***DRAFT***
September 3, 1998
Enrollment and Encounter Task Force
Elements Considered but Not Included
VII. ENCOUNTER ELEMENTS FILE [Elements Considered but Not Included.]:
Item |
FN-11 |
Source |
Other |
¬ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ Committee Recommendation ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ® |
|
# |
Data Element |
Document |
Name |
Definition |
Workgroup Comments |
1 |
Psych. ER visits for non-emergency | EE #14 |
|||
2 |
Residential Placement | EE #17 |
|||
3 |
Principal Procedures | EE #48 |
Principal Procedure (inpatient) or ambulatory | ||
4 |
Other Procedures | EE #49 |
|||
5 |
Dates of Procedures | EE #50 |
|||
6 |
Attending Physician Identification (inpatient) | EE #38 |
Unique identifier to the physician who provided the service. | ||
7 |
Date payment made | EE #69, 61 |
Check date | ||
8 |
Admitting service | EE #19 |
|||
9 |
Employee home phone | EE #97 |
Home phone number of the organization’s staff member who provided a service | ||
10 |
Visits during office hours | EE #8 |
|||
11 |
Benefits Currently Used | EE #67 |
Benefits currently received | ||
12 |
Date of Referral | EE #96 |
Date on which the referral was made (mm/dd/yyyy) | ||
13 |
Type of Referral | EE #95 |
|||
14 |
Daily Activity Code | EE #7 |
|||
Item |
FN-11 |
Source |
Other |
¬ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ Committee Recommendation ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ® |
|
# |
Data Element |
Document |
Name |
Definition |
Workgroup Comments |
15 |
Service hours and days of operation | EE #25 |
|||
16 |
Dependent Birthdays | EE #92 |
Date of birth for the dependent(s) of the client (mm/dd/yyyy) | ||
17 |
Dependent gender | EE #93 |
Gender of the dependent(s) of the client (male/female) | ||
18 |
Patient’s relationship to subscriber/ enrollee | EE #91 |
|||
19 |
Number of visits for each client | EE #11 |
|||
20 |
Total Amount Paid | EE #58 |
|||
21 |
Staff member(s) reporting | EE #63 FN-10, p.60 |
Unique identifier(s) used to associate the data in the human resources component or file with the staff member(s) reporting | ||
22 |
Persons involved in event | EE #60 |
|||
23 |
Scheduled event | FN-10 p.63 |
Event was scheduled, i.e.,
the activity, patient, and staff involved in the event were known at least 24 hours in
advance. Event was unscheduled, i.e., the activity, patient, and staff involved in the event were not known at least 24 hours in advance |
||
24 |
Medical Record Number | EE #65 |
Unique client number used by service facility/county/state. | ||
Item |
FN-11 |
Source |
Other |
¬ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ Committee Recommendation ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ® |
|
# |
Data Element |
Document |
Name |
Definition |
Workgroup Comments |
25 |
Client’s Expected Sources of Payment | EE #56, 74 FN-10 p.45 |
Type of Coverage; Expected Payment Source | None (organization to
absorb total cost) Personal resources (patient’s or patient’s family) Commercial health insurance Service contract (to provide mental health services under a written agreement on a fee-for-services, capitation, or lump-sum basis) Medicare (Title XVIII) Medicaid (Title XIX) CHAMPUS Worker’s Compensation Other public sources |
|
26 |
Authorized Service | The type of service(s) authorized by payer. | |||
27 |
Authorized Units | EE #30, 71 |
Eligibility Days (or time between eligibility begin and eligibility end); Units of Service Authorized | The number of visits days the payer has authorized for the client. | |
28 |
Medications Prescribed | EE #52 |
The medication name prescribed for the client at time of service. | ||