Quick Bar: Overview---Demographics---Insurance---Credit_Messages---Balance_Detail---Workers'_Compensation---Patient_Specifics---Referral_Authorization (More)---Recall_Logging---Appointments_List
Patient Entry - Referral Authorization Employer Areas
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. |
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Employer 1 Area |
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To display the Employer 2 Area, click Additional Info. |
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Click one of the following options in the drop-down list:
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Entry Options:
Notes:
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Select the Patient Cause Code from the drop-down list below, or you can enter your own code. (up to 2 characters)
Note: The Cause Code entered here can be pulled into the Charge Entry - Location Provider Area. |
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Enter the Cause Date. (mm/dd/ccyy) Note: The Cause Date entered here can be pulled into the Charge Entry - Location Provider Area. |
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Enter the date last seen. (mm/dd/ccyy) |
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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. |
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To display the Employer 1 Area, click Employer Info. |
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Enter the Partial Disability From Date. (mm/dd/ccyy) |
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Enter the Partial Disability Thru Date. (mm/dd/ccyy) |
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Enter the Total Disability From Date. (mm/dd/ccyy) |
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Enter the Total Disability Thru Date. (mm/dd/ccyy) |
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Enter the Hospitalization From Date. (mm/dd/ccyy) |
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Enter the Hospitalization Thru Date. (mm/dd/ccyy) |
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Enter the Symptoms From Date. (mm/dd/ccyy) |
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Enter the Symptoms Thru Date. (mm/dd/ccyy) |
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Enter the Date Resumed Work. (mm/dd/ccyy) |
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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. |
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Entry Options:
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Entry Options:
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