***DRAFT***
September 3, 1998
Provider/Organization
Data Elements
VIII. PROVIDER/ORGANIZATION DATA ELEMENTS [Data reported once but may be corrected as needed.]:
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 |
Provider Identification (individual clinician) | EE #35 FN-10 p.132 |
Provider Identification (ambulatory); Name and Identifier of the mental health organization | Federal ID Number or Nation Provider ID Number | ||
2 |
Organization Identifier | EE #34 FN-10 p.149 |
Federal ID Number or National Provider ID Number | |||
3 |
Provider location | EE #36 FN-10 p.132 |
Provider location or address (ambulatory); Mailing address of the mental health organization | P.O. Box number or street number and name, city or town, State, zip-code | ||
4 |
Type of Facility | EE #33, 39 FN-10 p.134 |
Provider Specialty; Rural Health Clinic; Type of Organization | The category that best characterizes its general type. Psychiatric hospital Psychiatric unit of general hospital Organization providing residential services Outpatient mental health clinic Mental Health partial day organization Multi-service mental health organization Consumer-Run Rural Health Other Consumer-Run Mental Health Organization FQHC (Federally Qualified Health Clinic) Other mental health organization |
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