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Setting up programmer environment This is a TEST account.
Terminal Type set to: C-VT100
You have 98 new messages. Select OPTION NAME: DGMGR MAS MANAGER
ADT Manager Menu ...
[7mYou've got PRIORITY mail!
[m Select MAS MANAGER Option: ADT Manager Menu
Copyright, Trade Secret and Trademark CPT codes, descriptions and other data are copyright 1966, 1970, 1973, 1977, 1981, 1983-2010 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association. You acknowledge that the AMA retains all right, title, and interest in the File provided to you. U.S. Government Rights CPT is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable which were developed exclusively at private expense by the American Medical Association, 515 North State Street, Chicago, Illinois 60654. U.S. government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015 (b) (2) (November 1995) and/or subject to the restrictions of DFARS 227.7202-1 (a) (June 1995) and DFARS 227.7202-3 (a) (June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department of Defense Federal procurements.
LIMITED WARRANTY AND REMEDIES THE FILE IS PROVIDED "AS IS" WITHOUT WARRANTY OF
ANY KIND, EITHER EXPRESSED OR IMPLIED, INCLUDING, WITHOUT LIMITATION, THE IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE. THE AMA DISCLAIMS RESPONSIBILITY AND ANY LIABILITY FOR ANY ERRORS IN THE FILE AND ANY CONSEQUENCES, DECISIONS, JUDGMENTS OR RESULTS ATTRIBUTABLE TO OR RELATED TO ANY USES, NON-USES OR INTERPRETATIONS OF INFORMATION OR DATA CONTAINED IN OR NOT CONTAINED IN THE FILE. IN NO EVENT WILL THE AMA BE LIABLE TO YOU FOR ANY DAMAGES, INCLUDING ANY LOST PROFITS, LOST SAVINGS OR OTHER INCIDENTAL OR CONSEQUENTIAL DAMAGES ARISING OUT OF THE USE OR INABILITY TO USE THE FILE EVEN IF THE AMA HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES, OR FOR ANY CLAIM BY ANY OTHER PARTY. THE AMA DOES NOT WARRANT THAT THE DATA CONTAINED IN THE FILE WILL MEET YOUR REQUIREMENTS OR THAT THE OPERATION OF THE FILE WILL BE UNINTERRUPTED OR WITHOUT ERROR.
Press any key to continue[7;1H[1;1H[J[2J[H Hi Robert. Welcome to MAS, VERSION 5.3
= = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = =
AMIS 401-420 Reports ............... Last run for month of Auto Recalculation ................. Last run MAY 14, 2011@21:00:01 on CPU EHR
................. Scheduled for (not currently scheduled) ................. Rescheduled to run at 9 p.m.
The current time is 22:51 ??
Embosser Option from Registration .. Is turned OFF Gains & Losses (G&L) ............... Last run MAY 14, 2011@21:48 HINQ Option from Registration ...... Is turned OFF RUG-II Background Job .............. Last run NOV 30, 2004@16:19 Appointment Status Update .......... Last run
.......... Updated appointments for .......... Scheduled for (not currently scheduled)
IRT Background Job ................. Last run
................. Scheduled for (not currently scheduled)
YOU ARE PRESENTLY ON CPU EHR,EHR
Press RETURN to continue:
Patient Inquiry
[7mYou've got PRIORITY mail!
[m Select ADT Manager Menu Option:
ADT Manager Menu ...
[7mYou've got PRIORITY mail!
[m Select MAS MANAGER Option: ?
ADT Manager Menu ...
Enter ?? for more options, ??? for brief descriptions, ?OPTION for help text.
[7mYou've got PRIORITY mail!
[m Select MAS MANAGER Option:
[7mYou've got PRIORITY mail!
[m
Do you really want to halt? YES
Logged out at May 14, 2011 10:51 pm
GTM>[?1h=S[C [CD[CU[CZ[C=[C9[C [CD[C [C[CX[CU[CP[C[?1l>
Setting up programmer environment This is a TEST account.
