 ACAST FRI 0800 12 Oct 01 NEW 1/0 ACARDI ===================== Scratchpad contains 2 Appointments ====================== Select (C)hange Search Criteria, (P)lace appointments on Scratchpad, (F)ile 4-50 MULTIPLE CLINIC DIFFERENT DAY PATIENT BOOKING Name: SANDERS,ALLAN A Patient Category: USA AD OFFICER Patient Type: MCP Status: ACV: Direct Care: ELIGIBLE FMP/SSN: DDS: Sex: DOB/Age: DMIS ID: Medicare: 20/600-60-6501 MALE 16 Mar 1975/26Y NOT ELIGIBLE ------------------------------------------------------------------------------------------------------------------------------------------------ Sponsor Name: Station/Unit: Home Address: City: ZIP Code: Duty Phone: Registration Comment: Last Registration Date: Outpatient Record Room: MCP Enroll Date: Primary Care Manager: Primary OHI: SANDERS,ALLAN A 400-ARMY 123 ELM ST. SAN DIEGO 92122 222-1234 Rank: CAPTAIN DSN: State: CALIFORNIA Home Phone: 222-2345 Work Phone: 222-1234 21 Jun 2001@1246 End Enroll Date: PCM Phone: Case Mgmt: ------------------------------------------------------------------------------------------------------------------------------------------------ Select (F)ull, (M)ini, (N)ew Patient, (C)ontinue, or (Q)uit DEMO: C// <Return> ======================================================================== Use <Select> to select appointment(s) that are to be booked ___________________________________________________________________________ <Return> PAS BOOK A PATIENT INTO MULTIPLE CLINICS SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides Patient: FMP/SSN: Clinic: CAST CLINIC/DIVA Appt. Type: Clinic Phone: 202 427-4281 Provider: CALHOUN Service: Time Range: 0001 to 2400 Duration: Dates: 12 Oct 2001 to 13 Oct 2001 Days of Week: M TU W TH F ======================================================================== * FRI 0700 12 Oct 01 NEW 1/0 ACARDI * FRI 0800 12 Oct 01 NEW 1/0 ACAST DEMOGRAPHICS DISPLAY BOOK A PATIENT INTO MULTIPLE CLINICS (continued) PATIENT APPOINTMENT: SANDERS,ALLAN FRI 0700 12 Oct 01 NEW FILE APPOINTMENT Patient: SANDERS,ALLAN FMP/SSN: 20/600-60-6501 Clinic: CAST CLINIC/DIV A Appt. Type: Clinic Phone: 202 427-4281 Provider: CALHOUN Service: Time Range: 0001 to 2400 Duration: Dates: 12 Oct 2001 to 13 Oct 2001 Days of Week: M TU W TH F ======================================================================== FRI 0700 12 Oct 01 NEW 1/0 ACAST FRI 0800 12 Oct 01 NEW 1/0 ACARDI FILE APPOINTMENT 1/0 ACARDI No reminder notice will be sent. Clinic Message: Clinic/Appt. Type Instructions: Provider Message: Provider/Appt. Type Instructions: Arrival Message: 10 minutes Registration Comment: MEPRS Code: BEBA Requesting Service: Referred By: Send Reminder Notice: NO Appointment Comment: Reason for Appointment: ============================Select Slot #1 of 2============================== Select (B)ook appt, (S)kip appt, (V)iew, or (Q)uit file appointment: B 4-51 File/Exit Abort Edit ______________________________________________________________________________________ PAS BOOK A PATIENT INTO MULTIPLE CLINICS SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides MEPRS Code: <Return> Requesting Service: Referred by: <Return> Send Reminder Notice: <Return> Appt. Comment: <Return> Reason for Appointment: <Return> File the data. Appointment Booked BOOK A PATIENT INTO MULTIPLE CLINICS (continued) PATIENT APPOINTMENT: SANDERS,ALLAN FRI 0800 12 Oct 01 RET FILE APPOINTMENT Patient: SANDERS, ALLAN FMP/SSN: 20/600-60-6501 Clinic: CAST CLINIC/DIV A Appt. Type: Clinic Phone: 202 427-4281 Provider: CALHOUN,CRAIG M Service: Time Range: 0001 to 2400 Duration: Dates: 21 Dec 20021 to 01 Feb 2003 Days of Week: M TU W TH F ======================================================================== FRI 0800 12 Oct 01 NEW 1/0 ACARDI FILE APPOINTMENT 1/0 ACAST No reminder notice will be sent. Clinic Message: Clinic/Appt. Type Instructions: Provider Message: Provider/Appt. Type Instructions: Arrival Message: 10 minutes Registration Comment: MEPRS Code: BACA Requesting Service: Referred By: Send Reminder Notice: NO Appointment Comment: Reason for Appointment: 4-52 ============================ Select Slot #2 of 2 ============================= Select (D)elete/Print appointment orders/Wait List requests, (B)ook appt, (S)kip appt, (V)iew, or (Q)uit File Appointment: B ASK FOR HELP = HELP SCREEN EXIT = F10 ___________________________________________________________________________ PAS BOOK A PATIENT INTO MULTIPLE CLINICS SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides MEPRS Code: <Return> Requesting Service: Referred by: <Return> Send Reminder Notice: <Return> Appt. Comment: <Return> Reason for Appointment: <Return> File the data. Appointment Booked BOOK A PATIENT INTO MULTIPLE CLINICS (continued) BOOKING SEARCH CRITERIA Patient: SANDERS,ALLAN FMP/SSN: 20/600-60-6501 Clinic: CAST CLNIC/DIVA Appt. Type: Clinic Phone: 202 427-4281 Provider: CALHOUN Service: Time Range: 0001 to 2400 Duration: Dates: 12 Oct 2001 to 13 Oct 2001 Days of Week: M TU W TH F ======================================================================== Notes: • This example consists of a single patient booked in two different clinics on the same day. • Both new and registered patients can be booked using this action. • New patients can be registered as their appointments are booked. • Registered patients can have their demographic data updated as their appointments are booked. ======================================================================== Remind patient of other appointments/Wait List requests? Yes// N 4-53 BOOKING SEARCH CRITERIA ======================================================================== Select (C)hange Search Criteria, (B)rowse, (S)ingle Patient, (W)ait List Add, (T)el-Consult, PAS BOOK A PATIENT INTO MULTIPLE CLINICS SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides Patient: FMP/SSN: Clinic: CAST CLNIC/DIVA Appt. Type: Clinic Phone: 202 427-4281 Provider: CALHOUN Service: Time Range: 0001 to 2400 Duration: Dates: 12 Oct 2001 to 13 Oct 2001 Days of Week: M TU W TH F ======================================================================== BOOK APPOINTMENTS FOR A SINGLE PATIENT This action allows you to book one or more appointments in a single clinic on one or more days for an individual patient. MENU PATH: PAS System Menu ➔ Clerk Scheduling Menu ➔ BOK BOOKING SEARCH CRITERIA Patient: FMP/SSN: Clinic: Appt. Type: Clinic Phone: Provider: Service: Time Range: 0001 to 2400 Duration: Dates: Days of Week: ======================================================================== 4-54 ======================================================================== Select (C)hange Search Criteria, (B)rowse, (W)ait List Add, (M)ultiple Clinic, (F)amily, or (Q)uit: C// <Return> BOOK APPOINTMENTS FOR A SINGLE PATIENT SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides PAS BOOK APPOINTMENTS FOR A SINGLE PATIENT (continued) BOOKING SEARCH CRITERIA 4-55 Patient: FMP/SSN: Clinic: Appt. Type: Clinic Phone: Provider: Service: Time Range: 0001 to 2400 Duration: Dates: Days of Week: ======================================================================== Appointment Type * Provider * Clinic * Dates Patient Time Range * Days of Week Duration + Service ======================================================================== Use <Select> to select Search Criteria to be changed ___________________________________________________________________ <Return> Select Clinic: ACARDI Select Provider: CALDWELL Start Date: (Today’s Date)// 30 Jul 2001 Stop Date: (Six weeks from Start Date)// 6 Aug 2001 BOOKING SEARCH CRITERIA Patient: FMP/SSN: Clinic: CARDIOLOGY CLINIC/DIV A Appt. Type: Clinic Phone: 202 427-4281 Provider: CALDWELL,LORRAINE Service: Time Range: 0001 to 2400 Duration: Dates: 30 Jul 2001 to 6 Aug 2001 Days of Week: ======================================================================== Appointment Type * Provider * Clinic * Dates Patient Time Range * Days of Week Duration + Service ======================================================================== Select acceptable days of the week with an "X." Press "Space bar" to remove an entry. Enter "^" to accept all entries. Use the Return and/or Backspace keys to position the cursor on a specific day. M: X TU: W: TH: F: SA: SU: ___________________________________________________________________________ <Return> Quick Reference Guides PAS BOOK APPOINTMENTS FOR A SINGLE PATIENT SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Select (C)hange Search Criteria, (B)rowse, (S)ingle Patient, (W)ait List Add, (T)el-Consult, (M)ultiple Clinic, (B)lock, (F)amily, or (Q)uit: S// <Return>. BOOK APPOINTMENTS FOR A SINGLE PATIENT (continued) SINGLE PATIENT BOOKING SINGLE PATIENT BOOKING 4-56 Patient: FMP/SSN: Clinic: CARDIOLOGY CLINIC/DIV A Appt. Type: Clinic Phone: 202 427-4281 Provider: CALDWELL,LORRAINE Service: Time Range: 0001 to 2400 Duration: Dates: 30 Jul 2001 to 6 Aug 2001 Days of Week: M ======================================================================== MON 0700 30 Jul 01 NEW1/0 * MON 0800 30 Jul 01 NEW1/0 MON 0 900 30 Jul 01 RET1/0 MON 0930 30 Jul 01 RET1/0 MON 1000 30 Jul 01 FU1/0 MON 1030 30 Jul 01 FU1/0 MON 1100 30 Jul 01 RET1/0 MON 1130 30 Jul 01 RET1/0 + MON 1200 30 Jul 01 LUNCH 1/0 ======================================================================== Use <Select> to select appointment(s) to be booked ___________________________________________________________________________ Patient: FMP/SSN: Clinic: CARDIOLOGY CLINIC/DIV A Appt. Type: Clinic Phone: 202 427-4281 Provider: CALDWELL,LORRAINE Service: Time Range: 0001 to 2400 Duration: Dates: 30 Jul 2001 to 6 Aug 2001 Days of Week: M ======================================================================== MON 0700 6 Aug 01 NEW1/0 * MON 0800 6 Aug 01 FU1/0 MON 0 900 6 Aug 01 RET1/0 MON 0930 6 Aug 01 RET1/0 MON 1000 6 Aug 01 FU1/0 MON 1030 6 Aug 01 FU1/0 MON 1100 6 Aug 01 RET1/0 MON 1130 6 Aug 01 RET1/0 + MON 1200 6 Aug 01 LUNCH ======================================================================== Use <Select> to select appointment(s) to be booked ___________________________________________________________________________ Searching . . . Select Patient Name: 20/600606501 (Note: Use the up- and down-arrow keys to display additional appointment slots for this provider.) BOOK APPOINTMENTS FOR A SINGLE PATIENT SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides PAS BOOK APPOINTMENTS FOR A SINGLE PATIENT (continued) FMP/SSN: DDS: Sex: DOB/Age: DMIS ID: Medicare: 20/600-60-6501 MALE 16 Mar 1975/26Y NOT ELIGIBLE ------------------------------------------------------------------------------------------------------------------------------------------------ 4-57 Sponsor Name: Station/Unit: Home Address: City: ZIP Code: Duty Phone: Registration Comment: Last Registration Date: Outpatient Record Room: MCP Enroll Date: Primary Care Manager: Primary OHI: SANDERS, ALLAN A 400-ARMY 123 ELM ST. SAN DIEGO 92122 222-1234 DOB: 16Mar75 PATCAT: A11 Mini Registration Sex: M ---------------------------------------------------------------------------------------------------------------------- ------------------------ DEMOGRAPHICS DISPLAY Name: SANDERS, ALLAN A Patient Category: USA AD OFFICER Patient Type: MCP Status: ACV: Direct Care: ELIGIBLE Patient: SANDERS,ALLAN A FMP/SSN: 20/600-60-6501 Rank: CAPTAIN DSN: State: CALIFORNIA Home Phone: 222-2345 Work Phone: 222-1234 21 Jun 2001@1246 MEDICAL RECORDS FILE ROOM End Enroll Date: PCM Phone: Case Mgmt: Patient: PATCAT: Home Phone: Patient Addr: City: Sponsor: FMP: PATCAT: Command Sec: Station/Unit: Duty Address: City: Duty Phone: SANDERS,ALLAN A A11 (USA AD OFFICER) 222-2345 W: 222-1234 123 ELM ST. SAN DIEGO St/Cntry: CA SANDERS,ALLAN A 20 A11 (USA AD OFFICER) DOB: 16 Mar 1975 FMP: 20 Sex: MALE Zip: 92122 Service: SSN: DOB: Rank: ARMY 600-60-6501 16 Mar 1975 FIRST LIEUTENANT 400-ARMY St/Cntry: 222-1234 Zip: DSN: O/P Rec Loc: MEDICAL RECORDS FILE ROOM Rec Loc Comnt: Primary Phy: Reg Comment: Help = HELP Exit = F10 File/Exit = DO INSERT OFF Quick Reference Guides Select (F)ull, (M)ini, (N)ew Patient, (C)ontinue, or (Q)uit DEMO: C// M Sponsor name: Sanders, Allan A// <Return> Does SANDERS,ALLAN A want to be an organ donor? Y Edit Allergy Information? NO// YES PAS BOOK APPOINTMENTS FOR A SINGLE PATIENT SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 ------------------------------------------------------------------------------------------------------------------------------------------------ BOOK APPOINTMENTS FOR A SINGLE PATIENT (continued) Clinical History: SANDERS,ALLAN A PATIENT ALLERGIES Select Allergy: BARBITURATES ASK FOR HELP = HELP Allergy: BARBITURATES Patient: SANDERS,ALLAN FMP/SSN: 20/600-60-6501 Clinic: CARDIOLOGY CLINIC/DIV A Appt. Type: Clinic Phone: 202 427-4281 Provider: CALDWELL,LORRAINE Service: Time Range: 0001 to 2400 Duration: Dates: 30 Jul 01 to 6 Aug 01 Days of Week: M ======================================================================== * MON 0800 30 Jul 01 NEW1/0 MON 0900 06 Aug 01 Ret1/0 SCREEN EXIT = F10 PATIENT ALLERGIES--CONTINUATION 4-58 Allergy: BARBITURATES Allergy Comment: MENTAL CONFUSION ASK FOR HELP = HELP FILE APPOINTMENT ============================= Select Slot #1 of 2 ============================ Select (D)elete/Print appointment orders/Wait List requests, Select (B)ook appt, (S)kip appt, (V)iew, or (Q)uit File Appointment: B SCREEN EXIT = F10 PATIENT ALLERGIES Quick Reference Guides Select Allergy: BARBITURATES OK to File? Y Enroll in Managed Care? N Note: At the demographics, press <Return> to continue. PAS BOOK APPOINTMENTS FOR A SINGLE PATIENT SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Clinical History: SANDERS,ALLAN A BOOK APPOINTMENTS FOR A SINGLE PATIENT (continued) FILE APPOINTMENT PATIENT APPOINTMENT: SANDERS,ALLAN MON 0800 30 Jul 01 NEW FILE APPOINTMENT 1/0 No reminder notice will be sent. Hand-carry Cardiology/Patient records. Clinic Message: Clinic/Appt. Type Instructions: Provider Message: Provider/Appt. Type Instructions: Arrival Message: 10 minutes Registration Comment: 4-59 MEPRS Code: BACA Requesting Service: Referred By: Send Reminder Notice: YES Appointment Comment: Reason for Appointment: Patient: SANDERS,ALLAN FMP/SSN: 600-60-6501 Clinic: CARDIOLOGY CLINIC/DIV A Appt. Type: Clinic Phone: 202 427-4281 Provider: CALDWELL,LORRAINE Service: Time Range: 0001 to 2400 Duration: Dates: 30 Jul 2001 to 6 Aug 2001 Days of Week: M ======================================================================== + MON 0900 06 Aug 01 Ret- 1/0 ============================= Select Slot #1 of 2 ============================ Select (D)elete/Print appointment orders/Wait List requests (B)ook appt, (S)kip appt, (V)iew, or (Q)uit File Appointment: B ASK FOR HELP = HELP SCREEN EXIT = F10 ___________________________________________________________________________ PAS BOOK APPOINTMENTS FOR A SINGLE PATIENT SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides MEPRS Code: <Return> Requesting Service: Referred By: <Return> Send Reminder Notice: <Return> Appointment Comment: <Return> Reason for Appointment: <Return> File the data. Appointment Booked BOOK APPOINTMENTS FOR A SINGLE PATIENT (continued) PATIENT APPOINTMENT: SANDERS,ALLAN MON 0800 6 Aug 01 FU FILE APPOINTMENT 1/0 No reminder notice will be sent. Hand-carry Cardiology/Patient records. Clinic Message: Clinic/Appt. Type Instructions: Provider Message: Provider/Appt. Type Instructions: Arrival Message: 10 minutes Registration Comment: 4-60 MEPRS Code: BACA Requesting Service: Referred By: Send Reminder Notice: YES Appointment Comment: Reason for Appointment: SINGLE PATIENT BOOKING Patient: SANDERS,ALLAN FMP/SSN: 20/600-60-6501 Clinic: CARDIOLOGY CLINIC/DIV A Appt. Type: Clinic Phone: 202 427-4181 Provider: CALDWELL,LORRAINE Service: Time Range: 0001 to 2400 Duration: Dates: 30 Jul 2001 to 6 Aug 2001 Days of Week: M ======================================================================== ======================================================================== Remind patient of other appointments/Wait List requests? Yes// N ASK FOR HELP = HELP SCREEN EXIT = F10 ___________________________________________________________________________ PAS BOOK APPOINTMENTS FOR A SINGLE PATIENT SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides MEPRS Code: <Return> Requesting Service: <Return> Referred By: <Return> Send Reminder Notice: <Return> Appointment Comment: <Return> Reason for Appointment: <Return> File the data. Appointment Booked BOOK APPOINTMENTS FOR A SINGLE PATIENT (continued) SINGLE PATIENT BOOKING Patient: FMP/SSN: Clinic: CARDIOLOGY CLINIC/DIV A Appt. Type: Clinic Phone: 202 427-4281 Provider: CALDWELL,LORRAINE Service: Time Range: 0001 to 2400 Duration: Dates: 30 Jul 2001 to 6 Aug 2001 Days of Week: M ======================================================================== • Use the following actions on the File Appointments Action Bar when more than one schedule time slot is selected and displayed: (B)ook appointment allows you to book the schedule time slot that is highlighted. (S)kip appointment allows you to skip over the currently highlighted schedule time slot to the next schedule time slot in sequence . . . (V)iew allows you to directly select a specific schedule time slot when multiple slots are displayed in the File Appointment middle window. 4-61 ======================================================================== Select (C)hange Search Criteria, (B)rowse, (S)ingle Patient, (W)ait List Add, (M)ultiple Clinic, B(l)ock, (F)amily, or (Q)uit: S// Q Notes: • This example is the booking of a single patient in the same clinic for two appointments; the two appointments are one week apart. • Both new and registered patients can be booked using this action. Quick Reference Guides • Registered patients can have their demographic data updated as their appointments are booked. PAS BOOK APPOINTMENTS FOR A SINGLE PATIENT SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 • New patients can be registered as their appointments are booked. BOOK FAMILY MEMBERS INTO DIFFERENT CLINICS ON SAME DAY This action allows you to book one or more appointments in one or more clinics on one or more days for several or all members of a family. MENU PATH: PAS System Menu ➔ Clerk Scheduling Menu ➔ BOK BOOKING SEARCH CRITERIA Patient: FMP/SSN: Clinic: Appt. Type: Clinic Phone: Provider: Service: Time Range: 0001 to 2400 Duration: Dates: 21 Jun 2001 to 02 Aug 2001 Days of Week: ======================================================================== FAMILY BOOKING SAME DAY SEARCH CRITERIA Patient: FMP/SSN: Clinic: Providers Appt. Type: 1. 2. 3. Dates: 21 Jun 2001 to 02 Aug 2001 Time Range: 0001 to 2400 ======================================================================== ======================================================================== Select (C)hange Search Criteria, or (Q)uit: C// <Return> FAMILY BOOKING SAME DAY SEARCH CRITERIA 4-62 ======================================================================== Select (C)hange Search Criteria, (B)rowse, (W)ait List Add, (M)ultiple Clinic, (F)amily, or (Q)uit: C// F ___________________________________________________________________________ Search Multiple Clinics for same day match ? NO// Y ======================================================================== Use <Select> to select Search Criteria to be changed PAS BOOK FAMILY MEMBERS INTO DIFFERENT CLINICS ON SAME DAY SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides Patient: FMP/SSN: Clinics Providers Appt. Types 1. 2. 3. Dates: 21 Jun 2001 to 02 Aug 2001 Time Range: 0001 to 2400 ======================================================================== * Clinic, Provider, Appointment Type 1 * Clinic, Provider, Appointment Type 2 Clinic, Provider, Appointment Type 3 * Dates Time Range Patient Default Search Criteria BOOK FAMILY MEMBERS INTO DIFFERENT CLINICS ON SAME DAY (continued) FAMILY BOOKING SAME DAY SEARCH CRITERIA 4-63 Patient: FMP/SSN: Clinics Providers Appt. Types 1. 2. 3. Dates: 21 Jun 2001 to 02 Aug 2001 Time Range: 0001 to 2400 ======================================================================== * Clinic, Provider, Appointment Type 1 * Clinic, Provider, Appointment Type 2 Clinic, Provider, Appointment Type 3 * Dates Time Range Patient Default Search Criteria ======================================================================== <Return> Select Clinic 1: ACARDI ___________________________________________________________________________ FAMILY BOOKING SAME DAY SEARCH CRITERIA Patient: FMP/SSN: Clinics Providers Appt. Types 1. CARDIOLOGY CLINIC/DIVA CALDWELL,LORRAINE C NEW PATIENT 2. GENERAL MEDICINE CLINIC/DIVA ADDAMS,HENRY W NEW PATIENT 3. Dates: 21 Jun 2001 to 02 Aug 2001 Time Range: 0001 to 2400 ======================================================================== * Clinic, Provider, Appointment Type 1 * Clinic, Provider, Appointment Type 2 Clinic, Provider, Appointment Type 3 * Dates Time Range Patient Default Search Criteria ======================================================================== Select (C)hange Search Criteria, (S)earch for same day appointment date, or (Q)uit FAMILY BOOKING: S// <Return> Searching . . . Quick Reference Guides Select Clinic 2: AGNMED Select Provider 2: ADDAMS,HENRY W Select Appt. Type 2: NEW Start Date: 27 AUG 2001 Stop Date: 31 AUG 2001 012345555 PAS BOOK FAMILY MEMBERS INTO DIFFERENT CLINICS ON SAME DAY SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Select Provider 1: CALDWELL,LORRAINE C 157742958 Select Appt. Type 1: NEW ___________________________________________________________________________ BOOK FAMILY MEMBERS INTO DIFFERENT CLINICS ON SAME DAY (continued) FAMILY BOOKING SAME DAY PATIENT BOOKING Patient: FMP/SSN: Clinics Providers Appt. Types 1. CARDIOLOGY CLINIC/DIVA CALDWELL,LORRAINE C NEW PATIENT 2. GENERAL MEDICINE CLINIC/DIVA ADDAMS,HENRY W NEW PATIENT 3. Dates: 27 Aug 2001 to 31 Aug 2001 Time Range: 0001 to 2400 ======================================================================== * 30 Aug 2001 THURSDAY ======================================================================== Searching . . . FILE APPOINTMENT Patient: Clinics FMP/SSN: Providers Appt. Types 1. CARDIOLOGY CLINIC/DIVA 2. GENERAL MEDICINE CLINIC/DIVA CALDWELL,LORRAINE C ADDAMS,HENRY W NEW PATIENT NEW PATIENT 3. Dates: 27 Aug 2001 to 31 Aug 2001 Time Range: 0001 to 2400 ======================================================================== THU 1500 30 Aug 01 NEW 1/0 ACARDI THU 1500 30 Aug 01 NEW 1/0 AGNMED ============================ Select Slot #1 of 2 ============================= Select Patient Name: SANDERS,ANDY 4-64 FAMILY BOOKING SAME DAY PATIENT BOOKING Patient: Clinics FMP/SSN: Providers Appt. Types 1. CARDIOLOGY CLINIC/DIVA 2. GENERAL MEDICINE CLINIC/DIVA CALDWELL,LORRAINE C ADDAMS,HENRY W NEW PATIENT NEW PATIENT PAS BOOK FAMILY MEMBERS INTO DIFFERENT CLINICS ON SAME DAY SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides 3. Dates: 27 Aug 2001 to 31 Aug 2001 Time Range: 0001 to 2400 ======================================================================== + THU 1400 30 Aug 01 NEW 1/0 ACARDI THU 1400 30 Aug 01 NEW 1/0 AGNMED THU 1430 30 Aug 01 NEW 1/0 ACARDI THU 1430 30 Aug 01 NEW 1/0 AGNMED * THU 1500 30 Aug 01 NEW 1/0 ACARDI * THU 1500 30 Aug 01 NEW 1/0 AGNMED THU 1530 30 Aug 01 NEW 1/0 ACARDI + THU 1530 30 Aug 01 NEW 1/0 AGNMED ======================================================================== Use <Select> to select appointment(s) to be booked <Return> BOOK FAMILY MEMBERS INTO DIFFERENT CLINICS ON SAME DAY (continued) DEMOGRAPHICS DISPLAY Name: SANDERS, ANDY FMP/SSN: Patient Category: USA DEP AD, EXC FORM SPOUSE DDS: Patient Type: Sex: MCP Status: DOB/Age: ACV: DMIS ID: Direct Care: ELIGIBLE Medicare: 01/600-60-6501 MALE 03 May 1987/03Y FILE APPOINTMENT Patient: SANDERS,ANDY FMP/SSN: 01/600-60-6501 Clinic: CARDIOLOGY CLINIC/DIVA Appt. Type: NEW PATIENT Provider: CALDWELL,LORRAINE C Specialty: Time Range: 0001 to 2400 Duration: Dates: 27 Aug 2001 to 31 Aug 2001 Days of Week: M TU W TH F ======================================================================== THU 1500 30 Aug 01 NEW 1/0 ACARDI THU 1500 30 Aug 01 NEW 1/0 AGNMED NOT ELIGIBLE ------------------------------------------------------------------------------------------------------------------------------------------------ 4-65 Sponsor Name: Station/Unit: Home Address: City: ZIP Code: Duty Phone: Registration Comment: Last Registration Date: Outpatient Record Room: MCP Enroll Date: Primary Care Manager: Primary OHI: SANDERS, ALLAN A 400-ARMY 123 ELM ST. SAN DIEGO 92122 222-1234 Rank: CAPTAIN DSN: ============================ Select Slot #1 of 2 ============================= Select (B)ook appt, (S)kip appt, (V)iew, or (Q)uit File Appointment: B State: CALIFORNIA Home Phone: 222-2345 Work Phone: End Enroll Date: PCM Phone: Case Mgmt: ------------------------------------------------------------------------------------------------------------------------------------------------ Select (F)ull, (M)ini, (N)ew Patient, (C)ontinue, or (Q)uit DEMO: C// <Return> BOOK FAMILY MEMBERS INTO DIFFERENT CLINICS ON SAME DAY SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides PAS BOOK FAMILY MEMBERS INTO DIFFERENT CLINICS ON SAME DAY (continued) PATIENT APPOINTMENT: SANDERS,ANDY THU 1500 30 Aug 01 NEW FILE APPOINTMENT 1/0 Clinic Message: ARRIVE 10 MINUTES EARLY Clinic/Appt. Type. Instructions: Provider Message: Provider/Appt. Type. Instructions: Arrival Message: 10 minutes Registration Comment: 4-66 MEPRS Code: BACA Requesting Service: Referred By: Send Reminder Notice: YES Appointment Comment: Reason for Appointment: ASK FOR HELP = HELP SCREEN EXIT = F10 ___________________________________________________________________________ Patient: SANDERS,ANDY FMP/SSN: 01/600-60-6501 ======================================================================== 01/600-60-6501 SANDERS,ANDY M 03 May 1987 02/600-60-6501 SANDERS,ALICE F 14 Feb 1973 20/600-60-6501 SANDERS,ALLAN A M 16 Mar 1964 * 30/600-60-6501 SANDERS,ANN F 26 Apr 1966 ======================================================================== Select (S)ame patient, (F)amily member, (D)ifferent patient, or (Q)uit FAMILY: F// <Return> ___________________________________________________________________________ Use <Select>key to select a family member. FILE APPOINTMENT Patient: SANDERS,ANN Clinic: GENERAL MEDICINE CLINIC Provider: ADDAMS,HENRY W Time Range: 0001 to 2400 Dates: 27 Aug 2001 to 31 Aug 2001 FMP/SSN: 30/600-60-6501 Appt. Type: NEW PATIENT Service: Duration: Days of Week: M TU W TH F ======================================================================== THU 1500 30 Aug 01 NEW 1/0 AGNMED ============================ Select Slot #2 of 2 ============================= Select (B)ook appt, (S)kip appt, (V)iew, or (Q)uit File Appointment: B PAS BOOK FAMILY MEMBERS INTO DIFFERENT CLINICS ON SAME DAY SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides MEPRS Code: <Return> Requesting Service: Referred By: <Return> Send Reminder Notice: <Return> Appointment Comment: <Return> Reason for Appointment: <Return> File the data. Appointment Booked Remind patient of other appointments/Wait List requests? Yes// N SELECT FAMILY MEMBER BOOK FAMILY MEMBERS INTO DIFFERENT CLINICS ON SAME DAY (continued) PATIENT APPOINTMENT: SANDERS,ANN THU 1500 30 Aug 01 NEW FILE APPOINTMENT 1/0 Clinic Message: Clinic/Appt. Type Instructions: Provider Message: Provider/Appt. Type Instructions: Arrival Message: 10 minutes Registration Comment: 4-67 MEPRS Code: BHAA Requesting Service: Referred By: Send Reminder Notice: YES Appointment Comment: Reason for Appointment: FAMILY BOOKING SAME DAY PATIENT BOOKING Patient: SANDERS,ANN FMP/SSN: 30/600-60-6501 Clinics Providers Appt. Types 1. CARDIOLOGY CLINIC/DIVA CALDWELL,LORRAINE C 2. GENERAL MEDICINE CLINIC/DIVA ADDAMS,HENRY W 3. Dates: 27 Aug 2001 to 31 Aug 2001 Time Range: 0001 to 2400 ===================================================================== 30 Aug 01 THURSDAY ====================================================================== Use <Select> to select a date to search for same day appointments <Return> ASK FOR HELP = HELP SCREEN EXIT = F10 ___________________________________________________________________________ PAS BOOK FAMILY MEMBERS INTO DIFFERENT CLINICS ON SAME DAY SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides MEPRS Code: <Return> Requesting Service: <Return> Referred By: <Return> Send Reminder Notice: <Return> Appointment Comment: <Return> Reason for Appointment: <Return> File the data. Appointment Booked Remind patient of other appointments/Wait List requests? Yes// N BOOK FAMILY MEMBERS INTO DIFFERENT CLINICS ON SAME DAY (continued) FAMILY BOOKING SAME DAY PATIENT BOOKING Patient: SANDERS,ANN FMP/SSN: 30/600-60-6501 Clinics Providers Appt. Types 1. CARDIOLOGY CLINIC/DIVA CALDWELL,LORRAINE C 2. GENERAL MEDICINE CLINIC/DIVA ADDAMS,HENRY W 3. Dates: 27 Aug 2001 to 31 Aug 2001 Time Range: 0001 to 2400 ===================================================================== Notes: • Family members are grouped by Sponsor SSN and are distinguished by differing family member prefixes. This feature allows you to make appointments for family members without reentering common family data or restarting the search process. • Both new and registered family member patients can be booked using this action. • New patients can be registered as their appointments are booked. • Registered patients can have their demographic data updated as their appointments are booked. 4-68 ====================================================================== Select (C)hange Search Criteria, (S)earch for same day appointment date, or (Q)uit FAMILY BOOKING: C// Q • You must specify at least two clinics and you may specify as many as three different clinics, providers, and appointment types for this type of search. • Although you are prompted for all three parameters, only clinic is mandatory. • Provider and appointment type are optional. BOOK FAMILY MEMBERS INTO DIFFERENT CLINICS ON SAME DAY SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides PAS CANCEL APPOINTMENT BY PATIENT The Cancel Appointment by Patient option allows you to cancel booked appointments at the patient’s request. MENU PATH: PAS System Menu ➔ Clerk Scheduling Menu ➔ CBP OPTION PATH: SEARCH for Appointments ➔ SELECT Appointment to Cancel ➔ RESCHEDULE Appointment (optional) ➔ FILL Cancelled Appointment from Wait List (optional) 4-69 CANCELLATION BY PATIENT SEARCH CRITERIA Patient: FMP/SSN: Clinic: Appt. Type: Clinic Phone: Provider: Service: Time Range: 0001 to 2400 Duration: Dates: 21 Jun 2001 to 20 Jun 2002 Days of Week: ======================================================================== Quick Reference Guides Enter Patient Name: SUMMERS,ALLAN A FMP/SSN: 20/600-60-6510 OK ? YES // PAS CANCEL APPOINTMENT BY PATIENT SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 ======================================================================== Select (C)hange Search Criteria, (S)earch for Appointments, (Q)uit: S// <Return> ___________________________________________________________________________ CANCEL APPOINTMENT BY PATIENT (continued) DEMOGRAPHICS DISPLAY Name: SUMMERS, ALLAN A Patient Category: USA AD OFFICER Patient Type: MCP Status: ACV: Direct Care: ELIGIBLE FMP/SSN: DDS: Sex: DOB/Age: DMIS ID: Medicare: 20/600-60-6510 MALE 20 Oct 1964/36Y NOT ELIGIBLE -----------------------------------------------------------------------------------------------------------------------------------------------Sponsor Name: SUMMERS, ALLAN A Rank: FIRST LIEUTENANT Station/Unit: 400-ARMY Home Address: City: ZIP Code: Duty Phone: DSN: State: Home Phone: Work Phone: Registration Comment: 4-70 Last Registration Date: Outpatient Record Room: MEDICAL RECORDS FILE ROOM MCP Enroll Date: End Enroll Date: Primary Care Manager: PCM Phone: Primary OHI: Case Mgmt: ------------------------------------------------------------------------------------------------------------------------------------------------ Select (F)ull, (M)ini, (N)ew Patient, (C)ontinue, or (Q)uit DEMO: C// <Return> CANCEL/RESCHEDULE PATIENT APPOINTMENTS Patient: SUMMERS,ALLAN FMP/SSN: 20/600-60-6510 Clinic: Appt. Type: Clinic Phone: Provider: Service: Time Range: 0001 To 2400 Duration: Dates: 21 Jun 2001 to 20 Jun 2002 Days of Week: ======================================================================== WED 0700 21 Jun 01 NEW ACARDI QUIVERN ======================================================================== Use <Select> to select appointments to be cancelled/rescheduled ___________________________________________________________________________ Select the appointment for cancellation When finished selecting all appointments for cancellation, press <Return> CANCEL/RESCHEDULE PATIENT APPOINTMENTS Patient: SUMMERS,ALLAN FMP/SSN: 20/600-60-6510 Clinic: Appt. Type: Clinic Phone: Provider: Service: Time Range: 0001 To 2400 Duration: Dates: 21 Jun 2001 to 20 Jun 2002 Days of Week: ======================================================================== * WED 0700 21 Jun 01 NEW ACARDI QUIVERN PAS CANCEL APPOINTMENT BY PATIENT SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides ====================== Select appointment #1 of 1 ============================= Select (C)ancel, (R)eschedule, or (Q)uit CANCEL/RESCHEDULE: C ___________________________________________________________________________ Canceling Appointment . . . *Want to book cancelled appointment slot(s) from Wait List requests? No// <Return> CANCEL APPOINTMENT BY PATIENT (continued) CANCELLATION BY PATIENT SEARCH CRITERIA Patient: FMP/SSN: Clinic: Appt. Type: Clinic Phone: Provider: Service: Time Range: 0001 to 2400 Duration: Dates: 2 May 2001 to 13 Jun 2001 Days of Week: ======================================================================== • Patient cancellations are compiled into a statistical report, the “Patient Cancellation Statistical Report.” • Patient cancellations can only be performed for appointments scheduled for the current or future time, and cannot be used to cancel appointments in the past. • When rescheduling an appointment, the system will not cancel the original appointment until the new appointment booking transaction is complete. ======================================================================== Select (C)hange Search Criteria, (S)earch for Appointments, (Q)uit: S// Q Notes: 4-71 • The patient identifier must be entered before the appointment search can be initiated. • The system allows you to reschedule the appointment for the patient without exiting from the Cancellation by Patient option. • The system then assigns the status of Wait to the cancelled appointment slot, and makes it available for rebooking from the Wait List. • After you use <Select> to select Patient as your required field, you have the option of updating the patient’s registration data. • A cancelled patient appointment is indicated as a Patient Cancellation with a status of “CANCEL(P)” when observed in Display Patient Appointment option. PAS CANCEL APPOINTMENT BY PATIENT SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides • System allows you to rebook the cancelled appointment slot from the Wait List without exiting from the Cancellation by Patient option. INTERACTIVE DEERS ELIGIBILITY REQUEST The Defense Enrollment Eligibility Reporting System (DEERS) interface determines whether the patient is eligible for treatment. CHCS is integrated with DEERS and runs the eligibility check as part of registration. The patient date of birth (DOB) and sponsor Social Security number (SSN) access the DEERS record, which contains the eligibility for all patients registered under that SSN. If DEERS and CHCS are not connected, the following message displays: DEERS link is down/DEERS request being batched. Your request is then placed in a batch file and processed when the link is reestablished. If the patient DOB and sponsor SSN match in the DEERS database, the Sponsor/ Patient Information screen displays. 4-72 If the sponsor’s SSN matches one in the DEERS database but the DOB does not match, the Family Member Screen displays and the user is prompted to select the corresponding family member. If the family member/sponsor is not selected, the user is returned to the Sponsor Name prompt. After providing sponsor/patient information, the DEERS Eligibility Data screen displays. Quick Reference Guides MENU PATH: PAS System Menu ➔ MAN ➔ EMCP ➔ IENR PAD INTERACIVE DEERS ELIGILITY REQUEST SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 DEERS Eligibility checking is available through several other CHCS functionalities. In MCP, you may also request eligibility information for a specific period of time. INTERACTIVE DEERS ELIBILITY REQUEST (continued) If the patient is DEERS eligible, you can proceed with the registration. If the patient is not DEERS eligible, you can enter an override code that indicates the override justification and continue with the registration. DEERS ELIG/REG RESPONSE: Patient Name: Date of Birth: Sponsor SSN: Family Member Prefix: Eligibility Start Date: Eligibility End Date DEERS INTER REC DEERS ELIGIBILITY OVERRIDE CODES: POET,ZANE E 12 Sep 1965 100201601 20 4-73 DEERS ELIGIBILITY DATA Name: Patient Category: DOB/Age: FMP/SSN: DDS: Sex: ___________________________________________________________________ DOB: SSN: Care Denied - Not treated. 02 Presented valid DD form 1172 and valid ID card. 03 Patient recently eligible (less than 10 days). Patient not on DEERS. 04 Sponsor recently entered active duty for greater than 30 days. 05 Newborn infant less than one year old. 06 Patient has valid ID issued within 120 days (shown DEERS eligible). 07 Emergency Care - Eligibility and billing determination still required. 08 Sponsor duty station outside the 50 states or within APO/FPO address. 09 Survivor of deceased sponsor - one time exception. 10 DEERS enrollment exception - billing determination required. 99 SSN erroneously keyed. Disregard ineligible response. PAD INTERACIVE DEERS ELIGILITY REQUEST SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides NAME: SEX: DDS: ACV: AVC Start Date: DMIS ID: Sponsor Rank: Sponsor UIC: Direct Care: Elig Start Date: Elig End Date: Eligibility Comment: 01 DISPLAY PATIENT APPOINTMENTS The Display Patient Appointments option allows you to display or print a patient’s future or past appointments as well as those of other family members registered under the same Social Security number. MENU PATH: PAS System Menu ➔ Clerk Scheduling Menu ➔ DPA Select PATIENT NAME: SANDERS,ALLAN 20/600-60-6501 16 Mar 1975 M AO3 OK? YES// Select (F)uture, (P)ast, (W)ait List, (S)pecific Date, (Q)uit: F// S 4-74 Display from which Date: 15 Jun 2001 Device: <Return> RIGHT MARGIN: 80// <Return> DISPLAY PATIENT APPOINTMENTS SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides PAS DISPLAY PATIENT APPOINTMENTS (continued) DISPLAY PATIENT APPOINTMENTS Personal Data - Privacy Act of 1974 (PL 93-579) History of Appts for SANDERS,ALLAN from: 15 Jun 2001 CLINIC/DIV PROVIDER DATE/TIME TYPE STATUS ====================================================================== (Appointment data) WAIT LIST REQUESTS FOR SANDERS,ALLAN (FMP/SSN) TYPE58 PRI DATE IN TARGET DATE PROVIDER ====================================================================== (Wait List data) CLINIC/DIV • The Display Appointments display is divided into two sections: – Top section lists past and future appointments for the patient. – Bottom section lists the Wait List requests for the patient. • Appointment status of Cancel indicates that the appointment was cancelled. • Appointment status of Cancel(P) indicates that the appointment was cancelled by Patient. • Appointment status of Cancel(F) indicates that the appointment was cancelled by Facility (Provider). • Displaying patient appointments in the past will show appointments up to 360 days in the past 4-75 ====================================================================== Press <Return> to continue Display/Print Appointment History of Other Family Member? No// <Return> Notes: • DPA printouts may be given to patients to remind them of future appointments. • DPA printouts also provide a listing of applicable instructions and appointment type messages. PAS DISPLAY PATIENT APPOINTMENTS SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides • Displaying a patient’s appointment is a quick way to find out which provider saw a patient on a previous visit so that return visits can be scheduled with the same provider for continuity of care. EDIT CLINIC PROFILE The Clinic Profile Edit option allows you to set up the parameters for pull product, Wait List, schedule, and booking for each clinic. All valid appointment types and providers for the clinic are also defined in this option. MENU PATH: PAS System Menu ➔ Scheduling Supervisor Menu ➔ PROF ➔ CPRO Select Clinic: ACARDI Select (A)ctive, (I)nactive appointment types, or (Q)uit: A// <Return> Hospital Location: CARDIOLOGY CLINIC SD CLINIC PROFILE 4-76 ASK FOR HELP = HELP Screen Exit = F10 SD CLINIC PROFILE - - CONTINUATION Wait List Activated: YES Maximum Wait List Days: Wait List Provider Mandatory: NO Wait List Hold Duration: Automatic Wait List Processing: NO Schedule Hold Duration: Prompt for Requesting Service: YES Patient Record Pull: Clinic Type: COUNT Radiology Record Pull: Check Holiday File: Roster Production: Cost Pool Code: Prepare Reminder Notice: Activation Status: ACTIVATED Available Schedule: Clinic Appt Instructions: ARRIVE 10 MINUTES EARLY Hospital Location: CARDIOLOGY CLINIC 200 day(s) 7 day(s) 1 day(s) 1 day(s) 1 day(s) 1 day(s) 4 day(s) 30 day(s) SD CLINIC PROFILE- -CONTINUATION Select Appointment Type: ADMIN* DAPT EVAL FOL INPT LUN* MTG* MULTI NEW PRO60 RET SCALL WI ASK FOR HELP = HELP SCREEN EXIT = F10 FILE/EXIT = DO File/Exit=DO PAS EDIT CLINIC PROFILE SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides Name: CARDIOLOGY CLINIC ABBREVIATION: ACARDI Facility: TRAINING MEDICAL TREATMENT FAC Division: DIV A - TRAINING HOSPITAL Building Name: Building Number: Street Address: Zip: City: STATE: DISTRICT OF COLUMBIA Clinic Location: Clinic Availability: Telephone: Enrollee Lockout: Type of Care: Service: CARDIOLOGY Department: MEDICAL CARE Specialty: MEPRS Code: BACA Hospital Location: CARDIOLOGY CLINIC EDIT CLINIC PROFILE (continued) Appointment Type: FOL SD CLINIC PROFILE - - CONTINUATION Duration: 15 Workload type: COUNT Pull Patient Record: YES Produce Encounter Forms: YES Total # of Overbooks: Instructions: Select Booking Authority: Status: ACTIVE Referral Required: NO Pull Radiology Record: YES Send Reminder Notice: YES Max # of Overbooks Per Slot: • Status describes whether an appointment is active or inactive. • Workload Type describes whether an appointment type is a count or a noncount. Select Appt Change Authority: 4-77 Select Overbook Authority: Notes: • New clinics can only be created in the Hospital Location file using the Create a New Clinic (CFIL) option in the File/Table Maintenance Menu. Quick Reference Guides • Do not delete the name of an existing clinic. • If clinic is no longer used, deactivate the clinic by setting the Activation Status to Not Active. • You must set Wait List Activated field to Yes for automatic Wait List processing to occur within the system. • The Wait List Hold Duration field must have a number of days entered for automatic Wait List processing to occur within the system. PAS EDIT CLINIC PROFILE SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 • Once a new clinic has been created, you can use the Clinic Profile to complete, modify, or view the profile data and parameters. EDIT EMERGENCY ROOM PROFILE Hospital Location: EMERGENCY ROOM The Emergency Room Clinic Profile Edit option allows you to designate a hospital location as an emergency room and control the printing of the SF 558 form. MENU PATH: PAS System Menu ➔ Scheduling Supervisor Menu ➔ PROF ➔ EPRO ➔ 1 Edit Emergency Room Clinic Profile Select Clinic: EMERGENCY ROOM Clinic(c) Div(A)--Train 1 BIAA Select (A)ctive, (I)nactive appointment types, or (Q)uit: A// <Return> SD EROOM CLINIC PROFILE 4-78 Name: EMERGENCY ROOM Abbreviation: ER Facility: TRAINING MEDICAL TREATMENT FAC Division: DIV A - TRAINING HOSPITAL Building Name: Building Number: Street Address: 1610 CONSTITUTION AVE Zip: City: State: DISTRICT OF COLUMBIA Activation Status: ACTIVATED Telephone: Service: EMERGENCY MEDICAL SERVICE Department: PRIMARY CARE DEPARTMENT Specialty: MEPRS Code: BIAA Cost Pool Code: Clinic Type: COUNT Clinic Location: Clinic Availability: EDIT EMERGENCY ROOM PROFILE SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides PAS EDIT EMERGENCY ROOM PROFILE (continued) Hospital Location: EMERGENCY ROOM SD EROOM CLINIC PROFILE--CONTINUATION Is This an Emergency Room: YES Provider Name to Default in CER Option: Default of Now for Date/Time of Release: Default Printer: Print SF 558 Default in NER Option: Print SF 558 Default in CER Option: Notes: • Once a new Emergency Room Clinic has been created, you can use this option to complete, modify, or view profile data and parameters. • A default YES can be set in the NER and CER options when printing SF558 forms. • A default printer identifies the printer where the SF558 is printed; i.e., SLAVE might be the name of the printer. • New emergency room locations can be created using the Create a New Clinic (CFIL) option in the File/Table Maintenance Menu. Hospital Location: EMERGENCY ROOM SD EROOM CLINIC PROFILE--CONTINUATION • The Emergency Room Profile can also be set using the Emergency Room Profile (EER) Enter/Edit option. Select Appointment Type: 4-79 • Locations that have YES in the Is this an Emergency Room field cannot edit Appt/Date and time in End-of-Day processing (per JCAHO requirements). ERAPT EROOM T-CON WI Appointment Type: EROOM SD EROOM CLINIC PROFILE--CONTINUATION Status: ACTIVE File the data. PAS EDIT EMERGENCY ROOM PROFILE SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides Duration: 30 MINUTES Workload Type: COUNT • The appointment type EROOM is required for each emergency room. END-OF-DAY PROCESSING This option allows you to edit, modify, or update patient appointment history data including the status of daily appointments for each clinic and provider. MENU PATH: PAS System Menu ➔ Clerk Scheduling Menu ➔ EOD END-OF-DAY PROCESSING Clinic: Provider: Time Range: 0001 t2001 to 21 Jun 2001 Dates: 21 Jun 2001 to 21 Jun 2001 4-80 _________________________Place of Care is REQUIRED____________________________ Select (C)hange Search Criteria, or (Q)uit: C// <Return> END-OF-DAY PROCESSING SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides PAS END-OF-DAY PROCESSING (continued) END-OF-DAY PROCESSING Clinic: Provider: Time Range: 0001 to 2400 Dates: 21 Jun 2001 to 21 Jun 2001 Appt. Type: * Clinic * Provider Time Range Date Range * Data Elements Delinquent Appointments Only Default Search Criteria Clinic is REQUIRED END-OF-DAY PROCESSING Clinic: CAST CLINIC/DIVA Appt. Type: Provider: CALHOUN,CRAIG Time Range: 0001 to 2400 Dates: 21 Jun 2001 to 21 Jun 2001 * Appointment Status * MEPRS Code Provider Secondary Provider Outpatient Disposition Provider’s Comment Clinic Appointment Type + Appointment Date/Time 4-81 Select DATA ELEMENTS to edit Select (C)hange Search Criteria, (S)earch for Appts, (Q)uit: S// <Return> SELECT to mark the Search Criteria to be changed ___________________________________________________________________________ Select Clinic: CAST Select Provider: CALHOUN,CRAIG END-OF-DAY PROCESSING SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides PAS END-OF-DAY PROCESSING (continued) END-OF-DAY PROCESSING Clinic: CAST CLINIC/DIVA Provider: CALHOUN,CRAIG Time Range: 0001 to 2400 Dates: 21 Jun 2001 to 21 Jun 2001 ========================================================= 0900 SCHMIDT,BARBARA B 20/6603 RET CALHOUN,CR 21 Jun 2001 BEBA Pending 0930 SCOTT,OLIVER O 20/7904 RET CALHOUN,CR 21 Jun 2001 BEBA Pending 1011 SCOTT,OLIVER O 20/7904 RET CALHOUN,CR 21 Jun 2001 BEBA Tel-Con 1030 SCOTT,CHARLES C 20/6704 RET CALHOUN,CR 21 Jun 2001 BEBA Pending 1311 AMHOFF,ALLAN A 20/2345 WI 21 Jun 2001 BEBA Walk-In ========================================================= Select appointment(s) to process END-OF-DAY PROCESSING PATIENT APPT DATA Personal Data - Privacy Act of 1974 Patient: SHAW,CHARLES C FMP/SSN: 20/600-60-6705 -----------------------------------------------------------------------------------------------------------------------------Appt Date/Time: 21 Jun 2001@0700 Appt Status: PENDING Clinic: CAST CLINIC MEPRS: BEBA Provider: CALHOUN,CRAIG M Appt Type: NEW Secondary Provider: Checked-In: Referred By: Request Svc: Appt Comment: Reason for Appt: Cancelled By: Date/Time Cancelled: Help = HELP Exit = F10 File/Exit = DO INSERT OFF 4-82 ======================================================================== Appointment Status: PENDING// 4 (NO-SHOW) Press <Return> to continue File the data. END-OF-DAY PROCESSING SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides PAS END-OF-DAY PROCESSING (continued) END-OF-DAY PROCESSING PATIENT APPT DATA Personal Data - Privacy Act of 1974 Patient: SHAW,CHARLES C FMP/SSN: 20/600-60-6705 -----------------------------------------------------------------------------------------------------------------------------Outpatient Disposition: Modified Duty Until: Referred To: Admitted To: Provider’s Comment: EOD REPORTS Place of Care: CAST CLINIC/DIVA Provider: CALHOUN,CRAIG M Time Range: 0001 to 2400 Dates: 21 Jun 2001 to 21 Jun 2001 -------------------------------------------------------------------------------------------------------------------------------- ---------------------There are missing providers and/or pendings appointments-----------------------------Select (D)elinquent EOD Report, (E)nd-of-Day Processing Report, or (Q)uit: D// E Help = HELP Exit = F10 File/Exit = DO INSERT OFF 4-83 END-OF-DAY PROCESSING Place of Care: CAST CLINIC/DIVA Provider: CALHOUN,CRAIG M Time Range: 0001 to 2400 Dates: 21 Jun 2001 to 21 Jun 2001 -------------------------------------------------------------------------------------------------------------------------------- EOD REPORTS Place of Care: CAST CLINIC/DIVA Provider: CALHOUN,CRAIG M Time Range: 0001 to 2400 Dates: 21 Jun 2001 to 21 Jun 2001 -------------------------------------------------------------------------------------------------------------------------------- Quick Reference Guides -------------------------------------------------------------------------------------------------------------------------------Select: (C)hange Search Criteria, (S)earch for Appointments, (P)rint EOD Reports, or (Q)uit: P// <Return> PAS END-OF-DAY PROCESSING SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 ---------------------There are missing providers and/or pendings appointments-----------------------------Enter DEVICE: [device identifier] RIGHT MARGIN: 80// <Return> END-OF-DAY PROCESSING (continued) TRAINING MEDICAL TREATMENT FACILITY 22 Jun 2001@1610 Page 1 Personal Data-Privacy Act of 1974 (PL 93-579) END-OF-DAY PROCESSING 22 JUN 2001 @ 1610 From: 21 Jun 1990 To: 22 Jun 2001 Division: DIV A - TRAINING HOSPITAL Clinic: CAST CLINIC ================================================================================== TIME PATIENT NAME FMP/SSN TYPE PROVIDER DATE MEPRS STATUS ================================================================================== 0900 0930 1011 1030 1311 SCHMIDT,BARBARA B SCOTT,OLIVER O SCOTT,OLIVER O SCOTT,CHARLES C AMHOFF,ALLAN A 20/6603 20/7904 20/7904 20/6704 20/2345 RET RET RET RET WI CALHOUN,CR CALHOUN,CR CALHOUN,CR CALHOUN,CR 21 Jun 2001 21 Jun 2001 21 Jun 2001 21 Jun 2001 21 Jun 2001 BEBA BEBA BEBA BEBA BEBA No-Show Pending Tel-Con Pending Walk-In 4-84 **Daily Clinic Appointment Status Summary with COUNT Appt. Types** ================================================================================== Provider Kpt WI SC TC Can NS Adm LWOBS O-S |Total| • To save yourself time in your search you may elect to only use the editing criterion ‘Data Elements.’ With this selection you select only those fields you need to change. For example, you may decide to change appointment status and Provider. • There are 14 data elements that you can identify by either a number code or by name. Double question marks (??) at the prompt allows you to see these available elements. • All end-of-day processing must be completed within seven days of the appointment. After seven days, only supervisory personnel with the SDCL1 or MCPCL1 security key will be able to perform end-of-day processing. • End-of-Day processing must be fully completed before the Monthly Statistical Reports can be calculated and printed. • If an End-of-Day Report (not shown) has been completed, the system will give you a breakdown of the kinds of patients each provider had for the day. For example: No. of No-Shows, No. of Walk-ins. ================================================================================== SEYMOUR,RO 0 0 0 0 0 1 0 0 0 | 0| ------------------------------------------------------------------------------------------------------------------------- ----------------------- Total 0 0 0 0 0 1 0 0 0 | 1| ================================================================================== Quick Reference Guides Kpt WI SC TC Can NS Adm LWOBS O-S |Total| ================================================================================== SEYMOUR,RO 0 0 0 1 0 0 0 0 0 | 0| ------------------------------------------------------------------------------------------------------------------------- ----------------------- Total 0 0 0 1 0 0 0 0 0 | 1| • The Delinquent End-of-Day Processing Report should be printed showing you appointments that need changes in appointment status or have missing provider names. This report will print out the total of appointments you will need to edit in the lower-lefthand corner, along with the exact appointment times to the right of the page. Notes: • Place of Care is a required field. PAS END-OF-DAY PROCESSING SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 • You should select the Criteria, Delinquent appointments only, to display the appointments with a Pending status and/or missing provider. **Daily Clinic Appointment Status Summary with NONCOUNT Appt. Types** Provider • You should select the End-of-Day Processing Report when there are no pending appointments or missing providers on the End-of-Day Processing screen. GENERATE A PROVIDER ROSTER The Consolidated or Provider Roster (One Clinic) option allows you to print two different report types. If the provider is specified, a roster of only that provider’s appointments is produced. If no provider is specified, a consolidated roster with all the patients of each provider in the specified clinic is produced. MENU PATH: PAS System Menu ➔ Clerk Scheduling Menu ➔ ORM ➔ Consolidated OR Provider Roster (one Clinic) Select Operational Reports Menu Option: 3 Consolidated OR Provider Roster (One Clinic) Select Date: 21 Jun 2001 Select another Date: <Return> Select Clinic: ACARDI 4-85 Select Provider: ALL// CALDWELL,LORRAINE Number of Copies? 1// <Return> THIS IS A 132 COLUMN REPORT: Device: <Return> Right Margin: 80// <Return> TRAINING MEDICAL TREATMENT FACILITY 21 Jun 2001@1121 Page 11 Personal Data - Privacy Act of 1974 (PL 93-579) PROVIDER ROSTER (One Clinic) From: 21 Jun 2001 To: 21 Jun 2001 Division: DIV A - TRAINING HOSPITAL DEPT: MEDICAL CARE Clinic: CARDIOLOGY CLINIC PROVIDER: CALDWELL,LORRAINE ====================================================================== Time Type Name FMP/SSN Sex Age Cat GR Int CSP Fly Provider Out/In Ward Home Phone Work Phone Sponsor Unit GR/Spon Reason for Appointment: Appointment Comment: Referred by: Registration Comment: ====================================================================== Appointment data for the day. Notes: • You need a printer with 132-column paper that is set at the top of the form. Note: Enter <Return> to print ‘Consolidated Roster’ OR Enter name of Provider to print ‘Provider Roster’ • Users can exit this option either at the START or STOP date prompt by entering a caret (^). • Rosters are sorted in priority by: Clinic, then by Provider, then by Appointment time, then by Patient name PAS GENERATE A PROVIDER ROSTER SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides – – – – INDIVIDUAL PATIENT CHECK-IN This option allows you to check-in a patient with a booked appointment. Clinic is REQUIRED Select (C)hange Search Criteria, (S)earch for Appts, (Q)uit: S// <Return> MENU PATH: PAS System Menu ➔ Clerk Scheduling Menu ➔ IPC INDIVIDUAL PATIENT CHECK-IN Patient: FMP/SSN: Clinic: Appt. Type: Provider: Service: Time Range: 0001 to 2400 Date: 21 Jun 2001 Days of Week: THURSDAY ===================================================================== ===================================================================== Clinic is REQUIRED Select (C)hange Search Criteria, (S)earch for Appts, (Q)uit: C// <Return> 4-86 Use <Select> to choose Patient(s) to check-in Select Clinic: INTERNAL MEDICINE CLINIC/DIVA PAS INDIVIDUAL PATIENT CHECK-IN SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides INDIVIDUAL PATIENT CHECK-IN Patient: FMP/SSN: Clinic: Appt. Type: Provider: Specialty: Time Range: 0001 to 2400 Date: 21 Jun 2001 Days of Week: THURSDAY ===================================================================== * Clinic Patient Provider Time Range ===================================================================== Use <Select> to mark the Search Criteria to be changed ________________________________________________________________________ INDIVIDUAL PATIENT CHECK-IN Patient: FMP/SSN: Clinic: INTERNAL MEDICINE CLINIC/DIVA Appt. Type: Provider: Service: Time Range: 0001 to 2400 Date: 21 Jun 2001 Days of Week: THURSDAY ===================================================================== 0700 SHAW,H 20/7205 NEW OUT AINMED CARSON,C Pending 0700 KEENAN,B 20/6617 INPUT INP AINMED HARTMAN,C Pending 0700 SUMMERS,H 20/7210 NEW OUT AINMED QUIST,A Pending 0710 KEENAN,F 20/7013 INPUT INP AINMED HARTMAN,C Pending 0720 KEENAN,I 20/7011 INPUT INP AINMED HARTMAN,C Pending 0740 KAGAN,F 20/7011 INPUT INP AINMED HARTMAN,C Pending 0750 KEAN,B 20/6612 INPUT INP AINMED HARTMAN,C Pending 0800 KEAN,F 20/7012 INPUT INP AINMED HARTMAN,C Pending +* 0810 KEAN,I 20/7312 INPUT INP AINMED HARTMAN,C Pending INDIVIDUAL PATIENT CHECK-IN (continued) INDIVIDUAL PATIENT CHECK-IN Patient: FMP/SSN: Clinic: INTERNAL MEDICINE CLINIC/DIVA Appt. Type: Provider: Service: Time Range: 0001 to 2400 Date: 21 Jun 2001 Days of Week: THURSDAY ====================================================================== • The system only displays appointments with an appointment status of Pending. After patient check-in, the appointment status is changed from Pending to Kept. • Individual patient check-ins can only be done on the day of the appointment. After that, all appointments with a pending status must be individually changed to a Kept status using the End-of-Day (EOD) Processing option. • Search criteria are the rules by which the system searches for an appointment and include defining the Clinic. Any unrequired criteria that is blank will be interpreted as All or Any. • The Provider’s name can be changed at the time of check-in instead of waiting until the end of the day. 4-87 • Patient appointment comments appear on the screen. • After checking in a patient for a scheduled visit, the appointment status Pending is replaced by the MEPRS Code, time of check-in, and Ck In. Quick Reference Guides • When checking in an inpatient for an unscheduled visit into an outpatient clinic, the prompt - Is this clinic visit related to inpatient episode of care? No// - is displayed. A Yes changes the patient’s visit to reflect the inpatient MEPRS Code that the patient is currently admitted under. This response categorizes this as a Noncount visit for the outpatient clinic and provider. A No response categorizes this as a Count visit for the outpatient clinic and provider. Clinic is REQUIRED Select (C)hange Search Criteria, (S)earch for Appts, (Q)uit: C// Q PAS INDIVIDUAL PATIENT CHECK-IN SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 0700 SHAW,H 20/7205 NEW OUT AINMED CARSON,C BAAA 0950 Ck in 0700 KEENAN,B 20/6617 INPT INP AINMED HARTMAN,C Pending 0700 SUMMERS,H 20/7210 NEW OUT AINMED QUIST,A Pending 0710 KEENAN,F 20/7013 INPT INP AINMED HARTMAN,C Pending 0720 KEENAN,I 20/7011 INPT INP AINMED HARTMAN,C Pending 0740 KAGAN,F 20/7011 INPT INP AINMED HARTMAN,C Pending 0750 KEAN,B 20/6612 INPT INP AINMED HARTMAN,C Pending 0800 KEAN,F 20/7012 INPT INP AINMED HARTMAN,C Pending + 0810 KEAN,I 20/7312 INPT INP AINMED HARTMAN,C Pending ====================================================================== OK to file YES// (YES) Is this Clinic Visit RELATED to the Inpatient Episode of Care? No// <Return> Select MEPRS CODE: BAAA// <Return> Select Requesting Service: <Return> INTERNAL MEDICINE CLINIC Select Provider: HARTMAN,CHRIS C// <Return> HARTMAN,CHRIS 123435686 OK? YES// (YES) Press <Return> to continue Produce an encounter form NO// <Return> Press <Return> to continue _________________________________________________________________________ ‘ Notes: MULTIPLE CHECK-IN BY DEFAULT The Multiple Check-in by Default option allows you to check-in all patients scheduled for appointments, and those who showed up and were treated in a single transaction. MENU PATH: PAS System Menu ➔ Clerk Scheduling Menu ➔ MCD MULTIPLE PATIENT CHECK-IN Clinic: Appt. Type: Provider: Service: Time Range: 0001 to 2400 Date: 21 Jun 01 Days of Week: THURSDAY ===================================================================== MULTIPLE PATIENT CHECK-IN Clinic: Appt. Type: Provider: Service: Time Range: 0001 to 2400 Date: 21 Jun 01 Days of Week: THURSDAY ===================================================================== * Clinic * Provider Time Range ===================================================================== 4-88 Use the <Select> to mark the SEARCH CRITERIA to be changed ===================================================================== Clinic is REQUIRED Select (C)hange Search Criteria, (B)ulk or (S)elective Check-In, (Q)uit: C// <Return> Select Clinic: ACARDI Select Provider: CALDWELL,LORRAINE MULTIPLE CHECK-IN BY DEFAULT SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides PAS MULTIPLE CHECK-IN BY DEFAULT (continued) MULTIPLE PATIENT CHECK-IN Clinic: CARDIOLOGY Appt. Type: Provider: CALDWELL,LORRAINE C Specialty: Time Range: 0001 to 2400 Date: 21 Jun 2001 Days of Week: THURSDAY ===================================================================== * Clinic * Provider Time Range SELECTIVE PATIENT CHECK-IN Clinic: CARDIOLOGY CLINIC/DIVA Appt Type: Provicer: CALDWELL,LORRAINE C Service: Time Range: 0001 to 2400 Date: 21 Jun 2001 Day of Week: Thursday ---------------------------------------------------------------------------------------------------------------------------------------------0700 SHAW,ALLAN A 20/6505 NEW OUT CALDWELL Pending 0730 SCHMIDT,ALLAN 20/6503 NEW OUT CALDWELL Pending 0900 SCHMIDT,ALLAN 20/6503 RET OUT CALDWELL Pending * 0930 SCOTT,PAULA P 20/8004 RET OUT CALDWELL Pending 1000 SCOTT,PAULA P 20/8004 RET OUT CALDWELL Pending 1030 SCOTT,ALLAN A 20/6504 RET OUT CALDWELL Pending * 1500 SHAW,ALLAN A 20/6505 NEW OUT CALDWELL Pending 1530 SCOTT,BARBARA 20/6604 NEW OUT CALDWELL Pending 1700 SHAW,ALLAN A 20/6505 DAPT OUT CALDWELL Pending ---------------------------------------------------------------------------------------------------------------------------------------------Use the Select key to mark Patient(s) to check-in. OK TO FILE ?? Yes// ===================================================================== 4-89 Clinic is REQUIRED Select (C)hange Search Criteria, (B)ulk or (S)elective Check-In, (Q)uit: S// <Return> Checking for MEPRS Code . . . SELECTIVE PATIENT CHECK-IN Select (C)hange Search Criteria, (B)ulk or (S)elective Check-In, (Q)uit: C// <Return> PAS MULTIPLE CHECK-IN BY DEFAULT SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides Clinic: CARDIOLOGY CLINIC/DIVA Appt. Type: Provider: CALDWELL,LORRAINE C Service: Time Range: 0001 to 2400 Date: 21 Jun 2001 Days of Week: THURSDAY ------------------------------------------------------------------------------------------------------------------------------------------0700 SHAW,ALLAN A 20/6505 NEW OUT CALDWELL Pending 0730 SCHMIDT,ALLAN 20/6503 NEW OUT CALDWELL Pending 0900 SCHMIDT,ALLAN 20/6503 RET OUT CALDWELL Pending 0930 SCOTT,PAULA P 20/8004 RET OUT CALDWELL BACA 1512 Cki 1000 SCOTT,PAULA P 20/8004 RET OUT CALDWELL Pending 1030 SCOTT,ALLAN A 20/6504 RET OUT CALDWELL Pending 1500 SHAW,ALLAN A 20/6505 NEW OUT CALDWELL BACA 1512 Ck 1530 SCOTT,BARBARA 20/6604 NEW OUT CALDWELL Pending 1700 SHAW,ALLAN A 20/6505 DAPT OUT CALDWELL Pending ------------------------------------------------------------------------------------------------------------------------------------------Use the Select key to mark Patient(s) to check-in. MULTIPLE CHECK-IN BY DEFAULT (continued) SELECTIVE PATIENT CHECK-IN Clinic: CARDIOLOGY Appt. Type: Provider: CALDWELL,LORRAINE C Specialty: Time Range: 0001 to 2400 Date: 21 Jun 2001 Days of Week: Thursday --------------------------------------------------------------------------------------------------------------------------------------------------0700 SHAW,ALLAN A 20/6505 NEW OUT CALDWELL Pending 0730 SCHMIDT,ALLAN 20/6503 NEW OUT CALDWELL Pending 0900 SCHMIDT,ALLAN 20/6503 RET OUT CALDWELL Pending 0930 SCOTT,PAULA P 20/8004 RET OUT CALDWELL BACA 1512 Cki 1000 SCOTT,PAULA P 20/8004 RET OUT CALDWELL Pending 1030 SCOTT,ALLAN A 20/6504 RET OUT CALDWELL Pending 1500 SHAW,ALLAN A 20/6505 NEW OUT CALDWELL BACA 1512 Ck 1530 SCOTT,BARBARA 20/6604 NEW OUT CALDWELL Pending 1700 SHAW,ALLAN A 20/6505 DAPT OUT CALDWELL Pending --------------------------------------------------------------------------------------------------------------------------------------------------Clinic is REQUIRED Select (C)hange Search Criteria, (B)ulk or (S)elective Check-In, (Q)uit: C// B 4-90 BULK PATIENT CHECK-IN Clinic: CARDIOLOGY Appt. Type: Provider: CALDWELL,LORRAINE C Specialty: Time Range: 0001 to 2400 Date: 21 Jun 2001 Days of Week: Thursday --------------------------------------------------------------------------------------------------------------------------------------------------0700 SHAW,ALLAN A 20/6505 NEW OUT CALDWELL BACA 1522 Cki 0730 SCHMIDT,ALLAN 20/6503 RET OUT CALDWELL BACA 1522 Cki 0900 SCHMIDT,ALLAN 20/6503 RET OUT CALDWELL BACA 1522 Cki 1000 SCOTT,PAULA P 20/8004 RET OUT CALDWELL BACA 1522 Cki 1030 SCOTT,ALLAN A 20/6504 RET OUT CALDWELL BACA 1522 Cki 1530 SCOTT,BARBARA 20/6604 NEW OUT CALDWELL BACA 1522 Cki 1700 SHAW,ALLAN A 20/6505 DAPT OUT CALDWELL BACA 1522 Cki --------------------------------------------------------------------------------------------------------------------------------------------------Clinic is REQUIRED Select (C)hange Search Criteria, (B)ulk or (S)elective Check-In, (Q)uit: C// Q Notes: • Multiple Check-in by Default can only be performed on the date of the appointment. It cannot be done for days in the past. Therefore, it is important to do End-Of-Day Processing and Multiple Check-in by Default on a daily basis. • Using the (B)ulk option, you can check-in all patients on the displayed list simultaneously. If appointments are wrongly checked in, it is corrected during EOD processing • Using the (S)elect option, you can check-in selected patients before or after End-of-Day processing. PAS MULTIPLE CHECK-IN BY DEFAULT SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides --------------------------------------------------------------------------------------------------------------------------------------------------* 0700 SHAW,ALLAN A 20/6505 NEW OUT CALDWELL Pending * 0730 SCHMIDT,ALLAN 20/6503 NEW OUT CALDWELL Pending * 0900 SCHMIDT,ALLAN 20/6503 RET OUT CALDWELL Pending * 1000 SCOTT,PAULA P 20/8004 RET OUT CALDWELL Pending * 1030 SCOTT,ALLAN A 20/6504 RET OUT CALDWELL Pending * 1530 SCOTT,BARBARA 20/6604 NEW OUT CALDWELL Pending * 1700 SHAW,ALLAN A 20/6505 DAPT OUT CALDWELL Pending --------------------------------------------------------------------------------------------------------------------------------------------------Use Prev Screen and Next Screen keys to view data OR press <Return> to file. Ok to file ?? Yes// <Return> BULK PATIENT CHECK-IN Clinic: CARDIOLOGY Appt. Type: Provider: CALDWELL,LORRAINE C Specialty: Time Range: 0001 to 2400 Date: 21 Jun 2001 Days of Week: Thursday PRINT A CLINIC WORKLOAD REPORT The Clinic Workload Report is one of the Management Reports accessible through the Schedule Supervision Menu. It provides displayed or printed clinic workload data and visit summary reports. This report is an on-demand, single clinic, and single or multiple provider version of the Monthly Statistical Report. MENU PATH: PAS System Menu ➔ Scheduling Supervisor Menu ➔ MGRM ➔ SMGR ➔ 4 Clinic Workload Report *WARNING* In order for the Clinic Workload report to be accurately produced, End-ofDay Processing/Editing MUST be COMPLETED for ALL providers in the clinic even when this report is ordered for only one provider. If the selected clinic has ANY delinquent appointments, then the Delinquent Appointment Report will follow instead. 4-91 Select Clinic: CARDIOLOGY CLINIC Select Provider: CALDWELL,LORRAINE C OK? YES// <Return> CLINIC (C) DIV A - TRAIN BACA 157-74-2958 Report Month & Year OR ‘^’ to enter specific date range: May 2001// ^ Report Start Date: 1 JUL (01 Jul 2001) Report Stop Date: T+31 (22 Jul 2001) Select Device: SLAVE PRINT A CLINIC WORKLOAD REPORT SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides PAS PRINT A CLINIC WORKLOAD REPORT (continued) Training Medical Treatment Facility Training Medical Treatment Facility 4 Oct 2001@2200 Division: ====================================================================== Appt MEPRS | COUNT WORKLOAD | NONCOUNT WORKLOAD Type Code | # In # Out Total | # In # Out Total ====================================================================== INTERNAL MEDICINE CLINIC (T) *** Clinic Totals *** -------------------------------------------------------------------------NEW AAAA 0 0 0 11 0 11 BAAA 1 54 55 0 0 0 Subtotal: 1 54 55 11 0 11 4-92 BAAA 5 23 28 0 0 0 AAAA BAAA Subtotal: 0 0 0 0 0 0 0 0 0 12 4 16 0 17 17 12 21 33 6 77 83 27 17 44 RX Clinic Total: Page 2 CLINIC WORKLOAD REPORT From: 01 Sep 2001 To: 30 Sep 2001 CLINIC WORKLOAD REPORT From: 01 Sep 2001 To: 30 Sep 2001 RET 4 Oct 2001@2200 Page 1 ------------------------------------------------------------------------------------------------------------------------------------------------ Division: DIV A - TRAINING HOSPITAL ====================================================================== Appt MEPRS | COUNT WORKLOAD | NONCOUNT WORKLOAD Type Code | # In # Out Total | # In # Out Total ====================================================================== INTERNAL MEDICINE CLINIC (T) ----------------------------------------------Provider: JONES,DONALD NEW AAAA BAAA Subtotal: 0 1 1 0 32 32 0 33 33 3 0 3 0 0 0 3 0 3 RET BAAA 3 11 14 0 0 0 AAAA BAAA Subtotal: 0 0 0 0 0 0 0 0 0 5 4 9 0 7 7 5 11 16 4 43 47 12 7 19 RX Provider Total: PRINT A CLINIC WORKLOAD REPORT SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides PAS PRINT A CLINIC WORKLOAD REPORT (continued) Training Medical Treatment Facility 4 Oct 2001@2200 4 Oct 2001@2200 Page 3 CLINIC WORKLOAD REPORT From: 01 Sep 2001 To: 30 Sep 2001 CLINIC WORKLOAD REPORT From: 01 Sep 2001 To: 30 Sep 2001 Division: DIV A - TRAINING HOSPITAL ========================================================== Appt Cat | COUNT WORKLOAD | NONCOUNT WORKLOAD Type Code DESCRIPTION | # In # Out Total | # In # Out Total ========================================================== INTERNAL MEDICINE CLINIC (T) ---------------------------------------------NEW A11 USA AD ENLISTED 1 A41 USA DEP AD 0 A43 USA DEP RET (EXC FORM 0 Subtotal: 4-93 RET 1 A11 USA AD ENLISTED 2 A41 USA DEP AD 1 A43 USA DEP RET (EXC FORM 2 Subtotal: 5 Page 4 32 22 0 54 33 22 0 55 7 0 4 11 0 0 0 0 7 0 4 11 10 12 1 23 12 13 3 28 0 0 0 0 0 0 0 0 0 0 0 0 Division: ====================================================================== Cat | COUNT WORKLOAD | NONCOUNT WORKLOAD Code DESCRIPTION | # In # Out Total | # In # Out Total ====================================================================== INTERNAL MEDICINE CLINIC (T) ---------------------------------------------A11 USA AD ENLISTED A41 USA DEP AD A43 USA DEP RET (EXC FORM SP Clinic Total: 3 1 2 42 34 1 45 35 3 14 5 8 17 0 0 31 5 8 6 77 83 27 17 44 ------------------------------------------------------------------------------------------------------------------------------------------------ PRINT A CLINIC WORKLOAD REPORT SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides PAS PRINT A CLINIC WORKLOAD REPORT (continued) 4 Oct 2001@2200 4 Oct 2001@2200 CLINIC WORKLOAD REPORT From: 01 Sep 2001 To: 30 Sep 2001 CLINIC WORKLOAD REPORT From: 01 Sep 2001 To: 30 Sep 2001 Division: ====================================================================== Appt Cat | COUNT WORKLOAD | NONCOUNT WORKLOAD Type Code DESCRIPTION | # In # Out Total | # In # Out Total ====================================================================== INTERNAL MEDICINE CLINIC (T) ---------------------------------------------Provider: JONES,DONALD 4-94 NEW A11 USA AD ENLISTED 1 A41 USA DEP AD 0 A43 USA DEP RET (EXC FORM 0 Subtotal: 1 RET A11 USA AD ENLISTED 2 A41 USA DEP AD1 0 1 0 A43 USA DEP RET (EXC FORM 0 Page 6 Page 5 32 0 0 32 33 0 0 33 3 0 0 3 0 0 0 0 3 0 0 3 12 0 1 14 7 0 7 0 7 0 0 0 7 3 Provider Total: 2 34 36 8 10 18 Clinic Total: 6 77 83 27 17 44 AAAA Internal Medicine Ward BAAA Internal Medicine Clinic Clinic Total: 0 6 0 77 0 83 23 4 0 17 23 21 6 77 83 27 17 44 ------------------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------------------ PAS PRINT A CLINIC WORKLOAD REPORT SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides Subtotal: 10 0 1 11 Division: ====================================================================== MEPRS | COUNT WORKLOAD | NONCOUNT WORKLOAD Code DESCRIPTION | # In # Out Total | # In # Out Total ====================================================================== INTERNAL MEDICINE CLINIC (T) ---------------------------------------------- PRINT A CLINIC WORKLOAD REPORT (continued) 4 Oct 2001@2200 4 Oct 2001@2200 CLINIC WORKLOAD REPORT From: 01 Sep 2001 To: 30 Sep 2001 CLINIC WORKLOAD REPORT From: 01 Sep 2001 To: 30 Sep 2001 Division: ====================================================================== MEPRS Appt | COUNT WORKLOAD | NONCOUNT WORKLOAD Code Type | # In # Out Total | # In # Out Total ====================================================================== INTERNAL MEDICINE CLINIC (T) ---------------------------------------------Provider: JONES,DONALD AAAA Page 8 Page 7 Division: ====================================================================== Requesting | COUNT WORKLOAD | NONCOUNT WORKLOAD Service DESCRIPTION | # In # Out Total | # In # Out Total ====================================================================== INTERNAL MEDICINE CLINIC (T) ---------------------------------------------AAAA ABAA AEAA BACA Internal Medicine Ward General Surgery Ward Orthopedic Ward Cardiology Clinic 0 4 5 6 0 5 7 9 20 0 0 0 0 0 0 0 20 0 0 0 6 15 21 20 0 20 NEW RX 0 0 0 0 0 0 0 0 0 3 5 8 0 0 0 3 5 8 NEW RET RX Subtotal: 1 3 0 4 32 11 0 43 33 14 0 47 0 0 4 4 0 0 7 7 0 0 11 11 Provider Total: 4 43 47 12 7 19 Notes: 6 77 83 27 17 44 • Page 1 of the Clinic Workload Report provides data on who saw the patient. It lists the number of inpatient clinic visits (MEPRS Code beginning with A), the number of outpatient clinic visits MEPRS Code beginning with B), and the total number of patient clinic visits in the specified clinic by appointment type and MEPRS Code for the specified date range for both count and noncount (occasion of service) workloads. Subtotal: 4-95 0 1 2 3 Clinic Total: BAAA Clinic Total: ------------------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------------------ PRINT A CLINIC WORKLOAD REPORT SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides PAS PRINT A CLINIC WORKLOAD REPORT (continued) • Page 2 of this report also provides data on who saw the patient. It lists by individual providers within the clinic the number of inpatient clinic visits (MEPRS Code beginning with A), the number of outpatient clinic visits (MEPRS Code beginning with B), and the total number of patient clinic visits in the specified clinic by appointment type and MEPRS Code for the specified date range for both count and noncount (occasion of service) workloads. • Page 3 provides data on the beneficiary status of the patient. It lists the number of inpatient clinic visits, the number of outpatient clinic visits, and the total number of patient clinic visits in the specified clinic by appointment type and patient category code for the date range specified for both count and noncount (occasion of service) workloads. 