Patient Entry - Referral Authorization Employer Areas

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Use the two Referral Authorization Employer Areas to enter optional Workers' Compensation information that is related to the referral and will print on the 1500s forms. You can enter an alternate employer or insurance address, cause information, and dates of various medical events. You can toggle between the two areas by clicking the Employer Info and Additional Info buttons. The table following the window example describes the Referral Authorization Employer Areas for Patient Entry.

Tip: For additional Workers' Compensation data, see the Patient Entry - Workers' Compensation Window.

Directions:

To display the Referral Authorization Employer Area:

Open the Referral Authorization Window.
Tip: For details about opening windows, refer to the Patient Reference Panel.
Enter an Authorization Number.
Click Employer .
To display the Employer 2 Area, click Additional Info .

Or, to revert back to the Employer 1 Area, click Employer Info .

Example: Employer 1 Area

Example: Employer 2 Area

Patient Entry - Referral Authorization Employer Area Prompts Tip: To see more information about a field, click the hyperlink for the field name.
Employer 1 Area
	To display the Employer 2 Area, click Additional Info.
Address Flag	Click one of the following options in the drop-down list: (E)mployer: Specifies that the address is for the patient's employer. (I)nsurance: Specifies that the address is for the patient's insurance company.
Employer Code or Insurance Code	Entry Options: Employer: If you specified the (E)mployer Address Flag, enter the Employer/Lawyer ID. Insurance: If you specified the (I)nsurance Address Flag, enter the Insurance Code. Notes: To search for an Insurance Code or Employer/Lawyer ID, click Search or press [CTRL + f]. To create a new Insurance Code or Employer/Lawyer ID, click Fast Maintenance or press [CTRL + o].
Cause	Select the Patient Cause Code from the drop-down list below, or you can enter your own code. (up to 2 characters) A - Auto. Accident E - Emergency O - Other S - Surgery U - Pull from Patient W - Work Related Note: The Cause Code entered here can be pulled into the Charge Entry - Location Provider Area.
Cause Date	Enter the Cause Date. (mm/dd/ccyy) Note: The Cause Date entered here can be pulled into the Charge Entry - Location Provider Area.
Date Last Seen	Enter the date last seen. (mm/dd/ccyy)
Employer/Insurance	Displays the employer/lawyer name or insurance name.
Address	Displays the employer/lawyer address or insurance address.
City	Displays the employer/lawyer city or insurance city.
State	Displays the employer/lawyer state or insurance state.
Zip	Displays the employer/lawyer Zip Code (postal code) or the insurance Zip Code.
Phone Number	Displays the employer/lawyer phone number or the insurance phone number.
Ext	Displays the employer/lawyer phone extension.
Employer 2 Area Note: Enter the following fields, if applicable.
	To display the Employer 1 Area, click Employer Info.
Partial Disability From	Enter the Partial Disability From Date. (mm/dd/ccyy)
Partial Disability Thru	Enter the Partial Disability Thru Date. (mm/dd/ccyy)
Total Disability From	Enter the Total Disability From Date. (mm/dd/ccyy)
Total Disability Thru	Enter the Total Disability Thru Date. (mm/dd/ccyy)
Hospitalization From	Enter the Hospitalization From Date. (mm/dd/ccyy)
Hospitalization Thru	Enter the Hospitalization Thru Date. (mm/dd/ccyy)
Symptoms From	Enter the Symptoms From Date. (mm/dd/ccyy)
Symptoms Thru	Enter the Symptoms Thru Date. (mm/dd/ccyy)
Date Resumed Work	Enter the Date Resumed Work. (mm/dd/ccyy)
Claim State	Enter the state abbreviation for the claim state. (2 characters) Tip: You can enter just the first letter of the state code, and then click the appropriate state in the drop-down list.
Old Symptom	Entry Options: If the symptom is an old symptom, click to select the Old Symptom box. If the symptom is not old, de-select the box.
Outside Lab	Entry Options: If this referral is for an Outside Lab, select the Outside Lab box. If the referral is not for an Outside Lab, de-select the box.