Terminal Type set to: C-VT100
You have 98 new messages. Select OPTION NAME: PFT TF
1 PTF BACKGROUND JOB DG PTF BACKGROUND JOB PTF Background Job 2 PTF BEDSECTION REPORT RA LWKLBEDSEC PTF Bedsection Report 3 PTF EXPANDED CODE LISTING DG PT EXPANDED CODE LIST PTF Expanded Co
de Listing
4 PTF MENU DG PTF MENU PTF Menu 5 PTF OUTPUT MENU DG PTF OUTPUT MENU PTF Output Menu
Press <RETURN> to see more, '' to exit this list, OR CHOOSE 1-5:
6 PTF RECORDS TRANSMITTED WITH M DG PTF TRANS MT EQUAL U RPT PTF Rec
ords Transmitted with MT Indicator of U
7 PTF TRANSMISSION DG PTF TRANSMISSION VADATS PTF Transmission 8 PTFDGPTFMO1 DG PTF COMPREHENSIVE INQUIRY Inquire PTF Record
CHOOSE 1-8: 4 DG PTF MENU PTF Menu
Census Menu ... Checkoff PTF Message DRG Calculation Enter PTF Message Incomplete Records Tracking Menu ... Inquire PTF Message Load/Edit PTF Data National Patient Care Database ... PTF Output Menu ... Quick Load/Edit PTF Data Set Up Non-VA PTF Record Utility Menu ...
[7mYou've got PRIORITY mail!
[m Select PTF Menu Option: UTility Menu
Establish PTF Record from Past Admission Print Special Transaction Request Log PTF Expanded Code Listing Purge Special Transaction Request Log Validity Check of PTF Record
[7mYou've got PRIORITY mail!
[m Select Utility Menu Option: EStablish PTF Record from Past Admission
Select Patient: ZZ PATIENT,TEST ONE ZZ PATIENT,TEST ONE
<A> F 01-24-1945 000003322 1
*WARNING*
*RESTRICTED RECORD*
*WARNING*
*RESTRICTED RECORD*
Select Admission Date: 5/2/11@9 (MAY 02, 2011@09:00) 5-2-2011@09:00:00 ZZ PAT IENT,TEST ONE (000003322)
ADMISSION: DIRECT
Creating new PTF record...
SOURCE OF ADMISSION: 1P OUTPATIENT TREATMENT HOSPITAL
record #5 created.
Select Patient: ZZ PATIENT,TEST THREE ZZ PATIENT,TEST THREE
<CA> M 01-15-1968 3
Select Admission Date: MAY 11, 2011@09:00 (MAY 11, 2011@09:00) 5-11-2011@09:00 :00 ZZ PATIENT,TEST THREE ()
ADMISSION: DIRECT
Creating new PTF record...
SOURCE OF ADMISSION: 1P OUTPATIENT TREATMENT HOSPITAL
record #6 created.
Select Patient:
Establish PTF Record from Past Admission Print Special Transaction Request Log PTF Expanded Code Listing Purge Special Transaction Request Log Validity Check of PTF Record
[7mYou've got PRIORITY mail!
[m Select Utility Menu Option:
Census Menu ... Checkoff PTF Message DRG Calculation Enter PTF Message Incomplete Records Tracking Menu ... Inquire PTF Message Load/Edit PTF Data National Patient Care Database ... PTF Output Menu ... Quick Load/Edit PTF Data Set Up Non-VA PTF Record Utility Menu ...
[7mYou've got PRIORITY mail!
[m Select PTF Menu Option:
[7mYou've got PRIORITY mail!
[m
Do you really want to halt? YES
Logged out at May 14, 2011 10:53 pm
GTM>[?1h=S[C [CD[CU[CZ[C=[C9[C [CD[C [C[CX[CU[CP[C[?1l>
Setting up programmer environment This is a TEST account.