4-96 • Page 4 also provides data on the beneficiary status of the patient. It lists the number of inpatient clinic visits, the number of outpatient clinic visits, and the total number of patient clinic visits in the specified clinic by patient category code for the date range specified for both count and noncount (occasion of service) workloads. • Page 7 of the Clinic Workload Report also provides data on the service charged with the visit. It lists by individual providers within the clinic the number of inpatient clinic visits, the number of outpatient clinic visits, and the total number of patient clinic visits in the specified clinic by appointment type and MEPRS Code for the date range specified for both count and noncount (occasion of service) workloads. • Page 8 provides information on who referred the patient. It is based upon the Requesting Service MEPRS Code entered during booking. This prompt appears during the Booking options if the PROMPT FOR REQUESTING SERVICE: field in the Clinic Profile is set to YES. Since the REQUESTING SERVICE: prompt is an optional field and represents who referred the patient, the totals in this part of the report may be different from the other parts of the Clinic Workload Report. • This report does not print unless all delinquent end-of-day processing is complete for the reporting interval. • If end-of-day processing is not complete, the Delinquent End-of-Day Report is printed instead of the Clinic Workload Report. • Page 6 provides data on the service charged with the clinic visit. It lists the number of inpatient clinic visits, the number of outpatient clinic visits, and the total number of patient clinics visits in the specified clinic by MEPRS Code for the date range specified for both count and noncount (occasion of service) workloads. PAS PRINT A CLINIC WORKLOAD REPORT SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides • Page 5 also provides data on the beneficiary status of the patient. It lists by individual providers within the clinic the number of inpatient clinic visits, the number of outpatient clinic visits, and the total number of patient clinic visits in the specified clinic by appointment type and patient category code for the date range specified for both count and noncount (occasion of service) workloads. PRINT AN OUTPATIENT ENCOUNTER FORM (SF600) The Outpatient Encounter Forms option allows you to print an Encounter Form for all scheduled appointments. With this option, you can produce an Encounter Form for appointments scheduled for a specified date. MENU PATH: PAS System Menu ➔ Clerk Scheduling Menu ➔ ORM ➔ Daily Outpatient Encounter Forms (Clin/Prov/Indv) Select Operational Reports Menu Option: 4 Forms (Clin/Prov/Indv) Select (C)linic, (P)rovider, (I)ndividual, or (Q)uit: C Select CLINIC:CAST CLINIC CLINIC Date: 22 Jun 2001// Daily Outpatient Encounter DIV A - TRAINI BEBA CAST CLINIC REF: RSN: BP: CALHOUN,CRAIG M CMT: PULSE: RESP: 22 Jun 2001 TEMP: 1400 HT: MULT BEBA WT: ADDITIONAL COMMENTS: 20/600-60-6610 (22 Jun 2001) 4-97 This option will produce an Encounter Form for appointments scheduled for the date(s) specified. Please make sure that the printer has 80- column paper and is at the top of form. Device: TRAINING MEDICAL TREATMENT FACILITY DIVISION: DIV A - TRAINING Personal Data - Privacy Act of 1974 (PL 93-579) Automated Version of SF600 Printed: 21 Jun 2001@1448 Page 1 SF600 SUMMERS,BARBARA B 01 Jun 1974 FEMALE Spon: SUMMERS,BARBARA B CS: Unit: 1100-AIR BASE F11 W: 202-555-7466 H: 918-555-3431 CIC: D: 202-555-7466 Rank: 1LT RR: MEDICAL RECORDS FILE ROOM Notes: • You need a printer with 80-column paper that is set at the top of the form. • You get prompted to produce this form when you are checking in an individual patient and when using the Unscheduled Visit (USV) option. • The Additional Comments field information is printed out on SF600 forms. This allows you to receive Clinical (CLIN) order processing information. PAS PRINT AN OUTPATIENT ENCOUNTER FORM (SF600) SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides • You can exit this option either at the Start or Stop date prompt by entering a caret (^). PRINT WAIT LIST HOLD/RELEASE SCHEDULES Use this option when appointment slots in existing schedules need to be reserved for Wait List processing or released from Wait List reserved status. MENU PATH: PAS System Menu ➔ Scheduling Supervisor Menu ➔ SCHE ➔ MSCH ➔ WMSC HOLD/RELEASE WAIT LIST STATUS PAS 121 Clinic: Provider: Dates: ====================================================================== 4-98 ====================================================================== Clinic, Provider, Start Date & Stop Date are REQUIRED Select Clinic: ACARDI Select Provider: CALDWELL Input Start Date: 21 JUN 01 Input Stop Date: 22 JUN 01 __________________________________________________________________________ Select (O)pen Slots, (W)ait List Slots, or (Q)uit: O// W HOLD/RELEASE WAIT LIST STATUS PAS 121 Clinic: CARDIOLOGY CLINIC/DIVA Provider: CALDWELL, LORRAINE C Dates: 21 Jun 2001 to 22 Jun 2001 ====================================================================== 21 Jun 2001 THURSDAY 0800 NEW OPEN 1 0 * 0830 NEW OPEN 1 0 1100 RET OPEN 1 0 * 1130 RET OPEN 1 0 1200 RET OPEN 1 0 1300 MULTI OPEN 4 0 1400 MULTI OPEN 4 0 + 1600 NEW OPEN 1 0 ====================================================================== Use <Select> to mark the slot(s) to change status to WAIT Enter the DATE to AUTOMATICALLY CHANGE the schedule segment of >>>THURSDAY 21 Jun 2001 to FRIDAY 22 Jun 2001 <<< Input STOP DATE: 21 Jun 2001// <Return> (21 Jun 2001) [THURSDAY 21 Jun 2001] OK? Y// <Return> PRINT WAIT LIST HOLD/RELEASE SCHEDULES SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides PAS PRINT WAIT LIST HOLD/RELEASE SCHEDULES (continued) HOLD/RELEASE WAIT LIST STATUS PAS 121 4-99 Clinic: CARDIOLOGY CLINIC/DIVA Provider: CALDWELL, LORRAINE C Dates: 21 Jun 2001 to 22 Jun 2001 ================================================================================== 21 Jun 2001 THURSDAY 0830 NEW WAIT 1 0 1130 WI WAIT 1 0 1200 LUN* OPEN 1 0 1300 MULTI OPEN 4 0 1400 MULTI OPEN 4 0 1600 NEW OPEN 1 0 1630 NEW OPEN 1 0 + 1800 DAPT OPEN 1 0 ================================================================================== Select (I)nteractive-Phone OR Mailer, or (Q)uit: I// <Return> Sort by (P)riority, (E)ntered or (T)arget Date, (N)ame, or (Q)uit sort: P// <Return> Select Priority FROM: FIRST// <Return> Select Priority TO: LAST// <Return> WAIT LIST PROCESSING BY PRIORITY PAS 520 Clinic: CARDIOLOGY CLINIC/DIVA Appt Type: Provider: CALDWELL,LORRAINE C -------------------------------------------------------------------------------------------------------------------------------------------------Target Appt Zip Telephone Patient FMP/SSN Prio Date Type Provider Code Attempts -------------------------------------------------------------------------------------------------------------------------------------------------STANTON,INA 01/0407 2 12Oct01 RET CALDWELL,LORRA 12204 0 STANTON,ALLEN 01/0407 2 12Oct01 NEW CALDWELL,LORRA 12204 0 SANDERS,ALLAN A 20/6501 6 20Jun01 RET CALDWELL,LORRA 22101 0 SANDERS,BARBARA B 20/6601 6 20Jun01 RET CALDWELL,LORRA 21201 0 SANDERS,CHARLES C 20/6701 6 20Jun01 RET CALDWELL,LORRA 22040 0 SANDERS,DONNA D 20/6801 6 20Jun01 RET CALDWELL,LORRA 22030 0 SANDERS,EARL E 20/6901 6 20Jun01 RET CALDWELL,LORRA 22030 0 SANDERS,FLORENCE F 20/7001 6 20Jun01 RET CALDWELL,LORRA 22101 0 + SANDERS,GEORGE G 20/7101 6 20Jun01 RET CALDWELL,LORRA 21201 0 -------------------------------------------------------------------------------------------------------------------------------------------------Select (A)ll, (I)ndividual patient, (H)ardcopy, or (Q)uit processing: Q Notes: • The status of slots can be changed to Wait List reserved for schedules that are currently open for appointment booking or schedules that are in HOLD status. PAS PRINT WAIT LIST HOLD/RELEASE SCHEDULES SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides • Wait List reserved slots not booked within the defined automatic release time are released for open booking after the user-defined number of days specified in the Clinic Profile. PROBLEM AVOIDANCE REPORT The Problem Avoidance Report (PAR) option allows you to generate eight integration reports. Each report focuses on different areas of schedule management. The PAR is sorted by department and clinic and may be ordered for a specific clinic, a specific division, or the entire facility. MENU PATH: PAS System Menu ➔ Scheduling Supervisor Menu ➔ MGRM ➔ PMGR ➔ 2 (Problem Avoidance Report (PAR)) • Pending Appointments and Missing Providers Report - Lists all pending appointments and missing providers that must be updated before the statistical reports. These include Cancellation Statistics, Clinic Workload, Command Facility Workload Recap, Monthly Statistical and No Show Statistical. • Wait List Mailer No Shows Report - Lists patients who received Wait List mailers informing them of their scheduled appointments, but were No Shows. Only clinics that have scheduling deficiencies appear in the PAR. The Problem Avoidance Report (PAR) contains the following eight reports: • Appointment Orders for Inpatients Not Processed Report - Lists orders that were entered through the Order Entry, but have not been acted upon as of this report date. 4-100 • Cancelled Appointment Slots Report - Lists all appointment slots cancelled by the facility where the patient has not been notified by phone or mail as of this report date. • Frozen Slots Report - Lists all frozen slots that fall within the window defined by the appointment date and the clinic-defined schedule hold duration as specified in the clinic profile. • Schedule Deficiencies Report - Lists clinics and providers that need additional schedules created. • Open Schedules Report - Lists schedules that have been created but not yet opened for booking. PAS PROBLEM AVOIDANCE REPORT SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides • Wait List Status Report - Lists the total number of patients on the Wait List for each clinic along with the number of restricted status slots (Wait) being withheld from general booking for Wait List processing. PROCESS APPOINTMENT ORDERS The Appointment Order Processing option allows you to transfer orders entered through the Order Entry functionality interface between the Clinical and PAS subsystems. This option electronically transfers appointment information to appropriate patient care plans and sends electronic mail bulletins to the order location providers notifying them whether requested appointments were booked. MENU PATH: PAS System Menu ➔ Clerk Scheduling Menu ➔ AOP Do you want to process all clinics? NO// (NO) Select Clinic: INTERNAL MEDICINE CLINIC Start Date: 21 JUNE (21 Jun 2001) Stop Date: 28 JUNE (28 Jun 2001 ) CLINIC (C) - TR BAAA 4-101 PROCESS APPOINTMENT ORDERS SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides PAS PROCESS APPOINTMENT ORDERS (continued) APPOINTMENT ORDER PROCESSING Division: DIV A - TRAINING HOSPITAL Clinic: INTERNAL MEDICINE CLINIC Date Range: 21 Jun 2001 to 21 Jun 2001 Patient Req Appt. Date Prio Req Clinic Requesting Provider ====================================================================== KIMBALL,GEORGE G 21 Jun 2001 1 INTERNAL M HARTMAN,CHRIS KIMBALL,IAN I 21 Jun 2001 2 INTERNAL M HARTMAN,CHRIS * KIMBALL,JACKIE J 25 Jun 2001 1 INTERNAL M HARTMAN,CHRIS APPOINTMENT ORDER PROCESSING Patient: KIMBALL,JACKIE J FMP/SSN: 20/300-30-7418 Category: USAF ACTIVE DUTY ORDER #: 010620-00556 Home Phone: WORK PHONE: ====================================================================== Requested Appointment Date: 21 Jun 2001 Requested Provider: HARTMAN, CHRIS Requested Appointment Type: INPT Reason for Request: TEACHING Requested Clinic: INTERNAL MEDICINE CL Requested Clinic MEPRS Code: BAAA ORDERING PROVIDER: HARTMAN, CHRIS 4-102 ====================================================================== Use <Select> to select orders to process or Book. __________________________________________________________________________ Select (B)ook Request, (D)elete Request, (N)ext Request, (Q)uit: B// <Return> Want to Schedule Appt. Requests that you have marked ? YES// <Return> PROCESS APPOINTMENT ORDERS SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides PAS PROCESS APPOINTMENT ORDERS (continued) ORDER BOOKING SEARCH CRITERIA Patient: KIMBALL,JACKIE J FMP/SSN: 20/300-30-7418 Clinic: INTERNAL MEDICINE CLINIC/DIVA Appt. Type: INPATIENT CONSULT Clinic Phone: 202 427-4781 Provider: ALLEN,ERWIN Service: Time Range: 0001 to 2400 Duration: Dates: 21 Jun 2001 to 28 Jun 2001 Days of Week: ==================================================== Order Number: 900620-00556 Reason for appointment: TEACHING ==================================================== Select (C)hange Search Criteria, (B)rowse, (S)ingle Patient, (W)ait List Add, or (Q)uit: S// S 4-103 SINGLE PATIENT BOOKING Patient: KIMBALL,JACKIE J FMP/SSN: 20/300-30-7418 Clinic: INTERNAL MEDICINE CLINIC/DIVA Appt. Type: INPATIENT CONSULT Clinic Phone: 202 427-4781 Provider: ALLEN,ERWIN Service: Time Range: 0001 to 2400 Duration: Dates: 21 Jun 2001 to 28 Jun 2001 Days of Week: ==================================================== * MON 0700 25 Jun 01 INPT 1/0 MON 0745 25 Jun 01 INPT 1/0 MON 1700 25 Jun 01 INPT 1/0 MON 1715 25 Jun 01 INPT 1/0 MON 1730 25 Jun 01 INPT 1/0 MON 1745 25 Jun 01 INPT 1/0 MON 1800 25 Jun 01 INPT 1/0 MON 1815 25 Jun 01 INPT 1/0 + MON 1830 25 Jun 01 INPT 1/0 ==================================================== Use <Select> to select appointment(s) to be booked. PROCESS APPOINTMENT ORDERS SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides PAS PROCESS APPOINTMENT ORDERS (continued) Patient Appointment: KIMBALL,JACKIE J FILE APPOINTMENT Patient: KIMBALL,JACKIE J FMP/SSN: 20/300-30-7418 Clinic: INTERNAL MEDICINE CLINIC/DIVA Appt. Type: INPATIENT CONSULT Clinic Phone: 202 427-4781 Provider: ALLEN,ERWIN Service: Time Range: 0001 to 2400 Duration: Dates: 21 Jun 2001 to 28 Jun 2001 Days of Week: ==================================================== MON 0700 25 Jun 01 INPT 1/0 ==================================================== Select (B)ook appt, (S)kip appt, or (Q)uit File Appointment: B// <Return> FILE APPOINTMENT MON 0700 25 Jun 01 INPT 1/O No reminder notice will be sent. Hand-carry Radiology/Patient records. Clinic Message: Clinic/Appt Type Instructions: Provider Message: Provider/Appt Type Instructions: Arrival Message: minutes Registration Comment: 4-104 MEPRS Code: BAAA Requesting Service: Referred By: Send Reminder Notice: NO Appointment comment: Reason for Appointment: TEACHING File changes and exit Order/Entry Request Booked ====================================================================== Want to edit (M)ini, (F)ull, or (N)o Registration: N// <Return> PROCESS APPOINTMENT ORDERS SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides PAS PROCESS APPOINTMENT ORDERS (continued) Patient Appointment: KIMBALL,JACKIE J FILE APPOINTMENT Patient: KIMBALL,JACKIE J FMP/SSN: 20/300-30-7418 Clinic: INTERNAL MEDICINE CLINIC/DIVA Appt. Type: INPATIENT CONSULT Clinic Phone: 202 427-4781 Provider: ALLEN,ERWIN Service: Time Range: 0001 to 2400 Duration: Dates: 21 Jun 2001 to 28 Jun 2001 Days of Week: ==================================================== MON 0700 25 Jun 01 INPT 1/0 ==================================================== Select (B)ook appt, (S)kip appt, or (Q)uit File Appointment: B// <Return> FILE APPOINTMENT MON 0700 25 Jun 01 INPT 1/O No reminder notice will be sent. Hand-carry Radiology/Patient records. Clinic Message: Clinic/Appt Type Instructions: Provider Message: Provider/Appt Type Instructions: Arrival Message: minutes Registration Comment: 4-105 MEPRS Code: BAAA Requesting Service: Referred By: Send Reminder Notice: NO Appointment comment: Reason for Appointment: TEACHING File changes and exit Order/Entry Request Booked ====================================================================== Want to edit (M)ini, (F)ull, or (N)o Registration: N// <Return> PROCESS APPOINTMENT ORDERS SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides PAS PROCESS APPOINTMENT ORDERS (continued) SINGLE PATIENT BOOKING Patient: KIMBALL,JACKIE J FMP/SSN: 20/300-30-7418 Clinic: INTERNAL MEDICINE CLINIC/DIVA Appt. Type: INPATIENT CONSULT Clinic Phone: 202 427-4781 Provider: ALLEN,ERWIN Service: Time Range: 0001 to 2400 Duration: Dates: 21 Jun 2001 to 28 Jun 2001 Days of Week: ==================================================== Notes: • If no appointments are available in the clinic and stop and start dates you select, you will receive a message back stating no appointments be found for that particular clinic for those dates. • If there are no available appointments for your selected patient(s) on a particular date(s), you may put your patient(s) on the Wait List if that clinic has a Wait List and the Wait List has been activated in the Clinic Profile. ==================================================== Remind patient of other appointments/Wait List requests? Yes// N 4-106 Order/Request Successfully booked as appt # 1397 on 21 Jun 2001@1710 REMOVING ORDER REQUEST FROM PROCESSING LIST FOR Patient Req Appt. Date Prio Req Clinic Requesting Provider ================================================ * KIMBALL,JACKIE J 25 Jun 2001 9 INTERNAL M HARTMAN,CHRIS ================================================ Press <Return> to continue PROCESS APPOINTMENT ORDERS SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides PAS SCHEDULE CREATION FOR WAIT LIST PROCESSING The Create Schedules option also allows you to create, open, and print provider schedules with or without templates specifically for Wait List processing and general appointment booking. MENU PATH: PAS System Menu ➔ Scheduling Supervisor Menu ➔ SCHE ➔ CSCH Select Clinic: CAST CLINIC BEBA CAST CLINIC CLINIC Select Provider Name: CALHOUN,CRAIG M 237821644 OK? YES// <Return> Schedule Start Date: 22 Oct 2001// <Return> 23 Oct 2001 TUESDAY Schedule Stop Date: 22 Oct 23 Oct 2001 TUESDAY Create schedule using templates? YES// <Return> 4-107 Select Template I.D.: TUE CALHOUN STANDARD Another: <Return> Week of 22 Oct 2001 MON TUE WED THU FRI SAT SUN X … SCHEDULE IS BEING FILED. PLEASE WAIT… < Schedule created for 22 Oct 2001 to 22 Oct 2001 > PAS SCHEDULE CREATION FOR WAIT LIST PROCESSING SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides Is this schedule correct? YES// <Return> SCHEDULE CREATION FOR WAIT LIST PROCESSING (continued) Clinic: CAST CLINIC/DIVA Provider: CALHOUN,CRAIG M. Display schedule? NO// <Return> Select (O)pen Schedules, (H)old for Future Release, (W)ait List Schedules: O// W Enter the date to AUTOMATICALLY change the schedule segment of >>> TUESDAY 22 Oct 2001 to TUESDAY 22 Oct 2001 <<< from WAIT to OPEN: 24 Jun 2001// <Return> [SUNDAY 24 Jun 2001] OK? Y: <Return> …SCHEDULE IS BEING WAIT LISTED. PLEASE WAIT… 4-108 < SCHEDULE WAIT LISTED FROM 23 Oct 2001 TO 23 Oct 2001 Display Schedule? YES// N Select (I)nteractive-Phone OR Mailer, (A)utomatic Wait List, or (Q)uit: I// <Return> WAIT LIST PROCESSING SEARCH CRITERIA Clinic: CAST CLINIC/DIVA Provider: CALHOUN,CRAIG M. WAIT LIST PROCESSING BY PRIORITY PAS 520 Appt Type: ------------------------------------------------------------------------------------------------------------------------- ----------------------- Target Appt Zip Telephone Patient FMP/SSN Prio Date Type Provider Code Attempts ====================================================================== ADAMS,ALLAN A 20/6536 2 22Jun 01 NEW CALHOUN,CRAIG 1 SAWYER,ALLAN A 20/6502 2 22Jun 01 NEW CALHOUN,CRAIG 92122 0 SCHMIDT,ALLAN A 20/6503 2 22Jun 01 RET CALHOUN,CRAIG 92122 0 SIMPSON,ALLAN A 20/6506 6 22Jun 01 RET CALHOUN,CRAIG 21013 0 SANDERS,BARBARA B 20/6601 6 20Jun 01 RET CALHOUN,CRAIG 92106 0 SANDERS,CHARLES C 20/6701 6 20Jun 01 RET CALHOUN,CRAIG 92106 0 SANDERS,DONNA D 20/6801 6 20Jun 01 RET CALHOUN,CRAIG 92106 0 SANDERS,EARL E 20/69011 6 20Jun 01 RET CALHOUN,CRAIG 92106 0 SANDERS,FLORENCE F 20/7001 6 20Jul 01 RET CALHOUN,CRAIG 92106 0 ======================================================================== Select (A)ll, (I)ndividual patients, (H)ardcopy, or (Q)uit processing: I PAS 520 Appt Type: ------------------------------------------------------------------------------------------------------------------------------------------------ ====================================================================== Sort by (P)riority, (E)ntered or (T)arget Date, (N)ame, or (Q)uit sort: P// <Return> Select Priority From: FIRST// <Return> Select Priority To: LAST// <Return> PAS SCHEDULE CREATION FOR WAIT LIST PROCESSING SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides Target Appt Zip Telephone Patient FMP/SSN Prio Date Type Provider Code Attempts ====================================================================== SCHEDULE CREATION FOR WAIT LIST PROCESSING (continued) WAIT LIST BOOKING SEARCH CRITERIA NOTIFICATION PROCESSING DIVISION: DIV A - TRAINING HOSPITAL PATIENT: SAWYER,ALLAN A FMP/SSN: 20/600-60-6502 SPONSOR: SAWYER,ALLAN A DUTY PHONE: AGE: 26 ------------------------------------------------------------------------------------------------------------------------------------------------ HOME PHONE: 222-2345 WAIT LIST REQUEST: 22 Jun 01 TIME RANGE: 0001 TO 2400 WAIT LIST COMMENT: REASON FOR APPOINTMENT: WORK PHONE: 222-1234 NEW LAST CALHOUN,CRAIG M. DAYS OF WEEK: M TU W TH F PRIORITY: 2 ZIP CODE: 92122 CONTACT ATTEMPTS DATE@TIME (Yes/No) ======================================================================== 4-109 ======================================================================== Select (T)elephone/No Mailer, (M)ailer/Appointment-No Contact, (D)elete, or (Q)uit Processing: T Was patient contacted: NO// Y Select Book (R)egular, (M)ore, or (Q)uit telephone: R// <Return> Patient: SAWYER,ALLAN A Clinic: CAST CLINIC/DIVA Clinic Phone: 202 427-4281 Provider: CALHOUN,CRAIG M. Time Range: 0001 to 2400 Dates: 22 Jun 2001 to 03 Aug 2001 FMP/SSN: 20/600-60-6502 Appt Type: NEW PATIENT Service: Duration: Days of Week: M TU W TH F ------------------------------------------------------------------------------------------------------------------------------------------------ Wait List Comment: Wait List Priority: 2 Wait List Target Date: 22 Jun 01 Wait List Entry Date: 21 Jun 2001 Reason for Appointment: ====================================================================== Select (C)hange Search Criteria, (B)rowse, (S)ingle Patient, or (Q)uit: S// <Return> (The system now enters the Single Patient Booking function. When booking is complete, the Notifications Processing Screen is displayed--See Notes.) SCHEDULE CREATION FOR WAIT LIST PROCESSING SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides PAS SCHEDULE CREATION FOR WAIT LIST PROCESSING (continued) NOTIFICATION PROCESSING DIVISION: DIV A - TRAINING HOSPITAL PATIENT: FMP/SSN: SPONSOR: DUTY PHONE: • The system automatically books slots from the Wait List and generates the mailers informing the patient(s) of the scheduled appointment(s). This normally occurs at 2000 hours nightly. AGE: --------------------------------------------------------------------------------------------------------------------------- -------------------- HOME PHONE: WAIT LIST REQUEST: TIME RANGE: TO WAIT LIST COMMENT: REASON FOR APPOINTMENT: WORK PHONE: DAYS OF WEEK: PRIORITY: ZIP CODE: CONTACT ATTEMPTS DATE@TIME (Yes/No) ====================================================================== • The Wait List status is only available when Wait List requests already exist for the clinic with the newly created schedule. • In order for a clinic to have a Wait List, the Wait List Activated field in the Clinic Profile must be set to YES. • If slots have been designated as Wait, they will not be available for regular appointment booking. • The system automatically enters Single Patient Booking so that the patient can be booked to a newly created schedule slot for Wait List processing. Refer to QRG: Book Appointments for a Single Patient. 4-110 ============== All Wait List requests SELECTED have been processed ============== Notes: • The (W)ait List Schedules function designates schedule slots with a status of Wait. Another action bar appears requesting you to Select (I)nteractive-Phone OR Mailer, (A)utomatic Wait List, or (Q)uit. • (A)utomatic Wait List allows the system to book appointments automatically on the Wait Listed schedule and generate mailers. When automatic processing is selected, the date range of the schedule must be at least seven days from the processing date. PAS SCHEDULE CREATION FOR WAIT LIST PROCESSING SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides • Selecting (I)nteractive-Phone OR Mailer allows you to book Wait List requests for this clinic and notify the patient(s) by either telephone or mailer. SPLIT AN APPOINTMENT SLOT AND BOOK ONE OF THE MODIFIED SLOTS This Split Slot action allows you to split one Open schedule slot into two separate slots with shorter durations. MENU PATH: PAS System Menu ➔ Clerk Scheduling Menu ➔ BOK SINGLE PATIENT BROWSE SEARCH CRITERIA Patient: FMP/SSN: Clinic: Provider: Date: 21 Jun 2001 ====================================================================== BOOKING SEARCH CRITERIA Patient: FMP/SSN: Clinic: Appt. Type: Clinic Phone: Provider: Specialty: Time Range: 0001 to 2400 Duration: Dates: 21 Jun 2001 to 02 Aug 2001 Days of Week: ====================================================================== 4-111 ====================================================================== Select (C)hange Search Criteria, (B)rowse, (S)ingle Patient, (W)ait List Add, (M)ultiple Clinic, (F)amily, or (Q)uit: C// B ====================================================================== Select (C)hange Search Criteria, (S)earch Schedule, or (Q)uit: BROWSE: C// <Return> SINGLE PATIENT BROWSE SEARCH CRITERIA Patient: FMP/SSN: Clinic: Provider: Date: 21 Jun 2001 ====================================================================== * Clinic * Provider * Date Patient Default Search Criteria Select Provider: CALDWELL,LORRAINE C Date: 27 Jun 2001 PAS SPLIT AN APPOINTMENT SLOT AND BOOK ONE OF THE MODIFIED SLOTS SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides ====================================================================== Select Clinic: ACARDI __________________________________________________________________________ SPLIT AN APPOINTMENT SLOT AND BOOK ONE OF THE MODIFIED SLOTS (continued) SINGLE PATIENT BROWSE SEARCH CRITERIA Patient: FMP/SSN: Clinic: CARDIOLOGY CLINIC/DIVA Provider: CALDWELL,LORRAINE C. Date: 27 Jun 2001 ====================================================================== * Clinic * Provider * Date Patient Default Search Criteria 4-112 ====================================================================== Select (C)hange Search Criteria, (S)earch Schedule, or (Q)uit: BROWSE: S// <Return> SINGLE PATIENT BROWSE Patient: FMP/SSN: Clinic: CARDIOLOGY CLINIC/DIVA Clinic Phone: 202 427-4181 Provider: CALDWELL,LORRAINE C. Date: 27 Jun 2001 ====================================================================== WED 0700 27 Jun 01 NEW 1/0 60 MIN OPEN WED 0800 27 Jun 01 NEW 1/0 60 MIN OPEN WED 0 900 27 Jun 01 MULTI 3/1 30 MIN OPEN WED 0930 27 Jun 01 MULTI 3/0 30 MIN OPEN WED 1000 27 Jun 01 RET 1/0 30 MIN OPEN WED 1030 27 Jun 01 FU 1/0 30 MIN OPEN WED 1100 27 Jun 01 RET 1/0 30 MIN OPEN WED 1130 27 Jun 01 FU 1/0 30 MIN OPEN WED 1300 27 Jun 01 NEW 1/0 60 MIN OPEN WED 1400 27 Jun 01 MULTI 3/0 30 MIN OPEN + WED 1430 27 Jun 01 RET 1/0 30 MIN OPEN ====================================================================== Select one slot to Change, Split, Book, or Overbook. Select multiple consecutive slots to Join. SPLIT AN APPOINTMENT SLOT AND BOOK ONE OF THE MODIFIED SLOTS SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides PAS SPLIT AN APPOINTMENT SLOT AND BOOK ONE OF THE MODIFIED SLOTS (continued) APPOINTMENT SLOTS: 1 SINGLE PATIENT BROWSE - CHANGE WED 0800 27 Jun 01 NEW SINGLE PATIENT BROWSE 4-113 Patient: FMP/SSN: Clinic: CARDIOLOGY CLINIC/DIVA Provider: CALDWELL,LORRAINE C. Date: 27 Jun 2001 ====================================================================== WED 0700 27 Jun 01 NEW 1/0 60 MIN OPEN * WED 0800 27 Jun 01 NEW 1/0 60 MIN OPEN WED 0 900 27 Jun 01 MULTI 3/1 30 MIN OPEN WED 0930 27 Jun 01 MULTI 3/0 30 MIN OPEN WED 1000 27 Jun 01 RET 1/0 30 MIN OPEN WED 1030 27 Jun 01 FOL 1/0 30 MIN OPEN WED 1100 27 Jun 01 RET 1/0 30 MIN OPEN WED 1130 27 Jun 01 FOL 1/0 30 MIN OPEN WED 1300 27 Jun 01 NEW 1/0 60 MIN OPEN WED 1400 27 Jun 01 MULTI 3/0 30 MIN OPEN + WED 1430 27 Jun 01 RET 1/0 30 MIN OPEN ====================================================================== Select (C)hange, (S)plit, (B)ook, (V)iew, or (Q)uit: S Clinic: Provider: Division: Booked appointments: Maximum overbooks allowed: Duration: Day of Week: Appointment Slot Status: 1/0 30 MIN OPEN CARDIOLOGY CLINIC/DIVA CALDWELL,LORRAINE C. DIVA-TRAINING HOSPITAL 30 minutes WED OPEN Appointment Type: FOL Number of patients: 1 Appointment Slot Comment: SPLIT SLOT File changes and exit. SPLIT AN APPOINTMENT SLOT AND BOOK ONE OF THE MODIFIED SLOTS SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides PAS SINGLE PATIENT BROWSE - ADD SPLIT AN APPOINTMENT SLOT AND BOOK ONE OF THE MODIFIED SLOTS (continued) WED 0830 27 Jun 01 Clinic: Provider: Division: Booked appointments: Maximum overbooks allowed: Duration Day of Week: Appointment Slot Status: CARDIOLOGY CLINIC/DIVA CALDWELL,LORRAINE C. minutes WED OPEN 4-114 Appointment Type: EVAL Number of patients: 1 Referred By: Appointment SLOT Comment: SPLIT SLOT SINGLE PATIENT BROWSE Patient: FMP/SSN: Clinic: CARDIOLOGY CLINIC/DIVA Provider: CALDWELL,LORRAINE C. Date: 27 Jun 2001 ===================================================================== WED 0700 27 Jun 01 NEW 1/0 60 MIN OPEN WED 0730 27 Jun 01 NEW 1/0 60 MIN OPEN * WED 0800 27 Jun 01 MULTI 3/1 30 MIN OPEN SPLIT SLOT * WED 0815 27 Jun 01 MULTI 3/0 30 MIN OPEN SPLIT SLOT WED 0900 27 Jun 01 RET 1/0 30 MIN OPEN WED 0930 27 Jun 01 FOL 1/0 30 MIN OPEN WED 1000 27 Jun 01 RET 1/0 30 MIN OPEN WED 1030 27 Jun 01 FOL 1/0 30 MIN OPEN WED 1100 27 Jun 01 NEW 1/0 60 MIN OPEN WED 1130 27 Jun 01 MULTI 3/0 30 MIN OPEN + WED 1300 27 Jun 01 RET 1/0 30 MIN OPEN ====================================================================== Select (J)oin, (B)ook, (V)iew, or (Q)uit: B Select Patient Name: SANDERS,ALLAN File changes and exit. SPLIT AN APPOINTMENT SLOT AND BOOK ONE OF THE MODIFIED SLOTS SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides PAS SPLIT AN APPOINTMENT SLOT AND BOOK ONE OF THE MODIFIED SLOTS (continued) DEMOGRAPHICS DISPLAY Name: SANDERS, ALLAN A Patient Category: USA AD OFFICER Patient Type: MCP Status: ACV: Direct Care: ELIGIBLE FMP/SSN: DDS: Sex: DOB/Age: DMIS ID: Medicare: 20/600-60-6501 MALE 16 Mar 1975/26Y FILE APPOINTMENT Patient: SANDERS,ALLAN FMP/SSN: 20/600-60-6501 Clinic: CARDIOLOGY CLINIC/DIVA Clinic Phone: 202 427-4181 Provider: CALDWELL,LORRAINE C. Date: 27 Jun 2001 ====================================================================== WED 0800 27 Jun 03 RET 1/0 30 MIN OPEN SPLIT SLOT WED 0830 27 Jun 03 RET 1/0 30 MIN OPEN SPLIT SLOT NOT ELIGIBLE -------------------- 4-115 Sponsor Name: Station/Unit: Home Address: City: ZIP Code: Duty Phone: Registration Comment: Last Registration Date: Outpatient Record Room: MCP Enroll Date: Primary Care Manager: Primary OHI: SANDERS, ALLAN A Rank: Research Mgmt Washington DSN: 123 ELM ST. SAN DIEGO State: 92122 Home Phone: 222-1234 Work Phone: CAPTAIN ============================ Select Slot #1 of 2 ============================ Select (D)elete/Print appointment orders/Wait List requests, (B)ook appt, (S)kip appt, (V)iew, or (Q)uit FILE APPOINTMENT: S CALIFORNIA 222-2345 222-1234 11 Nov 1999@0736 NOT ASSIGNED End Enroll Date: PCM Phone: Case Mgmt: ------------------------------------------------------------------------------------------------------------------------------------------------ Select (F)ull, (M)ini, (N)ew Patient, (C)ontinue, or (Q)uit DEMO: C// <Return> SPLIT AN APPOINTMENT SLOT AND BOOK ONE OF THE MODIFIED SLOTS SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides PAS SPLIT AN APPOINTMENT SLOT AND BOOK ONE OF THE MODIFIED SLOTS (continued) PATIENT APPOINTMENT: SANDERS,ALLAN WED 0830 27 Jun 01 RET FILE APPOINTMENT Patient: SANDERS,ALLAN FMP/SSN: 20/600-60-6501 Clinic: CARDIOLOGY CLINIC/DIVA Provider: CALDWELL,LORRAINE C Date: 27 Jun 2001 ====================================================================== + WED 0830 27 Jun 03 RET 1/0 30 MIN OPEN SPLIT SLOT 30 MIN OPEN SPLIT SLOT Hand-carry Patient records. Clinic Message: Clinic/Appt. Type Instructions: Provider Message: Provider/Appt. Type Instructions: Arrival Message: 10 minutes Registration Comment: MEPRS Code: BACA Requesting Service: Referred By: Send Reminder Notice: NO Appointment Comment: Reason for Appointment: ============================ Select Slot #2 of 2 ============================ Select (D)elete/Print appointment orders/Wait List requests, (B)ook appt, (S)kip appt, (V)iew, or (Q)uit FILE APPOINTMENT: B 4-116 ASK FOR HELP = HELP 1/0 FILE APPOINTMENT SCREEN EXIT = F10 File changes and exit. SPLIT AN APPOINTMENT SLOT AND BOOK ONE OF THE MODIFIED SLOTS SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides PAS SPLIT AN APPOINTMENT SLOT AND BOOK ONE OF THE MODIFIED SLOTS (continued) SINGLE PATIENT BROWSE SEARCH CRITERIA Patient: SANDERS,ALLAN FMP/SSN: 20/600-60-6501 Clinic: CARDIOLOGY CLINIC/DIVA Clinic Phone: Provider: CALDWELL,LORRAINE C. Date: 27 Jun 2001 ====================================================================== Notes: • When you split a slot, the system allows you to change the appointment type originally designated for this slot. • You can specify a different appointment type for each of the two newly created slots to accommodate your scheduling requirements. • Before the system allows you to change an appointment type, it verifies that the appointment type specified for the newly split slot is valid for the schedule’s provider. • If the appointment type specified is not currently set up in the provider’s profile, the system will not allow you to change the appointment type. 4-117 ====================================================================== Select (C)hange Search Criteria, (S)earch Schedule, or (Q)uit BROWSE: C// Q • In addition to changing the appointment type, the system will allow you to enter a slot comment that will be used for both new slots. BOOKING SEARCH CRITERIA Patient: SANDERS,ALLAN FMP/SSN: 20/600-60-6501 Clinic: CARDIOLOGY CLINIC/DIVA Provider: CALDWELL,LORRAINE C. Date: 27 Jun 2001 ====================================================================== Device: [device] Right Margin: 80// <Return> PAS SPLIT AN APPOINTMENT SLOT AND BOOK ONE OF THE MODIFIED SLOTS SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides ====================================================================== Remind patient of other appointments/Wait List requests? Yes// <Return> __________________________________________________________________________ TELEPHONE CONSULTS The Telephone Consult option integrates the PAS and Clinical software. It allows a user to create a new telephone consult for a patient with a specific provider in a clinic, review and/or update existing telephone consults, redirect an existing telephone consult that has not yet been read to a different provider in the same clinic, print the telephone consult for the provider, or delete an existing telephone consult that has not been read by the provider. MENU PATH: PAS System Menu ➔ Clerk Scheduling Menu ➔ USV ALTERNATE MENU PATH: PAS System Menu ➔ Clerk Scheduling Menu ➔ BOK • Select the (T)el-Consult action: T • Save the default selection criteria. CLERK ENTRY: 21 Jun 2001@1024TELEPHONE-CONSULTATION Patient: SANDERS,ALLAN A FMP/SSN: 20/600-60-6501 Home Phone: 703-555-9001 Duty Phone: 202-555-6802 Work Phone: 202-555-6802 Provider: ADDAMS,HENRY W Outpatient Volume: =============================================================== Clinic: GENERAL MEDICINE CLINIC MEPRS Code: Clerk’s Note: Clerk Name: MCP, FMF Date/Time: 21 Jun 2001@1024 THE NOTE IS ENTERED HERE. • Select the (C)hange the TEL-CON criteria action: <Return> 4-118 • Select the Clinic criterion: <Select> • Activate the selection: <Return> Ask for Help = HELP Screen Exit = F10 File/Exit = DO INSERT OFF • Select the clinic: [clinic name] • Select the (C)hange the TEL-CON criteria action: <Return> Quick Reference Guides • Activate the selections: <Return> • Select and confirm patient name: [name] • File the data. • Confirm the default MEPRS code. • Pull the patient’s medical record? Yes or No • Select the (C)ontinue action from the Demographics Display screen. • Select and confirm the provider: [provider] PAS TELEPHONE CONSULTS SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 • Mark all criteria except Clinic. • Complete the Clerk’s note. TELEPHONE CONSULTS (continued) To redirect an existing telephone consult to another provider in the same clinic: To add a note to an existing telephone consult: • Select the (R)edirect action: R 4-119 TELEPHONE-CONSULTATION SEARCH CRITERIA Patient: SANDERS,ALLAN A FMP/SSN: 20/600-60-6501 Clinic: GENERAL MEDICINE CLINIC/DIVA Appt Type: TELEPHONE CONSULT Clinic Phone: 202-427-7112 Provider: ADDAMS, HENRY W Service: Time Range: 2118 to 2118 Duration: Dates: 21 Jun 2001 to 21 Jun 2001 Days of Week: ----------------------------------------------------------------------------------------------------------------------------------------------- TELEPHONE-CONSULTATION SEARCH CRITERIA Patient: SANDERS,ALLAN A FMP/SSN: 20/600-60-6501 Clinic: GENERAL MEDICINE CLINIC/DIVA Appt Type: TELEPHONE CONSULT Provider: ADDAMS, HENRY W Service: Time Range: 2220 to 2220 Duration: Dates: 21 Jun 2001 to 21 Jun 2001 Days of Week: ----------------------------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------------------------Select (C)hange the TEL-CON criteria, (N)ew Patient, (A)dd, (P)rint, (V)iew, (R)edirect, (D)elete, or (Q)uit TEL-CON: A ----------------------------------------------------------------------------------------------------------------------------------------------Select (C)hange the TEL-CON criteria, (N)ew Patient, (A)dd, (P)rint, (V)iew, (R)edirect, (D)elete, or (Q)uit TEL-CON: R • Select the (A)dd action: A • Complete the Clerk’s note. • File the data. Note: This prompt will not appear if the patient’s medical record had been requested by the clerk entering the previous note. • Quit and return to the Clerk Scheduling Menu. Notes: • PAS clerks may enter telephone consults, redirect them, or update an existing telephone consult. When a clerk enters a new telephone consult or redirects an existing one, the system will display a new telephone consults notification at provider sign-on and on the provider's Clinical Desktop. When a PAS clerk creates a new telephone consult, or updates an existing telephone consult, the PAS clerk may also request that the patient's medical records be sent to the specified clinic. PAS TELEPHONE CONSULTS SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides • Pull the patient’s medical record? Yes or No. • Select and verify the new provider information: [provider] TELEPHONE CONSULTS (continued) • A completed telephone consult is considered a separate appointment and may count as a clinic visit if the provider, using the Clinical functionality, sets the workload status to count. • A PAS-initiated telephone consult will have an appointment status of OCCSVC (a non-count status) until the provider completes it. Upon completion, the appointment status changes to TEL-CON. The provider determines whether the TEL-CON will be COUNT or NON-COUNT for workload statistics. • When entering many telephone consults for a single clinic, it is recommended that you follow this time-saving procedure: 4-120 – Set up the clinic first by selecting the Clinic criterion. Enter the clinic name. • The system automatically defaults to the division of the patient's outpatient medical record room. If the patient does not have an outpatient record room entered, the following message is displayed: Records can’t be pulled. No Outpatient Record Room entered. • The Borrower is automatically set to the clinic to which the specified provider is associated. The Requested Records Division of Requestor is automatically set to the user's current division. • If the patient has no records, the system displays the message - Patient has no records - above the action bar. • A provider must be in the clinic Provider Profile and also entered as a user of the system in order to receive a telephone consult. – Re-select the (C)hange the TEL-CON criteria action from the action bar. • A receiving provider may forward the telephone consult to a provider outside of the clinic Provider Profile. When the receiving provider completes the TEL-CON, the workload is credited to the generic TELCON, PROVIDER. – Select the Patient, Provider, and Default Search Criteria options. Enter the appropriate information for the Patient and Provider options. • Every provider who will be receiving telephone consults requires the TCON* appointment type in the Provider Profile. – Select to Save the Default Search Criteria. The Pull Patient’s Medical Record Prompt • When a user responds YES to the - Do you want the patient's medical record pulled? - prompt, the system goes directly into the Medical Record Tracking functionality. From here the user requests the specified patient's medical record. PAS TELEPHONE CONSULTS SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides This procedure will preset the system to prompt the user for the Patient and Provider information ONLY each time a new telephone consult search is initiated. UNANSWERED TELEPHONE CONSULTS - Allows you to view all previously entered clerk notes for an existing telephone consult. This action is helpful when following-up on a previously entered telephone consult. (R)edirect - Allows you to redirect an unanswered telephone consult to another provider in the same clinic. The (R)edirect action does not appear on the “smart action bar” if the telephone consult has been read by the specified provider. (D)elete - Allows you to delete a telephone consult. A consult may be deleted only if it has not yet been read by the specified provider. The (D)elete action does not appear on the “smart action bar” if the telephone consult has been read by the specified provider. (Q)uit TEL-CON - Allows you to quit the Telephone Consult process and return to the Unscheduled Visit Search Criteria screen. ALTERNATE MENU PATH: PAS System Menu ➔ Clerk Scheduling Menu ➔ USV PAS clerks may generate a list of old unanswered telephone consults by clinic, provider, or patient for a specific date range by accessing option 8 on the Operational Reports (ORM) Menu. Refer to Quick Reference Guide: Unanswered Telephone Consults Report, for more information. Unanswered telephone consults are those which the provider has not read or completed. The provider may read a telephone consult without completing it. The provider may print the message and save it until the patient's medical record arrives. 4-121 If, after entering the search criteria, the system locates an unanswered telephone consult, the Telephone Consultation Search Criteria action bar displays with the following actions: Quick Reference Guides (C)hange the TEL-CON criteria - Allows you to change the search criteria. (N)ew Patient - Allows you to enter a telephone consult for a new patient with the selected provider and clinic information. (A)dd - Allows you to update an existing telephone consult. Each new set of clerk notes will show on the view action. Previously entered clerk notes cannot be edited. (P)rint - Allows you to print the existing telephone consult to an output device for the specified provider. PAS UNANSWERED TELEPHONE CONSULTS SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 (V)iew MENU PATH: PAS System Menu ➔ Clerk Scheduling Menu ➔ BOK THE UNANSWERED TELEPHONE CONSULTS REPORT The Unanswered Telephone Consult Report by Patient - This report lists the clinic, provider, date/time of the initial telephone consult, and the status (i.e., updated, new, read) for each unanswered telephone consult for the patient. The Unanswered Telephone Consults Report (8) option is located on the Operational Reports Menu. MENU PATH: PAS System Menu ➔ Clerk Scheduling Menu ➔ ORM ➔ 10 This report is also located on the Problem Avoidance Reports Menu located on the Management Reports Menu. ALTERNATE MENU PATH: PAS System Menu ➔ Scheduling Supervisor Menu ➔ MGRM ➔ PMGR ➔ 4 4-122 This report is used to generate a list of unanswered telephone consults by clinic, provider or patient. Individual sites can set the Site Parameters to determine the number of days before an unanswered telephone consult becomes “old.” Unanswered Telephone Consult Report by Clinic - This report lists the patient name, FMP/SSN, date/time of the initial telephone consult, and the status (i.e., updated, new, read) for each unanswered telephone consult by individual provider within the specified clinic. This report also gives the total number of unanswered Telephone Consults by provider and by clinic. This report also gives the number of unanswered Telephone Consults for the specified provider by clinic and then the total number of unanswered telephone consults for the specified provider in all the clinics. PAS THE UNANSWERED TELEPHONE CONSULTS REPORT SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides Unanswered Telephone Consult Report by Provider - This report lists the patient name, FMP/SSN, date/time of the initial telephone consult, and the status (i.e., updated, new, read) for each unanswered telephone consult by individual clinics for the specified provider. UNSCHEDULED VISITS The Unscheduled Visit option allows you to check-in a patient for a walk-in visit, telephone consultation, and/or sick-call. If the patient is unregistered at your facility, this option allows you to register the patient. MENU PATH: PAS System Menu ➔ Clerk Scheduling Menu ➔ USV OPTION PATH: SELECT (W)alk-in ➔ SELECT Walk-In Criteria ➔ COMPLETE mini registration (optional) ➔ PROCESS walk-in criteria ➔ PRINT an encounter form (optional) 4-123 UNSCHEDULED VISIT SEARCH CRITERIA Patient: FMP/SSN: Clinic: Appt. Type: Clinic Phone: Provider: Service: Time Range: 1529 to 1529 Duration: Dates: 21 Jun 2001 to 21 Jun 2001 Days of Week: ====================================================================== WALK-IN SEARCH CRITERIA Patient: FMP/SSN: Clinic: Appt. Type: Clinic Phone: Provider: Service: Time Range: 1816 to 1816 Duration: Dates: 21 Jun 2001 to 21 Jun 2001 Days of Week: ====================================================================== Patient Clinic Provider Appointment Type Default Search Criteria ====================================================================== Use <Select> key to select SEARCH CRITERIA to be changed Quick Reference Guides Select (W)alk-In, (S)ick-Call, (T)ele-Consult, (D)EERS-Check, (Q)uit: W// <Return> Patient, Clinic, and Appointment Type are REQUIRED Select (C)hange the WALK-IN criteria, or (Q)uit WALK-IN: C// <Return> PAS UNSCHEDULED VISITS SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 ====================================================================== UNSCHEDULED VISITS (continued) WALK-IN SEARCH CRITERIA FMP/SSN: Appt. Type: Patient: Clinic: Clinic Phone: Provider: Service: Time Range: 1816 to 1816 Duration: Dates: 21 Jun 2001 to 21 Jun 2001 Days of Week: ====================================================================== * * * Patient Clinic Provider Appointment Type Default Search Criteria 4-124 ====================================================================== Select Patient Name: SABATINI,ARTHUR Are you adding SABATINI,ARTHUR as a new PATIENT? Y (YES) Sponsor Name: SABATINI,APRIL Are you adding ‘SABATINI,APRIL’ as a new SPONSOR? Y Personal Data - Privacy Act of 1974 (PL 93-579) Sponsor Name: SABATINI,APRIL Patient - Initial Information Sponsor SSN: 800-80-0706 ====================================================================== Patient Name: SABATINI,ARTHUR Patient FMP: 01 Patient DOB: 06 Jul 1980 Patient SSN: 563-56-8680 Verify SSN: 563-56-8680 Patient Pat Cat: N41 Note: At this point, the system presents the Mini Registration displays, so that both the sponsor and /or patient can be registered into CHCS. Only after registration is accomplished and a DEERS check is successfully run, will the patient continue to be checked in as a Walk-in patient. See Quick Reference Guides: Mini Registration and DEERS Check. File the changes. PAS UNSCHEDULED VISITS SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides PATIENT: SABATINI,ARTHUR Sponsor - Initial Information ====================================================================== Sponsor: SABATINI,APRIL Sponsor FMP: 20 Sponsor DOB: 26 Feb 1957 Sponsor SSN: 563-56-8682 Verify Sponsor SSN: 563-56-8682 Sponsor Pat Cat: N11 UNSCHEDULED VISITS (continued) WALK-IN SEARCH CRITERIA FMP/SSN: Appt. Type: Patient: Clinic: Clinic Phone: Provider: Service: Time Range: 1816 to 1816 Duration: Dates: 21 Jun 2001 to 21 Jun 2001 Days of Week: ====================================================================== * * * Patient Clinic Provider Appointment Type Default Search Criteria 4-125 ====================================================================== Select Patient Name: SABATINI,ARTHUR Are you adding SABATINI,ARTHUR as a new PATIENT? Y (YES) Sponsor Name: SABATINI,APRIL Are you adding ‘SABATINI,APRIL’ as a new SPONSOR? Y Personal Data - Privacy Act of 1974 (PL 93-579) Sponsor Name: SABATINI,APRIL Patient - Initial Information Sponsor SSN: 800-80-0706 ====================================================================== Patient Name: SABATINI,ARTHUR Patient FMP: 01 Patient DOB: 06 Jul 1980 Patient SSN: 563-56-8680 Verify SSN: 563-56-8680 Patient Pat Cat: N41 Note: At this point, the system presents the Mini Registration displays, so that both the sponsor and /or patient can be registered into CHCS. Only after registration is accomplished and a DEERS check is successfully run, will the patient continue to be checked in as a Walk-in patient. See Quick Reference Guides: Mini Registration and DEERS Check. File the changes. PAS UNSCHEDULED VISITS SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides PATIENT: SABATINI,ARTHUR Sponsor - Initial Information ====================================================================== Sponsor: SABATINI,APRIL Sponsor FMP: 20 Sponsor DOB: 26 Feb 1957 Sponsor SSN: 563-56-8682 Verify Sponsor SSN: 563-56-8682 Sponsor Pat Cat: N11 UNSCHEDULED VISITS (continued) WALK-IN CRITERIA Patient: FMP/SSN: 20/600-60-6501 Clinic: CARDIOLOGY CLINIC/DIVA Appt. Type: Clinic Phone: 202 427-4181 Provider: Service: Time Range: 1520 to 1520 Duration: Dates: 21 Jun 2001 to 21 Jun 2001 Days of Week: ====================================================================== • When checking in an inpatient for an unscheduled visit into an outpatient clinic, the prompt - Is this clinic visit related to inpatient episode of care? No// - is displayed. A Yes response categorizes this as a Noncount visit for the outpatient clinic and provider. A No response categorizes this as a Count visit for the outpatient clinic and provider. ====================================================================== Patient, Clinic, and Appointment Type are REQUIRED (C)hange the WALK-IN criteria, (N)ew patient, or (Q)uit WALK-IN: N// Q 4-126 Notes: • Patient, clinic, and appointment type are still required fields. • You can select Default Search Criteria when entering this option and setting up the initial search criteria. Quick Reference Guides • After you use the <Select> key to mark Patient as one of your required fields you will have the option of updating the patient’s registration information. • Provider is not required when processing walk-in patients. If you do not enter a provider during walk-in, you must include a provider during End-of-Day processing. • Before exiting the option, you may print the patient’s Encounter Form (SF 600). PAS UNSCHEDULED VISITS SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 • The USV option allows you to add and register a new patient who has never been to this facility. ADD AN AGREEMENT EXCEPTION TO A PROVIDER GROUP PROFILE The Agreement Exceptions action allows you to modify an existing group agreement for an individual provider. Notes: • The modified data affects only this provider. The original data still applies to all other participating providers. The Agreement Exception action bar contains the following actions: MENU PATH: PAS System Menu ➔ MAN ➔ PMCP ➔ INET After you access the INET option, take the following steps: Enter the provider name. Access the Agreement Maintenance action bar. Select the Agreement eXception action. Select the Edit action. 4-127 PROVIDER GROUP AGREEMENT HISTORY Provider: PRIMROSE,ZELDA C Provider Group: INDIGO MG ----------------------------------------------------------------------------------------------------------------------------------------------- • (E)dit - Edits the following agreement data for an individual provider: Effective Date, Stop Date, Overall Discount, FI Notified. • (P)articipation Status - Adds or removes a participation exception for a provider. • (S)pecialty Exceptions - Enters or edits specialty exceptions on an active agreement. • (C)PT-4 Exceptions - Enters or edits procedure exceptions on an active agreement. • Enrollment (M)ix - Enters or edits the PCM capacity of the individual provider on an active agreement. Agreement Effective Overall FI Type Date Stop Date Discount Notified Except PCM ----------------------------------------------------------------------------------------------------------------------------------------------21 Jun 2001 20 Jun 2002 CA- 10% 21 Jun 2001 * SUP Modify the data for the selected agreement. MCP ADD AN AGREEMENT EXCEPTION TO A PROVIDER GROUP PROFILE SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides Select the agreement to modify for this provider. ADD AN AGREEMENT TO A PROVIDER GROUP PROFILE Add an agreement. PROVIDER GROUP AGREEMENT HISTORY The Group Profile/Agreements option allows you to add a new group agreement. MENU PATH: PAS System Menu ➔ MAN ➔ PMCP ➔ GNET After you access this option and enter the MCP Provider Group name, the following screen displays: PROVIDER: PRIMROSE,ZELDA C Agreement Effective Overall FI Type Date Stop Date Discount Notified ----------------------------------------------------------------------------------------------------------------------------------------------NET 21 Jun 2001 21 Jun 2002 CA- 18% 21 Jun 2001 SUP <--- NEW agreement may be added here IND PROF4 INDIVIDUAL PROVIDER PROFILE Provider Group: INDIGO MG =========================================================== 4-128 Short Group ID: INDMG Tax ID#: 3948394 Provider Type: NETWORK PROVIDER GROUP Enter effective date, overall discount category code, and percentage of discount. PERIOD OF AGREEMENT: 21 Jun 2001 Provider Group: INDIGO MG ------------------------------------------------------------------------------------------------------------------------------------------------ Agreement Type 1405 DARBY STREET 20307 WASHINGTON DISTRICT OF COL Payment Contact: INEZ,AMY 202 544-0923 INTERNAL MEDCINE CLINIC Quick Reference Guides Review the Provider Group Places of Care screen and press <Next Screen> GRP AGREE2 PROVIDER GROUP OVERALL DISCOUNT Effective Date Stop Date Overall Discount FI Notified Except PCM ================================================================================= SUP 21 Jun 2001 20 Jun 2002 UC -10% Notes: • If the agreement type is the same as a previously entered agreement, the effective date of the new agreement must be later than the stop date of the previous agreement. • The CPZ AGRMOD security key is required to edit existing agreement effective dates. MCP ADD AN AGREEMENT TO A PROVIDER GROUP PROFILE SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Payment Address 1: Payment Address 2: Payment Zip: Payment City: Payment State: Payment Phone: Place of Care: Provider Group: INDIGO MG ----------------------------------------------------------------------------------------------------------------------------------------------- APPOINTMENT REFERRAL BOOKING The Appointment Referral Booking option allows you to generate and book specialized health care appointment referrals for both enrolled and non-enrolled patients to both MTF and non-MTF health care providers. MENU PATH: PAS System Menu ➔ MAN ➔ HMCP ➔ AHCF Patient: Patient Category: DOB/Age: unk/ Case Mgmt: Patient Type: PCM: APPOINTMENT REFFERAL BOOKING FMP/SSN: / Pat SSN: -DDS: Sex: MCP Status: PCM Phone: - Notes: • DEERS PROCESSING. The system automatically performs a DEERS Eligibility Query to see if the patient has not received a positive response from DEERS within the past five days: – If the patient was DEERS eligible or the override code was used, the system displays the Current DEERS Eligibility screen. You can either repeat the inquiry or go on to the patient’s Demographics Display screen. - 4-129 Referral# Date/Time Provider Specialty Status ----------------------------------------------------------------------------------------------------------------------------------------------- – If the patient was DEERS ineligible, the system runs another inquiry and displays the DEERS Eligibility screen. * If the patient is eligible, you can print the data and/or go to the Demographic Display screen. * If the patient in ineligible, you can override the ineligibility and continue on to the Demographics Display screen. Quick Reference Guides • Select Patient action. • Enter Patient Name. • Verify Sponsor Name. MCP APPOINTMENT REFERRAL BOOKING SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 ----------------------------------------------------------------------------------------------------------------------------------------------Select PATIENT NAME: PICARD,ZACHARY E 20/379-43-6114 31 May 1955 M AE5 OK? YES// (YES) SPONSOR NAME: PICARD,ZACHARY E// APPOINTMENT REFERRAL BOOKING (continued) 4-130 DEMOGRAPHICS DISPLAY Name: PICARD,ZACHARY E FMP/SSN: 20/379-43-6114 Patient Category: USA AD ENLISTED DDS: Patient Type: MCP/ACTIVE DUTY Sex: MALE MCP Status: ENROLLED DOB/Age: 31 May 1955/35Y ACV: A-ACTIVE DUTY/MCP ENROLLED DMIS ID: 6015 Direct Care: ELIGIBLE Medicare: NOT ELIGIBLE ----------------------------------------------------------------------------------------------------------------------------------------------Sponsor Name: PICARD,ZACHARY E Rank: SERGEANT Station/Unit: FORT BELVOIR DSN: Home Address: 814 CARMINE ST. City: ARLINGTON State: VIRGINIA ZIP Code: 22222 Home Phone: 703-622-5234 Duty Phone: Work Phone: Registration Comment: Last Registration Date: 21 Jun 2001@1311 Outpatient Record Room: MEDICAL RECORDS FILE ROOM MCP Enroll Date: 21 Jun 2001 End Enroll Date: 21 Jun 2002 Primary Care Manager: ESPOSITO,FRANK M PCM Phone: 202 271-5850 Primary OHI: Case Mgmt: NO ----------------------------------------------------------------------------------------------------------------------------------------------Select (F)ull, (M)ini, (E)nrollment, (O)HI, (P)CM, Ca(s)e, F(a)mily, (D)isenroll, (H)istory, (N)ew Patient, (C)ontinue, or (Q)uit DEMO: C// Notes: Patient: Patient Category: DOB/Age: Case Mgmt: Patient Type: PCM: APPOINTMENT REFERRAL BOOKING PICARD,ZACHARY E FMP/SSN: USA AD ENLISTED Pat SSN: 31 May 1955/35Y DDS: Sex: MCP/ACTIVE DUTY MCP Status: ESPOSITO,FRANK M PCM Phone: 20/379-43-6114 379-43-6114 MALE ENROLLED 202 271-5850 Referral# Date/Time Provider Specialty Status _____________________________________________________________________________________ ------------------------------------------------- No Appointment Referrals found--------------------------------------------------Select (P)atient, (A)dd, or (Q)uit: A// • Select the Add action. Note: • THE APPOINTMENT REFERRAL PROCESSING SCREEN. The (M)odify action only appears on the action bar if the patient has previous appointments. MCP APPOINTMENT REFERRAL BOOKING SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides • THE DEMOGRAPHIC DISPLAY SCREEN. You need a security key to access the Ca(s)e action: which are used to enter an exception provider for a case management and (o)HI patient or other health insurance information. • Select the Continue action. APPOINTMENT REFERRAL BOOKING (continued) • Complete the Interview/Referral screens. MCP REFERRAL: 200100045 Patient: PICARD,ZACHARY E Patient Category: USA ACTIVE DUTY OFFICER DOB/Age: 19 Feb 1966/35Y FMP/SSN: Pat SSN: DDS: Sex: City: ZIP Code: D Phone: INTERVIEW/REFERRAL 20/379-43-6114 379-43-6114 4-131 Male Street: 862 WEST WYLAND DR FAIRFAX State: VIRGINIA 22030 H Phone: 918-555-0287 202-555-6802 W Phone: 202-555-6802 PCM: ESPOSITO,FRANK M PCM Phone: 303 271-5850 Case Mgmt Provider: Case Mgmt: ================================================================================== Referral Number: 200100045 Referral Date/Time: 21Jun01@1434 MCP Status: ENROLLED Patient Type: MCP/ACTIVE DUTY Specialty: OCCUPATIONAL THERAPY Location: 20307 Requested Start Time: 0900 Requested Stop Time: 1400 Days of the Week: M TU W TH F Number of Visits: 1 Treatment Start Date: 21 Jun 2001 Treatment Stop Date: 06 Jul 2001 Priority: ROUTINE Gender Preference: Language: Primary OHI: Ask for Help = HELP Screen Exit = F10 File/Exit = DO MCP REFERRAL: 200100045 INTERVIEW/REFERRAL -- CONTINUED Patient: PICARD,ZACHARY E FMP/SSN: 20/379-43-6114 Patient Category: USA ACTIVE DUTY OFFICER Pat SSN: 379-43-6114 DOB/Age: 19 Feb 1966/35Y DDS: Patient Type: MCP/ACTIVE DUTY Sex: MALE MCP Status: ENROLLED PCM: ESPOSITO,FRANK M PCM Phone: 202 271-5850 Case Mgmt Provider: Case Mgmt: ================================================================================== Referred By: ESPOSITO,FRANK M UPIN: ESPOFM Referral From: BGAZ Related To: Reason for Referral: ACTIVE/PASSIVE ROM EXTREMITIES Ask for Help = HELP Screen Exit = F10 File/Exit = DO INSERT OFF INSERT OFF The Location field allows you to enter either the zip code(s), a “wild card” zip code, or a geographical area as defined in the CHCS Zip Code Combination MCP APPOINTMENT REFERRAL BOOKING SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides Note: APPOINTMENT REFERRAL BOOKING (continued) MCP REFERRAL: 200100045 INTERVIEW/REFERRAL -- CONTINUED Patient: PICARD,ZACHARY E FMP/SSN: 20/379-43-6114 Patient Category: USA ACTIVE DUTY OFFICER Pat SSN: 379-43-6114 DOB/Age: 19 Feb 1966/35Y DDS: Patient Type: MCP/ACTIVE DUTY Sex: MALE MCP Status: ENROLLED PCM: ESPOSITO,FRANK M PCM Phone: 202 271-5850 Case Mgmt Provider: Case Mgmt: ================================================================================== Select Provisional Diagnosis: 342.10 SPASTIC HEMIPLEGIA & HEMIPARESIS AFFECTING UNSPECIFIED SIDE Select Provisional Diagnosis (Free Text): Patient: Patient Category: DOB/AGE: Patient Type: MCP Status: PCM: Case Mgmt Provider: ADD APPOINTMENT REFFERAL PICARD,ZACHARY E FMP/SSN: USA ACTIVE DUTY ENLISTED Pat SSN: 19 Feb 1966/35Y DDS: MCP/ACTIVE DUTY Sex: ENROLLED ESPOSITO,FRANK M PCM Phone: Case Mgmt: 20/379-43-6114 379-43-6114 MALE 202 271-5850 NO Referral# Date/Time Provider Specialty -------------------------------------------------------------------------------------------------------------200100045 OCCUPATIONAL TH Status -------------------------------------------------------------------------------------------------------------Select (I)nterview/Referral, (P)rovider, (O)utputs, (D)elete, or (Q)uit ADD APPOINTMENT REFERRAL: P// <Return> Select Referral Procedure: 4-132 • Select the Provider action. --------------------------------------------------------------------------------------------------------------File/exit Abort Edit File changes and exit. • File the data Note: • THE ADD APPOINTMENT REFERRAL SCREEN. A newly created referral has no appointments linked to it, so the system displays only the Referral Number and Provider Specialty fields. Quick Reference Guides The (N)AS action only appears on the action bar if the specified patient is CHAMPUS-eligible. MCP APPOINTMENT REFERRAL BOOKING SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 The (E)xception action only appears on the action bar if the specified patient is a case management patient. APPOINTMENT REFERRAL BOOKING (continued) The requested appointment type must match the appointment types that are defined in the Master Appointment Type file. If you do not enter an appointment type, the system lists all MTF and non-MTF providers who meet the other search criteria, and displays “MTF” for MTF appointments or the discount percentage for non-MTF appointments in the DT/DISC column. 4-133 PROVIDER SEARCH Patient: PICARD,ZACHARY E FMP/SSN: 20/379-43-6114 Patient Category: USA ACTIVE DUTY OFFICER Pat SSN: 379-43-6114 DOB/Age: 19 Feb 1966/35Y DDS: Patient Type: MCP/ACTIVE DUTY Sex: MALE MCP Status: ENROLLED PCM: ESPOSITO,FRANK M PCM Phone: 202 271-5850 Case Mgmt Provider: Case Mgmt: NO Specialty: OCCUPATIONAL THERAPY Appt Type: Location: 20307 Start Date: 21 Jun 2001 Stop Date: 06 Jul 2001 Days of Week: Number of Visits: 1 Priority: ROUTINE Gender Preference: Language: Primary OHI: NOT ASSIGNED ------------------------------------------------------------------------------------------------------------------------------------------------ Patient: Patient Category: DOB/Age: Patient Type: MCP Status: PCM: Case Mgmt Provider: Specialty: Location: Start Date: Days of Week: Priority: Language: PROVIDER SEARCH PICARD,ZACHARY E FMP/SSN: USA ACTIVE DUTY OFFICER Pat SSN: 19 Feb 1966/35Y DDS: MCP/ACTIVE DUTY Sex: ENROLLED ESPOSITO,FRANK M PCM Phone: Case Mgmt: OCCUPATIONAL THERAPY Appt Type: 20307 21 Jun 2001 Stop Date: Number of Visits: ROUTINE Gender Preference: Primary OHI: 20/379-43-6114 379-43-6114 MALE 202 271-5850 NO 06 Jul 2001 1 NOT ASSIGNED Provider CS Cat Agr Place of Care Zip 1st Available Appt ------------------------------------------------------------------------------------------------------------------------------* PACHINI,EDWARD MD MTF OT MTF 20307 26 Jun 2001@0900 ------------------------------------------------------------------------------------------------------------------------------Use the SELECT key to Select the Provider to whom to refer the patient Press F9 to view Schedule, Discount Summaries, Place of Care, or Watch Codes. Note: • THE PROVIDER SEARCH SCREEN. The Provider Search screen displays all MTF providers first. If you have entered an appointment type, these MTF provider names are listed by the first available appointments of that type. Next the system lists all non-MTF providers, who accept the specified appointment type. The non-MTF providers are listed in order of highest to lowest discount rate. MCP APPOINTMENT REFERRAL BOOKING SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides -----------------------------------------------------------------------------------------------------------------------------------------------Search for (A)ppt Refusal, (P)rovider Name, (M)TF, (E)xternal, N(o)n-Network, or (Q)uit Provider Search: P Select Provider: PACHINI,EDWARD Select Appt Type: NEW APPOINTMENT REFERRAL BOOKING (continued) • Select the Book action. Network providers are listed on the screen in the following order: First - MTF providers with appointments available for the appointment type indicated. Second - Network individual/group providers. Third - Only service available providers. The Date (DT)/Discount rate (Disc) field is variable depending upon whether the provider is MTF or non-MTF. The date of the first available open appointment slot of the designated appointment type applies to MTFs only. The discount rate applies to non-MTFs only. 4-134 • Select the Provider. Patient: Patient Category: DOB/Age: Patient Type: MCP Status: PCM: Case Mgmt Provider: Date/Time Provider 20/379-43-6114 379-43-6114 -----------------------------------------------------------------------------------------------------------------------------Select (C)hange Search Criteria, (B)rowse, (S)ingle Patient, Appt (R)efusal, (W)ait List Add, (T)el-Consult, or (Q)uit: S// <Return> MALE 202 271-5850 NO Specialty Status Note: Quick Reference Guides ----------------------------------------------------------------------------------------------------------------------------------------------- 900000055 OCCUPATIONAL TH • THE MTF BOOKING SEARCH CRITERIA SCREEN. The system displays a different booking searching criteria screen depending upon which type of patient and health care provider you are using: – Enrolled/MTF - MTF Booking Search Criteria screen. ------------------------------Provider eligibility dates are from 21 Jun 2001 to 06 Jul 2001------------------------------Select (I)nterview/Referral, (P)rovider, (B)ook,(O)utputs, (D)elete, (A)ppt Refusal, or (Q)uit ADD APPOINTMENT REFERRAL: B// <Return> MCP APPOINTMENT REFERRAL BOOKING SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Referral# ADD APPOINTMENT REFFERAL PICARD,ZACHARY E FMP/SSN: USA ACTIVE DUTY OFFICER Pat SSN: 19 Feb 1966/35Y DDS: MCP/ACTIVE DUTY Sex: ENROLLED ESPOSITO,FRANK M PCM Phone: Case Mgmt: MTF BOOKING SEARCH CRITERIA Patient: PICARD,ZACHARY E FMP/SSN: 20/379-43-6114 Patient Type: MCP/ACTIVE DUTY Appt Type: Clinic: OT MTF/DIVA Specialty: OCCUPATIONAL THERAPY Clinic Phone: 202 456-9876 Provider: PAANGA, ABBAS M Duration: Location: 20307 Days of Week: Dates: 21 Jun 2001 to 06 Jul 2001 Time Range: 0900 to 1400 -----------------------------------------------------------------------------------------------------------------------------Referral Number: 900000055 Referral Date/Time: 21 Jun 2001@1338 Patient Type: MCP/ACTIVE DUTY CCP Status: ENROLLED Pt Home Phone: 918-555-0287 Pt Duty Phone: 202 555-6802 PCM: ESPOSITO,FRANK M PCM Phone: 202-555-5850 Priority: ROUTINE Number of Visits: 1 Appts Booked: Wait List Requests: Reason for Referral: ACTIVE/PASSIVE ROM EXTREMITIES APPOINTMENT REFERRAL BOOKING (continued) – Enrolled/Non-MTF - Non-MTF Booking Search Criteria screen. – Non-Enrolled /MTF - Non-Enrolled MTF Booking Search Criteria screen. – Non-Enrolled/Non-MTF - Non-Enrolled Non-MTF Booking Search Criteria screen. The (W)ait List Add action only appears if the specified clinic maintains an active Wait List. Note: • THE MTF SINGLE PATIENT BOOKING SCREEN. The booking process varies at this point. If you have chosen an MTF health care provider, you then choose a scheduled time slot and book to it. If you have chosen a non-MTF health care provider, you must create an appointment slot and book to it. Refer to Quick Reference Guide: Non-Enrolled Booking, for an example of creating an appointment slot. • Confirm the selection(s). • Select the Single Patient action. 4-135 FILE APPOINTMENT Patient: PICARD,ZACHARY E FMP/SSN: 20/379-43-6114 Patient Type: MTF/ACTIVE DUTY Appt Type: Clinic: OT MTF/DIVA Specialty: OCCUPATIONAL THERAPY Clinic Phone: 202 456-9876 Provider: PAANGA, ABBAS M Duration: Location: 20307 Days of Week: Dates: 21 Jun 2001 to 06 Jul 2001 Time Range: 0900 to 1400 ----------------------------------------------------------------------------------------------------------------------------------------------TUE 0900 26 Jun 01 NEW 1/0 -----------------------------------------------------------Select Slot #1 of 1-----------------------------------------------------------Select (B)ook appt, or (Q)uit FILE APPOINTMENT: B// • Select appointment slot(s) to book. MCP APPOINTMENT REFERRAL BOOKING SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides MTF SINGLE PATIENT BOOKING Patient: PICARD,ZACHARY E FMP/SSN: 20/379-43-6114 Patient Type: MTF/ACTIVE DUTY Appt Type: Clinic: OT MTF/DIVA Specialty: OCCUPATIONAL THERAPY Clinic Phone: 202 456-9876 Provider: PAANGA, ABBAS M Duration: Location: 20307 Days of Week: Dates: 21 Jun 2001 to 06 Jul 2001 Time Range: 0900 to 1400 ----------------------------------------------------------------------------------------------------------------------------------------------TUE 0900 26 Jun 01 NEW 1/0 TUE 0930 26 Jun 01 NEW 1/0 TUE 1000 26 Jun 01 NEW 1/0 TUE 1030 26 Jun 01 NEW 1/0 TUE 1100 26 Jun 01 NEW 1/0 TUE 1130 26 Jun 01 NEW 1/0 THU 0900 28 Jun 01 NEW 1/0 THU 0930 28 Jun 01 NEW 1/0 + THU 1000 28 Jun 01 NEW 1/0 ----------------------------------------------------------------------------------------------------------------------------------------------Use SELECT key to select appointment(s) to be booked APPOINTMENT REFERRAL BOOKING (continued) Note: • THE FILE APPOINTMENT SCREEN. This screen contains a “smart” action bar: Note: • CONFLICTING APPOINTMENT SLOTS. The system prompts you if there are overlapping or direct conflict appointments. The system allows you to override overlapping or appointments in close proximity, but does not allow you to override a direct conflict. The amount of time allowed before an overlap becomes a direct conflict is defined by the site. If overlapping appointments exist, you receive a message before you are allowed to continue with booking. • Select the book action. PATIENT APPOINTMENT: PICARD,ZACHARY E FILE APPOINTMENT 4-136 TUE 0900 26 Jun 01 NEW1/0 Clinic Message: Arrive 10 minutes early. Clinic/Appt Type Instructions: Provider Message: Provider/Appt Type Instructions: Arrival Message: 10 minutes Registration Comment: – If you have selected more than one appointment in book, the Skip and View actions also appear on the action bar. • File the data. MTF SINGLE PATIENT BOOKING Patient: PICARD,ZACHARY E FMP/SSN: 20/379-43-6114 Patient Type: MTF/ACTIVE DUTY Appt Type: Clinic: OT MTF/DIVA Specialty: OCCUPATIONAL THERAPY Clinic Phone: 202 456-9876 Provider: PAANGA, ABBAS M Duration: Location: 20307 Days of Week: Dates: 21 Jun 2001 to 06 Jul 2001 Time Range: 0900 to 1400 ----------------------------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------------------------Remind patient of other appointments/Wait List requests? Yes// Select DEVICE: RIGHT MARGIN: 80// ----------------------------------------------------------------------------------------------------------------------------------------------File/exit Abort Edit File changes and exit. • Remind patient of other appointments/Wait List requests. MCP APPOINTMENT REFERRAL BOOKING SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides MEPRS Code: DHBA Requesting Service: Referred By: Send Reminder Notice: YES Appointment Comment: Reason for Appointment: – If you have selected only one appointment to book, only the Book and Quit File Appointment actions appear on the action bar. APPOINTMENT REFERRAL BOOKING (continued) • Press <Return> (to continue). • Enter Device: <Return> • Enter Right Margin: <Return> DISPLAY PATIENT APPOINTMENTS Personal Data - Privacy Act of 1974 (PL 93-579) FUTURE APPOINTMENTS FOR PICARD,ZACHARY E 20/379-43-6114 CLINIC/DIV PROVIDER DATE/TIME TYPE STATUS ================================================================================== OT MTF/DIVA PACHINI, EDWARD 26 Jun 2001@0900 NEW PENDING Arrive 10 min early 4-137 WAIT LIST REQUESTS FOR PICARD,ZACHARY E 20/379-43-6114 CLINIC/DIV TYPE PRI DATE IN TARGET DATE PROVIDER ================================================================================== NO WAIT LIST REQUESTS! Patient: Patient Category: DOB/Age: Patient Type: MCP Status: PCM: Case Mgmt Provider: ADD APPOINTMENT REFERRAL PICARD,ZACHARY E FMP/SSN: USA ACTIVE DUTY OFFICER Pat SSN: 19 Feb 1966/35Y DDS: MCP/ACTIVE DUTY Sex: ENROLLED ESPOSITO,FRANK M PCM Phone: Case Mgmt: 20/379-43-6114 379-43-6114 MALE 202 271-5850 NO Referral# Date/Time Provider Specialty Status _____________________________________________________________________________________ 200100046 26 Jun 2001@0900 PACHINI, EDWARD M OCCUPATIONAL TH PENDING -----------------------------------------------------------------------------------------------------------------------------------------------Select (I)nterview/Referral, (O)utputs, or (Q)uit ADD APPOINTMENT REFERRAL: O// • Select the Quit action until you return to the Health Care Finder Menu. Press <RETURN> to continue APPOINTMENT REFERRAL BOOKING SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides MCP ASSIGN AN EXCEPTION PROVIDER TO AN MCP PATIENT FOR CASE MANAGEMENT This option allows you to assign an MCP patient to an exception provider for case management. MENU PATH: PAS System Menu ➔ MAN ➔ EMCP ➔ EENR Select PATIENT NAME: PEARL,ZACHARY N 20/569-69-4415 22 Apr 1972 M NE7 OK? YES// (YES) SPONSOR NAME: PEARL,ZACHARY N// 4-138 Name: Patient Category: Patient Type: MCP Status: ACV: Direct Care: DEMOGRAPHICS DISPLAY PEARL,ZACHARY N FMP/SSN: USN ACTIVE DUTY DDS: MCP/ACTIVE DUTY Sex: PENDING ENROLLMENT DOB/AGE: A-ACTIVE DUTY/MCP ENROLLED DMIS ID: Medicare: Select the Case action. CASE MANAGEMENT Patient: PEARL,ZACHARY N FMP/SSN: 20/569-69-4415 Patient Category: USN ACTIVE DUTY DDS: NOT ENTERED Patient Type: MCP/ACTIVE DUTY Sex: MALE MCP Status: PENDING ENROLLMENT DOB/AGE: 22 Apr 1962/28Y PCM: FONTANA,LUISA M Date: 21 Jun 2001 --------------------------------------------------------------------------------------------------------------------------------- --------------Exception Provider Specialty Start Date Stop Date _____________________________ No Exception Providers Assigned______________________________ 20/569-69-4415 -----------------------------------------------------------------------------------------------------------------------------Select (E)nter/edit Exception Provider, or (Q)uit Case: E// <Return> MALE 22 Apr 1962/28Y 6015 -----------------------------------------------------------------------------------------------------------------------------PEARL,ZACHARY N FLEET COMBAT TRAINING CENTER Rank: CHIEF PETTY OFFICE DSN: State: Home Phone: Work Phone: 21 Jun 2001@1342 MEDICAL RECORDS FILE ROOM 21 Jun 2001 End Enroll Date: 21 Jun 2002 FONTANA,LUISA M PCM Phone: 202 271-5850 Case Mgmt: NO -----------------------------------------------------------------------------------------------------------------------------Select (F)ull, (M)ini, (E)nrollment, (O)HI, (P)CM, Ca(s)e, F(a)mily, (D)isenroll, (H)istory, (N)ew Patient, (C)ontinue, or (Q)uit DEMOGRAPHICS: Q// S MCP ASSIGN AN EXCEPTION PROVIDER TO AN MCP PATIENT FOR CASE MANAGEMENT SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides Sponsor Name: Station/Unit: Home Address: City: ZIP Code: Duty Phone: Registration Comment: Last Registration Date: Outpatient Record Room: MCP Enroll Date: Primary Care Manager: Primary OHI: ASSIGN AN EXCEPTION PROVIDER TO AN MCP PATIENT FOR CASE MANAGEMENT (continued) CASE MANAGEMENT - ENTER/EDIT Patient: PEARL,ZACHARY N FMP/SSN: 20/569-69-4415 Patient Category: USN ACTIVE DUTY DDS: NOT ENTERED Patient Type: MCP/ACTIVE DUTY Sex: MALE MCP Status: PENDING ENROLLMENT DOB/AGE: 22 Apr 1962/28Y PCM: FONTANA,LUISA M Date: 21 Jun 2001 --------------------------------------------------------------------------------------------------------------------------------- --------------Exception Provider Specialty Start Date Stop Date ______________________________________________________________________________________ PHARIS,DARNELL C <--- Enter Exception Provider EXCEPTION PROVIDER: PHARIS,DARNELL C CP EXCEPTION INFORMATION -- CONTINUATION Patient: PEARL,ZACHARY N FMP/SSN: 20/569-69-4415 Patient Category: USN ACTIVE DUTY DDS: NOT ENTERED Patient Type: MCP/ACTIVE DUTY Sex: MALE MCP Status: PENDING ENROLLMENT DOB/AGE: 22 Apr 1962/28Y PCM: FONTANA,LUISA M Date: 21 Jun 2001 ================================================================================== Exception Provider: PHARIS,DARNELL C Phone: 301 644-4009 Provider Specialty: NEPHROLOGIST Start Date: 21 Jun 2001 Stop Date: 19 Sep 2001 Condition: CRITICAL CARE ------------------------------------------------------------------------------------------------------------------------------ 4-139 Enter a new Exception Provider or Press <RETURN> to continue PHARIS,DARNELL C PHARIS,DARNELL C 626-33-6917 OK? YES// <Return> Are you adding ‘PHARIS,DARNELL C’ as a new EXCEPTION PROVIDER (the 1st for this MCP PATIENT)? Y -----------------------------------------------------------------------------------------------------------------------------File/exit Abort Edit File changes and exit. ASSIGN AN EXCEPTION PROVIDER TO AN MCP PATIENT FOR CASE MANAGEMENT SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides MCP ASSIGN AN EXCEPTION PROVIDER TO AN MCP PATIENT FOR CASE MANAGEMENT (continued) CASE MANAGEMENT - ENTER/EDIT Patient: PEARL,ZACHARY N FMP/SSN: 20/569-69-4415 Patient Category: USN ACTIVE DUTY DDS: NOT ENTERED Patient Type: MCP/ACTIVE DUTY Sex: MALE MCP Status: PENDING ENROLLMENT DOB/AGE: 22 Apr 1962/28Y PCM: FONTANA,LUISA M Date: 21 Jun 2001 -----------------------------------------------------------------------------------------------------------------------------------------------Exception Provider Specialty Start Date Stop Date -----------------------------------------------------------------------------------------------------------------------------PHARIS,DARNELL C NEPHROLOGIST <--- Enter Exception Provider 21 Jun 01 19 Sep 01 Notes: • You may only assign a provider who is currently defined as an exception provider (Provider Type = Non-Network Provider) in the MCP Provider Group Profile. • At the Provider Specialty prompt, only specialties that are currently defined in the Provider file for this provider can be entered. • To view the patient’s exception provider history, move the cursor to the desired provider, then press <F9>. The Case Management Condition screen is displayed. 4-140 -----------------------------------------------------------------------------------------------------------------------------Use SELECT Key to select Exception Provider to edit. Use F9 Key to View History or Press <RETURN> to continue Return to the Enrollment Processing Menu. ASSIGN AN EXCEPTION PROVIDER TO AN MCP PATIENT FOR CASE MANAGEMENT SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides MCP ASSIGN A PCM TO AN MCP PATIENT The Enrollment Enter/Edit option allows you to assign a primary care manager to an MCP-enrolled patient. MENU PATH: PAS System Menu ➔ MAN ➔ EMCP ➔ EENR After you enroll a patient into the MCP, the PCM Search Criteria screen is displayed. (Or you can select the PCM action from the Demographics Display screen.) PCM SEARCH CRITERIA Patient: PEARL,ZACHARY N FMP/SSN: 20/569-69-4415 Language: DDS: Specialty: DOB/Age: 20 Jun 1975/26Y PCM: PCM Gender: Location: Date: 21 Jun 2001 4-141 ------------------------------------------------------------------------------------------------------ ______________________________________________________________________ Select (C)hange Search Criteria, (D)irect PCM Assignment, (V)iew Family Assignments, or (Q)uit PCM: C// ASSIGN A PCM TO AN MCP PATIENT SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides MCP ASSIGN A PCM TO AN MCP PATIENT (continued) Select the Change Search Criteria action. PCM SEARCH CRITERIA Patient: PEARL,ZACHARY N FMP/SSN: 20/569-69-4415 Language: DDS: Specialty: DOB/Age: 20 Jun 1975/26Y PCM: PCM Gender: Location: Date: 21 Jun 2001 ______________________________________________________________________ * Specialty * Location PCM Gender Patient Language Default Search Criteria 4-142 ____________________________ Specialty and Location are required_____________________________ Use SELECT key to select SEARCH CRITERIA to be changed • Default Search Criteria. PCM ASSIGNMENT Patient: PEARL,ZACHARY N FMP/SSN: 20/569-69-4415 Language: DDS: Specialty: FAMILY PRACTICE/PRIMARY CARE DOB/Age: 20 Jun 1975/26Y PCM: PCM Gender: Location: 20307 Date: 21 Jun 2001 -----------------------------------------------------------------------------------------------------------------------------------------------Provider CS Cat Specialty Agr Locat Sex Disc Avail _____________________________________________________________________________________ ALVAREZ,GILBERT M MD FAMILY PRACTICE MTF 20307 M MTF 496 BALLARD,SHARON M MD FAMILY PRACTICE MTF 20307 F MTF 496 CHUNG,KYLE M NPC PRIMARY CARE NUR MTF 20307 M MTF 497 DOE,ALICE M MD FAMILY PRACTICE MTF 20307 F MTF 500 ESPOSITO,FRANK M NPC PRIMARY CARE NUR MTF 20307 M MTF 497 *FONTANA,LUISA M PA FAMILY PRACTICE/ MTF 20307 F MTF 500 GREENE,JOHN M PA FAMILY PRACTICE/ MTF 20307 M MTF 497 AUSTIN,GILBERT M MD FAMILY PRACTICE MTF 20307 M MTF 496 BATES,SHARON M MD FAMILY PRACTICE MTF 20307 F MTF 496 _____________________________________________________________________________________ Use SELECT key to select PCM to be assigned. Press F9 Key to view Assignment Preferences, Place of Care, or Watch codes. • Select Specialty from list and continue. • Select Location from list and continue. • OK to file PCM? Yes// <Return> • Display/print PCM and place of care? No// Y Quick Reference Guides • Select DEVICE: <Return> RIGHT MARGIN: 80// <Return> MCP ASSIGN A PCM TO AN MCP PATIENT SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 • Select Search PCM. AUTO ENROLL A PATIENT INTO THE MCP The Auto Enroll a Patient Into the MCP option allows you to automatically enroll an active-duty, never-enrolled patient into the MCP when registering the patient through the Mini Registration option. The Mini Registration option can be accessed from several subsystem menus. Refer to the QRG: Mini Registration, for more information. After completing a mini registration for an active-duty, never-enrolled patient, if you hold the CPZ AUTO ENROLL security key, you are automatically prompted to enroll the patient into the MCP. ACTIVE DUTY AUTO-ENROLLMENT Patient Name: PRIDE,ZANE N FMP/SSN: 20/620-20-4110 MCP Status: ______________________________________________________________________________________ Station/Unit: WALTER REED MED HOLD PP Enrolling Division: DIV A - TRAINING HOSPITAL Default PCM: ALVAREZ,GILBERT M Agreement Type: MTF Max AD Capacity: 477 # AD Assigned: 10 Enrollment Date: 21 Jun 2001 -----------------------------------------------------------------------------------------------------------------------------------------------Accept default PCM? Yes// Enrolling in MCP... 4-143 The process for auto-enrollment is determined by several factors: if the patient's UIC is a valid entry in the Unit Ship ID Codes file (8111), and if the patient's UIC is currently assigned to a default PCM. You may accept the default PCM, and the patient will be enrolled in the MCP. AUTO-ENROLLMENT - MATCHING UIC If you reject the default PCM and select and assign a different PCM, the PCM managers are notified by mail. Menu Path: PAS System ➔ MAN ➔ FMCP ➔ RREG ➔ MRDM If the patient's UIC is a valid entry in the Unit Ship ID Codes file, you are prompted to automatically enroll the patient. Enroll in Managed Care? Note: If the PCM does not have sufficient capacity, the PCM managers are notified by mail and you are prompted to select and assign another PCM. Patient Name: PRIDE,ZANE N FMP/SSN: 20/620-20-4110 MCP Status: ______________________________________________________________________________________ Station/Unit: WALTER REED MED HOLD PP Enrolling Division: DIV A - TRAINING HOSPITAL Default PCM: ALVAREZ,GILBERT M Agreement Type: MTF Max AD Capacity: 477 # AD Assigned: 10 Enrollment Date: 21 Jun 2001 -----------------------------------------------------------------------------------------------------------------------------------------------Accept default PCM? Yes// N MCP AUTO ENROLL A PATIENT INTO THE MCP SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides The Active Duty Auto-Enrollment screen is displayed. This example shows an existing default PCM with sufficient capacity to accept the patient. ACTIVE DUTY AUTO-ENROLLMENT AUTO ENROLL A PATIENT INTO THE MCP (continued) ACTIVE DUTY AUTO-ENROLLMENT Patient Name: PRIDE,ZANE N FMP/SSN: 20/620-20-4110 MCP Status: ______________________________________________________________________________________ Station/Unit: WALTER REED MED HOLD PP Enrolling Division: DIV A - TRAINING HOSPITAL Default PCM: ALVAREZ,GILBERT M Agreement Type: MTF Max AD Capacity: 477 # AD Assigned: 10 Enrollment Date: 21 Jun 2001 -----------------------------------------------------------------------------------------------------------------------------------------------Select PCM: FAM MED MTF FAM MED MTF OK? YES// 4-144 ACTIVE DUTY AUTO-ENROLLMENT - SELECT PCM You are prompted to automatically enroll the patient and must select and assign a PCM to the patient using the same methods as described in the previous screens. Need to know: • The auto-enrollment prompt only displays after mini registration when the patient is active duty and has never been enrolled in MCP before. The autoenrollment prompt does not display for active-duty patients with an MCP status of Disenrolled. • Authorized users must have the CPZ AUTO ENROLL security key. Users who do not hold this key do not see the prompt for auto-enrollment. • During automatic enrollment, the default PCM, agreement type, maximum PCM capacity, and number of enrollees assigned default for user acceptance. • The enrollment date automatically defaults to today's date. Patient Name: PRIDE,ZANE N FMP/SSN: 20/620-20-41 MCP Status: ______________________________________________________________________________________ Provider Specialty Agr Locat Sex Disc Avail -----------------------------------------------------------------------------------------------------------------------------------------------* FAM MED MTF FAMILY PRACTICE MTF 20307 MTF 125 AUTO-ENROLLMENT - NONMATCHING UIC If the patient’s UIC is not a valid entry in the Unit Ship ID Codes file, the PCM managers are notified by mail: UIC Code does not match CHCS codes. Notifying PCM Managers... MCP AUTO ENROLL A PATIENT INTO THE MCP SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides -----------------------------------------------------------------------------------------------------------------------------------------------Display/print PCM and place of care? No// BATCH PCM REASSIGNMENT PROCESSING The Batch PCM Reassignment Menu option allows you to reassign a group of enrollees to a new PCM without having to do individual reassignments. METHODS OF REASSIGNMENT The Batch PCM Reassignment option allows you to reassign patients using the following methods: • Reassign All - Reassign all the patients assigned to the current PCM to a new gaining PCM. • Reassign by UIC - Reassign all the patients with a specified UIC to a new gaining PCM. 4-145 • By Patient Type - Reassign a group of enrollees of the same patient type; for example, all CCA (Enrolled Active Duty) patients, from the current PCM to a new gaining PCM. • Provider Assignment Notification (PRPT) - Lists all patients that have been reassigned to a PCM using the Batch PCM Reassignment option since a specified date. A cover letter can also be generated to include the payment address for the PCM and the MCP office that generated the roster. This report can also be folded and placed in a window envelope. • PCM Reassignment Report (RRPT) - A three-part report that lists the results of a Batch PCM Reassignment: – Part I, Roster of Reassigned Patients, lists the patients who have been reassigned successfully. – Part II, Reassignment Discrepancies, lists any patients who were not successfully reassigned. These patients must be reassigned again. – Part III, Appointments with a Prior PCM, lists any appointments with the prior PCM that are scheduled for the patients listed in Part I. The system automatically names each PCM Reassignment Report generated, for example: • Family - Reassign a family or selected members of a family to a new PCM. CP BATCH 02 Mar 2001-1600 206 03-02- 01 BERGIN,ALAN • CP BATCH - Indicates a PCM Reassignment Report. REASSIGNMENT REPORTS • 02 Mar 2001 - The date of the reassignment. The following reports are generated as a result of the Batch PCM Reassignment option, and can be printed during the first five days after a reassignment is completed: • 1600 - The time the reassignment process completed. • 206 - The unique internal entry number of the user who performed the reassignment. • Enrollee/Patient Assignment Notification (ERPT) - Generated for each patient who is reassigned. The report, which can be folded and placed in a window envelope, informs the patient of the reassignment and includes directions and other information about the new place of care for the PCM. MCP BATCH PCM REASSIGNMENT PROCESSING SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides • Multiple PCMs - Reassign patients assigned to the current PCM to other PCMs within the same provider group. BATCH PCM REASSIGNMENT PROCESSING (continued) • 03-02- 01 - The date of the reassignment. • BERGIN,ALAN - The name of the user who performed the reassignment. The name of the report associated with a particular reassignment is included in the Mail Bulletin sent after reassignment completes. Notes: • For a batch reassignment, the system does not display PCMs with insufficient capacity to accept the patients to be reassigned. • If a patient does not appear in Part I, Roster of Reassigned Patients, of the PCM Reassignment Report, then the patient was not successfully reassigned to a gaining PCM. Check for discrepancies that resulted in the failure of the patient to be reassigned. • Patients who are listed in Part II, Reassignment Discrepancies, of the PCM Reassignment Report, must be reassigned again. • A reassignment discrepancy might occur because the reassignment occurs in the background at a later time than the time of the user request. If a patient record is being accessed at the time the reassignment occurs, the reassignment process places the patient on the discrepancy list and proceeds to the next patient. 4-146 • For a batch reassignment, the reassignment process is sent to TaskMan to be processed as time permits. After the reassignment process completes, you receive a bulletin indicating the completed reassignment. The bulletin is also sent to the mail group BATCH PCM. • The system does not generate a bulletin indicating the family reassignment, as is done for the Batch PCM Reassignment process. In addition, family reassignment information is not included in the PCM Reassignment Report. • When reassigning the patients from a PCM to multiple PCMs, the gaining PCMs must be in the same provider group and have the same agreement type as the current PCM. Family members are reassigned to the same PCM. • The system automatically deletes the PCM Reassignment Reports for a reassignment five days after the reassignment is completed. MCP BATCH PCM REASSIGNMENT PROCESSING SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides • After a family reassignment completes, the system checks each reassigned family member for pending appointments with the prior PCM. If pending appointments exist, the Report Family Appointments action displays. This report lists any pending appointments with the prior PCM that may need to be rescheduled with the gaining PCM. CHANGE THE PARTICIPATION STATUS OF AN INDIVIDUAL PROVIDER The Participation Status action is used to change the agreement participation status of an individual provider. MENU PATH: PAS System Menu ➔ MAN ➔ PMCP ➔ GNET To access the Participation Status action on the Provider Group Profile/ Agreement Maintenance screen, select the Providers action (P) on the Group Profile action bar, then select Agreements eXceptions (X) on the Individual Provider action bar, then select the individual provider. MENU PATH: PAS System Menu ➔ MAN ➔ PMCP ➔ INET 4-147 To access the Participation Status action on the Individual Provider Profile/ Agreement Maintenance screen, select the Agreements eXception (X) action. INDIVIDUAL PROVIDER GROUP AGREEMENT PARTICIPATION INDIVIDUAL PROVIDER AGREEMENT EXCEPTION HISTORY Provider: PRIMROSE,ZELDA C Provider Group: INDIGO MG ----------------------------------------------------------------------------------------------------------------------------------------------Agreement Effective Overall FI Type Date Stop Date Discount Notified Except PCM ----------------------------------------------------------------------------------------------------------------------------------------------21 Jun 2001 20 Jun 2002 CA- 10% 19 Jun 2001 SUP • Select the agreement type in which the provider does not participate. Notes: • Agreement types displayed on the Individual Provider Group Agreement Participation screen with an asterisk (*) are agreements in which this provider does not currently participate. • The provider can be reassigned to participate in an agreement type by deselecting the agreement type (removing the asterisk). • The Individual Provider Agreement Exception History screen shows only those agreements in which the selected provider participates. Quick Reference Guides MCP CHANGE THE PARTICIPATION STATUS OF AN INDIVIDUAL PROVIDER SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Provider: PRIMROSE,ZELDA C Provider Group: INDIGO MG ----------------------------------------------------------------------------------------------------------------------------------------------Agreement Effective Overall FI Type Date Stop Date Discount Notified Except PCM ----------------------------------------------------------------------------------------------------------------------------------------------* NET 21 Jun 2001 21 Jun 2002 CA- 18% 21 Jun 2001 S SUP 21 Jun 2001 20 Jun 2002 CA- 10% 19 Jun 2001 • Select the Participation Status action. CREATE A NEW SET OF ZIP CODE COMBINATIONS The Zip Code Combinations option allows you to create a new zip code combination, or edit information for an existing zip code combination, in the MCP Zip Code Combination file. MENU PATH: PAS System Menu ➔ MAN ➔ FMCP ➔ FTAB ➔ ZIPC Need to know information: • Press <Return> to accept the identifier (name). • The cursor bypasses the Programmer Access Required field. • To enter a code, press <Return> first to position the cursor in the Code field. Then enter the code. This must be a valid entry from the Zip Code table. After you access this option, the following prompt displays: • After you confirm a code, the City and State fields are automatically entered. ZIP CODE COMBINATIONS Enter/Edit • Add as many zip codes as desired. Select ZIP CODE COMBINATION: NORFOLK Are you adding ‘NORFOLK’ as a new MCP ZIP CODE COMBINATIONS (the 4th)? Y 4-148 Enter a new MCP zip code 1-35 characters in length. • Zip code combinations make it easier and quicker for HCFs to perform a provider search, without making it necessary to know the individual zip codes. • All zip code combinations should be entered prior to entering any information defining provider groups and their associated agreements. MCP ZIP CODE COMBINATIONS: NORFOLK CP ZIP CODE COMBINATIONS • To delete a zip code from the combination, move the cursor to the zip code to be deleted, then press <Return>. When the cursor is on the desired code, press <Remove>, then confirm the deletion. Identifier: NORFOLK Programmer Access Required: Code 23501 23502 23503 City NORFOLK NORFOLK NORFOLK State VIRGINIA VIRGINIA VIRGINIA ______________________________________________________________________ File/exit Abort Edit File changes and exit. MCP CREATE A NEW SET OF ZIP CODE COMBINATIONS SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides • A short delay may occur when adding or deleting zip codes from a zip code combination if provider groups already exist in the system. The system is updating or creating the connections between the zip code combination and places of care that use that zip code. CREATE A PROVIDER GROUP PROFILE The Group Profile/Agreements Enter/Edit option allows you to create new provider group profiles and to maintain existing provider group, place of care, and provider profiles. MENU PATH: PAS System Menu ➔ MAN ➔ PMCP ➔ GNET STEPS IN CREATING A NEW PROVIDER NETWORK: Prior to creating a provider group, you must review the Place of Care file and Department/Service file to ensure that the data is available to create a group profile. The place of care or clinic must be a valid entry in the Hospital Location file before it can be entered into the provider group profile. 4-149 Provider group profile information is always entered first. It is the basic data used for each individual provider within a group. All MTF clinics must be entered in the system as MCP provider groups. All providers who practice in the MTF clinic must be entered into the MCP provider file. Quick Reference Guides Entering clinics and providers in MCP is required, even if the information has previously been entered through the PAS Schedule Supervisor Menu. MCP CREATE A PROVIDER GROUP PROFILE SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Clinics and providers that have not been entered in the system are not included on the MCP displays, screens, searches, or reports. CREATE A PROVIDER GROUP PROFILE (continued) HOSPITAL LOCATION: INDIGO MC The following must be entered for a new provider group profile: GRP PL1 PROVIDER GROUP PLACES OF CARE – A minimum of one place of care/clinic must be entered in a provider group profile or the new profile will be deleted. – A minimum of one agreement and one provider must be entered into the provider group profile. One place of care/clinic, one agreement, and one provider must be in the provider group profile for the file to remain active in MCP. MCP PROVIDER GROUP: INDIGO MG GRP PRO1 Provider Group: INDIGO MG ======================================================================== Name: Location Abbreviation: Building Name: Building Number: Street Address: Zip: City: State: Phone: INDIGO MC INDIMC INDGO MEDICAL CENTER 16W 1405 Darby Street 20307 WASHINGTON DISTRICT OF COL 202 544-0923 PROVIDER GROUP PROFILE 4-150 ========================================================== Short Group ID: INDMG Tax ID#: 7800249 CHAMPUS Number: 4100438 Provider Type: NETWORK PROVIDER GROUP Activate Group Provider: NO 1405 DARBY STREET 20307 WASHINGTON DISTRICT OF COL 202 544-0923 GRP PL2 PROVIDER GROUP PLACES OF CARE Provider Group: INDIGO MG ======================================================================== Type of Facility: MULTISERVICE CLINIC Appt Contact Name: NANCY CARTER DMIS ID: 6015 CMHA, FT. MONMOUTH Payment Contact: INEZ,AMY Places of Care: INDIGO MC --------------------------------------------------- Hours of Service---------------------------------------------------Day of Week AM PM + TUESDAY 0700 - 1200 1201 - 1700 WEDNESDAY 0800 - 1200 1201 - 1300 THURSDAY 0700 - 1200 1201 - 1300 FRIDAY 0700 - 1200 1201 - 1700 + SATURDAY 0800 - 1200 1201 - 1300 Enter a place of care from the Hospital Location file. MCP CREATE A PROVIDER GROUP PROFILE SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides Payment Address 1: Payment Address 2: Payment Zip: Payment City: Payment State: Payment Phone: MCP PLACE OF CARE: INDIGO MC CREATE A PROVIDER GROUP PROFILE (continued) HOSPITAL LOCATION: INDIGO MC MCP PLACE OF CARE: INDIGO MC SD CLINIC PROFILE GRP PL3 PROVIDER GROUP PLACES OF CARE Provider Group: INDIGO MG ======================================================================== ---------------------------------------------Directions to Place of Care---------------------------------------------- --------------------------------------------Comments on Place of Care--------------------------------------------- Enter PAS Clinic Profile information. No patients may be booked to a provider unless the PAS information is entered. 4-151 NAME: INDIGO MC ABBREVIATION: INDIMC FACILITY: WALTER REED AMC WASHINGTON DC DIVISION: MCP CIVILIAN NETWORK BUILDING NAME: INDGO MEDICAL CENTER BUILDING NUMBER: 16W STREET ADDRESS: 1405 Darby Street ZIP: 20307 CITY: WASHINGTON STATE: DISTRICT OF COLUMBIA CLINIC LOCATION: CLINIC AVAILABILITY: TELEPHONE: 202 544-0923 ENROLLEE LOCKOUT: TYPE OF CARE: SERVICE: MCP FAM PRACT SERVICE DEPARTMENT: MCP DEPARTMENT SPECIALTY: MEPRS CODE: BGAA HOSPITAL LOCATION: INDIGO MC SD CLINIC PROFILE -- CONTINUATION MCP day(s) day(s) 0 day(s) 0 day(s) 0 day(s) day(s) day(s) day(s) CREATE A PROVIDER GROUP PROFILE SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides WAIT LIST ACTIVATED: MAXIMUM WAIT LIST DAYS: WAIT LIST PROVIDER MANDATORY: WAIT LIST HOLD DURATION: AUTO WAIT LIST PROCESSING: SCHEDULE HOLD DURATION: PROMPT FOR REQUESTING SERVICE: YES PATIENT RECORD PULL: CLINIC TYPE: NON-COUNT RADIOLOGY RECORD PULL: CHECK HOLIDAY FILE: NO ROSTER PRODUCTION: COST POOL CODE: PREPARE REMINDER NOTICE: ACTIVATION STATUS: ACTIVATED AVAILABLE SCHEDULE: CLINIC APPT INSTRUCTIONS: Arrive 10 minutes early. CREATE A PROVIDER GROUP PROFILE (continued) Provider: PRIMROSE,ZELDA C Add appointment types to clinic profile. IND PROF4 INDIVIDUAL PROVIDER PROFILE APPOINTMENT TYPE: PRO30 DURATION: 30 WORKLOAD TYPE: COUNT PULL PATIENT RECORDS: YES PRODUCE ENCOUNTER FORMS: NO TOTAL # OF OVERBOOKS: INSTRUCTIONS: Select BOOKING AUTHORITY: SD CLINIC PROFILE -- CONTINUATION STATUS: ACTIVE REFERRAL REQUIRED: YES PULL RADIOLOGY RECORD: NO SEND REMINDER NOTICE: YES MAX # OF OVERBOOKS PER SLOT: Select APPT CHANGE AUTHORITY: Select OVERBOOK AUTHORITY: Transfer appointment types to provider profiles. Provider Group: INDIGO MG ========================================================== SSN#: Gender: Military Status: Signature Line: 626-34-1323 FEMALE CIVILIAN Zelda C. Primrose, M.D. 4-152 Provider Group: INDIGO MG ------------------------------------------------------------------------------------------------------------------------ ----------------------- Provider: PRIMROSE,ZELDA C Add providers to group profile. IND PROF4 INDIVIDUAL PROVIDER PROFILE Provider Group: INDIGO MG ================================================================================== Tax ID#: 626-34-132 Provider Type: NETWORK INDIVIDUAL PROVIDER Payment Address 1: Payment Address 2: Payment Zip: Payment City: Payment State: Payment Phone: Payment Contact: MCP 20307 WASHINGTON DISTRICT OF COL 202 544-0923 INEZ,AMY CREATE A PROVIDER GROUP PROFILE SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides Agreement Effective Overall FI Type Date Stop Date Discount Notified Except PCM ------------------------------------------------------------------------------------------------------------------------ ----------------------NET 21 Jun 2001 21 Jun 2002 CA- 18% 21 Jun 2001 <--- NEW agreement may be added here CIVILIAN Languages: SPANISH Add agreements to group profile. PROVIDER GROUP AGREEMENT HISTORY DEA#: Rank: CREATE A PROVIDER GROUP PROFILE (continued) PLACE OF CARE: INDIGO MC • Confirm agreement participation for the provider: <Return> IND PL1 PROVIDER GROUP AGREEMENT HISTORY INDIVIDUAL PROVIDER PROFILE Provider: PRIMROSE,ZELDA C Provider Group: INDIGO MG ================================================================================= Speciality(s): ALLERGIST FAMILY PRACTICE PHYSICIAN Provider Group: INDIGO MG ----------------------------------------------------------------------------------------------------------------------------------------------Agreement Effective Overall FI Type Date Stop Date Discount Notified Except PCM ----------------------------------------------------------------------------------------------------------------------------------------------NET 21 Jun 2001 21 Jun 2002 CA- 18% 21 Jun 2002 <--- NEW agreement may be added here Notes: INDIVIDUAL PROVIDER SERVICES OFFERED PROFILE 4-153 • Refer to QRG: Enter a New Place of Care, for information on creating a new place of care in the Place of Care file. Provider: PRIMROSE,ZELDA C Place of Care: INDIGO MG Provider Group: INDIGO MG ----------------------------------------------------------------------------------------------------------------------------------------------- CPT-4 Code Description ----------------------------------------------------------------------------------------------------------------------------------------------- 864585 SKIN TEST, CANDIDA <--- NEW CPT-4 Code may be added here CREATE A PROVIDER GROUP PROFILE SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides MCP DISENROLL A PATIENT FROM THE MCP The Disenrollment option allows you to disenroll an MCP-enrolled patient. MENU PATH: PAS System Menu ➔ MAN ➔ EMCP ➔ DENR DISENROLLMENT PROCESSING Select PATIENT NAME: PEARL,ZACHARY N 20/569-69-4415 22 Apr 1962 M NE7 OK? YES// <Return> 4-154 ______________________________________________________________________________________ Select (F)ull, (M)ini, (O)HI, (N)ew Patient, (C)ontinue, or (Q)uit DEMOGRAPHICS: C// <Return> MCP DISENROLL A PATIENT FROM THE MCP SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides DEMOGRAPHICS DISPLAY Name: PEARL,ZACHARY N FMP/SSN: 20/569-69-4415 Patient Category: USN ACTIVE DUTY DDS: Patient Type: MCP/ACTIVE DUTY Sex: MALE MCP Status: PENDING ENROLLMENT DOB/Age: 22 Apr 1962/28Y ACV: A-ACTIVE DUTY/MCP ENROLLED DMIS ID: 6015 Direct Care: Medicare: ______________________________________________________________________________________ Sponsor Name: PEARL,ZACHARY N Rank: CHIEF PETTY OFFICE Station/Unit: FLEET COMBAT TRAINING CENTER DSN: Home Address: City: State: ZIP Code: Home Phone: Duty Phone: Work Phone: Registration Comment: Last Registration Date: 21 Jun 2001@1342 Outpatient Record Room: MEDICAL RECORDS FILE ROOM MCP Enroll Date: 21 Jun 2001 End Enroll Date: 21 Jun 2002 Primary Care Manager: FONTANA,LUISA M PCM Phone: 202 271-5850 Primary OHI: Case Mgmt: NO DISENROLL A PATIENT FROM THE MCP (continued) Select the Continue action. DISENROLLMENT Patient: PEARL,ZACHARY N FMP/SSN: 20/569-69-4415 Patient Category: USN ACTIVE DUTY DDS: MCP Status: ENROLLED Date: 21 Jun 2001 ______________________________________________________________________________________ FMP/SSN Family Member Sex DOB ENR Date Status ______________________________________________________________________________________ * 20/569-69-4415 PEARL,ZACHARY N M 22 Apr 62 21 Jun 01 E Notes: • This example shows how to disenroll one specified individual. You may also disenroll all family members. • On the Disenrollment screen, those selectable family members with a current status of Enrolled, Pending Enrollment, Conditional Enrollment, or Invalid Disenrollment are highlighted. • If the patient being disenrolled has pending appointments, you are notified. • Disenrollment reasons must exist in the Disenrollment Reason file. • The Reciprocal Disenrollment option prompts you to confirm you wish to disenroll from another MTF or Region. 4-155 ____________________________ There are no other family members______________________________ Select (A)ll Family Members, (I)ndividual Family Members, or (Q)uit Family Disenroll: A// I • The Reciprocal Disenrollment option is accessible during Enrollment (EENR) if you wish to enroll patient into your MTF or Regional program, or Reciprocal Disenrollment (DENR) if you do not wish to enroll patient into your MTF or Regional program. Use SELECT key to select family member OK TO DISENROLL PEARL,ZACHARY N? Yes// <Return> Disenrollment Date: 21 Jun 2001// <Return> (21 Jun 2001) Enter Disenrollment Reason: MNM MOVING (TO NON MCP SITE) Quick Reference Guides MCP DISENROLL A PATIENT FROM THE MCP SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Exit the Disenrollment screen. DOCUMENT A PATIENT CANCELLATION This option allows you to document when either an enrolled patient cancels an appointment with either an MTF or a non-MTF health care provider. MENU PATH: PAS System Menu ➔ MAN ➔ CMCP CANCELLATION BY PATIENT SEARCH CRITERIA Patient: FMP/SSN: Clinic: Appt Type: Clinic Phone: Provider: Service: Time Range: 0001 to 2400 Duration: Dates: 21 Jun 2001 to 20 Jun 2002 Days of Week: ----------------------------------------------------------------------------------------------------------------------------------------------- 4-156 ----------------------------------------------------------------------------------------------------------------------------------------------Select (C)hange Search Criteria, (S)earch for Appointments (Q)uit: S// • Select Search for Appointments action. • Select Patient Name. DEMOGRAPHICS DISPLAY Patient: PICARD,ZACHARY E FMP/SSN: 20/379-43-6114 Patient Category: USA ACTIVE DUTY ENLISTED DDS: Patient Type: MCP/ACTIVE DUTY Sex: MALE MCP Status: ENROLLED DOB/Age: 31 May 1955/35Y ACV: A-ACTIVE DUTY/MCP ENROLLED DMIS ID: 6015 Direct Care: ELIGIBLE Medicare: NOT ELIGIBLE ----------------------------------------------------------------------------------------------------------------------------------------------Sponsor Name: PICARD,ZACHARY E Rank: SERGEANT Station/Unit: FORT BELVOIR DSN: Home Address: 814 CARMINE ST. City: ARLINGTON State: VIRGINIA ZIP Code: 22222 Home Phone: 703-622-5234 Duty Phone: Work Phone: Registration Comment: Last Registration Date: 21 Jun 2001@1311 Outpatient Record Room: MEDICAL RECORDS FILE ROOM MCP Enroll Date: 21 Jun 2001 End Elig Enroll Date: 21 Jun 2002 Primary Care Manager: ESPOSITO,FRANK M PCM Phone: 202 271-5850 Primary OHI: Case Mgmt: NO ----------------------------------------------------------------------------------------------------------------------------------------------Select (F)ull, (M)ini, (O)HI, (N)ew Patient, (C)ontinue, or (Q)uit DEMO: C// DOCUMENT A PATIENT CANCELLATION (continued) • Select the Continue action. MCP DOCUMENT A PATIENT CANCELLATION SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides CANCEL/RESCHEDULE PATIENT APPOINTMENTS Patient: FMP/SSN: 20/379-43-6114 Clinic: Appt Type: Clinic Phone: Provider: Service: Time Range: 0001 to 2400 Duration: Dates: 21 Jun 2001 to 20 Jun 2002 Days of Week: DOCUMENT A PATIENT CANCELLATION (continued) • Select the Continue action. CANCEL/RESCHEDULE PATIENT APPOINTMENTS Patient: FMP/SSN: 20/379-43-6114 Clinic: Appt Type: Clinic Phone: Provider: Service: Time Range: 0001 to 2400 Duration: Dates: 21 Jun 2001 to 20 Jun 2002 Days of Week: • Confirm the selection. CANCEL/RESCHEDULE PATIENT APPOINTMENTS Patient: PICARD,ZACHARY E FMP/SSN: 20/379-43-6114 Clinic: Appt Type: Clinic Phone: Provider: Service: Time Range: 0001 to 2400 Duration: Dates: 21 Jun 2001 to 20 Jun 2002 Days of Week: -----------------------------------------------------------------------------------------------------------------------------FRI 0800 22 Jun 01 NEW FPAM ESPOSITO, F ----------------------------------------------------------------------------------------------------------------------------------------------FRI 0800 22 Jun 01 NEW FPAM ESPOSITO, F FRI 1500 22 Jun 01 FU FPAM ESPOSITO, F TUE 0 900 26 Jun 01 NEW OTMTF PAANGA, A 4-157 ----------------------------------------------------------------------------------------------------------------------------------------------Use SELECT key to select appointments to be cancelled/rescheduled ----------------------------------------------------- Select appointment #1 of 1 -----------------------------------------------------This appointment was booked from PCM Booking Select (C)ancel, or (Q)uit CANCEL/RESCHEDULE: • Select the Cancel action. • Select an appointment to cancel. • Select the Quit action and return to the Managed Care Program Menu. DOCUMENT A PATIENT CANCELLATION SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides MCP DOCUMENT A PATIENT CANCELLATION (continued) Need to know: – If the appointment to be cancelled is an MTF appointment, the system displays the message - Canceling appointment... - and immediately cancels the appointment. The system returns to the Cancellation by Patient Search Criteria screen. THE CANCELLATION BY PATIENT SEARCH CRITERIA SCREEN. • The only required search criteria is the patient's name. Once the patient's name is entered, the system displays a list of all MTF (pending) and Network (booked) appointments. If no appointments have been made for this patient during the specified times, the system displays a blank Cancellation by Patient Search Criteria screen with the message - No appointments for this patient after the start date specified. 4-158 • If this is the case, you can either use the Change Search Criteria action on the action bar and enter new dates, or you can quit the screen and return to the Managed Care Program Menu. • If the date range was not altered by way of the Change Search Criteria action, the default date range is one year. All appointments are listed chronologically by date and time. The (R)eschedule action is used to enter the booking screens and reschedule the selected appointments. – If the appointment to be rescheduled is an MTF appointment, the system displays the MTF Booking Search Criteria screen. – If the appointment to be rescheduled is a non-MTF appointment, the system displays the Non-MTF Booking Search Criteria screen. – If you reschedule an MTF appointment without leaving the Cancellation by Patient option, the appointment status changes to Open and it becomes available for rebooking from the Wait List if the specified clinic has an active Wait List. • You can verify that the appointment has been cancelled by accessing the Display Patient Appointments (DMCP) option on the Managed Care Program Menu. THE CANCEL/RESCHEDULE PATIENT APPOINTMENTS SCREEN. Quick Reference Guides – If the appointment to be cancelled is a non-MTF appointment, the system queries you to see if the place of care has been notified. * If you respond yes, the system cancels the appointment and returns to the Cancellation by Patient Search Criteria screen. * If you respond no, the system displays the message - This appointment cannot be cancelled at this time - and returns to the Cancellation by Patient Search Criteria screen. MCP DOCUMENT A PATIENT CANCELLATION SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 • Different screens appear depending upon the type of appointment to be cancelled: DOCUMENT A PATIENT REFUSAL This option allows you to document either enrolled or non-enrolled patient refusals for patients who have refused appointments with either an MTF or nonMTF health care provider. MENU PATH: PAS System Menu ➔ MAN ➔ HMCP ➔ AHCF ALTERNATE MENU PATHS: PAS System Menu ➔ MAN ➔ HMCP ➔ PHCF PAS System Menu ➔ MAN ➔ HMCP ➔ NHCF 4-159 Patient: Patient Category: DOB/Age: Case Mgmt: Patient Type: PCM: Referral# 900000059 APPOINTMENT REFUSAL PICARD,ZACHARY E FMP/SSN: USA AD ENLIST Appt Type: 31 May 1966/35Y DDS: Sex: MCP/ACTIVE DUTY MCP Status: ESPOSITO,FRANK M PCM Phone: Date/Time Provider Specialty • Select the Add Refusal action. APPOINTMENT REFUSAL Patient: PICARD,ZACHARY E FMP/SSN: 20/379-43-6114 Patient Category: USA AD ENLISTED Pat SSN: 379-43-6114 DOB/Age: 31 May 1966/35Y DDS: Case Mgmt: SEX: MALE Patient Type: MCP/ACTIVE DUTY MCP STATUS: ENROLLED PCM: ESPOSITO,FRANK M PCM Phone: 202 271-5850 ================================================================================== Referral Number: 900000059 Refusal Date/Time: 21 Jun 2001@1720 Specialty: DERMATOLOGY Location: DISTRICT OF COLUMB HCF: MCP, HCF Refusal Status: MTF DECLINED Refusal Reason: 2 APPOINTMENT DATE/TIME UNACCEPTABLE Refused Provider: Refusal Reason: (Free Text) 20/379-43-6114 379-43-6114 MALE ENROLLED 202 271-5850 HCF Comment: File/exit Abort File changes and exit. Edit Status DERMATOLOGY • Complete the Appointment Refusal screens. Quick Reference Guides DOCUMENT A PATIENT REFUSAL (continued) -----------------------------------------------------------------------------------------------------------------------------------------------Select (A)dd Refusal, or (Q)uit APPT REFUSAL: A// • Select the View History action: V APPOINTMENT REFUSAL MCP DOCUMENT A PATIENT REFUSAL SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 • File the data. DOCUMENT A PATIENT REFUSAL (continued) • Select the View History action: V Patient: Patient Category: DOB/Age: Patient Type: MCP Status: PCM: Case Mgmt Provider: APPOINTMENT REFUSAL PICARD,ZACHARY E FMP/SSN: USA ACTIVE DUTY OFFICER Pat SSN: 19 Feb 1966/35Y DDS: MCP/ACTIVE DUTY Sex: ENROLLED ESPOSITO,FRANK M PCM Phone: Case Mgmt: 20/379-43-6114 379-43-6114 MALE 202 271-5850 NO Date/Time HCF Reason for Refusal Status -----------------------------------------------------------------------------------------------------------------------------------------------21 Jun 01@1720 MCP, HCF APPOINTMENT DATE/TIME UNACCE MTF DECLINED The Appointment Refusal action appears on the Non-Enrolled Booking Search Criteria and Non-Enrolled Non-MTF Booking Search Criteria screens for non-enrolled patients. These are accessed through the Non-Enrolled Booking (NMCP) option on the Managed Care Program Menu. An appointment refusal must be documented before the appointment is booked. • THE APPOINTMENT REFUSAL SCREEN. Only the Add Refusal and Quit actions appear on the action bar if no previous patient refusals are linked to this appointment. The View History action appears on the action bar when you enter a patient refusal. 4-160 -----------------------------------------------------------------------------------------------------------------------------------------------Use the SELECT key to select individual Appointment Refusals to view • Press <Return> to continue. • Select the Quit action until you return to the Health Care Finder Menu. • PATIENT APPOINTMENT REFUSALS. The Appointment Refusal action appears on the MTF Booking Search Criteria and Non-MTF Booking Search Criteria screens for enrolled patients. These are accessed through the Appointment Referral Processing (AHCF) option on the Health Care Finder Menu. MCP DOCUMENT A PATIENT REFUSAL SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides Notes: EDIT AN INDIVIDUAL PROVIDER PROFILE The Individual Provider Profile/Agreements Enter/Edit option allows you to enter or modify an individual provider’s profile and agreement information. MENU PATH: PAS System Menu ➔ MAN ➔ PMCP ➔ INET After you access this option, enter the provider name. Then select the Edit Profile action on the Individual Provider Profile/Agreement Maintenance action bar. The following PAS Provider Profile screens are displayed: • CP NET HCP PROFILE -- CONTINUATION screen - Clinic Hours, Location, Max # of Patient Appts Per Day, Appt Arrival Advance Time, Provider Instructions, Print Roster with open Appts, Inactivation Date. • CP NET HCP PROFILE -- CONTINUATION screen - Appointment Type (add/edit appointment types). Notes: The following screens are displayed: • Individual Provider Profile screen (IND PROF 1) - SSN, DEA#, Gender, Rank, Military Status, Signature Line, Languages. • Individual Provider Profile screen (IND PROF 3) - UPIN#, CHAMPUS NBR, Professional Category. 4-161 • Individual Provider Profile screen (IND PROF 4) - Tax ID#, Provider Type, Payment information. • Individual Provider Profile screen (IND PROF 5) - Places of Care. • The INET option is not used to create a new provider profile. The provider’s specialties and languages, gender, military rank, military status, and professional category should be entered using the Provider Enter/Edit option on the Provider Network File/Table Maintenance Menu. • The Agreement Exceptions action is used to enter exceptions to group agreements for an individual provider. • The Inactivate/Reactivate action is used to enter an inactivation or reactivation date and a reason for inactivation. • Individual Provider Profile screen (IND PL1) - Specialities. • Individual Provider Profile screen (IND PL2) - Hours of Service. MCP EDIT AN INDIVIDUAL PROVIDER PROFILE SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides • Individual Provider Services Offered Profile screen - Add single or block CPT codes of services offered. EDIT TEXT FOR AN MCP FORM The MCP Forms Text Enter/Exit option allows you to edit text for Form and the Enrollment Form. MENU PATH: PAS System Menu ➔ MAN ➔ FMCP ➔ ETAB ➔ FORM MCP Forms Text Enter/Edit Select TYPE OF FORM: CAF The existing Care Authorization Form is displayed: • Select TYPE OF FORM: CAF 4-162 • Choose 1, CAF-ACTIVE DUTY. MCP EDIT TEXT FOR AN MCP FORM SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides Choose from: CAF-ACTIVE DUTY CAF-CHAMPUS ELIGIBLE CAF-DIRECT CARE CAF-MCP/ACTIVE DUTY CAF-MEDICARE CAF-NON-ENROLLED/CHAMPUS ELIGI CAF-OTHER CAF-SUPPLEMENTAL CARE DIAGNOSI DISENROLLMENT NOTIFICATION ENROLLMENT FORM RENEWAL NOTIFICATION EDIT TEXT FOR AN MCP FORM (continued) MCP FORM TEXT: CAF-ACTIVE DUTY CP FORMS TEXT Maximum Text Lines: 7 This Care Authorization covers necessary specialty care directed and authorized by the referring provider. the care covered may be provided either within the MTF or, if authorized, through the Supplemental Care Program. As the patient is an active duty participant, the government is responsible for all authorized cost shares accrued during this episode of care. Active Duty. Need to Know: • This example demonstrates only the option to edit the Care Authorization Form. The Enrollment Form can also be edited. • The maximum number of lines for each form is specified in the Maximum Text Lines field. This setting is based on the actual number of lines available on the printed form and cannot be changed by the user. • Refer to QRG: Screen Editor Options, for more information on editing. Ask for Help = HELP Screen Exit = F10 File/Exit = DO INSERT OFF Edit the text. 4-163 For this example, lines 3, 4, and 5 are deleted and replaced with the text as shown in the following screen. MCP FORM TEXT: CAF-ACTIVE DUTY CP FORMS TEXT Quick Reference Guides Ask for Help = HELP Screen Exit = F10 File/Exit = DO INSERT OFF MCP EDIT TEXT FOR AN MCP FORM SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Maximum Text Lines: 7 This Care Authorization covers necessary specialty care directed and authorized by the referring provider. As the patient is an active duty participant, the government is responsible for all authorized cost shares accrued during this episode of care. Active Duty. ENROLL A PATIENT INTO THE MCP The Enrollment Enter/Edit option allows you to verify the DEERS eligibility of a patient, then enroll the patient into MCP. Note: This example is for a patient already registered in CHCS. MENU PATH:PAS System Menu ➔ MAN ➔ EMCP ➔ EENR FAMILY MEMBER SCREEN Patient Name: PEARL,ZACHARY N FMP/SSN: 20/596-69-4415 DOB: 12 Jun 1975 Sponsor Name: PEARL,ZACHARY N Sponsor SSN: 569-69-7715 Elig Start Date: 25 Sep 1998 Elig End Date: 1999 -----------------------------------------------------------------------------------------------------------------------------------------------Name Sex DOB DDS ACV Dir Med DMIS ID PEARL,ZACHARY N PEARL,ZELDA N M F 12 Jun 1975 02 Jan 1976 20 30 N C E E N N Select PATIENT NAME: Pearl,Zachary N 569-69-4415 12 Jun 1975 MNE7 PRP OK? YES// <Return> SPONSOR NAME: Pearl,Zachary N// <Return> 4-164 CURRENT DEERS ELIGIBILITY Name: Pearl,Zachary N FMP/SSN: 20/569-69-4415 Patient Category: USN ACTIVE DUTY DDS: 20 DOB/Age: 12 Jun 1975/26Y Sex: MALE -----------------------------------------------------------------------------------------------------------------------------------------------Sponsor Rank: CHIF PETTY OFFICER Sponsor UIC: W2DH05-WALTER REED MED HOLD PP DMIS ID: ACV: N-NOT ENROLLER/CHAMPUS INELIGIBLE ACV Start Date: Region Code: Care Authorization PH#: PCM Location Dir Care Elig Start Date: Medicare: NOT ELIGIBLE Dir Care Elig End Date: CHAMPUS: Eligibility End Reason: -----------------------------------------------------------------------------------------------------------------------------------------------Use SELECT key to select Other Family Member(s) to process, or use F9 key to view family members currently registered in CHCS Press <Return> • Select the Continue action. MCP ENROLL A PATIENT INTO THE MCP SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides BRAC Pharmacy Eligibility: Override Code: Date of Request: 21 Jun 2001@1155 -----------------------------------------------------------------------------------------------------------------------------------------------Select to (V)iew more DEERS data, (P)rint, (R)epeat DEERS check, (C)ontinue, or (Q)uit: C// ENROLL A PATIENT INTO THE MCP (continued) ENROLLMENT HISTORY: 08 Nov 2002 MCP Enrollment -- CONTINUATION DEMOGRAPHICS DISPLAY Name: Patient Category: Patient Type: MCP Status: ACV: Direct Care: PEARL,Z USN ACTIVE DUTY FMP/SSN: DDS: Sex: DOB/Age: N-NOT ENROLLED/CHAMPUS INELI DMIS ID: ELIGIBLE Medicare: 4-165 Sponsor Name: PEARL,Z Rank: Station/Unit: WALTER REED MED HOLD PP DSN: City: HAMPTON State: ZIP Code: 23665 Home Phone: Duty Phone: (301) 555-4993 Work Phone: Registration Comment: New Patient Last Registration Date: 21 Jun 2001@101002 Outpatient Record Room: MEDICAL RECORDS FILE ROOM MCP Enroll Date: End Enroll Date: Primary Care Manager: PCM Phone: Primary OHI: NOT ASSIGNED Case Mgmt: 20/569-69-4415 20 MALE 12 Jun 1975/26Y NOT ELIGIBLE CHIEF PETTY OFFICE 331 VIRGINIA 8329742333 (301) 555-4993 Name: Pearl,Z FMP/SSN: 20/569-69-4415 Patient Category: USA ACTIVE DUTY DDS: 20 Patient Type: MCP/ACTIVE DUTY Sex: MALE MCP Status: DOB/Age: 22 Jun 1975/26Y Primary Care Manager: PCM Phone: Primary OHI: NOT ASSIGNED Case Mgmt: NO ACV: Direct Care: ELIGIBLE Medicare: NOT ELIGIBLE ----------------------------------------------------------------------------------------------------------------------------------------------Enrolling Division: DIV A - TRAINING HOSPITAL Patient Type: MCP/ACTIVE DUTY MCP Enroll Date: 21 Jun 2001 End Enroll Date: 30 Jun 2002 Enrollment Comment: Select (F)ull, (M)ini, (E)nrollment, (N)ew Patient, or (Q)uit DEMOGRAPHICS: E// Ask for Help = HELP • Select the Enrollment action. Screen Exit = F10 File/exit = DO INSERT OFF Complete the Enrollment Continuation Screen. ENROLL A PATIENT INTO THE MCP SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides MCP ENROLL A PATIENT INTO THE MCP (continued) PATIENT: JAVENS,CHRISTOPHER L Name: Patient Category: Patient Type: MCP Status: Primary Care Manager: Primary OHI: ACV: Direct Care: PEARL,Z USA ACTIVE DUTY MCP/ACTIVE DUTY NOT ASSIGNED A-ACTIVE DUTY/MCP ENROLLED ELIGIBLE MCP ENROLLMENT • If a patient is not currently registered in CHCS, you can register the patient as you enroll the patient in MCP. FMP/SSN: DDS: Sex: DOB/Age: PCM Phone: Case Mgmt: • If enrollment is restricted by residential address and the patient you are enrolling is not within the catchment area, the following message is displayed to holders of the CPZ ZIP security key - Invalid patient zip code, location is not within Catchment Area. Do you want to override? No//. You may select to override the restriction and continue with the enrollment. 20/569-69-4415 20 MALE 12 Jun 1975/26Y NO Medicare: NOT ELIGIBLE ======================================================================= Patient SSN: 569-69-4415 • The patient type is derived by the system based on the patient's PATCAT, ACV code, and age, if no DEERS response is received. • The patient type cannot be edited for an active-duty patient; only the patient type for a nonactive-duty patient can be changed. Language: 4-166 ID Card Number: 19944 Effective Date: 17 Nov 2000 Need to know information: Date Issued: 17 Nov 2000 Expiration Date: INDEFINITE ______________________________________________________________________________________ File/exit Abort Edit File changes and exit. • You are allowed to edit the Patient Type field to enter MCP/Non-CHAMPUS Eligible; the system then inserts a D in the ACV field. • The ACV is derived by DEERS and sent to CHCS. It defines the type of eligibility for the patient and cannot be edited directly. • Refer to QRG: Assign a Primary Care Manager to an MCP Patient. • Complete the second Enrollment Continuation screen. • You must assign a PCM to the patient, or the enrollment will be deleted. MCP ENROLL A PATIENT INTO THE MCP SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides Note: To complete the enrollment, you must assign a PCM to the patient. Refer to QRG: Assign a PCM to an MCP Patient. This example ends when the PCM Search Criteria screen is displayed. ENROLL FAMILY MEMBERS INTO THE MCP The Enrollment Enter/Edit option allows you to enroll family members into the MCP. MENU PATH: PAS System Menu ➔ MAN ➔ EMCP ➔ EENR Select PATIENT NAME: PATRICK,ZELDA E 30/637-24-9618 07 May 1960 F OK? YES// <Return> SPONSOR NAME: PATRICK,ZIGGY E// <Return> Because a DEERS check was processed for this patient within the last five days, the Current DEERS Eligibility screen is displayed. Bypass the DEERS transaction: <Return> The Demographics Display screen is displayed: 4-167 DEMOGRAPHICS DISPLAY Name: PATRICK,ZELDA E FMP/SSN: 30/637-24-9618 Patient Category: USN FAM MBR AD DDS: Patient Type: MCP/CHAMPUS ELIGIBLE Sex: FEMALE MCP Status: ENROLLED DOB/Age: 07 May 1960/30Y ACV: E-MCP ENROLLED/DIR. CARE CHA DMIS ID: 0037 Direct Care: ELIGIBLE Medicare: NOT ELIGIBLE _____________________________________________________________________________________ Sponsor Name: PATRICK,ZIGGY E Rank: ENSIGN Station/Unit: WASHINGTON NAVAL YARD DSN: Home Address: 8650 EAGLEPOINT RD. City: SILVER SPRING State: MARYLAND ZIP Code: 20904 Home Phone: (301) 589-2929 Duty Phone: Work Phone: Registration Comment: Last Registration Date: 21 Jun 2001@1207 Outpatient Record Room: MEDICAL RECORDS FILE ROOM MCP Enroll Date: 21 Jun 2001 End Enroll Date: 21 Jun 2002 Primary Care Manager: PEKNY,JAMES M PCM Phone: 202 456-9878 Primary OHI: BLUE CROSS BLUE SHIELD, NC Case Mgmt: NO _____________________________________________________________________________________ Select (F)ull, (M)ini, (E)nrollment, (O)HI, (P)CM, Ca(s)e, F(a)mily, (D)isenroll, (H)istory, (N)ew Patient, or (Q)uit DEMOGRAPHICS: E// A Quick Reference Guides Select the Family action. Patient: Patient Category: PCM: Pi OHI MCP FAMILY ENROLLMENT PATRICK,ZELDA E FMP/SSN: 30/637-24-9618 USN FAM MBR AD DDS: PEKNY,JAMES M PCM Phone: 202 456-9878 BLUE CROSS/BLUE SHIELD NC D t 21 J 2001 ENROLL FAMILY MEMBERS INTO THE MCP SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 ENROLL FAMILY MEMBERS INTO THE MCP (continued) ENROLL FAMILY MEMBERS INTO THE MCP (continued) ENROLLMENT HISTORY: 21 Jun 2001 MCP Enrollment -- CONTINUATION Select the Family action. FAMILY ENROLLMENT Patient: PATRICK,ZELDA E FMP/SSN: 30/637-24-9618 Patient Category: USN FAM MBR AD DDS: PCM: PEKNY,JAMES M PCM Phone: 202 456-9878 Primary OHI: BLUE CROSS/BLUE SHIELD, NC Date: 21 Jun 2001 ----------------------------------------------------------------------------------------------------------------------------------------------FMP/SSN Family Member Sex DOB Status ______________________________________________________________________________________ * 01/637-24-9618 PATRICK,ZACH N M 09 Jan 1984 20/637-24-9618 PATRICK,ZIGGY E M 07 Oct 1958 E 30/637-24-9618 PATRICK,ZELDA E F 07 May 1960 E Name: PATRICK,ZACH N FMP/SSN: 01/637-24-9618 Patient Category: USN FAM MBR AD DDS: Patient Type: MCP/CHAMPUS ELIGIBLE Sex: MALE MCP Status: DOB/Age: 09 Jan 1984/06Y Primary Care Manager: PCM Phone: Primary OHI: NOT ASSIGNED Case Mgmt: NO ACV: E-MCP ENROLLED/DIR. CARE CHA Direct Care: ELIGIBLE Medicare: NOT ELIGIBLE ================================================================================== Enrolling Division: DIV A - TRAINING HOSPITAL Patient Type: MCP/CHAMPUS ELIGIBLE 4-168 MCP Enroll Date: 21 Jun 2001 End Enroll Date: 21 Jun 2002 ______________________________________________________________________________________ Select (A)ll Family Members, (I)ndividual Members, or (Q)uit FAMILY: A// I Use SELECT key to select family member Do you want to copy OHI to PATRICK,ZACH N? No// YES Relationship to Insured: CHILD Do you want to copy PCM to PATRICK,ZACH N? No// YES Enrollment Comment: Ask for Help = HELP File/Exit = DO INSERT OFF ENROLL FAMILY MEMBERS INTO THE MCP SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides MCP Screen Exit = F10 ENROLL FAMILY MEMBERS INTO THE MCP (continued) PATIENT: PATRICK,ZACH N MCP ENROLLMENT Name: PATRICK,ZACH N FMP/SSN: 01/637-24-9618 Patient Category: USN FAM MBR AD DDS: Patient Type: MCP/CHAMPUS ELIGIBLE Sex: MALE MCP Status: DOB/Age: 09 Jan 1984/06Y Primary Care Manager: PCM Phone: Primary OHI: NOT ASSIGNED Case Mgmt: NO ACV: E-MCP ENROLLED/DIR. CARE CHA Direct Care: ELIGIBLE Medicare: NOT ELIGIBLE ================================================================================== Patient SSN: • If no additional family members exist for the patient, the message - There are no other family members - displays at the bottom of the Family Enrollment screen. • You can copy the PCM from a patient to the specified family member if the patient is not active duty. • You can copy OHI information from a patient to a Family member. • The Enroll/End Date fields can be edited. The Enroll date is today for active duty and the first day of the next month for non-active duty.The system enters an End Enroll date if received from DEERS for active duty. If no date is received from DEERS, the system automatically inserts a date that is years in the future from the enrollment date. For non-active duty, the system defaults the End Enroll date to one year from the enroll date. Language: 4-169 ID Card Number: 20111 Effective Date: 19 Jun 2001 Date Issued: 13 Oct 2000 Expiration Date: 24 Mar 2002 ______________________________________________________________________________________ File/exit Abort Edit File changes and exit. Quick Reference Guides • Return to the Enrollment Processing Menu. Notes: • This example shows how to enroll one specified individual. You may also enroll all family members. MCP ENROLL FAMILY MEMBERS INTO THE MCP SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 The Family Enrollment screen displays. ENTER A NEW MCP OFFICE The MCP Office Enter/Edit option allows you to enter or edit MCP office information in the MCP Office file. MENU PATH: PAS System Menu ➔ MAN ➔ FMCP ➔ FTAB ➔ OFFI After you access this option, the following prompt displays: Select MCP OFFICE: CENTRAL MCP OFFICE Are you adding ‘CENTRAL MCP OFFICE’ as a new MCP OFFICE (the 2nd)? Y Enter a unique office name 3-45 characters in length. MCP OFFICE: CENTRAL MCP OFFICE Need to know information: For the office supervisor, enter a user number, name, initials, nick name, or mail name. After you enter the zip code, the city and state fields are automatically entered. • A new MCP office must be added to the MCP Office file before the staff at the new office can be added to the MCP Health Care Finder file. • MCP office information is displayed on the Care Authorization Form and other forms sent to the patient. • An office supervisor must be an existing valid user in the CHCS User List. CP OFFICE PROFILE 4-170 MCP OFFICE: CENTRAL MCP OFFICE MCP OFFICE SUPERVISOR: PARCEL,ZINA N STREET ADDRESS: 846 CENTRAL AVE ZIP: 92111 CITY: SAN DIEGO STATE: CALIFORNIA OFFICE PHONE: (619) 555-4738 OFFICE LOCATION: 2ND FLOOR, SUITE 2300 OFFICE HOURS: 8AM TO 4PM MCP ENTER A NEW MCP OFFICE SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides -----------------------------------------------------------------------------------------------------------------------------File/exit Abort Edit File changes and exit. ENTER A NEW MILITARY STATUS IN THE MILITARY STATUS FILE The Military Status Enter/Edit option allows you to enter a new military status, or edit information for an existing military status, in the Provider file. MENU PATH: PAS System Menu ➔ MAN ➔ FMCP ➔ PTAB ➔ MILI Need to know information: • The associated description field displays automatically after the professional category code is entered. • The professional categories assigned to MCP are audiologist, dental, surgeon, and licensed practical nurses. After you access this option, enter the Military Status. The following screen displays: MILITARY STATUS: IRR MILITARY STATUS MILITARY STATUS ENTER/EDIT ================================================================================== 4-171 Code: IRR Description: INACTIVE READY RESERVE MCP ENTER A NEW MILITARY STATUS IN THE MILITARY STATUS FILE SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides -----------------------------------------------------------------------------------------------------File/exit Abort Edit File changes and exit. ENTER A NEW PROFESSIONAL CATEGORY IN THE PROFESSIONAL CATEGORY FILE The Professional Category Enter/Edit option allows you to enter a new MCP provider, or edit information for an existing Provider Profile, in the Provider file. MENU PATH: PAS System Menu ➔ MAN ➔ FMCP ➔ PTAB ➔ PROF After you access this option, enter the Professional Category. The following screen displays. PROFESSIONAL CATEGORY: MFCC Professional Category Code: Description: CP PROFESSIONAL CATEGORY MFCC MARRIAGE AND FAMILY COUNSELOR 4-172 MCP ENTER A NEW PROFESSIONAL CATEGORY IN THE PROFESSIONAL CATEGORY FILE SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides -----------------------------------------------------------------------------------------------------File/exit Abort Edit File changes and exit. ENTER AND EDIT A NEW MCP PROVIDER IN THE PROVIDER FILE The Provider Enter/Edit option allows you to enter a new civilian provider, or edit information for an existing provider profile, in the Provider file. This new provider is then included in the MCP network. MENU PATH: PAS System Menu ➔ MAN ➔ FMCP ➔ PTAB ➔ PROV After you access this option, enter the Provider name. IND PROF1a INDIVIDUAL PROVIDER PROFILE ========================================================== SSN#: Gender: Military Status: Signature Line: 671-87-5521 MALE CIVILIAN PAUL R. ADAIR MD DEA#: Rank: CIVILIAN Speciality(s): FAMILY PRACTICE PHYSICIAN The following screen is displayed: PROVIDER: ADAIR,PAUL R PROVIDER: ADAIR,PAUL R DOD ADD PROVIDER 4-173 Provider Flag: PROVIDER Provider Speciality(s): 001 HCP SIDR-ID: 001192 Provider Location: CHAMPUS SUPPORT Provider Class: OUTSIDE PROVIDER Languages: FRENCH Ask for Help = HELP HCP SIDR-ID: 001192 Screen Exit = F10 File/Exit = D0 Provider ID: ADAIPR Provider DOB: 25 Aug 1963 Provider SSN: 671-87-5521 Quick Reference Guides -----------------------------------------------------------------------------------------------------File/exit Abort Edit File changes and exit. MCP ENTER AND EDIT A NEW MCP PROVIDER IN THE PROVIDER FILE SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Provider DEA#: Provider HCP#: 67-8777 Provider Clinic: Id Provider Department Id Code: ENTER AND EDIT A NEW MCP PROVIDER IN THE PROVIDER FILE (continued) MCP PROVIDER: ADAIR,PAUL R IND PROF3a Notes: • Do not enter C in the Provider Flag field. This entry should be made only by the system. ========================================================== • In the Provider Specialty field, enter one or more provider specialties from the Provider Specialty file. Enter either the entry number for the specialty or the first three characters of the name. UPIN#: 2309 CHAMPUS NBR: 19666 Professional Category: PHYSICIAN (OTHER THAN SURGEON) • The only appropriate entry in the Provider Location field for a civilian provider is CHAMPUS Support. INDIVIDUAL PROVIDER PROFILE • In the Provider Class field, you may enter a provider class already existing in the Provider Class table, or you may enter a new provider class. • Leave the Provider Clinic ID and Provider ID Department Code fields blank for a civilian provider. 4-174 -----------------------------------------------------------------------------------------------------------------------------File/exit Abort Edit File changes and exit. • In the Rank field, enter the provider's military grade and rank. For a civilian provider, enter XCIV (Civilian). The Military Status field is then automatically entered. • The HCP SIDR-ID field is automatically entered with the provider's SIDR identification for one of the provider's specialties. ENTER AND EDIT A NEW MCP PROVIDER IN THE PROVIDER FILE SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides MCP ENTER AND EDIT A NEW NAS ISSUING OFFICER IN THE NAS ISSUING OFFICER FILE The NAS Issuing Officer Enter/Edit option allows you to enter and edit NAS issuing officer information in the NAS Issuing Officer file. MENU PATH:PAS System Menu ➔ MAN ➔ FMCP ➔ FTAB ➔ ISSO After you access the option, the following prompt displays. Select NAS ISSUING OFFICER: FRANKLIN,ROBERT E Are you adding ‘FRANKLIN,ROBERT E’ as a new NAS ISSUING OFFICER (the 2nd)? Y NAS ISSUING OFFICER RANK: AO6 Need to know information: • If you enter a new title for the NAS Issuing Officer, the title must be 3-30 characters in length. • Enter a Military Rank or a Civilian Rank, but not both. • The NAS Issuing Officer is a required field for the NAS Issuance option,. Only valid entries from the NAS Issuing Officer file can be used. • The name, title, and rank of the NAS Issuing Officer are sent to DEERS with each new NAS issued, and are printed on the DD Form 1251 (NAS). • An Issuing Officer can only have either a Military Rank or a Civilian Rank, but not both. A Civilian Rank must be a valid entry in the Federal Civil Service Paygrade file. 4-175 After you enter the Officer Rank, the following screen displays: NAS ISSUING OFFICER: FRANKLIN,ROBERT E MCP NAS ISSUING OFFICER NAS ISSUING OFFICER ENTER/EDIT ========================================================== FRANKLIN,ROBERT E Title: NAS ISSUING OFFICER Military Rank: COLONEL Civilian Rank: Quick Reference Guides -----------------------------------------------------------------------------------------------------File/exit Abort Edit File changes and exit. MCP ENTER AND EDIT A NEW NAS ISSUING OFFICER IN THE NAS ISSUING OFFICER FILE SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Name: ENTER AND EDIT A NEW PLACE OF CARE The Place of Care Enter/Edit option allows you to enter a new MCP non-MTF place of care, or edit information for an existing place of care, in the Hospital Location file. MENU PATH: PAS System Menu ➔ MAN ➔ FMCP ➔ PTAB ➔ PLAC After you access this option, enter the following information: • Place of Care Name - Check with your site POC to determine naming conventions to use. • Hospital Location Abbreviation • Hospital Location Description 4-176 • Hospital Location Type - If this type is MCP Non-MTF, only the MCP division can be assigned in the Hospital Location Division field. • Hospital Location Division • Hospital Location MEPRS Code ENTER AND EDIT A NEW PLACE OF CARE SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides MCP ENTER AND EDIT A NEW PLACE OF CARE (continued) The DOD Hospital Location Edit screen is displayed: HOSPITAL LOCATION: IMMUN CLINIC MCP DOD HOSP LOCATION EDIT HOSPITAL LOCATION: IMMUN CLINIC MCP DOD HOSP LOCATION EDIT -- CONTINUATION SPECIALITY: IMM ASSOC SVC MEPRS CODE: FCCA PROMPT FOR REQUESTING SERVICE: COST POOL CODE: ENROLLEE LOCKOUT: NAME: IMMUN CLINIC MCP ABBREV: IMCL TYPE OF CARE: DESCRIPTION: LOCATION TYPE: MCP NON-MTF Select KEY PERSON: FACILITY: TRAINING MEDICAL TREATMENT FACILITY SERVICE: IMM ASSOC SVC Select DUPLICATE CHECKING ORDER TYPE: DIVISION: MCP CIVILIAN NETWORK BLDG NAME: EMPIRE PROFESSIONAL BUILDING BLDG NUMBER: A100 INACTIVE FLAG: 4-177 TELEPHONE: STREET ADDRESS: 84 LINCOLN AVENUE SW ZIP: 20307 CITY: WASHINGTON -----------------------------------------------------------------------------------------------------File/exit Abort File changes and exit. Edit STATE: DISTRICT OF COLUMBIA DEFAULT DEVICE: FIELD INFORMATION: Quick Reference Guides • SPECIALTY: Enter a service or department associated with this Hospital Location. The entry must exist in the Department and Service file. • FACILITY: The entry must exist in the Medical Treatment Facility file. • SERVICE: Enter the name of the service associated with this Hospital Location. The entry must exist in the Department and Service file. • PROMPT FOR REQUESTING SERVICE: Press <Return>. Entering YES in this field causes the system to prompt for the requesting service every time an appointment is booked at this clinic. Set this clinic to YES if this is a clinic that does a majority of referral work. MCP ENTER AND EDIT A NEW PLACE OF CARE SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 FIELD INFORMATION: ENTER AND EDIT A NEW PLACE OF CARE (continued) Confirm the information. • COST POOL CODE: Press <Return>. This is a pointer to the MEPRS Master Table. Cost pool codes must have an X in the third position from the left. This field is normally left blank because cost pool codes are not used for non-MTF places of care. • INACTIVE FLAG: To inactivate a place of care, enter 1 in this field. MCP non-MTF locations must first be inactivated via MCP software. HOSPITAL LOCATION: IMMUN CLINIC MCP GRP PL1a PLACE OF CARE ========================================================== 4-178 Name: Location Abbrev: Building Name: Building Number: Street Address: Zip: City: State: Phone: Screen Exit = F10 File/Exit = DO GRP PL2a PLACE OF CARE ========================================================== Type of Facility: PHYSICIAN OFFICE Appt Contact: MARY ROBINSON DMIS ID#: 6015 CMHA, FT. MONMOUTH --------------------------------------------------- Hours of Service --------------------------------------------------Day of Week AM PM MONDAY 0800 - 1130 1330 - 1630 TUESDAY 0800 - 1130 1330 - 1630 THURSDAY 0800 - 1130 1330 - 1630 FRIDAY 1300 - 1800 FIELD INFORMATION: • DMIS ID#: This is automatically entered by the system and cannot be edited. INSERT OFF MCP ENTER AND EDIT A NEW PLACE OF CARE SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides Ask for Help = HELP IMMUN CLINIC MCP IMCL EMPIRE PROFESSIONAL BUILDING A100 84 LINCOLN AVENUE SW 20307 WASHINGTON DISTRICT OF COL (202) 555-4039 MCP PLACE OF CARE: IMMUN CLINIC MCP ENTER AND EDIT A NEW PLACE OF CARE (continued) MCP PLACE OF CARE: IMMUN CLINIC MCP 3. GRP PL3a PLACE OF CARE Enter the PAS-oriented information about the place of care through the Place of Care PAS Clinic Profile. • Refer to QRG: Create a Provider Group Profile, for more information. • Entries to this file must be made from within the MCP division to ensure MCP MEPRS codes are available. ================================================================================== ----------------------------------------------------- Directions to Place of Care--------------------------------------------------- From the Main Hospital, proceed South on 16th Street. Turn right onto Lincoln. The office is located 3 blocks down across from the Mobile station. ---------------------------------------------------- Comments to Place of Care-------------------------------------------------- • Do not change the information for MTF clinics that are already in the Hospital Location file using the Place of Care PAS Clinic Profile. • Adding a new location in the Hospital Location file impacts the entire system. • Refer to MCP: Provider Network Management Functions. Check in with the receptionist. 4-179 ----------------------------------------------------------------------------------------------------------------------------------------------- File/exit Abort Edit File changes and exit. Quick Reference Guides Notes: • There are three parts to defining a place of care. All three parts can be defined through the MCP Group and Individual Provider options: 1. Enter the place of care into the Hospital Location file using the Place of Care Enter/Edit option. 2. Enter the MCP-specific information in the Place of Care file. MCP ENTER AND EDIT A NEW PLACE OF CARE SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 This example presents only the option to enter the place of care into the Hospital Location file. It does not present updating PAS clinic profile information. See Notes. ENTER AND EDIT A NEW SERVICE/DEPARTMENT IN THE DEPARTMENT AND SERVICE FILE The Department and Service File Enter/Edit option allows you to enter a new department or service, or edit information for an existing department or service, in the MCP Department and Service file. This file defines organizational relationships within the MTF and is important for obtaining PAS workload reports that reflect the number of referral visits made to each MCP provider group and its associated place of care. MENU PATH: PAS System Menu ➔ MAN ➔ FMCP ➔ PTAB ➔ DEPT Select DEPARTMENT AND SERVICE NAME: IMM ASSOC SVC Are you adding ‘IMM ASSOC SVC’ as a new DEPARTMENT AND SERVICE? Y 4-180 After you confirm the new Department/Service name, the following screen displays. NAME: IMM ASSOC SVC DOD DEPT AND SVC EDIT CODE: (DEPARTMENT) DEPT NAME: IMMUNOLOGY ASSOC DEPT Note: • This example demonstrates only the option to enter a new department. Follow the same procedures to enter a new service. • Enter the department in the file first because the department is a higher organizational level than the service, and defines the grouping of services. • Civilian places of care have one department and one service created for each place of care. • The entries in this file are used in the Clinic and Place of Care profiles when you create or maintain provider groups. • In the Department Code field, valid entries are S (Service) D (Department) and DIV (Division). • When entering a new department, leave the Department Name field blank. However, when entering a new service, enter the name of the department to which the service is associated. • Leave the Inactive Flag field blank unless you want to inactivate the entry and flag it as obsolete. • To inactivate a department or service, enter 1 in the Inactive Flag field. ABBREVIATION: IMMAC INACTIVE FLAG: ______________________________________________________________________ File/exit Abort Edit File changes and exit. MCP ENTER AND EDIT A NEW SERVICE/DEPARTMENT IN THE DEPARTMENT AND SERVICE FILE SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides SELECT DIVISION ENTER AND EDIT AN MCP HEALTH CARE FINDER IN THE MCP HEALTH CARE FINDER FILE The MCP Health Care Finder Profile Enter/Edit option allows you to enter a new health care finder, or edit information for an existing health care finder in the MCP Health Care Finder file. MENU PATH: PAS System Menu ➔ MAN ➔ FMCP ➔ FTAB ➔ HEAL After you access this option, the following prompt displays: MCP HCF Profile Enter/Edit Select HEALTH CARE FINDER: PARCEL,ZINA N ZNPA Are you adding ‘PARCEL,ZINA N’ as a new MCP HCF (the 12th)? Y Need to know information: • A staff member must be an existing valid user in the CHCS User List before being entered into the Health Care Finder file. • Each Health Care Finder is a member of an MCP office. • A new MCP office must be added to the MCP Office file before the staff at the new office can be added to the MCP Health Care Finder file. • Health Care Finder information is displayed on the Care Authorization Form and other forms sent to the patient. • The Health Care Finder can be entered using User name, name, initial, or Nickname, or Mail name. 4-181 After you confirm the Health Care Finder name, the following screen displays: MCP HCF: PARCEL,ZINA N CP HCF PROFILE HCF: PARCEL,ZINA N HCF PHONE: (202) 555-4039 MCP OFFICE: CENTRAL MCP OFFICE MCP ENTER & EDIT AN MCP HEALTH CARE FINDER IN THE MCP HEALTH CARE FINDER FILE SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides ______________________________________________________________________ File/exit Abort Edit File changes and exit. ENTER AND UPDATE INSURANCE COMPANY DATA The Insurance Company Enter/Edit option allows you to enter or edit insurance company data in the Insurance Company file. MENU PATH: PAS System Menu ➔ MAN ➔ FMCP ➔ ETAB ➔ INSU After you access this option, the following prompt displays. Select INSURANCE COMPANY: VIRGINIA ALL HEALTH COMPANY Are you adding ‘VIRGINIA ALL HEALTH COMPANY’ as a new INSURANCE CO FILE (the 9th)? Y (YES) INSURANCE CO FILE SHORT NAME: VAH • Enter a short name or abbreviation for the insurance company using from 3 to 14 characters. INSURANCE CO FILE: VAH INSURANCE COMPANY - ENTER/EDIT Insurance Company Name: Qualifier: Short Name (Standard Code): TPOCS Print Type: VIRGINIA ALL HEALTH COMPANY VAH Attorney? Unknown Ins Company? Blue Cross/Blue Shield Code: Electronic Data interface Code: Claims Address: City: Date Last Updated: Inactive Date: FAIRFAX 4-182 Claims Contact Person: Phone Number 1: Phone Number 2: FAX Number: State: VIRGINIA: Zip: 22031 ext: ext: Standard Comment: Local Comment: Help = HELP Exit = F10 File/Exit = DO INSERT OFF Need to know to information: MCP ENTER AND UPDATE INSURANCE COMPANY DATA SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides • You must have the FileMan access code A in order to add new insurance companies to the Insurance Company file. ENTER OHI INFORMATION FOR AN MCP PATIENT This option allows you to enter other health insurance information for an MCPenrolled patient. MENU PATH: PAS System Menu ➔ MAN ➔ EMCP ➔ EENR Select the OHI action at the Demographics Display screen. Select the Add OHI action at the Other Health Insurance screen. POLICY: OTHER HEALTH INSURANCE - ENTER/EDIT 4-183 Name: PEARL,MARIEL N FMP/SSN: 30/569-69-4415 Patient Category: USN DEP AD, EXC FORM SPOUSE DDS: NOT ENTERED Patient Type: MCP/CHAMPUS ELIGIBLE Sex: FEMALE MCP Status: PENDING ENROLLMENT DOB/AGE: 02 Mar 1962/28Y PCM: PEPPINO,VICTOR M Date: 21 Jun 2001 ================================================================================= Policy number: 3377 Insurance Company Name: AETNA LIFE AND CASUALTY Phone: 8133451123 Effective Date: 01 JAN 2001 Expiration Date: 01 Mar 2004 Group Name: AMERICAN OFF SUPP Group Number: 12399 Precertification/UR: PREADMISSION APPROVAL IS REQUIRED Ask for Help = HELP YES, PRIMARY POLICY CHAMPUS SUPPLEMENT PEARL,MARIEL N 569-69-4400 SELF Screen Exit = F10 File/Exit = DO OTHER HEALTH INSURANCE - ENTER/EDIT Name: PEARL,MARIEL N FMP/SSN: 30/569-69-4415 Patient Category: USN DEP AD, EXC FORM DDS: NOT ENTERED Patient Type: MCP/CHAMPUS ELIGIBLE Sex: FEMALE MCP Status: PENDING ENROLLMENT DOB/AGE: 02 Mar 1962/28Y PCM: PEPPINO,VICTOR M Date: 21 Jun 2001 ================================================================================== Insured Employer Name: AMERICAN OFFICE SUPPLY Phone: 555-2812 Street Address: 123 FROST BLVD City: CLOVERDALE State: OR Zip: 97112 ______________________________________________________________________________________ File/exit Abort Edit File changes and exit. Billing Status: BILLABLE INSERT OFF MCP ENTER OHI INFORMATION FOR AN MCP PATIENT SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides Primary Policy: Policy Type: Policy Holder Name: Policy Holder SSN: Relationship to Insured: POLICY: 3377 ENTER OHI INFORMATION FOR AN MCP PATIENT (continued) Notes: This example begins at the Demographics Display screen. OTHER HEALTH INSURANCE Patient: PEARL,MARIEL N FMP/SSN: 30/569-69-4415 Patient Category: USN DEP AD, EXC FORM SPOUSE DDS: NOT ENTERED Patient Type: MCP/CHAMPUS ELIGIBLE Sex: FEMALE MCP Status: PENDING ENROLLMENT DOB/AGE: 02 Mar 1962/28Y PCM: PEPPINO,VICTOR M Date: 21 Jun 2001 ================================================================================== Insurance Company (P=Primary) Policy Number Effective Expiration B/N ______________________________________________________________________________________ P) AETNA LIFE AND CASUALTY 3377 01 Jan 2001 01 Mar 2004 B • You may enter up to three insurance policies for each patient. • The insurance company name must exist in the Insurance Company file or you may enter ZUNK if company name is unknown, or ZNEW if company name does not exist on. • For this demonstration, the policy is not a group policy. To enter a group policy under which the patient is insured, make an entry at the Group Name Field. • If the entry in the Primary Policy field is YES, then the entry in the Billing Status field must be Billable. 4-184 ______________________________________________________________________________________ Select (A)dd OHI, (E)dit OHI, (C)ase, or (Q)uit OHI: Q// ENTER OHI INFORMATION FOR AN MCP PATIENT SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides MCP FILE MAINTENANCE CONCEPTS AND DEFINITIONS Table A file which contains a list of items (i.e., Disenrollment Reasons is a list of acceptable disenrollment reasons and their related fields). Following is a discussion of file terminology and definitions. Refer to the Maintenance Manual for File and Table Data, SAIC/CHCS Doc. TC-3-0052A, for further information regarding files. FILE CLASSIFICATIONS FILE TERMINOLOGY Term Definition Standard files These files contain Department of Defense/ military department (DOD/MILDEP) data supplied by the government (DOD standard files) or medical/hospital data (e.g., the Current Procedural Terminology file). They are installed with all entries complete and may not be modified by the site. Site-specific files The site may enter or customize entries in these files to meet their own needs. Some sitespecific files are installed with entries, while some have no entries. (Site personnel are responsible for all entries.) These entries may or may not be modifiable, depending on the specific type of file. Patient-specific files These files are installed at the site with no entries. Entries are generated by the system or are interactively generated by users as a direct result of patient visits, diagnoses, and treatments. These files are historical and patient-specific. Administrative/System files These files contain entries that facilitate reporting, as well as administrative and technical software and hardware functions. Definition Internal Entry Number (IEN) A unique value assigned to each entry in a file. This number is used internally by the software to identify specific records in a file. Field A piece of information contained within a record is stored in a field. Each field usually appears in every record within that file. For example, Social Security number (SSN) is a field in each record in the Patient file. 4-185 Term A unique value assigned to each field. This number is used internally by the software to identify the field. File A grouping of items with a single functional purpose. In the system, patient information is stored in the Patient files; data about wards and clinics is in the Hospital Location file, and so on. File Number A unique identifier assigned to each file. Record An entry or record is a single occurrence of all data items in a file. For example, the set of information in the Patient file for a single patient is considered a record. MCP FILE MAINTENANCE CONCEPTS AND DEFINITIONS SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides Field Number Files are classified into several different groups based on specific characteristics: GENERATE A CARE AUTHORIZATION FORM This option allows you to generate a Care Authorization Form for an enrolled patient. MENU PATH: PAS System Menu ➔ MAN ➔ HMCP ➔ OHCF GENERATE APPOINTMENT REFERRAL PRODUCTS Patient: FMP/SSN: DOB/Age: unk/ Pat SSN: Patient Type: DDS: MCP Status: PCM: PCM Phone: Case Mgmt Provider: Case Mgmt: NO Referral# Date/Time Provider Specialty Status ----------------------------------------------------------------------------------------------------------------------------------------------- 4-186 ----------------------------------------------------------------------------------------------------------------------------------------------Select (P)atient, or (Q)uit: P// Select the Patient action. GENERATE A CARE AUTHORIZATION FORM SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides MCP GENERATE A CARE AUTHORIZATION FORM (continued) • Enter Patient Name. Name: Patient Category: Patient Type: MCP Status: ACV: Direct Care: DEMOGRAPHICS DISPLAY PICARD,ZACHARY E USA ACTIVE DUTY ENLISTED MCP/ACTIVE DUTY ENROLLED A-ACTIVE DUTY/MCP ENROLLED ELIGIBLE FMP/SSN: DDS: Sex: DOB/Age: DMIS ID: Medicare: 20/379-43-6114 MALE 31 May 1966/35Y 6015 NOT ELIGIBLE 4-187 Sponsor Name: PICARD,ZACHARY E Rank: CAPTAIN Station/Unit: RESOURCE MGMT WASHINGTON DSN: Home Address: 862 WEST WYLAND DR City: FAIRFAX State: VIRGINIA ZIP Code: 22030 Home Phone: 918-555-0287 Duty Phone: Work Phone: 202-555-6802 Registration Comment: Last Registration Date: 02 May 1999@1032 Outpatient Record Room: MEDICAL RECORDS FILE ROOM MCP Enroll Date: 21 Jun 2001 End Enroll Date: 10 Feb 2003 Primary Care Manager: ESPOSITO,FRANK M PCM Phone: 202 271-5850 Primary OHI: NOT ASSIGNED Case Mgmt: NO • Select the Continue action. Patient: Patient Category: DOB/Age: Case Mgmt: Patient Type: PCM: GENERATE APPOINTMENT REFERRAL PRODUCTS PICARD,ZACHARY E FMP/SSN: 20/379-43-6114 USA ACTIVE DUTY ENLISTED Pat SSN: 379-43-6114 31 May 1955/35Y DDS: Sex: MALE MCP/ACTIVE DUTY MCP Status: ENROLLED ESPOSITO,FRANK M PCM Phone: 202 271-5850 Referral# Date/Time Provider Specialty Status ----------------------------------------------------------------------------------------------------------------------------------------------200100045 OCCUPATIONAL TH 200100046 22 Jun 2001@1000 PEARY,ZACHARY C INTERNAL MEDICI BOOKED ----------------------------------------------------------------------------------------------------------------------------------------------Select (N)ew Patient, (E)nrollment Form, (M)embership ID, (C)are Authorization, (P)atient Label, Provider (L)abel, or (Q)uit: C// Select (F)ull, (M)ini, (E)nrollment, (P)CM, Ca(s)e, F(a)mily, (D)isenroll, (H)istory, (N)ew Patient, (C)ontinue, or (Q)uit DEMO: C// GENERATE A CARE AUTHORIZATION FORM SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides MCP GENERATE A CARE AUTHORIZATION FORM (continued) • Select the (C)are Authorization action. Patient: Patient Category: DOB/Age: Case Mgmt: Patient Type: PCM: GENERATE APPOINTMENT REFERRAL PRODUCTS PICARD,ZACHARY E FMP/SSN: 20/379-43-6114 USA ACTIVE DUTY ENLISTED Pat SSN: 379-43-6114 19 Feb 1966/35Y DDS: Sex: MALE MCP/ACTIVE DUTY MCP Status: ENROLLED ESPOSITO,FRANK M PCM Phone: 202 271-5850 Need to know information: • The system does not allow you to print the Care Authorization Form to the terminal screen. • The (C)are Authorization action appears on the action bar only if the current referral has at least one appointment linked to it. • The Provider (L)abel action appears on the action bar only if the current referral has at least one appointment linked to it. Referral# Date/Time Provider Specialty Status ----------------------------------------------------------------------------------------------------------------------------------------------200100045 OCCUPATIONAL TH 200100046 22 Jun 2001@1000 PEARY,ZACHARY C INTERNAL MEDICI BOOKED 4-188 ----------------------------------------------------------------------------------------------------------------------------------------------Use the SELECT key to select the Care Authorization to print Send Patient Records? YES// (NO) Send Radiology Records? YES// (NO) Send Lab Results? YES// (NO) • Send Patient’s medical and radiology records and lab results, if applicable. • Select Printer Device. • Select the Quit action until you return to the Health Care Finder Menu. MCP GENERATE A CARE AUTHORIZATION FORM SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides • Select the Appointment Referral for this Care Authorization Form. GENERATE A NON-AVAILABILITY STATEMENT The Interactive NAS Processing option allows you to generate Non-Availability Statements for CHAMPUS-eligible patients. MENU PATH: PAS System Menu ➔ MAN ➔ IMCP ➔ NNAS • Select the Patient action: <Return> • Enter Patient Name: PARROT,WENDY • Confirm the sponsor. 4-189 CURRENT DEERS ELIGIBILITY Name: PARROT,WENDY FMP/SSN: 30/101-10-0035 Patient Category: USA FAM MBR AD DDS: 30 DOB/Age: 02 Feb 1962/28Y Sex: FEMALE Sponsor Rank: Sponsor UIC: DMIS ID: ACV: ACV Start Date: Care Authorization PH#: Dir Care Elig Start Date: Dir Care Elig End Date: Eligibility End Reason: LIEUTENANT COLONEL S31LFJSQ-0459 OPERATIONS GP 0037-WALTER REED AMC C-CHAMPUS/DIRECT CARE ELIGIBLE Region Code: PCM Location: 12 Mar 2001 Medicare: NOT ELIGIBLE 10 Feb 2003 Select to (V)iew more DEERS data, (P)rint, (R)epeat DEERS check, (C)ontinue, or (Q)uit: C// <Return> • Select the Continue action. CHCS - DEERS Processing DEERS Request Waiting to Process... Processing Request.... Transaction Complete.... Press 'Q' to quit and not process the DEERS request. • Select the Continued action. MCP GENERATE A NON-AVAILABILITY STATEMENT SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides BRAC Pharmacy Eligibility: Override Code: Date of Request: 17 Jun 2001 DEMOGRAPHICS DISPLAY Name: PARROT,WENDY FMP/SSN: 30/101-10-0035 Patient Category: USA FAM MBR AD DDS: 30 Patient Type: Sex: FEMALE MCP Status: DOB/Age: 02 FEB 1953/48Y ACV: C-CHAMPUS/DIRECT DMIS ID: CARE ELIGIBLE Direct Care: ELIGIBLE Medicare: NOT ELIGIBLE ================================================================================= Sponsor Name: PARROT,VINCENT Rank: LIEUTENANT COLONEL Station/Unit: 0459 OPERATIONS DSN: Home Address: 867 GIBSON BLVD City: FAIRFAX State: VIRGINIA Zip Code: 22030 Home Phone: 918-55-2227 Duty Phone: 202-555-1117 Work Phone: Registration Comment: Last Registration Date: 20 Feb 2001@1030 Outpatient Record Room: MEDICAL RECORDS FILE ROOM MCP Enroll Date: End Enroll Date: Primary Care Mgr: PCM Phone: Primary OHI: NOT ASSIGNED Case Mgmt: ================================================================================= Select (F)ull, (M)ini, (O)HI, (N)ew Patient, (R)epeat DEERS, (C)ontinue, or (Q)uit DEMOGRAPHICS: C// <Return> GENERATE A NON-AVAILABILITY STATEMENT (continued) Complete the NAS Issue screen. NAS DATA: PARROT,WENDY NAS HISTORY Patient: PARROT,WENDY FMP/SSN: 30/101-10-0035 Patient Category: A41 DDS: 30 DOB/Age: 02 Feb 1953/48Y Sex: FEMALE ACV: CHAMPUS/DIRECT CARE ELIGIBLE ---------------------------------------------------------------------------------------------------------------NAS Number Status MDC Reason for Issue 00373221700 00373221701 Uncond Uncond 13 13 Facility temporarily not available Professional capability temporarily not available Select (I)ssue, (C)ancel, (P)rint, or (Q)uit: I// <Return> NAS ISSUE Patient: PARROT,WENDY FMP/SSN: 30/101-10-0035 Patient Category: USA DEP AD DDS: 30 Sex: FEMALE DOB/Age: 02 Feb 1953/48Y ACV: CHAMPUS/DIRECT CARE ================================================================================= NAS Number: Issue Date: 21 Jun 2001 Issue Type: Status: UNCONDITIONAL Issue Reason: DMIS ID: MDC: Admitting Facility: Admission Date: Other Insurance: No Insurance Insurance Company: Policy Number: 4-190 Issuing Officer: Remarks 1: 2: 3: • Select the Issue action. Personal Data - Privacy Act of 1974 (PL 93-579) GENERATE A NON-AVAILABILITY STATEMENT SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides MCP GENERATE A NON-AVAILABILITY STATEMENT (continued) NAS DATA: PARROT,WENDY NAS ISSUE Patient: PARROT,WENDY FMP/SSN: 30/101-10-0035 Patient Category: USA DEP AD DDS: 30 Sex: FEMALE DOB/Age: 02 Feb 1962/28 ACV: CHAMPUS/DIRECT CARE ================================================================================= Medically Inappropriate Code: Treatment Facility: ZIP Code: City: State: Mileage: ------------------------------------------------------------------------------------------------------------------------------------------------ 4-191 File/exit Abort Edit File changes and exit. File the data. CHCS - DEERS NAS DISPLAY Patient: PARROT,WENDY FMP/SSN: 30/101-10-0035 Patient Category: A41 DDS: 30 DOB/Age: 02 Feb 1953/48Y Sex: FEMALE ACV: CHAMPUS/DIRECT CARE ELIGIBLE ================================================================================= NAS Number: 00373207001 Issue Date: 21 Jun 2001 Status: UNCONDITIONAL Issue Reason: 5 - Professional capability temporarily not available. MDC: 14 PREGNANCY, CHILDBIRTH AND THE PUERPERIUM Facility: Admission Date: Other Insurance: N Policy Number: Insurance Company: Issuing Officer: SMITH,JAMES A Remarks 1: 2: 3: Medically Inapp Code: Mileage: Facility: City: State: Zip: ================================================================================= OK TO PRINT? Yes// <Return> Need to know information: Processing DEERS Request • DEERS PROCESSING. The system automatically performs a DEERS Eligibility Query to see if the patient has received a positive response from DEERS within the past five days: Press 'Q' to quit and not process the DEERS request. – If the patient was DEERS eligible or the Override Code was used, the system displays the Current DEERS Eligibility screen. You can either repeat the inquiry or go on to the patient’s Demographics Display screen. MCP GENERATE A NON-AVAILABILITY STATEMENT SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides Waiting to Process... Processing Request.... Transaction Complete.... • PREVIOUS NON-AVAILABILITY STATEMENTS. Previous NASs can be accessed by NAS number. GENERATE A NON-AVAILABILITY STATEMENT (continued) • The name of the Issuing Officer is required for NAS issue. • When the Issue Reason is a 7, 8, or 9, you should enter the following remarks: 4-192 – If the patient was DEERS ineligible, the system runs another inquiry and displays the DEERS Eligibility screen. – Remarks Line 1: Referred By: (Name of referring provider or PCM). • PATIENT CATEGORY SCREENING. The patient must be CHAMPUSeligible. – Remarks Line 2: Referred To: (Name of the provider to whom the patient is referred). • THE NAS HISTORY SCREEN. The NAS History screen action bar only contains the cancel or print actions if the patient has any previously issued NASs. These previously issued NASs are listed on the screen. • DEERS NAS ISSUE RESPONSES. After you have completed the NAS Issue screen and filed the NAS issue data, you could receive any of several different NAS response screens: • The system automatically queries the DEERS for a history of any NASs issued for the patient, and must find a positive match of the patient’s date of birth (DOB), DEERS dependent suffix (DDS), and sponsor’s Social Security number (SSN): – If all data is compatible between DEERS and your entry on the local system, the system displays the completed NAS Display screen. – If there is any discrepancy exists between your data and the data on DEERS, you receive the All Other NAS Responses screen. – If a match is found, the system displays NAS History screen for the patient. • THE NAS ISSUE SCREEN. If the Issue Reason is Number 3 - Medically Inappropriate - the NAS Issue Secondary screen must be completed. • The NAS Issue Status defaults based upon the DEERS eligibility response: – If the NAS issuance requires a two-part transaction, you get the Successful Transmission message after you successfully transmit Part 1. • THE NAS DISPLAY SCREEN. The newly generated NAS does not appear on the screen until you leave the NAS issuing process and reaccess DEERS history for that patient. Quick Reference Guides – Conditional - The sponsor is on the DEERS, but the patient is not (i.e., new spouse or newborn child). • PRINTING. You cannot print to the terminal screen, but you can print to a slave printer. – If the sponsor is not resident on the DEERS, the NAS cannot be issued.The name of the Admitting Facility is required for retroactive issue types. MCP GENERATE A NON-AVAILABILITY STATEMENT SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 – Unconditional - The patient is on the DEERS. GENERATE AN MCP MEMBERSHIP ID CARD This option allows you to generate and customize an MCP Membership Card for an enrolled patient. MENU PATH: PAS System Menu ➔ MAN ➔ HMCP ➔ OHCF ALTERNATE MENU PATH: PAS System Menu ➔ MAN ➔ HMCP ➔ AHCF 4-193 GENERATE APPOINTMENT REFERRAL PRODUCTS Patient: FMP/SSN: / - Patient Category: Pat SSN: - DOB/Age: unk/ DDS: Patient Type: Sex: MCP Status: PCM: PCM Phone: Case Mgmt Provider: Case Mgmt: NO Referral# Date/Time Provider Specialty Status ----------------------------------------------------------------------------------------------------------------------------------------------- Quick Reference Guides • Select the Patient action. MCP GENERATE AN MCP MEMBERSHIP ID CARD SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 ----------------------------------------------------------------------------------------------------------------------------------------------Select (P)atient, or (Q)uit: P// GENERATE AN MCP MEMBERSHIP ID CARD (continued) • Enter the Patient Name. 4-194 DEMOGRAPHICS DISPLAY Name: PICARD,ZACHARY E FMP/SSN: 20/379-43-6114 Patient Category: USA ACTIVE DUTY OFFICER DDS: Patient Type: MCP/ACTIVE DUTY Sex: MALE MCP Status: ENROLLED DOB/Age: 19 Feb 1966/35Y ACV: E-MCP ENROLLED/DIR. CARE CHA DMIS ID: 0037 Direct Care: ELIGIBLE Medicare: NOT ELIGIBLE ----------------------------------------------------------------------------------------------------------------------------------------------Sponsor Name: PICARD,ZACHARY E Rank: CAPTAIN Station/Unit: RESOURCE MGMT WASHINGTON DSN: Home Address: 862 WEST WYLAND DR. City: FAIRFAX State: VIRGINIA ZIP Code: 22030 Home Phone: 918-555-0287 Duty Phone: 202-555-6802 Work Phone: 202-555-6802 Registration Comment: Last Registration Date: 02 May 1999@1032 Outpatient Record Room: MEDICAL RECORDS FILE ROOM MCP Enroll Date: 21 Jun 2001 End Enroll Date: 10 Feb 2003 Primary Care Manager: ESPOSITO,FRANK M PCM Phone: 202 271-5850 Primary OHI: NOT ASSIGNED Case Mgmt: NO ----------------------------------------------------------------------------------------------------------------------------------------------Select (F)ull, (M)ini, (E)nrollment, (P)CM, Ca(s)e, F(a)mily, (D)isenroll, (H)istory, (N)ew Patient, (C)ontinue, or (Q)uit DEMOMOGRAPHICS: C// Patient: Patient Category: DOB/Age: Case Mgmt: Patient Type: PCM: GENERATE APPOINTMENT REFERRAL PRODUCTS PICARD,ZACHARY E FMP/SSN: 20/379-43-6114 USA ACTIVE DUTY ENLISTED Pat SSN: 379-43-6114 19 FEB 1966/35Y DDS: Sex: MALE MCP/ACTIVE DUTY MCP Status: ENROLLED ESPOSITO,FRANK M PCM Phone: 202 271-5850 Referral# Date/Time Provider Specialty Status 200100045 200100045 22 Jun 2001@1000 PEARY,ZACHARY C OCCUPATIONAL TH INTERNAL MEDICI BOOKED ----------------------------------------------------------------------------------------------------------------------------------------------Select (N)ew Patient, (E)nrollment Form, (M)embership ID, (C)are Authorization, (P)atient Label, Provider (L)abel, or (Q)uit: C// M • Select the (M)embership ID action. • Enter Embosser Format Name. MCP GENERATE AN MCP MEMBERSHIP ID CARD SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides • Select the Continue action. GENERATE AN MCP MEMBERSHIP ID CARD (continued) Display the card for the selected patient. <<<<<<----------------------------------------------Column No.------------------------------------------->>>>>> 0 - - - - - - 1- - - - - - - - 2- - - - - - - - 3- - - - - - - - 4- - - - - - - - 5- - - - - - - - 6- - - - - - - 7 - - - - - - - 8 0 0 0 0 0 0 0 0 0 20 379-43-6114 N 4-195 PICARD,ZACHARY E 19FEB66 M CPT ARMY ALL 788 GRANT ST WASHINGTON DC 20310 8888 TRAINING MEDICAL T The (C)are Authorization action appears on the action bar only if the current referral has at least one appointment linked to it. The Provider (L)abel action appears on the action bar only if the current referral has at least one appointment linked to it. CUSTOMIZING THE MEMBERSHIP ID CARD. • The system allows you to customize the membership card using the Edit Embosser Cards (EEC) option on the System Definitions Menu (SDM) option located on the PAD System Menu. • At your site, you can customize the MCP membership ID cards by: – Adding or deleting the number of rows of print, including blanks, on each card. – Editing the number of cards to be printed for each patient. – Adding or deleting fields to be included on the card, and repositioning the location of the individual fields. Print Embosser Card? YES// – Displaying some of the fields (e.g., Patient Name and FMP/SSN) in “double height” so that they stand out on the card. Quick Reference Guides • Select the Quit action until you return to the Health Care Finder Menu. Need to know information: THE GENERATE APPOINTMENT REFERRAL PRODUCTS SCREEN. • The system does not allow you to print the membership ID card to the terminal screen or to a standard printer. MCP GENERATE AN MCP MEMBERSHIP ID CARD SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 • Print the embosser card only if you have the special embosser machine needed to print these cards. INACTIVATE/REACTIVATE AN MCP PROVIDER The Inactivate/Reactivate Provider action allows you to change the status of a provider currently participating as a member of a provider group or a specified place of care. MENU PATH: PAS System Menu ➔ MAN ➔ PMCP ➔ INET • If the provider was previously inactivated, the inactivation date is displayed. • The Provider inactivation causes the provider to be inactivated for all agreements for the provider group. • The Place of Care inactivation only inactivates the provider in the selected places of care. The provider is still active in the provider group agreements. • Past or future inactivation dates can be entered. The system automatically inactivates the provider on the date entered in the Inactivation Date field. Select a Provider. Access the Agreement Maintenance action bar. • Future Activation dates may be entered. The provider is automatically reactivated on that date. Select the Inactivate/Reactivate Provider action. PROVIDER: PIERGROSSI,ZACHARY C IND PROF5 4-196 REASON FOR INACTIVATION Provider Group: INDIGO MG ======================================================================= Inactivation Date: Reactivation Date: Reason for Inactivation: • A provider cannot be inactivated from a group if the following conditions exist: – Appointments are booked for the provider with the group. – Wait list requests exist. – Patients are assigned to this provider as PCM. The Discrepancy Avoidance Report lists the discrepancies which must be resolved before a provider or place of care can be inactivated. Quick Reference Guides Enter a Reason for Inactivation. Notes: • Providers cannot be deleted from a provider group profile. When a provider ceases to be an active member of a provider group, that provider must be inactivated. MCP INACTIVATE/REACTIVATE AN MCP PROVIDER SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Enter the Inactivation Date. INTERACTIVE NAS PROCESSING The Non-Availability Statement Processing (NNAS) option is used to generate Non-Availability Statements (NASs) for CHAMPUS-eligible patients. MENU PATH: PAS System Menu ➔ MAN ➔ IMCP ➔ NNAS After you access this option, the following prompts display: Select (N)AS Number, (P)atient Name, (Q)uit: P// Select the Patient action: <Return> Enter Patient Name: PARROT,WENDY Verify the Sponsor Name: <Return> 4-197 Quick Reference Guides ------------------------------------------------------------------------------------------select to (V)iew more DEERS data, (P)rint, (R)epeat DEERS check, (C)ontinue, or (Q)uit: C// Note: DEMOGRAPHICS DISPLAY Name: PARROT,WENDY FMP/SSN: 30/101-10-0035 Patient Category: USA FAM MBR AD DDS: 30 Patient Type: Sex: FEMALE MCP Status: DOB/Age: 02 FEB 1973/28Y ACV: C-CHAMPUS/DIRECT DMIS ID: Direct Care: ELIGIBLE Medicare: NOT ELIGIBLE =================================================================== Sponsor Name: PARROT,VINCENT Rank: CAPTAIN Station/Unit: FORT EUSTIS, VA DSN: Home Address: 9673 CLEAR VIEW LANE City: ARLINGTON State: VIRGINIA ZIP Code: 22209 Home Phone: (703) 696-3744 Duty Phone: Work Phone: Registration Comment: Last Registration Date: 21 JUN 2001@1037 Outpatient Record Room: MEDICAL RECORDS FILE ROOM MCP Enroll Date: End Enroll Date: Primary Care Mgr: PCM Phone: Primary OHI: Case Mgmt: =================================================================== Select (F)ull, (M)ini, (O)HI, (N)ew Patient, (R)epeat DEERS, (C)ontinue, or (Q)uit DEMOGRAPHICS: C// Select the Continue action: C CHCS - DEERS Processing DEERS Request Waiting to Process... Processing Request.... Transaction Complete.... Press 'Q' to quit and not process the DEERS request. • PREVIOUS NON-AVAILABILITY STATEMENTS. Previous NASs can be accessed by NAS number. MCP INTERACTIVE NAS PROCESSING SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 CURRENT DEERS ELIGIBILITY Name: PARROT,WENDY FMP/SSN: 30/101-10-0035 Patient Category: USA FAM MBR AD DDS: 30 DOB/Age: 02 Feb 1953/48Y Sex: FEMALE ------------------------------------------------------------------------------------------Sponsor Rank: LIEUTENANT COLONEL Sponsor UIC: 831LFJSQ-0459 OPERATIONS GP DMIS ID: 0037-WALTER REED AMC ACV: C-CHAMPUS/DIRECT CARE ELIGIBLE ACV Start Date: Region Code: Care Authorization PH#: PCM Location: Direct Care: ELIGIBLE Medicare: NOT ELIGIBLE Dir Care elig Start Date: 12 Mar 2001 CHAMPUS: Dir Care Elig End Date: 10 Feb 2003 Eligibility End Reason: BRAC Pharmacy Eligibility: Override Code: Date of Request: 17 Jun 2001 Do not repeat the DEERS transaction. INTERACTIVE NAS PROCESSING (continued) NAS HISTORY Patient: PARROT,WENDY FMP/SSN: 30/101-10-0035 Patient Category: A41 DDS: 30 DOB/AGE: 02 Feb 1973/28Y Sex: FEMALE ACV: CHAMPUS/DIRECT CARE ELIGIBLE ---------------------------------------------------------------------------------------------------------------------NAS Number Status MDC Reason for Issue =================================================================== • THE NAS HISTORY SCREEN. The NAS History screen action bar only contains the cancel or print actions if the patient has any previously issued NASs. These previously issued NASs will be listed on the screen. The system automatically queries the DEERS for a history of any NASs issued for the patient. It must find a positive match of the patient’s date of birth (DOB), DEERS dependent suffix (DDS), and sponsor’s Social Security number (SSN): – If a match is found, the system displays the patient’s NAS History screen. – If a match is not found, the system displays the DEERS Family Member Verification screen. When you select the correct patient, the system displays the patient’s NAS History screen. 4-198 ================= No previously issued NAS for this patient ================== Select (I)ssue, or (Q)uit: I// Select the Issue action: <Return> Notes: • DEERS PROCESSING. The system automatically performs a DEERS eligibility query to see if the patient has received a positive response from DEERS within the past 5 days. – If the patient was DEERS ineligible, the system runs another inquiry and displays the DEERS Eligibility screen. • PATIENT CATEGORY SCREENING. The patient must be CHAMPUSeligible. MCP INTERACTIVE NAS PROCESSING SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides – If the patient was DEERS eligible or the override code was used, the system displays the Current DEERS Eligibility screen. You can either repeat the inquiry or go on to the patient’s Demographic Display screen. INTERACTIVE NAS PROCESSING (continued) NAS DATA: Complete the NAS Issue screen. NAS DATA: PARROT,WENDY NAS ISSUE 4-199 Patient: PARROT,WENDY FMP/SSN: 30/101-10-0035 Patient Category: USA FAM MBR AD DDS: 30 Sex: FEMALE DOB/Age: 02 Feb 1973/28 ACV: CHAMPUS/DIRECT CARE ========================================================== NAS Number: Issue Date: 21 Jun 2001 Issue Type: Status: UNCONDITIONAL Issue Reason: DMIS ID: 0037 MDC: Admitting Facility: Admission Date: PARROT,WENDY NAS ISSUE Patient: PARROT,WENDY FMP/SSN: 30/101-10-0035 Patient Category: USA FAM MBR AD DDS: 30 Sex: FEMALE DOB/Age: 02 Feb 1973/28 ACV: CHAMPUS/DIRECT CARE =================================================================== Medically Inappropriate Code: Treatment Facility: ZIP Code: City: State: Mileage: ---------------------------------------------------------------------------------------------------------------------File/exit Abort Edit File changes and exit. File the data. Other Insurance: No Insurance Insurance Company: Policy Number: Processing DEERS Request Waiting to Process... Processing Request.... Transaction Complete.... Press 'Q' to quit and not process the DEERS request. Ask for Help = HELP Screen Exit = F10 File/Exit = DO INSERT OFF Personal Data - Privacy Act of 1974 (PL 93-579) MCP INTERACTIVE NAS PROCESSING SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides Issuing Officer: Remarks 1: 2: 3: CHCS - DEERS INTERACTIVE NAS PROCESSING (continued) The name of the Issuing Officer is required for NAS issue. When the Issue Reason is a 7, 8, or 9, you should enter the following remarks: 4-200 NAS DISPLAY Patient: PARROT,WENDY FMP/SSN: 30/101-10-0035 Patient Category: A41 DDS: 30 DOB/Age: 02 Feb 1973/28Y Sex: FEMALE ACV: CHAMPUS/DIRECT CARE ELIGIBLE =================================================================== NAS Number: XXXXXXXXXXX Issue Date: 21 Jun 2001 Status: UNCONDITIONAL Issue Reason: 5 - Professional capability temporarily not available. MDC: 14 PREGNANCY, CHILDBIRTH AND THE PUERPERIUM Facility: Admission Date: Other Insurance: N Policy Number: Insurance Company: N Issuing Officer: SMITH,JAMES A Remarks 1: 2: 3: Medically Inapp Code: Mileage: Facility: City: State: ZIP: =================================================================== OK TO PRINT? Yes// • THE NAS ISSUE SCREEN. If the Issue Reason is Number 3 - Medically Inappropriate - the NAS Issue secondary screen must be completed. Quick Reference Guides - Unconditional - The patient is resident on the DEERS - Conditional - The sponsor is resident on the DEERS, but the patient is not (i.e., new spouse or newborn child). - If the sponsor is not resident on the DEERS, the NAS cannot be issued. Remarks Line 1: Referred By: [Name of referring provider or PCM] - Remarks Line 2: Referred To: [Name of the provider to whom the patient is referred] • DEERS NAS ISSUE RESPONSES. After you have completed the NAS Issue screen and filed the NAS issue data, you could receive any of several different NAS response screens: - If all data is compatible between DEERS and what you have entered for the patient on the local system, the system displays the completed NAS Display screen. - If any discrepancy exists between your data and the data on DEERS, you receive the All Other NAS Responses screen. - If the NAS insurance requires a two-part transaction, you get the Successful Transmission message after you successfully transmit Part 1. • THE NAS HISTORY SCREEN. The newly generated NAS does not appear on the screen until you leave the NAS issuing process and reaccess a DEERS history for that patient. • PRINTING. You cannot print to the terminal screen, but you can print to a slave printer. The name of the Admitting Facility is required for Retroactive issue types. MCP INTERACTIVE NAS PROCESSING SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 The NAS Issue Status defaults based upon the DEERS eligibility response: - NON-ENROLLED BOOKING The Non-Enrolled Booking option allows you to generate referrals for nonenrolled patients and book them to either an MTF or a non-MTF health care provider. MENU PATH: PAS System Menu ➔ MAN ➔ NMCP ALTERNATE MENU PATH: PAS System Menu ➔ MAN ➔ HMCP ➔ NHCF 4-201 NON-ENROLLED BOOKING SEARCH CRITERIA Patient: FMP/SSN: Patient Type: Appt Type: Clinic: Specialty: Clinic Phone: Provider: Duration: Location: Days of Week: Dates: 21 Jun 2001 to 06 Jul 2001 Time Range: 0001 to 2400 ----------------------------------------------------------------------------------------------------------------------------------------------- Quick Reference Guides MCP NON-ENROLLED BOOKING SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 ---------------------------- Patient, Patient Type, Speciality, Location, Provider are required-------------------------Select (C)hange Search Criteria, or (Q)uit: C// NON-ENROLLED BOOKING (continued) • Select the Change Search Criteria action. 