Terminal Type set to: C-VT100
You have 98 new messages. Select OPTION NAME: BED CONTROL MENU DG BED CONTROL Bed Control Menu
Admit a Patient Cancel a Scheduled Admission Check-in Lodger Delete Waiting List Entry Detailed Inpatient Inquiry Discharge a Patient DRG Calculation Extended Bed Control Lodger Check-out Provider Change Schedule an Admission Seriously Ill List Entry Switch Bed Transfer a Patient Treating Specialty Transfer Waiting List Entry/Edit
[7mYou've got PRIORITY mail!
[m Select Bed Control Menu Option: EXtended Bed Control
Select PATIENT NAME:
ZZ PATIENT,TEST THREE <CA> M 01-15-1968 3
CHOOSE FROM:
1> MAY 11,2011@09:00 DIRECT TO:
CHOOSE 1-1: 1[11;1H[1;1H[J[2J[H
ADMISSION:
MAY 11,2011@09:00 DIRECT TO:
TRANSFERS:
TREATING SPECIALTY CHANGES:
DISCHARGE:
CHOOSE FROM:
1 - Admit Patient 2 - Transfer Patient 3 - Discharge Patient
Select Option: 1 ADMIT PATIENT
ADMISSION DATE: MAY 11,2011@09:00 @
Are you sure you want to delete this movement? No Y (Yes)
Updating automated team lists...completed. MAS Patient Movement - Activating Mental Health Update
Starting Mental Health Update... No MH actions taken... done... Executing HL7 ADT Messaging Executing HL7 ADT Messaging (RAI/MDS)
Updating incomplete records...
...Inpatient Medications check... ...discontinuing Inpatient Medication orders....done...
Updating visit status...completed.
Select PATIENT NAME:
ZZ PATIENT,TEST THREE <CA> M 01-15-1968 3
No admissions on file
Select PATIENT NAME: ZZ PATIENT,TEST ONE ZZ PATIENT,TEST ONE
<A> F 01-24-1945 000003322 1
*WARNING*
*RESTRICTED RECORD*
*WARNING*
*RESTRICTED RECORD*
CHOOSE FROM:
1> MAY 2,2011@09:00 DIRECT TO:
CHOOSE 1-1: 1[5;1H[1;1H[J[2J[H
ADMISSION:
MAY 2,2011@09:00 DIRECT TO:
TRANSFERS:
TREATING SPECIALTY CHANGES:
DISCHARGE:
CHOOSE FROM:
1 - Admit Patient 2 - Transfer Patient 3 - Discharge Patient
Select Option: 1 ADMIT PATIENT
ADMISSION DATE: MAY 2,2011@09:00 w ??
Examples of Valid Dates:
JAN 20 1957 or 20 JAN 57 or 1/20/57 or 012057 T (for TODAY), T+1 (for TOMORROW), T+2, T+7, etc. T-1 (for YESTERDAY), T-3W (for 3 WEEKS AGO), etc.
If the year is omitted, the computer uses CURRENT YEAR. Two digit year
assumes no more than 20 years in the future, or 80 years in the past.
If only the time is entered, the current date is assumed. Follow the date with a time, such as JAN 20@10, T@10AM, 10:30, etc. You may enter a time, such as NOON, MIDNIGHT or NOW. You may enter NOW+3' (for current date and time Plus 3 minutes
*Note--the Apostrophe following the number of minutes)
Seconds may be entered as 10:30:30 or 103030AM. Time is REQUIRED in this response.
Enter a date which is less than or equal to NOW.
ADMISSION DATE: MAY 2,2011@09:00 Y @
Are you sure you want to delete this movement? No Y (Yes)
Updating automated team lists...completed. MAS Patient Movement - Activating Mental Health Update
Starting Mental Health Update... No MH actions taken... done... Executing HL7 ADT Messaging Executing HL7 ADT Messaging (RAI/MDS)
Updating incomplete records...
...Inpatient Medications check... ...discontinuing Inpatient Medication orders....done...
Updating visit status...completed.
Select PATIENT NAME:
Admit a Patient Cancel a Scheduled Admission Check-in Lodger Delete Waiting List Entry Detailed Inpatient Inquiry Discharge a Patient DRG Calculation Extended Bed Control Lodger Check-out Provider Change Schedule an Admission Seriously Ill List Entry Switch Bed Transfer a Patient Treating Specialty Transfer Waiting List Entry/Edit
[7mYou've got PRIORITY mail!
[m Select Bed Control Menu Option:
[7mYou've got PRIORITY mail!
[m
Do you really want to halt? YES
Logged out at May 14, 2011 10:54 pm
GTM>[?1h=S[C [CD[CU[CZ[C=[C9[C [CX[C [C D[C [C[CX[CU[CP[C[?1l>
Setting up programmer environment This is a TEST account.
Terminal Type set to: C-VT100
You have 98 new messages. Select OPTION NAME: EVE
1 EVE Systems Manager Menu 2 EVENT CAPTURE (ECS) EXTRACT AU ECX ECS SOURCE AUDIT Event Capture
(ECS) Extract Audit
3 EVENT CAPTURE DATA ENTRY ECENTER Event Capture Data Entry 4 EVENT CAPTURE EXTRACT ECXEC Event Capture Extract 5 EVENT CAPTURE MANAGEMENT MENU ECMGR Event Capture Management Menu
Press <RETURN> to see more, '' to exit this list, OR CHOOSE 1-5: 1 EVE Systems Manager Menu
Core Applications ... Device Management ... Menu Management ... Programmer Options ... Operations Management ... Spool Management ... Information Security Officer Menu ... Taskman Management ... User Management ...
FM VA FileMan ...
Application Utilities ... Capacity Planning ... HL7 Main Menu ... Manage Mailman ... MAS Parameter Entry/Edit
[7mYou've got PRIORITY mail!
[m Select Systems Manager Menu Option: VA FileMan
VA FileMan Version 22.0
Enter or Edit File Entries Print File Entries Search File Entries Modify File Attributes Inquire to File Entries Utility Functions ... Data Dictionary Utilities ... Transfer Entries Other Options ...
[7mYou've got PRIORITY mail!
[m Select VA FileMan Option: INQuire to File Entries
OUTPUT FROM WHAT FILE: PATIENT MOVEMENT Select PATIENT MOVEMENT DATE/TIME: ?
Answer with PATIENT MOVEMENT, or DATE/TIME, or WARD LOCATION, or
ROOM-BED, or ADMISSION/CHECK-IN MOVEMENT
Choose from: MAY 12, 2011@09:00 COLLINS,FRANK ()
ADMISSION: DIRECT
MAY 12, 2011@09:00 COLLINS,FRANK ()
SPECIALTY TRANSFER: PROVIDER/SPECIALTY CHANGE
MAY 12, 2011@16:35:04 FEY,TINA (702050907P)
ADMISSION: DIRECT
MAY 12, 2011@16:35:04 FEY,TINA (702050907P)
SPECIALTY TRANSFER: PROVIDER/SPECIALTY CHANGE
MAY 13, 2011@16:00 FEY,TINA (702050907P)
DISCHARGE: REGULAR
Select PATIENT MOVEMENT DATE/TIME: %GTM-I-CTRLC, CTRL_C encountered
GTM>[?1h=s[C S[C [CD[CU[CZ[C=[C9[C [CD[C [C[CX[CU[CP[C[?1l>
Setting up programmer environment This is a TEST account.
Terminal Type set to: C-VT100
You have 98 new messages. Select OPTION NAME: EVE
1 EVE Systems Manager Menu 2 EVENT CAPTURE (ECS) EXTRACT AU ECX ECS SOURCE AUDIT Event Capture
(ECS) Extract Audit
3 EVENT CAPTURE DATA ENTRY ECENTER Event Capture Data Entry 4 EVENT CAPTURE EXTRACT ECXEC Event Capture Extract 5 EVENT CAPTURE MANAGEMENT MENU ECMGR Event Capture Management Menu
Press <RETURN> to see more, '' to exit this list, OR CHOOSE 1-5: 1 EVE Systems Manager Menu
Core Applications ... Device Management ... Menu Management ... Programmer Options ... Operations Management ... Spool Management ... Information Security Officer Menu ... Taskman Management ... User Management ...