4-202 NON-ENROLLED BOOKING SEARCH CRITERIA Patient: FMP/SSN: Patient Type: Appt Type: Clinic: Specialty: Clinic Phone: Provider: Duration: Location: Days of Week: Dates: 21 Jun 2001 to 02 Aug 2001 Time Range: 0001 to 2400 -----------------------------------------------------------------------------------------------------------------------------------------------Appointment Type Specialty Location Patient Patient Type Dates Time Range + Days of Week ----------------------------- Patient, Patient Type, Speciality, Location, Provider are required-------------------------Select PATIENT NAME: PHOTON,ZACHARY N 20/353-30-4614 25 Sep 1932 M NO7 OK? YES// (YES) SPONSOR NAME: PHOTON,ZACHARY N// DEMOGRAPHICS DISPLAY Name: PHOTON,ZACHARY N FMP/SSN: 20/353-30-4614 Patient Category: USN RET LOS OFFICER DDS: Patient Type: Sex: MALE MCP Status: DOB/Age: 25 Sep 1932/57Y ACV: N-NOT ENROLLED/CHAMPUS INELI DMIS ID: 6015 Direct Care: ELIGIBLE Medicare: NOT ELIGIBLE -----------------------------------------------------------------------------------------------------------------------------------------------Sponsor Name: PHOTON,ZACHARY N Rank: COMMODORE Station/Unit: DSN: Home Address: 154o CLEAR WATER CIR. City: ARLINGTON State: VIRGINIA ZIP Code: 22222 Home Phone: 703-622-5234 Duty Phone: Work Phone: Registration Comment: Last Registration Date: 21 Jun 2001@1103 Outpatient Record Room: MEDICAL RECORDS FILE ROOM MCP Enroll Date: End Enroll Date: Primary Care Manager: PCM Phone: Primary OHI: Case Mgmt: -----------------------------------------------------------------------------------------------------------------------------------------------Select (F)ull, (M)ini, (N)ew Patient, (C)ontinue, or (Q)uit DEMO: C • Select Patient, Patient Type, Location, Specialty. • Verify Sponsor Name. • Select the Continue action at the DEERS Eligibility Screen. MCP NON-ENROLLED BOOKING SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides • Select Patient Name. NON-ENROLLED BOOKING (continued) • Select the Continue action. NON-ENROLLED BOOKING SEARCH CRITERIA Patient: PHOTON, ZACHARY N FMP/SSN: 20/353-30-4614 Patient Type: CHAMPUS Appt Type: OCCUPATIONAL THERAPY Clinic: Specialty: Clinic Phone: Provider: Duration: Location: DISTRICT OF COLUMBIA Days of Week: Dates: 21 Jun 2001 to 02 Aug 2001 Time Range: 0001 to 2400 ------------------------------------------------------------------------------------------------------------------------------------------------ • Complete the Non-Enrolled Booking Search Criteria screen. NON-ENROLLED BOOKING SEARCH CRITERIA Patient: PHOTON, ZACHARY N FMP/SSN: 20/353-30-4614 Patient Type: CHAMPUS Appt Type: Clinic: Specialty: OCCUPATIONAL THERAPY Clinic Phone: Provider: Duration: Location: DISTRICT OF COLUMBIA Days of Week: Dates: 21 Jun 2001 to 02 Aug 2001 Time Range: 0001 to 2400 ------------------------------------------------------------------------------------------------------------------------------------------------Patient Home Phone: 410-555-0602 Patient Duty Phone: ------------------------------------------------------------------------------------------------------------------------------------------------Search for (P)rovider Name, (M)TF, (E)xternal, N(o)n-Network, or (Q)uit Provider Search: 4-203 -----------------------------------------------------------------------------------------------------------------------------------------------Select PATIENT TYPE: CHA Select SPECIALTY: OCCUPATIONAL THERAPY Select LOCATION: DISTRICT OF COLUMBIA • Select the MTF Provider Search. • Select Appointment Type: <Return>. • Select the Provider Search action. NON-ENROLLED BOOKING SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides MCP NON-ENROLLED BOOKING (continued) • Select the Provider. NON-ENROLLED BOOKING SEARCH CRITERIA Patient: PHOTON, ZACHARY N FMP/SSN: 20/353-30-4614 Patient Type: CHAMPUS Appt Type: Clinic: Specialty: OCCUPATIONAL THERAPY Clinic Phone: Provider: Duration: Location: DISTRICT OF COLUMBIA Days of Week: Dates: 21 Jun 2001 to 02 Aug 2001 Time Range: 0001 to 2400 4-204 Provider CS Cat Agr Place of Care Zip 1st Available Appt ----------------------------------------------------------------------------------------------------------------------------------------------PAANGA,ABBAS M MD MTF OT MTF 20307 26 Jun 2001@0800 PEACEMAKER,BARB MD MTF OT MTF 20307 26 Jun 2001@0800 PACHA,CLIFTON M MD MTF OT MTF 20307 26 Jun 2001@0800 PACHOULI,DIANE MD MTF OT MTF 20307 26 Jun 2001@0800 PACHINI,EDWARD MD MTF OT MTF 20307 26 Jun 2001@0800 PALESTRA,FRANCE MD MTF OT MTF 20307 26 Jun 2001@0800 PADUKA,GEORGE M MD MTF OT MTF 20307 26 Jun 2001@0800 PACKER,HELEN M MD MTF OT MT 20307 26 Jun 2001@0800 PADDY,ISSAC M MD MTF OT MT 20307 26 Jun 2001@0800 + PADRONE,JULIE M MD MTF OT MT 20307 26 Jun 2001@0800 ----------------------------------------------------------------------------------------------------------------------------------------------Use the SELECT key to Select the Provider to whom to refer the patient Press F9 to view Schedule, Discount Summaries, Place of Care, or Watch Codes ADD AN APPOINTMENT SLOT Patient: PHOTON, ZACHARY N FMP/SSN: 20/353-30-4614 Patient Type: CHAMPUS Appt Type: Clinic: OT MTF/DIVA Specialty: OCCUPATIONAL THERAPY Clinic Phone: 202 456-9876 Provider: PAANGA,ABBAS M Duration: Location: DISTRICT OF COLUMBIA Days of Week: Dates: 21 Jun 2001 to 02 Aug 2001 Time Range: 0001 to 2400 -----------------------------------------------------------------------------------------------------------------------------------------------TUE 0800 26 Jun 01 NEW 1/0 * TUE 0830 26 Jun 01 NEW 1/0 TUE 0900 26 Jun 01 NEW 1/0 TUE 0930 26 Jun 01 NEW 1/0 TUE 1000 26 Jun 01 NEW 1/0 TUE 1030 26 Jun 01 NEW 1/0 TUE 1100 26 Jun 01 NEW 1/0 + TUE 1130 26 Jun 01 NEW 1/0 -----------------------------------------------------------------------------------------------------------------------------------------------Use SELECT an appointment • Select an appointment. NON-ENROLLED BOOKING SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides MCP NON-ENROLLED BOOKING (continued) ADD AN APPOINTMENT SLOT FMP/SSN: 20/353-30-4614 Appt Type: Specialty: OCCUPATIONAL THERAPY PATIENT APPOINTMENT: PHOTON,ZACHARY N TUE 0830 26 Jun 01 NEW 1/0 Patient: PHOTON, ZACHARY N Patient Type: CHAMPUS Clinic: OT MTF/DIVA Clinic Phone: 202 456-9876 Provider: PAANGA,ABBAS M Duration: Location: DISTRICT OF COLUMBIA Days of Week: Dates: 21 Jun 2001 to 02 Aug 2001 Time Range: 0001 to 2400 ----------------------------------------------------------------------------------------------------------------------------------------------TUE 0830 26 Jun 01 New 1/0 4-205 ----------------------------------------------------------------------------------------------------------------------------------------------Select (B)ook appt, or (Q)uit FILE APPOINTMENT: B// • Book the appointment: <Return> FILE APPOINTMENT Clinic Message: Arrive 10 minutes early. Clinic/Appt Type Instructions: Provider Message: Provider/Appt Type Instructions: Arrival Message: 10 minutes Registration Comment: MEPRS Code: DHBA Requesting Service: Referred By: Send Reminder Notice: YES Appointment Comment: Reason for Appointment: ----------------------------------------------------------------------------------------------------------------------------------------------Ask for Help = HELP Screen Exit = F10 File/Exit = DO INSERT OFF • File the data. • Complete the File Appointment Secondary screen. • File the data. Quick Reference Guides MCP NON-ENROLLED BOOKING SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 • Select the Quit action until you return to the Managed Care Program Menu. NON-ENROLLED BOOKING (continued) Need to Know: THE NON-ENROLLED BOOKING SEARCH CRITERIA SCREEN. • The Patient, Patient Type, Specialty, Location, and Provider fields are required search criteria fields. You need not select all of them from the list. If you select Provider Search, the system automatically prompts you for the Patient Name, Patient Type, Specialty Location, and Appointment Type fields. You need to enter the correct patient type when generating a referral, because the system matches your entry with compatible provider agreement types when searching for a health care provider. 4-206 The Location field allows you to enter either the zip code(s), a “wild card” zip code, or a geographical area as defined in the CHCS Zip Code Combination file. THE NON-ENROLLED NON-MTF BOOKING SEARCH CRITERIA SCREEN. The (W)ait List Add action only appears if the specified clinic maintains an active Wait List. THE ADD AN APPOINTMENT SLOT SCREEN. • The booking process varies at this point. If you have chosen an MTF health care provider, you then choose a scheduled time slot and book to it. If you have chosen a non-MTF health care provider, you must create an appointment slot and book to it. Refer to Quick Reference Guide: Appointment Referral Booking, for an THE FILE APPOINTMENT SCREEN. • This screen contains a “smart” action bar: – If you have selected only one appointment to book, only the Book and Quit File appointment actions appear on the action bar. – If you have selected more than one appointment to book, the Skip and View actions also appear on the action bar. • The system displays a different booking search criteria screen depending upon which type of patient and health care provider you are using: – Enrolled/Non-MTF - Non-MTF Booking Search Criteria screen. – Non-Enrolled/MTF - Non-Enrolled MTF Booking Search Criteria screen. – Non-Enrolled/Non-MTF - Non-Enrolled Non-MTF Booking Search Criteria screen. MCP NON-ENROLLED BOOKING SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides – Enrolled/MTF - MTF Booking Search Criteria screen. PCM BOOKING The PCM Booking option allows you to book appointments for enrolled patients to assigned primary care manager. MENU PATH: PAS System Menu ➔ MAN ➔ HMCP ➔ PHCF PCM BOOKING SEARCH CRITERIA Patient: FMP/SSN: Patient Type: Appt Type: Clinic: Specialty: Provider: Duration: Location: Days of Week: Dates: 21 Jun 2001 to 02 Aug 2001 Time Range: 0001 to 2400 ----------------------------------------------------------------------------------------------------------------------------------------------- 4-207 ----------------------------------------------------------------------------------------------------------------------------------------------Select PATIENT NAME: PICARD, ZACHARY E 20/379-43-6114 31 May 1955 M AE5 OK? YES// (YES) SPONSOR NAME: PICARD, ZACHARY E// • Verify Sponsor Name. • Select the Continue action at the Current DEERS Eligibility screen DEMOGRAPHICS DISPLAY Name: PICARD,ZACHARY E FMP/SSN: 20/379-43-6114 Patient Category: USA ACTIVE DUTY ENLISTED DDS: Patient Type: MCP/ACTIVE DUTY Sex: MALE MCP Status: ENROLLED DOB/Age: 31 May 1966/35Y ACV: A-ACTIVE DUTY/MCP ENROLLED DMIS ID: 6015 Direct Care: ELIGIBLE Medicare: NOT ELIGIBLE ----------------------------------------------------------------------------------------------------------------------------------------------Sponsor Name: PICARD,ZACHARY E Rank: CAPTAIN Station/Unit: RESOURCE MGMT WASHINGTON DSN: Home Address: 862 West Wyland Dr City: FAIRFAX State: VIRGINIA ZIP Code: 22030 Home Phone: 918-55-0287 Duty Phone: 202-555-6802 Work Phone: 202-555-6802 Registration Comment: Last Registration Date: 21 Jun 1999@1032 Outpatient Record Room: MEDICAL RECORDS FILE ROOM MCP Enroll Date: 21 Jun 2001 End Enroll Date: 10 Feb 2003 Primary Care Manager: ESPOSITO,FRANK M PCM Phone: 202 271-5850 Primary OHI: NOT ASSIGNED Case Mgmt: NO ----------------------------------------------------------------------------------------------------------------------------------------------Select (F)ull, (M)ini, (E)nrollment, (P)CM, Ca(s)e, F(a)mily, (D)isenroll, (H)istory, (N)ew Patient, (C)ontinue, or (Q)uit DEMOGRAPHICS: C// Quick Reference Guides • Enter Patient Name. MCP PCM BOOKING SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 • Select Patient action. PCM BOOKING (continued) • Select the Continue action. PCM MTF BOOKING SEARCH CRITERIA Patient: PICARD, ZACHARY E FMP/SSN: 20/379-43-6114 Patient Type: MCP/ACTIVE DUTY Appt Type: Clinic: FAM PRAC MTF/DIVA Specialty: NURSING Clinic Phone: 202 271-5850 Provider: ESPOSITO, FRANK M Duration: Location: 20307 Days of Week: Dates: 21 Jun 2001 to 02 Aug 2001 Time Range: 0001 to 2400 ----------------------------------------------------------------------------------------------------------------------------------------------Patient Home Phone: 703-622-5234 Patient Duty Phone: 4-208 ----------------------------------------------------------------------------------------------------------------------------------------------Select (C)hange Search Criteria, (B)rowse, (S)ingle Patient, Appt (R)efusal, (W)ait List Add, (T)el-Consult, or (Q)uit: S// • Select the Single Patient action. PCM MTF SINGLE PATIENT BOOKING Patient: PICARD, ZACHARY E FMP/SSN: 20/379-43-6114 Patient Type: MCP/ACTIVE DUTY Appt Type: Clinic: FAM PRAC MTF/DIVA Specialty: NURSING Clinic Phone: 202 271-5850 Provider: ESPOSITO, FRANK M Duration: Location: 20307 Days of Week: Dates: 21 Jun 2001 to 02 Aug 2001 Time Range: 0001 to 2400 ----------------------------------------------------------------------------------------------------------------------------------------------FRI 0800 22 Jun 01 NEW 1/0 FRI 0830 22 Jun 01 NEW 1/0 FRi 0900 22 Jun 01 NEW 1/0 FRI 0930 22 Jun 01 NEW 1/0 FRI 1000 22 Jun 01 NEW 1/0 FRI 1030 22 Jun 01 NEW 1/0 FRI 1100 22 Jun 01 NEW 1/0 FRI 1130 22 Jun 01 NEW 1/0 ----------------------------------------------------------------------------------------------------------------------------------------------Use SELECT key to select appointment(s) to be booked • Select an appointment slot to book. PCM BOOKING SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides MCP PCM BOOKING (continued) • Select the book action. PATIENT APPOINTMENT: PICARD,ZACHARY E FILE APPOINTMENT FMP/SSN: 20/379-43-6114 Appt Type: Specialty: NURSING Patient: PICARD, ZACHARY E Patient Type: MCP/ACTIVE DUTY Clinic: FAM PRAC MTF/DIVA Clinic Phone: 202 271-5850 Provider: ESPOSITO, FRANK M Duration: Location: 20307 Days of Week: Dates: 21 Jun 2001 to 02 Aug 2001 Time Range: 0001 to 2400 ----------------------------------------------------------------------------------------------------------------------------------------------FRI 0800 22 Jun 01 NEW 1/0 FILE APPOINTMENT FRI 0800 26 Jun 01 NEW 1/0 No reminder notice will be sent. Hand-carry Radiology/Patient records. Clinic Message: Arrive 10 minutes early. Clinic/Appt Type Instructions: Provider Message: Provider/Appt Type Instructions: Arrival Message: 10 minutes Registration Comment: MEPRS Code: BGAZ Requesting Service: Referred By: Send Reminder Notice: NO Appointment Comment: Reason for Appointment: 4-209 -----------------------------------------------------------Select Slot #1 of 1-----------------------------------------------------------Select (B)ook appt, or (Q)uit FILE APPOINTMENT: B// ----------------------------------------------------------------------------------------------------------------------------------------------File/exit Abort Edit File changes and exit. • Complete the File Appointment Secondary screen. Quick Reference Guides • Do not remind patient of other appointments/Wait List requests. • Select the Quit action until you return to the Health Care Finder Menu. MCP PCM BOOKING SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 • File the data. PCM BOOKING (continued) Need to know information: – If the assigned PCM is a non-MTF place of care (e.g., Family Practice Associates), the system displays the PCM Non-MTF Booking Search Criteria screen and defaults the place of care as the PCM. ENROLLMENT STATUS FOR PCM APPOINTMENTS. THE PCM MTF BOOKING SEARCH CRITERIA SCREEN. • If the patient is not enrolled in MCP, you must enroll the patient and assign a PCM before the system allows you to book an appointment to a PCM. • The (W)ait List Add action only appears if the specified clinic maintains an active Wait List. Only network providers can be designated as PCMs. THE FILE APPOINTMENT SCREEN. The system could display three different screens, depending upon the type of PCM assigned to the patient. • This screen contains a “smart” action bar: – If the assigned PCM is an MTF provider, the system displays the PCM MTF Booking Search Criteria screen. 4-210 – If the assigned PCM is an MTF group provider/clinic (e.g., Family Practice), the system displays the PCM MTF Appointment Search screen, where: – If you have selected only one appointment to book, only the Book and Quit File Appointment actions appear on the action bar. – If you have selected more than one appointment to book, the Skip and View action also appear on the action bar. * If the clinic has schedules, the system displays open appointment slots for the clinic, and you can book the appointment directly to the clinic. Quick Reference Guides * If the clinic does not have schedules, but some of the providers in the clinic are designated as individual PCMs, the system displays open appointment slots only for those individual providers who are designated as PCMs. – If the assigned PCM is a non-MTF provider, the system displays the PCM Non-MTF Booking Search Criteria screen, where the system prompts you to add an appointment to the provider’s schedule, and book that appointment for the patient. MCP PCM BOOKING SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 * If the clinic does not have schedules, and no provider is designated as an individual PCM, the system displays open appointment slots for all providers as PCMs. TERMINATE AN MCP PROVIDER AGREEMENT MENU PATH: PAS System Menu ➔ MAN ➔ PMCP ➔ GNET Enter the provider group name. Press <Next Screen> to access the Provider Group Profile/Agreement Maintenance screen. Select the Agreements action. Select the Terminate action. Select the agreement to be terminated. 4-211 PROVIDER GROUP AGREEMENT HISTORY ----------------------------------------------------------------------------------------------------------------------------------------------Agreement Effective Overall FI Type Date Stop Date Discount Notified Except PCM ----------------------------------------------------------------------------------------------------------------------------------------------NET 21 Jun 2001 20 Jun 2002 CA- 18% 21 Jun 2001 S * SUP 21 Jun 2001 20 Jun 2002 CA- 10% 19 Jun 2001 Enter the stop date and the date that the FI is notified. Enter the reason for terminating the agreement early. • The new stop date cannot be earlier than the start date. MCP END TERMINATE AN MCP PROVIDER AGREEMENT SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Quick Reference Guides Notes: SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 PATIENT APPOINTMENT AND SCHEDULING REFERENCE MANUAL Section 5 Subsystem Glossary 5-1 Subsystem Glossary SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 PATIENT APPOINTMENT AND SCHEDULING REFERENCE MANUAL Section 5. Subsystem Glossary Term Definition Access The process of requesting an entry in a particular file or in certain fields in a given file. Also refers to data security functions for files or certain fields in a file. Access Code See User Security. Access/Verify Codes The Access and Verify codes are used in the logon process to identify a legitimate user and to gain access to CHCS. Both codes are site-specific and established by the CHCS System Manager. Only the verify code may be changed by the individual user. The codes do not show on the screen when entered. Action Bar A horizontal bar that provides two or more functions to choose from by typing the character(s) within the parentheses and pressing <Return>. The selected function is performed and control is then returned to this action bar. (See also Smart Action Bar.) Active Parameter A specific value for a search criterion that the system will use to search for open schedule slots. Active parameters are displayed in the Display Window of a Search Criteria screen. Ad Hoc Reports Reports that consist of variable data and that are generated for a particular purpose or need. Admission The process of bringing a patient into the medical treatment facility (MTF) as an inpatient. Alternate Care Value (ACV) Information used by DEERS to define a patient's eligibility. This information is then sent to CHCS. A value of U indicates that the patient is enrolled in a United States Treatment 5-2 Subsystem Glossary SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Subsystem Glossary (continued) Term Definition Facility (USTF) and is not eligible for care in a medical treatment facility (MTF). Ancillary Any work area that supports the care of patients on the ward or in the clinics. “Ancillary to” the ward or clinic. Ancillary Workcenter Those supporting workcenters targeted for automation (e.g., LAB, RAD, PAD, PHR, PAS, and DTS). ANSI MUMPS American National Standards Institute accepted standard for the Massachusetts General Hospital Utility Multi-Programming System (MUMPS) programming language. Application Software Software that runs CHCS and performs functions necessary to control or make the system work. Appointing Synonymous with “appointment booking” or just “booking.” Appointment, Patient A specific time reservation for a patient to see a specified care provider. Patients are said to have appointments; clinics and care providers are said to have schedules. Appointment Booking The process of searching for, selecting, and reserving an appropriate schedule slot for a specified patient booking. Appointment Referral A patient appointment request for specialized care generated by the primary care manager (PCM). Appointment Search Criteria See Search Criteria. Appointment Slot A single time opening in a provider's template or schedule for a certain type of appointment. The 5-3 Subsystem Glossary SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Subsystem Glossary (continued) Term Definition slot has a begin and end time, and the maximum number of patients that can be seen during that period. This is also referred to as a schedule time slot. Appointment Type A broad generic designation of the type of care to be provided during an appointment or encounter. Appointment Type, Alternate A secondary appointment type for a schedule slot that is not filled within a specified time (e.g., 48 hours before the appointment). Used for changing unused appointment slots into different usable slots shortly before the appointment day. Archive/Purge The process of storing historical patient data in the archive database (archive) while removing nonhistorical patient data from the production database (purge). Arrival Time (Appointment) The time patients are told to arrive for their appointments. This may or may not be different from the beginning time or booking time, which is the time at which they are actually scheduled to be seen. At Sign (@) 1) An edit response meaning delete the current value and leave the field empty of data. 2) Used to show appointment times (e.g., 13Jun@1000). Attribute Information describing a file or data element. Types of attributes include data types, ranges, descriptions, and checks performed upon entry of a data element. Authority Having all required security keys needed to perform specified functions using CHCS. 5-4 Subsystem Glossary SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Subsystem Glossary (continued) Term Authorization Level (Order Entry and RAD) Definition In order entry and Radiology, there are five authorization levels: Clerk, Nurse, and three kinds of health care provider (HCP): Clerk Authorization: The system prompts clerks to provide the ordering/authorizing HCP. Clerks may only transcribe written orders. Although clerks may enter new orders, these orders do not become active until they are signed by a nurse or physician. Nurse Authorization: The system prompts nurses to provide the ordering/authorizing HCP and the order origin (verbal, telephone, or handwritten). The orders that nurses enter become active, but they must be signed by a physician. HCP Authorization: This is the standard physician authority and the highest level needed for all orders except those special procedures requiring a countersignature. Physicians are not prompted for ordering or authorizing HCP or order origin. HCP Requiring Countersignature: This authorization level is similar to the nurse in that countersignature is always required. This level of authorization is usually assigned to interns, physician assistants, and medical students. The orders that they enter may be signed by anyone with HCP authorization. These do not require the Countersigning HCP authorization level. Countersigning HCP: This level of authority allows the physician to countersign orders for special procedures. For example, this authorization level would be assigned to 5-5 Subsystem Glossary SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Subsystem Glossary (continued) Term Definition radiologists who need to approve certain tests and procedures. Backspace/Delete Key See Computer Control Keys. Batch PCM Reassignment Allows the reassignment of a group of enrollees in the Managed Care Program (MCP) from one primary care manager (PCM) to another without having to do individual reassignments. Beneficiary Type Synonymous with “patient category” (i.e., patient type). Block Booking A processing function of the Book Appointments option, Block Booking allows the user to book one or more patients for appointments within one schedule time slot. Booking Authority A restriction on an appointment slot that allows booking only by specified classes of appointers. For example, certain slots may be designated as being bookable only by persons with greater medical knowledge who would be assigned a higher booking authority. This is independent of, and distinct from, any other booking restrictions based on, for example, clinic (perhaps one clinic may not be allowed to book into another), or function (some users may be allowed to register patients, but not book them or may be allowed to book appointments but not to maintain schedules). Borrower In Record Tracking, a borrower is defined as a location, entity, or individual to whom records are loaned. This may be a physician, a hospital employee, a clinic, a ward, a hospital location, or a patient. Browse Action (PAS) The Browse options are used to display a provider's schedule, overbook scheduled appointment slots, or modify slots for a specific 5-6 Subsystem Glossary SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Subsystem Glossary (continued) Term Definition booking need. Slots can be modified by changing appointment type, splitting one slot into two slots, or joining several slots into one slot. Browse is accessed by selecting the Browse Action from either the Search Action Bar or the Appointments Action Bar when booking appointments. Bulletin A MailMan message sent to a mailgroup by the Postmaster or automatically by the system based on a CHCS event. Cancellation The process of voiding a pending appointment. There are two modes of cancellation: 1) Patient-initiated cancellation, in which the patient calls in to cancel an appointment. In this case, the canceled slot becomes free for another appointment. 2) Clinic-initiated cancellation, in which the health care provider (HCP) and/or clinic cancels an entire block of appointments (or schedule slots). In this case, a list of patients with booked appointments in the schedule block is printed so that they can be contacted and informed of the cancellation. (In some systems, cancellation notices are mailed to the patients.) When a clinic cancellation occurs, the slots become frozen, in “hold” status, and cannot be used for appointments at that time. Catchment Area A catchment area is the geographical area within a 40-mile radius of a medical treatment facility (MTF). 5-7 Subsystem Glossary SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Subsystem Glossary (continued) Term Definition Cathode Ray Tube (CRT) A TV-like type of video display terminal for interacting with an online computer system. See Keyboard Video Display Terminal. Check-In The data entry function, whereby the facts of a completed appointment are entered into the system to “close the loop.” Check-in data include primarily the indication of whether the patient did or did not keep the appointment (Show or No-Show), and which provider treated this patient. Class Critique Form Form used by the students to evaluate a CHCS class. Class Evaluation Report Form used by CHCS presenters to document their perception of how effective the class was and what measures could be taken to make the class presentation better. Clinic 1) An outpatient department or a hospital location. 2) A search criterion in which the parameter identifies a clinic schedule. Clinical Service A clinical specialty within a medical treatment facility (MTF). Clinical Subsystem (CLN) The Clinical Subsystem includes order-entry capabilities, automated due lists related to patient care activities, and results-entry capabilities. Special management activities include patient acuity, nursing care hours, nursing-specific bed management procedures, and Nursing quality assurance. See Facility Quality Assurance. The clinical subsystem's primary users include nurses, and allied health personnel. 5-8 Subsystem Glossary SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Subsystem Glossary (continued) Term Definition Clinic Scheduling The process of entering and maintaining clinic schedules. Refers also to the entire area of scheduling and entry/maintenance of clinic, care provider, facility, and profile data. Command Security Command security refers to Personnel Reliability Program, Presidential Support Program, and sensitive compartmented information. Composite Health Care System (CHCS) A fully automatic, integrated medical information system. CHCS facilitates the coordination of health care activities and patient information among all departments within a medical treatment facility (MTF) and its medically integrated outlying clinics. Computer An electronic device used to perform high-speed data processing operations and that can store the data for retrieval. Computer-Based A system that makes use of computer-related hardware (physical components of a computer) and software (programs that control computer operations). CHCS is computer-based. Computer Control Keys The following is a list of the basic computer control keys used in CHCS, and their specific location and function. Backspace/Delete Key: Located in the upperright corner of the keyboard's main keypad, this key is used to delete (erase) the character to the left of the cursor. It is identified on the keyboard by a large left-arrow symbol containing an X. Caret (^) Key: Entered using <Shift>, <6> on the keyboard's main keypad, this key is used to exit the current activity. This key is not the same as an “up-arrow” key. 5-9 Subsystem Glossary SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Subsystem Glossary (continued) Term Definition Cursor Control Keys: Located to the right of the keyboard's main keypad. These keys allow the user to move between fields in Screen Mode. (These keys are also referred to as the up-arrow, down-arrow, left-arrow and right-arrow keys.) Help: Help text is available throughout CHCS to assist users: 1) Press ? or <Help> at menu prompts for online help. 2) Press ?? for a list of secondary menu options. 3) Press ??? for a brief description of options. 4) Press ? [option] for the OLUM text on an option. When accessing help from a field (in a prompt series on a screen): 1) Press ? or <Help> for a quick one-line help message. 2) Press ?? for extended help. 3) Press ??? to access the OLUM. Note: Refer to the glossary entry for the Online User Manual (OLUM). <Hold Screen> Key: Located on the far upperleft corner of the keyboard, in line with the function keys, this key is used to stop data from scrolling off the screen. Press it again to resume data scrolling. <Lock> Key: This key locks the alphabetical characters of the keypad into uppercase. It is located on the left side of the keyboard above the 5-10 Subsystem Glossary SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Subsystem Glossary (continued) Term Definition <Shift> key. A light indicates when the keyboard is “locked.” A locked keyboard does not affect symbol/numeric keys. Most data should be entered in uppercase. To unlock the keyboard, just press <Lock> again. Question Mark (?) Key: Located on the lower right side of the keyboard's main keypad, it can be used to access CHCS Help Menu at most prompts. There are three levels of help available: – Enter ? to access the first level. – Enter ?? to access the second level. – Enter ??? to access the third level. Note: Refer to the glossary entry for Online User Manual. <Return> Key: Located on the right side of the keyboard's main keypad, it is used to tell the computer to process data just entered. <Select> Key: Located on the editing keypad, it is used to choose an item for editing or review. Once <Select> is pressed, an asterisk (*) appears next to the chosen item. Some selections are activated automatically, for others you must press <Return>. To deselect an item, press <Select> again. <Shift> Key: Located on the left and right sides of the keyboard's main keypad, these keys are used to enter individual uppercase alphabetic characters, or to enter symbols above the numeric keys. 5-11 Subsystem Glossary SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Subsystem Glossary (continued) Term Definition Spacebar: A space is entered by pressing the spacebar at the bottom of the keyboard's main keypad. Spacebar, <Return>: Entered by pressing the spacebar, then <Return> on the keyboard's main keypad. This sequence of keys is used to recall the most recent value entered at any Select prompt. The <Return> key must be pressed after data is entered; otherwise, the computer does not know that the response to a prompt has been given. Cost Pool Code These are codes used to account for expenses that cannot be directly assigned to specific services or summary accounts but are known to be associated with a selected group of services. The cost pool is a valid entry in the Medical Expense and Performance Reporting System (MEPRS) Code Table. The third character in a cost pool is always X (e.g., BCXA). Current Appointment An appointment that has been booked, but not yet kept. The status of such an appointment is marked by the system as “pending.” Also sometimes called a "future" appointment or a pending appointment, although these terms also have other meanings. A current appointment is not on a waiting list. Current Procedural Terminology (CPT) A system developed by the American Medical Association, for standardizing the terminology and coding used to describe medical services and procedures. The number affixed to the acronym represents the current version. In the Managed Care Program (MCP), these procedure and medical service codes are used to define services offered and exceptions to the 5-12 Subsystem Glossary SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Subsystem Glossary (continued) Term Definition overall discount schedule for Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) allowable (CA) and Usual and Customary (UC) fees. Cursor The flashing rectangle or underscore on the screen showing where the character is entered as the user types in responses or data. Data A specific value in a field for a given record. All the data for a file is stored in a data global. Database A collection of data organized into files fundamental to an application. Database Management System (DBMS) This software serves as the interface between the application programs and the database. FileMan is the CHCS database management system. Data Element A field within a specified file defined by specific attributes. Also, the field characteristics and the data entered in accordance with those characteristics. Data Type A specification associated with each field that indicates the kind of information to be entered, the format for entering information, and the way in which data is stored and retrieved. See Field. Valid data types are as follows: Computed: A field whose value is computed from other data. No data is actually stored in a field possessing this data type. Date/Time: A field that allows time data, including year, month, day, and time of day. 5-13 Subsystem Glossary SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Subsystem Glossary (continued) Term Definition Entries to this field are based on the system's built-in “clock”; the user may enter a partial date/time and the system will enter the remaining data. Free Text: A field containing any combination of alphabetic characters, numbers, and punctuation marks. The user may enter any text in the field. The characters may be limited to a minimum and/or a maximum, and the exact form can be specified, such as the Social Security number (SSN). Numeric: A field that allows only data containing numbers. Pointer to a File: A field that provides a reference to data in a different file to preclude the reentering of redundant data. The possible entries for this field type “point” to another file that provides choices available for response. For example, this field type may point to the states in the United States, or procedures in the Radiology Procedures file. Data entry from different prompts in different options into the pointed-to file may or may not be controlled. – Controlled Entry: At the prompt, the user must select from existing entries in the pointed to file. – LAYGO (Learn As You Go) Entry: At the prompt, the user may select from existing entries in the pointed-to file, or add to the list of entries. Set of Codes: A field that provides for the creation of a simple set of codes (alphabetic, 5-14 Subsystem Glossary SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Subsystem Glossary (continued) Term Definition numeric, or symbols) in order to input standard data choices. The possible responses to this field type are limited to a list of available entries or their abbreviations. Word Processing: A field that allows multiline text to be treated as a single unit, even though its data can be edited one line at time. This field type provides for word processing input, such as is required for Radiology Exam Result. The system software provides a variety of word processing editing options. Days of Week A search criterion where the parameter identifies specific day(s) from Monday through Sunday. DEA Number This is a unique number defined by the Drug Enforcement Administration (DEA) and associated with the provider. The DEA numbers have the following format: A or B followed by the first letter of the provider's last name, followed by seven digits (e.g., AZ7654321). This number, if assigned, should be inserted in the DEA number field of the provider profile. Default This is the text provided by the system in response to a field or prompt. A default allows entry of the most commonly used answer or the most recently inserted field value, with only one keystroke; that is, you press <Return> to accept the default. Default Division The division accessed by the user at logon. Default Response An expected response of the most common answer to a prompt. The default response may 5-15 Subsystem Glossary SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Subsystem Glossary (continued) Term Definition be provided by FileMan or defined by the user to save keystrokes and is followed by two slashes (//). Default Search Criteria The search criteria identified by a user as that user's default criteria selections, that is, the criteria for which the user wishes to change parameters continually. Default Search Criteria retain their select marks so the user does not have to reselect them. Default View Basket This option allows you to choose the MailMan basket into which the View Text messages are sent. If you do not indicate a basket, the View Text messages are sent to your IN basket. It is suggested that you create a mail basket (called View Text or some similar name) and specify it as your default view basket. This will keep your IN basket from being cluttered with view text. Defense Enrollment Eligibility Reporting System (DEERS) A Department of Defense (DOD) program for determining and ensuring the eligibility of potential patients for military health care. Defense Medical Information System Identification (DMIS-ID) The Expense Assignment System (EAS) uses the DMIS-ID to define which divisions roll their workload together. Each division has a unique DMIS-ID and a parent DMIS-ID. The parent DMIS-ID defines divisions that combine their workload. A group DMIS-ID is assigned to the parent DMIS-ID for upward reporting. Dietetics Subsystem (DTS) The DTS Subsystem provides dietetics personnel with access to patient demographic and clinical information, and provides other system users with a mechanism for communicating diet orders and diet consults to the Dietetics Department. 5-16 Subsystem Glossary SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Subsystem Glossary (continued) Term Definition Directory Setup Screen The screen that displays the various setups for the VT320. It is used to access all other setup screens. Display In CHCS documentation, this heading refers to the display of a menu or a screen of information, as opposed to a prompt or a message. Display Window In Patient Appointment and Scheduling (PAS), the top section of the Search Criteria screen. Active search parameters are displayed in this window. Disposition The end point of a patient's hospitalization (inpatient episode). There are numerous disposition types, i.e., discharge, death, or the patient's leaving against medical advice. Divided Workcenter (DWC) A CHCS-supported workcenter with two or more elements that provide similar services. Duplicate Patient Two patient data records that actually belong to the same patient, or a patient registered twice in the system. Emergency Contact Person to contact in case of patient emergency. Emergency Encounter Form See SF558. Encounter There are two types of encounters: 1) A visit by a patient to an outpatient clinic. 2) All data related to an outpatient visit. End-of-Day Processing The update of patient appointment data for an outpatient clinic on a specified day. Patient appointment data includes, but is not limited to, appointment status and type, provider, clinic, and checked-in (date and time). 5-17 Subsystem Glossary SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Subsystem Glossary (continued) Term Definition Entry A data value within a field, record, or file. Environment The place in the computer in which the user is working, and its characteristics. Episode All data related to an inpatient visit, starting with admission and continuing through disposition. EVE Menu Also called the Systems Manager Menu, this is the very first menu that will appear after logon. This menu is the parent of all other CHCS menus. External Provider A non-network provider who is a member of a provider network; who has the CON,NET,PEX, or SUP agreement types; and who has a location type of Other. Facility See Medical Treatment Facility. Family Booking Appointments in multiple clinics for multiple related or unrelated patients. Family Member Prefix (FMP) A two-digit code that identifies a patient's relationship to the sponsor (e.g., son, daughter, spouse, dependent parent, etc.). FMPs are as follows: 01-19 = 1st through 19th child; 20 = sponsor; 30 = spouse; 40 = mother of sponsor; 45 = father of sponsor; 50 = mother-in-law; 55 = father-in-law; 60 = 1st other eligible dependent; 61 = 2nd other eligible dependent; 98 = civilian emergency; 99 = other. 5-18 Subsystem Glossary SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Subsystem Glossary (continued) Term Field Definition 1) The space in a record used to define a data element. A field has attributes, such as a data type, storage location, and label. Data element and field are often used interchangeably. 2) A labeled area within a screen in which the user may enter and edit text. File 1) A grouping of items with a single functional purpose. Patient information is stored in the Patient file. Ward locations, clinics, and all other hospital locations are stored in the Hospital Location file. 2) As in “to file,” used in Screen Mode when data is stored. File Manager (FileMan) The database management system (DBMS) used in CHCS. A general-purpose DBMS based on the Massachusetts General Hospital Utility Multi-Programming (MUMPS) programming language used to create and maintain files. Free Text See Data Type. Frequency 1) This term is used to refer to how often a medication is given (e.g., Q6H, or given with a frequency of every 6 hours). 2) The estimated hours, listed on the particular intravenous (IV) bottle, that the IV will run. Frozen Schedule Slot A schedule slot on hold. Frozen slots will not display during appointment booking. These slots are temporarily frozen and are either released manually by the user, or automatically by the system on a user-specified date. General Set-Up Screen The screen used to set up the general user preference features of the VT320 terminal. 5-19 Subsystem Glossary SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Subsystem Glossary (continued) Term Definition Health Care Finder (HCF) A clerk who uses the Managed Care Program (MCP) to book appointments for enrolled patients with their primary care providers (PCPs), add/modify appointment referrals for enrolled and non-enrolled patients, book appointments with network providers for nonenrolled patients, cancel and reschedule appointments, and generate membership identification cards, care authorization forms, and patient/provider mailing labels. Health Care Provider (HCP) The specific member of the health care team providing health services to the patient. Usually, this is a physician; however, the HCP may be a nurse practitioner, dentist, physical therapist, clinical dietitian, etc. HCP is not used in reference to nurses, who represent a special category in themselves. An HCP is someone who has the authority to construct patient orders for entry into the system. See Provider Class. Health Record Outpatient medical record. Historical Data Information that is considered to be relevant for direct patient care and is removed from the production database and stored in the archive database. <Hold Screen> Key See Computer Control Keys. Home The device name used to specify output to the screen. Home Location In Record Tracking, the place of residence for a medical record or film jacket (X-ray file) when it is not being borrowed. This home location is usually a file room. Identifier The fields that are displayed when selecting an entry in order to aid in the unique identification of the record to be selected. 5-20 Subsystem Glossary SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Subsystem Glossary (continued) Term Definition Inactive See Order Status. Initialization (INIT) The act of starting up a system. Insert Mode As text is entered where text exists, the entered characters are inserted at the cursor position, pushing existing text to the right. Interact Window In Patient Appointment and Scheduling (PAS), the bottom section of the Search Criteria screen. Messages, prompts, and action bars appear in this window. Internal Entry Number (IEN) A unique number assigned to each file. It is used internally in the software to identify specific records within a file. John (Jane) Doe A male (female) patient whose identity is unknown. Keyboard A typewriter-like instrument used to enter information to be sent to the computer. Keyboard Set-Up Screen The screen used to set up the keyboard characteristics, such as keyclick and bells. Keyboard Video Display Terminal (KVDT) A terminal complex that includes a keyboard and a video display. See CRT. Laboratory Subsystem of CHCS (LAB) The software programs that process orders for lab tests; specifically, the programs that allow the user to log in specimens, to track order status, to enter and certify results, to maintain lab files, and to generate lab reports. Learn As You Go (LAYGO) The process of adding records to a file through data entry into other file(s). When a field is defined as a pointer, the creator indicates whether the user is allowed to enter new data into the pointed-to file. Without LAYGO, the user must select from existing entries in the 5-21 Subsystem Glossary SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Subsystem Glossary (continued) Term Definition pointed-to file. With LAYGO, the user may enter new records into the pointed-to file. See Field. Local Empanelment Process used to conduct managed care activities on a local level, without changing the Alternate Care Value (ACV) of the non-active duty beneficiaries on the DEERS database. Login A process that records that a sample was received in the lab for testing. Logoff The user process to end a CHCS session. Three logoff choices are available: Halt: Allows the user to log off from any menu prompt. Restart: Allows the user to return directly to the Access Code prompt. Continue: Allows the user to end the session with the system remembering the user's location in the system. Allows the user to directly return to that system location when logging on again. Logon The user process to gain access to the CHCS system and begin a CHCS session. Lookup The process of selecting one particular entry or record from a file. Mail Basket Electronic file folder where the user can save MailMan mail messages. All MailMan messages are received in the IN mail basket. Mail Box The user file to which MailMan messages are addressed. 5-22 Subsystem Glossary SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Subsystem Glossary (continued) Term Definition Mailers Mailed notices of canceled or missed appointments. There are five different types of mailers available: Cancel Notifications, NoShow Notices, Strong No-Show Notice, Wait List, and Reminder Notices. Mailgroup A group of MailMan users, set up by the Postmaster, to which the user can address messages. Mail Manager (MailMan) The online electronic mail system of CHCS. Managed Care Program (MCP) A software program designed to assist military treatment facilities in the local management of Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) funds. MCP provides the capability to profile both military and civilian providers in terms of the type of medical care offered and the costs associated with the care. The software also provides the ability to enroll beneficiaries and assign a primary care manager (PCM). Referral and booking options provide the capability to record patient care needs, search for providers, book appointments, and issue care authorizations. MCP Agreement A provider's agreement with the government, stating the medical care to be provided to eligible beneficiaries at a negotiated rate. MCP Enrollment The act of enrolling a beneficiary into the Managed Care Program. MCP Patient Type Classifications are MCP/Active Duty, MCP/Non CHAMPUS Eligible, MCP CHAMPUS. MCP Status Used to determine a patient's status within the Managed Care Program (MCP). Statuses are as follows: 5-23 Subsystem Glossary SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Subsystem Glossary (continued) Term Definition Enrolled: A patient is currently enrolled in the MCP. Invalid Enrollment: A discrepancy response is received from Defense Enrollment Eligibility Reporting System (DEERS) as a result of filing a patient's enrollment into the MCP. Conditional Enrollment: An ineligible response is received form DEERS when enrolling a dependent patient who is not registered on DEERS; however, if the patient's sponsor is DEERS-registered and the ineligibility is overridden, the MCP status is displayed as Conditional Enrollment. Pending Enrollment: A response from DEERS was delayed (for example, if the DEERS line is busy and the inquiry must be batched) during patient enrollment, or the MCP enrollment date is a future date. Disenrolled: A patient formerly enrolled in the MCP is no longer enrolled. Invalid Disenrollment: A discrepancy response is received from DEERS after sending a Disenrollment transaction. Blank: A patient has no enrollment history in the MCP. Medical Expense and Performance Reporting System (MEPRS) The Medical Expense and Performance Reporting System for fixed military medical and dental treatment facilities. MEPRS provides consistent principles, standards, policies, definitions, and requirements for accounting and reporting of expense, manpower, and performance by Department of Defense (DOD) fixed medical facilities. 5-24 Subsystem Glossary SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Subsystem Glossary (continued) Term Definition Medical Record The physical record of a patient's care containing printed (paper) copies of the documents detailing the patient's treatment in either inpatient or outpatient settings. Medical Treatment Facility (MTF) A military hospital and its outlying affiliated workcenters. Also called Facility. Menu A list of options (choices) presented by the software that represents a decision point in the running of the program. The menus available to individual users are determined when the CHCS system manager sets up the User Record. Secondary Menu: A list of system options available when you enter ??. CHCS Orientation Menu: A special menu designed to support Orientation classes. Menu Management: A CHCS tool that is used to maintain menus, options, security keys, and help text. MEPRS Code A four-character alpha code used to identify cost centers at the medical treatment facility (MTF). The MEPRS code is used for workload accounting purposes. These codes are assigned to each transaction to track who ordered the transaction and to calculate workloads. MEPRS codes at the 4th level are unique at the CHCS Group/Division Level and consist of three Department of Defense (DOD) standard characters to identify the service provided and a unique fourth character assigned by the MTF. Message 1) Short for system message. It means information supplied by the system in response to user input, for example, ** END OF REPORT **. 5-25 Subsystem Glossary SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Subsystem Glossary (continued) Term Definition 2) When used with MailMan, message means an electronic note that has been transmitted. Mini Registration An abbreviated patient registration function. A series of screens used to create or update a basic patient record. Mnemonic A device designed to aid recall; for example, the menu synonyms used in the CHCS menu selection, such as ORE for Order Entry or BOK for Book Appointments. Monitor The part of the terminal containing the screen. Also called a visual display terminal (VDT) or visual display unit (VDU). (See Screen.) MTF-Specified/Defined A parameter specified at the division level in a multidivisional medical treatment facility (MTF) or at the MTF level if there is only a single division. This neither requires nor precludes that there be a specification at both the medical treatment facility (MTF) and division level. MTF-Specified Time Period A period of time determined by each medical treatment facility (MTF) that may be modified periodically. Multiple Clinic Booking Several appointments in multiple clinics for one patient. Multiple Field Often simply called a multiple, it is a field that can have more than one unique value. In effect, a multiple is a minirecord within a record. An indicator of a multiple is the Select prompt. NAS Issuing Officer The military medical commander or designee who is authorized to issue non-availability statements (NASs). 5-26 Subsystem Glossary SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Subsystem Glossary (continued) Term Definition Network Provider These are individual providers, organized as part of provider groups or institutions, that have an agreement with the medical treatment facility (MTF) to provide services at a discount rate to Managed Care Program (MCP) enrolled beneficiaries or to non-enrolled beneficiaries as part of a Preferred Provider Organization (PPO). The PPO may benefit non-enrolled patients, since non-enrolled patients may be booked to an MCP provider who charges less than Civilian Health and Medical Program of the Uniformed Services (CHAMPUS). Nonhistorical Data Information that is no longer vital to patientspecific medical care and is purged or erased from the production database. Non-Network Provider Only Service Available or Exception providers with an agreement type of NON and a location type of Other. Individual providers (which may be organized as provider groups or institutions) with whom the medical treatment facility (MTF) does not have an agreement to provide services to eligible beneficiaries at a discounted rate. Nonsearchable Schedule Slot A schedule slot into which patients Schedule Slot cannot be booked. The system automatically appends a nonsearchable appointment type with an asterisk (*), and these slots become place holders only in a provider's schedule. Examples of nonsearchable slots are lunch, meeting, TDY, rounds, etc. Online Users Manual (OLUM) The OLUM consists of the user instructions for the CHCS basic system, MailMan, ad hoc reporting options of FileMan, and each subsystem. Each subsystem volume provides the menu hierarchy, functional description for 5-27 Subsystem Glossary SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Subsystem Glossary (continued) Term Definition each option, step-by-step user instructions, and samples of screens and reports. 1) Enter OLUM at the Secondary Menu or any menu/option selection prompt to get to the OLUM Menu. 2) Enter ?OPTION NAME at menu/option selection prompt (only where the menu/ option is displayed) to go directly to the option description in the OLUM. 3) Enter ??? after enter/edit prompt within any option to go directly to the option description in the OLUM. Option One of a list of processes on a menu that allows the user to access data in a file or to access another menu. Order A request for procedure, service or item to be performed or delivered. Order Status Indicates an order's current level of execution: Active: An order that is current and available for workcenter and/or ancillary processing. Countersignature Due: A previously signed order to which a countersignature must be added to confirm and activate the order. Expiring: An order that will soon be no longer active, contingent upon the duration of the order. HCP Signature Due: An order that requires a physician's verification or signature. Inactive: An order that is not being executed at the present time. 5-28 Subsystem Glossary SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Subsystem Glossary (continued) Term Definition Modified: An order partially activated at patient arrival. Nurse Signature Due: An order that requires a nurse's verification or signature. On Hold: An order suspended until reactivation (e.g., preadmission orders remain on hold until altered). Pending: An active order awaiting further action (e.g., pending appointments). Pending Appointment: An order awaiting appointment scheduling from another subsystem. Preactive: An order that has not been activated; user is still entering orders for his batch. Outpatient Encounter Form See SF600I. Overbook To book more patients in a schedule slot than was allocated when the schedule was created. An overbooked schedule slot has more booked patients than the maximum number of patients per slot set for the slot when the schedule was created. Panel 1) In the Laboratory Subsystem, a group of related tests with the same collection sample, which may be ordered as a group. In most cases such as “Chem 7,” the tests on the panel can also be ordered individually. 2) Also, a group of health care providers (HCPs) to which a family is assigned in a family practice clinic. 5-29 Subsystem Glossary SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Subsystem Glossary (continued) Term Definition Parameters Fixed limits or boundaries that establish by what restrictions the system will perform a function. Patient Administration (PAD) Subsystem and Medical Services Accounting (MSA) The PAD Subsystem facilitates the collection recording of patient information regarding the admission, disposition, and transfer of patients. This subsystem also manages ward and bed status within the medical treatment facility (MTF). A component of the PAD Subsystem, MSA focuses on the initiation and monitoring of patient billing. The United States Military Services provide health care for millions of patients each year. The goal of Defense Medical Information Management (DMIM) is to enable military MTFs and clinics to use CHCS to enhance the quality of health care delivery provided. With an increase in the number and diversity of tasks performed by medical personnel, as well as an expansion of health-related technology, an improved approach to the management of medical information was needed. CHCS meets this need. As an integrated, computer-based system, CHCS provides an automated online alternative to many manually implemented tasks (i.e., writing patient care orders, documenting medication administration, generating reports, etc.), thus significantly reduces potentially massive amounts of paperwork. 5-30 Subsystem Glossary SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Subsystem Glossary (continued) Term Definition Patient Appointment and Scheduling Subsystem (PAS) of CHCS This subsystem enables individual clinics or providers to control their own scheduling, booking, and appointments, and alerts other system users to potentially conflicting schedules. Patient Category Code Patient Category codes indicate patient type (i.e., Active Duty Enlisted Air Force, Civilian Employee, Naval Officer's Dependent). Patient Identifying Data Patient name, family member prefix/Social Security number (FMP/SSN), date of birth (DOB), and sex. Patient Inquiry The act of retrieving CHCS-stored data regarding a selected patient. Patient Record A collection of data relative to a patient (e.g., patient name, Social Security number, date of birth, etc.). PCM Beneficiary Patients are designated as case management when they require an exception provider for specialty care. PCM Beneficiary Category The beneficiary categories for the PCM enrollment mix are: Active Duty, Active Duty Family Member, Retiree, Retiree Family Member, Other. For the PCM enrollment mix, these beneficiary categories replace the MCP Patient Types. Pending Appointment See Order Status. Pharmacy Subsystem of CHCS (PHR) The PHR Subsystem provides a versatile drug reference library. It allows flexibility in ordering medications (i.e., by trade or generic name, by drug component, route of administration, etc.) and provides online information regarding drug-to-drug interactions. 5-31 Subsystem Glossary SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Subsystem Glossary (continued) Term Definition Place of Care A medical treatment facility (MTF) or non-MTF clinic in the Managed Care Program (MCP). Postmaster The user responsible for managing mail groups, users, bulletins, and mail system protocol. The postmaster job is an assigned MailMan position. The position is often, but not necessarily, filled by the system manager. Power Switch Located on the left side of the terminal, this switch is used to turn on the terminal. Preadmission The process of entering admission data into CHCS for a potential patient. Preadmission Order An order written in anticipation of a future admission date and time. Preop See Priority. Prefix The two-to-four-character namespace assigned to routines and globals, distinguishing applications. Prescription Used to refer to a drug, administration schedule, and instructions ordered for an outpatient. Primary Care Manager (PCM) A Managed Care Program (MCP) health care provider (HCP) who is assigned as a primary physician for a patient. The PCM may be either an individual provider or a group provider. Primary Menu A user's initial or starting menu. Printer May be referred to as a printer device or output device: Shared Printer: A printer that is available to two or more terminals or output devices. 5-32 Subsystem Glossary SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Subsystem Glossary (continued) Term Definition Line Printer: A printer that prints a line or more at a time. (Line printer speeds are expressed in lines per second [lps] and may be over 100 lines per second.) Slave Printer: A printer attached directly to a terminal and used to print from that terminal only. Print Template A set of field specifications that allow exact print formats and specified data records to be used when printing reports. This allows the use of the same print logic again and again. Privilege(s) The capabilities allowed within the database management system (DBMS) based on the level of protection specified for any process, file, or user. Profile A collection of administrative, scheduling, and appointment information applicable to a specific facility, division, clinic, and provider. Patient Appointment and Scheduling (PAS) profiles define the basic rules and instructions by which the facility, division, clinic, and provider provide care; and they provide the parameters that control the way the system processes data. Prompt 1) A system-generated request for response. 2) A word or statement on the screen that tells the user what action needs to be taken or what information must be entered (i.e., Select Patient Name). Provider See Health Care Provider. Provider Class Description of provider groups such as nurse, social worker, or physician. Each provider class is linked to a signature class. Provider classes are medical treatment facility (MTF)-definable. 5-33 Subsystem Glossary SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Subsystem Glossary (continued) Term Definition Provider Group A provider group is one or more providers who have jointly negotiated an agreement to provide services to eligible beneficiaries. A provider group can have multiple individual providers, multiple places of care, and/or multiple agreements. Pseudo SSN A false system-generated Social Security number used in a patient data record when the real number is unknown. Pull List A list of all patients whose medical records must be pulled for a specified date. Question Mark (?) Key See Computer Control Keys. Quick Reference Guide (QRG) A quick reference guide contains information about an option: screen displays, entry path to access the option, and pertinent information for using the option. Quick reference guides are located in Section 4 of each subsystem reference manual. Radiology Subsystem of CHCS (RAD) The RAD Subsystem is designed to meet the functional requirements of the Radiology Department and Nuclear Medicine, including patient processing and room scheduling, defining and implementing site-specific radiology procedure requirements, work load statistics, and management reports. Record Number Also known as the record identifier number This is a unique sequential number assigned to each record within the Record Tracking functionality upon its creation. The record may be accessed by entering this number at any Select Record prompt. Record Room Location of patient records. 5-34 Subsystem Glossary SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Subsystem Glossary (continued) Term Definition Record Tracking The procedure for determining where records are physically located. Registration A registration must be completed on all patients, whether inpatient or outpatient, before CHCS can support any care or services rendered. Reminder Notices A form mailed to patients to remind them of upcoming appointments. Requesting Location A specific location within the medical treatment facility (MTF) from which the patient services are requested, i.e., a ward, clinic or other location, and receiving credit for the orders placed, and to which test results and orders will be sent. Response An action to be taken in response to a specific prompt generated by the CHCS System. (For instance, Enter Provider Name: [variable data].) In CHCS documentation, a required response is identified by FULL CAP BOLD text. Retrieve 1) The ability to review a patient's past medical history. 2) Process of retrieving historical patient data that has been archived. <Return> Key See Computer Control Keys. Routing Card A card attached to the medical record itself that is sent around with the record. This card indicates where the record is to go, based on the clinics in which that patient has appointments. Schedules An array of available time slots for a certain provider in a certain clinic for a certain date. 5-35 Subsystem Glossary SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Subsystem Glossary (continued) Term Definition Schedule Time Slot A single time opening in a provider's template or schedule for a certain type of appointment.The slot has a beginning and an end time, and a maximum number of patients that can be seen during that period. This is also referred to as an appointment slot. Screen 1) The part of the visual display terminal (VDT) that presents information sent from the computer or information typed on the keyboard. 2) This term is also used to describe a single display of information that takes up the whole screen. Screen Mode See Prompt Series. Scroll Mode The system's request for information, presented one prompt at a time. The bottom line on the screen is replaced with new information. The user moves between prompts using <Return>, or the up-arrow or down-arrow keys. See Screen Mode. Search The process of locating an unknown number of records, in one file, based on one or more user-specified criteria. Search Conditions Criteria specified as part of a search that are used to test each data record in a file. Contains: Used to locate data with specific strings embedded. This is abbreviated with left square bracket ([) or the letter C. Equals: Used to locate data that equals the exact value of the specified condition. This is abbreviated with an equal sign (=) or the letter E. 5-36 Subsystem Glossary SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Subsystem Glossary (continued) Term Definition Greater Than: Used to locate data greater than the value of the specified condition. This is abbreviated with the greater than sign (>) or the letter G. Less Than: Used to locate data less than the value of the specified condition. This is abbreviated with the less-than sign (<) or the letter L. Matches: Used on Numeric, Free-text, Pointer, and Set of Codes fields to locate patterns in strings of data. This is abbreviated with the letter M. Null: Used to determine fields that contain no entries. No value can be placed on the NULL condition. This is abbreviated with the letter N. Search Criteria The rules by which the system searches for information. In Patient Appointment and Scheduling (PAS), the items that the system uses to search for open schedule slots. Search criteria in Booking can be Dates, Provider, Time Range, Days of Week, Appointment Type, Clinic, Duration, or Specialty. A user must identify the specific value or parameter for each selected search criterion. The system tries to find open schedule slots that match the parameters for all selected search criteria. Search Logic Expressions that define the parameters of the search. Valid logic parameters are: AND: The system extracts a data record when all stated search conditions have been met. NOT: The system extracts a data record when none of the specified search conditions are met. 5-37 Subsystem Glossary SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Subsystem Glossary (continued) Term Definition OR: The system extracts a data record when any of the combined search conditions are met. Search Parameter In Patient Appointment and Scheduling (PAS), the specific value for a search criteria that the system uses to search for open schedule slots. Secondary Menu See Menu. Security Checks The system checks accessibility to CHCS as the user enters a series of codes (Username and Access/Verify codes). Security Key A code that relates to the ability to use a certain process. Some security keys are already defined in the system. Other security keys are defined by the system manager. The naming conventions and strategy for the use of these keys is determined at each facility. The system manager assigns security keys to users as appropriate for their use of CHCS. Select Function that defines how to decide what the value will be by selecting one from among two or more possible values. Select is used if the actual value that will exist when the data element is used cannot be precisely predicted. <Select> Key See Computer Control Keys. Select Mark A tilde (~) or asterisk (*) that appears when the <Select> key is pressed. This mark identifies a selected item on a list. Select Window In Patient Appointment and Scheduling (PAS), the middle section of the Search Criteria screen. The window lists items for user selection. Service A clinical specialty within a medical treatment facility (MTF). 5-38 Subsystem Glossary SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Subsystem Glossary (continued) Term Definition SF558 Record of emergency room encounter information from arrival to disposition. This form contains patient demographics, specifics about the arrival, medical status, disposition information, and discharge instructions to the patient. SF600 Record of an outpatient clinic visit. This form contains patient demographics, appointment information: date, time, location, appointment type, and sections for recording comments and patient vital signs. <Shift> and <Lock> Keys See Computer Control Keys. Single Patient Booking One or several appointments for one patient in one clinic. Slot See Appointment Slot. Spacebar See Computer Control Keys. Spacebar, <Return> See Computer Control Keys. Space Character A special character that does not have an associated graphic representation. It is displayed as the absence of any character, where one might otherwise appear. Specialty In Patient Appointment and Scheduling (PAS), a search criterion in Booking for which the parameter is a clinic service. The clinic specialty is identified in the clinic profile (for example, dental care, family practice, pediatrics). Sponsor Person who qualifies the patient for health care (e.g., active-duty father is the sponsor of the dependent patient daughter). 5-39 Subsystem Glossary SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Subsystem Glossary (continued) Term Definition Sponsorship The organization that entitles the patient to health care (e.g., Army, Navy, Dept. of Education, Veterans Administration, etc.). Switch Divisions The user process to switch to an alternate division from the default division, or back to the default division from an alternate. See Menu. System Manager (SYSMAN) Used generically to describe functions that must be accomplished to support CHCS initialization and operation at each site where CHCS is installed. Functions include database administration, system security management, installation management, and telecommunications management. Table A list of available choices. A table displays when ?? is entered at a field that has a table connected to it. A table cannot be appended from the field, but must be set up through the appropriate menu options or through FileMan. Target Audience The audience for which the training is designed. Template 1) A predefined structure that controls a data entry dialogue, a printed report format, a sort sequence of an output, or a series of search conditions. Templates may be used repeatedly by entering the assigned name in brackets [ ] at the appropriate prompt. 2) In Patient Appointment and Scheduling (PAS), an array of schedule slots governed by the rules entered in the profiles. Templates are linked to specific providers, but not to any particular date range. Template ID In Patient Appointment and Scheduling (PAS), a unique identifier for a particular template. It is recommended that the template ID include 5-40 Subsystem Glossary SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Subsystem Glossary (continued) Term Definition the following information: day, clinic, provider, and template type (master, temporary, etc.). Terminal A device used to enter and send information to the computer. The keyboard and screen are terminal components. Terminal Digit This is the last two digits of the sponsor's Social Security number (SSN), starting at 00 and ending with 99. Time Range A search criterion for which parameters indicate a begin and end time. Training Aid In training documentation, training aids are supplemental information used during instruction to enhance lesson content. Training Materials All materials used in a training class. This includes manuals, training aids, various forms for presenter and students to complete, and performance tests. Training Software The software that enables the user to become proficient in the use of the CHCS system or subsystems. Troop Medical Clinic (TMC) The Army term for an outpatient clinic designated for active-duty walk-in or sick-call patients. Type-ahead A setting in the User file that allows the user to type ahead of what the computer is actually reading. The computer stores the keystrokes and reads them at its own pace. Unique Patient Identifier A set of data elements that uniquely identifies a patient in the central patient database, composed of sponsor Social Security number and patient family member prefix. 5-41 Subsystem Glossary SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Subsystem Glossary (continued) Term Definition Update The addition, deletion or modification of existing data. User A person authorized by the medical treatment facility (MTF) to initiate a process in CHCS via a terminal. User authorization will be determined through the virtual memory system (VMS) and CHCS system security functions. User Attributes Characteristics or settings. User attributes, for example, include the settings for use of the system (e.g., type-ahead allowed, time-out setting, access authorization, etc.). Username See User Security. Username/Password User security checking at the virtual memory system (VMS) level. Codes provide user access to VMS files. User Security A series of codes that serves to protect the system from unauthorized users. These codes are checked when a user is accessing the system. Username and Access/Verify codes are the two levels of security checking. Access Code: This code, together with the verify code, is used in the logon process to identify a legitimate user and gain access to CHCS. The code is site-specific and established by the CHCS system manager. It usually cannot be changed by the individual user. Username: The first level of security checking and the first code entered into CHCS at logon. Verify Code: This code, together with the access code, is used in the logon process to identify a legitimate user and gain access to CHCS. The code is established by the CHCS system manager at the medical treatment 5-42 Subsystem Glossary SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Subsystem Glossary (continued) Term Definition facility (MTF) and may be changed by the individual user from the Edit User Characteristics option of the Secondary Menu. The code does not show on the screen when entered. Users Manual The Users Manual volumes for each subsystem provide information addressed primarily to the users of a particular subsystem. This user manual is also available online (OLUM). The OLUM can be accessed by entering "???" at any action prompt. Some sites may not load OLUM due to disk space limitations; the CHCS Training Database contains the MailMan volume only. Volume 1: Basic System Volume 2: General PAD Volume 3: PAD MSA Volume 4: PAS Volume 5: MCP Volume 6: LAB Volume 7: RAD Volume 8: PHR Volume 9: CLN Volume 10: CLN DTS Volume 11: CLN FQA Volume 12: RT There are three unnumbered OLUM volumes: – Release Notes – MailMan Users Guide – FileMan Ad Hoc Users Guide User-Specified Parameters input by the user at the time the function is being called/executed. Validity Check CHCS utility that determines data inconsistencies gathered during the registration process (e.g., entry of an Air Force patient 5-43 Subsystem Glossary SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Subsystem Glossary (continued) Term Definition category for a Navy patient, fields left blank with no entry, etc.). Viewgraphs Viewgraphs, also called transparencies, are diagrams or text reproduced on transparent material used for projecting information on a screen. Virtual Memory System (VMS) The operating system that runs the VAX computer. It manages the memory of the computer in such a way that the memory appears to be virtually unlimited to the average user. Wait List All Wait List requests for a particular clinic. The clinic Wait List identifies those patients waiting for open schedules slots for that clinic. The clinic profile indicates whether a specific clinic has a Wait List. This allows the entry of Wait List requests for that clinic. Wait List Request A patient request for an appointment in a specific clinic when no open slots or overbooks are available in a certain clinic. Ward A defined hospital area that contains a designated number of patient beds. It often corresponds to a medical specialty area such as Orthopedics (e.g., Orthopedics Ward). Word Processing Data Type See Data Type. Workcenter A functional or organizational subdivision of a medical treatment facility (MTF) for which provision is made to accumulate and measure expenses and to determine workload performance. Designation of a workcenter varies from facility to facility depending upon the MTF organizational structure. CHCS workcenters include clinics used in Patient 5-44 Subsystem Glossary SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Subsystem Glossary (continued) Term Definition Appointment and Scheduling (PAS), pharmacies, laboratories, and radiology imaging locations. Workload/MEPRS Reports Quality control reports containing statistics and management data generated by the system to monitor specific military and medical treatment facility (MTF) workload statistical reporting requirements. Zip Code Combination A name that represents a range of zip codes. This site-definable name can be used during Managed Care Program (MCP) provider searches. 5-45 Subsystem Glossary SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Subsystem Glossary (continued) Acronyms and Abbreviations ACV Alternate Care Value ADT Admission, Disposition, and Transfer AHP Allied Health Professional AQCESS Automated Quality of Care Evaluation Support System ASAP As Soon As Possible ASMRO Armed Services Medical Regulatory Office AWOL Absent Without Leave BC/BS Blue Cross/Blue Shield CAS Central Appointments Service CHAMPUS Civilian Health and Medical Program of the Uniformed Services CHCS Composite Health Care System CSU/DSU Channel Service Unit/Data Service Unit DEA Drug Enforcement Administration DEERS Defense Enrollment Eligibility Reporting System DOB Date of Birth DOD Department of Defense DRT Delinquent Record Tracking DTS Dietetics Subsystem of CHCS DWC Divided Workcenter 5-46 Subsystem Glossary SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Subsystem Glossary (continued) Acronyms and Abbreviations EAS Expense Assignment System ER Emergency Room ERD Emergency Room Death FI Fiscal Intermediary FileMan File Manager FMP Family Member Prefix FQA Facility Quality Assurance of CHCS HCF Health Care Finder HCP Health Care Provider HCP-ID Health Care Provider Identification HMO Health Maintenance Organization Ht Height ID Identification IEN Internal Entry Number INIT Initialization IP 1) Inpatient 2) Internet Protocol JCAHO Joint Commission on Accreditation of Health Care Organizations KVDT Keyboard Video Display Terminal LAB Laboratory Subsystem of CHCS 5-47 Subsystem Glossary SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Subsystem Glossary (continued) Acronyms and Abbreviations LAYGO Learn As You Go MailMan Mail Manager MAR Medication Administration Record MCP Managed Care Program MEPRS Medical Expense and Performance Reporting System MSA Medical Services Accounting MSAO Medical Services Accounting Office MTF Medical Treatment Facility MTRC Medical Treatment Record Card MUMPS Massachusetts General Hospital Utility Multi-Programming System MVVR Master Version Validation Report N 1) No 2) Variable number NAS Non-Availability Statement NEC Not Elsewhere Classified OCONUS Outside the Continental United States OCR Optical Character Reader recognition OHI Other Health Insurance OHMIS Occupational Health Management Information System 5-48 Subsystem Glossary SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Subsystem Glossary (continued) Acronyms and Abbreviations OLUM Online Users Manual OP Outpatient OSA Only Service Available PAD Patient Administration Subsystem of CHCS PAD MSA PAD Medical Services Accounting Subsystem of CHCS PAS 1) Patient Appointment and Scheduling Subsystem of CHCS 2) PAS Order PATCAT Patient Category PCM Primary Care Manager PCS Permanent Change of Station PEB Physical Evaluation Board PHR Pharmacy Subsystem of CHCS PNT,PT Patient PRP Personal Reliability Program PTF Patient Treatment File in DHCP PTID Patient Identifier Number (FMP/SSN) QA Quality Assurance RAD 1) Radiology Subsystem of CHCS 2) RAD Order RX 1) Outpatient medication 5-49 Subsystem Glossary SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Subsystem Glossary (continued) Acronyms and Abbreviations 2) Receive SAIC Science Applications International Corporation SASS Stand-Alone Appointing and Scheduling System SDSMGR PAS Scheduling Manager SSN Social Security Number STD Standard SW Software SYSMAN System Manager T 1) In the context of a data value that is expected to refer to a date, FileMan interprets the letter “T” to mean the date of the current day (i.e., Today). 2) Temperature TBD To Be Determined TDB Training Database TMC Troop Medical Clinic UCI User Class Identifier UPIN Unique Physician Identification Number UR Utilization Review VAX Virtual Address Extension VT320 Terminal The CHCS terminal used in most workstation configurations 5-50 Subsystem Glossary SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Subsystem Glossary (continued) Acronyms and Abbreviations WCS Workcenter Support Y Yes Y/N END Yes/No 5-51 Subsystem Glossary SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 PATIENT APPOINTMENT AND SCHEDULING REFERENCE MANUAL Section 6 Sample Output Reports END 6-1 Sample Output Reports SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 ---------------------------------------------------------------------------------------------------------------------------------TABLE OF CONTENTS ---------------------------------------------------------------------------------------------------------------------------------FIGURE REPORT NAME 4.4.1.1 Book Appointments (Appointment Reminder Notice & Telephone Consult 4.4.1.2 Unscheduled Visit 4.4.1.4 Display Patient Appointments 4.4.1.7 End-of-Day Processing/Editing 4.4.1.9 Wait List Processing (Mail/Phone) 4.4.1.10 Cancellation Processing (Mail/Phone) 4.4.1.11 No-Show Processing (Mail/Phone) 4.4.1.12 Repeat No-Show & Strong Notice Processing 4.4.3.1 Daily Outpatient Encounter Forms (Clin/Prov/Indv) 4.4.3.2 Daily Outpatient Encounter Forms (Division/All) 4.4.3.3 JCAHO Control Register Print 4.4.3.4 SF 558 Print 4.4.4.1 Appointment Order Processing 4.4.5.2 Facility Profile List 4.4.5.4 Division Profile List 4.4.5.6 Clinic Profile List 4.4.5.9 Provider Profile List 4.4.5.11 Appointment Type List 4.4.5.13 Emergency Room Clinic Profile List 4.4.5.16 Emergency Room Provider Profile List 4.4.6.4 Print Daily/Weekly Template 4.4.7.1 Create Schedules 6-2 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 4.4.7.3 Replicate Schedules 4.4.7.4 Print Clinic/Provider Schedules 4.4.8.1 Consolidated OR Provider Roster (One Clinic) 4.4.8.2 Consolidated Roster (ALL Clinics) 4.4.8.3 Provider Roster (ALL Clinics) 4.4.8.4 Print/Display Provider Roster 4.4.8.5 Inpatient Ward Roster for Today 4.4.8.6 Clinic Schedule Summary 4.4.8.7 Provider Schedule Summary 4.4.8.8 Wait List - Automatic Booking Roster 4.4.8.9 Outpatient Disposition Roster 4.4.9.1 Appointment Utilization Report 4.4.9.2 Aviation Medicine Report 4.4.9.3 Call No-Show Report 4.4.9.4 Facility Cancellation Statistical Report 4.4.9.5 Clerk Workload Recap Report 4.4.9.6 Clerk Workload Report 4.4.9.7 Clinic Workload Report 4.4.9.8 Command Facility Workload Recap Report 4.4.9.9 Command Security Program Report 4.4.9.10 Delinquent End-of-Day Processing Report 4.4.9.11 PAS DEERS Ineligibility Report 4.4.9.13 Military No-Show Report 4.4.9.14 Monthly Statistical Report 4.4.9.15 Next Available Appointment Report 4.4.9.16 No-Show Statistical Report 6-3 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 4.4.9.17 Patient Registration Report 4.4.9.18 Primary Provider Report 4.4.9.19 Schedule Deficiency Monitor Report 4.4.9.20 Trackable Entity Report 4.4.9.21 Wait List Management Report 4.4.9.22 Problem Avoidance Report 4.4.9.24 Patient Cancellation Statistical Report 4.4.9.25 Initial and Follow-up Clinic Visit Report 4.4.9.26 Unanswered Telephone Consults Report 4.4.9.27 Top Ambulatory Diagnoses Report 4.4.9.28 Top Ambulatory Procedures Report 4.4.9.29 Top Ambulatory Diagnoses and/or Procedures Report by Patient Category 4.4.9.30 Patient Visit Summary Report 4.4.10.2 Available Schedule Monitor Bulletin 4.4.10.5 List PAS Users 4.4.10.11 Print PAS User 4.4.10.19 View PAS Mailers 4.4.10.20 Print PAS Mailers 6-4 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 NAME: DAVIS,SHARON STREET ADDRESS: 1932 MAPLE LANE CITY: FT KNOX STATE: KENTUCKY ZIP CODE: 21903 According to our records, you have an appointment at the CLINIC, DATE, and TIME listed below. Please arrive on time, with your medical records if you have them at home. If you cannot make this appointment, please call Hospital Cancellations at 565-4949 or the clinic at least 48 hours in advance to make this time available for another patient. WED 1500 13 SEP 1989 STORER,T FIGURE 4.4.1.1. GEN SURG RET SAMPLE OUTPUT REPORT: BOOK APPOINTMENTS (REMINDER NOTICE) (Sheet 1 of 3) 6-5 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 NAME: DAVIS,SHARON STREET ADDRESS: 1932 MAPLE LANE CITY: FT KNOX STATE: KENTUCKY ZIP CODE: 21903 According to our records, you have an appointment at the CLINIC, DATE, and TIME listed below. Please arrive on time, with your medical records if you have them at home. If you cannot make this appointment, please call Hospital Cancellations at 565-4949 or the clinic at least 48 hours in advance to make this time available for another patient. WED 1500 13 SEP 1989 STORER,T FIGURE 4.4.1.1. GEN SURG RET SAMPLE OUTPUT REPORT: BOOK APPOINTMENTS (TELEPHONE CONSULTS) (Sheet 2 of 3) 6-6 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 Personal Data - Privacy Act of 1974 (PL-93-579) Page 1 Automated Version of DA5008/USAF & USN SF600 Overprint Telephone Consultation ---------------------Printed Date: 24 Jun 91 @ 1302 Division: BALBOA NAVY MEDICAL CENTER Clinic: ALLERGY (T)/TRIP Allergies: Clerk's Note: Clerk: GOTOVAC,JAKE 24 Jun 91 @ 1301 The patient is suffering from severe arthritis, yet her arthritis medication is irritating to the stomach. She requests that you recommend a different medication. Clerk: GOTOVAC,JAKE 24 Jun 91 @ 1302 Infectious mononucleosis also needs to be taken into consideration. Problem List: Provider's Note: *** END OF REPORT *** ______________________________________________________________________________ QUACKENBUSH,BARBARA 30/569-44-9789 USN FAM MBR RET DOB: 10 Mar 1929 H: 619-263-1608 W: Spon: QUACKENBUSH,STEPHEN Rank: MASTER CHIEF PETTY OFFICER Unit: RR: MAIN FILE ROOM (P) FIGURE 4.4.1.1. SAMPLE OUTPUT REPORT: BOOK APPOINTMENTS (TELEPHONE CONSULTS) (Sheet 3 of 3) 6-7 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER DIVISION: TRIPLER ARMY MEDI Personal Data - Privacy Act of 1974 (PL 93-579) Automated Version of SF600 Printed: 20 Feb 1992@1455 CARDIOLOGY CLINIC REF: RSN: LEBOW,LESTER 20 Feb 1992 1445 NEW BACA CMT: BP: PULSE: RESP: TEMP: HT: WT: ================================================================================ ADDITIONAL COMMENTS: ================================================================================ 20/140-22-1705 ANDERSON,BETTY A11 10 Mar 1951 FEMALE W:502-447-4030 H:502-223-9054 Spon: ANDERSON,BETTY CIC: CS: Rank: COLONEL D:502-447-4030 SF600 Unit: FT KNOX RR: MAIN FILE ROOM (P) FIGURE 4.4.1.2. SAMPLE OUTPUT REPORT: UNSCHEDULED VISIT (ENCOUNTER FORM) (Sheet 1 of 3) 6-8 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 Personal Data - Privacy Act of 1974 (PL 93-579) DEERS ELIGIBILITY DATA RETURNED FROM DEERS 20 Feb 1992@1459 NAME: ANDERSON, BETTY SEX: FEMALE DOB: 10 Mar 1951 SSN: 140-22-1705 DEERS ELIGIBILITY: ELIGIBLE FIGURE 4.4.1.2. SAMPLE OUTPUT REPORT: UNSCHEDULED VISIT (DEERS-CHECK REQUEST) (Sheet 2 of 3) 6-9 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 Personal Data - Privacy Act of 1974 (PL-93-579) Page 1 Automated Version of DA5008/USAF & USN SF600 Overprint Telephone Consultation ---------------------Printed Date: 20 Feb 92 @ 1502 Division: BALBOA NAVY MEDICAL CENTER Clinic: GASTROENTEROLOGY Allergies: Clerk's Note: Clerk: GOTOVAC,JAKE 20 Feb 92 @ 1501 The patient is suffering from severe arthritis, yet her arthritis medication is irritating to the stomach. She requests that you recommend a different medication. Clerk: GOTOVAC,JAKE 20 Feb 92 @ 1502 Infectious mononucleosis also needs to be taken into consideration. Problem List: Provider's Note: *** END OF REPORT *** ______________________________________________________________________________ QUACKENBUSH,BARBARA 30/569-44-9789 USN FAM MBR RET DOB: 10 Mar 1929 H: 619-263-1608 W: Spon: QUACKENBUSH,STEPHEN Rank: MASTER CHIEF PETTY OFFICER Unit: RR: MAIN FILE ROOM (P) FIGURE 4.4.1.2. SAMPLE OUTPUT REPORT: UNSCHEDULED VISIT (TELPHONE CONSULT REPORT) (Sheet 3 of 3) 6-10 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 DISPLAY PATIENT APPOINTMENTS Personal Data - Privacy Act of 1974 (PL 93-579) FUTURE APPOINTMENTS FOR ANDERSON,BETTY 20/140-22-1705 CLINIC/DIV PROVIDER DATE/TIME TYPE STATUS ================================================================================ ALLERGY/TRIP BARRON-BERMA 04 Dec 1991@0800 FU CANCEL(F) ALLERGY/TRIP BARRON-BERMA 05 Dec 1991@0900 FU CANCEL(P) ALLERGY/TRIP SEYMOUR,ROGE 13 Dec 1991@1030 NEW WALK-IN Arrive 10 min early Call 987-6543 to CANCEL/RESCHEDULE Appt! THESE ARE THE CLINICAL INSTRUCTIONS WAIT LIST REQUESTS FOR ANDERSON,BETTY 20/140-22-1705 CLINIC/DIV TYPE PRI DATE IN TARGET DATE PROVIDER ================================================================================ CARDIOLOGY CLINIC/IACH NEW 2 23 Oct 1989 24 Oct 1989 SEAY,ROBERT CARDIOLOGY CLINIC/IACH RET 2 30 Oct 1989 31 Oct 1989 TANNER,DON Press <RETURN> to continue Display/Print Appointment History of Other Family Members? NO// Personal Data - Privacy Act 1974 (PL 93-579) FIGURE 4.4.1.4. SAMPLE OUTPUT REPORT: DISPLAY PATIENT APPOINTMENTS (FUTURE) (Sheet 1 of 3) 6-11 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 DISPLAY PATIENT APPOINTMENTS Personal Data - Privacy Act of 1974 (PL 93-579) PAST APPOINTMENTS FOR ANDERSON,BETTY 20/140-22-1705 CLINIC/DIV PROVIDER DATE/TIME TYPE STATUS ================================================================================ GENERAL SURGERY CLIN/PEARL HERBERT,JEF 18 Sep 1989@1300 RET KEPT APPT **** AUTO-BOOKED from Wait List **** PEDIATRICS/PEARL SEAY,ROBERT 05 Oct 1989@0815 FU KEPT APPT DERMATOLOGY CLINIC/PEARL LEVINE,DAN 17 Oct 1989@0915 RET ADMIN Press <RETURN> to continue Display/Print Appointment History of Other Family Members? NO// Personal Data - Privacy Act 1974 (PL 93-579) FIGURE 4.4.1.4. SAMPLE OUTPUT REPORT: DISPLAY PATIENT APPOINTMENTS (PAST) (Sheet 2 of 3) 6-12 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 DISPLAY PATIENT APPOINTMENTS Personal Data - Privacy Act of 1974 (PL 93-579) History of Appts for ANDERSON,BETTY from: 31 Oct 1991 CLINIC/DIV PROVIDER DATE/TIME TYPE STATUS ================================================================================ CARDIOLOGY CLINIC/IACH SANTOS,MERVY 06 Dec 1991@0700 NEW NO-SHOW **** AUTO-BOOKED from Wait List **** CARDIOLOGY CLINIC/IACH SANTOS,MERVY 06 Dec 1991@1000 NEW NO-SHOW WAIT LIST REQUESTS FOR ANDERSON,BETTY 20/095675431 CLINIC/DIV TYPE PRI DATE IN TARGET DATE PROVIDER ================================================================================ DERMATOLOGY CLINIC/PEARL NEW 6 26 Jul 1989 27 Jul 1989 LEVINE,DAN Press <RETURN> to continue Display/Print Appointment History of Other Family Members? NO// Personal Data - Privacy Act 1974 (PL 93-579) FIGURE 4.4.1.4. SAMPLE OUTPUT REPORT: DISPLAY PATIENT APPOINTMENTS (SPECIFIC DATE) (Sheet 3 of 3) 6-13 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER AMC HONOLULU HI 06 Nov 1994@2206 Page 1 Personal Data - Privacy Act 1974 (PL 93-579) END-OF-DAY PROCESSING REPORT From: 06 Nov 1994 To: 06 Nov 1994 Division: TRIPLER ARMY MEDICAL CENTER Clinic: ALLERGY (T) ================================================================================ TIME PATIENT NAME FMP/SSN TYPE PROVIDER DATE MEPRS STATUS ================================================================================ 0830 BARRON,DAPHNE 30/3434 RET BARRON-BERM 06 Nov 94 BABA Kept 0900 THOMAS,MARY 01/3042 NEW THACKER,DA 06 Nov 94 BABA Kept 0930 TALWIN,AMANDA 20/1543 FU THACKER,DA 06 Nov 94 BABA Kept 1030 MARSHALL,PENNY 30/2266 RET THACKER,DA 06 Nov 94 BABA Kept 1100 DYLAN,ROBERT 01/6868 NEW THACKER,DA 06 Nov 94 BABA Kept 1300 DYLAN,THOMAS 20/6868 RET THACKER,DA 06 Nov 94 BABA Cancel-F 1330 ANDERSON,HARRY 04/3910 NEW THACKER,DA 06 Nov 94 BABA Kept 1400 DAVIS,LIZ 05/2387 RET THACKER,DA 06 Nov 94 BABA Kept 1500 CALE,JOHN J 20/1990 RET THACKER,DA 06 Nov 94 BABB Kept ================================================================================ **Daily Clinic Appointment Status Summary with COUNT Appt Types** ================================================================================ Provider Kpt WI SC TC |Total| Can NS Adm LWOBS O-S |Total| ================================================================================ BARRON-BERM 1 0 0 0 | 1| 0 0 0 0 0 | 0| THACKER,DA 7 0 0 0 | 7| 1 0 0 0 0 | 1| -------------------------------------------------------------------------------Total 8 0 0 O | 8| 1 0 0 0 0 | 1| FIGURE 4.4.1.7. SAMPLE OUTPUT REPORT: END-OF-DAY PROCESSING/EDITING (Sheet 1 of 2) 6-14 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER AMC HONOLULU HI 06 Nov 1994@2206 Page 2 Personal Data - Privacy Act 1974 (PL 93-579) END-OF-DAY PROCESSING REPORT From: 06 Nov 1994 To: 06 Nov 1994 Division: TRIPLER ARMY MEDICAL CENTER Clinic: ALLERGY (T) **Daily Clinic Appointment Status Summary with NON-COUNT Appt Types** ================================================================================ Provider Kpt WI SC TC |Total| Can NS Adm LWOBS O-S |Total| ================================================================================ HERTZ,PA 0 0 0 2 | 2| 0 0 0 0 0 | 0| SEAGER,PE 0 0 0 1 | 1| 0 0 0 0 0 | 0| -------------------------------------------------------------------------------Total 0 0 0 3 | 3| 0 0 0 0 0 | 3| FIGURE 4.4.1.7. SAMPLE OUTPUT REPORT: END-OF-DAY PROCESSING/EDITING (Sheet 2 of 2) 6-15 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 CDR, IACH Attn: Patient Appointments 3511 POST AVE. Fort Knox, Ky 20912 Penalty for Private Use $300 14 Jul 1992 To better manage the access and availability of care to our facility, several of our clinics maintain computerized Wait Lists. The following appointment has been AUTOMATICALLY booked by the computer based upon your previous request. Please call Patient Appointments at 123-4567 or the Clinic Phone Number listed below if you need to cancel/reschedule the appointment. PAS Testing Clinic with Pearce,Benjamin F at 1509 on 12 Nov 1992 Thursday Appointment Service Supervisor Clinic Phone: (212) 123-4567 John Q Patient 1234 West Woodlawn St San Diego, CA 92122 FIGURE 4.4.1.9. SAMPLE OUTPUT REPORT: WAIT LIST PROCESSING (MAIL/PHONE) (Sheet 1 of 2) 6-16 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 Ireland Army Community Hospital 14 Jul 1992@0902 Page 1 Personal Data - Privacy Act 1974 (PL 93-579) WAIT LIST MANAGEMENT REPORT BY CLINIC BY PRIORITY From: FIRST Thru: LAST Division: IRELAND Department: NEUROPSYCHIATRIC CARE ================================================================================ Patient FMP/SSN Prio Type Date-In Target Wait List# Home Phone Work Phone ================================================================================ Clinic: NEUROLOGY Provider: *Provider Not Entered* NASH,GERALD 30/800400101 H:405-455-5678 4 RET 13Jul92 14Jul92 W:405-234-1121 139.00002504 03/800510708 H:405-787-9909 3 FU 13Jul92 20Jul92 W:405-383-2996 139.00002508 02/786939748 H:405-754-8484 01/455633988 H:405-455-2189 5 NEW W: RET W: 13Jul92 16Jul92 139.00002509 09Jul92 15Jul92 139.00002349 20/455566879 H: 30/988234654 H: 4 RET W: FU W: 13Jul92 20Jul92 139.00002503 10Jul92 11Jul92 139.00002457 Provider: FINK,ED MAE,DAVID Provider: FUNKMEYER,ED HAGAR,ANN FOX,PENNY 2 Provider: HOBOLD,ERIC JACOBSEN,JANET FEINSTEIN,LINDA CLINIC TOTALS ============= FU NEW OR* RET Total: 0 2 4 6 8 = = = = = 4 2 1 0 3 6 BY DIRECTION OF COMMANDER ACTIVE DUTY MTF DEFINED NON-ACTIVE DUTY NON MILITARY 1 3 5 7 9 = = = = = PROVIDERS ORDERS MFT DEFINED MTF DEFINED MTF DEFINED LONG LEAD TIME FIGURE 4.4.1.9. SAMPLE OUTPUT REPORT: WAIT LIST PROCESSING (MAIL/PHONE) (Sheet 2 of 2) 6-17 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 CANCELLATION NOTICES 30 Aug 1990 STASKO,THOMAS CAST PAS 511 TIME TYPE PATIENT FMP/SSN REASON COMMENTS =================================================================================== 0815 FU GERE,RICHARD 20/234-12-5645 MEETINGS : Notified by Mail 0900 FU HARBOLD,GARY 20/336-22-6654 MEETING : Atmpt,14 Aug 90 0815 FU STRONG,SAMUEL 20/222-45-6332 MEETING : Atmpt,14 Aug 90 FIGURE 4.4.1.10. SAMPLE OUTPUT REPORT: CANCELLATION PROCESSING (MAIL/PHONE) (Sheet 1 of 2) 6-18 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 NAME: JOHNSON,ROGER STREET ADDRESS: 509 REDROCK PLACE CITY: FT KNOX STATE: KENTUCKY ZIP CODE: 20451 It is necessary for us to cancel the appointment listed below. We regret any inconvenience this may cause you. If your medical condition requires ongoing care, please contact the Central Appointment Service at 555-2232 or the clinic to reschedule this appointment. MON 0900 03 SEP 1990 STASKO,T FIGURE 4.4.1.10. DERM FU SAMPLE OUTPUT REPORT: CANCELLATION PROCESSING (MAIL/PHONE) (Sheet 2 of 2) 6-19 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 NO-SHOW NOTICES 23 Jan 1990 THACKER,DAVID T-ALGY PAS 521 TIME TYPE PATIENT FMP/SSN REASON COMMENTS ================================================================================ 0800 NEW SIMPSON,HOMER 20/362-77-6534 NO-SHOW : 1350 RET TAYLOR,ROGER 20/454-16-7789 NO-SHOW : Use SELECT Key to identify Patients to MAIL No-Show Notices to OR Press <RETURN> to Telephone, Reschedule or Delete Patient from notify list. Personal Data - Privacy Act 1974 (PL 93-579) FIGURE 4.4.1.11. SAMPLE OUTPUT REPORT: NO-SHOW PROCESSING (MAIL/PHONE) (Sheet 1 of 2) 6-20 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 NAME: DAVIS,SHARON STREET ADDRESS: 1932 MAPLE LANE CITY: FT KNOX STATE: KENTUCKY ZIP CODE: 21903 According to our records, you did not keep the appointment listed below. Since you require medical care, we encourage you to reschedule. In the future, if you are unable to keep a scheduled appointment, please call 555-2232 to cancel, so that another member of our community may have the appointment. WED 0830 22 JAN 1989 STORER,T FIGURE 4.4.1.11. GEN SURG RET SAMPLE OUTPUT REPORT: NO-SHOW PROCESSING (MAIL/PHONE) (Sheet 2 of 2) 6-21 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 NAME: ALLEN,JOSEPH STREET ADDRESS: 3511 POST AVE. CITY: FT KNOX STATE: KENTUCKY ZIP CODE: 20912 According to our records, you did not keep the appointment listed below and you missed others recently. We are concerned about the health of all our patients. If you can not keep an appointment, please call Central Appointments at 555-2232 or the clinic at least 24 hours in advance to reschedule your appointment. MON WED MON FRI TUES 1100 1500 0900 1430 0700 11 13 22 16 20 JAN JAN JAN FEB FEB 1989 1989 1989 1989 1989 STORER T STORER,T STASKO,T LEBOW,L HERSHEY,T FIGURE 4.4.1.12. GEN SURG GEN SURG DERM DERM CARD RET RET NEW FU MULT SAMPLE OUTPUT REPORT: REPEAT NO-SHOW & STRONG NOTICE PROCESSING 6-22 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER DIVISION: TRIPLER ARMY MEDI Personal Data - Privacy Act of 1974 (PL 93-579) Automated Version of SF600 Printed: 18 Jun 1992@1248 GENERAL SU REF: RSN: TESTING HERBERT,JEFF 18 Jun 1992 1247 NEW BBAA CMT: BP: PULSE: RESP: TEMP: HT: WT: ================================================================================ ADDITIONAL COMMENTS: ================================================================================ 20/433-20-0322 HAMILTON,ANDREW A11 03 Mar 1950 MALE W:546-4564 H:342-2342 Spon: HAMILTON,ANDREW CIC: CS: PRP Rank: CAPTAIN D:349-1122 SF600 Unit: 1116 USA SIGNAL BN RR: OUTPATIENT RECORD ROOM (I) FIGURE 4.4.3.1. SAMPLE OUTPUT SCREEN: DAILY OUTPATIENT ENCOUNTER FORMS (CLIN/PROV/INDV) 6-23 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER DIVISION: TRIPLER ARMY MEDI Personal Data - Privacy Act of 1974 (PL 93-579) Automated Version of SF600 Printed: 18 Jun 1992@1248 GENERAL SU REF: RSN: TESTING HERBERT,JEFF 18 Jun 1992 1247 NEW BBAA BP: PULSE: RESP: TEMP: HT: WT: ================================================================================ ADDITIONAL COMMENTS: ================================================================================ 20/433-20-0322 HAMILTON,ANDREW A11 03 Mar 1950 MALE W:546-4564 H:342-2342 Spon: HAMILTON,ANDREW CIC: CS: PRP Rank: CAPTAIN D:349-1122 SF600 Unit: 1116 USA SIGNAL BN RR: OUTPATIENT RECORD ROOM (I) FIGURE 4.4.3.2. SAMPLE OUTPUT SCREEN: DAILY OUTPATIENT ENCOUNTER FORMS (DIVISION/ALL) 6-24 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 08 Oct 1991@1611 Page 1 Personal Data - Privacy Act 1974 (PL 93-579) ER JCAHO CONTROL REGISTER by All Divisions From: 08 Oct 1991@0001 To: 08 Oct 1991@1609 Division: PEARL HARBOR Dept: PRIMARY CARE/COMMUNITY MEDICINE Clinic: EMERGENCY ROOM (P) ** = Patient with no DISPOSITION ================================================================================================================================== Patient Name FMP/SSN Sex Age Cat Rank Sponsor Name ER Log # Arrival Date/time Departure Date/time Disp Dur Provider Method of Transit Chief Complaint Home Phone Record Location ER Comment Work Phone ================================================================================================================================== BABBIS,CHARLES E 20/140-24-1708 MALE 44 N11 CAPT BABBIS,CHARLES E 890113-00002 08 Oct 1991@0736 08 Oct 1991@0905 Q48 45 min MURPHY,TOM POV BROKEN ARM H: 223-9056 USS PERMIT Cmnt: This patient fell onboard ship in port. W: 447-4032 ---------------------------------------------------------------------------------------------------------------------------------**LUDWIG,LAUREN M 03/212-67-3373 FEMALE 2 N41 PO1 LUDWIG,JOHN M 920910-00065 08 Oct 1991@0910 WI SHORTNESS OF BREATH H: 499-2588 PH DEPENDENT OUTPT REC Cmnt: W: 474-0266 FIGURE 4.4.3.3. SAMPLE OUTPUT REPORT: JCAHO CONTROL REGISTER PRINT (Sheet 1 of 2) 6-25 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 08 Oct 1991@1611 Page 2 Personal Data - Privacy Act 1974 (PL 93-579) ER JCAHO CONTROL REGISTER by All Divisions From: 08 Oct 1991@0001 To: 08 Oct 1991@1609 Division: TRIPLER ARMY MEDICAL CENTER Dept: PRIMARY CARE/COMMUNITY MEDICINE Clinic: EMERGENCY ROOM (P) ** = Patient with no DISPOSITION ================================================================================================================================== Patient Name FMP/SSN Sex Age Cat Rank Sponsor Name ER Log # Arrival Date/time Departure Date/time Disp Dur Provider Method of Transit Chief Complaint Home Phone Record Location ER Comment Work Phone ================================================================================================================================== DALMER,NEWTON 20/140-22-1603 MALE 23 M11 PVT DALMER,NEWTON 890113-00002 08 Oct 1991@0815 08 Oct 1991@0915 Q72 30 min MAYHEW,EDWIN POV SLAMMED FINGER IN RIFLE LOCK H: (212) 277-0152 OUTPATIENT RECORD ROOM Cmnt: Return in two weeks W: (303) 491-1098 ---------------------------------------------------------------------------------------------------------------------------------**GAYNOR,MARY DAWN 30/558-64-7500 FEMALE 31 K69 GAYNOR,ROBERT 910604-00003 08 Oct 1991@0933 08 Oct 1991@1000 AMB STRUCK BY BICYCLE H: (415) 744-9292 Cmnt: FIGURE 4.4.3.3. SAMPLE OUTPUT REPORT: JCAHO CONTROL REGISTER PRINT (Sheet 2 of 2) 6-26 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 Personal Data - Privacy Act of 1974 (PL 93-579) Automated Version SF558 -------------------------------------------------------------------------------EMERGENCY CARE & TREATMENT - TRIPLER ARMY MEDICAL CEN | LOG NUMBER: 940624-00001 -------------------------------------------------------------------------------Arrival Date/Time: 24 Jun 1994@0115 | 3rd Party Payer: NO Trans to Hospital: AMBULANCE/MTF | Time Seen: History Obtained From: PATIENT | Category: EMERGENCY -------------------------------------------------------------------------------Addr: 114 Lilac Lane PORTSMOUTH, VA 23665 | Phone: 3015907790 Chief Complaint: CHEST PAINS, NUMBNESS IN RT ARM | Sex: MALE Age: 33 -------------------------------------------------------------------------------VITAL SIGNS | Medications | Tetanus: Time ______ _____ _____| | Allergies: BP-SY ______ _____ _____| | MORPHINE, CODEINE, BP DI ______ _____ _____| | TETRACYCLINE Pulse ______ _____ _____| | VALPROATE SODIUM Resp ______ _____ _____|-----------------------------|------------------------Temp ______ _____ _____| WT-Ped _____ _____ _____| Orders Inits Time | ____________ _____ _____| ____________ _____ _____| ____________ _____ _____| ____________ _____ _____| ____________ _____ _____| ____________ _____ _____| ____________ _____ _____| ASSESSMENT/DIAGNOSIS | ________________________| ________________________| ________________________| ====== DISPOSITION =====| __Home __Full Duty | __Quarters | __24hrs __48hrs __72hrs| | Modified Duty Until: | Day:____ Mon:____ Yr:___| | Referred to: | | __Emergency __Today | __72 hours __Routine | | FIGURE 4.4.3.4. SAMPLE OUTPUT REPORT: (Sheet 1 of 2) 6-27 SF 558 PRINT SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 Admitted to: | | Others: | | Condition Upon Release: | __Improved __Unchanged | __Deteriorated | Signature of Provider/Stamp: Release Time: | ________________________________________________________________________________ Instructions to Patient: I HAVE RECEIVED AND UNDERSTAND MY DISCHARGE INSTRUCTIONS _______________________ -------------------------------------------------------------------------------20/335-33-5335 BRISTOL,HARRY N11 01 Jan 1960 MALE W:301-589-7790 H:301-590-7788 Loc: EMERGENCY ROOM (A) Spon: BRISTOL,HARRY Rank: CDR D:301-589-7790 SF558 Unit: USS GUAM RR: OUTPATIENT RECORD ROOM (A) FIGURE 4.4.3.4. SAMPLE OUTPUT REPORT: (Sheet 2 of 2) 6-28 SF 558 PRINT SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 DISPLAY PATIENT APPOINTMENTS Personal Data - Privacy Act of 1974 (PL 93-579) FUTURE APPOINTMENTS FOR MCCURDY,KEVIN 20/223-51-0903 CLINIC/DIV PROVIDER DATE/TIME TYPE STATUS ================================================================================ ALLERGY (T)/TRIP LEE,JUDY 17 Jan 1992@1400 FU PENDING Arrive 10 min early ALLERGY (T)/TRIP LEE,JUDY 17 Jan 1992@1430 FU PENDING Arrive 10 min early WAIT LIST REQUESTS FOR MCCURDY,KEVIN 20/800-51-0903 CLINIC/DIV TYPE PRI DATE IN TARGET DATE PROVIDER ================================================================================ NO WAIT LIST REQUESTS! FIGURE 4.4.4.1. SAMPLE OUTPUT REPORT: APPOINTMENT ORDER PROCESSING (Sheet 1 of 2) 6-29 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 Order/Request Successfully booked as appt # 4151 on 17 Jan 1992@1400 REMOVING ORDER REQUEST FROM PROCESSING LIST FOR Patient Req Appt Date Prio Req Clinic Requesting Provider ================================================================================ MCCURDY,KEVIN 15 Jan 1992 9 PEDIATRICS ROBERTSON,MARY =-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=Press <RETURN> to continue Personal Data - Privacy Act 1974 (PL 93-579) FIGURE 4.4.4.1. SAMPLE OUTPUT REPORT: APPOINTMENT ORDER PROCESSING (Sheet 2 of 2) 6-30 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 FACILITY PROFILE LIST 14 Oct 1991@1052 PAGE 1 ================================================================================ Name: Building Name: Building Number: Street Address: City: State: ZIP: Postal Permit Number: Schedule Deletion: Patient Record Pull: Radiology Record Pull: Schedule Hold Duration: DEERS Batch Pull: Appointment Overlap Interval: Inactivity Period: Print Encounter Data Report: OUTPATIENT ENCODER/GROUPER ENABLED IRELAND ACH IRELAND ARMY HOSPITAL 100 1 IRELAND AVENUE FT KNOX KENTUCKY 40121-5520 231456 30 DAY(S) 1 DAY(S) 1 DAY(S) 2 DAY(S) 1 DAY(S) 10 MINUTES 60 DAY(S) YES Press <RETURN> to continue FIGURE 4.4.5.2. SAMPLE OUTPUT REPORT: 6-31 FACILITY PROFILE LIST SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 DIVISION PROFILE LIST 10 Jun 1992@1218 PAGE 1 ================================================================================ Name: Abbreviation: Facility: Building Name: Building Number: Street Address: City: State: ZIP: Patient Record Pull: Radiology Record Pull: Schedule Hold Duration: PAS Mail Group: Group ID Code: DMIS ID Code: Default to Remind Patient of Other Enable DX/PX Coding for Outpatient Cross Division Record Pulling: TRIPLER ARMY MEDICAL CENTER TRIP TRIPLER AMC, HI TRIPLER BUILDING A12346 2312 JAMES STREET HONOLULU HAWAII 96859 1 DAY(S) 1 DAY(S) 7 DAY(S) BULLETIN CONTROL 0052 0052 Appts/Wait List Requests: YES Encounters in this Division: YES PEARL HARBOR TRIPLER ARMY MEDICAL CENTER Press <RETURN> to continue FIGURE 4.4.5.4. SAMPLE OUTPUT REPORT: 6-32 DIVISION PROFILE LIST SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 CLINIC PROFILE LIST 11 Sep 1994@0733 PAGE 1 ================================================================================ Name: Abbreviation: Facility: Division: Building Name: Building Number: Street Address: ZIP: City: State: Clinic Location: Clinic Availability: Telephone: Enrollee Lockout: Type of Care: Service: Department: Specialty: MEPRS Code: Wait List Activated: ALLERGY ALG IRELAND ACH, KY IRELAND ACH IRELAND ACH 851 851 IRELAND AVE 40121 FT KNOX KENTUCKY XIK-28 1ST FL M-F 0730-1630, SA 0800-1400 502-624-9160 YES SPECIALTY CARE MEDICAL SERVICE MEDICINE ALLERGY BABA YES Press <RETURN> to continue FIGURE 4.4.5.6. SAMPLE OUTPUT REPORT: (Sheet 1 of 7) 6-33 CLINIC PROFILE LIST SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 CLINIC PROFILE LIST 11 Sep 1994@0733 PAGE 2 ================================================================================ Maximum Wait List Days: Wait List Provider Mandatory: Wait List Hold Duration: Automatic Wait List Processing: Schedule Hold Duration: Prompt for Requesting Service: Patient Record Pull: Clinic Type: Radiology Record Pull: Check Holiday File: Roster Production: Activation Status: Prepare Reminder Notices: Cost Pool Code: Available Schedule: Clinic Appt Instructions: 30 DAY(S) YES 2 DAY(S) YES 7 DAY(S) YES 3 DAY(S) COUNT 1 DAY(S) YES 4 DAY(S) ACTIVATED 4 DAY(S) BAXA 60 DAY(S) PLEASE BRING ALLERGY TEST RESULTS ---Appointment Types--Press <RETURN> to continue FIGURE 4.4.5.6. SAMPLE OUTPUT REPORT: (Sheet 2 of 7) 6-34 CLINIC PROFILE LIST SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 CLINIC PROFILE LIST 11 Sep 1994@0733 PAGE 3 ================================================================================ Appointment Type: Duration: Status: Workload Type: Referral Required: Pull Patient Record: Pull Radiology Record: Produce Encounter Form: Send Reminder Notice: Total # of Overbooks: Max # of Overbooks per Slot: Instructions: Booking Authority: Appointment Change Authority: Overbook Authority: NEW 60 MINUTES ACTIVE COUNT YES YES NO YES NO 4 1 SDCL1 SDCL2 SDCL3 Press <RETURN> to continue FIGURE 4.4.5.6. SAMPLE OUTPUT REPORT: (Sheet 3 of 7) 6-35 CLINIC PROFILE LIST SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 CLINIC PROFILE LIST 11 Sep 1994@0733 PAGE 4 ================================================================================ Appointment Type: Duration: Status: Workload Type: Referral Required: Pull Patient Record: Pull Radiology Record: Produce Encounter Form: Send Reminder Notice: Total # of Overbooks: Max # of Overbooks per Slot: Instructions: Booking Authority: Appointment Change Authority: Overbook Authority: RET 30 MINUTES ACTIVE COUNT NO YES NO YES NO 4 1 SDCL1 SDCL2 SDCL3 Press <RETURN> to continue FIGURE 4.4.5.6. SAMPLE OUTPUT REPORT: (Sheet 4 of 7) 6-36 CLINIC PROFILE LIST SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 CLINIC PROFILE LIST 11 Sep 1994@0733 PAGE 5 ================================================================================ Appointment Type: Duration: Status: Workload Type: Referral Required: Pull Patient Record: Pull Radiology Record: Produce Encounter Form: Send Reminder Notice: Total # of Overbooks: Max # of Overbooks per Slot: Instructions: Booking Authority: Appointment Change Authority: Overbook Authority: FU 30 MINUTES INACTIVE NON-COUNT YES YES YES NO NO 3 1 SDCL1 SDCL2 SDCL3 ---Diagnosis/Procedure Coding--- Press <RETURN> to continue FIGURE 4.4.5.6. SAMPLE OUTPUT REPORT: (Sheet 5 of 7) 6-37 CLINIC PROFILE LIST SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 CLINIC PROFILE LIST 11 Sep 1994@0733 PAGE 6 ================================================================================ DX/PX Coding Enabled: Report DX/PX on SIDR Tape: Max # DX on Clinic Pick List: Top Ambulatory DX Report Default: Max # PX on Clinic Pick List: Top Ambulatory PX Report Default: YES YES 10 5 10 5 ---Diagnoses Pick List--Diagnosis: 381.05 ACUTE ALLERGIC MUCOID OTITIS MEDIA Diagnosis: 381.04 ACUTE ALLERGIC SEROUS OTITIS MEDIA Diagnosis: 477.8 ALLERGIC RHINITIS DUE TO OTHER ALLERGEN Diagnosis: 995.3 ALLERGY, UNSPECIFIED, NOT ELSEWHERE CLASSIFIED Diagnosis: 373.32 CONTACT AND ALLERGIC DERMATITIS OF EYELID Diagnosis: V70 GENERAL MEDICAL EXAMINATION Diagnosis: V07.1 NEED FOR DESENSITIZATION TO ALLERGENS Diagnosis: 372.14 OTHER CHRONIC ALLERGIC CONJUNCTIVITIS Diagnosis: 495.8 OTHER SPECIFIC ALLERGIC ALVEOLITIS AND PNEUMONITIS Diagnosis: 473.9 UNSPECIFIED SINUSITIS (CHRONIC) Press <RETURN> to continue FIGURE 4.4.5.6. SAMPLE OUTPUT REPORT: (Sheet 6 of 7) 6-38 CLINIC PROFILE LIST SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 CLINIC PROFILE LIST 11 Sep 1994@0733 PAGE 7 ================================================================================ ---Procedure Pick List--Procedure: 86003 ALLERGEN SPECIFIC IGE;QUANTITATIVE, EACH PANEL OF UP TO 12 ALLERGENS Procedure: 86315 IMMUNOASSAY FOR INFECTIOUS AGENT ANTIGEN, QUALITATIVE OR SEMIQUANTITATIVE; SINGLE STEP METHOD (EG, REAGENT STRIP) Procedure: 95065 DIRECT NASAL MUCOUS MEMBRANE TEST Procedure: 95070 INHALATION BRONCHIAL CHALLENGE TESTING (NOT INCLUDING NECESSARY PULMONARY FUNCTION TESTS); WITH HISTAMINE, METHACHOLINE, OR SIMILAR COMPOUNDS Procedure: 95071 INHALATION BRONCHIAL CHALLENGE TESTING (NOT INCLUDING PULMONARY FUNCTION TEST); WITH ANTIGENS OR GASES, SPECIFY Procedure: J0110 ADMINISTRATION OF INJECTION, INCLUDING THE COST OF DRUG Procedure: J0220 INJECTION, ALLERGY DESENSITIZATION, AQUEOUS PREPARATION Procedure: J0240 INJECTION, ALLERGY DESENSITIZATION, EMULSION NOT SPECIFIED Procedure: J7010 VIAL OF ALLERGY VACCINE, SINGLE DOSE Procedure: J7020 VIAL OF ALLERGY VACCINE, MULTIPLE DOSE, COST PER DOSE Press <RETURN> to continue FIGURE 4.4.5.6. SAMPLE OUTPUT REPORT: (Sheet 7 of 7) 6-39 CLINIC PROFILE LIST SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 PROVIDER PROFILE LIST 12 Sep 1991@1129 PAGE 1 Personal Data - Privacy Act of 1974 (PL 93-579) ================================================================================ Provider: Clinic: Title: Provider-MEPRS/Subclinic: Duty Phone: Home Phone: Clinic Hours: Clinic Location: Max # of Patient Appts per Day: Appt Arrival Advance Time: Provider Instructions: Print Roster with Open Aptts Inactivation Date: BROWN,CAROLYN CARDIOLOGY STAFF PHYSICIAN BAAA 437-8319 234-4564 0900 - 1600 RM 204 30 15 MINUTES YES ---Appointment Types--Appointment Type: NEW Press <RETURN> to continue FIGURE 4.4.5.9. SAMPLE OUTPUT REPORT: (Sheet 1 of 5) 6-40 PROVIDER PROFILE LIST SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 PROVIDER PROFILE LIST 12 Sep 1991@1129 PAGE 2 Personal Data - Privacy Act of 1974 (PL 93-579) ================================================================================ Duration: Status: Workload Type: Referral Required: Pull Patient Record: Pull Radiology Record: Produce Encounter Forms: Send Reminder Notice: Total # of Overbooks: Max # of Overbooks per Slot: Instructions: Booking Authority: 30 MINUTES ACTIVE NON-COUNT YES YES YES YES YES 6 1 Appointment Change Authority: SDCL2 Overbook Authority: SDCL1 SDCL3 Press <RETURN> to continue FIGURE 4.4.5.9. SAMPLE OUTPUT REPORT: (Sheet 2 of 5) 6-41 PROVIDER PROFILE LIST SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 PROVIDER PROFILE LIST 12 Sep 1991@1129 PAGE 3 Personal Data - Privacy Act of 1974 (PL 93-579) ================================================================================ Appointment Type: Duration: Status: Workload Type: Referral Required: Pull Patient Record: Pull Radiology Record: Produce Encounter Forms: Send Reminder Notice: Total # of Overbooks: Max # of Overbooks per Slot: Instructions: Booking Authority: RET 30 MINUTES ACTIVE COUNT NO YES YES NO NO 3 1 Appointment Change Authority: SDCL2 Overbook Authority: SDCL1 Appointment Type: Duration FU 30 MINUTES SDCL3 Press <RETURN> to continue FIGURE 4.4.5.9. SAMPLE OUTPUT REPORT: (Sheet 3 of 5) 6-42 PROVIDER PROFILE LIST SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 PROVIDER PROFILE LIST 12 Sep 1991@1129 PAGE 4 Personal Data - Privacy Act of 1974 (PL 93-579) ================================================================================ Status: Workload Type: Referral Required: Pull Patient Record: Pull Radiology Record: Produce Encounter Forms: Send Reminder Notice: Total # of Overbooks: Max # of Overbooks per Slot: Instructions: Booking Authority: Appointment Change Authority: Overbook Authority: INACTIVE NON-COUNT YES YES YES NO NO 3 1 Appointment Type: Duration: CAST 30 MINUTES Press <RETURN> to continue FIGURE 4.4.5.9. SAMPLE OUTPUT REPORT: (Sheet 4 of 5) 6-43 PROVIDER PROFILE LIST SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 PROVIDER PROFILE LIST 12 Sep 1991@1129 PAGE 5 Personal Data - Privacy Act of 1974 (PL 93-579) ================================================================================ Status: Workload Type: Referral Required: Pull Patient Record: Pull Radiology Record: Produce Encounter Forms: Send Reminder Notice: Total # of Overbooks: Max # of Overbooks per Slot: Instructions: Booking Authority: Appointment Change Authority: Overbook Authority: ACTIVE COUNT NO NO NO NO NO 0 Press <RETURN> to continue FIGURE 4.4.5.9. SAMPLE OUTPUT SCREEN: (Sheet 5 of 5) 6-44 PROVIDER PROFILE LIST SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 APPOINTMENT TYPE PROFILE LIST 16 Oct 1991@1101 PAGE 1 ARE APPT SLOTS NAME DESCRIPTION SEARCHABLE? STATUS CATEGORY =============================================================================== DAPT ERAPT FU INPT LUN* MTG* MULTI NEW PATCH RET ROU SCALL TECON WALK DOCTOR-APPOINTED EMERGENCY ROOM APPT FOLLOW UP INPATIENT VISIT LUNCH MEETING MASS APPOINTMENT NEW PATIENTS ONLY SKIN TEST RETURN APPOINTMENTS ROUTINE CHECKUP SICK CALL TELEPHONE CONSULT WALK-IN YES YES YES YES NO NO YES YES YES YES YES YES YES YES FIGURE 4.4.5.11. ACTIVE ACTIVE ACTIVE ACTIVE ACTIVE ACTIVE ACTIVE ACTIVE INACTIVE ACTIVE ACTIVE INACTIVE INACTIVE ACTIVE FOLLOW-UP FOLLOW-UP FOLLOW-UP FOLLOW-UP FOLLOW-UP FOLLOW-UP FOLLOW-UP INITIAL FOLLOW-UP FOLLOW-UP FOLLOW-UP FOLLOW-UP FOLLOW-UP INITIAL SAMPLE OUTPUT SCREEN: 6-45 APPOINTMENT TYPE LIST SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 EMERGENCY ROOM CLINIC PROFILE LIST 07 Oct 1994@0909 PAGE 1 ================================================================================ Name: Abbreviation: Facility: Division: Building Name: Building Number: Street Address: ZIP: City: State: Clinic Location: Clinic Availability: Activation Status: Telephone: Enrollee Lockout: Type of Care: Service: Department: Specialty: MEPRS Code: EMERGENCY ROOM (A) ER-A TRIPLER AMC, HI TRIPLER ARMY MEDICAL CENTER MAIN MEDICAL BUILDING 101 2312 JAMES STREET 96859 HONOLULU HAWAII EAST WING RM STE 234 M-F 0730-1800 ACTIVATED 808-624-5831 NO EMERGENCY MEDICAL PRIMARY CARE & COMM MEDICINE EMERGENCY MEDICAL BIAA Press <RETURN> to continue FIGURE 4.4.5.13. SAMPLE OUTPUT REPORT: EMERGENCY ROOM CLINIC PROFILE LIST (Sheet 1 of 5) 6-46 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 EMERGENCY ROOM CLINIC PROFILE LIST 07 Oct 1994@0909 PAGE 2 ================================================================================ Cost Pool Code: Clinic Type Is this an Emergency Room: CER Provider Default: Default Date/Time of Release: Default Printer: NER SF 558 Default: CER SF 558 Default: COUNT YES HOBOLD,ERIC NOW SLAVE YES NO ---Clinic Appointment Types--Appointment Type: Duration: Status: Workload Type: EROOM 30 MINUTES ACTIVE COUNT Appointment Type: Duration: Status: Workload Type: FU 30 MINUTES ACTIVE COUNT Appointment Type: Duration: NEW 60 MINUTES Press <RETURN> to continue FIGURE 4.4.5.13. SAMPLE OUTPUT REPORT: EMERGENCY ROOM CLINIC PROFILE LIST (Sheet 2 of 5) 6-47 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 EMERGENCY ROOM CLINIC PROFILE LIST 07 Oct 1994@0909 PAGE 3 ================================================================================ Status: Workload Type: ACTIVE COUNT Appointment Type: Duration: Status: Workload Type: RET 30 MINUTES ACTIVE COUNT ---Diagnosis/Procedure Coding--- Press <RETURN> to continue FIGURE 4.4.5.13. SAMPLE OUTPUT REPORT: EMERGENCY ROOM CLINIC PROFILE LIST (Sheet 3 of 5) 6-48 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 EMERGENCY ROOM CLINIC PROFILE LIST 07 Oct 1994@0909 PAGE 4 ================================================================================ DX/PX Coding Enabled: Report DX/PX on SIDR Tape: Max # DX on Clinic Pick List: Top Ambulatory DX Report Default: Max # PX on Clinic Pick List: Top Ambulatory PX Report Default: YES YES 10 5 10 5 ---Diagnosis Pick List--Diagnosis: 919.0 ABRASION/FRICTION BURN OF OTHER MULTIPLE/ UNSPECIFIED SITES Diagnosis: 466.0 ACUTE BRONCHITIS Diagnosis: 305.01 ALCOHOL ABUSE, CONTINUOUS DRINKING BEHAVIOR Diagnosis: 427.5 CARDIAC ARREST Diagnosis: 863.89 GASTROINTESTINAL TRACT INJ,SITE NOS,WO OPEN WOUND TO CAVITY, OTHER Diagnosis: 487.0 INFLUENZA WITH PNEUMONIA Diagnosis: 804.82 OP FX,SKULL,FACE,OTH BONE,OTH INTRACRAN HEMORRAGE,BRIEF UNCONSCIOUSNESS Diagnosis: 829.1 OPEN FRACTURE OF UNSPECIFIED BONE Diagnosis: 305.91 OTHER OR UNSPECIFIED DRUG ABUSE, CONTINUOUS USE Diagnosis: 308.2 REACTION TO STRESS, PSYCHOMOTOR DISTURBANCE PREDOMINANT Press <RETURN> to continue FIGURE 4.4.5.13. SAMPLE OUTPUT REPORT: EMERGENCY ROOM CLINIC PROFILE LIST (Sheet 4 of 5) 6-49 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 EMERGENCY ROOM CLINIC PROFILE LIST 07 Oct 1994@0909 PAGE 5 ================================================================================ ---Procedure Pick List--Procedure: 86710 ANTIBODY; INFLUENZA VIRUS Procedure: 92950 CARDIOPULMONARY RESUSCITATION (EG, IN CARDIAC ARREST) Procedure: 80100 DRUG, SCREEN; MULTIPLE DRUG CLASSES, EACH PROCEDURE Procedure: 44500 INTRODUCTION OF LONG GASTROINTESTINAL TUBE (EG, MILLER-ABBOTT) (SEPARATE PROCEDURE) Procedure: 24566 PERCUTANEOUS SKELETAL FIXATION OF HUMERAL EPICONDYLAR FRACTURE, MEDIAL OR LATERAL, WITH MANIPULATION Procedure: A0223 AMBULANCE SERVICE, ADVANCED LIFE SUPPORT (ALS) BASE RATE, WHERE NONREUSABLE ALS SUPPLIES ARE BILLED SEPARATELY, EMERGENCY TRANSPORT, ONE WASY Procedure: A4210 NEEDLE-FREE INJECTION DEVICE Procedure: A0070 AMBULANCE SERVICE, OXYGEN, ADMINISTRATION AND SUPPLIES, LIFE SUSTAINING SITUATION Procedure: L3980 UPPER EXTREMITY FRACTURE ORTHOSIS, HUMERAL Procedure: A4670 AUTOMATIC BLOOD PRESSURE MONITOR Press <RETURN> to continue FIGURE 4.4.5.13. SAMPLE OUTPUT REPORT: EMERGENCY ROOM CLINIC PROFILE LIST (Sheet 5 of 5) 6-50 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 EMERGENCY ROOM PROVIDER PROFILE LIST 07 Oct 1991@0909 PAGE 1 Personal Data - Privacy Act of 1974 (PL 93-579) ================================================================================ Clinic: ALLERGY (T) Provider: Title: Provider-MEPRS/Subclinic: Duty Phone: Home Phone: Clinic Hours: Clinic Location: Inactivation Date: SONGER,EDWARD DENTIST (SURGEON) BAAA 455-5540 0700-1700 ---Provider Appointment Types--Appointment Type: Duration: Status: NEW 60 MINUTES ACTIVE Press <RETURN> to continue FIGURE 4.4.5.16. SAMPLE OUTPUT REPORT: EMERGENCY ROOM PROVIDER PROFILE LIST (Sheet 1 of 3) 6-51 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 EMERGENCY ROOM PROVIDER PROFILE LIST 07 Oct 1991@0909 PAGE 2 Personal Data - Privacy Act of 1974 (PL 93-579) ================================================================================ Workload Type: COUNT Appointment Type: Duration: Status: Workload Type: RET 30 MINUTES ACTIVE COUNT Appointment Type: Duration: Status: Workload Type: FU 30 MINUTES ACTIVE COUNT Provider: Title: Provider-MEPRS/Subclinic: SEYMOUR,ROGER DENTIST (SURGEON BAAA Press <RETURN> to continue FIGURE 4.4.5.16. SAMPLE OUTPUT REPORT: EMERGENCY ROOM PROVIDER PROFILE LIST (Sheet 2 of 3) 6-52 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 EMERGENCY ROOM PROVIDER PROFILE LIST 07 Oct 1991@0909 PAGE 3 Personal Data - Privacy Act of 1974 (PL 93-579) ================================================================================ Duty Phone: Home Phone Clinic Hours: Clinic Location: Inactivation Date: 259-1257 0700-1800 ---Provider Appointment Types--Appointment Type: Duration: Status: Workload Type: NEW 60 MINUTES ACTIVE COUNT Appointment Type: Duration: Status: Workload Type: FU 30 MINUTES ACTIVE COUNT Press <RETURN> to continue FIGURE 4.4.5.16. SAMPLE OUTPUT REPORT: EMERGENCY ROOM PROVIDER PROFILE LIST (Sheet 3 of 3) 6-53 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 Template I.D.: MONDAY TS Clinic: GENERAL SURGERY CLINIC Provider: STORER,THOMAS Day: MONDAY Start Time Appt Type Patients Per Slot Slot Comment 0800 RET 1 0830 RET 1 0900 MULTI 1 1000 MULTI 1 1100 RET 1 1130 RET 1 1200 DAPT 1 LUNCH 1230 DAPT 1 1300 NEW 1 1400 NEW 1 -------------------------------------------------------------------------------Press <RETURN> to continue FIGURE 4.4.6.4. SAMPLE OUTPUT REPORT: 6-54 PRINT DAILY/WEEKLY TEMPLATE SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 Ireland Army Community Hospital (Test) 05 May 1990@1054 Page 3 CLINIC/PROVIDER SCHEDULE From: 08 May 1990 To: 08 May 1990 Division: IRELAND Dept: SURGERY Clinic: ALLERGY MAIN CLINIC Provider: SIMMONS,THOMAS ================================================================================== Date Day Time Type #/Slot #Book Status Comment ================================================================================== 08 May 1990 TUE 0800 RET 1 0 ---0830 RET 1 0 ---0900 RET 1 0 ---1000 RET 1 0 ---1030 RET 1 0 ---1100 RET 1 0 ---1130 RET 1 0 ---1300 RET 1 0 ---1400 NEW 1 0 ---1500 NEW 1 0 ---1600 NEW 1 0 ---Press <RETURN> to continue FIGURE 4.4.7.1. SAMPLE OUTPUT REPORT: 6-55 CREATE SCHEDULES SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 IRELAND ARMY COMMUNITY HOSPITAL 19 Apr 1990@0917 Page 1 CLINIC/PROVIDER SCHEDULE From: 24 May 1990 TO: 25 May 1990 Division: IRELAND Dept: MEDICINE Clinic: ALLERGY MAIN CLINIC Provider: MEYER,CHERYL ================================================================================ Date Day Time Type #/Slot #Book Status Comment ================================================================================ 24 May 1990 THU 0800 NEW 1 0 WAIT 0900 NEW 1 0 WAIT 1000 NEW 1 0 WAIT 1100 NEW 1 0 WAIT 1200 NEW 1 0 WAIT 1300 NEW 1 0 WAIT 1400 NEW 1 0 WAIT 1500 NEW 1 0 WAIT 1600 NEW 1 0 WAIT Press <RETURN> to continue FIGURE 4.4.7.3. SAMPLE OUTPUT REPORT: 6-56 REPLICATE SCHEDULES SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 IRELAND ARMY COMMUNITY HOSPITAL 18 Apr 1990@1036 Page 1 CLINIC/PROVIDER SCHEDULE From: 08 May 1990 To: 14 May 1990 Division: IRELAND Dept: MEDICINE Clinic: ALLERGY MAIN CLINIC Provider: JOHNSON,DARRELL ============================================================================= Date Day Time Type #/Slot #Book Status Comment ============================================================================= 23 Apr 1990 MON 0700 0730 0800 0830 0900 0930 1000 1030 1100 1300 1330 1400 1430 1500 1530 1600 NEW NEW NEW NEW NEW NEW NEW NEW NEW RET RET RET RET RET RET RET 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 OPEN OPEN WAIT OPEN OPEN OPEN OPEN OPEN OPEN OPEN OPEN OPEN FROZ FROZ OPEN OPEN LUNCH AT 1200 REL BY 19 APR REL BY 19 APR Press <RETURN> to continue, "^" to exit FIGURE 4.4.7.4. SAMPLE OUTPUT REPORT: 6-57 PRINT CLINIC/PROVIDER SCHEDULES SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 Ireland Army Community Hospital (Test) 12 Dec 1991@1345 Page 1 Personal Data - Privacy Act of 1974 (PL 93-579) PROVIDER ROSTER (One Clinic) From: 10 Dec 1991 To: 10 Dec 1991 Division: IRELAND DEPT: MEDICINE Clinic: CARDIOLOGY CLINIC ================================================================================================================================== Time Type Name FMP/SSN Sex Age Cat GR CMD Int CSP Fly Provider Out/In Ward Home Phone Work Phone Sponsor Unit GR/Spon Reason for Appointment: Appointment Comment: Referred by: Registration Comment: ================================================================================================================================== 0800 NEW HAMMER,MARK SANTOS,MERVYN OUT: RSN: REF: 0830 NEW 1 OPEN SLOT 0830 NEW 1 OPEN SLOT 0900 NEW 1 OPEN SLOT 0930 NEW 1 OPEN SLOT 1000 NEW HAMMER,MARK 1030 NEW 1 OPEN SLOT 1100 NEW 1 OPEN SLOT 1130 RET SEAY,ROBERT 20/234-12-9876 W:619-535-7641 M 25 CON CMT: REG: K82 GAINES,THERESA OUT: H: RSN: REF: 01/753-98-3844 W: F 11 PENTAGON CMT: REG: A43 FIELD,RONALD E. OUT: H:703-338-3916 RSN: REF: 20/224-72-4297 W:301-295-2340 M 29 F11 F03 BETHESDA CMT: REG: PT. NEED PHYSICAL EXAM FIGURE 4.4.8.1. H:619-277-7209 VIP SAMPLE OUTPUT REPORT: CONSOLIDATED OR PROVIDER ROSTER (ONE CLINIC) (Sheet 1 of 2) 6-58 ELG A31 PRP F03 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 Ireland Army Community Hospital (Test) 12 Dec 1991@1401 Page 1 Personal Data - Privacy Act of 1974 (PL 93-579) CONSOLIDATED ROSTER (One Clinic) From: 10 Dec 1991 To: 10 Dec 1991 Division: IRELAND DEPT: MEDICINE Clinic: CARDIOLOGY CLINIC ================================================================================================================================== Time Type Name FMP/SSN Sex Age Cat GR CMD Int CSP Fly Provider Out/In Ward Home Phone Work Phone Sponsor Unit GR/Spon Reason for Appointment: Appointment Comment: Referred by: Registration Comment: ================================================================================================================================== 0930 NEW 2 OPEN SLOTS GUAJARDO,ROBERT 1000 NEW 1 OPEN SLOT SMITH,DOUG 1000 NEW 1 OPEN SLOT SANTOS,MERVYN 1000 RET MCDONALD,BECKY ANDERSON,JOHN OUT RSN: REF: H: NEW 2 OPEN SLOTS GUAJARDO,ROBERT 1030 NEW 1 OPEN SLOT SMITH,DOUG 1030 NEW 1 OPEN SLOT SANTOS,MERVYN 1030 NEW SMITH,AMY OUT RSN: REF: 2 OPEN SLOTS M 35 A11 AE7 H: 20/576-82-7222 W: F 41 A31 CMT: REG: GUAJARDO,ROBERT FIGURE 4.4.8.1. SAMPLE OUTPUT REPORT: CONSOLIDATED OR PROVIDER ROSTER (ONE CLINIC) (Sheet 2 of 2) 6-59 PRP AE7 CMT: REG: 1000 1030 RET MCDONALD,BECKY 20/557-88-9874 W: Y SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 12 Dec 1991@0952 Page 1 Personal Data - Privacy Act of 1974 (PL 93-579) CONSOLIDATED ROSTER (All Clinics) by Division From: 13 Dec 1991 To: 13 Dec 1991 Division: TRIPLER ARMY MEDICAL CENTER DEPT: CLINICAL SUPPORT Clinic: ALLERGY (T) ================================================================================================================================== Time Type Name FMP/SSN Sex Age Cat GR CMD Int CSP Fly Provider Out/In Ward Home Phone Work Phone Sponsor Unit GR/Spon Reason for Appointment: Appointment Comment: Referred by: Registration Comment: ================================================================================================================================== 0830 ICON BLACK,FREDERICK HEPBURN,FRANK OUT: RSN: REF: 0900 FU BROOKE,THOMAS 0915 FU BROOKE,THOMAS 20/444-21-7610 W:731-6754 M 26 A11 AO6 SCI PENTAGON AO6 CMT: REG: PLEASE VERIFY PHONE NBR AND ADDRESS HEBERT,MICHAEL OUT: H:233-6565 RSN: REF: 20/218-46-7019 W: M HENSLEY,MARY OUT: RSN: REF: 20/245-76-8412 W:898-7676 H:234-5678 H:322-1121 A11 AO5 AO5 CMT: REG: F 37 A11 AE7 AE7 CMT: REG: 0800 NEW 1 OPEN SLOT BARRON-BERMANT,JANE 0900 FU 3 OPEN SLOTS SONGER,EDWARD FIGURE 4.4.8.2. 38 SAMPLE OUTPUT REPORT: 6-60 CONSOLIDATED ROSTER (ALL CLINICS) Y SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 12 Dec 1991@0952 Page 1 Personal Data - Privacy Act of 1974 (PL 93-579) CONSOLIDATED ROSTER (All Clinics) by Division From: 13 Dec 1991 To: 13 Dec 1991 Division: TRIPLER ARMY MEDICAL CENTER DEPT: CLINICAL SUPPORT Clinic: CARDIOLOGY (A) Provider: HOWLAND,WILLIAM ================================================================================================================================== Time Type Name FMP/SSN Sex Age Cat GR CMD Int CSP Fly Provider Out/In Ward Home Phone Work Phone Sponsor Unit GR/Spon Reason for Appointment: Appointment Comment: Referred by: Registration Comment: ================================================================================================================================== 0900 RET HOWLAND,WILLIAM TANGER,FREDERICK OUT H:233-3232 PRB: REF: 20/213-43-6253 W:233-5454 0930 RET HOWLAND,WILLIAM HEPBURN,FRANK OUT PRB: REF: H:234-5678 20/444-21-7610 W:731-6754 M 26 A11 NO6 PRP COMNAVCONBTLN A NO6 SCI CMT: REG: PLEASE VERIFY PHONE NBR AND ADDRESS 1000 RET HOWLAND,WILLIAM HAGEL,STEVE OUT PRB: REF: 20/431-87-4126 W:234-4531 M H: 0800 NEW 1 OPEN SLOT 0900 FU 3 OPEN SLOTS FIGURE 4.4.8.3. M 67 A31 CMT: REG: 35 N11 NO4 NO4 CMT: REG: SAMPLE OUTPUT REPORT: 6-61 PROVIDER ROSTER (ALL CLINICS) Y SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 Ireland Army Community Hospital 12 Dec 1991@0718 Page 1 Personal Data - Privacy Act of 1974 (PL 93-579) PROVIDER ROSTER (One Clinic) From: 10 Dec 1991 To: 10 Dec 1991 Division: IRELAND DEPT: MEDICINE Clinic: CARDIOLOGY CLINIC Provider: DE BLASIO,MICHAEL =============================================================================== Time Type Name FMP/SSN Out/In Ward Home Phone Work Phone =============================================================================== '*' next to patient name indicates a FROZEN-BOOKED slot '#' next to patient name indicates the schedule slot has been deleted 0800 NEW BENSON,JACK OUT RSN: 0800 NEW TAYLOR,ALVIN OUT RSN: 0900 NEW 1 OPEN SLOT 0930 NEW 1 OPEN SLOT H:818-233-7878 CMT: H:818-234-2311 CMT: FIGURE 4.4.8.4. 20/262-31-7633 W: 30/100-00-1006 W:818-235-3312 SAMPLE OUTPUT REPORT: 6-62 PRINT/DISPLAY PROVIDER ROSTER SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 Ireland Army Community Hospital (Test) 12 Dec 1991@1641 Page 1 Personal Data - Privacy Act of 1974 (PL 93-579) WARD ROSTER by Clinic From: 12 Dec 1991 To: 12 Dec 1991 Ward: ORTHOPEDICS WARD ================================================================================================================================== Time Type Duration Name FMP/SSN Sex DOB Room-Bed Clinic HCP Reason: Comment: Referred by: Registration Comment: ================================================================================================================================== 0900 RET 15 MAE,CAROLE 701-A RSN: REF: FIGURE 4.4.8.5. 01/003-59-9999 DERMATOLOGY CLINIC SAMPLE OUTPUT REPORT: 6-63 F 08 Jul 1951 LEVINE,DAN CMT: REG: INPATIENT WARD ROSTER FOR TODAY SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 Ireland Army Community Hospital 18 Dec 1991@1049 Page 1 CLINIC SCHEDULE SUMMARY From: 01 Dec 1991 To: 18 Dec 1991 Division: IRELAND Clinic: CARDIOLOGY CLINIC Dept: MEDICINE ================================================================================ Slot Max Current DAY Date@Time Provider AT Status Booking Booking ================================================================================ TUE 12 Dec 1991@0800 LEBOW,LESTER NEW OPEN 1 0 THU 14 Dec 1991@0800 STASKO,THOMAS NEW BOOK 1 1 THU 14 Dec 1991@0830 LEBOW,LESTER NEW CANC 1 0 THU 14 Dec 1991@0900 STASKO,THOMAS NEW OPEN 1 0 THU 14 Dec 1991@0930 LEBOW,LESTER NEW CANC 1 0 THU 14 Dec 1991@1000 STASKO,THOMAS NEW BOOK 1 1 THU 14 Dec 1991@1030 STASKO,THOMAS NEW OPEN 1 0 THU 14 Dec 1991@1100 STASKO,THOMAS NEW OPEN 1 0 THU 14 Dec 1991@1130 LEBOW,LESTER NEW BOOK 1 0 FRI 15 Dec 1991@0800 LEBOW,LESTER RET BOOK 1 1 FRI 15 Dec 1991@0830 LEBOW,LESTER NEW BOOK 1 1 FRI 15 Dec 1991@0900 LEBOW,LESTER NEW OPEN 1 0 FRI 15 Dec 1991@0930 LEBOW,LESTER NEW BOOK 1 1 FRI 15 Dec 1991@1000 LEBOW,LESTER NEW OPEN 1 0 FRI 15 Dec 1991@1030 LEBOW,LESTER NEW OPEN 1 0 FRI 15 Dec 1991@1100 End of Clinic Schedule LEBOW,LESTER NEW BOOK 1 1 FIGURE 4.4.8.6. SAMPLE OUTPUT REPORT: 6-64 CLINIC SCHEDULE SUMMARY SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 Ireland Army Community Hospital 09 Dec 1991@1243 Page 1 PROVIDER SCHEDULE SUMMARY From: 01 Dec 1991 To: 09 Dec 1991 Provider: HERMANN,PAUL ================================================================================ Appt Slot Max # # DAY Date@Time Clinic Type Status Slot Booked ================================================================================ MON 01 Dec 1991@0700 DERMATOLOGY CLINIC NEW BOOK 1 1 MON 01 Dec 1991@0730 DERMATOLOGY CLINIC NEW OPEN 2 0 MON 01 Dec 1991@0800 DERMATOLOGY CLINIC NEW BOOK 1 1 MON 01 Dec 1991@0830 DERMATOLOGY CLINIC RET CANC 1 0 MON 01 Dec 1991@0900 DERMATOLOGY CLINIC End of Provider Schedule NEW OPEN 1 0 FIGURE 4.4.8.7. SAMPLE OUTPUT REPORT: 6-65 PROVIDER SCHEDULE SUMMARY SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 Ireland Army Community Hospital 17 Jun 1991@1128 Page 1 Personal Data - Privacy Act of 1974 (PL 93-579) WAIT LIST - AUTOMATIC BOOKING ROSTER by DIVISION From: 18 May 1991 To: 17 Jun 1991 Division: IRELAND Department: MEDICINE ================================================================================================================================== Clinic/Patient FMP/SSN Appt Date/Day/Time Appt Type Home Phone Duty Phone Work Phone Wait List # Provider Street Address City State ZIP CODE ================================================================================================================================== ALLERGY (I) ----------BAHRAMI,KIMBERLY 20/259-19-9876 20 Jun 91 THU 0800 NEW 15.00019758 BARRON-BERMANT,J 100 GA. AVENUE WASHINGTON DC 20307 DABNEY,NOEL 15.00019762 09/123-09-8712 HARMON,TRACEY 20 Jun 91 THU 0800 1111 NEWPORT DR NEW HAAN,PAUL 15.00019764 20/555-66-4432 HARMON,TRACEY 21 Jun 91 FRI 0800 123 C ST RET FIGURE 4.4.8.8. 567-3983 342-3432 SAMPLE OUTPUT REPORT: SAN DIEGO CA 234-5678 SAN DIEGO 234-5678 CA 92121 WAIT LIST - AUTOMATIC BOOKING ROSTER 6-66 92111 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 03 Mar 1995@1635 Page 1 Personal Data - Privacy Act 1974 (PL-93-579) OUTPATIENT DISPOSITION ROSTER By PROVIDER From: 03 Feb 1995 To: 03 Mar 1995 Provider: GIBFRIED,KATHERINE J Clinic: FAMILY PRACTICE ================================================================================================================================== PATCAT/Outpatient Disposition Patient FMP/SSN Sponsor UIC H Phone D Phone W Phone Appt Date/Time Appt Type Appt Status ================================================================================================================================== ACTIVE DUTY ----------ADMT - ADMITTED TO: =================== SMITH, ROBERT T 20/800-45-1220 CO A 1ST BN 1ST MAR 808-223-4567 808-223-4567 25 Feb 1995@1340 NEW S-CALL Admitted To: 2B HOME - HOME =========== WALTERS,MARY T Q24 - QUARTERS FOR 24 HOURS =========================== WAGNER,TIMOTHY R Q48 - QUARTERS FOR 48 HOURS =========================== JACKSON,ESTHER P FAM MBR OF ACTIVE DUTY ---------------------HOME - HOME =========== HAMILTON,MARGIE F 20/689-22-0987 23 Feb 1995@0955 BARBERS POINT FU 808-362-6489 KEPT 808-434-8865 808-434-7123 20/129-54-2001 23 Feb 1995@1035 1912 COMPUTER SQUAD NEW 808-363-6543 WALK-IN 808-336-2256 808-336-2256 20/755-09-3659 24 Feb 1995@0732 SCHOLFIELD BKS NEW 808-434-1780 S-CALL 808-435-9087 808-435-9123 30/756-45-6468 23 Feb 1995@1118 FORD ISLAND NAS FU 808-644-9852 KEPT FIGURE 4.4.8.9. SAMPLE OUTPUT REPORT: OUTPATIENT DISPOSITION ROSTER (BY PROVIDER) (Sheet 1 of 4) 6-67 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 03 Mar 1995@1637 Page 1 Personal Data - Privacy Act 1974 (PL-93-579) OUTPATIENT DISPOSITION ROSTER By CLINIC From: 03 Feb 1995 To: 03 Mar 1995 Clinic: FAMILY PRACTICE ================================================================================================================================== PATCAT/Outpatient Disposition Patient FMP/SSN Sponsor UIC H Phone D Phone W Phone Appt Date/Time Appt Type Appt Status Provider ================================================================================================================================== ACTIVE DUTY ----------HOME - HOME =========== SMITH, ROBERT T 20/800-45-1220 CO A 1ST BN 1ST MAR 808-223-4567 808-223-4567 22 Feb 1995@1340 NEW S-CALL GIBFRIED,KATHERINE MDU - MODIFIED DUTY UNTIL: ========================== WALTERS,MARY T Q24 - QUARTERS FOR 24 HOURS =========================== WAGNER,TIMOTHY R Q48 - QUARTERS FOR 48 HOURS =========================== JACKSON,ESTHER P FAM MBR OF ACTIVE DUTY ---------------------HOME - HOME =========== HAMILTON,MARGIE F 20/689-22-0987 BARBERS POINT 25 Feb 1995@0955 FU Modified Duty Until: 3 Mar 1995 808-362-6489 KEPT 808-434-8865 808-434-7123 GIBFRIED,KATHERINE 20/129-54-2001 23 Feb 1995@1035 1912 COMPUTER SQUAD NEW 808-363-6543 WALK-IN 808-336-2256 808-336-2256 GIBFRIED,KATHERINE 20/755-09-3659 24 Feb 1995@0732 SCHOLFIELD BKS NEW 808-434-1780 S-CALL 808-435-9087 808-435-9123 GIBFRIED,KATHERINE 30/756-45-6468 23 Feb 1995@1118 FORD ISLAND NAS FU 808-644-9852 KEPT GIBRIED,KATHERINE FIGURE 4.4.8.9. SAMPLE OUTPUT REPORT: OUTPATIENT DISPOSITION ROSTER (BY CLINIC) (Sheet 2 of 4) 6-68 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 03 Mar 1995@1639 Page 1 Personal Data - Privacy Act 1974 (PL-93-579) OUTPATIENT DISPOSITION ROSTER By DIVISION From: 03 Feb 1995 To: 03 Mar 1995 Division: A DIVISION Clinic: FAMILY PRACTICE ================================================================================================================================== PATCAT/Outpatient Disposition Patient FMP/SSN Sponsor UIC H Phone D Phone W Phone Appt Date/Time Appt Type Appt Status Provider ================================================================================================================================== ACTIVE DUTY ----------HOME - HOME =========== SMITH, ROBERT T 20/800-45-1220 CO A 1ST BN 1ST MAR 808-223-4567 808-223-4567 22 Feb 1995@1340 NEW S-CALL GIBFRIED,KATHERINE WALTERS,MARY T Q24 - QUARTERS FOR 24 HOURS =========================== WAGNER,TIMOTHY R REF - REFERRED TO: ================== JACKSON,ESTHER P FAM MBR OF ACTIVE DUTY ---------------------HOME - HOME =========== HAMILTON,MARGIE F 20/689-22-0987 23 Feb 1995@0955 BARBERS POINT FU 808-362-6489 KEPT 808-434-8865 808-434-7123 GIBFRIED,KATHERINE 20/129-54-2001 23 Feb 1995@1035 1912 COMPUTER SQUAD NEW 808-363-6543 WALK-IN 808-336-2256 808-336-2256 GIBFRIED,KATHERINE 20/755-09-3659 SCHOLFIELD BKS 27 Feb 1995@0732 NEW Referred to: Primary Care (A) 808-434-1780 S-CALL 808-435-9087 808-435-9123 GIBFRIED,KATHERINE 30/756-45-6468 23 Feb 1995@1118 808-644-9852 KEPT GIBRIED,KATHERINE FIGURE 4.4.8.9. FORD ISLAND NAS FU SAMPLE OUTPUT REPORT: OUTPATIENT DISPOSITION ROSTER (BY DIVISION) (Sheet 3 of 4) 6-69 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 03 Mar 1995@1641 Page 1 Personal Data - Privacy Act 1974 (PL-93-579) OUTPATIENT DISPOSITION ROSTER By GROUP From: 03 Feb 1995 To: 03 Mar 1995 Group: TRIPLER AMC Division: A DIVISION ================================================================================================================================== PATCAT/Outpatient Disposition Patient FMP/SSN Sponsor UIC H Phone D Phone W Phone Appt Date/Time Appt Type Appt Status Provider ================================================================================================================================== FAMILY PRACTICE =============== ACTIVE DUTY ----------HOME - HOME =========== SMITH, ROBERT T 20/800-45-1220 CO A 1ST BN 1ST MAR 808-223-4567 808-223-4567 22 Feb 1995@1340 NEW S-CALL GIBFRIED,KATHERINE WALTERS,MARY T Q24 - QUARTERS FOR 24 HOURS =========================== WAGNER,TIMOTHY R Q48 - QUARTERS FOR 48 HOURS =========================== JACKSON,ESTHER P FAM MBR OF ACTIVE DUTY ---------------------HOME - HOME =========== HAMILTON,MARGIE F 20/689-22-0987 23 Feb 1995@0955 BARBERS POINT FU 808-362-6489 KEPT 808-434-8865 808-434-7123 GIBFRIED,KATHERINE 20/129-54-2001 23 Feb 1995@1035 1912 COMPUTER SQUAD NEW 808-363-6543 WALK-IN 808-336-2256 808-336-2256 GIBFRIED,KATHERINE 20/755-09-3659 24 Feb 1995@0732 SCHOLFIELD BKS NEW 808-434-1780 S-CALL 808-435-9087 808-435-9123 GIBFRIED,KATHERINE 30/756-45-6468 23 Feb 1995@1118 FORD ISLAND NAS FU 808-644-9852 KEPT GIBRIED,KATHERINE FIGURE 4.4.8.9. SAMPLE OUTPUT REPORT: OUTPATIENT DISPOSITION ROSTER (BY GROUP) (Sheet 4 of 4) 6-70 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 14 Jul 1992@1522 Page 1 APPOINTMENT UTILIZATION REPORT by ALL FACILITY From: Jun 1992 To: Jun 1992 Division: TRIPLER ARMY MEDICAL CENTER Clinic: DERMATOLOGY CLINIC Department: MEDICINE ================================================================================================================================== | | *INFO ONLY* | | APPOINTMENTS AVAILABLE TO PATIENTS | | | | Facility | Booked | Unbooked Appts | Total | % Provider | Appt Type | Cancel | Appts | Frozen | Open | Wait | Total | Appts | Unbooked ================================================================================================================================== BLACK,MARGARET F/UP NEW RET Subtotal: 0 11 0 11 0 0 7 7 3 7 62 72 3 6 107 116 0 12 0 12 6 25 169 200 6 25 176 200 100.0 100.0 96.0 97.6 STONER,SUSAN ASHOT NEW RET Subtotal: 3 3 0 6 9 12 0 21 2 2 0 4 14 19 3 36 0 0 0 0 16 21 3 40 25 33 3 61 64.0 63.6 100.0 65.6 Clinic Summary: ASHOT F/UP NEW RET 3 0 14 0 9 0 12 7 2 3 9 62 14 3 25 110 0 0 12 0 16 6 46 172 25 6 58 179 64.0 100.0 79.3 96.1 FIGURE 4.4.9.1. SAMPLE OUTPUT REPORT: APPOINTMENT UTILIZATION REPORT (Sheet 1 of 3) 6-71 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 14 Jul 1992@1522 Page 2 APPOINTMENT UTILIZATION REPORT by ALL FACILITY From: Jun 1992 To: Jun 1992 Division: TRIPLER ARMY MEDICAL CENTER Clinic: UROLOGY Department: MEDICINE (continued) ================================================================================================================================== | | *INFO ONLY* | | APPOINTMENTS AVAILABLE TO PATIENTS | | | | Facility | Booked | Unbooked Appts | Total | % Provider | Appt Type | Cancel | Appts | Frozen | Open | Wait | Total | Appts | Unbooked ================================================================================================================================== HECTOR,JAMES NEW RET Subtotal: 2 0 2 6 8 14 0 0 0 18 31 49 0 0 0 18 31 49 24 39 63 75.0 79.5 78.0 Clinic Summary NEW RET 2 0 6 8 0 0 18 31 0 0 18 31 24 39 75.0 79.5 FIGURE 4.4.9.1. SAMPLE OUTPUT REPORT: APPOINTMENT UTILIZATION REPORT (Sheet 2 of 3) 6-72 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 14 Jul 1992@1522 Page 3 APPOINTMENT UTILIZATION REPORT by ALL FACILITY From: Jun 1992 To: Jun 1992 Division: TRIPLER ARMY MEDICAL CENTER ***DIVISION SUMMARY*** Department: MEDICINE ================================================================================================================================== | *INFO ONLY* | | APPOINTMENTS AVAILABLE TO PATIENTS | | | Facility | Booked | Unbooked Appts | Total | % Clinic | Cancel | Appts | Frozen | Open | Wait | Total | Appts | Unbooked ================================================================================================================================== DERMATOLOGY 17 28 76 152 12 240 268 98.8 UROLOGY 2 14 0 49 0 49 63 78.0 --------------------------------------------------------------------------------------------------------------------------------Division Total: 19 FIGURE 4.4.9.1. 42 76 201 12 SAMPLE OUTPUT REPORT: APPOINTMENT UTILIZATION REPORT (Sheet 3 of 3) 6-73 289 331 87.3 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 12 Sep 1992@0600 Page 1 Personal Data - Privacy Act of 1974 (PL 93-579) AVIATION MEDICINE REPORT From: 11 Sep 1992 To: 11 Sep 1992 Unit: CAMP SMITH ================================================================================================================================== FMP/SSN Name Program DOB Sex GR Category Code Provider Clinic Type Time Status Clinic Phone # ================================================================================================================================== 20/520-44-1144 CARSON,JOHN W FLY 29 Dec 1971 M AO2 A11 IKEI,D ORTHOPEDIC CLINIC WOUND 1330 KEPT 433-4133/6655 Drug Fill Date Status QTY Ref Left ----------------------------------------------------------------------------------------TYLOX--PO CAP 04 Sep 1992 ACTIVE 30 NR TYLOX--PO CAP 08 Sep 1992 ACTIVE 20 NR TYLENOL #3--PO TAB 26 Aug 1992 R 12 NR TYLENOL #3--PO TAB 01 Sep 1992 ACTIVE 25 NR IBUPROFEN--PO 400MG TAB 07 Apr 1992 R 60 NR CYCLOBENZAPRINE HCL--PO 10MG TAB 07 Apr 1992 R 15 NR SIMETHICONE--PO 40MG/.6ML DROPS 10 Aug 1992 R 1 NR BISACODYL--PO 5MG TBEC 10 Aug 1992 R 3 NR COLYTE--PO SOLR 10 Aug 1992 R 1 NR ANUSOL--RECT SUPP 21 Aug 1992 ACTIVE 12 2 of 2 DIBUCAINE--TOP 1% OINT 21 Aug 1992 ACTIVE 1 NR DOCUSATE SODIUM--PO 100MG CAP 04 Sep 1992 R 60 NR TYLENOL (ACETAMINOPHEN)--PO 325MG TAB 04 Sep 1992 R 50 NR FIGURE 4.4.9.2. SAMPLE OUTPUT REPORT: AVIATION MEDICINE REPORT (Sheet 1 of 3) 6-74 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 12 Sep 1992@0600 Page 2 Personal Data - Privacy Act of 1974 (PL 93-579) AVIATION MEDICINE REPORT From: 11 Sep 1992 To: 11 Sep 1992 Unit: HEADQUARTERS CINC PAC J07 STAF ================================================================================================================================== FMP/SSN Name Program DOB Sex GR Category Code Provider Clinic Type Time Status Clinic Phone # ================================================================================================================================== 20/247-72-2259 HUNTER,SCOTTIE T FLY 04 Sep 1970 M AO2 F11 NURSE,ALLERGY IMMUNOTHERAPY IT 0848 WALK-IN 433-6332 Drug Fill Date Status QTY Ref Left ----------------------------------------------------------------------------------------FIORINAL--PO TAB 29 Jul 1991 R 30 NR BACTRIM DS (EQ)--PO TAB ($1.20/F10) 28 Jan 1991 R 28 NR NORGESIC FORTE--PO TAB 11 Jul 1991 R 90 NR DIAZEPAM--PO 5MG TAB 15 Jul 1991 R 28 NR TYLOX--PO CAP 05 Nov 1991 R 30 NR TYLOX--PO CAP 07 Jan 1992 R 30 NR TYLENOL W/COD ELIXIR--PO ELIX 22 Jul 1991 R 120 NR TYLENOL W/COD ELIXIR--PO ELIX 17 Aug 1991 R 3 1 of 1 TYLENOL #3--PO TAB 25 Nov 1991 R 12 NR TYLENOL #3--PO TAB 28 Jan 1992 R 24 NR TYLENOL #3--PO TAB 23 Jul 1992 R 30 NR ACTIFED--PO ($.01/TAB) 06 Jun 1991 R 30 5 of 5 ACTIFED--PO ($.01/TAB) 19 Sep 1991 R 30 NR BISACODYL--RECT 10MG SUPP 22 Jul 1991 R 30 NR PROCHLORPERAZINE--RECT 25MG SUPP 23 Jul 1991 R 12 2 of 2 PIROXICAM--PO 20MG ($1.04/CAP) 12/12 02 Oct 1991 R 30 NR PROCHLORPERAZINE--RECT 25MG SUPP 17 Aug 1991 R 12 NR DOCUSATE SODIUM--PO 100MG CAP 17 Aug 1991 R 60 NR IBUPROFEN--PO 400MG TAB 25 Nov 1991 R 20 NR MAXITROL--OPT OINT 07 Jan 1992 R 1 NR DEXAMETHASONE--PO 4MG TAB 15 Jan 1992 R 28 NR RANITIDINE--PO 150MG TAB 15 Jan 1992 R 14 NR ASTEMIZOLE--PO 10MG ($.79/TAB) 23 Jan 1992 R 30 2 of 2 FIGURE 4.4.9.2. SAMPLE OUTPUT REPORT: AVIATION MEDICINE REPORT (Sheet 2 of 3) 6-75 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 12 Sep 1992@0600 Page 3 Personal Data - Privacy Act of 1974 (PL 93-579) AVIATION MEDICINE REPORT From: 11 Sep 1992 To: 11 Sep 1992 Unit: USS ASPRO, SSN 648 ================================================================================================================================== FMP/SSN Name Program DOB Sex GR Category Code Provider Clinic Type Time Status Clinic Phone # ================================================================================================================================== 20/514-82-3344 BALLARD,CHARLES LEON FLY 26 May 1964 M NE7 N11 BENTON,CINDY J PHYSICAL THERAPY CLINIC BKSCH 0702 WALK-IN 433-6958 Drug Fill Date Status QTY Ref Left ----------------------------------------------------------------------------------------ERYTHROMYCIN BASE--PO 250MG TAB 07 Feb 1991 R 40 NR CLOTRIMAZOLE--TOP 1% CREAM 07 Feb 1991 R 1 5 of 5 IBUPROFEN--PO 800MG TAB 07 Feb 1991 R 30 NR CYCLOBENZAPRINE HCL--PO 10MG TAB 03 Sep 1992 R 21 NR IBUPROFEN--PO 800MG TAB 03 Sep 1992 R 21 NR CLOTRIMAZOLE--TOP 1% CREAM 21 Aug 1992 ACTIVE 1 5 of 5 END NOTE: This report prints appointments with appointment statuses of KEPT, WALK-IN, S-CALL AND TEL-CON for Active Duty Patients. FIGURE 4.4.9.2. SAMPLE OUTPUT REPORT: AVIATION MEDICINE REPORT (Sheet 3 of 3) 6-76 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 28 Jun 1992@1821 Page 1 CALL NO-SHOW REPORT by Clinic From: 27 Jun 1992 To: 27 Jun 1992 Division: TRIPLER ARMY MEDICAL CENTER DEPT: MEDICINE ================================================================================ Name FMP/SSN Sex Age Provider Time Type Work/Duty Phone Home Phone ================================================================================ CARDIOLOGY CLINIC ANDERSON,SCOTT W: BEERMAN,CYNTHIA W:988-1710 HAGLUND,BARBARA W: HAGLUND,CHESTER W:453-0949 HAMILTON,ANDRES W:564-4564 HAMILTON,BARBARA W: HAMILTON,CLAIRE W: HAMILTON,THOMAS W: 01/140-22-1705 H:234-3367 20/544-09-4788 H: 30/000-00-9901 H:453-4532 20/000-00-9901 H:453-4532 20/000-00-1050 H:342-2342 30/000-00-1050 H:342-2342 01/000-00-1050 H:342-2342 01/000-00-1050 H:342-2342 M 27 STASKO 0930 NEW F 36 STASKO 1000 NEW F 32 HAMMER 1130 NEW M 34 HAMMER 1130 RET M 33 HAMMER 1300 NEW F 33 HAMMER 1300 NEW F 9 HAMMER 1330 RET M 7 HAMMER 1330 NEW CLINIC Total No-Shows for 27 Jun 1992 = 8 FIGURE 4.4.9.3. SAMPLE OUTPUT SCREEN: 6-77 CALL NO-SHOW REPORT SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 20 Sep 1991@0850 Page 1 FACILITY CANCELLATION STATISTICAL REPORT by GROUP From: 01 Aug 1991 To: 31 Aug 1991 Division: TRIPLER ARMY MEDICAL CENTER Department: MEDICINE ================================================================================================================================== Clinic/ # Facility Cancellations Per Reason Total Total % | COUNT WORKLOAD | NON-COUNT WORKLOAD Provider 1 2 3 4 5 6 7 8 9 10 11 12 #Appt Canc Canc | #Visits #Canc %Canc | #Trans #Canc %Canc ================================================================================================================================== ALLERGY CLINIC -------------JONES,DONALD 0 0 0 0 0 0 0 0 3 2 6 0 66 11 14.2 47 6 11.3 19 5 20.8 SMITH,JOHN 0 0 0 0 0 0 0 0 0 0 9 0 61 9 12.8 36 4 10.0 25 5 16.6 Clinic Total: 0 0 0 0 0 0 0 0 3 2 15 0 127 20 13.6 83 10 10.7 44 10 18.5 DERMATOLOGY CLINIC -----------------JONES,FRED 0 SMITH,JILL 0 Clinic Total: 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 3 2 0 2 6 9 15 0 0 0 66 61 127 11 9 20 14.2 12.8 13.6 47 36 83 6 4 10 11.3 10.0 10.7 19 25 44 5 5 10 20.8 16.6 18.5 Dept Total: 0 0 0 0 0 0 0 6 4 30 0 254 40 13.6 166 20 10.7 88 20 18.5 0 NOTE: Appointment statuses changed to CANCEL during EOD Processing are counted in the "EOD CANCELLATIONS" column, while free text reasons for cancellations are counted in the "Other" column. The Total #Appt = the number of count clinic visits (Kept Appts and Unscheduled Visits) plus the number of non-count transactions (Kept Appts, Unscheduled Visits, and Occasions of Service). The %Canc = the number of cancellations divided by the #Visits (or #Trans) plus the number of cancellations. Cancellation Reasons ================================================================================================================================== 1 PROV CANCELLED 2 SCHEDULE HELD 3 HOLIDAY 4 MASS CASUALTY 5 TDY 6 LEAVE 7 MEETING 8 CONFERENCE 9 NOT DEFINED 10 NOT DEFINED 11 EOD CANCELLATION 12 OTHER FIGURE 4.4.9.4. SAMPLE OUTPUT REPORT: FACILITY CANCELLATION STATISTICAL REPORT (Sheet 1 of 4) 6-78 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 20 Sep 1991@0850 Page 2 FACILITY CANCELLATION STATISTICAL REPORT by GROUP From: Aug 1991 To: Aug 1991 Division: TRIPLER ARMY MEDICAL CENTER Department: SURGERY ================================================================================================================================== Clinic/ # Facility Cancellations Per Reason Total Total % | COUNT WORKLOAD | NON-COUNT WORKLOAD Provider 1 2 3 4 5 6 7 8 9 10 11 12 #Appt Canc Canc | #Visits #Canc %Canc | #Trans #Canc %Canc ================================================================================================================================== GENERAL SURGERY CLINIC ---------------------ALBERTSON,SAM 0 0 0 0 0 0 0 0 3 2 6 0 66 11 14.2 47 6 11.3 19 5 20.8 SAMSON,DAN 0 0 0 0 0 0 0 0 0 0 9 0 61 9 12.8 36 4 10.0 25 5 16.6 Clinic Total: 0 0 0 0 0 0 0 0 3 2 15 0 127 20 13.6 83 10 10.7 44 10 18.5 UROLOGY CLINIC -------------JONES,SAM SMITH,DAN Clinic Total: 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 3 2 0 2 6 9 15 0 0 0 66 61 127 11 9 20 14.2 12.8 13.6 47 36 83 6 4 10 11.3 10.0 10.7 19 25 44 5 5 10 20.8 16.6 18.5 Dept Total: 0 0 0 0 0 0 0 0 6 4 30 0 254 40 13.6 166 20 10.7 88 20 18.5 Division Total: 0 0 0 0 0 0 0 0 12 8 60 0 508 80 13.6 332 40 10.7 176 40 18.5 NOTE: Appointment statuses changed to CANCEL during EOD Processing are counted in the "EOD CANCELLATIONS" column, while free text reasons for cancellations are counted in the "Other" column. The Total #Appt = the number of count clinic visits (Kept Appts and Unscheduled Visits) plus the number of non-count transactions (Kept Appts, Unscheduled Visits, and Occasions of Service). The %Canc = the number of cancellations divided by the #Visits (or #Trans) plus the number of cancellations. Cancellation Reasons ================================================================================================================================== 1 PROV CANCELLED 2 SCHEDULE HELD 3 HOLIDAY 4 MASS CASUALTY 5 TDY 6 LEAVE 7 MEETING 8 CONFERENCE 9 NOT DEFINED 10 NOT DEFINED 11 EOD CANCELLATION 12 OTHER FIGURE 4.4.9.4. SAMPLE OUTPUT REPORT: FACILITY CANCELLATION STATISTICAL REPORT (Sheet 2 of 4) 6-79 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 20 Sep 1991@0850 Page 3 FACILITY CANCELLATION STATISTICAL REPORT by GROUP From: Aug 1991 To: Aug 1991 Division: TRIPLER ARMY MEDICAL CENTER Department: SURGERY ================================================================================================================================== Department/ # Facility Cancellations Per Reason Total Total % | COUNT WORKLOAD | NON-COUNT WORKLOAD Clinic 1 2 3 4 5 6 7 8 9 10 11 12 #Appt Canc Canc | #Visits #Canc %Canc | #Trans #Canc %Canc ================================================================================================================================== ***Division Summary*** MEDICINE -------Allergy Dermatology Dept Total: 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 3 6 2 2 4 15 15 30 0 0 0 127 127 254 20 20 40 13.6 13.6 13.6 83 83 166 10 10 20 10.7 10.7 10.7 44 44 88 10 10 20 18.5 18.5 18.5 SURGERY ------General Surgery 0 Urology 0 Dept Total: 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 3 6 2 2 4 15 15 30 0 0 0 127 127 254 20 20 40 13.6 13.6 13.6 83 83 166 10 10 20 10.7 10.7 10.7 44 44 88 10 10 20 18.5 18.5 18.5 Division Total: 0 0 0 0 0 0 0 12 8 60 0 508 80 13.6 332 40 10.7 176 40 18.5 0 NOTE: Appointment statuses changed to CANCEL during EOD Processing are counted in the "EOD CANCELLATIONS" column, while free text reasons for cancellations are counted in the "Other" column. The Total #Appt = the number of count clinic visits (Kept Appts and Unscheduled Visits) plus the number of non-count transactions (Kept Appts, Unscheduled Visits, and Occasions of Service). The %Canc = the number of cancellations divided by the #Visits (or #Trans) plus the number of cancellations. Cancellation Reasons ================================================================================================================================== 1 PROV CANCELLED 2 SCHEDULE HELD 3 HOLIDAY 4 MASS CASUALTY 5 TDY 6 LEAVE 7 MEETING 8 CONFERENCE 9 NOT DEFINED 10 NOT DEFINED 11 EOD CANCELLATION 12 OTHER FIGURE 4.4.9.4. SAMPLE OUTPUT REPORT: FACILITY CANCELLATION STATISTICAL REPORT (Sheet 3 of 4) 6-80 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 20 Sep 1991@0850 Page 4 FACILITY CANCELLATION STATISTICAL REPORT by GROUP From: Aug 1991 To: Aug 1991 Group: TRIPLER AMC ================================================================================================================================== Division / # Facility Cancellations Per Reason Total Total % | COUNT WORKLOAD | NON-COUNT WORKLOAD Department 1 2 3 4 5 6 7 8 9 10 11 12 #Appt Canc Canc | #Visits #Canc %Canc | #Trans #Canc %Canc ================================================================================================================================== ***Group Summary*** TRIPLER ------Medicine Surgery Division Total: 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 6 12 4 4 8 30 30 60 0 0 0 254 254 508 40 40 80 13.6 13.6 13.6 166 166 332 20 20 40 10.7 10.7 10.7 88 88 176 20 20 40 18.5 18.5 18.5 SCHOFIELD --------Medicine Surgery Division Total: 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 6 12 4 4 8 30 30 60 0 0 0 254 254 508 40 40 80 13.6 13.6 13.6 166 166 332 20 20 40 10.7 10.7 10.7 88 88 176 20 20 40 18.5 18.5 18.5 Group Total: 0 0 0 0 0 0 0 0 24 16 120 0 1016 160 13.6 664 80 10.7 352 80 18.5 NOTE: Appointment statuses changed to CANCEL during EOD Processing are counted in the "EOD CANCELLATIONS" column, while free text reasons for cancellations are counted in the "Other" column. The Total #Appt = the number of count clinic visits (Kept Appts and Unscheduled Visits) plus the number of non-count transactions (Kept Appts, Unscheduled Visits, and Occasions of Service). The %Canc = the number of cancellations divided by the #Visits (or #Trans) plus the number of cancellations. Cancellation Reasons ================================================================================================================================== 1 PROV CANCELLED 2 SCHEDULE HELD 3 HOLIDAY 4 MASS CASUALTY 5 TDY 6 LEAVE 7 MEETING 8 CONFERENCE 9 NOT DEFINED 10 NOT DEFINED 11 EOD CANCELLATION 12 OTHER FIGURE 4.4.9.4. SAMPLE OUTPUT REPORT: FACILITY CANCELLATION STATISTICAL REPORT (Sheet 4 of 4) 6-81 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 01 Jul 1992@1649 Page 1 CLERK WORKLOAD RECAP REPORT by GROUP From: Jun 1992 To: Jun 1992 Division: TRIPLER ARMY MEDICAL CENTER Department: MEDICINE ================================================================================================================================== Clinic/ Appts #Fac #Pat #No | Walk Sick Tel Unsch | Non-Count Appt Statuses Clerk Made Canc Canc Show | In Call Cons Total | ADMIN LWOBS OCC-SVC ================================================================================================================================== ALLERGY CLINIC -------------CLARK,JAMES S Clerk Total: 469 20 24 10 469 0 0 469 10 60 59 # of Days = 20 Daily Average: 23.5 1.0 1.2 0.5 23.5 0.0 0.0 23.5 0.5 3.0 2.9 Clinic Total: # of Days = 20 Daily Average: 469 20 24 10 469 0 0 469 10 60 59 23.5 1.0 1.2 0.5 23.5 0.0 0.0 23.5 0.5 3.0 2.9 FIGURE 4.4.9.5. SAMPLE OUTPUT REPORT: CLERK WORKLOAD RECAP REPORT (Sheet 1 of 6) 6-82 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 01 Jul 1992@1649 Page 2 CLERK WORKLOAD RECAP REPORT by GROUP From: Jun 1992 To: Jun 1992 Division: TRIPLER ARMY MEDICAL CENTER (continued) Department: MEDICINE ================================================================================================================================== Clinic/ Appts #Fac #Pat #No | Walk Sick Tel Unsch | Non-Count Appt Statuses Clerk Made Canc Canc Show | In Call Cons Total | ADMIN LWOBS OCC-SVC ================================================================================================================================== DERMATOLOGY CLINIC -----------------WILLIAMS,TED Clerk Total: 469 20 24 10 469 0 0 469 10 60 59 # of Days = 18 Daily Average: 26.1 1.1 1.3 0.6 26.1 0.0 0.0 26.1 0.6 3.3 3.3 WILLS,TOM Clerk Total: # of Days = 18 Daily Average: Clinic Total: # of Days = 20 Daily Average: Department Total: # of Days = 20 Daily Average: 469 20 24 10 469 0 0 469 10 60 59 26.1 1.1 1.3 0.6 26.1 0.0 0.0 26.1 0.6 3.3 3.3 938 40 48 20 938 0 0 938 20 120 118 47.0 2.0 2.4 1.0 47.0 0.0 0.0 47.0 1.0 6.0 5.9 1407 60 74 30 1407 0 0 1407 30 180 177 70.35 3.0 1.4 3.7 70.35 0.0 0.0 70.35 1.5 9.0 8.9 FIGURE 4.4.9.5. SAMPLE OUTPUT REPORT: CLERK WORKLOAD RECAP REPORT (Sheet 2 of 6) 6-83 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 01 Jul 1992@1649 Page 3 CLERK WORKLOAD RECAP REPORT by GROUP From: Jun 1992 To: Jun 1992 Division: TRIPLER ARMY MEDICAL CENTER Department: SURGERY ================================================================================================================================== Clinic/ Appts #Fac #Pat #No | Walk Sick Tel Unsch | Non-Count Appt Statuses Clerk Made Canc Canc Show | In Call Cons Total | ADMIN LWOBS OCC-SVC ================================================================================================================================== GENERAL SURGERY CLINIC ---------------------COOK,JANE Clerk Total: 469 20 24 10 469 0 0 469 10 60 59 # of Days = 20 Daily Average: 23.5 1.0 1.2 0.5 23.5 0.0 0.0 23.5 0.5 3.0 2.9 Clinic Total: # of Days = 20 Daily Average: 469 20 24 10 469 0 0 469 10 60 59 23.5 1.0 1.2 0.5 23.5 0.0 0.0 23.5 0.5 3.0 2.9 FIGURE 4.4.9.5. SAMPLE OUTPUT REPORT: CLERK WORKLOAD RECAP REPORT (Sheet 3 of 6) 6-84 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 01 Jul 1992@1649 Page 4 CLERK WORKLOAD RECAP REPORT by GROUP From: Jun 1992 To: Jun 1992 Division: TRIPLER ARMY MEDICAL CENTER (continued) Department: SURGERY ================================================================================================================================== Clinic/ Appts #Fac #Pat #No | Walk Sick Tel Unsch | Non-Count Appt Statuses Clerk Made Canc Canc Show | In Call Cons Total | ADMIN LWOBS OCC-SVC ================================================================================================================================== UROLOGY CLINIC -------------WILLIAMS,ED Clerk Total: 469 20 24 10 469 0 0 469 10 60 59 # of Days = 18 Daily Average: 26.1 1.1 1.3 0.6 26.1 0.0 0.0 26.1 0.6 3.3 3.3 YEATS,WILLIAM Clerk Total: # of Days = 18 Daily Average: Clinic Total: # of Days = 20 Daily Average: Department Total: # of Days = 20 Daily Average: Division Total: # of Days = 20 Daily Average: 469 20 24 10 469 0 0 469 10 60 59 26.1 1.1 1.3 0.6 26.1 0.0 0.0 26.1 0.6 3.3 3.3 938 40 48 20 938 0 0 938 20 120 118 47.0 2.0 2.4 1.0 47.0 0.0 0.0 47.0 1.0 6.0 5.9 1407 60 74 30 1407 0 0 1407 30 180 177 70.35 3.0 1.4 3.7 70.35 0.0 0.0 70.35 1.5 9.0 8.9 2814 120 148 60 2814 0 0 2814 60 360 354 140.7 6.0 7.4 3.0 140.7 0.0 0.0 140.7 3.0 18.0 17.5 FIGURE 4.4.9.5. SAMPLE OUTPUT REPORT: CLERK WORKLOAD RECAP REPORT (Sheet 4 of 6) 6-85 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 01 Jul 1992@1649 Page 5 CLERK WORKLOAD RECAP REPORT by GROUP From: Jun 1992 To: Jun 1992 Division: TRIPLER ARMY MEDICAL CENTER ================================================================================================================================== Department/ Appts #Fac #Pat #No | Walk Sick Tel Unsch | Non-Count Appt Statuses Clinic Made Canc Canc Show | In Call Cons Total | ADMIN LWOBS OCC-SVC ================================================================================================================================== ***Division Summary*** MEDICINE -------ALLERGY CLINIC Clinic Total: # of Days = 20 Daily Average: DERMATOLOGY CLINIC Clinic Total: # of Days = 20 Daily Average: Department Total: # of Days = 20 Daily Average: SURGERY ------GENERAL SURGERY CLINIC Clinic Total: # of Days = 20 Daily Average: UROLOGY CLINIC Clinic Total: # of Days = 20 Daily Average: Department Total: # of Days = 20 Daily Average: Division Total: # of Days = 20 Daily Average: 469 20 24 10 469 0 0 469 10 60 59 23.5 1.0 1.2 0.5 23.5 0.0 0.0 23.5 0.5 3.0 2.9 938 40 48 20 938 0 0 938 20 120 118 47.0 2.0 2.4 1.0 47.0 0.0 0.0 70.35 1.5 9.0 8.9 1407 60 74 30 1407 0 0 1407 30 180 177 70.35 3.0 1.4 3.7 70.35 0.0 0.0 140.7 3.0 18.0 17.5 469 20 24 10 469 0 0 469 10 60 59 23.5 1.0 1.2 0.5 23.5 0.0 0.0 23.5 0.5 3.0 2.9 938 40 48 20 938 0 0 938 20 120 118 47.0 2.0 2.4 1.0 47.0 0.0 0.0 47.0 1.0 6.0 5.9 1407 60 74 30 1407 0 0 1407 30 180 177 70.35 3.0 1.4 3.7 70.35 0.0 0.0 70.35 1.5 9.0 8.9 2814 120 148 60 2814 0 0 2814 60 360 354 140.7 6.0 7.4 3.0 140.7 0.0 0.0 140.7 3.0 18.0 17.5 FIGURE 4.4.9.5. SAMPLE OUTPUT REPORT: CLERK WORKLOAD RECAP REPORT (Sheet 5 of 6) 6-86 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 Tripler Army Medical Center 15 Nov 1991@1649 Page 6 CLERK WORKLOAD RECAP REPORT by DIVISION From: 30 Oct 1991 To: 15 Nov 1991 Group: TRIPLER AMC ================================================================================================================================== Division/ Appts #Fac #Pat #No | Walk Sick Tel Unsch | Non-Count Appt Statuses Department Made Canc Canc Show | In Call Cons Total | ADMIN LWOBS OCC-SVC ================================================================================================================================== ***Group Summary*** TRIPLER ------MEDICINE: # of Days = 20 Daily Average: SURGERY: # of Days = 20 Daily Average: Division Total: # of Days = 20 Daily Average: SCHOFIELD --------MEDICINE: # of Days = 20 Daily Average: SURGERY: # of Days = 20 Daily Average: Division Total: # of Days = 20 Daily Average: GROUP TOTAL: # of Days = 20 Daily Average: 1407 60 74 30 1407 0 0 1407 30 180 177 70.35 3.0 1.4 3.7 70.35 0.0 0.0 70.35 1.5 9.0 8.9 1407 60 74 30 1407 0 0 1407 30 180 177 70.35 3.0 1.4 3.7 70.35 0.0 0.0 70.35 1.5 9.0 8.9 2814 120 148 60 2814 0 0 2814 60 360 354 140.7 6.0 7.4 3.0 140.7 0.0 0.0 140.7 3.0 18.0 17.5 1407 60 74 30 1407 0 0 1407 30 180 177 70.35 3.0 1.4 3.7 70.35 0.0 0.0 70.35 1.5 9.0 8.9 1407 60 74 30 1407 0 0 1407 30 180 177 70.35 3.0 1.4 3.7 70.35 0.0 0.0 70.35 1.5 9.0 8.9 2814 120 148 60 2814 0 0 2814 60 360 354 140.7 6.0 7.4 3.0 140.7 0.0 0.0 140.7 3.0 18.0 17.5 5628 340 296 120 5628 0 0 5628 120 720 708 281.4 17.0 14.8 6.0 281.4 0.0 0.0 281.4 6.0 36.0 35.4 ***NOTE*** 'Appts Made' is based upon the number of appointments 'MADE' by the clerks in the specified clinic during the date range specified not the number of appointments made for that date range. 