FM VA FileMan ...
Application Utilities ... Capacity Planning ... HL7 Main Menu ... Manage Mailman ... MAS Parameter Entry/Edit
[7mYou've got PRIORITY mail!
[m Select Systems Manager Menu Option: VA FileMan
VA FileMan Version 22.0
Enter or Edit File Entries Print File Entries Search File Entries Modify File Attributes Inquire to File Entries Utility Functions ... Data Dictionary Utilities ... Transfer Entries Other Options ...
[7mYou've got PRIORITY mail!
[m Select VA FileMan Option: INQuire to File Entries
OUTPUT FROM WHAT FILE: PATIENT MOVEMENT PATIENT
1 PATIENT (93 entries) 2 PATIENT ALLERGIES (18 entries) 3 PATIENT APPOINTMENT INFO LOG (0 entries) 4 PATIENT CONSCIOUSNESS (7 entries) 5 PATIENT DATA ELEMENT (0 entries)
Press <RETURN> to see more, '' to exit this list, OR CHOOSE 1-5: 1 PATIENT (93 entries) Select PATIENT NAME: ?
Identify the Patient in one of the following ways:
- Enter the Patient's NAME or a portion of the NAME in the following format:
SMITH,JOHN DOE or SMITH,JOHN
1...Use from 3 to 30 letters 2...a COMMA MUST FOLLOW THE LAST NAME 3...If "JR" or "II", etc, is included, follow the form SMITH,JOHN DOE,JR. 4...NO SPACES after commas.
- Enter the Patient's Health Record Number
- Enter the Patient's DOB in one of the following forms:
B01221966 or any valid date e.g. 01/22/66, 01-22-66, JAN 22,1966
- Enter the Patient's SSN or the last 4 digits of the SSN
or the last 4 digits preceded by the first letter of the last name
- If the Patient is an Inpatient, enter the Ward or Room-Bed in the form:
66-2 PEDIATRICS
- Enter Patient's residence PHONE NUMBER
Select PATIENT NAME: Y
??
Select PATIENT NAME: ??
Choose from: ADAMS,THOMAS <A> M 03-01-1950 5 ALLEN,ERIC M 12-21-2003 7 ALLEN,JASON M 10-16-1953 6 ANDERSON,GEORGE M 02-14-1994 8 ANDERSON,JANET F 09-30-1986 73 ANDERTON,LARS M 01-20-2009 9 BARNES,DANIEL M 10-21-1945 10 BLACK,EDWARD M 01-24-1953 11 BLACK,GEORGE M 03-03-2007 12 BRENT,NORA F 02-15-2009 13 BROOKS,MARIA F 04-09-2006 14 BROOKS,RICHARD M 05-16-1956 15 BROWN,MARK M 06-17-1988 80 BURKE,MICHAEL M 04-15-1966 16 CAMPBELL,SARAH F 03-08-1953 17 CLARKSON,PAULA F 03-15-1981 84 COLE,SUSAN F 11-24-1948 18 COLEMAN,CYNTHIA F 07-29-1968 19 COLLINS,FRANK M 12-09-1965 20 '' TO STOP:
COLLINS,JESSICA F 06-19-1949 21 COOK,FRANK M 10-06-1953 23 DAVIS,CHARLES M 11-11-1961 22 DEMO,JOHN M 01-12-1955 24 DIAZ,BRIAN M 10-22-1969 25 DOOLITTLE,DEXTER M 05-09-1998 202050998P 357692 FEY,TINA F 05-09-2007 702050907P 357693 FORD,CHRISTOPHER M 05-28-1965 27 FORD,SHIRLEY F 09-24-1964 26 GARCIA,PAUL M 01-17-1933 30 GIBSON,GEORGE M 07-13-1981 28 GILBERT,THOMAS M 04-04-2009 29 GLENN,GINA <A> F 05-09-1994 303050994P 357695 GREER,ANTHONY M 05-10-2001 103051001P 357691 HAENA,MARY F 11-22-1979 82 HALL,CAROL F 11-25-1951 31 HARRIS,JOHN M 01-26-1953 32 HHAENA,MARY F 11-22-1979 76 HILL,BARBARA F 02-15-1991 33 HOWSER,DOUG M 05-10-2008 203051008P 357690 JACKSON,JESSICA <A> F 06-02-1934 34 JAMES,DAVID M 11-14-1965 35 '' TO STOP:
JAMES,WANDA F 04-30-1981 77 JOHNSON,PHILIP M 05-26-2007 72 JONES,CYNTHIA F 05-24-2000 37 JONES,ELIZABETH F 12-23-1959 38 JONES,JEFFREY F 03-07-2011 002387604 83 JONES,MELISSA F 01-12-1961 36 KELLY,DAVID M 02-09-1925 39 KING,MATT M 08-23-1956 4 LEE,SANDRA F 02-23-1946 40 LEWIS,ALEX M 09-12-1939 41 MELBROOK,DENISE F 05-09-2002 205050902P 357694 MOORE,CARL M 11-17-2003 42 MORGAN,CHARLES M 03-13-2004 44 MORGAN,JASON M 06-03-1954 46 MORGAN,MARGARET F 02-22-1999 43 MORGAN,SCOTT M 05-26-1948 45 MORTON,HELEN F 01-18-2011 47 OWENS,ELIZABETH F 07-28-1979 48 PARKER,PATRICK M 01-23-1960 49 PARKINSON,FRANCIS M 10-15-2010 50 REED,RICHARD M 08-27-1995 51 RODGERS,RONALD M 02-28-1981 52 '' TO STOP:
ROSS,JESSICA F 07-03-1943 53 SINCLAIR,JOHN M 10-12-1987 75 SINGER,CARLTON M 10-15-1978 79 SMITH,ELAINE F 11-05-2010 87 SMITH,JEFFERY M 03-04-2011 86 SMITH,MARIA F 07-01-1939 54 SMITHSON,PETER M 07-12-2010 55 TAKAMURA,MICHAEL M 08-15-1982 74 TALBOT,LARS M 02-20-2009 56 TAYLOR,BETTY F 06-12-2007 57 THOMAS,JONAS M 02-03-2009 58 THOMPKINS,FRANCINE F 04-13-2009 59 THOMPKINSON,SANDRA REID F 04-02-2009 60 THOMPSON,REBECCA F 10-06-1962 61 TYLER,CHRISTINE F 07-28-1988 78 TYLER,ROBERT M 07-06-2010 62 VANE,HARRIET F 11-06-2009 63 WALKER,LAWRENCE M 01-29-2009 64 WATSON,ALINE WEST F 02-24-2009 65 WEST,LISA F 11-30-1963 66 WEST,SANDRA F 05-25-1932 67 WHITE,PATRICIA F 10-24-1949 68 '' TO STOP:
WHITEAGLE,ADAM M 03-21-1980 81 WILLIAMSON,DANIEL M 03-24-2009 69 WILSON,NANCY F 11-14-1927 70 YOUNG,AMY F 12-24-1981 71 ZZ PATIENT,TEST ONE <A> F 01-24-1945 000003322 1 ZZ PATIENT,TEST THREE <CA> M 01-15-1968 3 ZZ PATIENT,TEST TWO <A> M 12-25-1957 2 ZZLABTEST,PATIENT M 09-09-1967 609090967P 357689
Select PATIENT NAME:
Enter or Edit File Entries Print File Entries Search File Entries Modify File Attributes Inquire to File Entries Utility Functions ... Data Dictionary Utilities ... Transfer Entries Other Options ...
[7mYou've got PRIORITY mail!