'Appts Made' will thus be different for Clerk Workload Reports and Monthly Statistical Reports, since different data is being reported. FIGURE 4.4.9.5. SAMPLE OUTPUT REPORT: CLERK WORKLOAD RECAP REPORT (Sheet 6 of 6) 6-87 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 14 Oct 1991@1649 Page 1 CLERK WORKLOAD REPORT by GROUP From: Sep 1991 To: Sep 1991 Division: TRIPLER ARMY MEDICAL CENTER Department: MEDICINE ================================================================================================================================== Clinic/ Appts #Fac #Pat #No | Walk Sick Tel Unsch | Non-Count Appt Statuses Clerk Date Made Canc Canc Show | In Call Cons Total | ADMIN LWOBS OCC-SVC ================================================================================================================================== ALLERGY CLINIC -------------CLARK,JAMES S 01Sep91 31 1 3 0 26 0 0 26 1 13 6 02Sep91 27 1 2 2 10 0 0 10 0 5 0 05Sep91 29 2 0 0 15 0 0 15 0 3 15 ~ ~ ~ ~ 26Sep91 30 3 5 2 12 0 0 12 1 1 2 27Sep91 19 1 1 3 17 0 0 17 0 6 3 28Sep91 23 4 1 1 19 0 0 19 1 1 17 Clerk Total: 469 20 24 10 469 0 0 469 10 60 59 # of Days = 20 Daily Average: 23.5 1.0 1.2 0.5 23.5 0.0 0.0 23.5 0.5 3.0 2.9 Clinic Total: # of Days = 20 Daily Average: DERMATOLOGY CLINIC -----------------WILLIAMS,TED 01Sep91 02Sep91 05Sep91 ~ ~ ~ ~ 26Sep91 27Sep91 28Sep91 Clerk Total: # of Days = 18 Daily Average: 469 20 24 10 469 0 0 469 10 60 59 23.5 1.0 1.2 0.5 23.5 0.0 0.0 23.5 0.5 3.0 2.9 31 27 29 1 1 2 3 2 0 0 2 0 26 10 15 0 0 0 0 0 0 26 10 15 1 0 0 13 5 3 6 0 15 30 19 23 469 3 1 4 20 5 1 1 24 2 3 1 10 12 17 19 469 0 0 0 0 0 0 0 0 12 17 19 469 1 0 1 10 1 6 1 60 2 3 17 59 26.1 1.1 1.3 0.6 26.1 0.0 0.0 26.1 0.6 3.3 3.3 FIGURE 4.4.9.6. SAMPLE OUTPUT REPORT: (Sheet 1 of 8) 6-88 CLERK WORKLOAD REPORT SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 14 Oct 1991@1649 Page 2 CLERK WORKLOAD REPORT by GROUP From: Sep 1991 To: Sep 1991 Division: TRIPLER ARMY MEDICAL CENTER (continued) Department: MEDICINE ================================================================================================================================== Clinic/ Appts #Fac #Pat #No | Walk Sick Tel Unsch | Non-Count Appt Statuses Clerk Date Made Canc Canc Show | In Call Cons Total | ADMIN LWOBS OCC-SVC ================================================================================================================================== WILLS,TOM 01Sep91 02Sep91 05Sep91 ~ ~ ~ ~ 26Sep91 27Sep91 28Sep91 Clerk Total: # of Days = 18 Daily Average: Clinic Total: # of Days = 20 Daily Average: Department Total: # of Days = 20 Daily Average: 31 27 29 1 1 2 3 2 0 0 2 0 26 10 15 0 0 0 0 0 0 26 10 15 1 0 0 13 5 3 6 0 15 30 19 23 469 3 1 4 20 5 1 1 24 2 3 1 10 12 17 19 469 0 0 0 0 0 0 0 0 12 17 19 469 1 0 1 10 1 6 1 60 2 3 17 59 26.1 1.1 1.3 0.6 26.1 0.0 0.0 26.1 0.6 3.3 3.3 938 40 48 20 938 0 0 938 20 120 118 47.0 2.0 2.4 1.0 47.0 0.0 0.0 47.0 1.0 6.0 5.9 1407 60 74 30 1407 0 0 1407 30 180 177 70.35 3.0 1.4 3.7 70.35 0.0 0.0 70.35 1.5 9.0 8.9 FIGURE 4.4.9.6. SAMPLE OUTPUT REPORT: (Sheet 2 of 8) 6-89 CLERK WORKLOAD REPORT SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 14 Oct 1991@1649 Page 3 CLERK WORKLOAD REPORT by GROUP From: Sep 1991 To: Sep 1991 Division: TRIPLER ARMY MEDICAL CENTER (continued) Department: SURGERY ================================================================================================================================== Clinic/ Appts #Fac #Pat #No | Walk Sick Tel Unsch | Non-Count Appt Statuses Clerk Date Made Canc Canc Show | In Call Cons Total | ADMIN LWOBS OCC-SVC ================================================================================================================================== GENERAL SURGERY CLINIC ---------------------COOK,JANE 01Sep91 31 1 3 0 26 0 0 26 1 13 6 02Sep91 27 1 2 2 10 0 0 10 0 5 0 05Sep91 29 2 0 0 15 0 0 15 0 3 15 ~ ~ ~ ~ 26Sep91 30 3 5 2 12 0 0 12 1 1 2 27Sep91 19 1 1 3 17 0 0 17 0 6 3 28Sep91 23 4 1 1 19 0 0 19 1 1 17 Clerk Total: 469 20 24 10 469 0 0 469 10 60 59 # of Days = 20 Daily Average: 23.5 1.0 1.2 0.5 23.5 0.0 0.0 23.5 0.5 3.0 2.9 Clinic Total: # of Days = 20 Daily Average: UROLOGY CLINIC -------------WILLIAMS,ED 01Sep91 02Sep91 05Sep91 ~ ~ ~ ~ 26Sep91 27Sep91 28Sep91 Clerk Total: # of Days = 18 Daily Average: 469 20 24 10 469 0 0 469 10 60 59 23.5 1.0 1.2 0.5 23.5 0.0 0.0 23.5 0.5 3.0 2.9 31 27 29 1 1 2 3 2 0 0 2 0 26 10 15 0 0 0 0 0 0 26 10 15 1 0 0 13 5 3 6 0 15 30 19 23 469 3 1 4 20 5 1 1 24 2 3 1 10 12 17 19 469 0 0 0 0 0 0 0 0 12 17 19 469 1 0 1 10 1 6 1 60 2 3 17 59 26.1 1.1 1.3 0.6 26.1 0.0 0.0 26.1 0.6 3.3 3.3 FIGURE 4.4.9.6. SAMPLE OUTPUT REPORT: (Sheet 3 of 8) 6-90 CLERK WORKLOAD REPORT SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 14 Oct 1991@1649 Page 4 CLERK WORKLOAD REPORT by GROUP From: Sep 1991 To: Sep 1991 Division: TRIPLER ARMY MEDICAL CENTER (continued) Department: SURGERY ================================================================================================================================== Clinic/ Appts #Fac #Pat #No | Walk Sick Tel Unsch | Non-Count Appt Statuses Clerk Date Made Canc Canc Show | In Call Cons Total | ADMIN LWOBS OCC-SVC ================================================================================================================================== YEATS,WILLIAM 01Sep91 02Sep91 05Sep91 ~ ~ ~ ~ 26Sep91 27Sep91 28Sep91 Clerk Total: # of Days = 18 Daily Average: Clinic Total: # of Days = 20 Daily Average: Department Total: # of Days = 20 Daily Average: Division Total: # of Days = 20 Daily Average: Group Total: # of Days = 20 Daily Average: 31 27 29 1 1 2 3 2 0 0 2 0 26 10 15 0 0 0 0 0 0 26 10 15 1 0 0 13 5 3 6 0 15 30 19 23 469 3 1 4 20 5 1 1 24 2 3 1 10 12 17 19 469 0 0 0 0 0 0 0 0 12 17 19 469 1 0 1 10 1 6 1 60 2 3 17 59 26.1 1.1 1.3 0.6 26.1 0.0 0.0 26.1 0.6 3.3 3.3 938 40 48 20 938 0 0 938 20 120 118 47.0 2.0 2.4 1.0 47.0 0.0 0.0 47.0 1.0 6.0 5.9 1407 60 74 30 1407 0 0 1407 30 180 177 70.35 3.0 1.4 3.7 70.35 0.0 0.0 70.35 1.5 9.0 8.9 2814 120 148 60 2814 0 0 2814 60 360 354 140.7 6.0 7.4 3.0 140.7 0.0 0.0 140.7 3.0 18.0 17.5 2814 120 148 60 2814 0 0 2814 60 360 354 140.7 6.0 7.4 3.0 140.7 0.0 0.0 140.7 3.0 18.0 17.5 FIGURE 4.4.9.6. SAMPLE OUTPUT REPORT: (Sheet 4 of 8) 6-91 CLERK WORKLOAD REPORT SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 14 Oct 1991@1649 Page 5 CLERK WORKLOAD REPORT by GROUP From: Sep 1991 To: Sep 1991 Division: TRIPLER ARMY MEDICAL CENTER ================================================================================================================================== Department/ Appts #Fac #Pat #No | Walk Sick Tel Unsch | Non-Count Appt Statuses Clinic/Date Made Canc Canc Show | In Call Cons Total | ADMIN LWOBS OCC-SVC ================================================================================================================================== ***Division Summary*** MEDICINE -------ALLERGY CLINIC 01Sep91 02Sep91 05Sep91 ~ ~ ~ ~ 26Sep91 27Sep91 28Sep91 Clinic Total: # of Days = 20 Daily Average: DERMATOLOGY CLINIC 01Sep91 02Sep91 05Sep91 ~ ~ ~ ~ 26Sep91 27Sep91 28Sep91 Clinic Total: # of Days = 20 Daily Average: Department Total: # of Days = 20 Daily Average: 31 27 29 1 1 2 3 2 0 0 2 0 26 10 15 0 0 0 0 0 0 26 10 15 1 0 0 13 5 3 6 0 15 30 19 23 469 3 1 4 20 5 1 1 24 2 3 1 10 12 17 19 469 0 0 0 0 0 0 0 0 12 17 19 469 1 0 1 10 1 6 1 60 2 3 17 59 23.5 1.0 1.2 0.5 23.5 0.0 0.0 23.5 0.5 3.0 2.9 62 54 58 2 2 4 6 4 0 0 4 0 52 20 30 0 0 0 0 0 0 52 20 30 2 0 0 26 10 6 12 0 30 60 38 46 938 6 2 8 40 10 2 2 48 4 6 2 20 24 34 38 938 0 0 0 0 0 0 0 0 24 34 38 938 2 0 2 20 2 12 2 120 4 6 34 118 47.0 2.0 2.4 1.0 47.0 0.0 0.0 47.0 1.0 6.0 5.9 1407 60 74 30 1407 0 0 1407 30 180 177 70.35 3.0 1.4 3.7 70.35 0.0 0.0 70.35 1.5 9.0 8.9 FIGURE 4.4.9.6. SAMPLE OUTPUT REPORT: (Sheet 5 of 8) 6-92 CLERK WORKLOAD REPORT SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 14 Oct 1991@1649 Page 6 CLERK WORKLOAD REPORT by GROUP From: Sep 1991 To: Sep 1991 Division: TRIPLER ARMY MEDICAL CENTER (continued) ================================================================================================================================== Department/ Appts #Fac #Pat #No | Walk Sick Tel Unsch | Non-Count Appt Statuses Clinic/Date Made Canc Canc Show | In Call Cons Total | ADMIN LWOBS OCC-SVC ================================================================================================================================== ***Division Summary*** (continued) SURGERY -------GENERAL SURGERY CLINIC 01Sep91 02Sep91 05Sep91 ~ ~ ~ ~ 26Sep91 27Sep91 28Sep91 Clinic Total: # of Days = 20 Daily Average: UROLOGY CLINIC 01Sep91 02Sep91 05Sep91 ~ ~ ~ ~ 26Sep91 27Sep91 28Sep91 Clinic Total: # of Days = 20 Daily Average: Department Total: # of Days = 20 Daily Average: Division Total: # of Days = 20 Daily Average: Group Total: # of Days = 20 Daily Average: 31 27 29 1 1 2 3 2 0 0 2 0 26 10 15 0 0 0 0 0 0 26 10 15 1 0 0 13 5 3 6 0 15 30 19 23 469 3 1 4 20 5 1 1 24 2 3 1 10 12 17 19 469 0 0 0 0 0 0 0 0 12 17 19 469 1 0 1 10 1 6 1 60 2 3 17 59 23.5 1.0 1.2 0.5 23.5 0.0 0.0 23.5 0.5 3.0 2.9 62 54 58 2 2 4 6 4 0 0 4 0 52 20 30 0 0 0 0 0 0 52 20 30 2 0 0 26 10 6 12 0 30 60 38 46 938 6 2 8 40 10 2 2 48 4 6 2 20 24 34 38 938 0 0 0 0 0 0 0 0 24 34 38 938 2 0 2 20 2 12 2 120 4 6 34 118 47.0 2.0 2.4 1.0 47.0 0.0 0.0 47.0 1.0 6.0 5.9 1407 60 74 30 1407 0 0 1407 30 180 177 70.35 3.0 1.4 3.7 70.35 0.0 0.0 70.35 1.5 9.0 8.9 2814 120 148 60 2814 0 0 2814 60 360 354 140.7 6.0 7.4 3.0 140.7 0.0 0.0 140.7 3.0 18.0 17.5 2814 120 148 60 2814 0 0 2814 60 360 354 140.7 6.0 7.4 3.0 140.7 0.0 0.0 140.7 3.0 18.0 17.5 FIGURE 4.4.9.6. SAMPLE OUTPUT REPORT: (Sheet 6 of 8) 6-93 CLERK WORKLOAD REPORT SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 14 Oct 1991@1649 Page 7 CLERK WORKLOAD REPORT by GROUP From: Sep 1991 To: Sep 1991 Group: TRIPLER AMC ================================================================================================================================== Department/ Appts #Fac #Pat #No | Walk Sick Tel Unsch | Non-Count Appt Statuses Clinic/Date Made Canc Canc Show | In Call Cons Total | ADMIN LWOBS OCC-SVC ================================================================================================================================== ***Group Summary*** TRIPLER ARMY MEDICAL CENTER --------------------------MEDICINE 01Sep91 02Sep91 05Sep91 ~ ~ ~ ~ 26Sep91 27Sep91 28Sep91 Department Total: # of Days = 20 Daily Average: 1407 93 81 87 60 3 3 6 74 9 6 0 30 0 6 0 1407 78 30 45 0 0 0 0 0 0 0 0 1407 78 30 45 30 3 0 0 180 39 15 9 177 18 0 45 90 57 69 1407 9 3 12 60 15 3 3 74 6 9 3 30 36 51 57 1407 0 0 0 0 0 0 0 0 36 51 57 1407 3 0 3 30 3 18 3 180 6 9 51 177 70.35 3.0 1.4 3.7 70.35 0 0 70.35 1.5 9.0 8.9 93 81 87 3 3 6 9 6 0 0 6 0 78 30 45 0 0 0 0 0 0 78 30 45 3 0 0 39 15 9 18 0 45 90 57 69 1407 9 3 12 60 15 3 3 74 6 9 3 30 36 51 57 1407 0 0 0 0 0 0 0 0 36 51 57 1407 3 0 3 30 3 18 3 180 6 9 51 177 70.35 3.0 1.4 3.7 70.35 0 0 70.35 1.5 9.0 8.9 2814 120 148 60 2814 0 0 2814 60 360 354 140.7 6.0 7.4 3.0 140.7 0.0 0.0 140.7 3.0 18.0 17.5 2814 120 148 60 2814 0 0 2814 60 360 354 140.7 6.0 7.4 3.0 140.7 0.0 0.0 140.7 3.0 18.0 17.5 SURGERY 01Sep91 02Sep91 05Sep91 ~ ~ ~ ~ 26Sep91 27Sep91 28Sep91 Department Total: # of Days = 20 Daily Average: Division Total: # of Days = 20 Daily Average: Group Total: # of Days = 20 Daily Average: FIGURE 4.4.9.6. SAMPLE OUTPUT REPORT: (Sheet 7 of 8) 6-94 CLERK WORKLOAD REPORT SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 14 Oct 1991@1649 Page 8 CLERK WORKLOAD REPORT by GROUP From: Sep 1991 To: Sep 1991 Group: TRIPLER AMC ================================================================================================================================== Department/ Appts #Fac #Pat #No | Walk Sick Tel Unsch | Non-Count Appt Statuses Clinic/Date Made Canc Canc Show | In Call Cons Total | ADMIN LWOBS OCC-SVC ================================================================================================================================== ***Group Summary*** (continued) ***NOTE*** 'Appts Made' is based upon the number of appointments 'MADE' by the clerk on that date, not the number of appointments made for that date. 'Appts Made' will thus be different for Clerk Workload Reports and Monthly Statistical Reports, since different data is being reported. FIGURE 4.4.9.6. SAMPLE OUTPUT REPORT: (Sheet 8 of 8) 6-95 CLERK WORKLOAD REPORT SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 03 Jul 1991@1634 Page 1 CLINIC WORKLOAD REPORT From: Jun 1992 To: Jun 1992 Division: TRIPLER ARMY MEDICAL CENTER ================================================================================ Appt MEPRS | COUNT WORKLOAD | NON-COUNT WORKLOAD Type Code | # In # Out Total | # In # Out Total ================================================================================ NUTRITION CLINIC *** Clinic Totals *** ---------------------------------------------FU BAAB 1 0 1 0 0 0 BAAC 2 0 2 0 0 0 BCCA 1 0 1 0 0 0 NEW AAAA AABS AAEA BAAC 0 0 0 0 0 0 0 1 0 0 0 1 2 2 2 0 0 0 0 0 2 2 2 0 PRO30 BAAB BAAC 0 0 3 1 3 1 0 0 0 0 0 0 PRO60 BAAB BAAC 1 0 7 1 8 1 0 0 0 0 0 0 RET AAAA BAAB 0 0 0 0 0 0 1 1 0 4 1 5 Clinic Total: 5 13 18 8 4 12 FIGURE 4.4.9.7. SAMPLE OUTPUT REPORT: (Sheet 1 of 8) 6-96 CLINIC WORKLOAD REPORT SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 03 Jul 1991@1634 Page 2 CLINIC WORKLOAD REPORT From: Jun 1992 To: Jun 1992 Division: TRIPLER ARMY MEDICAL CENTER ================================================================================ Appt MEPRS | COUNT WORKLOAD | NON-COUNT WORKLOAD Type Code | # In # Out Total | # In # Out Total ================================================================================ NUTRITION CLINIC ---------------Provider: MILLER,JIM FU BAAC 1 0 1 0 0 O NEW AAAA AABS AAEA 0 0 0 0 0 0 0 0 0 1 1 2 0 0 0 1 1 2 PRO30 BAAB 0 1 1 0 0 0 PRO60 BAAB BAAC 1 0 5 0 6 0 0 1 0 0 0 1 Provider: THOMAS,SCOTT FU BAAB BAAC BCCA 1 1 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 NEW AAAA AABS BAAC 0 0 0 0 0 1 0 0 1 1 1 0 0 0 0 1 1 0 PRO30 BAAB BAAC 0 0 2 1 2 1 0 0 0 0 0 0 PRO60 BAAB 0 2 2 0 0 0 RET AAAA BAAB 0 0 0 0 0 0 1 0 0 4 1 4 5 12 17 8 4 12 Clinic Total: FIGURE 4.4.9.7. SAMPLE OUTPUT REPORT: (Sheet 2 of 8) 6-97 CLINIC WORKLOAD REPORT SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 03 Jul 1991@1634 Page 3 CLINIC WORKLOAD REPORT From: Jun 1992 To: Jun 1992 Division: TRIPLER ARMY MEDICAL CENTER ================================================================================ Appt Cat | COUNT WORKLOAD | NON-COUNT WORKLOAD Type Code Description | # In # Out Total | # In # Out Total ================================================================================ NUTRITION CLINIC ---------------FU A11 USA ACTIVE DUTY OFFICER 4 0 4 0 0 0 NEW A11 A41 USA ACTIVE DUTY OFFICER USA FAM MBR AD 0 0 0 1 0 1 4 2 0 0 4 2 PRO30 A11 USA ACTIVE DUTY ENLISTED 0 4 4 0 0 0 PRO60 A11 A41 USA AD ENLISTED USA FAM MBR AD 1 0 7 1 8 1 0 0 0 0 0 0 RET A11 A41 USA ACTIVE DUTY OFFICER USA FAM MBR AD 0 0 0 0 0 0 0 2 2 2 2 4 5 13 18 8 4 12 Clinic Total: FIGURE 4.4.9.7. SAMPLE OUTPUT REPORT: (Sheet 3 of 8) 6-98 CLINIC WORKLOAD REPORT SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 03 Jul 1991@1634 Page 4 CLINIC WORKLOAD REPORT From: Jun 1992 To: Jun 1992 Division: TRIPLER ARMY MEDICAL CENTER ================================================================================ Cat | COUNT WORKLOAD | NON-COUNT WORKLOAD Code Description | # In # Out Total | # In # Out Total ================================================================================ NUTRITION CLINIC ---------------A11 USA ACTIVE DUTY ENLISTED 5 11 16 4 2 6 A41 USA FAM MBR AD 0 2 2 4 2 6 Clinic Total: 5 13 FIGURE 4.4.9.7. 18 8 4 SAMPLE OUTPUT REPORT: (Sheet 4 of 8) 6-99 12 CLINIC WORKLOAD REPORT SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 03 Jul 1991@1634 Page 5 CLINIC WORKLOAD REPORT From: Jun 1992 To: Jun 1992 Division: TRIPLER ARMY MEDICAL CENTER ================================================================================ Appt Cat | COUNT WORKLOAD | NON-COUNT WORKLOAD Type Code Description | # In # Out Total | # In # Out Total ================================================================================ NUTRITION CLINIC ---------------Provider: MILLER,JIM FU A11 USA ACTIVE DUTY OFFICER 1 0 1 0 0 0 NEW A11 A41 USA ACTIVE DUTY ENLISTED USA FAM MBR AD 0 0 0 0 0 0 3 1 0 0 3 1 PRO30 A11 USA ACTIVE DUTY OFFICER 0 1 1 0 0 0 PRO60 A11 A41 USA ACTIVE DUTY OFFICER USA FAM MBR AD 1 0 5 1 6 1 0 0 0 0 0 0 RET A41 USA FAM MBR AD 0 0 0 1 0 1 Provider: THOMAS,SCOTT FU A11 USA ACTIVE DUTY OFFICER 3 0 3 0 0 0 NEW A11 A41 USA ACTIVE DUTY OFFICER USA FAM MBR AD 0 0 0 1 0 1 1 1 0 0 1 1 PRO30 A11 USA ACTIVE DUTY ENLISTED 0 3 3 0 0 0 PRO60 A11 USA ACTIVE DUTY ENLISTED 0 2 2 0 0 0 RET A11 A41 USA ACTIVE DUTY OFFICER USA FAM MBR AD 0 0 0 0 0 0 0 1 2 2 2 3 5 13 18 8 4 12 Clinic Total: FIGURE 4.4.9.7. SAMPLE OUTPUT REPORT: (Sheet 5 of 8) 6-100 CLINIC WORKLOAD REPORT SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 03 Jul 1991@1634 Page 6 CLINIC WORKLOAD REPORT From: Jun 1992 To: Jun 1992 Division: TRIPLER ARMY MEDICAL CENTER ================================================================================ MEPRS | COUNT WORKLOAD | NON-COUNT WORKLOAD Code Description | # In # Out Total | # In # Out Total ================================================================================ NUTRITION CLINIC ---------------AAAA NUTRITION 0 0 0 3 0 3 AABS CARDIOLOGY - CRI/RESOURCE SH 0 0 0 2 0 2 AAEA ENDOCRINOLOGY 0 0 0 2 0 2 BAAB NUTRITION CLINIC 2 10 12 1 4 5 BAAC NUTRITION CLINIC 2 3 5 0 0 0 BCCA OBSTETRICS CLINIC 1 0 1 0 0 0 Clinic Total: 5 13 FIGURE 4.4.9.7. 18 8 4 SAMPLE OUTPUT REPORT: (Sheet 6 of 8) 6-101 12 CLINIC WORKLOAD REPORT SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 03 Jul 1991@1634 Page 7 CLINIC WORKLOAD REPORT From: Jun 1992 To: Jun 1992 Division: TRIPLER ARMY MEDICAL CENTER ================================================================================ MEPRS Appt | COUNT WORKLOAD | NON-COUNT WORKLOAD Code Type | # In # Out Total | # In # Out Total ================================================================================ NUTRITION CLINIC ---------------Provider: MILLER,JIM AAAA PRO30 0 0 0 1 0 1 AABS PRO30 0 0 0 1 0 1 AAEA PRO30 0 0 0 2 0 2 BAAB FU NEW RET 0 1 0 1 5 0 1 6 0 0 0 1 0 0 0 0 0 1 BAAC PRO60 NEW 1 0 0 1 1 1 0 0 0 0 0 0 Provider: THOMAS,SCOTT AAAA PRO30 RET 0 0 0 0 0 0 1 1 0 0 1 1 AABS PRO30 0 0 0 1 0 1 BAAB PRO60 FU NEW RET 1 0 0 0 0 2 2 0 1 2 2 0 0 0 0 0 0 0 0 4 0 0 0 4 BAAC PRO60 PRO30 FU 1 0 0 0 1 1 1 1 1 0 0 0 0 0 0 0 0 0 BCCA PRO60 1 0 1 0 0 0 5 13 18 8 4 12 Clinic Total: FIGURE 4.4.9.7. SAMPLE OUTPUT REPORT: (Sheet 7 of 8) 6-102 CLINIC WORKLOAD REPORT SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 03 Jul 1991@1634 Page 8 CLINIC WORKLOAD REPORT From: Jun 1992 To: Jun 1992 Division: TRIPLER ARMY MEDICAL CENTER ================================================================================ Requesting | COUNT WORKLOAD | NON-COUNT WORKLOAD Service Description | # In # Out Total | # In # Out Total ================================================================================ NUTRITION CLINIC ---------------???? *No Requesting Service* 0 1 1 0 0 0 BAJA NEPHROLOGY CLINIC 0 1 1 2 4 6 BCCA OBSTETRICS CLINIC 2 2 4 2 0 2 BEAA ORTHOPEDICS CLINIC 0 2 2 0 0 0 BIAA EMERGENCY ROOM - TRIPLER 3 7 10 4 0 4 Clinic Total: 5 13 FIGURE 4.4.9.7. 18 8 4 SAMPLE OUTPUT REPORT: (Sheet 8 of 8) 6-103 12 CLINIC WORKLOAD REPORT SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER AMC, HI 25 Jul 1992@1619 Page 1 COMMAND FACILITY WORKLOAD RECAP REPORT by GROUP From: Jun 1992 To: Jun 1992 ***Appointment Statistics Summary*** Division: TRIPLER ARMY MEDICAL CENTER ================================================================================================================================== Department/ | COUNT WORKLOAD | #No %No | #Fac %Fac | #Pat %Pat | Non-Count Appt Statuses | Total Clinic | #In #Out Total | Show Show | Canc Canc | Canc Canc | ADMIN LWOBS OCC-SVC | Interactions ================================================================================================================================== MEDICINE DEPARTMENT ------------------Allergy Clinic 6 77 83 10 10.7 10 10.7 13 13.5 3 2 2 123 Dermatology Clinic 6 77 83 7 7.7 10 10.7 13 13.5 2 0 0 115 Department Total: 12 154 166 17 9.2 20 10.7 26 13.5 5 2 2 238 SURGERY ------General Surgery Urology Clinic Department Total: 6 6 12 77 77 154 83 83 166 10 7 17 10.7 7.7 9.2 10 10 20 10.7 10.7 10.7 13 13 26 13.5 13.5 13.5 3 2 5 2 0 2 2 0 2 123 115 238 Division Total: 24 308 332 34 9.2 40 10.7 52 13.5 10 4 4 476 ================================================================================================================================== NOTE: The %NoShow = the number of no-shows divided by the number of count clinic visits (Kept Appts and Unscheduled Visits) plus the number of no-shows. The %Fac Canc = the number of facility cancellations divided by the number of count clinic visits (Kept Appts and Unscheduled Visits) plus the number of facility cancellations. The %Pat Canc = the number of patient cancellations divided by the number of count clinic visits (Kept Appts and Unscheduled Visits) plus the number of patient cancellations. FIGURE 4.4.9.8. SAMPLE OUTPUT REPORT: COMMAND FACILITY WORKLOAD RECAP REPORT (Sheet 1 of 5) 6-104 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER AMC, HI 25 Jul 1992@1619 Page 2 COMMAND FACILITY WORKLOAD RECAP REPORT by GROUP From: Jun 1992 To: Jun 1992 ***Appointment Statistics Summary*** Division: TRIPLER ARMY MEDICAL CENTER ================================================================================================================================== Division/ | COUNT WORKLOAD | #No %No | #Fac %Fac | #Pat %Pat | Non-Count Appt Statuses | Total Department | #In #Out Total | Show Show | Canc Canc | Canc Canc | ADMIN LWOBS OCC-SVC | Interactions ================================================================================================================================== ***Group Summary*** TRIPLER ------Medicine Surgery Division Total: 12 12 24 154 154 308 166 166 332 17 17 34 9.2 9.2 9.2 20 20 40 10.7 10.7 10.7 26 26 52 13.5 13.5 13.5 5 5 10 2 2 4 2 2 4 238 238 476 SCHOFIELD --------Medicine Surgery Division Total: 12 12 24 154 154 308 166 166 332 17 17 34 9.2 9.2 9.2 20 20 40 10.7 10.7 10.7 26 26 52 13.5 13.5 13.5 5 5 10 2 2 4 2 2 4 238 238 476 Group Total: 48 616 664 68 9.2 80 10.7 104 13.5 20 8 8 952 ================================================================================================================================== NOTE: The %NoShow = the number of no-shows divided by the number of count clinic visits (Kept Appts and Unscheduled Visits) plus the number of no-shows. The %Fac Canc = the number of facility cancellations divided by the number of count clinic visits (Kept Appts and Unscheduled Visits) plus the number of facility cancellations. The %Pat Canc = the number of patient cancellations divided by the number of count clinic visits (Kept Appts and Unscheduled Visits) plus the number of patient cancellations. FIGURE 4.4.9.8. SAMPLE OUTPUT REPORT: COMMAND FACILITY WORKLOAD RECAP REPORT (Sheet 2 of 5) 6-105 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER AMC, HI 25 Jul 1992@1619 Page 3 COMMAND FACILITY WORKLOAD RECAP REPORT by GROUP From: Jun 1992 To: Jun 1992 ***Next Available Appointment Summary*** Division: TRIPLER ARMY MEDICAL CENTER ================================================================================================================================== Clinic Appt Type Next Available Date ================================================================================================================================== ALLERGY CLINIC F/UP 23 Jul 1992@1400 GT 26 Jul 1992@1500 IN 30 Jul 1992@1000 MSE 29 Jul 1992@0800 DERMATOLOGY CLINIC SC 29 Jul 1992@1300 WARTS 29 Jul 1992@0700 GENERAL SURGERY CLINIC F/UP 05 Aug 1992@1100 MSUR 28 Jul 1992@0900 NEW 28 Jul 1992@0700 ROUT 23 Jul 1992@1400 VASC 03 Aug 1992@0900 ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ UROLOGY CLINIC F/UP 28 Jul 1992@1000 NEW 27 Jul 1992@1300 FIGURE 4.4.9.8. SAMPLE OUTPUT REPORT: COMMAND FACILITY WORKLOAD RECAP REPORT (Sheet 3 of 5) 6-106 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER AMC, HI 25 Jul 1992@1619 Page 4 COMMAND FACILITY WORKLOAD RECAP REPORT by GROUP From: Jun 1992 To: Jun 1992 ***Clerk Workload Summary*** Division: TRIPLER ARMY MEDICAL CENTER ================================================================================================================================== Department/ Appts #Fac #Pat #No | Walk Sick Tel Unsch | Non-Count Appt Statuses Clinic Made Canc Canc Show | In Call Cons Total | ADMIN LWOBS OCC-SVC ================================================================================================================================== MEDICINE -------ALLERGY CLINIC 469 20 24 10 469 0 0 469 10 60 59 DERMATOLOGY CLINIC 469 20 24 10 469 0 0 469 10 60 59 Department Total: 938 40 48 20 938 0 0 938 20 120 118 SURGERY ------GENERAL SURGERY UROLOGY CLINIC Department Total: Division Total: 469 469 938 20 20 40 24 24 48 10 10 20 469 469 938 0 0 0 0 0 0 469 469 938 10 10 20 60 60 120 59 59 118 1876 80 56 40 1876 0 0 1876 40 240 236 FIGURE 4.4.9.8. SAMPLE OUTPUT REPORT: COMMAND FACILITY WORKLOAD RECAP REPORT (Sheet 4 of 5) 6-107 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER AMC, HI 25 Jul 1992@1619 Page 5 COMMAND FACILITY WORKLOAD RECAP REPORT by GROUP From: Jun 1992 To: Jun 1992 ***Clerk Workload Summary*** Division: TRIPLER ARMY MEDICAL CENTER ================================================================================================================================== Division / Appts #Fac #Pat #No | Walk Sick Tel Unsch | Non-Count Appt Statuses Department Made Canc Canc Show | In Call Cons Total | ADMIN LWOBS OCC-SVC ================================================================================================================================== ***Group Summary*** TRIPLER ------MEDICINE SURGERY Division Total: 938 938 1876 40 40 80 48 48 96 20 20 40 938 938 1876 0 0 0 0 0 0 938 938 1876 20 20 40 120 120 240 118 118 236 SCHOFIELD --------GENERAL SURGERY UROLOGY Division Total: 938 938 1876 40 40 80 48 48 96 20 20 40 938 938 1876 0 0 0 0 0 0 938 938 1876 20 20 40 120 120 240 118 118 236 Group Total: 3752 160 192 80 3752 0 0 3752 80 480 472 FIGURE 4.4.9.8. SAMPLE OUTPUT REPORT: COMMAND FACILITY WORKLOAD RECAP REPORT (Sheet 5 of 5) 6-108 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 12 Sep 1992@0600 Page 1 Personal Data - Privacy Act of 1974 (PL 93-579) COMMAND SECURITY PROGRAM From: 11 Sep 1992 To: 11 Sep 1992 Unit: CAMP SMITH ================================================================================================================================== FMP/SSN Name Program DOB Sex GR Category Code Provider Clinic Type Time Status Clinic Phone # ================================================================================================================================== 20/520-44-1144 CARSON,JOHN W PRP 29 Dec 1971 M AO2 A11 IKEI,D ORTHOPEDIC CLINIC WOUND 1330 KEPT 433-4133/6655 Drug Fill Date Status QTY Ref Left ----------------------------------------------------------------------------------------TYLOX--PO CAP 04 Sep 1992 ACTIVE 30 NR TYLOX--PO CAP 08 Sep 1992 ACTIVE 20 NR TYLENOL #3--PO TAB 26 Aug 1992 R 12 NR TYLENOL #3--PO TAB 01 Sep 1992 ACTIVE 25 NR IBUPROFEN--PO 400MG TAB 07 Apr 1992 R 60 NR CYCLOBENZAPRINE HCL--PO 10MG TAB 07 Apr 1992 R 15 NR SIMETHICONE--PO 40MG/.6ML DROPS 10 Aug 1992 R 1 NR BISACODYL--PO 5MG TBEC 10 Aug 1992 R 3 NR COLYTE--PO SOLR 10 Aug 1992 R 1 NR ANUSOL--RECT SUPP 21 Aug 1992 ACTIVE 12 2 of 2 DIBUCAINE--TOP 1% OINT 21 Aug 1992 ACTIVE 1 NR DOCUSATE SODIUM--PO 100MG CAP 04 Sep 1992 R 60 NR TYLENOL (ACETAMINOPHEN)--PO 325MG TAB 04 Sep 1992 R 50 NR FIGURE 4.4.9.9. SAMPLE OUTPUT REPORT: COMMAND SECURITY PROGRAM REPORT (Sheet 1 of 3) 6-109 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 12 Sep 1992@0600 Page 2 Personal Data - Privacy Act of 1974 (PL 93-579) COMMAND SECURITY PROGRAM From: 11 Sep 1992 To: 11 Sep 1992 Unit: HEADQUARTERS CINC PAC J07 STAF ================================================================================================================================== FMP/SSN Name Program DOB Sex GR Category Code Provider Clinic Type Time Status Clinic Phone # ================================================================================================================================== 20/247-72-2259 HUNTER,SCOTTIE T SCI 04 Sep 1970 M AO2 A11 NURSE,ALLERGY IMMUNOTHERAPY IT 0848 WALK-IN 433-6332 Drug Fill Date Status QTY Ref Left ----------------------------------------------------------------------------------------FIORINAL--PO TAB 29 Jul 1991 R 30 NR BACTRIM DS (EQ)--PO TAB ($1.20/F10) 28 Jan 1991 R 28 NR NORGESIC FORTE--PO TAB 11 Jul 1991 R 90 NR DIAZEPAM--PO 5MG TAB 15 Jul 1991 R 28 NR TYLOX--PO CAP 05 Nov 1991 R 30 NR TYLOX--PO CAP 07 Jan 1992 R 30 NR TYLENOL W/COD ELIXIR--PO ELIX 22 Jul 1991 R 120 NR TYLENOL W/COD ELIXIR--PO ELIX 17 Aug 1991 R 3 1 of 1 TYLENOL #3--PO TAB 25 Nov 1991 R 12 NR TYLENOL #3--PO TAB 28 Jan 1992 R 24 NR TYLENOL #3--PO TAB 23 Jul 1992 R 30 NR ACTIFED--PO ($.01/TAB) 06 Jun 1991 R 30 5 of 5 ACTIFED--PO ($.01/TAB) 19 Sep 1991 R 30 NR BISACODYL--RECT 10MG SUPP 22 Jul 1991 R 30 NR PROCHLORPERAZINE--RECT 25MG SUPP 23 Jul 1991 R 12 2 of 2 PIROXICAM--PO 20MG ($1.04/CAP) 12/12 02 Oct 1991 R 30 NR PROCHLORPERAZINE--RECT 25MG SUPP 17 Aug 1991 R 12 NR DOCUSATE SODIUM--PO 100MG CAP 17 Aug 1991 R 60 NR IBUPROFEN--PO 400MG TAB 25 Nov 1991 R 20 NR MAXITROL--OPT OINT 07 Jan 1992 R 1 NR DEXAMETHASONE--PO 4MG TAB 15 Jan 1992 R 28 NR RANITIDINE--PO 150MG TAB 15 Jan 1992 R 14 NR ASTEMIZOLE--PO 10MG ($.79/TAB) 23 Jan 1992 R 30 2 of 2 FIGURE 4.4.9.9. SAMPLE OUTPUT REPORT: COMMAND SECURITY PROGRAM REPORT (Sheet 2 of 3) 6-110 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 12 Sep 1992@0600 Page 3 Personal Data - Privacy Act of 1974 (PL 93-579) COMMAND SECURITY PROGRAM From: 11 Sep 1992 To: 11 Sep 1992 Unit: USS ASPRO, SSN 648 ================================================================================================================================== FMP/SSN Name Program DOB Sex GR Category Code Provider Clinic Type Time Status Clinic Phone # ================================================================================================================================== 20/514-82-3344 BALLARD,CHARLES LEON PRP 26 May 1964 M NE7 N11 BENTON,CINDY J PHYSICAL THERAPY CLINIC BKSCH 0702 WALK-IN 433-6958 Drug Fill Date Status QTY Ref Left ----------------------------------------------------------------------------------------ERYTHROMYCIN BASE--PO 250MG TAB 07 Feb 1991 R 40 NR CLOTRIMAZOLE--TOP 1% CREAM 07 Feb 1991 R 1 5 of 5 IBUPROFEN--PO 800MG TAB 07 Feb 1991 R 30 NR CYCLOBENZAPRINE HCL--PO 10MG TAB 03 Sep 1992 R 21 NR IBUPROFEN--PO 800MG TAB 03 Sep 1992 R 21 NR CLOTRIMAZOLE--TOP 1% CREAM 21 Aug 1992 ACTIVE 1 5 of 5 END NOTE: This report prints appointments with appointment statuses of KEPT, WALK-IN, S-CALL AND TEL-CON for Active Duty Patients. FIGURE 4.4.9.9. SAMPLE OUTPUT REPORT: COMMAND SECURITY PROGRAM REPORT (Sheet 3 of 3) 6-111 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 IRELAND ARMY COMMUNITY HOSPITAL 23 Oct 1994@1622 Page 1 DELINQUENT END-OF-DAY PROCESSING REPORT By DIVISION From: 24 Aug 1994 To: 23 Oct 1994 Division: IRELAND Department: MEDICINE ================================================================================ Clinic/ Appt Appt Date Provider Time Type ================================================================================ ALLERGY CLINIC -------------23 Oct 1994 TALBOT,ARNOLD 0800 NEW 0900 NEW 1000 NEW 1100 NEW HARMON,TRACEY Clinic Total 0900 1330 1400 1430 1500 RET RET RET RET F/U 9 FIGURE 4.4.9.10. SAMPLE OUTPUT REPORT: DELINQUENT END-OF-DAY PROCESSING REPORT (Sheet 1 of 7) 6-112 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 IRELAND ARMY COMMUNITY HOSPITAL 25 Nov 1994@1622 Page 2 DELINQUENT END-OF-DAY PROCESSING REPORT By DIVISION From: 26 Sep 1994 To: 25 Nov 1994 Division: IRELAND (continued) Department: MEDICINE (continued) ================================================================================ Clinic/ Appt Appt Date Provider Time Type ================================================================================ CARDIOLOGY (I) -------------23 Oct 1994 THACKER,DAVID 0800 RET Clinic Total: 1 FIGURE 4.4.9.10. SAMPLE OUTPUT REPORT: DELINQUENT END-OF-DAY PROCESSING REPORT (Sheet 2 of 7) 6-113 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 IRELAND ARMY COMMUNITY HOSPITAL 25 Nov 1994@1622 Page 3 DELINQUENT END-OF-DAY PROCESSING REPORT By DIVISION From: 26 Sep 1994 To: 25 Nov 1994 Division: IRELAND (continued) Department: MEDICINE (continued) ================================================================================ Clinic/ Appt Appt Date Provider Time Type ================================================================================ INTERNAL MEDICINE (I) --------------------30 Oct 1994 MILLER,JIM 0800 NEW 1000 FU 1300 RX1400 A-I-N THOMAS,SCOTT 31 Oct 1994 MILLER,JIM THOMAS,SCOTT Clinic Total: 0800 0900 1000 1300 1330 NEW NEW FU RXRX- 1404 1406 1408 1416 1417 1418 1440 NEW NEW NEW A-I-R A-I-R A-I-R NEW 1409 1412 1413 1414 1419 1420 FU FU RXRXA-I-N A-I-N 23 FIGURE 4.4.9.10. SAMPLE OUTPUT REPORT: DELINQUENT END-OF-DAY PROCESSING REPORT (Sheet 3 of 7) 6-114 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 IRELAND ARMY COMMUNITY HOSPITAL 25 Nov 1994@1622 Page 4 DELINQUENT END-OF-DAY PROCESSING REPORT By DIVISION From: 26 Sep 1994 To: 25 Nov 1994 Division: IRELAND (continued) Department: MEDICINE (continued) ================================================================================ Clinic/ Appt Appt Date Provider Time Type ================================================================================ KJS CLINIC ---------23 Oct 1994 **PROVIDER NOT ENTERED** 1528 NEW 28 Oct 1994 **PROVIDER NOT ENTERED** SMITH,KATHERINE JEAN Clinic Total: Dept Total: 1509 NEW 1430 1445 NEW NEW 4 37 FIGURE 4.4.9.10. SAMPLE OUTPUT REPORT: DELINQUENT END-OF-DAY PROCESSING REPORT (Sheet 4 of 7) 6-115 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 IRELAND ARMY COMMUNITY HOSPITAL 25 Nov 1994@1622 Page 5 DELINQUENT END-OF-DAY PROCESSING REPORT By DIVISION From: 26 Sep 1994 To: 25 Nov 1994 Division: IRELAND (continued) Department: PRIMARY CARE & COMM MEDICINE ================================================================================ Clinic/ Appt Appt Date Provider Time Type ================================================================================ EMERGENCY ROOM (I) -----------------24 Oct 1994 **PROVIDER NOT ENTERED** 1449 EROOM 28 Oct 1994 **PROVIDER NOT ENTERED** Clinic Total: 0856 1644 EROOM EROOM 3 FIGURE 4.4.9.10. SAMPLE OUTPUT REPORT: DELINQUENT END-OF-DAY PROCESSING REPORT (Sheet 5 of 7) 6-116 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 IRELAND ARMY COMMUNITY HOSPITAL 25 Nov 1994@1622 Page 6 DELINQUENT END-OF-DAY PROCESSING REPORT By DIVISION From: 26 Sep 1994 To: 25 Nov 1994 Division: IRELAND (continued) Department: PRIMARY CARE & COMM MEDICINE (continued) ================================================================================ Clinic/ Appt Appt Date Provider Time Type ================================================================================ KS EMERGENCY ROOM ----------------29 Oct 1994 **PROVIDER NOT ENTERED** 1500 EROOM Clinic Total: 1 FIGURE 4.4.9.10. SAMPLE OUTPUT REPORT: DELINQUENT END-OF-DAY PROCESSING REPORT (Sheet 6 of 7) 6-117 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 IRELAND ARMY COMMUNITY HOSPITAL 25 Nov 1994@1622 Page 7 DELINQUENT END-OF-DAY PROCESSING REPORT By DIVISION From: 26 Sep 1994 To: 25 Nov 1994 Division: IRELAND (continued) Department: PRIMARY CARE & COMM MEDICINE (continued) ================================================================================ Clinic/ Appt Appt Date Provider Time Type ================================================================================ PROCEDURE CLINIC ---------------30 Oct 1994 HENDERSON,KAREN 1300 NEW 1500 FU 31 Oct 1994 HENDERSON,KAREN TAYLOR,JOHN Clinic Total: Dept Total: 1400 1422 1423 NEW NEW NEW 1400 1430 NEW FU 9 13 Division Total: 50 FIGURE 4.4.9.10. SAMPLE OUTPUT REPORT: DELINQUENT END-OF-DAY PROCESSING REPORT (Sheet 7 of 7) 6-118 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 18 Aug 1995@1254 Page 1 PAS DEERS INELIGIBILITY REPORT by DIVISION Personal Data - Privacy Act 1974 (PL 93-579) Appointments for 02 Aug 1995 Part 1 of 2 Division: A DIVISION ================================================================================================================================== Clinic/ Patient Name FMP/SSN DOB Last DEERS Check Next Appt. Home Phone/ Work Phone DEERS Status Clerk ================================================================================================================================== ALLERGY (T) ---------ABERCROMBE,DOUGLAS 99/800-44-0407 07 Apr 1944 18 Aug 1995@0939 06 Aug 1995@1100 NOT ELIGIBLE THACKER,DAVID SIMPSON,BETTY NOT ELIGIBLE 01-362-77-6576 07 Sep 1973 30 Sep 1995@1531 10 Oct 1995@0900 446-6644 DE BLASIO,MICHAEL CARDIOLOGY (A) ------------SMITH,DANIEL 20/457-65-2398 25 Aug 1960 30 Sep 1995@0802 No Response on Latest DEERS Check. Previous check: ELIGIBLE TUCKER,ELIZABETH 20/161-61-6161 16 AUG 1968 29 Sep 1995@1147 No Response on Latest DEERS Check. Previous check: NOT ELIGIBLE 02 Oct 1995@1000 678-0987 THACKER,DAVID 01 Oct 1995@1300 555-2121 977-3450 METCALF,DAVID ================================================================================================================================== NOTE: Patients, whose names appear on this report, should be reminded to bring proof of their eligibility at the time of their appointment. FIGURE 4.4.9.11. SAMPLE OUTPUT REPORT: PAS DEERS INELIGIBILITY REPORT (Sheet 1 of 2) 6-119 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 18 Aug 1995@1254 Page 2 PAS DEERS INELIGIBILITY REPORT by DIVISION Personal Data - Privacy Act 1974 (PL 93-579) Appointments for 02 Aug 1995 Part 2 of 2 Division: A DIVISION ================================================================================================================================== Clinic/ Patient Name FMP/SSN DOB Last DEERS Check Next Appt. Home Phone/ Work Phone Alternate Care Value DEERS Direct Care Eligibility Clerk ================================================================================================================================== ALLERGY (T) ---------ABERCROMBE,DOUGLAS 99/800-44-0407 07 Apr 1944 18 Aug 1995@0939 06 Aug 1995@1100 U/ENROLLED IN USTF MANAGED CARE NOT ELIGIBLE THACKER,DAVID SIMPSON,BETTY 01-362-77-6576 U/ENROLLED IN USTF MANAGED CARE 07 Sep 1973 30 Sep 1995@1531 NOT ELIGIBLE 10 Oct 1995@0900 446-6644 DE BLASIO,MICHAEL (NOTE: The system shall generate Part 2 only if there are DEERS ineligible patients who are enrolled in a USTF Managed Care plan to be included in this report. ================================================================================================================================== NOTE: Patients, whose names appear on this report section are currently enrolled in a Uniformed Services Treatment Facilities (USTF) Managed Care Plan. This facility will not be reimbursed for non-emergency care provided to these patients unless their USTF agrees to pay this facility prior to rendering services to the patient. FIGURE 4.4.9.11. SAMPLE OUTPUT REPORT: PAS DEERS INELIGIBILITY REPORT (Sheet 2 of 2) 6-120 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER AMC, HI 24 Sep 1991 Page 1 Personal Data - Privacy Act of 1974 (PL 93-579) MILITARY NO-SHOW REPORT From: 17 Sep 1991 To: 23 Sep 1991 Unit: 16TH ENGR DET TERRAIN ================================================================================ FMP/SSN Name DOB Sex GR Cat Clinic HCP Type Date/Time ================================================================================ 20/000-00-1237 SANTOS,M 05 Apr 1965 M A04 A11 CARDIOLO LEE,JUDY RX20 Sep 1991@1100 20/000-00-1237 SANTOS,M CARDIOLO LEE,JUDY 05 Apr 1965 M CBOOK 20 Sep 1991@1500 FIGURE 4.4.9.13. A04 SAMPLE OUTPUT REPORT: 6-121 A11 MILITARY NO-SHOW REPORT SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 Ireland Army Community Hospital 20 Nov 1991@2153 Page 1 MONTHLY STATISTICAL REPORT by GROUP From: Oct 1991 To: Oct 1991 Division: IRELAND ACH Department: MEDICINE ================================================================================ Appt MEPRS | COUNT WORKLOAD | NON-COUNT WORKLOAD Type Code | # In # Out Total | # In # Out Total ================================================================================ INTERNAL MEDICINE (T) --------------------FU BAAB 1 0 1 0 0 0 BAAC 2 0 2 0 0 0 BCCA 1 0 1 0 0 0 Subtotal: 4 0 4 0 0 0 NEW AAAA AABS AAEA BAAC 0 0 0 0 0 0 0 0 1 1 0 0 0 1 1 2 2 2 0 6 0 0 0 0 0 2 2 2 0 6 BAAB BAAC 0 0 0 2 1 3 2 1 3 0 0 0 0 0 0 0 0 0 BAAB BAAC 1 0 1 5 1 6 6 1 7 0 0 0 0 0 0 0 0 0 AAAA BAAB Subtotal: 0 0 0 0 0 0 0 0 0 1 1 2 0 4 4 1 5 6 Clinic Total: 5 10 15 8 4 12 Subtotal: PRO30 Subtotal: PRO60 Subtotal: RET FIGURE 4.4.9.14. SAMPLE OUTPUT REPORT: MONTHLY STATISTICAL REPORT (Sheet 1 of 15) 6-122 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 Ireland Army Community Hospital 20 Nov 1991@2153 Page 2 MONTHLY STATISTICAL REPORT by GROUP From: Oct 1991 To: Oct 1991 Division: IRELAND ACH Department: MEDICINE ================================================================================ Appt MEPRS | COUNT WORKLOAD | NON-COUNT WORKLOAD Type Code | # In # Out Total | # In # Out Total ================================================================================ KJS CLINIC ---------NEW ABA 0 0 0 1 0 1 AEAA 0 0 0 1 0 1 BAAB 0 2 2 0 0 0 BAAC 0 3 3 0 0 0 Subtotal: 0 5 5 2 0 2 Clinic Total: 0 5 5 FIGURE 4.4.9.14. 2 0 2 SAMPLE OUTPUT REPORT: MONTHLY STATISTICAL REPORT (Sheet 2 of 15) 6-123 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 Ireland Army Community Hospital 20 Nov 1991@2153 Page 3 MONTHLY STATISTICAL REPORT by GROUP From: Oct 1991 To: Oct 1991 Division: IRELAND ACH Department: MEDICINE ================================================================================ Appt MEPRS | COUNT WORKLOAD | NON-COUNT WORKLOAD Type Code | # In # Out Total | # In # Out Total ================================================================================ INTERNAL MEDICINE (T) --------------------Provider: MILLER,JIM NEW BAAC 1 0 1 0 0 0 PRO30 AAAA AABS AAEA Subtotal: 0 0 0 0 0 0 0 0 0 0 0 0 1 1 2 4 0 0 0 0 1 1 2 4 PRO60 BAAB BAAC Subtotal: 1 0 1 4 1 5 5 1 6 0 0 0 0 0 0 0 0 0 RET 0 0 0 1 0 1 2 5 7 5 0 5 FU BAAB BAAC BCCA Subtotal: 1 1 1 3 0 0 0 0 1 1 1 3 0 0 0 0 0 0 0 0 0 0 0 0 NEW AAAA AABS BAAC Subtotal: 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 2 0 0 0 0 1 1 0 2 PRO30 BAAB BAAC Subtotal: 0 0 0 2 1 3 2 1 3 0 0 0 0 0 0 0 0 0 PRO60 BAAB 0 1 1 0 0 0 AAAA BAAB Subtotal: 0 0 0 0 0 0 0 0 0 1 0 1 0 4 4 1 4 5 Provider Total: 3 5 8 3 4 7 5 10 15 8 4 12 BAAB Provider Total: Provider: THOMAS,SCOTT RET Clinic Total: FIGURE 4.4.9.14. SAMPLE OUTPUT REPORT: MONTHLY STATISTICAL REPORT (Sheet 3 of 15) 6-124 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 Ireland Army Community Hospital 20 Nov 1991@2153 Page 4 MONTHLY STATISTICAL REPORT by GROUP From: Oct 1991 To: Oct 1991 Division: IRELAND ACH Department: MEDICINE ================================================================================ Appt MEPRS | COUNT WORKLOAD | NON-COUNT WORKLOAD Type Code | # In # Out Total | # In # Out Total ================================================================================ KJS CLINIC ---------Provider: SMITH,KATHERINE JEAN NEW ABA AEAA BAAB BAAC Subtotal: 0 0 0 0 0 0 0 2 3 5 0 0 2 3 5 1 1 0 0 2 0 0 0 0 0 1 1 0 0 2 Clinic Total: 0 5 5 2 0 2 Department Total: 5 15 20 10 4 14 FIGURE 4.4.9.14. SAMPLE OUTPUT REPORT: MONTHLY STATISTICAL REPORT (Sheet 4 of 15) 6-125 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 Ireland Army Community Hospital 20 Nov 1991@2153 Page 5 MONTHLY STATISTICAL REPORT by GROUP From: Oct 1991 To: Oct 1991 Division: IRELAND ACH Department: PRIMARY CARE & COMM MEDICINE ================================================================================ Appt MEPRS | COUNT WORKLOAD | NON-COUNT WORKLOAD Type Code | # In # Out Total | # In # Out Total ================================================================================ PROCEDURE CLINIC ---------------FU BHAA 0 0 0 2 0 2 NEW AAAA AABS AAEA 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 3 0 0 0 0 1 1 1 3 PRO30 BHAA 0 0 0 0 3 3 PRO60 BHAA 0 0 0 0 4 4 RET AAAA BHAA Subtotal: 0 0 0 0 0 0 0 0 0 1 1 2 0 4 4 1 5 6 Clinic Total: 0 0 0 7 11 18 Subtotal: FIGURE 4.4.9.14. SAMPLE OUTPUT REPORT: MONTHLY STATISTICAL REPORT (Sheet 5 of 15) 6-126 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 Ireland Army Community Hospital 20 Nov 1991@2153 Page 6 MONTHLY STATISTICAL REPORT by GROUP From: Oct 1991 To: Oct 1991 Division: IRELAND ACH Department: PRIMARY CARE & COMM MEDICINE ================================================================================ Appt MEPRS | COUNT WORKLOAD | NON-COUNT WORKLOAD Type Code | # In # Out Total | # In # Out Total ================================================================================ PROCEDURE CLINIC ---------------Provider: HENDERSON,KAREN FU BHAA 0 0 0 0 1 1 NEW BHAA 0 0 0 0 4 4 RET BHAA 0 0 0 0 2 2 0 0 0 0 7 7 BHAA 0 0 0 2 0 2 AAAA AABS AAEA Subtotal: 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 3 0 0 0 0 1 1 1 3 PRO60 BHAA 0 0 0 0 2 2 AAAA BHAA Subtotal: 0 0 0 0 0 0 0 0 0 1 1 2 0 2 2 1 3 4 Provider Total: 0 0 0 7 4 11 Clinic Total: 0 0 0 7 11 18 Department Total: 0 0 0 7 11 18 Division Total: 5 15 20 17 15 32 Group Total: 5 15 20 17 15 32 Provider Total: Provider: TAYLOR,JOHN FU PRO30 RET FIGURE 4.4.9.14. SAMPLE OUTPUT REPORT: MONTHLY STATISTICAL REPORT (Sheet 6 of 15) 6-127 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 Ireland Army Community Hospital 20 Nov 1991@2153 Page 7 MONTHLY STATISTICAL REPORT by GROUP From: Oct 1991 To: Oct 1991 Division: IRELAND ACH Department: MEDICINE ================================================================================ Cat | COUNT WORKLOAD | NON-COUNT WORKLOAD Code Description | # In # Out Total | # In # Out Total ================================================================================ INTERNAL MEDICINE (T) --------------------A11 USA ACTIVE DUTY ENLISTED 5 8 13 4 2 6 A41 USA FAM MBR AD 0 2 2 4 2 6 Clinic Total: 5 10 15 8 4 12 FIGURE 4.4.9.14. SAMPLE OUTPUT REPORT: MONTHLY STATISTICAL REPORT (Sheet 7 of 15) 6-128 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 Ireland Army Community Hospital 20 Nov 1991@2153 Page 8 MONTHLY STATISTICAL REPORT by GROUP From: Oct 1991 To: Oct 1991 Division: IRELAND ACH Department: MEDICINE ================================================================================ Cat | COUNT WORKLOAD | NON-COUNT WORKLOAD Code Description | # In # Out Total | # In # Out Total ================================================================================ KJS CLINIC ---------A11 USA ACTIVE DUTY OFFICER 0 3 3 0 0 0 A31 USA RET LOS OFFICER 0 1 1 0 0 0 A49 USA FAM MBR UNREMAR FRM SPOUSE 0 0 0 1 0 1 F11 USAF ACTIVE DUTY 0 1 1 1 0 1 Clinic Total: 0 5 5 2 0 2 Department Total: 5 15 FIGURE 4.4.9.14. 20 10 4 14 SAMPLE OUTPUT REPORT: MONTHLY STATISTICAL REPORT (Sheet 8 of 15) 6-129 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 Ireland Army Community Hospital 20 Nov 1991@2153 Page 9 MONTHLY STATISTICAL REPORT by GROUP From: Oct 1991 To: Oct 1991 Division: IRELAND ACH Department: PRIMARY CARE & COMM MEDICINE ================================================================================ Cat | COUNT WORKLOAD | NON-COUNT WORKLOAD Code Description | # In # Out Total | # In # Out Total ================================================================================ PROCEDURE CLINIC ---------------A11 USA ACTIVE DUTY ENLISTED 0 0 0 4 9 13 A41 USA FAM MBR AD 0 0 0 3 2 5 Clinic Total: 0 0 0 7 11 18 Department Total: 0 0 0 7 11 18 Division Total: 5 15 20 17 15 32 Group Total: 5 15 20 17 15 32 FIGURE 4.4.9.14. SAMPLE OUTPUT REPORT: MONTHLY STATISTICAL REPORT (Sheet 9 of 15) 6-130 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 Ireland Army Community Hospital 20 Nov 1991@2153 Page 10 MONTHLY STATISTICAL REPORT by GROUP From: Oct 1991 To: Oct 1991 Division: IRELAND ACH Department: MEDICINE ================================================================================ MEPRS | COUNT WORKLOAD | NON-COUNT WORKLOAD Code Description | # In # Out Total | # In # Out Total ================================================================================ INTERNAL MEDICINE (T) --------------------AAAA INTERNAL MEDICINE 0 0 0 3 0 3 AABS CARDIOLOGY - CRI/RESOURCE 0 0 0 2 0 2 AAEA ENDOCRINOLOGY 0 0 0 2 0 2 BAAB INTERNAL MEDICINE CLINIC 2 7 9 1 4 5 BAAC INTERNAL MEDICINE CLINIC 2 3 5 0 0 0 BCCA OBSTETRICS CLINIC 1 0 1 0 0 0 Clinic Total: 5 10 15 8 4 12 KJS CLINIC ---------ABA GENERAL SURGERY AEAA ORTHOPEDICS BAAB INTERNAL MEDICINE CLINIC BAAC INTERNAL MEDICINE CLINIC Clinic Total: 0 0 0 0 0 0 0 2 3 5 0 0 2 3 5 1 1 0 0 2 0 0 0 0 0 1 1 0 0 2 Department Total: 5 15 20 10 4 14 FIGURE 4.4.9.14. SAMPLE OUTPUT REPORT: MONTHLY STATISTICAL REPORT (Sheet 10 of 15) 6-131 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 Ireland Army Community Hospital 20 Nov 1991@2153 Page 11 MONTHLY STATISTICAL REPORT by GROUP From: Oct 1991 To: Oct 1991 Division: IRELAND ACH Department: PRIMARY CARE & COMM MEDICINE ================================================================================ MEPRS | COUNT WORKLOAD | NON-COUNT WORKLOAD Code Description | # In # Out Total | # In # Out Total ================================================================================ PROCEDURE CLINIC ---------------AAAA INTERNAL MEDICINE 0 0 0 2 0 2 AABS CARDIOLOGY - CRI/RESOURCE 0 0 0 1 0 1 AAEA ENDOCRINOLOGY 0 0 0 1 0 1 BHAA PRIMARY CARE GENERAL MED 0 0 0 3 11 14 Clinic Total: 0 0 0 7 11 18 Department Total: 0 0 0 7 11 18 Division Total: 5 15 20 17 15 32 Group Total: 5 15 20 17 15 32 FIGURE 4.4.9.14. SAMPLE OUTPUT REPORT: MONTHLY STATISTICAL REPORT (Sheet 11 of 15) 6-132 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 Ireland Army Community Hospital 20 Nov 1991@2153 Page 12 MONTHLY STATISTICAL REPORT by GROUP From: Oct 1991 To: Oct 1991 ================================================================================ Department/ | COUNT WORKLOAD | NON-COUNT WORKLOAD Clinic | # In # Out Total | # In # Out Total ================================================================================ ***DIVISION SUMMARY*** IRELAND ACH Department: MEDICINE -------------------INTERNAL MEDICINE (T) KJS CLINIC Department Total: 5 0 5 10 5 15 15 5 20 8 2 10 4 0 4 12 2 14 Department: PRIMARY CARE & COMM MEDICINE ---------------------------------------PROCEDURE CLINIC 0 0 0 7 11 18 Group Total: 5 15 20 17 15 32 FIGURE 4.4.9.14. SAMPLE OUTPUT REPORT: MONTHLY STATISTICAL REPORT (Sheet 12 of 15) 6-133 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 Ireland Army Community Hospital 20 Nov 1991@2153 Page 13 MONTHLY STATISTICAL REPORT by GROUP From: Oct 1991 To: Oct 1991 ================================================================================ Cat | COUNT WORKLOAD | NON-COUNT WORKLOAD Code Description | # In # Out Total | # In # Out Total ================================================================================ ***DIVISION SUMMARY*** Division: IRELAND ACH --------------------A11 USA ACTIVE DUTY ENLISTED A31 USA RET LOS OFFICER A41 USA FAM MBR AD A49 USA FAM MBR UNREMAR FRM SPOUSE F11 USAF ACTIVE DUTY Division Total: 5 0 0 0 0 5 11 1 2 0 1 15 16 1 2 0 1 20 8 0 7 1 1 17 11 0 4 0 0 15 19 0 11 1 1 32 Group Total: 5 15 20 17 15 32 FIGURE 4.4.9.14. SAMPLE OUTPUT REPORT: MONTHLY STATISTICAL REPORT (Sheet 13 of 15) 6-134 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 Ireland Army Community Hospital 20 Nov 1991@2153 Page 14 MONTHLY STATISTICAL REPORT by GROUP From: Oct 1991 To: Oct 1991 ================================================================================ MEPRS | COUNT WORKLOAD | NON-COUNT WORKLOAD Code Description | # In # Out Total | # In # Out Total ================================================================================ ***DIVISION SUMMARY*** Division: IRELAND ACH --------------------AAAA INTERNAL MEDICINE AABS CARDIOLOGY - CRI/RESOURCE AAEA ENDOCRINOLOGY ABA GENERAL SURGERY AEAA ORTHOPEDICS BAAB INTERNAL MEDICINE CLINIC BAAC INTERNAL MEDICINE CLINIC BCCA OBSTETRICS CLINIC BHAA PRIMARY CARE GENERAL MED Division Total: 0 0 0 0 0 2 2 1 0 5 0 0 0 0 0 9 6 0 0 15 0 0 0 0 0 11 8 1 0 20 5 3 3 1 1 1 0 0 3 17 0 0 0 0 0 4 0 0 11 15 5 3 3 1 1 5 0 0 14 32 Group Total: 5 15 20 17 15 32 FIGURE 4.4.9.14. SAMPLE OUTPUT REPORT: MONTHLY STATISTICAL REPORT (Sheet 14 of 15) 6-135 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 Ireland Army Community Hospital 20 Nov 1991@2153 Page 15 MONTHLY STATISTICAL REPORT by GROUP From: Oct 1991 To: Oct 1991 ================================================================================ | COUNT WORKLOAD | NON-COUNT WORKLOAD TOTALS | # In # Out Total | # In # Out Total ================================================================================ ***DIVISION SUMMARY*** Division: IRELAND ACH --------------------MEDICINE PRIMARY CARE & COMM MEDICINE Division Total: 5 0 5 15 0 15 20 0 20 10 7 17 4 11 15 14 18 32 Group Total: 5 15 20 17 15 32 FIGURE 4.4.9.14. SAMPLE OUTPUT REPORT: MONTHLY STATISTICAL REPORT (Sheet 15 of 15) 6-136 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 Ireland Army Community Hospital 22 Mar 1992@1618 Page 1 NEXT AVAILABLE APPOINTMENT by All Facility Division: IRELAND ACH DEPT: MEDICINE Clinic by Provider ========================================================================================= Clinic Provider Appt Type Date ========================================================================================= DERMATOLOGY CLINIC BLACK,MARGARET SC WARTS 29 Mar 1992 29 Mar 1992 ECHO HOLT 23 Mar 1992 26 Mar 1992 F/UP NEW 30 Mar 1992 28 Mar 1992 CELL CHOL DAPT F/UP NEW 26 02 30 23 28 Apr Apr Mar Mar Mar 1992 1992 1992 1992 1992 DAPT ESTT F/UP FLEX THAL 30 29 30 16 25 Mar Mar Mar Apr Apr 1992 1992 1992 1992 1992 BROADHURST,AVERY M ROUT SIG 04 Apr 1992 26 Mar 1992 JONES,MICHAEL K DAPT ESTT F/UP THAL 27 26 06 24 SOUTHERLAND,WILLIAM ESTT ROUT 23 Mar 1992 26 Mar 1992 ELECTROCARDIOGRAPH ROBINSON,ROY HEALTH MAINTENANCE CLINIC DUGAN,JAMES B NAPIER,GEORGE INTERNAL MEDICINE BILLINGS,JOSEPH C FIGURE 4.4.9.15. Mar Mar Apr Apr 1992 1992 1992 1992 SAMPLE OUTPUT REPORT: NEXT AVAILABLE APPOINTMENT REPORT (Sheet 1 of 2) 6-137 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 Ireland Army Community Hospital 22 Mar 1992@1618 Page 15 NEXT AVAILABLE APPOINTMENT by All Facility Division: IRELAND ACH DEPT: MEDICINE ***DIVISION SUMMARY*** ========================================================================================= Clinic Appt Type Date ========================================================================================= DERMATOLOGY CLINIC SC WARTS 29 Mar 1992 29 Mar 1992 ECHO HOLT 23 Mar 1992 26 Mar 1992 CELL CHOL DAPT F/UP NEW 26 02 30 23 28 Apr Apr Mar Mar Mar 1992 1992 1992 1992 1992 DAPT ESTT F/UP FLEX ROUT SIG THAL 27 23 30 10 26 26 28 Mar Mar Mar Apr Mar Mar Mar 1992 1992 1992 1992 1992 1992 1992 ELECTROCARDIOGRAPH HEALTH MAINTENANCE CLINIC INTERNAL MEDICINE FIGURE 4.4.9.15. SAMPLE OUTPUT REPORT: NEXT AVAILABLE APPOINTMENT REPORT (Sheet 2 of 2) 6-138 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 14 Jul 1992@0108 Page 1 NO-SHOW STATISTICAL REPORT by GROUP From: Jun 1992 To: Jun 1992 Division: TRIPLER ARMY MEDICAL CENTER Department: MEDICINE ================================================================================ Clinic/ COUNT WORKLOAD NON-COUNT WORKLOAD Provider #Visits #NoShow %NoShow #Trans #NoShow %NoShow ================================================================================ ALLERGY CLINIC -------------JONES,DONALD 47 6 11.3 19 5 20.8 SMITH,JOHN 36 4 10.0 25 5 16.6 Clinic Total: 83 10 10.7 44 10 18.5 DERMATOLOGY CLINIC -----------------JONES,FRED SMITH,JILL Clinic Total: Department Total: 47 36 83 3 4 7 6.0 10.0 7.7 19 25 44 2 3 5 9.5 10.7 10.2 166 17 9.2 88 15 14.5 NOTE: The #Visits = the number of count clinic visits (Kept Appts and Unscheduled Visits). The #Trans = the number of non-count transactions (Kept Appts, Unscheduled Visits, and Occasions of Service). The %NoShow = the number of no-shows divided by the #Visits (or #Trans) plus the number of no-shows. FIGURE 4.4.9.16. SAMPLE OUTPUT REPORT: NO-SHOW STATISTICAL REPORT (Sheet 1 of 5) 6-139 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 14 Jul 1992@0108 Page 2 NO-SHOW STATISTICAL REPORT by GROUP From: Jun 1992 To: Jun 1992 Division: TRIPLER ARMY MEDICAL CENTER (continued) Department: SURGICAL ================================================================================ Clinic/ COUNT WORKLOAD NON-COUNT WORKLOAD Provider #Visits #NoShow %NoShow #Trans #NoShow %NoShow ================================================================================ GENERAL SURGERY CLINIC ---------------------ALBERTSON,SAM 47 6 11.3 19 5 20.8 SAMSON,JOHN 36 4 10.0 25 5 16.6 Clinic Total: 83 10 10.7 44 10 18.5 UROLOGY CLINIC -------------JONES,SAM TANNER,DAN Clinic Total: 47 36 83 3 4 7 6.0 10.0 7.7 19 25 44 2 3 5 9.5 10.7 10.2 Department Total: 166 17 9.2 88 15 14.5 Division Total: 332 34 9.2 176 30 14.5 NOTE: The #Visits = the number of count clinic visits (Kept Appts and Unscheduled Visits). The #Trans = the number of non-count transactions (Kept Appts, Unscheduled Visits, and Occasions of Service). The %NoShow = the number of no-shows divided by the #Visits (or #Trans) plus the number of no-shows. FIGURE 4.4.9.16. SAMPLE OUTPUT REPORT: NO-SHOW STATISTICAL REPORT (Sheet 2 of 5) 6-140 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 14 Jul 1992@0108 Page 3 NO-SHOW STATISTICAL REPORT by GROUP From: Jun 1992 To: Jun 1992 Division: TRIPLER ARMY MEDICAL CENTER ================================================================================ Department/ COUNT WORKLOAD NON-COUNT WORKLOAD Clinic #Visits #NoShow %NoShow #Trans #NoShow %NoShow ================================================================================ ***Division Summary*** MEDICINE -------ALLERGY CLINIC DERMATOLOGY CLINIC Department Total: 83 83 166 10 7 17 10.7 7.7 9.2 44 44 88 10 5 15 18.5 10.2 14.5 SURGERY ------GENERAL SURGERY CLINIC UROLOGY CLINIC Department Total: 83 83 166 10 7 17 10.7 7.7 9.2 44 44 88 10 5 15 18.5 10.2 14.5 Division Total: 332 34 9.2 176 30 14.5 NOTE: The #Visits = the number of count clinic visits (Kept Appts and Unscheduled Visits). The #Trans = the number of non-count transactions (Kept Appts, Unscheduled Visits, and Occasions of Service). The %NoShow = the number of no-shows divided by the #Visits (or #Trans) plus the number of no-shows. FIGURE 4.4.9.16. SAMPLE OUTPUT REPORT: NO-SHOW STATISTICAL REPORT (Sheet 3 of 5) 6-141 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 14 Jul 1992@0108 Page 4 NO-SHOW STATISTICAL REPORT by GROUP From: Jun 1992 To: Jun 1992 Division: TRIPLER AMC ================================================================================ Division/ COUNT WORKLOAD NON-COUNT WORKLOAD Department #Visits #NoShow %NoShow #Trans #NoShow %NoShow ================================================================================ ***Group Summary*** TRIPLER ARMY MEDICAL CENTER --------------------------MEDICINE SURGERY Division Total: 166 166 332 17 17 34 9.2 9.2 9.2 88 88 176 15 15 30 14.5 14.5 14.5 Group Total: 332 34 9.2 176 30 14.5 NOTE: The #Visits = the number of count clinic visits (Kept Appts and Unscheduled Visits). The #Trans = the number of non-count transactions (Kept Appts, Unscheduled Visits, and Occasions of Service). The %NoShow = the number of no-shows divided by the #Visits (or #Trans) plus the number of no-shows. FIGURE 4.4.9.16. SAMPLE OUTPUT REPORT: NO-SHOW STATISTICAL REPORT (Sheet 4 of 5) 6-142 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 14 Jul 1992@0108 Page 5 Personal Data - Privacy Act of 1974 (PL 93-579) NO-SHOW STATISTICAL REPORT by GROUP From: Jun 1992 To: Jun 1992 Division: TRIPLER ARMY MEDICAL CENTER ================================================================================ COUNT WORKLOAD NON-COUNT WORKLOAD FMP/SSN NAME #Visits #NoShow #Trans #NoShow ================================================================================ ***Patient Summary*** 02/002-56-5521 20/003-54-6815 30/003-54-6815 20/004-70-3756 20/006-52-8659 01/006-64-2483 20/007-74-8525 20/008-62-1836 30/016-54-9359 20/019-58-1490 30/020-48-0153 02/024-50-3206 20/026-58-3613 30/026-58-3613 20/030-64-0834 ~ ~ ~ ~ 30/593-09-4034 20/601-16-9162 BARNABE,SARAH-ROSE A. DELAVAN,HARRY EDWARD DELAVAN,CATHIE S LUJAN,GENEVIEVE S SCHLOSSBACH,DONALD R LUNA,AARON J JR HOMAN,KEVAN OLSON,WILLIAM F JR STOREY,LISA D DELPY,JOHN GRAY,ANNETTE MATKIN,ALISE M JOHNSON,ROBERT D JOHNSON,ELAINE R TRAVIS,SCOTT ~ ~ ~ ~ WENDELL,RANDY YATES,JAMES B 2 3 6 2 1 3 11 4 5 2 4 5 14 8 5 1 1 1 1 1 1 1 1 1 1 1 1 2 1 1 3 1 2 0 1 4 5 4 0 1 5 0 6 3 2 0 1 1 0 0 2 0 2 0 0 4 0 1 1 2 1 1 1 1 2 0 1 0 Division Total: 154 34 90 30 Group Total: 154 34 90 30 No-Show Patient Count: Total Number of Different Patients Seen: Total Clinic Visits: Total Transactions: 23 169 332 176 FIGURE 4.4.9.16. SAMPLE OUTPUT REPORT: NO-SHOW STATISTICAL REPORT (Sheet 5 of 5) 6-143 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 11 Patient Registration Count Wednesday 06 Jun 1992 Page 1 ================================================================================ Patient Category Code Name Count ================================================================================ 000 A11 A11 A13 A31 A41 F11 K51 K53 K64 K65 K67 K68 K69 K72 K82 K84 K91 K92 K99 M11 N11 N41 N49 P49 USA DECEASED SPONSOR USA ACTIVE DUTY ENLISTED USA ACTIVE DUTY OFFICER USA AD RECRUIT USA RET LOS ENLISTED USA FAM MBR AD USAF ACTIVE DUTY STATE DEPT EMPLOYEE - OUTSIDE US HHS DEPT EMPLOYEE OTHER FEDERAL AGENCY/DEPT US CIV EMPL OF CONTRCTR - PHYS EXAM AMERICAN INDIAN, ALEUT, ESKIMO AMERICAN SAMOAN CITIZEN FAM MBR US CIV RTN POW-FMR SVC MBR NATO MILITARY ARMY SECT DESIGNEE (FMR PAY) AIR FORCE SECT DESIGNEE (FRR PAY) CIVILIAN - HUMANITARIAN EMERGENCY CARE PATIENT NOT OTHERWISE CLASSIFIED USMC ACTIVE DUTY USN ACTIVE DUTY USN FAM MBR AD USN FAM MBR UNREMAR FRM SPOUSE USPHS FAM MBR UNREMAR FRM SPOUSE 3 11 11 2 1 4 7 1 1 1 1 4 1 9 3 2 5 2 1 5 3 5 5 1 2 FACILITY Total 91 FIGURE 4.4.9.17. SAMPLE OUTPUT REPORT: 6-144 PATIENT REGISTRATION REPORT SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 11 Personal Data - Privacy Act of 1974 (PL 93-579) PRIMARY PROVIDER REPORT 10 Jul 1992 ================================================================================================================================== Primary Provider FMP/SSN Name Age Sex Cat GR Home Phone Work/Duty Phone Duty Code ================================================================================================================================== Clinic: BURN CLINIC AXELROD,ELLIOT 20/222-44-4454 20/507-69-6969 Provider Total= 2 DEPARTMENT: INTERNAL MEDICINE AABEL,JOHN BREWER,STEVE 39 24 M M A11 K69 A03 H:302-653-5689 H:212-212-4155 DIVISION: TRIPLER ARMY MEDICAL W:302-555-1212 W:818-919-2000 Clinic Total= 2 FIGURE 4.4.9.18. SAMPLE OUTPUT REPORT: 6-145 PRIMARY PROVIDER REPORT 124TH TC BN 1200 PSI MI SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 10 Jul 1992@1604 Page 1 Personal Data - Privacy Act of 1974 (PL 93-579) SCHEDULE DEFICIENCY MONITOR by ALL FACILITY 10 Jul 1992@1604 DIVISION: BARBERS POINT Department: MEDICINE ================================================================================ Clinic/ Required Days Schedule Provider Days Deficient Status ================================================================================ ALLERGY BENSON,JACK 30 0 Open thru 25 Sep 1992 NUTRITION BARRON-BERMANT,JANE 30 30 **CREATE SCHEDULES** WELL BABY CLINIC BENSON,JACK SEAY,ROBERT MCDONALD,BECKY 45 45 45 45 45 12 **CREATE SCHEDULES** **CREATE SCHEDULES Open thru 25 Sep 1992 FIGURE 4.4.9.19. SAMPLE OUTPUT REPORT: SCHEDULE DEFICIENCY MONITOR REPORT (Sheet 1 of 6) 6-146 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 10 Jul 1992@1604 Page 2 Personal Data - Privacy Act of 1974 (PL 93-579) SCHEDULE DEFICIENCY MONITOR by ALL FACILITY 10 Jul 1992@1604 DIVISION: HICKAM Department: SURGERY ================================================================================ Clinic/ Required Days Schedule Provider Days Deficient Status ================================================================================ PLASTIC SURGERY PETERSON,FRANK PHILLIPS,JOE PORTER,RANDY POTTS,GERALD PINCER,FRED 10 10 10 10 10 0 10 30 30 3 Open thru 13 Sep 1992 NO OPEN SCHEDULES **CREATE SCHEDULES** **CREATE SCHEDULES** Open thru 30 Aug 1992 GENERAL SURGERY SEAY,ROBERT SALEHI,DARIUSH BARRON-BERMANT,JANE 30 30 30 30 0 30 NO OPEN SCHEDULES Open thru 10 Oct 1992 NO OPEN SCHEDULES FIGURE 4.4.9.19. SAMPLE OUTPUT REPORT: SCHEDULE DEFICIENCY MONITOR REPORT (Sheet 2 of 6) 6-147 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 10 Jul 1992@1604 Page 3 Personal Data - Privacy Act of 1974 (PL 93-579) SCHEDULE DEFICIENCY MONITOR by ALL FACILITY 10 Jul 1992@1604 DIVISION: HICKAM (continued) Department: PRIMARY CARE & COMM MEDICINE ================================================================================ Clinic/ Required Days Schedule Provider Days Deficient Status ================================================================================ CARDIOLOGY CLINIC BENSON,CONNIE BENSON,JACK SEAY,ROBERT HERBERT,SAM HAMMER,MARK DUEBBERT,CAROL SANTOS,MERVYN MCDONALD,BECKY BARRON-BERMANT,JANE 14 14 14 14 14 14 14 14 14 FIGURE 4.4.9.19. 30 14 0 14 14 30 14 0 14 **CREATE SCHEDULES** NO OPEN SCHEDULES Open thru 08 Nov 1992 NO OPEN SCHEDULES NO OPEN SCHEDULES **CREATE SCHEDULES** NO OPEN SCHEDULES Open thru 07 Sep 1992 NO OPEN SCHEDULES SAMPLE OUTPUT REPORT: SCHEDULE DEFICIENCY MONITOR REPORT (Sheet 3 of 6) 6-148 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 10 Jul 1992@1604 Page 4 Personal Data - Privacy Act of 1974 (PL 93-579) SCHEDULE DEFICIENCY MONITOR by ALL FACILITY 10 Jul 1992@1604 DIVISION: SCHOFIELD BARRACKS Department: MEDICINE ================================================================================ Clinic/ Required Days Schedule Provider Days Deficient Status ================================================================================ INTERNAL MEDICINE ANDREWS,CAROL BROWN,MARK WHITEMAN,JOHN R NEWSOME,ROBERT MCDONALD,BECKY 5 5 5 5 5 30 5 30 30 5 **CREATE SCHEDULES** NO OPEN SCHEDULES **CREATE SCHEDULES** **CREATE SCHEDULES** NO OPEN SCHEDULES NEUROLOGY CLINIC WHITEMAN,JOHN R BENSON,JACK ROY,IMA 1 1 1 30 1 30 **CREATE SCHEDULES** NO OPEN SCHEDULES **CREATE SCHEDULES** OPHTHALMOLOGY CLINIC OLSON,SCOTT OAKS,TERRY 42 42 30 30 **CREATE SCHEDULES** **CREATE SCHEDULES** PRIMARY CARE BENSON,JACK 1 1 NO OPEN SCHEDULES FIGURE 4.4.9.19. SAMPLE OUTPUT REPORT: SCHEDULE DEFICIENCY MONITOR REPORT (Sheet 4 of 6) 6-149 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 10 Jul 1992@1604 Page 5 Personal Data - Privacy Act of 1974 (PL 93-579) SCHEDULE DEFICIENCY MONITOR by ALL FACILITY 10 Jul 1992@1604 DIVISION: TRIPLER ARMY MEDICAL CENTER Department: NUTRITION CARE ================================================================================ Clinic/ Required Days Schedule Provider Days Deficient Status ================================================================================ NUTRITION CLINIC BLEVINS,VICKIE BLALOCK,THEODORE BLOUNT,MATTHEW BLAZON,MARK HSU,DONNA MILLER,JIM WONG,DOREEN 30 30 30 30 30 30 30 FIGURE 4.4.9.19. 30 30 30 30 30 30 30 **CREATE SCHEDULES** **CREATE SCHEDULES** **CREATE SCHEDULES** **CREATE SCHEDULES** **CREATE SCHEDULES** **CREATE SCHEDULES** NO OPEN SCHEDULES SAMPLE OUTPUT REPORT: SCHEDULE DEFICIENCY MONITOR REPORT (Sheet 5 of 6) 6-150 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 10 Jul 1992@1604 Page 6 Personal Data - Privacy Act of 1974 (PL 93-579) SCHEDULE DEFICIENCY MONITOR by ALL FACILITY 10 Jul 1992@1604 DIVISION: TRIPLER ARMY MEDICAL CENTER (continued) Department: RADIOLOGY ================================================================================ Clinic/ Required Days Schedule Provider Days Deficient Status ================================================================================ CANCER CLINIC BENSON,JACK MCDONALD,PAM 30 30 30 0 NO OPEN SCHEDULES Open thru 09 Oct 1991 Mailman reminder notice sent to SDSMGR Mail Group! FIGURE 4.4.9.19. SAMPLE OUTPUT REPORT: SCHEDULE DEFICIENCY MONITOR REPORT (Sheet 6 of 6) 6-151 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 IRELAND ACH, NY 23 Aug 1989@1505 Page 1 Personal Data - Privacy Act 1974 (PL 93-579) TRACKABLE ENTITY REPORT Thru: 23 Aug 1989 Division: IRELAND Dept: MEDICINE -------------------------------------------------------------------------------DATE ER LOG # PATIENT NAME FMP/SSN HOME PHONE WORK PHONE -------------------------------------------------------------------------------TRACKABLE ENTITY: WHEELCHAIR BORROWED CLINIC: WELL BABY CLINIC 19 Jun 1989@0800 ABLE,BOB 475-8675 FIGURE 4.4.9.20. 20/500-55-5555 SAMPLE OUTPUT REPORT: (Sheet 1 of 5) 6-152 TRACKABLE ENTITY REPORT SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 IRELAND ACH, NY 23 Aug 1989@1505 Page 2 Personal Data - Privacy Act 1974 (PL 93-579) TRACKABLE ENTITY REPORT Thru: 23 Aug 1989 Division: IRELAND Dept: PRIMARY CARE & COMM MEDICINE -------------------------------------------------------------------------------DATE ER LOG # PATIENT NAME FMP/SSN HOME PHONE WORK PHONE -------------------------------------------------------------------------------TRACKABLE ENTITY: WHEELCHAIR BORROWED CLINIC: CARDIOLOGY CLINIC 22 Jul 1989@1105 890722-00002 TOLEDO,SUE FIGURE 4.4.9.20. 39/381-55-9491 SAMPLE OUTPUT REPORT: (Sheet 2 of 5) 6-153 TRACKABLE ENTITY REPORT SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 IRELAND ACH, NY 23 Aug 1989@1505 Page 3 Personal Data - Privacy Act 1974 (PL 93-579) TRACKABLE ENTITY REPORT Thru: 23 Aug 1989 Division: IRELAND Dept: PRIMARY CARE & COMM MEDICINE -------------------------------------------------------------------------------DATE ER LOG # PATIENT NAME FMP/SSN HOME PHONE WORK PHONE -------------------------------------------------------------------------------TRACKABLE ENTITY: CANE BORROWED FROM ER CLINIC: CARDIOLOGY CLINIC 27 Jun 1989@1704 890627-00002 SANTOS,MERVYN 619-277-7209 13 Jul 1989@1119 890713-00001 MAE,CAROLE 20/234-12-9876 619-535-7641 01/003-58-9999 22 Jul 1989@0900 890722-00004 ANDERSON,BETTY 20/003-25-9999 27 Jul 1989@0800 890727-00001 02/140-22-1805 03 Aug 1989@0838 890803-00003 SMITH,DALE 619-323-9054 ANDERSON,BETTY FIGURE 4.4.9.20. 20/003-25-9999 SAMPLE OUTPUT REPORT: (Sheet 3 of 5) 6-154 TRACKABLE ENTITY REPORT SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 IRELAND ACH, NY 23 Aug 1989@1505 Page 4 Personal Data - Privacy Act 1974 (PL 93-579) TRACKABLE ENTITY REPORT Thru: 23 Aug 1989 Division: IRELAND Dept: PRIMARY CARE & COMM MEDICINE -------------------------------------------------------------------------------DATE ER LOG # PATIENT NAME FMP/SSN HOME PHONE WORK PHONE -------------------------------------------------------------------------------TRACKABLE ENTITY: CRUTCHES BORROWED FROM ER CLINIC: CARDIOLOGY CLINIC 27 Jun 1989@1704 890627-00002 SANTOS,MERVYN 619-277-7209 03 Aug 1989@0838 890803-00003 ANDERSON,BETTY 20/234-12-9876 619-535-7641 20/003-25-9999 08 Aug 1989@0801 890808-00001 CARRERA,SUSANNA 04/381-55-9491 09 Aug 1989@1126 890809-00001 SANCHEZ,JULIO 20/098-98-9876 FIGURE 4.4.9.20. SAMPLE OUTPUT REPORT: (Sheet 4 of 5) 6-155 TRACKABLE ENTITY REPORT SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 IRELAND ACH, NY 23 Aug 1989@1505 Page 5 Personal Data - Privacy Act 1974 (PL 93-579) TRACKABLE ENTITY REPORT Thru: 23 Aug 1989 Division: IRELAND Dept: PRIMARY CARE & COMM MEDICINE -------------------------------------------------------------------------------DATE ER LOG # PATIENT NAME FMP/SSN HOME PHONE WORK PHONE -------------------------------------------------------------------------------TRACKABLE ENTITY: WHEELCHAIR BORROWED CLINIC: CARDIOLOGY CLINIC 27 Jun 1989@1704 890627-00002 SANTOS,MERVYN 619-277-7209 22 Jul 1989@0900 890722-00004 ANDERSON,BETTY 20/234-12-9876 619-535-7641 20/003-25-9999 03 Aug 1989@0838 20/003-25-9999 890803-00003 ANDERSON,BETTY FIGURE 4.4.9.20. SAMPLE OUTPUT REPORT: (Sheet 5 of 5) 6-156 TRACKABLE ENTITY REPORT SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 Ireland Army Community Hospital 20 Aug 1990@1421 Page 1 Personal Data - Privacy Act 1974 (PL 93-579) WAIT LIST MANAGEMENT REPORT BY ALL BY PRIORITY From: FIRST Thru: LAST Division: IRELAND Department: MEDICINE =================================================================================== Patient FMP/SSN Prio Type Date-In Target Wait List# Provider Home Phone Work Phone =================================================================================== Clinic: ALLERGY (I) Provider: *Provider Not Entered* MCDONALD,ROBERT TEST,BOB LABERGE,CHUCK LABERGE,CHUCK NEWBERN,JOHN 20/502900909 H:218-281-5671 20/444556767 H: 10/003558047 H: 10/003558047 H: 20/492443008 6 6 6 6 6 NEW 18May90 W:218-773-2198 RET 21Jul90 W: NEW 02Aug90 W: NEW 03Aug90 W: NEW 14Aug90 16Jun90 15.00000079 22Jul90 15.00001506 03Aug90 15.00002236 04Aug90 15.00002250 15Aug90 15.00002550 NEW W: NEW W: RET W: NEW W: NEW W: NEW W: NEW W: NEW W: NEW W: NEW W: 24May90 12Sep90 15.00000249 16Aug90 17Aug90 15.00002624 21Jul90 22Jul90 15.00001508 02Aug90 03Aug90 15.00002233 02Aug90 03Aug90 15.00002238 03Aug90 04Aug90 15.00002240 03Aug90 04Aug90 15.00002241 03Aug90 04Aug90 15.00002244 03Aug90 04Aug90 15.00002245 03Aug90 04Aug90 15.00002246 Provider: BARRON-BERMANT,JANE DE BLASIO,MICHAEL KANE,JEROME WILLIAM LONG,JOSHUA SMITH,JUDY SNOW,JAMES THOMAS,JAMES THOMPSON,RALPH THOMPSON,RUBY WALKER,TOM WILLIAMS,GARY 0 2 4 6 8 = = = = = 20/800520130 H: 20/432234590 H: 01/444443334 H: 20/223440011 H:213-338-1700 20/543446678 H: 20/322516855 H: 20/226994457 H: 20/443556789 H: 20/255443278 H: 20/114332467 H: BY DIRECTION OF COMMANDER ACTIVE DUTY MTF DEFINED NON-ACTIVE DUTY NON MILITARY 1 3 5 7 9 2 2 6 6 6 6 6 6 6 6 = = = = = PROVIDERS ORDERS MFT DEFINED MTF DEFINED MTF DEFINED LONG LEAD TIME FIGURE 4.4.9.21. SAMPLE OUTPUT REPORT: WAIT LIST MANAGEMENT REPORT (Sheet 1 of 5) 6-157 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 Ireland Army Community Hospital 20 Aug 1990@1421 Page 2 Personal Data - Privacy Act 1974 (PL 93-579) WAIT LIST MANAGEMENT REPORT BY ALL BY PRIORITY From: FIRST Thru: LAST Division: IRELAND (continued) Department: MEDICINE (continued) =================================================================================== Patient FMP/SSN Prio Type Date-In Target Wait List# Provider Home Phone Work Phone =================================================================================== Clinic: ALLERGY (I) (continued) Provider: BARRON-BERMANT,JANE (continued) ZUCKER,THADDEUS 20/223440878 H: 6 NEW W: 03Aug90 20/433556777 H: 20/000001001 H:303-342-3432 20/502900909 H:218-281-5671 20/502900909 H:218-281-5671 11/000001001 H: 30/800010101 H: 2 NEW 21Jul90 W: RET 17Aug90 W:303-555-6754 RET 18May90 W:218-773-2198 NEW 21Jul90 W: NEW 17Aug90 W: NEW 17Aug90 W: 04Aug90 15.00002249 22Jul90 15.00001505 18Aug90 15.00002680 27Jul90 15.00000078 22Jul90 15.00001511 18Aug90 15.00002678 18Aug90 15.00002679 Provider: HARMON,TRACEY DAGLAND,CHESTER HAGLUND,CHESTER MCDONALD,ROBERT MCDONALD,ROBERTA HAGLUND,AMY THOMAS,MARY CLINIC TOTALS ============= NEW RET Total: 0 2 4 6 8 = = = = = 2 5 6 6 6 20 4 25 BY DIRECTION OF COMMANDER ACTIVE DUTY MTF DEFINED NON-ACTIVE DUTY NON MILITARY 1 3 5 7 9 = = = = = PROVIDERS ORDERS MFT DEFINED MTF DEFINED MTF DEFINED LONG LEAD TIME FIGURE 4.4.9.21. SAMPLE OUTPUT REPORT: WAIT LIST MANAGEMENT REPORT (Sheet 2 of 5) 6-158 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 Ireland Army Community Hospital 20 Aug 1990@1421 Page 3 Personal Data - Privacy Act 1974 (PL 93-579) WAIT LIST MANAGEMENT REPORT BY ALL BY PRIORITY From: FIRST Thru: LAST Division: IRELAND (continued) Department: MEDICINE (continued) =================================================================================== Patient FMP/SSN Prio Type Date-In Target Wait List# Provider Home Phone Work Phone =================================================================================== Clinic: BURN CLINIC Provider: *Provider Not Entered* TEST,BOB DE BLASIO,MICHAEL DE BLASIO,MICHAEL SANTOS,MERVYN 20/444556767 1 H: 20/800520130 2 H: 20/800520130 2 H: 20/800630922 6 H:(619) 277-7209 NEW 18Jul90 21Jul90 W: NEW 12Jul90 22Jul90 W: NEW 12Jul90 15Jul90 W: NEW 20Jun90 21Jun90 W:(619) 535-7640 20/666885578 H: NEW W: 60.00001389 60.00000992 60.00001004 60.00000751 Provider: BENSON,CONNIE BASSINGER,KIM CLINIC TOTALS ============= NEW Total: 0 2 4 6 8 = = = = = 6 10Jul90 11Jul90 60.00000918 5 5 BY DIRECTION OF COMMANDER ACTIVE DUTY MTF DEFINED NON-ACTIVE DUTY NON MILITARY 1 3 5 7 9 = = = = = PROVIDERS ORDERS MFT DEFINED MTF DEFINED MTF DEFINED LONG LEAD TIME FIGURE 4.4.9.21. SAMPLE OUTPUT REPORT: WAIT LIST MANAGEMENT REPORT (Sheet 3 of 5) 6-159 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 Ireland Army Community Hospital 20 Aug 1990@1421 Page 4 Personal Data - Privacy Act 1974 (PL 93-579) WAIT LIST MANAGEMENT REPORT BY ALL BY PRIORITY From: FIRST Thru: LAST Division: IRELAND (continued) Department: MEDICINE (continued) =================================================================================== Patient FMP/SSN Prio Type Date-In Target Wait List# Provider Home Phone Work Phone =================================================================================== DEPARTMENT TOTALS ================= NEW 26 RET 4 Total: 31 0 2 4 6 8 = = = = = BY DIRECTION OF COMMANDER ACTIVE DUTY MTF DEFINED NON-ACTIVE DUTY NON MILITARY 1 3 5 7 9 = = = = = PROVIDERS ORDERS MFT DEFINED MTF DEFINED MTF DEFINED LONG LEAD TIME FIGURE 4.4.9.21. SAMPLE OUTPUT REPORT: WAIT LIST MANAGEMENT REPORT (Sheet 4 of 5) 6-160 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 Ireland Army Community Hospital 20 Aug 1990@1421 Page 5 Personal Data - Privacy Act 1974 (PL 93-579) WAIT LIST MANAGEMENT REPORT BY ALL BY PRIORITY From: FIRST Thru: LAST Division: IRELAND (continued) =================================================================================== Patient FMP/SSN Prio Type Date-In Target Wait List# Provider Home Phone Work Phone =================================================================================== DIVISION TOTALS =============== NEW 26 RET 4 Total: 31 0 2 4 6 8 = = = = = BY DIRECTION OF COMMANDER ACTIVE DUTY MTF DEFINED NON-ACTIVE DUTY NON MILITARY 1 3 5 7 9 = = = = = PROVIDERS ORDERS MFT DEFINED MTF DEFINED MTF DEFINED LONG LEAD TIME FIGURE 4.4.9.21. SAMPLE OUTPUT REPORT: WAIT LIST MANAGEMENT REPORT (Sheet 5 of 5) 6-161 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 IRELAND ACH, KY 05 May 1990@1345 Page 1 Personal Data - Privacy Act of 1974 (PL 93-579) PROBLEM AVOIDANCE REPORT From 01 May 1990 To 12 May 1990 **** APPOINTMENT ORDERS NOT PROCESSED **** DIVISION: IRELAND DEPARTMENT: MEDICINE ================================================================================================================================== Date Appt Appt Order Clinic/Provider Entered/Order # Date Type FMP/SSN Patient Ward/Outpatient Type ================================================================================================================================== ALLERGY CLINIC SEAY,ROBERT 03May90-00073 05May90 NEW 20/004-40-6345 FISHER,LARRY WARD: 4A CLN 03May90-00076 05May90 RET 20/004-44-4725 SMITH,SAM WARD: 3B CLN 04May90-00048 07May90 RET 20/434-22-3214 BROWN,JIM WARD: 3B CLN THOMAS,EDWARD 03May90-00135 06May90 FU 30/003-45-9217 BARRON,DAPHNE OUTPATIENT CLN CARDIOLOGY CLINIC LEBOW,LESTER DIVISION TOTALS =============== 03 May 1990 04 May 1990 03May90-00034 08May90 RET 20/444-21-7610 ALLERGY CLINIC CARDIOLOGY CLINIC Total: 3 1 4 Request(s) not processed ALLERGY CLINIC Total: 1 1 Request(s) not processed DIVISION TOTAL FOR SPECIFIED DATE RANGE: FIGURE 4.4.9.22. SAMPLE OUTPUT REPORT: HEPBURN,FRANK WARD: 5A 5 PROBLEM AVOIDANCE REPORT (APPOINTMENT ORDERS NOT PROCESSED) (Sheet 1 of 10) 6-162 ANC SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 IRELAND ACH, KY 05 May 1990@1345 Page 2 Personal Data - Privacy Act of 1974 (PL 93-579) PROBLEM AVOIDANCE REPORT From 05 May 1990 To 19 May 1990 **** CANCELLED APPOINTMENT SLOTS **** DIVISION: IRELAND DEPARTMENT: MEDICINE ================================================================================================================================== Clinic/Provider Appt Date Time Type Patient FMP/SSN Reason For Cancellation ================================================================================================================================== ALLERGY CLINIC SEAY,BOB SANTOS,MERVYN WELL BABY CLINIC BARRON,BROOKE ALLERGY CLINIC SEAY,BOB BRACE SHOP JONES,SAM DIVISION TOTALS =============== 07 May 1990 08 May 1990 07May90 07May90 07May90 1300 1330 1400 RET RET NEW FISHER,LAURA LEE,SARA BENSON,FRED 30/444-67-8967 01/234-56-9876 20/123-45-6789 PROV CANCELLED PROV CANCELLED PROV CANCELLED 07May90 0800 NEW BARRON,JON 03/004-44-4725 MEETING 07May90 07May90 07May90 1100 1300 1430 NEW RET RET BISSONNET,DON SHEMS,SANDY ALLEN,JULIE 20/323-33-2321 02/001-21-1992 01/344-69-5108 TDY TDY TDY 08May90 08May90 1300 1330 RET RET FINE,DAVE SANDOVER,GREG 20/343-43-4343 20/424-01-7830 MEETING MEETING 08May90 0900 RET PARKER,CHARLES 20/198-20-3498 PROVIDER CANCELLED ALLERGY CLINIC WELL BABY CLINIC Subtotal: 4 3 7 ALLERGY CLINIC BRACE SHOP Subtotal: 2 1 3 DIVISION TOTAL FOR SPECIFIED DATE RANGE: FIGURE 4.4.9.22. SAMPLE OUTPUT REPORT: 10 PROBLEM AVOIDANCE REPORT (CANCELLED APPOINTMENT SLOTS) (Sheet 2 of 10) 6-163 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 IRELAND ACH, KY 05 May 1990@1345 Page 3 Personal Data - Privacy Act of 1974 (PL 93-579) PROBLEM AVOIDANCE REPORT 05 May 1990 **** FROZEN SLOTS **** DIVISION: IRELAND DEPARTMENT: MEDICINE ================================================================================================================================== Clinic/Provider Appt Date Time Appt Type Reason For Freeze Release Type ================================================================================================================================== '*' next to the appointment type indicates this frozen slot is booked. ALLERGY CLINIC SEAY,BOB (Schedule Hold Duration: 4 Days) 06May90 06May90 06May90 11May90 11May90 1300 1400 1430 1000 1100 *NEW RET *RET *RET *NEW TDY TDY TDY MEETING MEETING AUTO MANUAL AUTO MANUAL MANUAL SANTOS,MERVYN 08May90 08May90 08May90 08May90 1300 1330 1400 1430 RET RET RET RET MEETING MEETING MEETING MEETING MANUAL MANUAL MANUAL MANUAL MCDONALD,BECKY 11May90 12May90 1300 1300 NEW NEW MEETING MEETING MANUAL MANUAL 0900 1000 1030 1100 NEW RET RET RET MEETING TDY TDY TDY MANUAL MANUAL MANUAL MANUAL CARDIOLOGY CLINIC (Schedule Hold Duration: 5 Days) BARRON-BERMANDT,JANE 11May90 12May90 12May90 12May90 PEDIATRICS CLINIC CARARRA,SUSAN WELL BABY CLINIC BARRON,BROOKE (Schedule Hold Duration: 5 Days) 08May90 11May90 (Schedule Hold Duration: 4 Days) 08May90 0900 1300 *MULTI RET COMPUTER CLASSES MEETING MANUAL MANUAL 1100 *MULTI LEAVE MANUAL NOTE: Schedule Hold Duration = the maximum number of days a schedule or slots may remain frozen before being released for appointment booking. FIGURE 4.4.9.22. SAMPLE OUTPUT REPORT: PROBLEM AVOIDANCE REPORT (FROZEN SLOTS) (Sheet 3 of 10) 6-164 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 IRELAND ACH, KY 05 May 1990@1345 Page 4 Personal Data - Privacy Act of 1974 (PL 93-579) PROBLEM AVOIDANCE REPORT 05 May 1990 **** FROZEN SLOTS **** DIVISION: IRELAND DEPARTMENT: MEDICINE ================================================================================================================================== Clinic/Provider Appt Date Time Appt Type Reason For Freeze Release Type ================================================================================================================================== DIVISION TOTALS =============== 06 May 1990 ALLERGY CLINIC Subtotal: 4 4 08 May 1990 ALLERGY CLINIC PEDIATRICS CLINIC WELL BABY CLINIC Subtotal: 4 1 1 6 11 May 1990 ALLERGY CLINIC CARDIOLOGY CLINIC PEDIATRICS CLINIC Subtotal: 3 1 1 5 12 May 1990 ALLERGY CLINIC CARDIOLOGY CLINIC Subtotal: 1 3 4 DIVISION TOTAL FOR SPECIFIED DATE RANGE: FIGURE 4.4.9.22. 19 SAMPLE OUTPUT REPORT: PROBLEM AVOIDANCE REPORT (FROZEN SLOTS) (Sheet 4 of 10) 6-165 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 IRELAND ACH, KY 05 May 1990@1345 Page 5 Personal Data - Privacy Act of 1974 (PL 93-579) PROBLEM AVOIDANCE REPORT 05 May 1990 **** WAIT LIST STATUS **** DIVISION: IRELAND DEPARTMENT: MEDICINE ================================================================================================================================= Clinic/ # Patients On # Wait List # Of Patients On Wait List With Wait List Priority Of Provider Wait List Slots Held 0 1 2 3 4 5 6 7 8 9 ================================================================================================================================= ALLERGY CLINIC SEAY,BOB SANTOS,MERVYN MCDONALD,SAM Subtotal: 36 13 45 94 14 7 10 31 20 10 33 63 WELL BABY CLINIC BARRON,BROOKE BERMANT,JUNE ZIMMERMAN,ROBERT Subtotal: 86 43 24 153 35 20 10 40 78 43 24 145 DIVISION TOTALS ================ ALLERGY CLINIC WELL BABY CLINIC Total: 94 153 247 206 137 343 63 145 208 0 = BY DIRECTION OF COMANDER 4 = MTF DEFINED 8 = MTF DEFINED 1 = PROVIDERS ORDERS 5 = MTF DEFINED 9 = LONG LEAD TIME FIGURE 4.4.9.22. 2 = ACTIVE DUTY 6 = NON-ACTIVE DUTY 16 3 10 29 2 2 6 33 2 6 33 2 12 12 29 33 62 2 2 4 3 = MTF DEFINED 7 = MTF DEFINED SAMPLE OUTPUT REPORT: PROBLEM AVOIDANCE REPORT (WAIT LIST STATUS) (Sheet 5 of 10) 6-166 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 IRELAND ACH, KY 05 May 1990@1345 Page 6 Personal Data - Privacy Act of 1974 (PL 93-579) PROBLEM AVOIDANCE REPORT 01 May 1990 **** SCHEDULE DEFICIENCIES **** DIVISION: IRELAND DEPARTMENT: MEDICINE ================================================================================================================================== Clinic Provider # of Days Deficient ================================================================================================================================== ALLERGY CLINIC CARDIOLOGY (Available Schedule: 14 Days) MCDONALD,BECKY SANTOS,MERVYN SEAY,BOB SMITH,FRED CLINIC WELL BABY CLINIC (Available Schedule: 15 Days) JONES,RON KANE,SHEILA SMITH,DALE SMITH,SAM 11 30 4 30 (Available Schedule: 15 Days) BARRON,BROOKE CLAPTON,ERIN DIVISION TOTALS =============== ALLERGY CLINIC CARDIOLOGY CLINIC WELL BABY CLINIC DIVISION TOTAL: NOTE: 8 10 3 30 1 23 4 4 2 10 Provider(s) Deficient Available Schedule = the minimum number of days schedules are required to be available for Booking Appointments. FIGURE 4.4.9.22. SAMPLE OUTPUT REPORT: PROBLEM AVOIDANCE REPORT (SCHEDULE DEFICIENCIES) (Sheet 6 of 10) 6-167 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 IRELAND ACH, KY 05 May 1990@1345 Page 7 Personal Data - Privacy Act of 1974 (PL 93-579) PROBLEM AVOIDANCE REPORT From 05 Apr 1990 To 05 May 1990 **** OPEN SCHEDULES **** DIVISION: IRELAND DEPARTMENT: MEDICINE ================================================================================================================================== Clinic Provider Schedule Date # of Schedule Slots Not Open ================================================================================================================================== ALLERGY CLINIC MCDONALD,BECKY SANTOS,MERVYN SEAY,BOB SMITH,FRED 05Apr90 06Apr90 07Apr90 01May90 29Apr90 07Apr90 16 20 16 8 16 16 JONES,RON KANE,SHEILA SMITH,DALE SMITH,SAM 05Apr90 03May90 07Apr90 23Apr90 40 10 16 20 CARDIOLOGY CLINIC DIVISION TOTALS =============== 05 Apr 1990 ALLERGY CLINIC CARDIOLOGY CLINIC Subtotal: 16 40 56 06 Apr 1990 ALLERGY CLINIC Subtotal: 20 20 07 Apr 1990 ALLERGY CLINIC CARDIOLOGY CLINIC Subtotal: 32 16 48 23 Apr 1990 CARDIOLOGY CLINIC Subtotal: 20 20 29 Apr 1990 ALLERGY CLINIC Subtotal: 16 16 01 May 1990 ALLERGY CLINIC Subtotal: 8 8 03 May 1990 CARDIOLOGY CLINIC Subtotal: 10 10 DIVISION TOTAL FOR SPECIFIED DATE RANGE: FIGURE 4.4.9.22. 178 SAMPLE OUTPUT REPORT: PROBLEM AVOIDANCE REPORT (OPEN SCHEDULES) (Sheet 7 of 10) 6-168 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 IRELAND ACH, KY 05 May 1990@1345 Page 8 Personal Data - Privacy Act of 1974 (PL 93-579) PROBLEM AVOIDANCE REPORT From 05 Apr 1990 To 05 May 1990 **** Pending Appointments and Missing Providers Status **** DIVISION: IRELAND DEPARTMENT: MEDICINE ================================================================================================================================== Clinic/Provider Appointment Date # of Pending Appointments # of Missing Providers ================================================================================================================================== ALLERGY CLINIC *PROVIDER NOT ENTERED* 22Apr90 2 SEAY,BOB 08Apr90 22Apr90 03May90 4 3 6 SANTOS,MERVYN 06Apr90 03May90 04May90 2 6 4 06Apr90 15Apr90 03May90 4 1 1 22Apr90 27Apr90 03May90 7 6 2 15Apr90 1 03May90 5 CARDIOLOGY CLINIC BARRON-BERMANT,JANE PEDIATRICS CLINIC CARARRA,SUSAN WELL BABY CLINIC *PROVIDER NOT ENTERED* BARRON,BROOKE DIVISION TOTALS =============== 06 Apr 1990 ALLERGY CLINIC CARDIOLOGY CLINIC Subtotal: 2 4 6 08 Apr 1990 ALLERGY CLINIC Subtotal: 4 4 15 Apr 1990 CARDIOLOGY CLINIC WELL BABY CLINIC Subtotal: 1 1 2 FIGURE 4.4.9.22. 2 1 1 SAMPLE OUTPUT REPORT: PROBLEM AVOIDANCE REPORT (PENDING APPOINTMENT STATUS) (Sheet 8 of 10) 6-169 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 IRELAND ACH, KY 05 May 1990@1345 Page 9 Personal Data - Privacy Act of 1974 (PL 93-579) PROBLEM AVOIDANCE REPORT From 05 Apr 1990 To 05 May 1990 **** Pending Appointments and Missing Providers Status **** DIVISION: IRELAND DEPARTMENT: MEDICINE ================================================================================================================================== Clinic/Provider Appointment Date # of Pending Appointments # of Missing Providers ================================================================================================================================== DIVISION TOTALS =============== 22 Apr 1990 ALLERGY CLINIC PEDIATRICS CLINIC Subtotal: 5 7 12 27 Apr 1990 PEDIATRICS CLINIC Subtotal: 6 6 03 May 1990 ALLERGY CLINIC CARDIOLOGY CLINIC PEDIATRICS CLINIC WELL BABY CLINIC Subtotal: 12 1 2 5 20 04 May 1990 ALLERGY CLINIC Subtotal: 4 4 DIVISION TOTAL FOR SPECIFIED DATE RANGE: FIGURE 4.4.9.22. SAMPLE OUTPUT REPORT: 54 PROBLEM AVOIDANCE REPORT (PENDING APPOINTMENT STATUS) (Sheet 9 of 10) 6-170 2 3 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 IRELAND ACH, KY 05 May 1990@1345 Page 10 Personal Data - Privacy Act of 1974 (PL 93-579) PROBLEM AVOIDANCE REPORT 05 May 1990 **** WAIT LIST MAILER NO-SHOWS**** DIVISION: IRELAND DEPARTMENT: MEDICINE ================================================================================================================================== Clinic/Provider Appt Date Time Type Patient FMP/SSN Wait List Comment ================================================================================================================================== DERMATOLOGY BARRON-BERMANT,JANE 05May90 0800 RET SAMPLEY,MARY 20/234-12-2345 TDY 05May90 0830 RET ALBERT,JILL 20/554-89-9870 REFERRAL 05May90 1000 RET TANDY,LANCE 20/347-13-3478 CHRONIC NO-SHOW ALLERGY LARSON,ROBERT BURN CLINIC GUAJADARO,ROBERT DIVISION TOTALS =============== 05 May 1990 05May90 05May90 0900 1030 RET RET RAMSEY,BURT MCDONALD,DEBBIE 03/789-93-1241 01/765-10-2352 LEAVING FOR GERMANY 05May90 0730 FU HARDWAY,PHILLIP 20/455-74-6202 TDY DERMATOLOGY Subtotal: 3 3 05 May 1990 ALLERGY Subtotal: 2 2 05 May 1990 BURN CLINIC Subtotal: 1 1 DIVISON TOTAL FOR SPECIFIED DATE RANGE: FIGURE 4.4.9.22. 6 SAMPLE OUTPUT REPORT: PROBLEM AVOIDANCE REPORT (WAIT LIST MAILER NO-SHOWS) (Sheet 10 of 10) 6-171 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 20 Jul 1992@0200 Page 1 PATIENT CANCELLATION STATISTICAL REPORT by GROUP From Jun 1992 To: Jun 1992 Division: TRIPLER ARMY MEDICAL CENTER Department: MEDICINE ================================================================================================================================== Clinic/ # Patient Cancellations Total Total % | COUNT WORKLOAD | NON-COUNT WORKLOAD Provider 1 2 #Appt Canc Canc | #Visits #Canc %Canc | #Trans #Canc %Canc ================================================================================================================================== ALLERGY ------JONES,DONALD 10 5 66 15 18.5 47 6 11.3 19 9 32.1 SMITH,JOHN 5 4 61 9 12.8 36 7 16.2 25 2 7.4 Clinic Total: 15 9 127 24 15.8 83 13 13.5 44 11 20.0 DERMATOLOGY CLINIC -----------------JONES,FRED SMITH,JILL Clinic Total: 10 5 15 5 4 9 66 61 127 15 9 24 18.5 12.8 15.8 47 36 83 6 7 13 11.3 16.2 13.5 19 25 44 9 2 11 32.1 7.4 20.0 Department Total: 30 18 254 48 15.8 166 26 13.5 88 22 20.0 NOTE: The Total #Appt = the number of count clinic visits (Kept Appts and Unscheduled Visits) plus the number of non-count transactions (Kept Appts, Unscheduled Visits, and Occasions of Service). The %Canc = the number of cancellations divided by the #Visits (or #Trans) plus the number of cancellations. Cancellation Types ================================================================================================================================== 1 PATIENT CANCELLED 2 PATIENT CANCELLED & RESCHEDULED FIGURE 4.4.9.24. SAMPLE OUTPUT REPORT: PATIENT CANCELLATION STATISTICAL REPORT (Sheet 1 of 4) 6-172 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 20 Jul 1992@0200 Page 2 PATIENT CANCELLATION STATISTICAL REPORT by GROUP From Jun 1992 To: Jun 1992 Division: TRIPLER ARMY MEDICAL CENTER (continued) Department: SURGERY ================================================================================================================================== Clinic/ # Patient Cancellations Total Total % | COUNT WORKLOAD | NON-COUNT WORKLOAD Provider 1 2 #Appt Canc Canc | #Visits #Canc %Canc | #Trans #Canc %Canc ================================================================================================================================== GENERAL SURGERY CLINIC ---------------------ALBERTSON,SAM 10 5 66 15 18.5 47 6 11.3 19 9 32.1 SAMSON,DAN 5 4 61 9 12.8 36 7 16.2 25 2 7.4 Clinic Total: 15 9 127 24 15.8 83 13 13.5 44 11 20.0 UROLOGY CLINIC -------------JONES,SAM SMITH,DAN Clinic Total: 10 5 15 5 4 9 66 61 127 15 9 24 18.5 12.8 15.8 47 36 83 6 7 13 11.3 16.2 13.5 19 25 44 9 2 11 32.1 7.4 20.0 Department Total: 30 18 254 48 15.8 166 26 13.5 88 22 20.0 Division Total: 60 36 508 96 15.8 332 52 13.5 176 44 20.0 Group Total: 60 36 508 96 15.8 332 52 13.5 176 44 20.0 NOTE: The Total #Appt = the number of count clinic visits (Kept Appts and Unscheduled Visits) plus the number of non-count transactions (Kept Appts, Unscheduled Visits, and Occasions of Service). The %Canc = the number of cancellations divided by the #Visits (or #Trans) plus the number of cancellations. Cancellation Types ================================================================================================================================== 1 PATIENT CANCELLED 2 PATIENT CANCELLED & RESCHEDULED FIGURE 4.4.9.24. SAMPLE OUTPUT REPORT: PATIENT CANCELLATION STATISTICAL REPORT (Sheet 2 of 4) 6-173 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 20 Jul 1992@0200 Page 3 PATIENT CANCELLATION STATISTICAL REPORT by GROUP From Jun 1992 To: Jun 1992 Division: TRIPLER ARMY MEDICAL CENTER ================================================================================================================================== Department/ # Patient Cancellations Total Total % | COUNT WORKLOAD | NON-COUNT WORKLOAD Clinic 1 2 #Appt Canc Canc | #Visits #Canc %Canc | #Trans #Canc %Canc ================================================================================================================================== ***Division Summary*** MEDICINE -------Allergy Dermatology Department Total: 15 15 30 9 9 18 127 127 254 24 24 48 15.8 15.8 15.8 83 83 166 13 13 26 13.5 13.5 13.5 44 44 88 11 11 22 20.0 20.0 20.0 SURGERY ------General Survery Urology Department Total: 15 15 30 9 9 18 127 127 254 24 24 48 15.8 15.8 15.8 83 83 166 13 13 26 13.5 13.5 13.5 44 44 88 11 11 22 20.0 20.0 20.0 Division Total: 60 36 508 96 15.8 332 52 13.5 176 44 20.0 Group Total: 60 36 508 96 15.8 332 52 13.5 176 44 20.0 NOTE: The Total #Appt = the number of count clinic visits (Kept Appts and Unscheduled Visits) plus the number of non-count transactions (Kept Appts, Unscheduled Visits, and Occasions of Service). The %Canc = the number of cancellations divided by the #Visits (or #Trans) plus the number of cancellations. Cancellation Types ================================================================================================================================== 1 PATIENT CANCELLED 2 PATIENT CANCELLED & RESCHEDULED FIGURE 4.4.9.24. SAMPLE OUTPUT REPORT: PATIENT CANCELLATION STATISTICAL REPORT (Sheet 3 of 4) 6-174 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 20 Jul 1992@0200 Page 4 PATIENT CANCELLATION STATISTICAL REPORT by GROUP From Jun 1992 To: Jun 1992 Division: TRIPLER AMC ================================================================================================================================== Division # Patient Cancellations Total Total % | COUNT WORKLOAD | NON-COUNT WORKLOAD Department 1 2 #Appt Canc Canc | #Visits #Canc %Canc | #Trans #Canc %Canc ================================================================================================================================== ***Group Summary*** Division: TRIPLER ARMY MEDICAL CENTER -------------------------------------MEDICINE 30 SURGERY 30 Division Total: 60 18 18 36 254 254 508 48 48 96 15.8 15.8 15.8 166 166 332 26 26 52 13.5 13.5 13.5 88 88 176 22 22 44 20.0 20.0 20.0 Division: SCHOFIELD ------------------MEDICINE SURGERY Division Total: 30 30 60 18 18 36 254 254 508 48 48 96 15.8 15.8 15.8 166 166 332 26 26 52 13.5 13.5 13.5 88 88 176 22 22 44 20.0 20.0 20.0 120 72 1016 192 15.8 664 104 13.5 352 88 20.0 Group Total: NOTE: The Total #Appt = the number of count clinic visits (Kept Appts and Unscheduled Visits) plus the number of non-count transactions (Kept Appts, Unscheduled Visits, and Occasions of Service). The %Canc = the number of cancellations divided by the #Visits (or #Trans) plus the number of cancellations. Cancellation Types ================================================================================================================================== 1 PATIENT CANCELLED 2 PATIENT CANCELLED & RESCHEDULED FIGURE 4.4.9.24. SAMPLE OUTPUT REPORT: PATIENT CANCELLATION STATISTICAL REPORT (Sheet 4 of 4) 6-175 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER AMC, HI 03 Jul 1992@1019 Page 1 INITIAL & FOLLOW-UP CLINIC VISIT REPORT by GROUP From: Jun 1992 To: Jun 1992 Division: SCHOFIELD BARRACKS ================================================================================ Department/ Inpatient | Outpatient | Total Clinic Visits Clinic Init F/U Total| Init F/U Total| Init F/U Total ================================================================================ ***Division Summary*** MEDICINE DEPARTMENT ------------------ALLERGY CARDIOLOGY DERMATOLOGY Department Total: 20 7 12 39 1 9 2 12 21 16 14 51 26 1 23 50 1 3 5 9 27 4 28 59 46 8 35 89 2 12 7 21 48 20 42 110 PRIMARY CARE & COMM MEDICINE ---------------------------CARDIOLOGY 0 FAMILY PRACTICE (A 0 Department Total: 0 0 0 0 0 0 0 2 2 4 2 0 2 4 2 6 2 2 4 2 0 2 4 2 6 SURGERY ------OBSTETRICS CLINIC Department Total: 12 12 2 2 14 14 32 32 8 8 40 40 44 44 10 10 54 54 Division Total: 51 14 65 86 19 105 137 33 170 Group Total: 51 14 65 86 19 105 137 33 170 FIGURE 4.4.9.25. SAMPLE OUTPUT REPORT: INITIAL AND FOLLOW-UP CLINIC VISIT REPORT (Sheet 1 of 2) 6-176 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER AMC, HI 03 Jul 1992@1019 Page 2 INITIAL & FOLLOW-UP CLINIC VISIT REPORT by GROUP From: Jun 1992 To: Jun 1992 Division: SCHOFIELD BARRACKS ================================================================================ Division / Inpatient | Outpatient | Total Clinic Visits Department Init F/U Total| Init F/U Total| Init F/U Total ================================================================================ ***Group Summary*** Division: SCHOFIELD BARRACKS ---------------------------MEDICINE DEPARTMEN 39 PRIMARY CARE & COM 0 SURGERY 12 Division Total: 51 12 0 2 14 51 0 14 65 50 4 32 86 9 2 8 19 59 6 40 105 89 4 44 137 21 2 10 33 110 6 54 170 Group Total: 14 65 86 19 105 137 33 170 51 FIGURE 4.4.9.25. SAMPLE OUTPUT REPORT: INITIAL AND FOLLOW-UP CLINIC VISIT REPORT (Sheet 2 of 2) 6-177 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 GENERAL HOSPITAL 12 Aug 1993@1006 Page 1 Personal Data - Privacy Act 1974 (PL-93-579) UNANSWERED TELEPHONE CONSULTS REPORT by CLINIC From: 28 Jun 1993 To: 22 Aug 1993 Division: AIR FORCE MTF DIVISION Department: MEDICINE DEPT ================================================================================ Patient FMP/SSN Date/Time Status ================================================================================ Clinic: FAMILY PRACTICE (ATC) ----------------------------Provider: CRAWFORD,WILLIAM JONES,JEROME 20/800-67-0405 10 Aug 1993@1407 NEW/NO NOTIFY LINDSAY,JAMES 20/551-23-1234 10 Aug 1993@1410 NEW PATTON,JUDY 01/800-34-0408 10 Aug 1993@1423 NEW Provider Total: 3 Provider: DALTON,JAMES NABB,ERIC VATINELLE,CAROL ZUMWALT,ZACHERY Provider Total: 3 20/444-65-3014 20/264-44-4109 20/801-65-1212 10 Aug 1993@1512 10 Aug 1993@1437 10 Aug 1993@1536 READ READ UPDATED Provider: HOLBERT,SUSAN BARRON,EARL CRAWFORD,KAREN THOMPSON,JOHN Provider Total: 3 20/004-44-4720 20/442-27-7242 20/264-44-4109 05 Aug 1993@1447 10 Aug 1993@0835 10 Aug 1993@1356 NEW NEW SAVED Clinic Total: 9 FIGURE 4.4.9.26. SAMPLE OUTPUT REPORT: UNANSWERED TELEPHONE CONSULTS REPORT (Sheet 1 of 3) 6-178 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 GENERAL HOSPITAL 12 Aug 1993@1006 Page 1 Personal Data - Privacy Act 1974 (PL-93-579) UNANSWERED TELEPHONE CONSULTS REPORT by PROVIDER From: 28 Jun 1993 To: 22 Aug 1993 ================================================================================ Patient FMP/SSN Date/Time Status ================================================================================ Provider: CRAWFORD,BUD ---------------------Clinic: FAMILY PRACTICE (ATC) BACKER,DAVID 20/446-08-6654 10 Aug 1993@1407 NEW/NO NOTIFY CRAWFORD,JACQUI 01/551-23-1234 10 Aug 1993@1410 NEW THOMAS,JAMES 01/800-34-0408 10 Aug 1993@1423 NEW Clinic Total: 3 Provider Total: 3 FIGURE 4.4.9.26. SAMPLE OUTPUT REPORT: UNANSWERED TELEPHONE CONSULTS REPORT (Sheet 2 of 3) 6-179 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 GENERAL HOSPITAL 12 Aug 1993@1006 Page 1 Personal Data - Privacy Act 1974 (PL-93-579) UNANSWERED TELEPHONE CONSULTS REPORT by PATIENT From: 28 Jun 1993 To: 22 Aug 1993 ================================================================================ Clinic Provider Date/Time Status ================================================================================ Patient: NABB,ERIC -----------------FAMILY PRACTICE (ATC) CRAWFORD,JACQUI 10 Aug 1993@1512 READ FIGURE 4.4.9.26. SAMPLE OUTPUT REPORT: UNANSWERED TELEPHONE CONSULTS REPORT (Sheet 3 of 3) 6-180 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 01 Mar 1995@1634 Page 1 TOP 5 AMBULATORY DIAGNOSES REPORT By CLINIC From: 01 Feb 1995 To: 01 Mar 1995 Clinic: FAMILY PRACTICE =============================================================================== #Occur Code Description ================================================================================ 234 V04.7 COMMON COLD 72 789.0 ABDOMINAL PAIN 55 466.0 ACUTE BRONCHITIS 45 487.0 INFLUENZA WITH PNEUMONIA 35 34 MEDICAL BACK PROBLEMS FIGURE 4.4.9.27. SAMPLE OUTPUT REPORT: TOP AMBULATORY DIAGNOSES REPORT (BY CLINIC) (Sheet 1 of 6) 6-181 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 01 Mar 1995@1634 Page 2 TOP 5 AMBULATORY DIAGNOSES REPORT By CLINIC From: 01 Feb 1995 To: 01 Mar 1995 Clinic: ALLERGY (A) =============================================================================== #Occur Code Description ================================================================================ 362 V07.1 NEED FOR DESENSITIZATION TO ALLERGENS 53 372.14 OTHER CHRONIC ALLERGIC CONJUNCTIVITIS 27 381.05 ACUTE ALLERGIC MUCOID OTITIS MEDIA 12 373.32 CONTACT AND ALLERGIC DERMATITIS OF EYELID 7 381.04 ACUTE ALLERGIC SEROUS OTITIS MEDIA FIGURE 4.4.9.27. SAMPLE OUTPUT REPORT: TOP AMBULATORY DIAGNOSES REPORT (BY CLINIC) (Sheet 2 of 6) 6-182 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 01 Mar 1995@1634 TOP 5 AMBULATORY DIAGNOSES REPORT By DIVISION From: 01 Feb 1995 To: 01 Mar 1995 Page 1 Division: PEARL HARBOR Clinic: ALLERGY (A) ================================================================================ #Occur Code Description ================================================================================ 362 V07.1 NEED FOR DESENSITIZATION TO ALLERGENS 53 372.14 OTHER CHRONIC ALLERGIC CONJUNCTIVITIS 27 381.05 ACUTE ALLERGIC MUCOID OTITIS MEDIA 12 373.32 CONTACT AND ALLERGIC DERMATITIS OF EYELID 7 381.04 ACUTE ALLERGIC SEROUS OTITIS MEDIA FIGURE 4.4.9.27. SAMPLE OUTPUT REPORT: TOP AMBULATORY DIAGNOSES REPORT (BY DIVISION) (Sheet 3 of 6) 6-183 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 01 Mar 1995@1634 Page 1 TOP 5 AMBULATORY DIAGNOSES REPORT By DIVISION From: 01 Feb 1995 To: 01 Mar 1995 *** Division Level Summary *** Division: PEARL HARBOR ================================================================================ #Occur Code Description ================================================================================ 55 466.0 ACUTE BRONCHITIS 49 506.0 BRONCHITIS AND PNEUMONITIS DUE TO FUMES AND VAPORS 17 484.3 PNEUMONIA IN WHOOPING COUGH 7 164.1 MALIGNANT NEOPLASM OF HEART 5 100.0 LEPTOSPIROSIS ICTEROHEMORRHAGICA FIGURE 4.4.9.27. SAMPLE OUTPUT REPORT: TOP AMBULATORY DIAGNOSES REPORT (DIVISION LEVEL SUMMARY) (Sheet 4 of 6) 6-184 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 01 Mar 1995@1634 Page 1 TOP 5 AMBULATORY DIAGNOSES REPORT By GROUP From: 01 Feb 1995 To: 01 Mar 1995 Group: TRIPLER Division: PEARL HARBOR ================================================================================ Clinic/ # Occur Code Description ================================================================================ ALLERGY _______ 362 V07.1 NEED FOR DESENSITIZATION TO ALLERGENS 53 372.14 OTHER CHRONIC ALLERGIC CONJUNCTIVITIS 27 381.05 ACUTE ALLERGIC MUCOID OTITIS MEDIA 12 373.32 CONTACT AND ALLERGIC DERMATITIS OF EYELID 7 381.04 ACUTE ALLERGIC SEROUS OTITIS MEDIA DERMATOLOGY ___________ 40 684 IMPETIGO 38 1106 DEEP DERMATOPHYTOSIS 20 0540 ECZEMA HERPETICUM 12 0549 HERPES SIMPLEX NOS 5 2148 LIPOMA NEC FIGURE 4.4.9.27. SAMPLE OUTPUT REPORT: TOP AMBULATORY DIAGNOSES REPORT (BY GROUP) (Sheet 5 of 6) 6-185 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 01 Mar 1995@1634 Page 1 TOP 5 AMBULATORY DIAGNOSES REPORT By GROUP From: 01 Feb 1995 To: 01 Mar 1995 *** Group Level Summary *** Group: TRIPLER ================================================================================ #Occur Code Description ================================================================================ 36 466.0 ACUTE BRONCHITIS 11 120.1 SCHISTOSOMIASIS DUE TO SCHISTOSOMA MANSONI 5 484.3 PNEUMONIA IN WHOOPING COUGH 4 123.4 DIPHYLLOBOTHRIASIS, INTESTINAL 1 255.2 ADRENOGENITAL DISORDERS FIGURE 4.4.9.27. SAMPLE OUTPUT REPORT: TOP AMBULATORY DIAGNOSES REPORT (GROUP LEVEL SUMMARY) (Sheet 6 of 6) 6-186 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 01 Mar 1995@1635 Page 1 TOP 5 AMBULATORY PROCEDURES REPORT By CLINIC From: 01 Feb 1995 To: 01 Mar 1995 Applicable FARS/DFARS Restrictions Apply to Government Use Any five digit numeric Physician's Current Procedural Terminology, (CPT-1995) codes, service descriptions, instructions and/or guidelines only are copyright 1994 (or such date of publication of CPT as defined in the federal copyright laws) American Medical Association. All Rights Reserved. No fee schedules, basic unit values, relative value guides, or related listings are included in CPT. The AMA assumes no responsibility for the consequences attributable to or related to any use or interpretation of information contained in or not contained in this product. The AMA shall not be deemed to be engaged in the practice of medicine or dispensing medical services. FIGURE 4.4.9.28. SAMPLE OUTPUT REPORT: TOP AMBULATORY PROCEDURES REPORT (BY CLINIC) (Sheet 1 of 12) 6-187 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 01 Mar 1995@1635 Page 2 TOP 5 AMBULATORY PROCEDURES REPORT By CLINIC From: 01 Feb 1995 To: 01 Mar 1995 Clinic: FAMILY PRACTICE ================================================================================ #Occur Code Description ================================================================================ 263 J0110 ADMINISTRATION OF INJECTION, INCLUDING THE COST OF DRUG 174 97799 PHYSICAL MEDICAL PROCEDURE 122 A4210 NEEDLE-FREE INJECTION DEVICE 53 93000 ELECTROCARDIOGRAM, ROUTINE ECG WITH AT LEAST 12 LEADS; WITH INTERPRETATION AND REPORT 34 81000 URINALYSIS; ROUTINE (PH, SPECIFIC GRAVITY, PROTEIN, TESTS FOR REDUCING SUBSTANCES SUCH AS GLUCOSE), WITH MICROSCOPY FIGURE 4.4.9.28. SAMPLE OUTPUT REPORT: TOP AMBULATORY PROCEDURES REPORT (BY CLINIC) (Sheet 2 of 12) 6-188 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 01 Mar 1995@1635 Page 3 TOP 5 AMBULATORY PROCEDURES REPORT By CLINIC From: 01 Feb 1995 To: 01 Mar 1995 Clinic: ALLERGY (A) ================================================================================ #Occur Code Description ================================================================================ 303 86003 ALLERGEN SPECIFIC IGE;QUANTITATIVE, EACH PANEL OF UP TO 12 ALLERGENS 295 J0110 ADMINISTRATION OF INJECTION, INCLUDING THE COST OF DRUG 276 J0240 INJECTION, ALLERGY DESENSITIZATION, EMULSION NOT SPECIFIED 47 95070 INHALATION BRONCHIAL CHALLENGE TESTING (NOT INCLUDING NECESSARY PULMONARY FUNCTION TESTS); WITH HISTAMINE, METHACHOLINE, OR SIMILAR COMPOUNDS 14 86315 IMMUNOASSAY FOR INFECTIOUS AGENT ANTIGEN, QUALITATIVE OR SEMIQUANTITATIVE; SINGLE STEP METHOD (EG, REAGENT STRIP) FIGURE 4.4.9.28. SAMPLE OUTPUT REPORT: TOP AMBULATORY PROCEDURES REPORT (BY CLINIC) (Sheet 3 of 12) 6-189 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 01 Mar 1995@1635 Page 1 TOP 5 AMBULATORY PROCEDURES REPORT By DIVISION From: 01 Feb 1995 To: 01 Mar 1995 Applicable FARS/DFARS Restrictions Apply to Government Use Any five digit numeric Physician's Current Procedural Terminology, (CPT-1995) codes, service descriptions, instructions and/or guidelines only are copyright 1994 (or such date of publication of CPT as defined in the federal copyright laws) American Medical Association. All Rights Reserved. No fee schedules, basic unit values, relative value guides, or related listings are included in CPT. The AMA assumes no responsibility for the consequences attributable to or related to any use or interpretation of information contained in or not contained in this product. The AMA shall not be deemed to be engaged in the practice of medicine or dispensing medical services. FIGURE 4.4.9.28. SAMPLE OUTPUT REPORT: TOP AMBULATORY PROCEDURES REPORT (BY DIVISION) (Sheet 4 of 12) 6-190 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 01 Mar 1995@1635 Page 2 TOP 5 AMBULATORY PROCEDURES REPORT By DIVISION From: 01 Feb 1995 To: 01 Mar 1995 Division: PEARL HARBOR Clinic: ALLERGY (A) ================================================================================ #Occur Code Description ================================================================================ 393 86003 ALLERGEN SPECIFIC IGE;QUANTITATIVE, EACH PANEL OF UP TO 12 ALLERGENS 303 J0240 INJECTION, ALLERGY DESENSITIZATION, EMULSION NOT SPECIFIED 297 J0110 ADMINISTRATION OF INJECTION, INCLUDING THE COST OF DRUG 223 97799 PHYSICAL MEDICAL PROCEDURE 154 A4210 NEEDLE-FREE INJECTION DEVICE FIGURE 4.4.9.28. SAMPLE OUTPUT REPORT: TOP AMBULATORY PROCEDURES REPORT (BY DIVISION) (Sheet 5 of 12) 6-191 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 01 Mar 1995@1635 Page 1 TOP 5 AMBULATORY PROCEDURES REPORT By DIVISION From: 01 Feb 1995 To: 01 Mar 1995 *** Division Level Summary *** Applicable FARS/DFARS Restrictions Apply to Government Use Any five digit numeric Physician's Current Procedural Terminology, (CPT-1995) codes, service descriptions, instructions and/or guidelines only are copyright 1994 (or such date of publication of CPT as defined in the federal copyright laws) American Medical Association. All Rights Reserved. No fee schedules, basic unit values, relative value guides, or related listings are included in CPT. The AMA assumes no responsibilty for the consequences attributable to or related to any use or interpretation of information contained in or not contained in this product. The AMA shall not be deemed to be engaged in the practice of medicine or dispensing medical services. FIGURE -4.4.9.28. SAMPLE OUTPUT REPORT: TOP AMBULATORY PROCEDURES REPORT (DIVISION LEVEL SUMMARY) (Sheet 6 of 12) 6-192 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 01 Mar 1995@1635 Page 2 TOP 5 AMBULATORY PROCEDURES REPORT By DIVISION From: 01 Feb 1995 To: 01 Mar 1995 *** Division Level Summary *** Division: PEARL HARBOR ================================================================================ #Occur Code Description ================================================================================ 393 86003 ALLERGEN SPECIFIC IGE;QUANTITATIVE, EACH PANEL OF UP TO 12 ALLERGENS 303 J0240 INJECTION, ALLERGY DESENSITIZATION, EMULSION NOT SPECIFIED 297 J0110 ADMINISTRATION OF INJECTION, INCLUDING THE COST OF DRUG 223 97799 PHYSICAL MEDICAL PROCEDURE 154 A4210 NEEDLE-FREE INJECTION DEVICE FIGURE 4.4.9.28. SAMPLE OUTPUT REPORT: TOP AMBULATORY PROCEDURES REPORT (DIVISION LEVEL SUMMARY) (Sheet 7 of 12) 6-193 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 01 Mar 1995@1635 Page 1 TOP 5 AMBULATORY PROCEDURES REPORT By GROUP From: 01 Feb 1995 To: 01 Mar 1995 Applicable FARS/DFARS Restrictions Apply to Government Use Any five digit numeric Physician's Current Procedural Terminology, (CPT-1995) codes, service descriptions, instructions and/or guidelines only are copyright 1994 (or such date of publication of CPT as defined in the federal copyright laws) American Medical Association. All Rights Reserved. No fee schedules, basic unit values, relative value guides, or related listings are included in CPT. The AMA assumes no responsibility for the consequences attributable to or related to any use or interpretation of information contained in or not contained in this product. The AMA shall not be deemed to be engaged in the practice of medicine or dispensing medical services. FIGURE 4.4.9.28. SAMPLE OUTPUT REPORT: TOP AMBULATORY PROCEDURES REPORT (BY GROUP) (Sheet 8 of 12) 6-194 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 01 Mar 1995@1635 Page 2 TOP 5 AMBULATORY PROCEDURES REPORT By GROUP From: 01 Feb 1995 To: 01 Mar 1995 Group: TRIPLER Division: PEARL HARBOR ================================================================================ Clinic/ # Occur Code Description ================================================================================ ALLERGY ------393 86003 ALLERGEN SPECIFIC IGE;QUANTITATIVE, EACH PANEL OF UP TO 12 ALLERGENS 303 J0240 INJECTION, ALLERGY DESENSITIZATION, EMULSION NOT SPECIFIED 297 J0110 ADMINISTRATION OF INJECTION, INCLUDING THE COST OF DRUG 223 97799 PHYSICAL MEDICAL PROCEDURE 154 A4210 NEEDLE-FREE INJECTION DEVICE FIGURE 4.4.9.28. SAMPLE OUTPUT REPORT: TOP AMBULATORY PROCEDURES REPORT (BY GROUP) (Sheet 9 of 12) 6-195 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 01 Mar 1995@1635 Page 3 TOP 5 AMBULATORY PROCEDURES REPORT By GROUP From: 01 Feb 1995 To: 01 Mar 1995 Group: TRIPLER (continued) Division: PEARL HARBOR ================================================================================ Clinic/ # Occur Code Description ================================================================================ FAMILY PRACTICE --------------263 J0110 ADMINISTRATION OF INJECTION, INCLUDING THE COST OF DRUG 174 97799 PHYSICAL MEDICAL PROCEDURE 122 A4210 NEEDLE-FREE INJECTION DEVICE 53 93000 ELECTROCARDIOGRAM, ROUTINE ECG WITH AT LEAST 12 LEADS; WITH INTERPRETATION AND REPORT 34 81000 URINALYSIS; ROUTINE (PH, SPECIFIC GRAVITY, PROTEIN, TESTS FOR REDUCING SUBSTANCES SUCH AS GLUCOSE), WITH MICROSCOPY FIGURE 4.4.9.28. SAMPLE OUTPUT REPORT: TOP AMBULATORY PROCEDURES REPORT (BY GROUP) (Sheet 10 of 12) 6-196 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 01 Mar 1995@1635 Page 1 TOP 5 AMBULATORY PROCEDURES REPORT By GROUP From: 01 Feb 1995 To: 01 Mar 1995 *** Group Level Summary *** Applicable FARS/DFARS Restrictions Apply to Government Use Any five digit numeric Physician's Current Procedural Terminology, (CPT-1995) codes, service descriptions, instructions and/or guidelines only are copyright 1994 (or such date of publication of CPT as defined in the federal copyright laws) American Medical Association. All Rights Reserved. No fee schedules, basic unit values, relative value guides, or related listings are included in CPT. The AMA assumes no responsibilty for the consequences attributable to or related to any use or interpretation of information contained in or not contained in this product. The AMA shall not be deemed to be engaged in the practice of medicine or dispensing medical services. FIGURE 4.4.9.28. SAMPLE OUTPUT REPORT: TOP AMBULATORY PROCEDURES REPORT (GROUP LEVEL SUMMARY) (Sheet 11 of 12) 6-197 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 01 Mar 1995@1635 Page 1 TOP 5 AMBULATORY PROCEDURES REPORT By GROUP From: 01 Feb 1995 To: 01 Mar 1995 *** Group Level Summary *** Group: TRIPLER ================================================================================ #Occur Code Description ================================================================================ 573 86003 ALLERGEN SPECIFIC IGE;QUANTITATIVE, EACH PANEL OF UP TO 12 ALLERGENS 452 97799 PHYSICAL MEDICAL PROCEDURE 407 J0110 ADMINISTRATION OF INJECTION, INCLUDING THE COST OF DRUG 313 J0240 INJECTION, ALLERGY DESENSITIZATION, EMULSION NOT SPECIFIED 210 A4210 NEEDLE-FREE INJECTION DEVICE FIGURE 4.4.9.28. SAMPLE OUTPUT REPORT: TOP AMBULATORY PROCEDURES REPORT (GROUP LEVEL SUMMARY) (Sheet 12 of 12) 6-198 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 01 Mar 1995@1634 Page 1 TOP 5 AMBULATORY DIAGNOSES REPORT By PATIENT CATEGORY From: 01 Feb 1995 To: 01 Mar 1995 Clinic: FAMILY PRACTICE ================================================================================ PATCAT/#Occur Code Description ================================================================================ ACTIVE DUTY ----------238 V04.7 COMMON COLD 75 766.0 ABDOMIAL PAIN 45 466.0 ACUTE BRONCHITIS 45 487.0 INFLUENZA WITH PNEUMONIA 35 34 MEDICAL BACK PROBLEMS 20 V70 GENERAL MEDICAL EXAMINATION 55 34 MEDICAL BACK PROBLEMS 54 V04.7 COMMON COLD 45 466.0 INFLUENZA WITH PNEUMONIA 22 789.0 ABDOMINAL PAIN 20 V70 GENERAL MEDICAL EXAMINATION RETIRED ------- FIGURE 4.4.9.29. SAMPLE OUTPUT REPORT: TOP AMBULATORY DIAGNOSES OR PROCEDURES REPORT BY PATCAT (DX REPORT BY CLINIC) (Sheet 1 of 18) 6-199 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 01 Mar 1995@1634 Page 2 TOP 5 AMBULATORY DIAGNOSES REPORT By PATIENT CATEGORY From: 01 Feb 1995 To: 01 Mar 1995 Clinic: ALLERGY =================================================================================== PATCAT/#Occur Code Description =================================================================================== ACTIVE DUTY ----------47 372.14 OTHER CHRONIC ALLERGIC CONJUNCTIVITIS 45 V07.1 NEED FOR DESENSITIZATION TO ALLERGENS 14 381.05 ACUTE ALLERGIC MUCOID OTITIS MEDIA 3 381.04 ACUTE ALLERGIC SEROUS OTITIS MEDIA 1 373.32 CONTACT AND ALLERGIC DERMATITIS OF EYELID V07.1 NEED FOR DESENSITIZATION TO ALLERGENS 13 381.05 ACUTE ALLERGIC MUCOID OTITIS MEDIA 11 373.32 CONTACT AND ALLERGIC DERMATITIS OF EYELID 6 372.14 OTHER CHRONIC ALLERGIC CONJUNCTIVITIS 4 381.04 ACUTE ALLERGIC SEROUS OTITIS MEDIA RETIRED ------317 FIGURE 4.4.9.29. SAMPLE OUTPUT REPORT: TOP AMBULATORY DIAGNOSES OR PROCEDURES REPORT BY PATCAT (DX REPORT BY CLINIC) (Sheet 2 of 18) 6-200 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 01 Mar 1995@1634 Page 1 TOP 5 AMBULATORY DIAGNOSES REPORT By PATIENT CATEGORY From: 01 Feb 1995 To: 01 Mar 1995 Division: PEARL HARBOR Clinic: FAMILY PRACTICE ================================================================================ PATCAT/#Occur Code Description ================================================================================ ACTIVE DUTY ----------238 V04.7 COMMON COLD 75 766.0 ABDOMIAL PAIN 45 466.0 ACUTE BRONCHITIS 45 487.0 INFLUENZA WITH PNEUMONIA 35 34 MEDICAL BACK PROBLEMS 20 V70 GENERAL MEDICAL EXAMINATION 55 34 MEDICAL BACK PROBLEMS 54 V04.7 COMMON COLD 45 466.0 INFLUENZA WITH PNEUMONIA 22 789.0 ABDOMINAL PAIN 20 V70 GENERAL MEDICAL EXAMINATION RETIRED ------- FIGURE 4.4.9.29. SAMPLE OUTPUT REPORT: TOP AMBULATORY DIAGNOSES OR PROCEDURES REPORT BY PATCAT (DX REPORT BY DIVISION) (Sheet 3 of 18) 6-201 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 01 Mar 1995@1634 Page 1 TOP 5 AMBULATORY DIAGNOSES REPORT By PATIENT CATEGORY From: 01 Feb 1995 To: 01 Mar 1995 Group: TRIPLER Division: PEARL HARBOR =================================================================================== Clinic PATCAT/#Occur Code Description ================================================================================ FAMILY PRACTICE --------------ACTIVE DUTY ----------238 V04.7 COMMON COLD 75 766.0 ABDOMIAL PAIN 45 466.0 ACUTE BRONCHITIS 45 487.0 INFLUENZA WITH PNEUMONIA 35 34 MEDICAL BACK PROBLEMS 20 V70 GENERAL MEDICAL EXAMINATION 55 34 MEDICAL BACK PROBLEMS 54 V04.7 COMMON COLD 45 466.0 INFLUENZA WITH PNEUMONIA 22 789.0 ABDOMINAL PAIN 20 V70 GENERAL MEDICAL EXAMINATION RETIRED ------- FIGURE 4.4.9.29. SAMPLE OUTPUT REPORT: TOP AMBULATORY DIAGNOSES OR PROCEDURES REPORT BY PATCAT (DX REPORT BY GROUP) (Sheet 4 of 18) 6-202 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 01 Mar 1995@1640 Page 1 TOP 5 AMBULATORY PROCEDURES REPORT By PATIENT CATEGORY From: 01 Feb 1995 To: 01 Mar 1995 Applicable FARS/DFARS Restrictions Apply to Government Use Any five digit numeric Physician's Current Procedural Terminology, (CPT-1995) codes, service descriptions, instructions and/or guidelines only are copyright 1994 (or such date of publication of CPT as defined in the federal copyright laws) American Medical Association. All Rights Reserved. No fee schedules, basic unit values, relative value guides, or related listings are included in CPT. The AMA assumes no responsibility for the consequences attributable to or related to any use or interpretation of information contained in or not contained in this product. The AMA shall not be deemed to be engaged in the practice of medicine or dispensing medical services. 4.4.9.29. SAMPLE OUTPUT REPORT: TOP AMBULATORY DIAGNOSES OR PROCEDURES REPORT BY PATCAT (PX REPORT BY CLINIC) (Sheet 5 of 18) 6-203 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 01 Mar 1995@1640 Page 2 TOP 5 AMBULATORY PROCEDURES REPORT By PATIENT CATEGORY From: 01 Feb 1995 To: 01 Mar 1995 Clinic: FAMILY PRACTICE ================================================================================ PATCAT/#Occur Code Description ================================================================================ FAM MBR OF ACTIVE DUTY -----------------------101 J0110 ADMINISTRATION OF INJECTION, INCLUDING THE COST OF DRUG 49 97799 PHYSICAL MEDICAL PROCEDURE 46 A4202 GAUZE, ELASTIC, ALL TYPES, PER ROLL 32 97039 PHYSICAL MEDICAL TREATMENT TO ONE AREA; INITIAL 30 MINUTES, EACH VISIT; ULTRASOUND 28 15850 REMOVAL OF SUTURES 125 97799 PHYSICAL MEDICAL PROCEDURE 96 A4210 NEEDLE-FREE INJECTION DEVICE 89 J0110 ADMINISTRATION OF INJECTION, INCLUDING THE COST OF DRUG 37 93000 ELECTROCARDIOGRAM, ROUTINE ECG WITH AT LEAST 12 LEADS; WITH INTERPRETATION AND REPORT 27 A4202 GAUZE, ELASTIC, ALL TYPES, PER ROLL OTHER ----- F4.4.9.29. SAMPLE OUTPUT REPORT: TOP AMBULATORY DIAGNOSES OR PROCEDURES REPORT BY PATCAT (PX REPORT BY CLINIC) (Sheet 6 of 18) 6-204 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 01 Mar 1995@1640 Page 3 TOP 5 AMBULATORY PROCEDURES REPORT By PATIENT CATEGORY From: 01 Feb 1995 To: 01 Mar 1995 Clinic: ALLERGY ================================================================================ PATCAT/#Occur Code Description ================================================================================ FAM MBR OF ACTIVE DUTY -----------------------250 A4770 BLOOD TESTING SUPPLIES (E.G. VACUTAINERS AND TUBES) 200 J0240 INJECTION, ALLERGY DESENSITIZATION, EMULSION NOT SPECIFIED 116 86003 ALLERGEN SPECIFIC IGE;QUANTITATIVE, EACH PANEL OF UP TO 12 ALLERGENS 75 J0110 ADMINISTRATION OF INJECTION, INCLUDING THE COST OF DRUG 17 95070 INHALATION BRONCHIAL CHALLENGE TESTING (NOT INCLUDING NECESSARY PULMONARY FUNCTION TESTS); WITH HISTAMINE, METHACHOLINE, OR SIMILAR COMPOUNDS FAM MBR OF RETIRED -------------------187 86003 ALLERGEN SPECIFIC IGE;QUANTITATIVE, EACH PANEL OF UP TO 12 ALLERGENS 87 J0110 ADMINISTRATION OF INJECTION, INCLUDING THE COST OF DRUG 30 95070 INHALATION BRONCHIAL CHALLENGE TESTING (NOT INCLUDING NECESSARY PULMONARY FUNCTION TESTS); WITH HISTAMINE, METHACHOLINE, OR SIMILAR COMPOUNDS 22 95071 INHALATION BRONCHIAL CHALLENGE TESTING (NOT INCLUDING PULMONARY FUNCTION TEST); WITH ANTIGENS OR GASES, SPECIFY 13 A4770 BLOOD TESTING SUPPLIES (E.G. VACUTAINERS AND TUBES) 4.4.9.29. SAMPLE OUTPUT REPORT: TOP AMBULATORY DIAGNOSES OR PROCEDURES REPORT BY PATCAT (PX REPORT BY CLINIC) (Sheet 7 of 18) 6-205 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 01 Mar 1995@1640 Page 1 TOP 5 AMBULATORY PROCEDURES REPORT By PATIENT CATEGORY From: 01 Feb 1995 To: 01 Mar 1995 Applicable FARS/DFARS Restrictions Apply to Government Use Any five digit numeric Physician's Current Procedural Terminology, (CPT-1995) codes, service descriptions, instructions and/or guidelines only are copyright 1994 (or such date of publication of CPT as defined in the federal copyright laws) American Medical Association. All Rights Reserved. No fee schedules, basic unit values, relative value guides, or related listings are included in CPT. The AMA assumes no responsibility for the consequences attributable to or related to any use or interpretation of information contained in or not contained in this product. The AMA shall not be deemed to be engaged in the practice of medicine or dispensing medical services. FIGURE 4.4.9.29. SAMPLE OUTPUT REPORT: TOP AMBULATORY DIAGNOSES OR PROCEDURES REPORT BY PATCAT (PX REPORT BY DIVISION) (Sheet 8 of 18) 6-206 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 01 Mar 1995@1640 Page 2 TOP 5 AMBULATORY PROCEDURES REPORT By PATIENT CATEGORY From: 01 Feb 1995 To: 01 Mar 1995 Division: PEARL HARBOR Clinic: FAMILY PRACTICE ================================================================================ PATCAT/#Occur Code Description ================================================================================ FAM MBR OF ACTIVE DUTY -----------------------101 J0110 ADMINISTRATION OF INJECTION, INCLUDING THE COST OF DRUG 49 97799 PHYSICAL MEDICAL PROCEDURE 46 A4202 GAUZE, ELASTIC, ALL TYPES, PER ROLL 32 97039 PHYSICAL MEDICAL TREATMENT TO ONE AREA; INITIAL 30 MINUTES, EACH VISIT; ULTRASOUND 28 15850 REMOVAL OF SUTURES 125 97799 PHYSICAL MEDICAL PROCEDURE 96 A4210 NEEDLE-FREE INJECTION DEVICE 89 J0110 ADMINISTRATION OF INJECTION, INCLUDING THE COST OF DRUG 37 93000 ELECTROCARDIOGRAM, ROUTINE ECG WITH AT LEAST 12 LEADS; WITH INTERPRETATION AND REPORT 27 A4202 GAUZE, ELASTIC, ALL TYPES, PER ROLL OTHER ----- FIGURE 4.4.9.29. SAMPLE OUTPUT REPORT: TOP AMBULATORY DIAGNOSES OR PROCEDURES REPORT BY PATCAT (PX REPORT BY DIVISION) (Sheet 9 of 18) 6-207 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 01 Mar 1995@1640 Page 1 TOP 5 AMBULATORY PROCEDURES REPORT By PATIENT CATEGORY From: 01 Feb 1995 To: 01 Mar 1995 *** Division Level Summary *** Applicable FARS/DFARS Restrictions Apply to Government Use Any five digit numeric Physician's Current Procedural Terminology, (CPT-1995) codes, service descriptions, instructions and/or guidelines only are copyright 1994 (or such date of publication of CPT as defined in the federal copyright laws) American Medical Association. All Rights Reserved. No fee schedules, basic unit values, relative value guides, or related listings are included in CPT. The AMA assumes no responsibilty for the consequences attributable to or related to any use or interpretation of information contained in or not contained in this product. The AMA shall not be deemed to be engaged in the practice of medicine or dispensing medical services. FIGURE 4.4.9.29. SAMPLE OUTPUT REPORT: TOP AMBULATORY DIAGNOSES OR PROCEDURES REPORT BY PATCAT (DIVISION LVL SUM) (Sheet 10 of 18) 6-208 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 01 Mar 1995@1640 Page 2 TOP 5 AMBULATORY PROCEDURES REPORT By PATIENT CATEGORY From: 01 Feb 1995 To: 01 Mar 1995 *** Division Level Summary *** Division: PEARL HARBOR ================================================================================ PATCAT/#Occur Code Description ================================================================================ FAM MBR OF ACTIVE DUTY -----------------------201 J0110 ADMINISTRATION OF INJECTION, INCLUDING THE COST OF DRUG 104 97799 PHYSICAL MEDICAL PROCEDURE 87 A4202 GAUZE, ELASTIC, ALL TYPES, PER ROLL 61 97039 PHYSICAL MEDICAL TREATMENT TO ONE AREA; INITIAL 30 MINUTES, EACH VISIT; ULTRASOUND 59 15850 REMOVAL OF SUTURES 249 97799 PHYSICAL MEDICAL PROCEDURE 177 A4210 NEEDLE-FREE INJECTION DEVICE 172 J0110 ADMINISTRATION OF INJECTION, INCLUDING THE COST OF DRUG 52 93000 ELECTROCARDIOGRAM, ROUTINE ECG WITH AT LEAST 12 LEADS; WITH INTERPRETATION AND REPORT 51 A4202 GAUZE, ELASTIC, ALL TYPES, PER ROLL OTHER ----- FIGURE 4.4.9.29. SAMPLE OUTPUT REPORT: TOP AMBULATORY DIAGNOSES OR PROCEDURES REPORT BY PATCAT (DIVISION LVL SUM) (Sheet 11 of 18) 6-209 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 01 Mar 1995@1640 Page 1 TOP 5 AMBULATORY PROCEDURES REPORT By PATIENT CATEGORY REPORT From: 01 Feb 1995 To: 01 Mar 1995 Applicable FARS/DFARS Restrictions Apply to Government Use Any five digit numeric Physician's Current Procedural Terminology, (CPT-1995) codes, service descriptions, instructions and/or guidelines only are copyright 1994 (or such date of publication of CPT as defined in the federal copyright laws) American Medical Association. All Rights Reserved. No fee schedules, basic unit values, relative value guides, or related listings are included in CPT. The AMA assumes no responsibility for the consequences attributable to or related to any use or interpretation of information contained in or not contained in this product. The AMA shall not be deemed to be engaged in the practice of medicine or dispensing medical services. FIGURE 4.4.9.29. SAMPLE OUTPUT REPORT: TOP AMBULATORY DIAGNOSES OR PROCEDURES REPORT BY PATCAT (PX REPORT BY GROUP) (Sheet 12 of 18) 6-210 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 01 Mar 1995@1640 Page 2 TOP 5 AMBULATORY PROCEDURES REPORT By PATIENT CATEGORY From: 01 Feb 1995 To: 01 Mar 1995 Group: TRIPLER Division: PEARL HARBOR ================================================================================ Clinic PATCAT/#Occur Code Description ================================================================================ FAMILY PRACTICE --------------FAM MBR OF ACTIVE DUTY -----------------------101 J0110 49 97799 ADMINISTRATION OF INJECTION, INCLUDING THE COST OF DRUG PHYSICAL MEDICAL PROCEDURE 46 A4202 GAUZE, ELASTIC, ALL TYPES, PER ROLL 32 97039 PHYSICAL MEDICAL TREATMENT TO ONE AREA; INITIAL 30 MINUTES, EACH VISIT; ULTRASOUND 28 15850 REMOVAL OF SUTURES OTHER ----125 97799 PHYSICAL MEDICAL PROCEDURE 96 A4210 NEEDLE-FREE INJECTION DEVICE 89 J0110 ADMINISTRATION OF INJECTION, INCLUDING THE COST OF DRUG 37 93000 ELECTROCARDIOGRAM, ROUTINE ECG WITH AT LEAST 12 LEADS; WITH INTERPRETATION AND REPORT 27 A4202 GAUZE, ELASTIC, ALL TYPES, PER ROLL FIGURE 4.4.9.29. SAMPLE OUTPUT REPORT: TOP AMBULATORY DIAGNOSES OR PROCEDURES REPORT BY PATCAT (PX REPORT BY GROUP) (Sheet 13 of 18) 6-211 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 01 Mar 1995@1640 Page 1 TOP 5 AMBULATORY PROCEDURES REPORT By PATIENT CATEGORY From: 01 Feb 1995 To: 01 Mar 1995 *** Group Level Summary *** Applicable FARS/DFARS Restrictions Apply to Government Use Any five digit numeric Physician's Current Procedural Terminology, (CPT-1995) codes, service descriptions, instructions and/or guidelines only are copyright 1994 (or such date of publication of CPT as defined in the federal copyright laws) American Medical Association. All Rights Reserved. No fee schedules, basic unit values, relative value guides, or related listings are included in CPT. The AMA assumes no responsibilty for the consequences attributable to or related to any use or interpretation of information contained in or not contained in this product. The AMA shall not be deemed to be engaged in the practice of medicine or dispensing medical services. FIGURE 4.4.9.29. SAMPLE OUTPUT REPORT: TOP AMBULATORY DIAGNOSES OR PROCEDURES REPORT BY PATCAT (GROUP LVL SUM) (Sheet 14 of 18) 6-212 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 01 Mar 1995@1640 Page 2 TOP 5 AMBULATORY PROCEDURES REPORT By PATIENT CATEGORY From: 01 Feb 1995 To: 01 Mar 1996 *** Group Level Summary *** Group: TRIPLER ================================================================================ PATCAT/#Occur Code Description ================================================================================ FAM MBR OF ACTIVE DUTY ---------------------412 J0110 ADMINISTRATION OF INJECTION, INCLUDING THE COST OF DRUG 189 97799 PHYSICAL MEDICAL PROCEDURE 178 A4202 GAUZE, ELASTIC, ALL TYPES, PER ROLL 161 97039 PHYSICAL MEDICAL TREATMENT TO ONE AREA; INITIAL 30 MINUTES, EACH VISIT; ULTRASOUND 101 15850 REMOVAL OF SUTURES OTHER ----298 97799 PHYSICAL MEDICAL PROCEDURE 288 A4210 NEEDLE-FREE INJECTION DEVICE 284 J0110 ADMINISTRATION OF INJECTION, INCLUDING THE COST OF DRUG 135 A4202 GAUZE, ELASTIC, ALL TYPES, PER ROLL 77 93000 ELECTROCARDIOGRAM, ROUTINE ECG WITH AT LEAST 12 LEADS; WITH INTERPRETATION AND REPORT FIGURE 4.4.9.29. SAMPLE OUTPUT REPORT: TOP AMBULATORY DIAGNOSES OR PROCEDURES REPORT BY PATCAT (GROUP LVL SUM) (Sheet 15 of 18) 6-213 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 01 Mar 1995@1645 Page 1 TOP 5 AMBULATORY DIAGNOSES REPORT By PATIENT CATEGORY From: 01 Feb 1995 To: 01 Mar 1995 Applicable FARS/DFARS Restrictions Apply to Government Use Any five digit numeric Physician's Current Procedural Terminology, (CPT-1995) codes, service descriptions, instructions and/or guidelines only are copyright 1994 (or such date of publication of CPT as defined in the federal copyright laws) American Medical Association. All Rights Reserved. No fee schedules, basic unit values, relative value guides, or related listings are included in CPT. The AMA assumes no responsibility for the consequences attributable to or related to any use or interpretation of information contained in or not contained in this product. The AMA shall not be deemed to be engaged in the practice of medicine or dispensing medical services. FIGURE 4.4.9.29. SAMPLE OUTPUT REPORT: TOP AMBULATORY DIAGNOSES OR PROCEDURES REPORT BY PATCAT (DX/PX REPORT BY CLINIC) (Sheet 16 of 18) 6-214 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 01 Mar 1995@1645 Page 2 TOP 5 AMBULATORY DIAGNOSES REPORT By PATIENT CATEGORY From: 01 Feb 1995 To: 01 Mar 1995 Clinic: FAMILY PRACTICE ================================================================================ PATCAT/#Occur Code Description ================================================================================ ACTIVE DUTY ----------238 V04.7 COMMON COLD 75 766.0 ABDOMIAL PAIN 45 466.0 ACUTE BRONCHITIS 45 487.0 INFLUENZA WITH PNEUMONIA 35 34 MEDICAL BACK PROBLEMS 20 V70 GENERAL MEDICAL EXAMINATION 55 34 MEDICAL BACK PROBLEMS 54 V04.7 COMMON COLD 45 466.0 INFLUENZA WITH PNEUMONIA 22 789.0 ABDOMINAL PAIN 20 V70 GENERAL MEDICAL EXAMINATION RETIRED ------- FIGURE 4.4.9.29. SAMPLE OUTPUT REPORT: TOP AMBULATORY DIAGNOSES OR PROCEDURES REPORT BY PATCAT (DX/PX REPORT BY CLINIC) (Sheet 17 of 18) 6-215 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 01 Mar 1995@1645 Page 3 TOP 5 AMBULATORY PROCEDURES REPORT By PATIENT CATEGORY From: 01 Feb 1995 To: 01 Mar 1995 Clinic: FAMILY PRACTICE ================================================================================ PATCAT/#Occur Code Description ================================================================================ ACTIVE DUTY ----------177 A4210 NEEDLE-FREE INJECTION DEVICE 49 A4202 GAUZE, ELASTIC, ALL TYPES, PER ROLL 49 97799 PHYSICAL MEDICAL PROCEDURE 32 97039 PHYSICAL MEDICAL TREATMENT TO ONE AREA; INITIAL 30 MINUTES, EACH VISIT; ULTRASOUND 28 15850 REMOVAL OF SUTURES RETIRED ------125 97799 PHYSICAL MEDICAL PROCEDURE 98 J0110 ADMINISTRATION OF INJECTION, INCLUDING THE COST OF DRUG 74 A4202 GAUZE, ELASTIC, ALL TYPES, PER ROLL 37 93000 ELECTROCARDIOGRAM, ROUTINE ECG WITH AT LEAST 12 LEADS; WITH INTERPRETATION AND REPORT 14 A0080 NON-EMERGENCY TRANSPORTATION: PER MILE VOLUNTEER, WITH NO VESTED OR PERSONAL INTEREST 4.4.9.29. SAMPLE OUTPUT REPORT: TOP AMBULATORY DIAGNOSES OR PROCEDURES REPORT BY PATCAT (DX/PX REPORT BY CLINIC) (Sheet 18 of 18) 6-216 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 03 Mar 1995@0822 Personal Data - Privacy Act 1974 (PL-93-579) Page 1 PATIENT VISIT SUMMARY By PATIENT From: 03 Feb 1995 To: 07 Mar 1995 Applicable FARS/DFARS Restrictions Apply to Government Use Any five digit numeric Physician's Current Procedural Terminology, (CPT-1995) codes, service descriptions, instructions and/or guidelines only are copyright 1994 (or such date of publication of CPT as defined in the federal copyright laws) American Medical Association. All Rights Reserved. No fee schedules, basic unit values, relative value guides, or related listings are included in CPT. The AMA assumes no responsibility for the consequences attributable to or related to any use or interpretation of information contained in or not contained in this product. The AMA shall not be deemed to be engaged in the practice of medicine or dispensing medical services. FIGURE 4.4.9.30. SAMPLE OUTPUT REPORT: PATIENT VISIT SUMMARY REPORT (BY PATIENT) (Sheet 1 of 7) 6-217 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 03 Mar 1995@0822 Personal Data - Privacy Act 1974 (PL-93-579) Page 2 PATIENT VISIT SUMMARY By PATIENT From: 03 Feb 1995 To: 07 Mar 1995 Clinic: FAMILY PRACTICE Provider: GIBFRIED,KATHERINE J ================================================================================ Patient FMP/SSN Sex DOB/Age Appt Date/Time Appt Type Appt Status ================================================================================ BARRON,DAPHNE 30/004-04-3434 FEMALE 08 Jan 1965/30Y ------------06 Mar 1995@0830 RET WALK-IN DX1 506.0 FUM/VAPOR BRONC/PNEUMON DX2 506.2 FUM/VAPOR UP RESP INFLAM PX1 31622 DIAGNOSTIC BRONCHOSCOPY PX2 99331 REST HOME VISIT, ESTAB PAT PX3 E0967 WHEELCH. HAND RIMS W/8 VERT. RUBBER TIPPED PROJECTIONS, PAIR FIGURE 4.4.9.30. SAMPLE OUTPUT REPORT: PATIENT VISIT SUMMARY REPORT (BY PATIENT) (Sheet 2 of 7) 6-218 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 03 Mar 1995@0824 Personal Data - Privacy Act 1974 (PL-93-579) Page 1 PATIENT VISIT SUMMARY By PROVIDER From: 03 Feb 1995 To: 07 Mar 1995 Applicable FARS/DFARS Restrictions Apply to Government Use Any five digit numeric Physician's Current Procedural Terminology, (CPT-1995) codes, service descriptions, instructions and/or guidelines only are copyright 1994 (or such date of publication of CPT as defined in the federal copyright laws) American Medical Association. All Rights Reserved. No fee schedules, basic unit values, relative value guides, or related listings are included in CPT. The AMA assumes no responsibility for the consequences attributable to or related to any use or interpretation of information contained in or not contained in this product. The AMA shall not be deemed to be engaged in the practice of medicine or dispensing medical services. FIGURE 4.4.9.30. SAMPLE OUTPUT REPORT: PATIENT VISIT SUMMARY REPORT (BY PROVIDER) (Sheet 3 of 7) 6-219 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 03 Mar 1995@0824 Personal Data - Privacy Act 1974 (PL-93-579) Page 2 PATIENT VISIT SUMMARY By PROVIDER From: 03 Feb 1995 To: 07 Mar 1995 Clinic: FAMILY PRACTICE Provider: GIBFRIED,KATHERINE J ================================================================================ Patient FMP/SSN Sex DOB/Age Appt Date/Time Appt Type Appt Status ================================================================================ BARRON,DAPHNE 30/004-04-3434 FEMALE 08 Jan 1965/30Y ------------06 Mar 1995@0830 RET WALK-IN DX1 506.0 FUM/VAPOR BRONC/PNEUMON DX2 506.2 FUM/VAPOR UP RESP INFLAM PX1 31622 DIAGNOSTIC BRONCHOSCOPY PX2 99331 REST HOME VISIT, ESTAB PAT PX3 A4210 NEEDLE-FREE INJECTION DEVICE PX4 E0967 WHEELCH. HAND RIMS W/8 VERT. RUBBER TIPPED PROJECTIONS, PAIR FIGURE 4.4.9.30. SAMPLE OUTPUT REPORT: PATIENT VISIT SUMMARY REPORT (BY PROVIDER) (Sheet 4 of 7) 6-220 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 03 Mar 1995@0824 Personal Data - Privacy Act 1974 (PL-93-579) Page 3 PATIENT VISIT SUMMARY By PROVIDER From: 03 Feb 1995 To: 07 Mar 1995 Clinic: FAMILY PRACTICE Provider: GIBFRIED,KATHERINE J ================================================================================ Patient FMP/SSN Sex DOB/Age Appt Date/Time Appt Type Appt Status ================================================================================ MCDOUGALL,WILLIAM O 01/566-57-9823 MALE 17 Aug 1985/10Y ------------------06 Mar 1995@1000 NEW KEPT DX1 V04.2 NEED PROPHYLACTIC VACCINATION PX1 90705 MEASLES IMMUNIZATION PX2 A4210 NEEDLE-FREE INJECTION DEVICE FIGURE 4.4.9.30. SAMPLE OUTPUT REPORT: PATIENT VISIT SUMMARY REPORT (BY PROVIDER) (Sheet 5 of 7) 6-221 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 03 Mar 1995@0826 Personal Data - Privacy Act 1974 (PL-93-579) Page 1 PATIENT VISIT SUMMARY By CLINIC From: 03 Feb 1995 To: 07 Mar 1995 Applicable FARS/DFARS Restrictions Apply to Government Use Any five digit numeric Physician's Current Procedural Terminology, (CPT-1995) codes, service descriptions, instructions and/or guidelines only are copyright 1994 (or such date of publication of CPT as defined in the federal copyright laws) American Medical Association. All Rights Reserved. No fee schedules, basic unit values, relative value guides, or related listings are included in CPT. The AMA assumes no responsibility for the consequences attributable to or related to any use or interpretation of information contained in or not contained in this product. The AMA shall not be deemed to be engaged in the practice of medicine or dispensing medical services. FIGURE 4.4.9.30. SAMPLE OUTPUT REPORT: PATIENT VISIT SUMMARY REPORT (BY CLINIC) (Sheet 6 of 7) 6-222 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 TRIPLER ARMY MEDICAL CENTER 03 Mar 1995@0826 Personal Data - Privacy Act 1974 (PL-93-579) Page 2 PATIENT VISIT SUMMARY By CLINIC From: 03 Feb 1995 To: 07 Mar 1995 Clinic: FAMILY PRACTICE Provider: GIBFRIED,KATHERINE J ================================================================================ Patient FMP/SSN Sex DOB/Age Appt Date/Time Appt Type Appt Status ================================================================================ BARRON,DAPHNE 30/004-04-3434 FEMALE 08 Jan 1965/30Y ------------06 Mar 1995@0830 RET WALK-IN DX1 506.0 FUM/VAPOR BRONC/PNEUMON DX2 506.2 FUM/VAPOR UP RESP INFLAM PX1 31622 DIAGNOSTIC BRONCHOSCOPY PX2 99331 REST HOME VISIT, ESTAB PAT PX3 E0967 WHEELCH. HAND RIMS W/8 VERT. RUBBER TIPPED PROJECTIONS, PAIR FIGURE 4.4.9.30. SAMPLE OUTPUT REPORT: PATIENT VISIT SUMMARY REPORT (BY CLINIC) (Sheet 7 of 7) 6-223 SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 DIVISION: TRIPLER ARMY MEDICAL CENTER There is at least one Provider that has a deficiency in the number of schedules that are open or created. Please see the PAS SCHEDULES MONITOR report that was printed as a background job by the TaskManager or run the DEFICIENCY MONITOR option under the PAS Supervisor Menu to reprint a new report. FIGURE 4.4.10.2. SAMPLE OUTPUT REPORT: 6-224 AVAILABLE SCHEDULE MONITOR BULLETIN SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 Ireland Army Community Hospital 05 Jul 1991@1050 Page 1 Personal Data - Privacy Act of 1974 (PL 93-579) PAS Users Report ================================================================================ Division: IRELAND ================================================================================ Clinic User Name ID # Sec Lev Primary Menu ================================================================================ ALLERGY CLINIC CORY,DAVID 1011 #DSLORPN EVE CARDIOLOGY CLIN BENSON,JACK 24 #PRLNODS EVE CARDIOLOGY CLIN HOWLAND,BILL 34 SsDdRrFf EVE CARDIOLOGY CLIN SMITH,BETH 1035 #QSLORPN OR-CORE-MENU PLASTIC SURGERY PASKE,CINDY 1072 #LlPpSsDd EVE UROLOGY CLINIC TOMPKINS,MICHELLE 1204 #&PpSsKkNnOoDd EVE FIGURE 4.4.10.5. SAMPLE OUTPUT REPORT: 6-225 LIST PAS USERS SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 SANTOS,MERVYN (#169) --------------------Default Division: TRIPLER ARMY MEDICAL CENT Last Sign-on: 26 Jun 1991@1407 ATTRIBUTES ---------Creator ....... Primary Menu .. Time-out ...... Title ......... Primary Loc ... BRINTON,JAY EVE 99999 PROGRAMMER/ANALYST UROLOGY CLINIC Date Entered ...... 18 Jul 1988 FileMan Access .... @SsDd Type-ahead ........ Y Termination Date .. SECONDARY MENU OPTIONS ---------------------1) SD PAS MAIN MENU SECURITY KEYS HELD ------------------1) XUPROG 2) XUMGR 3) XUPROGMODE 4) SD ARCHIVE FIGURE 4.4.10.11. SAMPLE OUTPUT REPORT: 6-226 PRINT PAS USER SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 Appointment Cancellation Clerk Tripler Army Medical Center Tripler Building 2313 James Street Honolulu, HI 99999 ******************************************* 08 Oct 1991 C-DIV-1-1234 ********** Cancellation Mailer ********** Because of unforeseen circumstances, our facility has had to cancel your appointment for the date and time listed below. Please call the number shown to reschedule your appointment for the next available appointment slot. Thank you. Allergy Clinic with Burns,Richard F at 1130 on 16 Oct 1991 Wednesday Appointment Service Supervisor Clinic Phone: (555) 555-1212 Wilbur B. Smith 1234 W. Woodlawn St. Honolulu, HI 99999 Press <RETURN> to continue FIGURE 4.4.10.19. SAMPLE OUTPUT REPORT: 6-227 VIEW PAS MAILERS SAIC/CHCS Doc. TC-4.5-706 29 Jul 1996 Appointment Cancellation Clerk Tripler Army Medical Center Tripler Building 2313 James Street Honolulu, HI 99999 ******************************************* 08 Oct 1991 C-DIV-1-1234 ********** Cancellation Mailer ********** Because of unforeseen circumstances, our facility has had to cancel your appointment for the date and time listed below. Please call the number shown to reschedule your appointment for the next available appointment slot. Thank you. Allergy Clinic with Burns,Richard F at 1130 on 16 Oct 1991 Wednesday Appointment Service Supervisor Clinic Phone: (555) 555-1212 Wilbur B. Smith 1234 W. Woodlawn St. Honolulu, HI 99999 FIGURE 4.4.10.20. SAMPLE OUTPUT REPORT: 6-228 PRINT PAS MAILERS SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Sample Output Reports MCP END 6-229 Sample Output Reports SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 ---------------------------------------------------------------------------------------------------------------------------------TABLE OF CONTENTS ---------------------------------------------------------------------------------------------------------------------------------FIGURE REPORT NAME 4.4.1.3 Modify Group Agreement Effective Date 4.4.1.5 Agreement Data Changes 4.4.1.6 Place of Care Data Changes 4.4.1.7 Group Data Changes 4.4.1.8 Provider Data Changes 4.4.2.1 Provider Alphabetic Agreement Roster 4.4.2.2 Specialty Provider Agreement Roster 4.4.2.3 Specialty Provider Agreement Summary 4.4.2.4 Discount Provider Agreement Roster 4.4.2.5 Expiration Date Provider Agreement Roster 4.4.2.6 ZIP Code Agreement Roster 4.4.2.7 Provider Batch Address Labels - Print Utility 4.4.2.8 Discrepancy Avoidance Report 4.4.2.9 Group Member Roster 4.4.2.10 Provider Group Report 4.4.2.11 Provider List by Specialty 4.4.2.12 MCP Place of Care Report 4.4.2.13 Incomplete Provider Address Report 4.4.2.14 Provider Agreement Detail Report 4.4.3.1 Enrollment Enter/Edit 4.4.3.1.3 Current DEERS Eligibility Display 4.4.3.2 Disenrollment 4.4.3.4 Interactive DEERS Eligibility Request 6-230 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 4.4.3.6 Batch PCM Reassignment 4.4.3.10 Update/Print/Enroll Potential AD Candidates 4.4.3.11 Print Batch Enrollment Report 4.4.3.13 Identify Candidates for Renewal Letter 4.4.3.14 Batch Renewal & Disenrollment Processing 4.4.4.1 Print/Display Enrollment History 4.4.4.2 MCP Enrollment Form 4.4.4.4 MCP Conditional Enrollment Roster 4.4.4.5 Enrollment/Disenrollment Discrepancy Report 4.4.4.6 MCP DEERS Ineligibility Report 4.4.4.7 Family Batch Enrollment Labels Print Utility 4.4.4.8 Incomplete Patient Address Report 4.4.4.9 AD Family Members by Unit Enrollment Roster 4.4.4.10 Alphabetic Enrollment Roster by Service 4.4.4.11 Case Management Program Enrollment Roster 4.4.4.12 Change in Eligibility Enrollment Roster 4.4.4.13 Disenrollees for Period by Reason Code 4.4.4.14 Enrollment Roster Exception Conditions 4.4.4.15 Disenrollment Summary by Reason 4.4.4.16 OHI Enrollment Summary 4.4.4.17 Patient Category Enrollment Summary 4.4.4.18 Enrollment Summary Report 4.4.4.19 Reciprocal Disenrollment by Reason Roster 4.4.4.20 Reciprocal Disenrollment Discrepancy Report 4.4.4.21 Track User Report 4.4.4.22 Enrollee Entitlement Discrepancy Report 4.4.4.23 Batch Renew & Disenroll Letters 6-231 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 4.4.4.24 Batch Renew & Disenroll Labels 4.4.4.25 Batch Renew & Disenroll Roster 4.4.4.26 Generate Individual Notification Letter & Label 4.4.5.1 Available PCM Capacity by Provider Group 4.4.5.2 Enrollment Roster by PCM 4.4.5.3 PCM Activity Report 4.4.5.4 PCM Assignment Change Roster by Reason 4.4.5.5 PCM Assignment Change Summary 4.4.5.6 Enrollee/Patient Assignment Notification 4.4.5.7 Provider Assignment Notification 4.4.5.8 PCM Reassignment Report 4.4.5.9 UIC Maintenance Report 4.4.5.10 Default PCM/UIC Report 4.4.5.11 PCM Enrollment Mix Discrepancy Statistical Summary 4.4.5.12 PCM Enrollment Mix Discrepancy Report 4.4.6.1 Appointment Referral Booking 4.4.6.1.4 AHCF-Provider Search Action Bar 4.4.6.2 Non-Enrolled Booking 4.4.6.4 PCM Booking 4.4.6.4.1 DEERS Check (Non-Enrollment) 4.4.6.5 Enter Appointment Refusals 4.4.7.1 Output Products 4.4.7.2 Print Patient Address Label 4.4.7.3 Agreement Type Referral Summary 4.4.7.4 Specialty Type Referral Summary 4.4.7.5 Refused Appointments Report 4.4.7.6 Provider Network List 6-232 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 4.4.7.7 Provider Patient Workload Report 4.4.8.1 Non-Availability Statement Processing 4.4.8.2 Branch of Service Summary Report 4.4.8.3 NAS Statistical Report 4.4.8.4 Reason for Issue by Patient Category Report 4.4.8.5 Reason for Issue Summary Report 4.4.9.12 MCP Parameters Profile Enter/Edit 6-233 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 MailMan message for WEBER,CHRIS Printed at MCP.SAIC.COM Wed, 14 Apr 1993 09:02:37 (#5) Subj: AGREEMENT MODIFICATION NOTICE Tue, 13 Apr 1993 15:59:03 17 Lines From: POSTMASTER (Sender: WEBER,CHRIS) in 'IN' basket. **NEW** -----------------------------------------------------------------------------The PEX Agreement Effective Date has been changed FROM: 15 Feb 1993 TO: 14 Feb 1993 for the following group: BLUE CROSS/BLUE. USER: WEBER, CHRIS DATE/TIME of CHANGE: 13 Apr 1993@15:58 The FI needs to be notified of this change and the date of notification entered for the specified agreement. The old agreement information is stored in the MCP AGREEMENT MODIFICATIONS FILE under record 42. ------------ Discrepancies --------------No discrepancies found. FIGURE 4.4.1.3. SAMPLE OUTPUT REPORT: MODIFY GROUP AGREEMENT EFFECTIVE DATE 6-234 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 TIDEWATER 14 Oct 1993@1331 Page 1 Personal Data - Privacy Act 1974 (PL-93-579) AGREEMENT DATA CHANGES AUDIT TRAIL ONE AGREEMENT/ONE GROUP/NO PROVIDERS Data Changes from 09 Jun 1993 to 01 Jul 1994 Provider Group: TORRES HEALTH CARE GROUP Agreement: MTF 10 Jun 1993 - 10 Jun 1994 Data Elements: 8 Selected ================================================================================ Data Element ------------------------------------------------------------------------------AGREEMENT STOP DATE Change Date/Time: 14 Oct 1993 @ 1116 User ID: TJERNAGEL,STEVEN Old: 09 Jun 1994 New: 10 Jun 1994 FIGURE 4.4.1.5. SAMPLE OUTPUT REPORT: AGREEMENT DATA CHANGES ONE AGREEMENT/ONE GROUP/NO PROVIDERS (Sheet 1 of 5) 6-235 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 TIDEWATER 14 Oct 1993@1331 Page 2 Personal Data - Privacy Act 1974 (PL-93-579) AGREEMENT DATA CHANGES AUDIT TRAIL ONE AGREEMENT/ONE GROUP/NO PROVIDERS Data Changes from 09 Jun 1993 to 01 Jul 1994 Provider Group: TORRES HEALTH CARE GROUP Agreement: MTF 10 Jun 1993 - 10 Jun 1994 Data Elements: 8 Selected ================================================================================ CPT-4 Code Effective Dates Data Element -------------------------------------------------------------------------------11000 - SURGICAL CLEANSING OF SKIN 11 Jun 1993 - 09 Jun 1994 CPT-4 STOP DATE Change Date/Time: 14 Oct 1993 @ 1120 User ID: TJERNAGEL,STEVEN Old: New: 09 Jun 1994 CPT-4 PERCENT Change Date/Time: 14 Oct 1993 @ 1120 Old: 20 New: 25 EXCEPT CPT-4 EFFECTIVE DATE Change Date/Time: 14 Oct 1993 @ 1120 Old: New: 11 Jun 1993 11040 - SURGICAL CLEANSING, ABRASION CPT-4 STOP DATE Change Date/Time: 14 Oct 1993 @ 1120 Old: 09 Jun 1994 New: 08 Jun 1994 CPT-4 FEE Change Date/Time: 14 Oct 1993 @ 1120 Old: 789789 New: 888888 EXCEPT CPT-4 Change Old: New: EFFECTIVE DATE Date/Time: 14 Oct 1993 @ 1120 10 Jun 1993 12 Jun 1993 User ID: TJERNAGEL,STEVEN User ID: TJERNAGEL,STEVEN 12 Jun 1993 - 08 Jun 1994 User ID: TJERNAGEL,STEVEN User ID: TJERNAGEL,STEVEN User ID: TJERNAGEL,STEVEN FIGURE 4.4.1.5. SAMPLE OUTPUT REPORT: AGREEMENT DATA CHANGES ONE AGREEMENT/ONE GROUP/NO PROVIDERS (Sheet 2 of 5) 6-236 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 TIDEWATER 14 Oct 1993@1350 Page 1 Personal Data - Privacy Act 1974 (PL-93-579) AGREEMENT DATA CHANGES AUDIT TRAIL MULTIPLE AGREEMENTS/MULTIPLE GROUPS/ALL PROVIDERS Data Changes from 01 Jan 1992 to 01 Jan 1998 Group: 2 Selected Agreements: 7 Selected Provider: ALL Data Elements: 8 Selected ================================================================================ Provider Group Provider Agreement Type Effective Dates Data Element -------------------------------------------------------------------------------TORRES HEALTH CARE GROUP DICE,DONALD CON-CONTRACT 31 Aug 1993 - 30 Aug 1994 IND STOP DATE Change Date/Time: 14 Oct 1993 @ 1122 User ID: TJERNAGEL,STEVEN Old: New: 29 Aug 1994 IND OVERALL DISCOUNT PERCENT Change Date/Time: 14 Oct 1993 @ 1122 Old: New: 10 IND START DATE Change Date/Time: 14 Oct 1993 @ 1122 Old: New: 30 Aug 1993 NET-CIVILIAN NETWORK PROVIDER IND STOP DATE Change Date/Time: 14 Oct 1993 @ 1122 Old: New: 01 Jun 1994 IND OVERALL DISCOUNT PERCENT Change Date/Time: 14 Oct 1993 @ 1122 Old: New: 99 IND START DATE Change Date/Time: 14 Oct 1993 @ 1122 Old: New: 13 Jun 1993 User ID: TJERNAGEL,STEVEN User ID: TJERNAGEL,STEVEN 10 Jun 1993 - 10 Jun 1994 User ID: TJERNAGEL,STEVEN User ID: TJERNAGEL,STEVEN User ID: TJERNAGEL,STEVEN FIGURE 4.4.1.5. SAMPLE OUTPUT REPORT: AGREEMENT DATA CHANGES MULTIPLE AGREEMENTS/MULTIPLE GROUPS/ALL PROVIDERS (Sheet 3 of 5) 6-237 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 TIDEWATER 14 Oct 1993@1350 Page 2 Personal Data - Privacy Act 1974 (PL-93-579) AGREEMENT DATA CHANGES AUDIT TRAIL MULTIPLE AGREEMENTS/MULTIPLE GROUPS/ALL PROVIDERS Data Changes from 01 Jan 1992 to 01 Jan 1998 Group: 2 Selected Agreements: 7 Selected Provider: ALL Data Elements: 8 Selected ================================================================================ Provider Group Provider Agreement Type Effective Dates CPT-4 Code/Desc Effective Dates Data Element -------------------------------------------------------------------------------GROUP C MEDICAL ASSOCIATION AVERY,MICHAEL C CON-CONTRACT 01 Jul 1993 - 31 Dec 1996 10040 - ACNE SURGERY 01 Jul 1993 - 28 Feb 1996 PERCENT Change Date/Time: 12 Oct 1993 @ 1236 User ID: WEBER,CHRIS Old: New: 13 TOMAYO,LAWRENCE C NET-CIVILIAN NETWORK PROVIDER 10040 - ACNE SURGERY PERCENT Change Date/Time: 12 Oct 1993 @ 0933 Old: New: 13 TORRES HEALTH CARE GROUP SMITH,JAMES NET-CIVILIAN NETWORK PROVIDER 10040 - ACNE SURGERY STOP DATE Change Date/Time: 14 Oct 1993 @ 1131 Old: New: 07 Jun 1994 FEE Change Date/Time: 14 Oct 1993 @ 1131 Old: 30 New: 35 EXCEPT START DATE Change Date/Time: 14 Oct 1993 @ 1131 Old: New: 13 Jun 1993 01 Jul 1993 - 31 Dec 1996 01 Jul 1993 - 31 Mar 1995 User ID: WEBER,CHRIS 10 Jun 1993 - 10 Jun 1994 13 Jun 1993 - 07 Jun 1994 User ID: TJERNAGEL,STEVEN User ID: TJERNAGEL,STEVEN User ID: TJERNAGEL,STEVEN FIGURE 4.4.1.5. SAMPLE OUTPUT REPORT: AGREEMENT DATA CHANGES MULTIPLE AGREEMENTS/MULTIPLE GROUPS/ALL PROVIDERS (Sheet 4 of 5) 6-238 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 TIDEWATER 14 Oct 1993@1350 Page 3 Personal Data - Privacy Act 1974 (PL-93-579) AGREEMENT DATA CHANGES AUDIT TRAIL MULTIPLE AGREEMENTS/MULTIPLE GROUPS/ALL PROVIDERS Data Changes from 01 Jan 1992 to 01 Jan 1998 Group: 2 Selected Agreements: 7 Selected Provider: ALL Data Elements: 8 Selected ================================================================================ Provider Group Provider Agreement Type Effective Dates CPT-4 Code/Desc Effective Dates Data Element -------------------------------------------------------------------------------TORRES HEALTH CARE GROUP SMITH,JAMES NET-CIVILIAN NETWORK PROVIDER 10 Jun 1993 - 10 Jun 1994 10080 - DRAINAGE OF PILONIDAL CYST 13 Jun 1993 - 07 Jun 1994 STOP DATE Change Date/Time: 14 Oct 1993 @ 1131 User ID: TJERNAGEL,STEVEN Old: New: 07 Jun 1994 PERCENT Change Date/Time: 14 Oct 1993 @ 1131 Old: 40 New: 45 EXCEPT START DATE Change Date/Time: 14 Oct 1993 @ 1131 Old: New: 13 Jun 1993 PERCENT Change Date/Time: 14 Oct 1993 @ 1127 Old: New: 40 User ID: TJERNAGEL,STEVEN User ID: TJERNAGEL,STEVEN User ID: TJERNAGEL,STEVEN FIGURE 4.4.1.5. SAMPLE OUTPUT REPORT: AGREEMENT DATA CHANGES MULTIPLE AGREEMENTS/MULTIPLE GROUPS/ALL PROVIDERS (Sheet 5 of 5) 6-239 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 TIDEWATER 18 Oct 1993@0957 Personal Data - Privacy Act 1974 (PL-93-579) PLACE OF CARE DATA CHANGES AUDIT TRAIL Data Changes from 01 Jan 1992 to 01 Jan 1998 Page 1 Place of Care: All Places of Care selected Data Elements: 12 ================================================================================ Place of Care Data Element -------------------------------------------------------------------------------DE ANZA NORTH COUNTY MEDICAL C PLACE OF CARE NAME Change Date/Time: 13 Oct 1993@0715 User ID: SAGE,FREDI Old: DE ANZA MEDICAL CENTER New: DE ANZA NORTH COUNTY MEDICAL C FIGURE 4.4.1.6. SAMPLE OUTPUT REPORT: 6-240 PLACE OF CARE DATA CHANGES SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 TIDEWATER 18 Oct 1993@1353 Page 1 Personal Data - Privacy Act 1974 (PL-93-579) PROVIDER GROUP NAME CHANGES AUDIT TRAIL Data Changes from 01 Jan 1992 to 01 Jan 1998 Provider Group: INACTIVATE PROVIDER GROUP 1 ================================================================================ Change Date/Time: 18 Oct 1993 @ 1310 User ID: SAGE,FREDI Old Name: New Name: INACTIVATE PROVIDER GROUP 1 FIGURE 4.4.1.7. SAMPLE OUTPUT REPORT: 6-241 GROUP DATA CHANGES SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 TIDEWATER 18 Oct 1993@1429 Personal Data - Privacy Act 1974 (PL-93-579) Page 1 PROVIDER DATA CHANGES AUDIT TRAIL Data Changes from 01 Jan 1992 to 01 Jan 1998 Provider: 333 Selected Data Elements: 4 Selected ================================================================================ Provider Group Data Element -------------------------------------------------------------------------------DE BLASIO,MICHAEL CARDIOLOGY PNH INACTIVATION DATE Change Date/Time: 18 Oct 1993@1414 User ID: SAGE,FREDI Old: 19 Oct 1993 New: 18 Oct 1993 INACTIVATION DATE Change Date/Time: 18 Oct 1993@1410 Old: New: 19 Oct 1993 ESPINOZA,RUBEN SHARP MAIN GROUP INACTIVATION DATE Change Date/Time: 14 Oct 1993@1359 Old: 12 Oct 1993 New: <Data Deleted> INACTIVATION DATE Change Date/Time: 13 Oct 1993@1522 Old: New: 12 Oct 1993 SMITH,TIMOTHY J. SHARP MAIN GROUP INACTIVATION DATE Change Date/Time: 13 Oct 1993@1523 Old: 06 Oct 1993 New: <Data Deleted> User ID: SAGE,FREDI User ID: WOLLIN,MAGDALENA User ID: WOLLIN,MAGDALENA User ID: WOLLIN,MAGDALENA FIGURE 4.4.1.8. SAMPLE OUTPUT REPORT: 6-242 PROVIDER DATA CHANGES SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 TIDEWATER 12 Oct 1993@1204 Page 1 Personal Data - Privacy Act 1974 (PL-93-579) PROVIDER ALPHABETIC AGREEMENT ROSTER Provider Type: NETWORK INSTITUTION/SERVICE ================================================================================================================================== Group Name Specialty Agreement Type Effective Date Stop Date Disc % Except ================================================================================================================================== CENTER FOR HEALTH CARE MEDICAL GENERAL MEDICAL OFFICER NET - CIVILIAN NETWORK PROVIDER 01 Jun 1993 31 May 1994 CA- 8% E DERMATOLOGY LAFB MTF - MTF STAFF DERMATOLOGIST ENT LAFB OTORHINOLARYNGOLOGIST 06 May 1993 06 May 1994 MTF 06 May 1993 06 May 1994 MTF OBSTETRICIAN & GYNECOLOGIST (OB/GYN) PEDIATRICIAN PLASTIC SURGEON 01 Jul 1993 01 Jul 1993 31 Dec 1996 31 Dec 1996 CA-20% CA-20% 06 May 1993 06 May 1993 06 May 1994 06 May 1994 MTF CA-25% 03 Jun 1993 15 Aug 1993 03 Jul 1993 02 Jun 1994 14 Aug 1994 02 Jul 1994 CA-18% MTF CA-12% 06 May 1993 06 May 1994 MTF 06 May 1993 06 May 1994 MTF 06 May 1993 06 May 1993 06 May 1994 06 May 1994 MTF CA-35% MTF - MTF STAFF GROUP C MEDICAL ASSOCIATION CON - CONTRACT NET - CIVILIAN NETWORK PROVIDER INT MED LAFB ALLERGIST CARDIOLOGIST INTERNIST MTF - MTF STAFF PIC - PARTNER INTERNAL KAREN'S GROUP FAMILY PRACTICE PHYSICIAN SURGERY CONSULTANT CON - CONTRACT MTF - MTF STAFF NET - CIVILIAN NETWORK PROVIDER NUTRITION LAFB MTF - MTF STAFF DIETICIAN-NUTRITIONIST OPHTHALMOLOGY LAFB MTF - MTF STAFF OPHTHALMOLOGIST PEDIATRICS LAFB MTF - MTF STAFF PIC - PARTNER INTERNAL PEDIATRICIAN FIGURE 4.4.2.1. SAMPLE OUTPUT REPORT: PROVIDER ALPHABETIC AGREEMENT ROSTER (Sheet 1 of 2) 6-243 E SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 TIDEWATER 12 Oct 1993@1204 Page 2 Personal Data - Privacy Act 1974 (PL-93-579) PROVIDER ALPHABETIC AGREEMENT ROSTER Provider Type: NETWORK INSTITUTION/SERVICE (continued) ================================================================================================================================== Group Name Specialty Agreement Type Effective Date Stop Date Disc % Except ================================================================================================================================== SAIC GENERAL MEDICINE MTF ALLERGIST, PEDIATRIC CERTIFIED NURSE MIDWIFE FAMILY PRACTICE PHYSICIAN INTERNAL MEDICINE CONSULTANT INTERNIST OB/GYN CONSULTANT OBSTETRICIAN & GYNECOLOGIST (OB/GYN) PEDIATRIC SURGEON PEDIATRICIAN PRIMARY CARE NURSE PRACTITIONER QUALIFIED MTF - MTF STAFF 12 Jul 1993 11 Jul 1994 MTF PIC - PARTNER INTERNAL 17 Jul 1993 16 Jul 1994 CA-10% SAIC INTERNAL MEDICINE GROUP CON NET PEX SUP - FAMILY PRACTICE PHYSICIAN INTERNAL MEDICINE CONSULTANT INTERNAL MEDICINE RESIDENT INTERNIST OBSTETRICIAN & GYNECOLOGIST (OB/GYN) OPHTHALMOLOGIST PRIMARY CARE NURSE PRACTITIONER QUALIFIED SURGERY CONSULTANT CONTRACT 23 Jul 1993 CIVILIAN NETWORK PROVIDER 01 Oct 1993 PARTNER EXTERNAL 02 Jul 1993 SUPPLEMENTAL CARE/DIAGNOSTIC SERVICES 22 Jul 1993 SURGERY LAFB MTF - MTF STAFF 28 30 18 21 May Sep May Jul 1994 1994 1994 1994 CA-18% CA-11% CA-10% CA-12% E E E GENERAL SURGEON 06 May 1993 06 May 1994 MTF Total agreements NETWORK INSTITUTION/SERVICE Type: 21 FIGURE 4.4.2.1. SAMPLE OUTPUT REPORT: PROVIDER ALPHABETIC AGREEMENT ROSTER (Sheet 2 of 2) 6-244 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 TIDEWATER 24 Sep 1993@1450 Page 1 Personal Data - Privacy Act 1974 (PL-93-579) PROVIDER AGREEMENT ROSTER BY SPECIALTY Provider Type: NETWORK INDIVIDUAL PROVIDER ================================================================================================================================== Specialty Agreement Provider Group Effective Date Stop Date Disc % Except ================================================================================================================================== CARDIOLOGIST CON - CONTRACT CRAWFORD,JACQUI CRAWFORD CARDIOLOGY 28 Jul 1993 27 Jul 1994 CA-3% E DEL CARMEN & HARRIS 12 Jul 1993 11 Jul 1994 CA-15% CRAWFORD,JOSEPH CRAWFORD CARDIOLOGY 28 Jul 1993 27 Jul 1994 CA-3% EDDY,JEANNINE CRAWFORD CARDIOLOGY CIV 03 Jun 1993 20 Dec 1993 CA-15% FAITH,GROVER RFD PRIM CARE 02 Jun 1993 01 Jun 1994 CA-9% JACKMAN,BYRON N SENTARA 03 May 1993 03 May 1995 CA-17% JANSSEN,CHRISTA SENTARA 03 May 1993 03 May 1995 CA-17% MARTIN.GLENN NDC MED GROUP (FRANK) 12 Jul 1993 11 Jul 1994 CA-22% E SANDERS,CARL A GROUP A MEDICAL ASSOCIATION 01 Jul 1993 31 Jul 1996 CA-20% E WEBSTER,BEULAH RIVERSIDE MEDICAL 03 May 1993 03 May 1994 CA-12% WILSON,LARRY RIVERSIDE MEDICAL 03 May 1993 03 May 1994 CA-12% MTF - MTF STAFF CRAWFORD,JACQUI CRAWFORD CARDIOLOGY 14 Jul 1993 13 Jul 1994 MTF CRAWFORD,JOSEPH CRAWFORD CARDIOLOGY 14 Jul 1993 13 Jul 1994 MTF SANDERS,CARL A GROUP A MEDICAL ASSOCIATION 01 Jul 1993 31 Jul 1995 MTF E NET - CIVILIAN NETWORK PROVIDER CRAWFORD,JACQUI DEL CARMEN & HARRIS 05 May 1993 05 May 1994 CA-20% HEALEY,WARREN RFD PRIM CARE 02 Jun 1993 01 Jun 1994 CA-5% JACKMAN,BYRON N SENTARA 03 May 1993 03 May 1994 CA-17% JANSSEN,CHRISTA SENTARA 03 May 1993 03 May 1994 CA-17% SANDERS,CARL A GROUP A MEDICAL ASSOCIATION 01 Jul 1993 31 Jul 1995 CA-15% E WEBSTER,BEULAH RIVERSIDE MEDICAL 01 Oct 1992 01 Oct 1993 CA-12% WILSON,LARRY FIGURE 4.4.2.2. SAMPLE OUTPUT REPORT: SPECIALTY PROVIDER AGREEMENT ROSTER (Sheet 1 of 4) 6-245 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 RIVERSIDE MEDICAL 01 Oct 1992 01 Oct 1993 TIDEWATER CA-12% 24 Sep 1993@1450 Page 2 Personal Data - Privacy Act 1974 (PL-93-579) PROVIDER AGREEMENT ROSTER BY SPECIALTY Provider Type: NETWORK INDIVIDUAL PROVIDER (continued) ================================================================================================================================== Specialty Agreement Provider Group Effective Date Stop Date Disc % Except ================================================================================================================================== CARDIOLOGIST (continued) NON - NON-NETWORK/EXCEPTION CRAWFORD,JACQUI CRAWFORD CARDIOLOGY 02 Jun 1993 01 Jun 1994 CA-0% CRAWFORD,JOSEPH CRAWFORD CARDIOLOGY 02 Jun 1993 01 Jun 1994 CA-0% PIC - PARTNER INTERNAL CRAWFORD,JACQUI CRAWFORD CARDIOLOGY 12 Jun 1993 11 Jun 1994 CA-25% DEL CARMEN & HARRIS 17 Aug 1993 16 Aug 1994 CA-22% CRAWFORD,JOSEPH CRAWFORD CARDIOLOGY 12 Jun 1993 11 Jun 1994 CA-25% PURCELL,OTIS INT MED LAFB 06 May 1993 06 May 1994 CA-25% ROBINSON,RENAE INT MED LAFB 06 May 1993 06 May 1994 CA-25% SUP - SUPPLEMENTAL CARE/DIAGNOSTIC SERVICES EDDY,JEANNINE CRAWFORD CARDIOLOGY CIV 03 Jun 1993 02 Jun 1994 CA-10% E CARDIOLOGIST Provider Totals: Total providers all specialties: FIGURE 4.4.2.2. SAMPLE OUTPUT REPORT: SPECIALTY PROVIDER AGREEMENT ROSTER (Sheet 2 of 4) 6-246 13 13 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 TIDEWATER 24 Sep 1993@1450 Page 3 Personal Data - Privacy Act 1974 (PL-93-579) PROVIDER AGREEMENT ROSTER BY SPECIALTY Provider Type: NETWORK INSTITUTION/SERVICE ================================================================================================================================== Specialty Agreement Group Effective Date Stop Date Disc % Except ================================================================================================================================== CARDIOLOGIST MTF - MTF STAFF INT MED LAFB 06 May 1993 06 May 1994 MTF PIC - PARTNER INTERNAL INT MED LAFB 06 May 1993 06 May 1994 CA-25% CARDIOLOGIST Group Totals: Total groups all specialties: FIGURE 4.4.2.2. SAMPLE OUTPUT REPORT: SPECIALTY PROVIDER AGREEMENT ROSTER (Sheet 3 of 4) 6-247 2 2 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 TIDEWATER 24 Sep 1993@1450 Page 4 Personal Data - Privacy Act 1974 (PL-93-579) PROVIDER AGREEMENT ROSTER BY SPECIALTY Provider Type: NETWORK PROVIDER GROUP ================================================================================================================================== Specialty Agreement Group Effective Date Stop Date Disc % Except ================================================================================================================================== CARDIOLOGIST CON - CONTRACT CRAWFORD CARDIOLOGY 28 Jul 1993 27 Jul 1994 CA-3% CRAWFORD CARDIOLOGY CIV 03 Jun 1993 20 Dec 1993 CA-15% DEL CARMEN & HARRIS 12 Jul 1993 11 Jul 1994 CA-15% GROUP A MEDICAL ASSOCIATION 01 Jul 1993 31 Dec 1996 CA-20% NDC MED GROUP (FRANK) 12 Jul 1993 11 Jul 1994 CA-10% E RFD PRIM CARE 02 Jun 1993 01 Jun 1994 CA-9% RIVERSIDE MEDICAL 03 May 1993 03 May 1994 CA-12% SENTARA 03 May 1993 03 May 1995 CA-17% MTF - MTF STAFF CARDIOLOGY PNH 07 May 1993 07 May 1996 MTF E CRAWFORD CARDIOLOGY 14 Jul 1993 13 Jul 1994 MTF GROUP A MEDICAL ASSOCIATION 01 Jul 1993 31 Dec 1996 MTF NET - CIVILIAN NETWORK PROVIDER DEL CARMEN & HARRIS 05 May 1993 05 May 1994 CA-20% E GROUP A MEDICAL ASSOCIATION 01 Jul 1993 31 Dec 1996 CA-20% RFD PRIM CARE 02 Jun 1993 01 Jun 1994 CA-5% RIVERSIDE MEDICAL 01 Oct 1992 01 Oct 1993 CA-12% SENTARA 03 May 1993 03 May 1994 CA-17% NON - NON-NETWORK/EXCEPTION CRAWFORD CARDIOLOGY 02 Jun 1993 01 Jun 1994 CA-0% PIC - PARTNER INTERNAL CRAWFORD CARDIOLOGY 12 Jun 1993 11 Jun 1994 CA-25% DEL CARMEN & HARRIS 17 Aug 1993 16 Aug 1994 CA-22% E GROUP A MEDICAL ASSOCIATION 01 Jul 1993 31 Dec 1996 CA-20% SUP - SUPPLEMENTAL CARE/DIAGNOSTIC SERVICES CRAWFORD CARDIOLOGY CIV 03 Jun 1993 02 Jun 1994 10% CARDIOLOGIST Group Totals: Total groups all specialties: FIGURE 4.4.2.2. SAMPLE OUTPUT REPORT: SPECIALTY PROVIDER AGREEMENT ROSTER (Sheet 4 of 4) 6-248 21 21 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 FLAG FOR DEERS PROGRAM OFFICE 05 Jan 1994@1111 Personal Data - Privacy Act 1994 (PL-93-579) PROVIDER AGREEMENT ROSTER BY SPECIALTY Page 1 Provider Type: NETWORK INDIVIDUAL PROVIDER ================================================================================= Specialty Agreement Number Agreements ================================================================================= CARDIOLOGIST ----------CON - CONTRACT 11 MTF - MTF STAFF 5 NET - CIVILIAN NETWORK PROVIDER 7 NON - NON-NETWORK/EXCEPTION 5 PEX - PARTNER EXTERNAL 1 PIC - PARTNER INTERNAL 6 SUP - SUPPLEMENTAL CARE/DIAGNOSTIC SERVICES 2 TOTAL AGREEMENTS FOR SPECIALTY CARDIOLOGIST: FAMILY PRACTICE PHYSICIAN -----------------------CON - CONTRACT MTF - MTF STAFF NET - CIVILIAN NETWORK PROVIDER NON - NON-NETWORK/EXCEPTION PEX - PARTNER EXTERNAL PIC - PARTNER INTERNAL SUP - SUPPLEMENTAL CARE/DIAGNOSTIC SERVICES 37 21 23 35 10 10 8 6 TOTAL AGREEMENTS FOR SPECIALTY FAMILY PRACTICE PHYSICIAN: GASTROENTEROLOGIST ----------------CON - CONTRACT NET - CIVILIAN NETWORK PROVIDER 113 4 2 TOTAL AGREEMENTS FOR SPECIALTY GASTROENTEROLOGIST: 6 TOTAL AGREEMENTS PROVIDER TYPE NETWORK INDIVIDUAL PROVIDER: 156 FIGURE 4.4.2.3. SAMPLE OUTPUT REPORTS: SPECIALTY PROVIDER AGREEMENT SUMMARY (Sheet 1 of 2) 6-249 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 FLAG FOR DEERS PROGRAM OFFICE 05 Jan 1994@1111 Personal Data - Privacy Act 1994 (PL-93-579) PROVIDER AGREEMENT ROSTER BY SPECIALTY Page 2 Provider Type: NETWORK PROVIDER GROUP ================================================================================= Specialty Agreement Number Agreements ================================================================================= CARDIOLOGIST ----------CON - CONTRACT 9 MTF - MTF STAFF 5 NET - CIVILIAN NETWORK PROVIDER 7 NON - NON-NETWORK/EXCEPTION 3 PEX - PARTNER EXTERNAL 1 PIC - PARTNER INTERNAL 4 SUP - SUPPLEMENTAL CARE/DIAGNOSTIC SERVICES 2 TOTAL AGREEMENTS FOR SPECIALTY CARDIOLOGIST: FAMILY PRACTICE PHYSICIAN -----------------------CON - CONTRACT MTF - MTF STAFF NET - CIVILIAN NETWORK PROVIDER NON - NON-NETWORK/EXCEPTION PEX - PARTNER EXTERNAL PIC - PARTNER INTERNAL SUP - SUPPLEMENTAL CARE/DIAGNOSTIC SERVICES 31 8 13 18 5 4 4 2 TOTAL AGREEMENTS FOR SPECIALTY FAMILY PRACTICE PHYSICIAN: GASTROENTEROLOGIST ----------------CON - CONTRACT MTF - MTF STAFF NET - CIVILIAN NETWORK PROVIDER 54 2 1 1 TOTAL AGREEMENTS FOR SPECIALTY GASTROENTEROLOGIST: 4 TOTAL AGREEMENTS PROVIDER TYPE NETWORK PROVIDER GROUP: 89 FIGURE 4.4.2.3. SAMPLE OUTPUT REPORTS: SPECIALTY PROVIDER AGREEMENT SUMMARY (Sheet 2 of 2) 6-250 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 TIDEWATER 24 Sep 1993@1554 Personal Data - Privacy Act 1974 (PL-93-579) Page 1 PROVIDER AGREEMENT ROSTER by DISCOUNT Agreement Type: CONTRACT ================================================================================ Provider Type: NETWORK INDIVIDUAL PROVIDER ================================================================================ Specialty: AEROSPACE MED FLIGHT SURGEON/FAMILY PRACTICE PHYSICIAN Discount: CA-34% MATT,COREY PROV MERGE TEST GROUP (MATT) Specialty: ALLERGIST Discount: CA-17% KANE,KERRY L SENTARA KANZIUS,CHRIS SENTARA TOTAL PROVIDERS AT CA-17%: 2 Discount: CA-12% YACABUCCI,JOHN E RIVERSIDE MEDICAL YAMATE,JAMES M RIVERSIDE MEDICAL TOTAL PROVIDERS AT CA-12%: 2 Specialty: ALLERGY Discount: CA- 9% HEALEY,WARREN RFD PRIM CARE Specialty: BURN THERAPIST Discount: 50% PIERCE,HANK MATT'S PROVIDER GROUP Specialty: CARDIAC SURGEON Discount: CA-30% WILSON,THOMAS GROUP A MEDICAL GROUP Discount: CA- 3% CRAWFORD,MICHELLE CRAWFORD CARDIOLOGY Discount: CA- 1% DANNY,JAY DANNY CARDIOLOGY GROUP FIGURE 4.4.2.4. SAMPLE OUTPUT REPORT: DISCOUNT PROVIDER AGREEMENT ROSTER (Sheet 1 of 2) 6-251 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 TIDEWATER 24 Sep 1993@1554 Personal Data - Privacy Act 1974 (PL-93-579) Page 2 PROVIDER AGREEMENT ROSTER by DISCOUNT Agreement Type: CONTRACT (continued) ================================================================================ Provider Type: NETWORK INDIVIDUAL PROVIDER (continued) ================================================================================ Specialty: CARDIOLOGIST Discount: CA-22% NEWMAN,MARCUS NDC MED GROUP (FRANK) Discount: CA-20% SANDERS,CARL A GROUP A MEDICAL ASSOCIATION Discount: CA-17% JACKMAN,BYRON N SENTARA JANSSEN,CHRISTA SENTARA TOTAL PROVIDERS AT CA-17%: 2 Discount: CA-15% CRAWFORD,JACQUI DEL CARMEN & HARRIS EDDY,JEANNINE CRAWFORD CARDIOLOGY CIV TOTAL PROVIDERS AT CA-15%: 2 Discount: CA-12% WEBSTER,BEULAH RIVERSIDE MEDICAL WILSON,LARRY RIVERSIDE MEDICAL TOTAL PROVIDERS AT CA-12%: 2 Discount: CA- 9% HAVEN,SAUL RFD PRIM CARE Specialty: CARDIOLOGY Discount: CA- 9% SHAW,HERB RFD PRIM CARE Specialty: COLON & RECTAL SURGEON Discount: 50% PIERCE,HANK FIGURE 4.4.2.4. SAMPLE OUTPUT REPORT: DISCOUNT PROVIDER AGREEMENT ROSTER (Sheet 2 of 2) 6-252 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 TIDEWATER 01 Oct 1993@1242 Page 1 Personal Data - Privacy Act 1974 (PL-93-579) Provider Agreement Roster By Expiration Date Period from 16 Sep 1993 to 01 Dec 1993 ======================================================================================================================== Provider Specialty Provider Group Payment Address Zip Code Phone Number Agreement Type Effective Dates Disc % Except ======================================================================================================================== ABBOTT,JAMES GENERAL SURGEON INTERNAL MEDICINE INTERNAL MEDICINE CONSULTANT SALISBURY TRAINING GROUP 6275 RANCHO MISSION ROAD PORTSMOUTH, VA 23667 (804) 780-0520 SUP - SUPPLEMENTAL CARE/DIAGNOSTIC SERVICES 18Oct92-17Oct93 CA-10% E RIVERSIDE MEDICAL P O BOX 5436 822 OLD HAMPTON PARKWAY NET - CIVILIAN NETWORK PROVIDER ACEVES,ALICIA RIVERSIDE MEDICAL P O BOX 5436 822 OLD HAMPTON PARKWAY NET - CIVILIAN NETWORK PROVIDER PEX - PARTNER EXTERNAL BALLANTINE,ELAINE G RIVERSIDE MEDICAL P O BOX 5436 822 OLD HAMPTON PARKWAY NET - CIVILIAN NETWORK PROVIDER BOOKER,DONALD T RIVERSIDE MEDICAL P O BOX 5436 822 OLD HAMPTON PARKWAY NET - CIVILIAN NETWORK PROVIDER CALLENDER,OTHELLO RIVERSIDE MEDICAL P O BOX 5436 822 OLD HAMPTON PARKWAY NET - CIVILIAN NETWORK PROVIDER FIGURE 4.4.2.5. HAMPTON, VA 23669 01Oct92-01Oct93 (804) 890-5432 CA-12% GENERAL SURGEON HAMPTON, VA 23669 05Sep92-05Sep93 01Oct92-01Oct93 (804) 890-5432 CA-17% CA-12% OPHTHALMOLOGIST HAMPTON, VA 23669 01Oct92-01Oct93 (804) 890-5432 CA-12% OPHTHALMOLOGIST HAMPTON, VA 23669 01Oct92-01Oct93 (804) 890-5432 CA-12% PODIATRIST HAMPTON, VA 23669 01Oct92-01Oct93 (804) 890-5432 CA-12% SAMPLE OUTPUT REPORT: EXPIRATION DATE PROVIDER AGREEMENT ROSTER (Sheet 1 of 7) 6-253 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 TIDEWATER 01 Oct 1993@1242 Page 2 Personal Data - Privacy Act 1974 (PL-93-579) Provider Agreement Roster By Expiration Date Period from 16 Sep 1993 to 01 Dec 1993 ======================================================================================================================== Provider Specialty Provider Group Payment Address Zip Code Phone Number Agreement Type Effective Dates Disc % Except ======================================================================================================================== DAMON,THOMAS R RIVERSIDE MEDICAL P O BOX 5436 822 OLD HAMPTON PARKWAY PIC - PARTNER INTERNAL DANIELS,DEANNA RIVERSIDE MEDICAL P O BOX 5436 822 OLD HAMPTON PARKWAY NET - CIVILIAN NETWORK PROVIDER ESPINOZA,EDNA SAIC INTERNAL MEDICINE GROUP SUITE A 10 NETWORK LANE NET - CIVILIAN NETWORK PROVIDER HOOD,DORIS A CHILDRENS HOSPITAL & CLINIC 1778 COLONIAL PARKWAY NET - CIVILIAN NETWORK PROVIDER HOPKINS,CHARLES R CHILDRENS HOSPITAL & CLINIC 1778 COLONIAL PARKWAY NON - NON-NETWORK/EXCEPTION QUINN,FRED RIVERSIDE MEDICAL P O BOX 5436 822 OLD HAMPTON PARKWAY NET - CIVILIAN NETWORK PROVIDER FIGURE 4.4.2.5. DERMATOLOGIST HAMPTON, VA 23669 01Oct92-01Oct93 (804) 890-5432 CA-12% DERMATOLOGIST HAMPTON, VA 23669 01Oct92-01Oct93 (804) 890-5432 CA-12% INTERNAL MEDICINE RESIDENT SAN DIEGO, CA 92120 25Sep92-25Sep93 (619) 555-0100 CA-12% PEDIATRICIAN YORKTOWN, VA 23690 (804) 890-7654 CA-16% 23690 (804) 890-7654 CA-16% 23669 (804) 890-5432 01Oct92-30Sep93 PEDIATRICIAN YORKTOWN, VA 01Oct92-30Sep93 INTERNIST HAMPTON, VA 01Oct92-01Oct93 CA-12% SAMPLE OUTPUT REPORT: EXPIRATION DATE PROVIDER AGREEMENT ROSTER (Sheet 2 of 7) 6-254 PCM SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 TIDEWATER 01 Oct 1993@1242 Page 3 Personal Data - Privacy Act 1974 (PL-93-579) Provider Agreement Roster By Expiration Date Period from 16 Sep 1993 to 01 Dec 1993 ======================================================================================================================== Provider Specialty Provider Group Payment Address Zip Code Phone Number Agreement Type Effective Dates Disc % Except ======================================================================================================================== RANGER,GLORIA GASTROENTEROLOGIST RIVERSIDE MEDICAL P O BOX 5436 HAMPTON, VA 23669 (804) 890-5432 822 OLD HAMPTON PARKWAY NET - CIVILIAN NETWORK PROVIDER 01Oct92-01Oct93 CA-12% READ,MELISSA RIVERSIDE MEDICAL P O BOX 5436 822 OLD HAMPTON PARKWAY NET - CIVILIAN NETWORK PROVIDER RIVERSIDE MEDICAL GASTROENTEROLOGIST HAMPTON, VA 23669 01Oct92-01Oct93 (804) 890-5432 CA-12% ALLERGIST CARDIOLOGIST DERMATOLOGIST GASTROENTEROLOGIST GENERAL SURGEON INTERNIST NEUROLOGICAL SURGEON NEUROLOGIST OBSTETRICIAN & GYNECOLOGIST (OB/GYN) OPHTHALMOLOGIST ORTHOPEDIC SURGEON OTORHINOLARYNGOLOGIST PEDIATRICIAN PODIATRIST RIVERSIDE MEDICAL 822 OLD HAMPTON PARKWAY P O BOX 5436 NET - CIVILIAN NETWORK PROVIDER SALISBURY TRAINING GROUP HAMPTON, VA 23669 01Oct92-01Oct93 (804) 890-5432 CA-12% FAMILY PRACTICE PHYSICIAN INTERNAL MEDICINE CONSULTANT INTERNAL MEDICINE RESIDENT INTERNIST OBSTETRICIAN & GYNECOLOGIST (OB/GYN) OPHTHALMOLOGIST PRIMARY CARE NURSE PRACTITIONER QUALIFIED SURGERY CONSULTANT FIGURE 4.4.2.5. SAMPLE OUTPUT REPORT: EXPIRATION DATE PROVIDER AGREEMENT ROSTER (Sheet 3 of 7) 6-255 PCM SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 TIDEWATER 01 Oct 1993@1242 Page 4 Personal Data - Privacy Act 1974 (PL-93-579) Provider Agreement Roster By Expiration Date Period from 16 Sep 1993 to 01 Dec 1993 ======================================================================================================================== Provider Specialty Provider Group Payment Address Zip Code Phone Number Agreement Type Effective Dates Disc % Except ======================================================================================================================== SALISBURY TRAINING GROUP 6275 RANCHO MISSION ROAD PORTSMOUTH, VA 23667 (804) 780-0520 SUP - SUPPLEMENTAL CARE/DIAGNOSTIC SERVICES 18Oct92-17Oct93 CA-10% E SHANNON,BERNICE V RIVERSIDE MEDICAL P O BOX 5436 822 OLD HAMPTON PARKWAY NET - CIVILIAN NETWORK PROVIDER SMITH,DENISE RIVERSIDE MEDICAL P O BOX 5436 822 OLD HAMPTON PARKWAY NET - CIVILIAN NETWORK PROVIDER TAIT,WILLIAM A RIVERSIDE MEDICAL P O BOX 5436 822 OLD HAMPTON PARKWAY CON - CONTRACT THACKER,DAVID RIVERSIDE MEDICAL P O BOX 5436 822 OLD HAMPTON PARKWAY NET - CIVILIAN NETWORK PROVIDER THORPE,FRANCES RIVERSIDE MEDICAL P O BOX 5436 822 OLD HAMPTON PARKWAY NET - CIVILIAN NETWORK PROVIDER VALDEZ,JUAN M RIVERSIDE MEDICAL P O BOX 5436 822 OLD HAMPTON PARKWAY NET - CIVILIAN NETWORK PROVIDER FIGURE 4.4.2.5. OBSTETRICIAN & GYNECOLOGIST (OB/GYN) HAMPTON, VA 23669 01Oct92-01Oct93 (804) 890-5432 CA-12% OBSTETRICIAN & GYNECOLOGIST (OB/GYN) HAMPTON, VA 23669 01Oct92-01Oct93 (804) 890-5432 CA-12% OBSTETRICIAN & GYNECOLOGIST (OB/GYN) HAMPTON, VA 23669 01Oct92-01Oct93 (804) 890-5432 CA-12% PEDIATRICIAN HAMPTON, VA 23669 01Oct92-01Oct93 (804) 890-5432 CA-12% OBSTETRICIAN & GYNECOLOGIST (OB/GYN) HAMPTON, VA 23669 01Oct92-01Oct93 (804) 890-5432 CA-12% OTORHINOLARYNGOLOGIST HAMPTON, VA 23669 01Oct92-01Oct93 (804) 890-5432 CA-12% SAMPLE OUTPUT REPORT: EXPIRATION DATE PROVIDER AGREEMENT ROSTER (Sheet 4 of 7) 6-256 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 TIDEWATER 01 Oct 1993@1242 Page 5 Personal Data - Privacy Act 1974 (PL-93-579) Provider Agreement Roster By Expiration Date Period from 16 Sep 1993 to 01 Dec 1993 ======================================================================================================================== Provider Specialty Provider Group Payment Address Zip Code Phone Number Agreement Type Effective Dates Disc % Except ======================================================================================================================== WATERHOUSE,ROBERT G ORTHOPEDIC SURGEON RIVERSIDE MEDICAL P O BOX 5436 HAMPTON, VA 23669 (804) 890-5432 822 OLD HAMPTON PARKWAY NET - CIVILIAN NETWORK PROVIDER 01Oct92-01Oct93 CA-12% WATERS,ANDREW T RIVERSIDE MEDICAL P O BOX 5436 822 OLD HAMPTON PARKWAY NET - CIVILIAN NETWORK PROVIDER WEBER,CHRISTOPHER G RIVERSIDE MEDICAL P O BOX 5436 822 OLD HAMPTON PARKWAY NET - CIVILIAN NETWORK PROVIDER WILSON,BEULAH RIVERSIDE MEDICAL P O BOX 5436 822 OLD HAMPTON PARKWAY NET - CIVILIAN NETWORK PROVIDER YAMAMOTO,JOHN E RIVERSIDE MEDICAL P O BOX 5436 822 OLD HAMPTON PARKWAY NET - CIVILIAN NETWORK PROVIDER YORK,JAMES H RIVERSIDE MEDICAL P O BOX 5436 822 OLD HAMPTON PARKWAY MTF - MTF STAFF FIGURE 4.4.2.5. ORTHOPEDIC SURGEON EDELSTEIN, IL 61526 01Oct92-01Oct93 (804) 890-5432 CA-12% CARDIOLOGIST HAMPTON, VA 23669 01Oct92-01Oct93 (804) 890-5432 CA-12% CARDIOLOGIST EDELSTEIN, IL 61526 01Oct92-01Oct93 (804) 890-5432 CA-12% ALLERGIST HAMPTON, VA 23669 01Oct92-01Oct93 (804) 890-5432 CA-12% ALLERGIST HAMPTON, VA 23669 01Oct92-01Oct93 (804) 890-5432 MTF SAMPLE OUTPUT REPORT: EXPIRATION DATE PROVIDER AGREEMENT ROSTER (Sheet 5 of 7) 6-257 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 TIDEWATER 01 Oct 1993@1242 Page 6 Personal Data - Privacy Act 1974 (PL-93-579) Provider Agreement Roster By Expiration Date Period from 16 Sep 1993 to 01 Dec 1993 ======================================================================================================================== Provider Specialty Provider Group Payment Address Zip Code Phone Number Agreement Type Effective Dates Disc % Except ======================================================================================================================== ZELENOVIC,CHRISTINA NEUROLOGICAL SURGEON NEUROLOGIST RIVERSIDE MEDICAL P O BOX 5436 HAMPTON, VA 23669 (804) 890-5432 822 OLD HAMPTON PARKWAY NON - NON-NETWORK/EXCEPTION 01Oct92-01Oct93 CA-12% FIGURE 4.4.2.5. SAMPLE OUTPUT REPORT: EXPIRATION DATE PROVIDER AGREEMENT ROSTER (Sheet 6 of 7) 6-258 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 TIDEWATER 01 Oct 1993@1242 Page 7 Personal Data - Privacy Act 1974 (PL-93-579) Provider Agreement Roster By Expiration Date Period from 16 Sep 1993 to 01 Dec 1993 ======================================================================================================================== Agreement Type Total ======================================================================================================================== CON - CONTRACT 1 MTF - MTF STAFF 2 NET - CIVILIAN NETWORK PROVIDER 21 NON - NON-NETWORK/EXCEPTION 2 PEX - PARTNER EXTERNAL 1 PIC - PARTNER INTERNAL 1 SUP - SUPPLEMENTAL CARE/DIAGNOSTIC SERVICES 1 -----------------------------------------------------------Total Agreements 29 FIGURE 4.4.2.5. SAMPLE OUTPUT REPORT: EXPIRATION DATE PROVIDER AGREEMENT ROSTER (Sheet 7 of 7) 6-259 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 TIDEWATER 28 Sep 1993@1051 Page 1 Personal Data - Privacy Act 1974 (PL-93-579) Provider Agreement Roster By ZIP Code ZIP Code: 23601 **PCM only** ======================================================================================================================== Specialty Provider Provider Group Agreement Type Effective Dates Disc % Except ======================================================================================================================== FAMILY PRACTICE PHYSICIAN ------------------------DEL CARMEN,GLEN R DEL CARMEN & HARRIS NET - CIVILIAN NETWORK PROVIDER 05May93-05May94 CA-20% EAKLE,THOMAS K FAMILY PRACTICE ASSOCIATES NET - CIVILIAN NETWORK PROVIDER 01Oct92-18May95 CA-10% EATON,GARY M FAMILY PRACTICE ASSOCIATES NET - CIVILIAN NETWORK PROVIDER 01Oct92-18May95 CA-10% ELLIS,BARBARA M FAMILY PRACTICE ASSOCIATES NET - CIVILIAN NETWORK PROVIDER 01Oct92-18May95 CA-10% EVANS,RICK FAMILY PRACTICE ASSOCIATES NET - CIVILIAN NETWORK PROVIDER 01Oct92-18May95 CA-10% HARRIS,SCOTT D DEL CARMEN & HARRIS NET - CIVILIAN NETWORK PROVIDER 05May93-05May94 CA-20% Total providers for FAMILY PRACTICE PHYSICIAN: Total providers for ZIP Code 23601: FIGURE 4.4.2.6. SAMPLE OUTPUT REPORT: ZIP CODE AGREEMENT ROSTER (Sheet 1 of 3) 6-260 E 6 6 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 TIDEWATER 28 Sep 1993@1051 Page 2 Personal Data - Privacy Act 1974 (PL-93-579) Provider Agreement Roster By ZIP Code ZIP Code: 23665 **PCM only** ======================================================================================================================== Specialty Provider Provider Group Agreement Type Effective Dates Disc % Except ======================================================================================================================== CARDIOLOGIST -----------CARDIOLOGY PNH CARDIOLOGY PNH MTF - MTF STAFF 07May93-07May96 MTF CRAWFORD CARDIOLOGY CRAWFORD CARDIOLOGY CON - CONTRACT MTF - MTF STAFF 28Jul93-27Jul94 14Jul93-13Jul94 CA- 3% MTF CRAWFORD,JACQUI CRAWFORD CARDIOLOGY CON - CONTRACT MTF - MTF STAFF 28Jul93-27Jul94 14Jul93-13Jul94 CA- 3% MTF Total providers for CARDIOLOGIST: EMERGENCY PHYSICIAN ------------------ROY,IMA ROY FAMILY PRACTICE NET - CIVILIAN NETWORK PROVIDER 31Mar93-31Mar94 CA-75% FAMILY PRACTICE PHYSICIAN ------------------------CORBIN,ANTHONY FAMILY PRACTICE LAFB MTF - MTF STAFF 06May93-06May94 MTF CRAWFORD CARDIOLOGY CRAWFORD CARDIOLOGY CON - CONTRACT MTF - MTF STAFF PIC - PARTNER INTERNAL 28Jul93-27Jul94 14Jul93-13Jul94 12Jun93-11Jun94 CA- 3% MTF CA-25% CRAWFORD,JACQUI CRAWFORD CARDIOLOGY CON - CONTRACT MTF - MTF STAFF 28Jul93-27Jul94 14Jul93-13Jul94 CA- 3% MTF FIGURE 4.4.2.6. SAMPLE OUTPUT REPORT: ZIP CODE AGREEMENT ROSTER (Sheet 2 of 3) 6-261 E 3 E SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 TIDEWATER 28 Sep 1993@1051 Page 3 Personal Data - Privacy Act 1974 (PL-93-579) Provider Agreement Roster By ZIP Code ZIP Code: 23665 **PCM only** ======================================================================================================================== Specialty Provider Provider Group Agreement Type Effective Dates Disc % Except ======================================================================================================================== FAMILY PRACTICE PHYSICIAN (continued) -------------------------------------FLETCHER,THOMAS FAMILY PRACTICE LAFB MTF - MTF STAFF 06May93-06May94 MTF KIRBY,SANDRA FAMILY PRACTICE LAFB MTF - MTF STAFF 06May93-06May94 MTF MADISON,MICHAEL FAMILY PRACTICE LAFB MTF - MTF STAFF 06May93-06May94 MTF MERCER,SARA FAMILY PRACTICE LAFB MTF - MTF STAFF 06May93-06May94 MTF OLIVER,SAMUEL FAMILY PRACTICE LAFB MTF - MTF STAFF 06May93-06May94 MTF ROY,IMA ROY FAMILY PRACTICE NET - CIVILIAN NETWORK PROVIDER 31Mar93-31Mar94 CA-75% Total providers for FAMILY PRACTICE PHYSICIAN: Total providers for ZIP Code 23665: FIGURE 4.4.2.6. SAMPLE OUTPUT REPORT: ZIP CODE AGREEMENT ROSTER (Sheet 3 of 3) 6-262 9 13 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 User: THACKER,DAVID Provider: 4 Selected TO: R E ALBAGHDADI CARDIOLOGY ASSOCIATES 14557 J. CLYDE MORRIS AVE. GLOUCESTER VA 23061 TO: CPT THERESA BARRETT CASHIER'S OFC 5 EFFINGHAM ST HAMPTON VA 23665 TO: COL MICHAEL DE BLASIO PERSHING CLINIC 3222 JAMES ST PORTSMOUTH VA 23708 TO: COL MARK HAMILTON EISENHOWER CLINIC 2365 KING ST HAMPTON VA 23668 FIGURE 4.4.2.7. SAMPLE OUTPUT REPORT: PROVIDER BATCH ADDRESS LABELS - PRINT UTILITY 6-263 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 NH PORTSMOUTH, VA 28 Apr 1993@1531 DISCREPANCY AVOIDANCE REPORT Personal Data - Privacy Act 1974 (PL-93-579) *** Patients Assigned to Primary Care Manager *** Page 1 Place of Care: RIVER RUN FAMILY PLANNING =============================================================================== Provider Group Provider Patient FMP/SSN =============================================================================== CAMPUS POINT FAMILY PLANNING, INC. BOLTON,DAVID ALLAN,MICHAEL ASHTON,TERRY DANIELSON,BRUCE DANIELSON,DAVID DANIELSON,MARY JO 20/456-09-3434 20/309-09-0923 30/609-12-3434 01/609-12-3434 20/609-12-3434 HAMMOND,PATRICIA SMITH,DAVID SMITH,SUSAN L 20/561-35-3540 30/561-35-3540 LUCAS,JONATHAN K FOSTER,JACOB 20/756-54-4545 RIVER RUN FAMILY PRACTICE GROUP APPLETON,MARGARET MARSHALL,JANE 20/891-34-3434 OZANICH,SANDRA MARIGOLD,RONALD NEILSON,KENNETH 20/564-01-1029 02/710-23-3233 ROTHSCHILD,ANDREW BEUFORD,KATLYNN BEUFORD,NATHAN 30/654-66-6666 20/654-66-6666 =============================================================================== Use the Batch PCM Reassignment Option (BMCP) to transfer assigned patients. FIGURE 4.4.2.8. SAMPLE OUTPUT REPORT: DISCREPANCY AVOIDANCE REPORT (Place of Care) (Sheet 1 of 8) 6-264 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 NH PORTSMOUTH, VA 28 Apr 1993@1531 DISCREPANCY AVOIDANCE REPORT Personal Data - Privacy Act 1974 (PL-93-579) *** Booked Appointment & Referrals *** Page 2 Place of Care: RIVER RUN FAMILY PLANNING =============================================================================== Provider Group Provider Patient Home Phone Appt Date/Time - Referral FMP/SSN Work Phone Appt Type Appt Status =============================================================================== CAMPUS POINT FAMILY PLANNING, INC. BOLTON,DAVID ALLAN,MICHAEL 20/456-09-3434 ASHTON,TERRY 20/309-09-0923 FOSTER,JACOB 20/765-56-6577 HATTERS,KAITLIN 02/689-34-2344 LUCAS,JONATHAN K 30/534-05-5455 PETRA,ANGELICA 20/544-09-4519 H: W: H: W: H: W: H: W: H: W: 565-9080 543-0000 432-0434 543-1234 654-6556 543-5435 790-3444 01 May 1993@0930 - 930000237 NEW 17 Jun 1993@0900 - 930000495 FU 16 Jun 1993@0830 CON 930000589 606-0565 543-0545 14 May 1993@0900 NEW 01 Jun 1993@0830 NEW H: 765-5435 W: 601-4324 930000610 CON RIVER RUN FAMILY PRACTICE GROUP APPLETON,MARGARET LINDHOLT,HERBERT 20/891-34-3434 H: 645-6546 W: 543-5454 23 May 1993@1645 RET ROTHSCHILD,ANDREW BEUFORD,KATLYNN 30/654-66-6666 H: 654-6666 W: 19 Jun 1993@1630 - 930000719 RET =============================================================================== Referrals should be reassigned using the Appointment Referral Processing option. Appointments should be canceled/rescheduled. FIGURE 4.4.2.8. SAMPLE OUTPUT REPORT: DISCREPANCY AVOIDANCE REPORT (Place of Care) (Sheet 2 of 8) 6-265 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 NH PORTSMOUTH, VA 28 Apr 1993@1531 DISCREPANCY AVOIDANCE REPORT Personal Data - Privacy Act 1974 (PL-93-579) *** Wait List Requests *** Page 3 Place of Care: RIVER RUN FAMILY PLANNING =============================================================================== Provider Group Provider Patient Home Phone Target Date - Referral FMP/SSN Work Phone Appt Type Appt Status =============================================================================== CAMPUS POINT FAMILY PLANNING, INC. BOLTON,DAVID MELCHIOR,CASPAR 20/543-00-3784 DALLMAN,JERALD 20/309-09-0923 WILSON,JUSTINE 20/765-56-6577 H: W: H: W: H: W: 565-9080 543-7384 784-3044 543-0987 432-6556 786-5435 23 May 1993 NEW 17 Jun 1993 FU 16 Jun 1993 CON - 930000101 WAITREQ - 930000495 WAITREQ - 930000781 WAITREQ RIVER RUN FAMILY PRACTICE GROUP APPLETON,MARGARET SMITH,HERBERT 05/432-04-3434 H: 431-6546 W: 01 Jul 1993 RET ROTHSCHILD,ANDREW BEUFORD,KATLYNN 30/654-66-6666 H: 654-6666 W: 19 Jun 1993 RET - 930000719 WAITREQ =============================================================================== Wait List Requests should be reassigned using Wait List Request option in PAS FIGURE 4.4.2.8. SAMPLE OUTPUT REPORT: DISCREPANCY AVOIDANCE REPORT (Place of Care) (Sheet 3 of 8) 6-266 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 NH PORTSMOUTH, VA 28 Apr 1993@1531 DISCREPANCY AVOIDANCE REPORT Personal Data - Privacy Act 1974 (PL-93-579) *** Provider List *** Page 4 Place of Care: RIVER RUN FAMILY PLANNING =============================================================================== Provider Group Provider =============================================================================== CAMPUS POINT FAMILY PLANNING, INC. BOLTON,DAVID HAMMOND,PATRICIA LUCAS,JONATHAN K ****** Only PLACE OF CARE ****** RIVER RUN FAMILY PRACTICE GROUP APPLETON,MARGARET OZANICH,SANDRA ROTHSCHILD,ANDREW ****** Only PLACE OF CARE ****** ================================================================================ Those providers that have the designation 'Only Place of Care' will not appear on any pick list once the Place of Care is inactivated. FIGURE 4.4.2.8. SAMPLE OUTPUT REPORT: DISCREPANCY AVOIDANCE REPORT (Place of Care) (Sheet 4 of 8) 6-267 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 NH PORTSMOUTH, VA 28 Apr 1993@1531 DISCREPANCY AVOIDANCE REPORT Personal Data - Privacy Act 1974 (PL-93-579) *** Patients Assigned to Provider as Primary Care Manager *** Page 1 Provider: SMITH,KATHERINE =============================================================================== Provider Group Place of Care Patient FMP/SSN =============================================================================== MT WHITNEY MEDICAL GROUP MT WHITNEY CLINIC ALLAN,MICHAEL ASHTON,TERRY DANIELSON,BRUCE DANIELSON,DAVID 20/456-09-3434 20/309-09-0923 30/609-12-3434 01/609-12-3434 MT WHITNEY MEDICAL CENTER SMITH,DAVID SMITH,LOWELL SMITH,NANCY SMITH,SUSAN L 20/561-35-3540 30/561-25-3540 30/561-85-3540 30/561-35-3540 =============================================================================== Use the Batch PCM Reassignment Option (BMCP) to transfer assigned patients. FIGURE 4.4.2.8. SAMPLE OUTPUT REPORT: DISCREPANCY AVOIDANCE REPORT (Provider) (Sheet 5 of 8) 6-268 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 NH PORTSMOUTH, VA 28 Apr 1993@1531 DISCREPANCY AVOIDANCE REPORT Personal Data - Privacy Act 1974 (PL-93-579) *** Booked Appointment & Referrals *** Page 2 Provider: SMITH,KATHERINE ================================================================================ Provider Group Place of Care Patient Home Phone Appt Date/Time - Referral FMP/SSN Work Phone Appt Type Appt Status ================================================================================ MT WHITNEY MEDICAL CENTER MT WHITNEY CLINIC ALLAN,MICHAEL 20/456-09-3434 ASHTON,TERRY 20/309-09-0923 DANIELSON,BRUCE 20/765-56-6577 DANIELSON,DAVID 02/689-34-2344 H: W: H: W: H: W: H: W: 565-9080 543-0000 432-0434 543-1234 654-6556 543-5435 790-3444 MT WHITNEY MEDICAL CENTER SMITH,DAVID H: 645-6546 20/561-35-3540 W: SMITH,LOWELL H: 645-6546 30/561-25-3540 W: 01 May 1993@0930 NEW 17 Jun 1993@0900 - 930000495 FU 16 Jun 1993@0830 CON 930000589 23 May 1993@1645 RET 23 May 1993@1645 RET =============================================================================== Referrals should be reassigned using the Appointment Referral Processing option. Appointments should be canceled/rescheduled. FIGURE 4.4.2.8. SAMPLE OUTPUT REPORT: DISCREPANCY AVOIDANCE REPORT (Provider) (Sheet 6 of 8) 6-269 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 NH PORTSMOUTH, VA 28 Apr 1993@1531 Page 3 DISCREPANCY AVOIDANCE REPORT Personal Data - Privacy Act 1974 (PL-93-579) *** Wait List Requests *** Provider: SMITH,KATHERINE =============================================================================== Provider Group Place of Care Patient Home Phone Target Date - Referral FMP/SSN Work Phone Appt Type Appt Status =============================================================================== MT WHITNEY MEDICAL GROUP MT WHITNEY CLINIC ALLAN,MICHAEL 20/456-09-3434 DANIELSON,BRUCE 20/765-56-6577 DANIELSON,DAVID 02/689-34-2344 SMITH,DAVID 20/561-35-3540 H: W: H: W: H: W: H: W: 565-9080 543-0000 654-6556 543-5435 790-3444 645-6546 11 Apr NEW 16 Jun CON 18 Jun FU 27 May RET 1993 1993 1993 1993 - 930000103 WAITREQ - 930000207 WAITREQ - 930000589 WAITREQ - 930000344 WAITREQ =============================================================================== Wait List Requests should be reassigned using Wait List Request option in PAS FIGURE 4.4.2.8. SAMPLE OUTPUT REPORT: DISCREPANCY AVOIDANCE REPORT (Provider) (Sheet 7 of 8) 6-270 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 NH PORTSMOUTH, VA 28 Apr 1993@1531 DISCREPANCY AVOIDANCE REPORT Personal Data - Privacy Act 1974 (PL-93-579) *** Provider Hospital Locations *** Page 4 Provider: SMITH,KATHERINE =============================================================================== Provider Group Place of Care =============================================================================== MT WHITNEY MEDICAL GROUP MT WHITNEY CLINIC MT WHITNEY MEDICAL CENTER DE ANZA MEDICAL GROUP DE ANZA MEDICAL CENTER =============================================================================== Other Locations Division =============================================================================== MT WHITNEY CLINIC AIR FORCE DIVISION WELL BABY CLINIC NAVY DIVISION ================================================================================ FIGURE 4.4.2.8. SAMPLE OUTPUT REPORT: DISCREPANCY AVOIDANCE REPORT (Provider) (Sheet 8 of 8) 6-271 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 TIDEWATER 23 Sep 1993@1105 Page 1 Personal Data - Privacy Act 1974 (PL-93-579) GROUP MEMBER ROSTER ALVIN WILLARD, MD GROUP DMIS ID(S): 8888 GROUP TAX ID: ================================================================================ Provider Name UPIN Tax ID DMIS ID Specialty Agreement Type Effective Dates Disc % ================================================================================ WILLARD,ALVIN 8888 INTERNIST NON - NON-NETWORK/EXCEPTION 05May93-05May94 0% FIGURE 4.4.2.9. SAMPLE OUTPUT REPORT: (Sheet 1 of 3) 6-272 GROUP MEMBER ROSTER SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 TIDEWATER 23 Sep 1993@1105 Page 2 Personal Data - Privacy Act 1974 (PL-93-579) GROUP MEMBER ROSTER CHILDRENS HOSPITAL & CLINIC GROUP DMIS ID(S): 6501 GROUP TAX ID: KIS ================================================================================ Provider Name UPIN Tax ID DMIS ID Specialty Agreement Type Effective Dates Disc % ================================================================================ HOOD,DORIS A 6501 PEDIATRICIAN NET - CIVILIAN NETWORK PROVIDER 01Oct92-30Sep93 CA-16% HOPKINS,CHARLES R PEDIATRICIAN NET - CIVILIAN NETWORK PROVIDER 6501 01Oct92-30Sep93 FIGURE 4.4.2.9. CA-16% SAMPLE OUTPUT REPORT: (Sheet 2 of 3) 6-273 GROUP MEMBER ROSTER SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 TIDEWATER 23 Sep 1993@1105 Page 3 Personal Data - Privacy Act 1974 (PL-93-579) GROUP MEMBER ROSTER CRAWFORD CARDIOLOGY GROUP DMIS ID(S): 8888 GROUP TAX ID: 567 ================================================================================ Provider Name UPIN Tax ID DMIS ID Specialty Agreement Type Effective Dates Disc % ================================================================================ CRAWFORD,JACQUI 568392 8888 CARDIOLOGIST FAMILY PRACTICE PHYSICIAN CON - CONTRACT 28Jul93-27Jul94 CA- 3% MTF - MTF STAFF 14Jul93-13Jul94 MTF NON - NON-NETWORK/EXCEPTION 02Jun93-01Jun94 CA PIC - PARTNER INTERNAL 12Jun93-11Jun94 CA-25% CRAWFORD,JOSEPH 46Y907 CARDIOLOGIST CON - CONTRACT MTF - MTF STAFF NON - NON-NETWORK/EXCEPTION PIC - PARTNER INTERNAL 8888 28Jul93-27Jul94 14Jul93-13Jul94 02Jun93-01Jun94 12Jun93-11Jun94 CRAWFORD,MICHELLE 754289 CARDIAC SURGEON FAMILY PRACTICE PHYSICIAN NEUROLOGIST CON - CONTRACT MTF - MTF STAFF NON - NON-NETWORK/EXCEPTION PIC - PARTNER INTERNAL 7261389 CRAWFORD,PHYLLIS 764328 CARDIOLOGY CON - CONTRACT MTF - MTF STAFF NON - NON-NETWORK/EXCEPTION PIC - PARTNER INTERNAL 6781904680 8888 28Jul93-27Jul94 14Jul93-13Jul94 02Jun93-01Jun94 12Jun93-11Jun94 CA- 3% MTF CA CA-25% 8888 28Jul93-27Jul94 14Jul93-13Jul94 02Jun93-01Jun94 12Jun93-11Jun94 FIGURE 4.4.2.9. CA- 3% MTF CA CA-25% CA- 3% MTF CA CA-25% SAMPLE OUTPUT REPORT: (Sheet 3 of 3) 6-274 GROUP MEMBER ROSTER SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 PORTSMOUTH NAVAL HOSPITAL 21 Jan 1993@1133 Personal Data - Privacy Act of 1974 (PL 93-579) PROVIDER GROUP REPORT *** Group Information *** PAGE 1 GROUP: CAMPUS POINT MEDICAL CENTER ================================================================================ Short Group ID: CAMPPT Tax ID#: 7584930201 CHAMPUS Nbr: MCP Provider Type: NETWORK PROVIDER GROUP Payment Address 1: Payment Address 2: Payment City: Payment State: Payment Zip Code: Payment Phone: Payment Contact: 45 DODD AVENUE Room 322 HAMPTON VA 23665 804-535-7927 JEANNINE ABRAMS FIGURE 4.4.2.10. SAMPLE OUTPUT REPORT: (Sheet 1 of 7) 6-275 PROVIDER GROUP REPORT SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 PORTSMOUTH NAVAL HOSPITAL 21 Jan 1993@1133 Personal Data - Privacy Act of 1974 (PL 93-579) PROVIDER GROUP REPORT *** Places of Care *** PAGE 2 GROUP: CAMPUS POINT MEDICAL CENTER (continued) ================================================================================ Place of Care: CAMPUS POINT MEDICAL CENTER Building Name: Building Number: Street Address: 45 DODD AVENUE City: HAMPTON State: VA Zip Code: 23665 Appt Phone: 804-535-7927 Type of Facility: MULTISERVICE CLINIC Division: LANGLEY AF HOSPITAL Department: MEDICINE LAFB Service: PEDIATRICS LAFB MEPRS Code: BDAA Cost Pool Code: Clinic Type: COUNT Location Type: CLINIC Clinic Appt Instructions: Appt Type/ Workload Referral Pull Patient Send Instructions Type Required Record Reminder ================================================================================ NEW COUNT N N N FU COUNT N N N CON COUNT N N N FIGURE 4.4.2.10. SAMPLE OUTPUT REPORT: (Sheet 2 of 7) 6-276 PROVIDER GROUP REPORT SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 PORTSMOUTH NAVAL HOSPITAL 21 Jan 1993@1133 Personal Data - Privacy Act of 1974 (PL 93-579) PROVIDER GROUP REPORT *** Places of Care *** PAGE 3 GROUP: CAMPUS POINT MEDICAL CENTER (continued) ================================================================================ Place of Care: WELL BABY CLINIC (F) Building Name: CHILDRENS CLINIC Building Number: Street Address: 45 DODD AVENUE City: HAMPTON State: VA Zip Code: 23665 Appt Phone: 804-535-7938 Type of Facility: SINGLE SERVICE CLINIC Division: LANGLEY AF HOSPITAL Department: MEDICINE LAFB Service: PEDIATRICS LAFB MEPRS Code: BDCA Cost Pool Code: Clinic Type: COUNT Location Type: CLINIC Clinic Appt Instructions: Appt Type/ Workload Referral Pull Patient Send Instructions Type Required Record Reminder ================================================================================ NEW COUNT N N N FU COUNT N N N CON COUNT N N N FIGURE 4.4.2.10. SAMPLE OUTPUT REPORT: (Sheet 3 of 7) 6-277 PROVIDER GROUP REPORT SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 PORTSMOUTH NAVAL HOSPITAL 21 Jan 1993@1133 Personal Data - Privacy Act of 1974 (PL 93-579) PROVIDER GROUP REPORT *** Agreements and Providers *** PAGE 4 GROUP: CAMPUS POINT MEDICAL CENTER (continued) ================================================================================ Effective Stop Overall Agreement Agreement Name Date Date Discount _________ ______________ _________ ____ ________ PIC PARTNER INTERNAL 24 Nov 92 24 Nov 93 CA- 35% MTF MTF STAFF 24 Nov 92 24 Nov 93 MTF GROUP INDIVIDUAL PROVIDERS _____ __________ _________ Provider Place of Care * Denotes Inactive Provider. CAMPUS POINT MEDICAL CENTER CAMPUS POINT MEDICAL CENTER TORREY PINES CLINIC Specialty GENERAL MEDICAL OFFICER INTERNIST INTERNIST TAYLOR,WILLIAM L CAMPUS POINT MEDICAL CENTER TORREY PINES CLINIC PEDIATRICIAN PEDIATRICIAN CORNWELL,EDWARD CAMPUS POINT MEDICAL CENTER PEDIATRIC SURGEON UNDERWOOD,IRENE CAMPUS POINT MEDICAL CENTER PEDIATRICIAN FIGURE 4.4.2.10. SAMPLE OUTPUT REPORT: (Sheet 4 of 7) 6-278 PROVIDER GROUP REPORT SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 PORTSMOUTH NAVAL HOSPITAL 21 Jan 1993@1133 Personal Data - Privacy Act of 1974 (PL 93-579) PROVIDER GROUP REPORT *** Primary Care Managers *** PAGE 5 GROUP: CAMPUS POINT MEDICAL CENTER (continued) ================================================================================ Provider Total Total Patient Type Agreement Capacity Assigned CAMPUS POINT MEDICAL CENTER MCP/CHAMPUS ELIGIBLE MCP 500 TAYLOR,WILLIAM L PIC 500 UNDERWOOD,IRENE MCP/CHAMPUS ELIGIBLE MCP 500 200 FIGURE 4.4.2.10. 1 1 SAMPLE OUTPUT REPORT: (Sheet 5 of 7) 6-279 PROVIDER GROUP REPORT SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 PORTSMOUTH NAVAL HOSPITAL 21 Jan 1993@1133 Personal Data - Privacy Act of 1974 (PL 93-579) PROVIDER GROUP REPORT *** Group Level Exceptions *** PAGE 6 GROUP: CAMPUS POINT MEDICAL CENTER (continued) ================================================================================ Exceptions to Agreement Type: PIC PARTNER INTERNAL (CHAMPUS/MCP) NON-PARTICIPATING PROVIDERS _________________ _________ TAYLOR,WILLIAM L UNDERWOOD,IRENE CODE ____ 142 00104 00140 Specialty/Procedure ___________________ ORTHOPEDIC RESIDENT ANESTH FOR ELECTROSHOCK ANESTH, PROCEDURES ON EYE Discount Fee Percent ___ _______ $ 95% $ 15% $ 15% FIGURE 4.4.2.10. Eff Date ____ 21 Aug 93 21 Aug 93 21 Aug 93 Stop Date ____ 21 Aug 94 21 Aug 94 21 Aug 94 SAMPLE OUTPUT REPORT: (Sheet 6 of 7) 6-280 PROVIDER GROUP REPORT SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 PORTSMOUTH NAVAL HOSPITAL 21 Jan 1993@1133 Personal Data - Privacy Act of 1974 (PL 93-579) PROVIDER GROUP REPORT *** Individual Provider Exception Data *** PAGE 7 GROUP: CAMPUS POINT MEDICAL CENTER (continued) ================================================================================ Agreement Type Discount Eff Stop Specialty/Procedure Description Fee Percent Date Date -------------------------------------------------------------------------------Provider: TAYLOR,WILLIAM L __________________________ PIC PARTNER INTERNAL (CHAMPUS/MCP) $ 25% 08 Jun 93 08 Jun 94 140 ORTHOPEDIC SURGEON $ 25% 08 Jun 93 08 Jun 94 141 HAND SURGEON $ 25% 08 Jun 93 08 Jun 94 01400 ANESTH, KNEE JOINT SURGERY $ 0% 08 Jun 93 08 Jun 94 01402 ANESTH, REPLACEMENT OF KNEE $ 0% 08 Jun 93 08 Jun 94 01404 ANESTH, AMPUTATION AT KNEE $ 0% 08 Jun 93 08 Jun 94 01420 ANESTH, KNEE JOINT CASTING $ 0% 08 Jun 93 08 Jun 94 01430 ANESTH, KNEE VEINS SURGERY $ 0% 08 Jun 93 08 Jun 94 01432 ANESTH, KNEE VESSEL SURG $ 0% 08 Jun 93 08 Jun 94 Provider: UNDERWOOD,IRENE _________________________ CON CONTRACT 142 ORTHOPEDIC RESIDENT $ $ FIGURE 4.4.2.10. 25% 5% 01 Jun 93 01 Jun 93 01 Jun 94 01 Jun 94 SAMPLE OUTPUT REPORT: (Sheet 7 of 7) 6-281 PROVIDER GROUP REPORT SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 TIDEWATER 23 Sep 1993@1431 Page 1 Personal Data - Privacy Act 1974 (PL-93-579) Provider List By Specialty Provider Type: NETWORK INDIVIDUAL PROVIDER ================================================================================================================================== Specialty Provider Sex Languages Place of Care POC Phone POC ZIP Code Provider Group Agreement Type Effective Date Stop Date Disc % Except ================================================================================================================================== ALLERGIST --------DE BLASIO,MICHAEL M CINDY 904-0989 92126 TOM NET - CIVILIAN NETWORK PROVIDER 01 May 93 12 Dec 93 CA-10% KANE,KERRY L M SENTARA CON - CONTRACT NET - CIVILIAN NETWORK PROVIDER SENTARA MEDICAL CENTER KANZIUS,CHRIS F SENTARA CON - CONTRACT NET - CIVILIAN NETWORK PROVIDER SENTARA MEDICAL CENTER STEWART,GARY INT MED LAFB MTF - MTF STAFF M ALLERGY (F) SULLIVAN,MITCHELL INT MED LAFB MTF - MTF STAFF M QB YACABUCCI,JOHN E M RIVERSIDE MEDICAL CON - CONTRACT NET - CIVILIAN NETWORK PROVIDER ALLERGY (F) RIVERSIDE HOSP & CLINICS (804) 865-0937 23667 03 May 93 03 May 93 03 May 95 03 May 94 (804) 865-0937 23667 03 May 93 03 May 93 03 May 95 03 May 94 764-6574 23665 06 May 93 06 May 94 764-6574 23665 06 May 93 06 May 94 (804) 560-9876 23669 03 May 93 01 Oct 92 03 May 94 01 Oct 93 CA-17% CA-17% CA-17% CA-17% MTF MTF CA-12% CA-12% Total providers for ALLERGIST: CARDIOLOGIST -----------CRAWFORD,JACQUI F CARDIOLOGY (F) CARDIOLOGY PARTNER (F) DEL CARMEN & HARRIS CLINIC ER TST CLINIC CRAWFORD CARDIOLOGY CON - CONTRACT MTF - MTF STAFF FIGURE 4.4.2.11. 223-9876 764-9574 (804) 265-3452 222-4455 23665 23665 23601 23665 28 Jul 93 14 Jul 93 27 Jul 94 13 Jul 94 SAMPLE OUTPUT REPORT: PROVIDER LIST BY SPECIALTY (Sheet 1 of 7) 6-282 CA- 3% MTF 6 E SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 TIDEWATER 23 Sep 1993@1431 Page 2 Personal Data - Privacy Act 1974 (PL-93-579) Provider List By Specialty Provider Type: NETWORK INDIVIDUAL PROVIDER (continued) ================================================================================================================================== Specialty Provider Sex Languages Place of Care POC Phone POC ZIP Code Provider Group Agreement Type Effective Date Stop Date Disc % Except ================================================================================================================================== CARDIOLOGIST (continued) ------------------------CRAWFORD,JACQUI (continued) F CRAWFORD CARDIOLOGY (continued) NON - NON-NETWORK/EXCEPTION 02 Jun 93 01 Jun 94 CA PIC - PARTNER INTERNAL 12 Jun 93 11 Jun 94 CA-25% DEL CARMEN & HARRIS CON - CONTRACT NET - CIVILIAN NETWORK PROVIDER PIC - PARTNER INTERNAL CRAWFORD,JOSEPH M CARDIOLOGY (F) CARDIOLOGY PARTNER (F) ER TST CLINIC CRAWFORD CARDIOLOGY CON - CONTRACT MTF - MTF STAFF NON - NON-NETWORK/EXCEPTION PIC - PARTNER INTERNAL 11 Jul 94 05 May 94 16 Aug 94 223-9876 764-9574 222-4455 23665 23665 23665 28 14 02 12 EDDY,JEANNINE F SENTARA MEDICAL CENTER CRAWFORD CARDIOLOGY CIV CON - CONTRACT SUP - SUPPLEMENTAL CARE/DIAGNOSTIC SERVICES HEALEY,WARREN M RFD PRIM CARD CON - CONTRACT NET - CIVILIAN NETWORK PROVIDER ROYAL CLINIC JACKMAN,BYRON N M SENTARA CON - CONTRACT NET - CIVILIAN NETWORK PROVIDER SENTARA MEDICAL CENTER JANSSEN,CHRISTA F SENTARA CON - CONTRACT NET - CIVILIAN NETWORK PROVIDER SENTARA MEDICAL CENTER FIGURE 4.4.2.11. 12 Jul 93 05 May 93 17 Aug 93 Jul Jul Jun Jun 93 93 93 93 Jul Jul Jun Jun 94 94 94 94 (804) 865-0937 23667 03 Jun 93 03 Jun 93 20 Dec 93 02 Jun 94 444-9090 23667 02 Jun 93 02 Jun 93 01 Jun 94 01 Jun 94 (804) 865-0937 23667 03 May 93 03 May 93 03 May 95 03 May 94 (804) 865-0937 23667 03 May 93 03 May 93 03 May 95 03 May 94 SAMPLE OUTPUT REPORT: PROVIDER LIST BY SPECIALTY (Sheet 2 of 7) 6-283 27 13 01 11 CA-15% CA-20% CA-22% CA- 3% MTF CA CA-25% CA-15% CA-10% CA- 9% CA- 5% CA-17% CA-17% CA-17% CA-17% SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 TIDEWATER 23 Sep 1993@1431 Page 3 Personal Data - Privacy Act 1974 (PL-93-579) Provider List By Specialty Provider Type: NETWORK INDIVIDUAL PROVIDER (continued) ================================================================================================================================== Specialty Provider Sex Languages Place of Care POC Phone POC ZIP Code Provider Group Agreement Type Effective Date Stop Date Disc % Except ================================================================================================================================== CARDIOLOGIST (continued) ------------------------PURCELL,OTIS M SI CARDIOLOGY PARTNER (F) 764-9574 23665 INT MED LAFB PIC - PARTNER INTERNAL 06 May 93 06 May 94 CA-25% ROBINSON,RENAE INT MED LAFB PIC - PARTNER INTERNAL F CARDIOLOGY PARTNER (F) SANDERS,CARL A M GROUP A MEDICAL ASSOCIATION CON - CONTRACT MTF - MTF STAFF NET - CIVILIAN NETWORK PROVIDER MONTGOMERY HEALTH CENTER WEBSTER,BEULAH F RIVERSIDE MEDICAL CON - CONTRACT NET - CIVILIAN NETWORK PROVIDER RIVERSIDE HOSP & CLINICS WILSON,LARRY M RIVERSIDE MEDICAL CON - CONTRACT NET - CIVILIAN NETWORK PROVIDER RIVERSIDE HOSP & CLINICS FIGURE 4.4.2.11. 764-9574 23665 06 May 93 06 May 94 (301) 963-4800 20850 01 Jul 93 01 Jul 93 01 Jul 93 31 Jul 96 31 Jul 95 31 Jul 95 (804) 560-9876 23669 03 May 93 01 Oct 92 03 May 94 01 Oct 93 (804) 560-9876 23669 03 May 93 01 Oct 92 03 May 94 01 Oct 93 CA-20% MTF CA-15% E CA-12% CA-12% CA-12% CA-12% Total providers for CARDIOLOGIST: 11 Total providers for NETWORK INDIVIDUAL PROVIDER: 17 SAMPLE OUTPUT REPORT: PROVIDER LIST BY SPECIALTY (Sheet 3 of 7) 6-284 CA-25% SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 TIDEWATER 23 Sep 1993@1431 Page 4 Personal Data - Privacy Act 1974 (PL-93-579) Provider List By Specialty Provider Type: NETWORK INSTITUTION/SERVICE ================================================================================================================================== Specialty Provider Sex Languages Place of Care POC Phone POC ZIP Code Provider Group Agreement Type Effective Date Stop Date Disc % Except ================================================================================================================================== ALLERGIST --------DRAKE,WILLIAM M ALLERGY (N) 303-0495 23708 INTERNAL MEDICINE PNH MTF - MTF STAFF 07 May 93 07 May 96 MTF PIC - PARTNER INTERNAL 07 May 93 07 May 94 CA-25% POLESTER,ROGER INTERNAL MEDICINE PNH MTF - MTF STAFF PIC - PARTNER INTERNAL M ALLERGY (N) 303-0495 23708 07 May 93 07 May 93 07 May 96 07 May 94 MTF CA-25% Total providers for ALLERGIST: CARDIOLOGIST -----------BLONDELL,AMY F CARDIOLOGY (N) CARDIOLOGY ASSOCIATES JANE'S EROOM CARDIOLOGY PNH MTF - MTF STAFF DAVIS,RICHARD M CARDIOLOGY (N) CARDIOLOGY ASSOCIATES JANE'S EROOM CARDIOLOGY PNH MTF - MTF STAFF FIGURE 4.4.2.11. 234-5678 234-5678 321-6543 23708 23708 23665 07 May 93 07 May 96 234-5678 234-5678 321-6543 23708 23708 23665 07 May 93 07 May 96 MTF MTF Total providers for CARDIOLOGIST: 2 Total providers for NETWORK INSTITUTION/SERVICE: 4 SAMPLE OUTPUT REPORT: PROVIDER LIST BY SPECIALTY (Sheet 4 of 7) 6-285 2 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 TIDEWATER 23 Sep 1993@1431 Page 5 Personal Data - Privacy Act 1974 (PL-93-579) Provider List By Specialty Provider Type: NETWORK INSTITUTION/SERVICE ================================================================================================================================== Specialty Provider Group Place of Care POC Phone POC ZIP Code Agreement Type Effective Date Stop Date Disc % Except ================================================================================================================================== ALLERGIST --------INT MED LAFB ALLERGY (F) 764-6574 23665 MTF - MTF STAFF CARDIOLOGIST -----------INT MED LAFB CARDIOLOGY PARTNER (F) PIC - PARTNER INTERNAL FIGURE 4.4.2.11. 06 May 93 06 May 94 764-9574 23665 06 May 93 06 May 94 SAMPLE OUTPUT REPORT: PROVIDER LIST BY SPECIALTY (Sheet 5 of 7) 6-286 MTF CA-25% SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 TIDEWATER 23 Sep 1993@1431 Page 6 Personal Data - Privacy Act 1974 (PL-93-579) Provider List By Specialty Provider Type: NETWORK PROVIDER GROUP ================================================================================================================================== Specialty Provider Group Place of Care POC Phone POC ZIP Code Agreement Type Effective Date Stop Date Disc % Except ================================================================================================================================== ALLERGIST --------INTERNAL MEDICINE PNH ALLERGY (N) 303-0495 23708 MTF - MTF STAFF PIC - PARTNER INTERNAL RIVERSIDE MEDICAL RIVERSIDE HOSP & CLINICS CON - CONTRACT NET - CIVILIAN NETWORK PROVIDER SENTARA SENTARA MEDICAL CENTER CON - CONTRACT NET - CIVILIAN NETWORK PROVIDER TOM CINDY NET - CIVILIAN NETWORK PROVIDER 07 May 93 07 May 93 07 May 96 07 May 94 (804) 560-9876 23669 03 May 93 01 Oct 92 03 May 94 01 Oct 93 (804) 865-0937 23667 03 May 93 03 May 93 03 May 95 03 May 94 904-0989 92126 01 May 93 12 Dec 93 MTF CA-25% CA-12% CA-12% CA-17% CA-17% CA-10% Total groups for ALLERGIST: CARDIOLOGIST -----------CARDIOLOGY PNH CARDIOLOGY (N) CARDIOLOGY ASSOCIATES JANE'S EROOM MTF - MTF STAFF CRAWFORD CARDIOLOGY CON MTF NON PIC - CARDIOLOGY (F) CARDIOLOGY PARTNER (F) CONTRACT MTF STAFF NON-NETWORK/EXCEPTION PARTNER INTERNAL CRAWFORD CARDIOLOGY CIV 234-5678 234-5678 321-6543 23708 23708 23665 07 May 93 07 May 96 223-9876 764-9574 23665 23665 28 14 02 12 SENTARA MEDICAL CENTER CON - CONTRACT FIGURE 4.4.2.11. Jul Jul Jun Jun 93 93 93 93 27 13 01 11 94 94 94 94 (804) 865-0937 23667 03 Jun 93 20 Dec 93 SAMPLE OUTPUT REPORT: PROVIDER LIST BY SPECIALTY (Sheet 6 of 7) 6-287 Jul Jul Jun Jun MTF CA- 3% MTF CA CA-25% CA-15% 4 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 SUP - SUPPLEMENTAL CARE/DIAGNOSTIC SERVICES 03 Jun 93 02 Jun 94 -10% E TIDEWATER 23 Sep 1993@1431 Page 7 Personal Data - Privacy Act 1974 (PL-93-579) Provider List By Specialty Provider Type: NETWORK PROVIDER GROUP (continued) ================================================================================================================================== Specialty Provider Group Place of Care POC Phone POC ZIP Code Agreement Type Effective Date Stop Date Disc % Except ================================================================================================================================== CARDIOLOGIST (continued) ------------------------DEL CARMEN & HARRIS DEL CARMEN & HARRIS CLINIC (804) 265-3452 23601 CON - CONTRACT NET - CIVILIAN NETWORK PROVIDER PIC - PARTNER INTERNAL GROUP A MEDICAL ASSOCIATION MONTGOMERY HEALTH CENTER CON - CONTRACT MTF - MTF STAFF NET - CIVILIAN NETWORK PROVIDER NDC MED GROUP (FRANK) NDC POC1 CON - CONTRACT RFD PRIM CARE ROYAL CLINIC CON - CONTRACT NET - CIVILIAN NETWORK PROVIDER RIVERSIDE MEDICAL RIVERSIDE HOSP & CLINICS CON - CONTRACT NET - CIVILIAN NETWORK PROVIDER SENTARA SENTARA MEDICAL CENTER CON - CONTRACT NET - CIVILIAN NETWORK PROVIDER FIGURE 4.4.2.11. 12 Jul 93 05 May 93 17 Aug 93 11 Jul 94 05 May 94 16 Aug 94 (301) 963-4800 20850 01 Jul 93 01 Jul 93 01 Jul 93 31 Jul 96 31 Jul 95 31 Jul 95 301963-4644 20877 12 Jul 93 11 Jul 94 444-9090 23667 02 Jun 93 02 Jun 93 01 Jun 94 01 Jun 94 (804) 560-9876 23669 03 May 93 01 Oct 92 03 May 94 01 Oct 93 (804) 865-0937 23667 03 May 93 03 May 93 03 May 95 03 May 94 CA-20% MTF CA-15% E CA-22% E CA- 9% CA- 5% CA-12% CA-12% CA-17% CA-17% Total groups for CARDIOLOGIST: 8 Total groups for NETWORK PROVIDER GROUP: 10 SAMPLE OUTPUT REPORT: PROVIDER LIST BY SPECIALTY (Sheet 7 of 7) 6-288 CA-15% CA-20% CA-22% SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 PLACE OF CARE DIRECTIONS/COMMENTS Place of Care: GENERAL SURGERY CLINIC (F) ================================================================================ Street Address: 45 DODD AVENUE City, State: HAMPTON, VA Zip: 23665 Appt Contact Name: JEANNINE ABRAMS Telephone: 804-535-7927 Place of Care Hours: Monday Tuesday Wednesday Thursday Friday From 0700 0700 0700 0700 0700 To 1200 1200 1200 1200 1200 From 1300 1300 1300 1300 1300 To 1630 1630 1630 1630 1630 Directions: Enter Langley Air Force Base from the North Entrance. Turn right at the 3rd stop light and continue for 5 blocks. Turn left on Dodd Avenue. Follow the signs for the Outpatient Clinics. Comments: There is handicap parking and an elevator. before signing in at the clinic desk. Pick up your medical records FIGURE 4.4.2.12. SAMPLE OUTPUT REPORT: 6-289 MCP PLACE OF CARE REPORT SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 TIDEWATER MCP 21 Dec 1993@1417 Personal Data - Privacy Act 1974 (PL-93-579) INCOMPLETE PROVIDER ADDRESS REPORT Page 1 Provider: 7 Selected ================================================================================ Group Provider/Address Contact Name Phone Number ================================================================================ DE ANZA MEDICAL GROUP JAMES,JOHN TORCHIA,JOYCE (804) 535-0923 PORTSMOUTH, VA WEBER,BOGDAN TERRY THOMPSON (804) 442-7334 PORTSMOUTH, VA 23711 Group Total: SENTARA BLONDELL,AMY 232 DROGHEDA ST PORTSMOUTH, VA DE BLASIO,MICHAEL SMITH,GARY AMBROSE,SANDY (804) 336-7112 AMBROSE,SANDY (804) 336-7112 FROST,LARRY 287-7705 2 PORTSMOUTH, VA 23708 Group Total: 3 Total Incomplete Provider Addresses: 5 FIGURE 4.4.2.13. SAMPLE OUTPUT REPORT: INCOMPLETE PROVIDER ADDRESS REPORT (Report) (Sheet 1 of 2) 6-290 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 User: WEBER,CHRIS Provider: 5 Selected TO: CAPT AMY BLONDELL 232 DROGHEDA ST PORTSMOUTH VA 23706 TO: 1LT MICHAEL DE BLASIO 477 NORTH MAIN ST PORTSMOUTH VA 23706 TO: 1LT JOHN JAMES 14557 J. CLYDE MORRIS AVE. PORTSMOUTH VA 23706 TO: 2LT GARY SMITH 700 EAST ENGEBRETSEN AVE PORTSMOUTH VA 23708 TO: COL BOGDAN WEBER 3222 JAMES ST PORTSMOUTH VA 23711 FIGURE 4.4.2.13. SAMPLE OUTPUT REPORT: INCOMPLETE PROVIDER ADDRESS REPORT (Generate Corrected Labels) (Sheet 2 of 2) 6-291 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 PORTSMOUTH/HAMPTON 20 Jul 1994@1045 Page 1 Personal Data - Privacy Act 1974 (PL-93-579) PROVIDER AGREEMENT DETAIL REPORT Provider Group: MIDWAY MEDICAL CENTER ================================================================================ Provider/ Place of Care Specialty at Place of Care Placement/Billing Information ================================================================================ HELLER,JOHN MIDWAY MEDICAL ORTHOPEDIC SURGEON 2345 GENESSEE AVE PO BOX 2345 SAN DIEGO, CA 92121 (619)555-4455 Contact: JOAN MORRIS MIDWAY SOUTH ORTHOPEDIC SURGEON 2345 GENESSEE AVE PO BOX 6789 SAN DIEGO,CA 92121 (619)555-6677 Contact: ANN BROWN Agr Discount Eff Stop Type Description Fee Percent Date Date ___________________________________________________________________________ CON CONTRACT CA- 50% 28 Apr 94 27 Apr 95 Fee Exceptions to CON: NONE Agr Discount Eff Stop Type Description Fee Percent Date Date ___________________________________________________________________________ MTF MTF STAFF CA-100% 14 Nov 93 13 Nov 94 Fee Exceptions to MTF: NONE FIGURE 4.4.2.14. SAMPLE OUTPUT REPORT: PROVIDER AGREEMENT DETAIL REPORT (Sheet 1 of 2) 6-292 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 PORTSMOUTH/HAMPTON 20 Jul 1994@1045 Page 2 Personal Data - Privacy Act 1974 (PL-93-579) PROVIDER AGREEMENT DETAIL REPORT Provider Group: MIDWAY MEDICAL CENTER ================================================================================ Provider/ Place of Care Specialty at Place of Care Placement/Billing Information ================================================================================ HELLER,JOHN (continued) Agr Discount Eff Stop Type Description Fee Percent Date Date ___________________________________________________________________________ NET CIVILIAN NETWORK PROVIDER 35% 02 Feb 94 01 Feb 95 Fee Exceptions to NET: CODE ____ 01400 01402 01401 Specialty/Procedure ___________________ ANESTH, KNEE JOINT SURGERY ANESTH, REPLACEMENT OF KNEE ANESTH, AMPUTATION AT KNEE Discount Fee Percent ___ _______ $ 75 $ 75 $ 75 FIGURE 4.4.2.14. Eff Date ____ 02 Feb 94 02 Feb 94 02 Feb 94 Stop Date ____ 01 Feb 95 01 Feb 95 01 Feb 95 SAMPLE OUTPUT REPORT: PROVIDER AGREEMENT DETAIL REPORT (Sheet 2 of 2) 6-293 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Personal Data - Privacy Act 1974 (PL-93-579) MCP CHCS/DEERS DISCREPANCY DATA Name: MOREHOUSE,MARYANNE FMP/SSN: 30/577-23-3789 Patient Category: USA FAM MBR AD DDS: 30 Patient Type: Sex: FEMALE MCP Status: DOB/Age: 01 Apr 1961/31Y ACV: C-CHAMPUS/DIRECT CARE ELIGIB DMIS ID: Direct Care: ELIGIBLE Medicare: NOT ELIGIBLE -------------------------------------------------------------------------------CHCS DATA DEERS DATA ================================================================================ Name : MOREHOUSE,MARYANNE MOREHOUSE,MARYANNE DOB : 01 Apr 1961 01 Apr 1961 Sex : FEMALE FEMALE Patient SSN : 578-57-5577 577-57-5577 Sponsor Rank : COLONEL Station/Unit : CAMP MICHAEL ID Issue Date : 08 Dec 1992 08 Dec 1992 ID Expire Date : 07 Dec 1995 08 Dec 1995 ID Card Number : ================================================================================ FIGURE 4.4.3.1 SAMPLE OUTPUT REPORT: ENROLLMENT ENTER/EDIT (CHCS/DEERS Discrepancy Data) (Sheet 1 of 5) 6-294 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 08 Dec 1992@0832 Page 1 Personal Data - Privacy Act of 1974 (PL 93-579) DISPLAY PRIMARY CARE MANAGER Patient: MOREHOUSE,MARYANNE FMP/SSN: 30/577-23-3789 ================================================================================ PCM: HIGGINBOTHAM,JERRY Phone Number: (619) 452-6454 Place of Care: WILSON FAMILY PRACTICE CLINIC Street Address: 425 WASHINGTON STREET City: EL CAJON State: CA Zip Code: 92020 Directions: ONE BLOCK WEST OF INTERSECTION OF JAMACHA AND WASHINGTON STREET. BRICK BUILDING ON LEFT (SOUTH) SIDE OF WASHINGTON. NEXT TO SCHOOL. -------------------------------Hours of Service--------------------------------MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY SUNDAY From 0800 0800 0800 0800 0800 --- To 1200 1200 1200 1200 1200 --- From 1300 1300 1300 1300 1300 --- To 1700 1700 1700 1700 1700 --- ---------------------------Comments on Place of Care---------------------------DO NOT PARK IN SCHOOL PARKING LOT FIGURE 4.4.3.1 SAMPLE OUTPUT REPORT: ENROLLMENT ENTER/EDIT (PCM and Place of Care) (Sheet 2 of 5) 6-295 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 BALBOA NAVY MEDICAL CENTER 08 Dec 1992@0848 Personal Data - Privacy Act 1974 (PL 93-579) MANAGED CARE PROGRAM ENROLLMENT FORM ___________________________________________________________________________ ENROLLMENT DATE: 08 Dec 1992 END ELIG/ENROLL DATE: 08 Dec 1997 ___________________________________________________________________________ PATIENT NAME: MOREHOUSE,MARYANNE FMP/SSN: 30/577-23-3789 Patient Category: USA FAM MBR AD DDS: 30 Sex: FEMALE Address: 500 NORTH NEWTON WAY DOB/Age: 01 Apr 1961/31Y City: EL CAJON Patient SSN: 577-57-5577 State: CA Home Phone: 444-5555 Zip Code: 92020 Work Phone: 555-6666 --------------------------------------------------------------------------SPONSOR NAME: MOREHOUSE,WILLIAM FMP/SSN: 20/577-23-3789 Patient Category: USA ACTIVE DUTY DOB/Age: 01 Apr 1960/32Y Service: ARMY Rank: COL Station Unit: CAMP MICHAEL Duty Phone: 555-6666 Duty Address: 500 NORTH NEWTON WAY City: EL CAJON State: CA Zip Code: 92020 ___________________________________________________________________________ PRIMARY CARE MANAGER: HIGGINBOTHAM,JERRY PCM PHONE: 320-0989 Place of Care: GENERAL SURGERY (A) Address: 11234 WASHINGTON STREET City: EL CAJON State: CA Zip Code: 92020 ___________________________________________________________________________ INSURANCE COMPANY: ACACIA MUTUAL LIFE INSURANCE C PHONE: (202) 628-4506 POLICY NUMBER: 2311232 Address: 600 E. JEFFERSON ST. City: HOUSTON State: TX Zip Code: 77002 Policy Holder: MOREHOUSE,MARYANNE SSN: 577-57-5577 Effective Date: 01 Aug 1992 Expiration Date: 30 Apr 1995 ___________________________________________________________________________ CASE MANAGEMENT: YES ___________________________________________________________________________ I understand that my enrollment in the Managed Care Program is contingent upon my continuing eligibility for health care under the MHSS. I understand the benefits and patient responsibilities of enrollment in the Managed Care Program and that enrollment remains in effect until I disenroll. I understand that enrollment is dependent on CHAMPUS eligibility as shown in DEERS and that CHAMPUS eligibility ceases upon eligibility for MEDICARE Part A. I further understand that my failure to follow the rules of this program may result in either increased cost share or complete non-reimbursement. --------------------------------------------------------------------------SIGNATURE: DATE: ___________________________________________________________________________ MOREHOUSE,MARYANNE 30/577-23-3789 RCD Rm: MAIN FILE ROOM (A) FIGURE 4.4.3.1 SAMPLE OUTPUT REPORT: ENROLLMENT ENTER/EDIT (Enrollment Form) (Sheet 3 of 5) 6-296 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 MARYANNE WILLIAMS 500 NORTH NEWTON WAY EL CAJON, CA 92020 FIGURE 4.4.3.1 SAMPLE OUTPUT REPORT: ENROLLMENT ENTER/EDIT (Address Label) (Sheet 4 of 5) 6-297 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 28 Jul 1995@1255 Page 1 Personal Data - Privacy Act of 1974 (PL 93-579) DISPLAY ENROLLMENT HISTORY Patient: MCDOUGALL,WILLIAM O FMP/SSN: 01/566-57-9823 Patient Category: USMC FAM MBR AD DDS: 1 Patient Type: MCP/CHAMPUS ELIGIBLE Sex: MALE MCP Status: ENROLLED DOB/Age: 17 Aug 1985/10Y ================================================================================ Enrolling Division: A DIVISION Patient Type: MCP/CHAMPUS ELIGIBLE Patient SSN: 566-57-9823 MCP Enroll Date: 01 Mar 1995 End Elig/Enroll Date: 29 Feb 1996 Enrollment Comment: ACV: MCP ENROLLED/DIR. CARE CHA DMIS ID: BALBOA NAVY MEDICAL CENTER Language: ID Card Number: 192837465 Date Issued: 01 Nov 1992 Effective Date: Expiration Date: Primary Care Manager: Case Mgmt: Primary OHI: Disenrollment Reason: HIGGINBOTHAM,JERRY PCM Phone: 619-377-7551 NO ACACIA MUTUAL LIFE INSURANCE CO. GRIEV/COMPLAINT - OTHER Enrolled Date: 02 Jun 1995 Enrolled By: TAYLOR,DUANE Last Modified Date: 02 Jul 1995 Last Modified By: NGUYEN,TRUONG PCM Date of Change: 20 Jun 1995 19 Jun 1995 PCM Name: THACKER,DAVID HIGGINBOTHAM,JERRY FIGURE 4.4.3.1 PCM Changed By: ARNETT,WILLIAM R NGUYEN,TRUONG SAMPLE OUTPUT REPORT: ENROLLMENT ENTER/EDIT (History) (Sheet 5 of 5) 6-298 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 CURRENT DEERS ELIGIBILITY Personal Data - Privacy Act 1974 (PL-93-579) Name: MOREHOUSE,KATHRYN FMP/SSN: 30/577-23-3789 Patient Category: USA FAM MBR AD DDS: 30 DOB/Age: 09 Apr 1959/36Y Sex: FEMALE ________________________________________________________________________________ Sponsor Rank: CAPTAIN Sponsor UIC: 31127-NAVCRUSERVDET HONOLULU DMIS ID: 6501-TRICARE ACV: E-MCP ENROLLED/DIR. CARE CHAMPUS ELIGIBLE ACV Start Date: 01 Jul 1995 Region Code: 02 Care Authorization PH#: 619-555-7526 PCM Location: CONTRACT Direct Care: ELIGIBLE Medicare: NOT ELIGIBLE Dir Care Elig Start Date: 01 Jul 1980 CHAMPUS: ELIGIBLE Dir Care Elig End Date: 01 Jul 2001 Eligibility End Reason: BRAC Pharmacy Eligibility: Override Code: CHAMPUS Dental Flag: 0-NO COVERAGE Dental Start Date: NAS Flag: YES Reportable Disease Database (RDDB) Date: Date of Request: 28 Sep 1995@1307 FIGURE 4.4.3.1.3 Dental End Date: Panograph Date: DNA: YES SAMPLE OUTPUT REPORT: 6-299 CURRENT DEERS ELIGIBILITY DISPLAY SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 DISPLAY PATIENT APPOINTMENTS Personal Data - Privacy Act of 1974 (PL 93-579) FUTURE APPOINTMENTS FOR SMITHSON,GEORGE 30/543-34-9112 CLINIC/DIV PROVIDER DATE/TIME TYPE STATUS ================================================================================ CLAIREMONT CLINIC LEE,JUDY 09 Dec 1992@1000 FU BOOKED Arrive 10 min early OTORHINOLARYNGOLOGY BLONDELL,AMY 09 Dec 1992@1400 CON CANCEL(P) WAIT LIST REQUESTS FOR SMITHSON,GEORGE 30/543-34-9112 CLINIC/DIV TYPE PRI DATE IN TARGET DATE PROVIDER ================================================================================ GASTROLOGY NEW 6 07 Dec 1992 08 Dec 1992 DOBLES,WILLI FIGURE 4.4.3.2. SAMPLE OUTPUT REPORT: 6-300 DISENROLLMENT SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 DEERS ELIGIBILITY DATA Name: MITCHELL,ANDREA FMP/SSN: 30/567-56-5678 Patient Category: USA FAM MBR AD DDS: 30 DOB/Age: 09 Aug 1961/31Y Sex: FEMALE ================================================================================ NAME: MITCHELL,ANDREA SEX: FEMALE DOB: 09 Aug 1961 DDS: 30 SSN: 567-56-5678 ACV: E-MCP ENROLLED/DIR. CARE CHAMPUS ELIGIBLE ACV Start Date: 01 Jun 1993 DMIS ID: 0052-TRIPLER ARMY MEDICAL CENTER Sponsor Rank: COLONEL Sponsor UIC: FF414-9991 MEDICAL GP Direct Care: ELIGIBLE Medicare: NOT ELIGIBLE Elig Start Date: 09 Oct 1992 Elig End Date: 15 Jul 2000 Eligibility Comment: Patient is Eligible ================================================================================ FIGURE 4.4.3.4. SAMPLE OUTPUT REPORT: INTERACTIVE DEERS ELIGIBILITY REQUEST 6-301 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 MailMan message for WEBER,CHRIS Printed at MCP.SAIC.COM Tue, 13 Apr 1993 09:01:37 (#1) Subj: BATCH PCM REASSIGNMENT COMPLETE Mon, 12 Apr 1993 15:59:03 17 Lines From: POSTMASTER (Sender: WEBER,CHRIS) in 'IN' basket. **NEW** -----------------------------------------------------------------------------The following Batch PCM Reassignment action has been completed: Prior PCM: HOWLAND,WILLIAM Provider Group: WILSON FAMILY PRACTICE Agreement: NET Gaining PCM: SWAZEY,PAUL Provider Group: STEVENS GROUP Agreement: MTF Assignment Date: 12 Apr 1993 Report Name: CP BATCH 12 Apr 1993-1558 205 REMINDER: Bring the Reassignment Report for complete details on the above Batch PCM Reassignment Process. *** This Report Must be Printed Within 5 Days Before Auto-Deletion *** FIGURE 4.4.3.6. SAMPLE OUTPUT REPORT: (Sheet 1 of 2) 6-302 BATCH PCM REASSIGNMENT SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 MailMan message for WEBER,CHRIS Printed at MCP.SAIC.COM Wed, 14 Apr 1993 09:01:37 (#3) Subj: MULTIPLE BATCH PCM REASSIGNMENT COMPLETE Tue, 13 Apr 1993 15:59:03 11 Lines From: POSTMASTER (Sender: WEBER,CHRIS) in 'IN' basket. **NEW** -----------------------------------------------------------------------------The following Multiple PCM Reassignment action has been completed: Prior PCM: JOHNSON,JOAN Provider Group: WILSON FAMILY PRACTICE Agreement: NET Gaining PCM(s): ARMSTRONG,CATHERINE SWAZEY,PAUL Assignment Date: 13 Apr 1993 Report Name: CP BATCH 13 Apr 1993-1558 205 FIGURE 4.4.3.6. SAMPLE OUTPUT REPORT: (Sheet 2 of 2) 6-303 BATCH PCM REASSIGNMENT SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 TRIPLER AMC HONOLULU HI 07 Mar 1995@1405 Page 1 Personal Data - Privacy Act 1974 (PL-93-579) POTENTIAL ACTIVE DUTY CANDIDATE REPORT *** Part 1: Candidates Eligible for Enrollment *** UIC: 1912 COMPUTER SYSTEMS GP Prov Grp: Alpha: AAA to MMM Default Enrolling Division: Default PCM: Current Avail AD Cap: Agr: ================================================================================================================================== SSN Rank Name SEX DOB Pat Cat DMIS ACV DEERS Spon Status CHCS UIC/Code DEERS UIC/Code DEERS Elig Code Elig Date End Elig Date PCM Group Agr Agr St Date Enrolling Division ---------------------------------------------------------------------------------------------------------------------------------000-00-2006 CPT AGNEW,CHRISTOPHER M 05 May 1955 M11 ACTIVE DUTY LE1CF602/1912 COMPUTER SYS ELIGIBLE 06 Mar 1995 BARRETT,THERESA FAMILY PRACTICE C MTF 11 Feb 1994 C DIVISION 000-00-2014 CPT ALDEN,BLAKE LE1CF602/1912 COMPUTER SYS BARRETT,THERESA FAMILY PRACTICE C M 05 May 1955 ELIGIBLE MTF F11 444-22-3333 MAJ AMSTUTZ,LIZA LE1CF602/1912 COMPUTER SYS F 06 Apr 1932 ELIGIBLE A11 112-33-4545 MAJ AMSTUTZ,SHIRLEY LE1CF602/1912 COMPUTER SYS F 05 May 1923 ELIGIBLE A11 234-87-6234 MAJ ANDERSON,CAMERON LE1CF602/1912 COMPUTER SYS SONGER,EDWARD CARDIOLOGY A M 05 Mar 1960 ELIGIBLE MTF A11 526-11-3333 PO1 APCOTS,DARRELL LE1CF602/1912 COMPUTER SYS M 03 Dec 1945 ELIGIBLE N11 069-40-1375 AMN CLAPP,GILBERT A LE1CF602/1912 COMPUTER SYS M 24 Mar 1948 ELIGIBLE F11 118-55-5555 SSG COSTNER,CHARLES LE1CF602/1912 COMPUTER SYS M 10 Oct 1954 ELIGIBLE F11 543-34-5678 CPT AMHURST,AL LE1CF602/1912 COMPUTER SYS FAMILY PRACTICE A FAMILY PRACTICE A M 05 May 1955 ELIGIBLE MTF A13 06 Mar 1995 11 Feb 1994 C DIVISION 06 Mar 1995 06 Mar 1995 06 Mar 1995 09 Feb 1994 A DIVISION 06 Mar 1995 Civilian 06 Mar 1995 06 Mar 1995 27 Feb 1995 08 Feb 1994 A DIVISION Total Potential Candidates for Alpha Range: FIGURE 4.4.3.10. SAMPLE OUTPUT REPORT: UPDATE/PRINT/ENROLL POTENTIAL AD CANDIDATES (Sheet 1 of 2) 6-304 9 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 TRIPLER AMC HONOLULU HI 07 Mar 1995@1405 Page 2 Personal Data - Privacy Act 1974 (PL-93-579) POTENTIAL ACTIVE DUTY CANDIDATE REPORT *** Part 2: Candidates not Eligible for Enrollment *** UIC: 1912 COMPUTER SYSTEMS GP Prov Grp: Alpha: AAA to MMM Default Enrolling Division: Default PCM: Current Avail AD Cap: Agr: ================================================================================================================================== SSN Rank Name SEX DOB Pat Cat DMIS ACV DEERS Spon Status CHCS UIC/Code DEERS UIC/Code DEERS Elig Code Elig Date End Elig Date PCM Group Agr Agr St Date Enrolling Division ---------------------------------------------------------------------------------------------------------------------------------123-55-4321 CPT AGNEW,CHRISTOPHER M 05 May 1955 M11 55555/UNKNOWN 01-INELIGIBLE - SSN not foun 28 Feb 1995 176-32-8050 TSG 55555/UNKNOWN MCBRIDE,BENJAMIN L 307-74-3606 SSG 55555/UNKNOWN ORTEGA,TONY L FIGURE 4.4.3.10. M 22 Jan 1962 F11 01-INELIGIBLE - SSN not foun 27 Feb 1995 M 04 Sep 1959 F11 01-INELIGIBLE - SSN not foun 27 Feb 1995 Total Non-Eligible Candidates for NOT A VALID UIC: Total Non-Eligible Candidates for All Enrollment Block Reasons: 3 3 Total Potential Candidates for Alpha Range: 417 SAMPLE OUTPUT REPORT: UPDATE/PRINT/ENROLL POTENTIAL AD CANDIDATES (Sheet 2 of 2) 6-305 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 TRIPLER AMC HONOLULU HI 02 Dec 1994@0944 Personal Data - Privacy Act 1974 (PL-93-579) ACTIVE DUTY BATCH ENROLLMENT *** Part 1: Successful Enrollments *** Page 1 Enrollment Date: 03 Dec 1994 --------------------------------------------------------------------------------SSN DOB Name Enrolling Division UIC Code UIC Description PCM Prov Group Agr Agr St Date ================================================================================= 354-77-4567 01 Jan 57 ABBOTT,CHARLES A 1ST MEDICAL GROUP LE1CF602 1912 COMMUNICATIONS GROUP LOESCHEN,STEVEN A FAM PRACT LAFB MTF 01 Feb 1994 243-66-0972 13 May 60 ADAMSON,JULIA T LE1CF602 1912 COMMUNICATIONS GROUP LOESCHEN,STEVEN A FAM PRACT LAFB 643-77-1232 22 Feb 58 BARNETT,GEORGE LE1CF602 1912 COMMUNICATIONS GROUP SEWELLS MNC SEWELLS MNC 1ST MEDICAL GROUP MTF 01 Feb 1994 1ST MEDICAL GROUP MTF 15 Jun 1994 Total Successful Enrollments: FIGURE 4.4.3.11. 3 SAMPLE OUTPUT REPORT: PRINT BATCH ENROLLMENT REPORT (Sheet 1 of 2) 6-306 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 TRIPLER AMC HONOLULU HI 02 Dec 1994@0944 Personal Data - Privacy Act 1974 (PL-93-579) ACTIVE DUTY BATCH ENROLLMENT *** Part 2: Candidates Unable to be enrolled *** Page 2 Enrollment Date: 03 Dec 1994 --------------------------------------------------------------------------------SSN DOB Name UIC PCM Prov Group Agr Agr St Date ================================================================================= PCM Agreement Not Active -----------------------444-56-2017 15 May 1975 AMOS,FRED 92007 BARRETT,THERESA FAMILY PRACTICE C MTF 11 Feb 1994 123-44-5555 03 Mar 1945 BARRETT,THERESA BOSTWICK,BARRY FAMILY PRACTICE C FORT ORD MTF 11 Feb 1994 Total Non-Enrollees for AGR: 2 Patient Ineligible on DEERS --------------------------455-55-0001 10 Oct 1954 FAMILY PRACTICE A ALABAMA,ALISTAIR A FAMILY PRACTICE A LE1CF602 MTF 08 Feb 1994 239-21-3113 02 Jul 1962 SONGER,EDWARD ALLEN,GARY D CARDIOLOGY A LE1CF602 MTF 09 Feb 1994 114-28-6130 15 Dec 1956 FAMILY PRACTICE A ASHBY,LEVEN FAMILY PRACTICE A LE1CF602 MTF 08 Feb 1994 Total Non-Enrollees for INEL: 3 Total Candidates Unable to be Enrolled: 5 FIGURE 4.4.3.11. SAMPLE OUTPUT REPORT: PRINT BATCH ENROLLMENT REPORT (Sheet 2 of 2) 6-307 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Subj: Identify Candidates for Renewal Completed (task #197664) Thu, 11 Jan 1996 21:00:48 11 Lines From: POSTMASTER (Sender: BENNETT,JANE) in 'IN' basket. **NEW** _____________________________Expires: 15 Jan 1996______________________________ The Identify Candidates for Renewal process (task #197664) has completed. Renewal Notification Letters and Labels may be printed using the Print Batch Renewal & Disenrollment Products option. Use the Incomplete Address Report contained within the Notification Letters spool document to identify candidates with incomplete addresses. Notification Letters: CP RENEWAL LTR-11Jan96-1704 Mailing Labels Task#: 197664 Mailing Labels User: BENNETT,JANE FIGURE 4.4.3.13. SAMPLE OUTPUT REPORT: IDENTIFY CANDIDATES FOR RENEWAL LETTER 6-308 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 Subj: Batch Disenroll Process Completed Thu, 11 Jan 1996 21:00:51 11 Lines From: POSTMASTER (Sender: BENNETT,JANE) in 'IN' basket. _____________________________Expires: 15 Jan 1996______________________________ The Batch Disenrollment (task #194045) has completed. You may use the PRINT BATCH RENEWAL & DISENROLLMENT PRODUCTS option to print Disenrollment Notification Letters and Labels as well as the Disenrollment Roster. Roster Name: Notification Letters: Mailing Labels Task#: Mailing Labels User: CP DISENROLL BATCH-11Jan96-1314 CP DISENROLL LTR-11Jan96-2100 197700 BENNETT,JANE FIGURE 4.4.3.14. SAMPLE OUTPUT REPORT: Batch Renewal & Disenrollment Processing 6-309 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 28 Jul 1995@0855 Page 1 Personal Data - Privacy Act of 1974 (PL 93-579) DISPLAY ENROLLMENT HISTORY Patient: BENSON,KATE FMP/SSN: 30/478-56-5145 Patient Category: USA FAM MBR AD DDS: 30 Patient Type: MCP/CHAMPUS ELIGIBLE Sex: FEMALE MCP Status: ENROLLED DOB/Age: 12 Oct 1971/21Y ================================================================================ Enrolling Division: BALBOA NAVY MEDICAL CENTER Patient Type: MCP/CHAMPUS ELIGIBLE Patient SSN: 588-54-0148 MCP Enroll Date: 31 May 1995 End Elig/Enroll Date: INDEFINITE Enrollment Comment: ACV: MCP ENROLLED/DIR. CARE CHAMPUS DMIS ID: BALBOA NAVY MEDICAL CENTER Language: ID Card Number: 3778095 Date Issued: 01 Jun 1994 Effective Date: 01 Jun 1994 Expiration Date: INDEFINITE Primary Care Manager: SMITH,EARNEST Case Mgmt: NO Primary OHI: Disenrollment Reason: PCM Phone: (619)377-7551 Enrolled Date: 04 Apr 1995 Enrolled By: SMITH,JANE Last Modified Date: 10 Jul 1995 Last Modified By: NGUYEN,TRUONG PCM Date of Change: 20 Jun 1995 19 Jun 1995 PCM Name: CHAN,EDMOND E SMITH,EARNEST FIGURE 4.4.4.1. PCM Changed By: ARNOLD,LOREEN NGUYEN,TRUONG SAMPLE OUTPUT REPORT: 6-310 PRINT/DISPLAY ENROLLMENT HISTORY SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 BALBOA NAVY MEDICAL CENTER 20 Jan 1993@0901 Personal Data - Privacy Act 1974 (PL 93-579) MANAGED CARE PROGRAM ENROLLMENT FORM ___________________________________________________________________________ ENROLLMENT DATE: 08 Dec 1992 END ELIG/ENROLL DATE: 08 Dec 1997 ___________________________________________________________________________ PATIENT NAME: ADLER,KATHLEEN FMP/SSN: 30/577-72-2843 Patient Category: USA FAM MBR AD DDS: 30 Sex: FEMALE Address: 500 NORTH NEWTON WAY DOB/Age: 13 Jun 1961/31Y City: SAN DIEGO Patient SSN: 572-23-7399 State: CA Home Phone: 542-7661 Zip Code: 92121 Work Phone: 670-1038 --------------------------------------------------------------------------SPONSOR NAME: ADLER,ROBERT FMP/SSN: 20/577-72-2843 Patient Category: USA ACTIVE DUTY DOB/Age: 01 Apr 1960/32Y Service: ARMY Rank: COL Station Unit: CAMP MICHAEL Duty Phone: 670-1038 Duty Address: 500 NORTH NEWTON WAY City: SAN DIEGO State: CA Zip Code: 92121 ___________________________________________________________________________ PRIMARY CARE MANAGER: SMITH,EARNEST IAM PCM PHONE: 377-7551 Place of Care: BALBOA NAVY MEDICAL CENTER Address: 11234 WASHINGTON STREET City: SAN DIEGO State: CA Zip Code: 92121 ___________________________________________________________________________ INSURANCE COMPANY: ASPEN MUTUAL PHONE: (202) 628-4506 POLICY NUMBER: 780932 Address: 732 E. PIKE ST. City: DENVER State: CO Zip Code: 57882 Policy Holder: ADLER,KATHLEEN SSN: 572-23-7399 Effective Date: 01 Aug 1992 Expiration Date: 30 Apr 1995 ___________________________________________________________________________ CASE MANAGEMENT: YES ___________________________________________________________________________ I understand that my enrollment in the Managed Care Program is contingent upon my continuing eligibility for health care under the MHSS. I understand the benefits and patient responsibilities of enrollment in the Managed Care Program and that enrollment remains in effect until I disenroll. I understand that enrollment is dependent on CHAMPUS eligibility as shown in DEERS and that CHAMPUS eligibility ceases upon eligibility for MEDICARE Part A. I further understand that my failure to follow the rules of this program may result in either increased cost share or complete non-reimbursement. --------------------------------------------------------------------------SIGNATURE: DATE: ___________________________________________________________________________ ADLER,KATHLEEN 30/577-72-2843 RCD Rm: MAIN FILE ROOM (A) FIGURE 4.4.4.2. SAMPLE OUTPUT REPORT: 6-311 MCP ENROLLMENT FORM SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 NH PORTSMOUTH, VA 22 Jan 1993@1110 Page 1 Personal Data - Privacy Act of 1974 (PL 93-579) MCP CONDITIONAL ENROLLMENT ROSTER Division: TRIPLER ARMY MEDICAL CENTER ================================================================================================================================== Name FMP/SSN DDS DOB Patient Category Spons Home Phone Enrollment Date Patient Address OHI PCM Rank Work Phone Auto Disenroll Date ================================================================================================================================== FARRINGTON,JOSEPHINE 30/098-00-0001 11 Nov 70 USN FAM MBR RET CDR 447-7560 26 May 93 9987 SUNSET ST LIMBAUGH,RUSH 23 Sep 93 PORTSMOUTH, VA 23701 GLASS,WHITNEY 1219 HALE DRIVE SAN DIEGO, CA 92101 02/224-13-4285 01 Jul 93 USAF FAM MBR AD WASHINGTON,WAYNE SSG 8048515119 06 Jul 93 03 Nov 93 KELEMAN,CATHERINE 303 S CHERRY MORRISON, IL 61270 40/359-46-8955 12 JUN 19 USAF FAM MBR AD PARKS,BERNICE CPT (805)772-3310 14 Jun 93 12 Oct 93 Division total: FIGURE 4.4.4.4. SAMPLE OUTPUT REPORT: 6-312 MCP CONDITIONAL ENROLLMENT ROSTER 3 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 TRIPLER AMC, HI 07 Jul 1993@1517 Page 1 Personal Data - Privacy Act of 1974 (PL 93-579) ENROLLMENT/DISENROLLMENT DISCREPANCY REPORT From: 06 Jul 1993 To: 07 Jul 1993 ================================================================================================================================== Patient FMP/SSN Sex DOB Home Phone Work Phone Date of Trans MCP Status Sponsor Sponsor Unit Pending Appts Duty Phone Discrepancy ================================================================================================================================== AURELIUS,GERTRUDE 30/808-60-0101 F 04 Jul 1960 H: W: 06 Jul 1993 INVALID ENROLLMENT CAMP SWAMPY NON-MTF D:444-5555 SSN Not Found in DEERS Data Base - Verify S DELANO,ANNA DELANO,KENNETH EUGENE 02/368-64-6645 F A COMPANY 16 Dec 1983 H:555 555-5444 W:555-555-0912 06 Jul 1993 INVALID ENROLLMENT D:555-8787 Invalid Enrollment Date Change - Patient No DELANO,WILBUR DELANO,KENNETH EUGENE 04/368-64-6645 M A COMPANY 19 Dec 1989 H:39009290760 W: D:555-8787 06 Jul 1993 INVALID ENROLLMENT Invalid Enrollment - Not Eligible For Plan GUILLERO,DANIEL GUILLERO,DONALD H 01/534-48-2466 M 31 Jul 1975 AIR COMBAT COMMAND H: 07 Jul 1993 INVALID ENROLLMENT Invalid Enrollment - Patient Already Enroll W: D: ---------------------------------------------------------------------------------------------------------------------------------Beneficiaries with a DEERS Discrepancy Code 56: 'Invalid Enrollment - Patient Already Enrolled' will need to be disenrolled from their current facility and re-enrolled here. FIGURE 4.4.4.5. SAMPLE OUTPUT REPORT: ENROLLMENT/DISENROLLMENT DISCREPANCY REPORT 6-313 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 NH PORTSMOUTH, VA 11 May 1993@0945 Page 1 Personal Data - Privacy Act of 1974 (PL 93-579) MCP DEERS INELIGIBILITY REPORT From: 10 May 1993 To: 11 May 1993 ================================================================================================================================== Patient FMP/SSN Sex DOB Date of Trans Home Phone Work Phone Pending Appts Sponsor Sponsor Unit Duty Phone Override MCP Status Process Type ================================================================================================================================== GALLOWAY,RAE 20/218480614 F 02 Nov 1946 06 May 1993@0900 H: W: Appts: GALLOWAY,RAE 1st Air Cav D: BATCH OLSON,SVEN OLSON,SVEN 20/317400514 M 1st Air Cav 07 Nov 1944 WILSON,FAYE GALLOWAY,R 20/408220678 F 1st Air Cav 01 Jan 1932 FIGURE 4.4.4.6. 07 May 1993@1503 H: D: W: 06 May 1993@1305 H: D: W: Appts: CONDITIONAL ENROLLMENT BATCH SAMPLE OUTPUT REPORT: 6-314 Appts: INTERACTIVE MCP DEERS INELIGIBILITY REPORT SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 User: DUEBBERT,CAROLE Address: HOME OHI: WITH Enroll Status: NONENROLLED Unit ID: 13 TO THE FAMILY OF: WINIFRED GLASS 1912 COMMUNICATIONS GROUP 1219 HALE DR HAMPTON VA 23663 TO THE FAMILY OF: BRITTANY S WHITMAN 1912 COMMUNICATIONS GROUP 104 KINGSBRIDGE LANE YORKTOWN VA 23692 FIGURE 4.4.4.7. SAMPLE OUTPUT REPORT: FAMILY BATCH ENROLLMENT LABELS PRINT UTILITY (Sheet 1 of 2) 6-315 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 User: DUEBBERT,CAROLE Address: DUTY OHI: WITH Enroll Status: ENROLLED Days to Expiration: 1 - 365 PCMs: 126 Unit ID: ALL TO THE FAMILY OF: TERENCE C BRUCE SSG 1912 COMMUNICATIONS GROUP 1212 TESTING BLVD HAMPTON VA 23665 TO THE FAMILY OF: MARY JOHNSON CPT 1912 COMMUNICATIONS GROUP 23697 COMM GROUP OCEANSIDE CA 92051 TO THE FAMILY OF: JERALD BLITON COL EDS TESTING UNIT 2203 HAMPTON VA 23665 FIGURE 4.4.4.7. SAMPLE OUTPUT REPORT: FAMILY BATCH ENROLLMENT LABELS PRINT UTILITY (Sheet 2 of 2) 6-316 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 TIDEWATER MCP 27 Apr 1994@1532 Personal Data - Privacy Act 1974 (PL-93-579) INCOMPLETE PATIENT HOME ADDRESS REPORT Page 1 Address: HOME Enroll Status: NONENROLLED Unit ID: ALL ================================================================================ Name FMP/SSN DDS Sponsor Home Phone Patient Home Address PATCAT Work Phone Rank Duty Phone ================================================================================ ANDREWS,JERRY 20/335-89-0112 20 ANDREWS,JERRY (804) 223-4788 USN ACTIVE DUTY LT (804) 442-2772 BASIL,GEORGE 20/447-09-9844 20 BASIL,GEORGE (804) 899-6224 USA ACTIVE DUTY PORTSMOUTH, VA 23711 SGT (804) 899-5176 ELKINS,RONALD 20/448-10-9887 20 ELKINS,RONALD (804) 223-4788 232 DROGHEDA ST USN ACTIVE DUTY (804) 337-4778 PORTSMOUTH, VA CAPT (804) 442-2772 NOBEL,ROXANNE 20/387-22-6554 20 NOBEL,ROXANNE (804) 224-4133 USAF ACTIVE DUTY PORTSMOUTH, VA 23706 LT (804) 442-2998 STANLEY,ROBERT 20/232-56-2776 20 STANLEY,ROBERT (804) 224-9667 USN ACTIVE DUTY PORTSMOUTH, VA 23708 LT (804) 442-3876 WILSON,MICHAEL 20/565-35-2887 20 WILSON,MICHAEL (804) 898-8995 USA ACTIVE DUTY PORTSMOUTH, VA 23706 CPT (804) 442-4555 Total Incomplete Home Addresses: FIGURE 4.4.4.8. SAMPLE OUTPUT REPORT: 6 INCOMPLETE PATIENT ADDRESS REPORT (Home Address Report) (Sheet 1 of 3) 6-317 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 TIDEWATER MCP 27 Apr 1994@1532 Personal Data - Privacy Act 1974 (PL-93-579) INCOMPLETE PATIENT DUTY ADDRESS REPORT Page 1 Address: DUTY Enroll Status: NONENROLLED Unit ID: ALL ================================================================================ Name FMP/SSN DDS Sponsor Home Phone Patient Duty Address PATCAT Work Phone Rank Duty Phone ================================================================================ BANCROFT,TOM 20/325-80-3112 20 BANCROFT,TOM (804) 224-4688 USN ACTIVE DUTY PORTSMOUTH, VA 23706 LT (804) 447-2772 DAMIAN,GEORGE 20/442-09-0844 20 DAMIAN,GEORGE (804) 899-6224 USA ACTIVE DUTY PORTSMOUTH, VA 23711 SGT (804) 899-5176 QUINCY,ANNA 20/447-01-9802 20 QUINCY,ANNA (804) 223-4788 USN ACTIVE DUTY PORTSMOUTH, VA 23706 CAPT (804) 447-2773 Total Incomplete Duty Addresses: FIGURE 4.4.4.8. SAMPLE OUTPUT REPORT: 3 INCOMPLETE PATIENT ADDRESS REPORT (Duty Address Report) (Sheet 2 of 3) 6-318 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 User: THACKER,DAVID Provider: 6 Selected TO: LT JERRY ANDREWS 14557 J. CLYDE MORRIS AVE. PORTSMOUTH VA 23706 TO: SGT GEORGE BASIL 3222 JAMES ST PORTSMOUTH VA 23711 TO: CAPT RONALD ELKINS 232 DROGHEDA ST PORTSMOUTH VA 23706 TO: LT ROXANNE NOBEL 477 NORTH MAIN ST PORTSMOUTH VA 23706 TO: LT ROBERT STANLEY 700 EAST ENGEBRETSEN AVE PORTSMOUTH VA 23708 TO: CPT MICHAEL WILSON 4777 WING ST PORTSMOUTH VA 23706 FIGURE 4.4.4.8. SAMPLE OUTPUT REPORT: INCOMPLETE PATIENT ADDRESS REPORT (Generate Corrected Labels) (Sheet 3 of 3) 6-319 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 TIDEWATER 14 Sep 1993@0925 Personal Data - Privacy Act 1974 (PL-93-579) ENROLLMENT ROSTER For ACTIVE DUTY FAMILY MEMBERS By UNIT Page 1 Unit: 1912 COMMUNICATIONS GROUP ================================================================================ Sponsor/ Sponsor Enrolled Family Members FMP/SSN/Rank FMP DDS DOB Date ================================================================================ BRUCE,TERENCE C 20/228-04-5815/SSG --------------------------------------------BRUCE,ESTHER 01 1 07 Aug 1991 13 Aug 1994 BRUCE,ANDREW 02 2 25 Nov 1987 13 Aug 1994 BRUCE,EILEEN 30 30 12 Jun 1967 11 Aug 1994 Family Member Total: WHITMAN,PETER D 20/298-66-4855/TSG --------------------------------------------WHITMAN,DAVID T 02 WHITMAN,BRITTANY S 04 2 4 24 Mar 1982 05 May 1985 Family Member Total: WILLIAMS,CURTIS W 20/533-78-2525/SSG --------------------------------------------WILLIAMS,CERISSA 03 WILLIAMS,KAREN L 30 3 13 Jun 1989 01 Nov 1963 Family Member Total: JOHNSON,MARY 20/800-78-0605/CPT --------------------------------------------JOHNSON,DON 30 FIGURE 4.4.4.9. 03 Feb 1957 3 06 Aug 1994 02 Jun 1994 2 11 Aug 1994 13 Aug 1994 2 30 Jul 1994 Family Member Total: 1 Unit Total: 8 SAMPLE OUTPUT REPORT: AD FAMILY MEMBERS BY UNIT ENROLLMENT ROSTER (Sheet 1 of 2) 6-320 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 TIDEWATER 14 Sep 1993@0925 Personal Data - Privacy Act 1974 (PL-93-579) ENROLLMENT ROSTER For ACTIVE DUTY FAMILY MEMBERS By UNIT Page 2 Unit: SIMA ================================================================================ Sponsor/ Sponsor Enrolled Family Members FMP/SSN/Rank FMP DDS DOB Date ================================================================================ SMITH,DAVID 20/543-54-5432/COL --------------------------------------------SMITH,FRED 01 05 May 1976 24 May 1994 SMITH,LARRY 02 15 Aug 1978 24 May 1994 SMITH,JEREMY 03 23 Feb 1980 24 May 1994 SMITH,ALBERT 04 30 Dec 1983 24 May 1994 SMITH,GEORGE 05 07 Jun 1985 24 May 1994 SMITH,CHRIS 06 12 Dec 1988 03 Jun 1994 SMITH,THOMAS 07 11 Nov 1989 04 Jun 1994 SMITH,ROBERT 08 07 Jul 1991 07 Jun 1994 SMITH,CLARA 30 17 May 1956 24 May 1994 Family Member Total: LONG,THERESA 20/654-32-1098/CPT --------------------------------------------LONG,TINA 01 LONG,CRISTY 02 LONG,LAURA 03 15 Sep 1972 05 Nov 1975 11 Jan 1978 Family Member Total: ALLISON,GEORGE 20/723-23-2345/MAJ --------------------------------------------ALLISON,AMY 31 04 Mar 1960 Family Member Total: Unit Total: 9 02 Jun 1994 02 Jun 1994 02 Jun 1994 3 15 Jul 1994 1 20 Selected Units Total: FIGURE 4.4.4.9. 28 SAMPLE OUTPUT REPORT: AD FAMILY MEMBERS BY UNIT ENROLLMENT ROSTER (Sheet 2 of 2) 6-321 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 TRIPLER AMC, HI 22 Jan 1996@1517 Page 1 Personal Data - Privacy Act 1974 (PL 93-579) ALPHABETIC ENROLLMENT ROSTER By SERVICE From: 16 Jan 1995 To: 19 Jan 1996 Division: TRICARE MCP DIVISION MARINE CORPS ================================================================================================================================== Name FMP/SSN DDS DOB PCM Spon Home Phone Effective Dates Patient Address OHI Patient Category Rank Work Phone MCP Status ================================================================================================================================== PALA,MINDY 31/800-82-0705 05 Jul 70 BANES,JOSEPH CPL 390-1023 01 Feb 95 - 02 Jun 98 293854 Highway 67 USMC FAM MBR AD Enrolled Escondido, CA 92026 PALA,PAUL 20/800-82-0705 12 Aug 72 ABBOTT,JAMES CPL 390-1023 01 Feb 95 - 02 Jun 98 293854 Highway 67 USMC ACTIVE DUTY Enrolled Escondido, CA 92026 FIGURE 4.4.4.10. MARINE CORP Total: 2 Division Total: 2 SAMPLE OUTPUT REPORT: ALPHABETIC ENROLLMENT ROSTER BY SERVICE (Sheet 1 of 3) 6-322 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 TRIPLER AMC, HI 22 Jan 1996@1517 Page 2 Personal Data - Privacy Act 1974 (PL 93-579) ALPHABETIC ENROLLMENT ROSTER By SERVICE From: 16 Jan 1995 To: 19 Jan 1996 Division: TRICARE MCP DIVISION MARINE CORPS ================================================================================================================================== PATCAT/Name FMP/SSN DDS DOB PCM Spon Home Phone Effective Dates Patient Address OHI Patient Category Rank Work Phone MCP Status ================================================================================================================================== FAM MBR OF ACTIVE DUTY ---------------------BENNETT,AURORA 01/229-66-1234 07 Nov 86 MICHAEL,GEORGE ADM 535-7546 01 Feb 95 - 31 Jan 96 1234 Any Street USN FAM MBR AD Pending Enrollment San Diego, CA 92108 HOPKINS,THUMPER K. 01/800-62-0102 03 Feb 85 KATZ,TEMME ENS 01-Nov 95 - 31 Oct 96 USN FAM MBR AD Invalid Enrollment PEARL,ZELDA N 30/577-55-7890 02 Jan 76 TRAINER,TEDDY CDR 702/289-2889 01 Jan 96 - 31 Dec 96 111 Carson St USN FAM MBR AD Conditionally Enrolled Fallon, NV 89406 ROY,CARLA 30/613-22-4444 23 Aug 60 MERWELL MEDICAL ADM 01 Oct 95 - 30 Sep 96 9467 Hi Prk Rd OHI USN FAM MBR AD Conditionally Enrolled FIGURE 4.4.4.10. MARINE CORP Total: 4 Division Total: 4 SAMPLE OUTPUT REPORT: ALPHABETIC ENROLLMENT ROSTER BY SERVICE (Sheet 2 of 3) 6-323 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 TRIPLER AMC, HI 22 Jan 1996@1517 Page 3 Personal Data - Privacy Act 1974 (PL 93-579) ALPHABETIC ENROLLMENT ROSTER By SERVICE From: 16 Jan 1995 To: 19 Jan 1996 Division: TRICARE MCP DIVISION MARINE CORPS ================================================================================================================================== Unit/Name FMP/SSN DDS DOB PCM Spon Home Phone Effective Dates Patient Address OHI Patient Category Rank Work Phone MCP Status ================================================================================================================================== 1st Marine Division ------------------ROY,CARLA 30/613-22-4444 23 Aug 60 MERWELL MEDICAL ADM 01 Oct 95 - 30 Sep 96 9467 Hi Prk Rd OHI USN FAM MBR AD Conditionally Enrolled Moscow, RS ROY,RANDY 20/613-22-4444 15 May 52 MERWELL MEDICAL ADM 22 Aug 95 - 31 Aug 96 9467 Hi Prk Rd USN ACTIVE DUTY Invalid Enrollment San Diego, CA 92121 FIGURE 4.4.4.10. MARINE CORP Total: 2 Division Total: 2 SAMPLE OUTPUT REPORT: ALPHABETIC ENROLLMENT ROSTER BY SERVICE (Sheet 3 of 3) 6-324 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 TIDEWATER 13 Sep 1993@1204 Page 1 Personal Data - Privacy Act 1974 (PL-93-579) CASE MANAGEMENT PROGRAM ENROLLMENT ROSTER Exception Provider: ADAMSON,GEORGE V Division: AIR FORCE MTF DIVISION ================================================================================================================================== Name FMP/SSN DDS DOB PCM Spon Home Phone Effective Dates Patient Address Condition Text OHI Patient Category Rank Work Phone MCP Status ================================================================================================================================== ROBERTS,HAROLD 20/555-66-6555 20 09 Feb 50 THACKER,DAVID COL 8329749273 23 Aug 93 - 07 Oct 93 8847 XENIA AVE USAF ACTIVE DUTY Enrolled HAMPTON, VA 23665 bleeding ulcer FIGURE 4.4.4.11. SAMPLE OUTPUT REPORT: CASE MANAGEMENT PROGRAM ENROLLMENT ROSTER (Sheet 1 of 4) 6-325 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 TIDEWATER 13 Sep 1993@1204 Page 2 Personal Data - Privacy Act 1974 (PL-93-579) CASE MANAGEMENT PROGRAM ENROLLMENT ROSTER Exception Provider: CRAWFORD,PHYLLIS Division: AIR FORCE MTF DIVISION ================================================================================================================================== Name FMP/SSN DDS DOB PCM Spon Home Phone Effective Dates Patient Address Condition Text OHI Patient Category Rank Work Phone MCP Status ================================================================================================================================== JAVENS,KAITLYN 01/478-55-5045 1 12 Oct 79 CRAWFORD,JACQUI SFC 619-543-5435 08 Sep 93 - 23 Oct 93 11345 SANDY LAKE DRIVE SOUTHWE OHI USA FAM MBR RET Enrolled HAMPTON, VA 23665 Urinary infection. FIGURE 4.4.4.11. SAMPLE OUTPUT REPORT: CASE MANAGEMENT PROGRAM ENROLLMENT ROSTER (Sheet 2 of 4) 6-326 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 TIDEWATER 13 Sep 1993@1204 Page 3 Personal Data - Privacy Act 1974 (PL-93-579) CASE MANAGEMENT PROGRAM ENROLLMENT ROSTER Exception Provider: JONES,ROBERT T Division: AIR FORCE MTF DIVISION ================================================================================================================================== Name FMP/SSN DDS DOB PCM Spon Home Phone Effective Dates Patient Address Condition Text OHI Patient Category Rank Work Phone MCP Status ================================================================================================================================== JAVENS,KAITLYN 01/478-55-5045 1 12 Oct 79 CRAWFORD,JACQUI SFC 619-543-5435 10 Sep 93 - 10 Sep 95 11345 SANDY LAKE DRIVE SOUTHWE OHI USA FAM MBR RET Enrolled HAMPTON, VA 23665 Urinary infection. FIGURE 4.4.4.11. SAMPLE OUTPUT REPORT: CASE MANAGEMENT PROGRAM ENROLLMENT ROSTER (Sheet 3 of 4) 6-327 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 TIDEWATER 13 Sep 1993@1204 Page 4 Personal Data - Privacy Act 1974 (PL-93-579) CASE MANAGEMENT PROGRAM ENROLLMENT ROSTER Exception Provider: ZAMBIA,ZELDA Division: AIR FORCE MTF DIVISION ================================================================================================================================== Name FMP/SSN DDS DOB PCM Spon Home Phone Effective Dates Patient Address Condition Text OHI Patient Category Rank Work Phone MCP Status ================================================================================================================================== ROBERTS,HAROLD 20/555-66-6555 20 09 Feb 50 THACKER,DAVID COL 8329749273 23 Aug 93 - 07 Oct 93 8847 XENIA AVE USAF ACTIVE DUTY Enrolled HAMPTON, VA 23665 Urinary infection. Division Total: FIGURE 4.4.4.11. SAMPLE OUTPUT REPORT: CASE MANAGEMENT PROGRAM ENROLLMENT ROSTER (Sheet 4 of 4) 6-328 4 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 TIDEWATER 14 Sep 1993@1323 Page 1 Personal Data - Privacy Act 1974 (PL-93-579) CHANGE in ELIGIBILITY ENROLLMENT ROSTER FROM: 14 Sep 1993 TO: 14 Sep 1994 Division: A DIVISION Eligibility Category: APPROACHING THE AGE OF 21 ================================================================================================================================== Name FMP/SSN DDS DOB PCM Spon Home Phone Enrollment Date Patient Address OHI Patient Category Rank Work Phone End Eligibility Date Sponsor Name MCP Status ================================================================================================================================== LONG,CRISTY 02/654-32-1098 05 Nov 72 MILES,DAVIS CPT 234-2344 02 Jun 93 12343 LIBERTY BLVD USA FAM MBR AD 02 Jun 94 SAN DIEGO, CA 92121 LONG,THERESA Enrolled FIGURE 4.4.4.12. SAMPLE OUTPUT REPORT: CHANGE IN ELIGIBILITY ENROLLMENT ROSTER (Sheet 1 of 3) 6-329 SAIC/CHCS Doc. TC-4.5-0706 29 Jul 1996 TIDEWATER 14 Sep 1993@1323 Page 2 Personal Data - Privacy Act 1974 (PL-93-579) CHANGE in ELIGIBILITY ENROLLMENT ROSTER FROM: 14 Sep 1993 TO: 14 Sep 1994 Division: A DIVISION Eligibility Category: Approaching the End of Eligibility Date ================================================================================================================================== Name FMP/SSN DDS DOB PCM Spon Home Phone Enrollment Date Patient Address OHI Patient Category Rank Work Phone End Eligibility Date Sponsor Name MCP Status ==========================================