[m Select VA FileMan Option:
Core Applications ... Device Management ... Menu Management ... Programmer Options ... Operations Management ... Spool Management ... Information Security Officer Menu ... Taskman Management ... User Management ...
FM VA FileMan ...
Application Utilities ... Capacity Planning ... HL7 Main Menu ... Manage Mailman ... MAS Parameter Entry/Edit
[7mYou've got PRIORITY mail!
[m Select Systems Manager Menu Option:
[7mYou've got PRIORITY mail!
[m
Do you really want to halt? YES
Logged out at May 14, 2011 11:00 pm
GTM>[?1h=S[C [CD[CU[CZ[C=[C8[C9[C 9[C [CD[C [C[CX[CU[CP[C[?1l>
Setting up programmer environment This is a TEST account.
Terminal Type set to: C-VT100
You have 98 new messages. Select OPTION NAME: REGISTRA
1 REGISTRANT GENERAL REPORT SPNL REGISTRANT GENERAL REPORT Registran
t General Report
2 REGISTRANT INJURY REPORT SPNL REGISTRANT INJURY REPORT Registrant
Injury Report
3 REGISTRATION AD HOC REPORT SPNP ADHOC REGISTRY Registration Ad Hoc
Report
4 REGISTRATION AND HEALTH CARE I SPNL INPUT/EDIT SCD REGISTRANT Regi
stration and Health Care Information
5 REGISTRATION MENU DG REGISTRATION MENU Registration Menu
Press <RETURN> to see more, '' to exit this list, OR CHOOSE 1-5: 5 DG REGISTRATION MENU Registration Menu
DA Disposition an Application EN Patient Enrollment PHH Purple Heart Request History PHS Purple Heart Status Report
Add/Edit/Delete Catastrophic Disability Collateral Patient Register Combat Vet Status Report Death Entry Delete a Registration Disposition Log Edit Edit Inconsistent Data for a Patient Eligibility Inquiry for Patient Billing Eligibility Verification Enter/Edit Patient Security Level Load/Edit Patient Data Means Test User Menu ... Patient Inquiry Preregistration Menu ... Print Patient Wristband Pseudo SSN Report (Patient) Register a Patient Report - All Address Change with Rx
Press 'RETURN' to continue, '' to stop:
Report - All Address Changes Report - All Patients flagged with a Bad Address Report - Patient Catastrophic Edits Unsupported CV End Dates Report View Patient Address View Registration Data
[7mYou've got PRIORITY mail!
[m Select Registration Menu Option: LOAd/Edit Patient Data
Select PATIENT NAME: ZZTE ?? Select PATIENT NAME: ZZ TE ?? Select PATIENT NAME: ZZZZ PATI
1 ZZ PATIENT,TEST ONE <A> F 01-24-1945 000003322 1 2 ZZ PATIENT,TEST THREE <CA> M 01-15-1968 3 3 ZZ PATIENT,TEST TWO <A> M 12-25-1957 2
CHOOSE 1-3: 1
ZZ PATIENT,TEST ONE <A> F 01-24-1945 000003322 1
*WARNING*
*RESTRICTED RECORD*
*WARNING*
*RESTRICTED RECORD*
Press ENTER to continue [1;1H[1;1H[J[2J[H ZZ PATIENT,TEST ONE 000-00-3322 JAN 24,1945 =============================================================================
COORDINATING MASTER OF RECORD: VOE OFFICE INSTITUTION OLD
Address: 12 WAYLAND AVE Temporary: NO TEMPORARY ADDRESS
BROOKLYN,NY 11234
County: KINGS (047) From/To: NOT APPLICABLE
Phone: UNSPECIFIED Phone: NOT APPLICABLE
Office: UNSPECIFIED
Cell: UNSPECIFIED
E-mail: UNSPECIFIED
Bad Addr:
Confidential Address: Confidential Address Categories:
NO CONFIDENTIAL ADDRESS
From/To: NOT APPLICABLE
Primary Eligibility: REIMBURSABLE INSURANCE (NOT VERIFIED) Other Eligibilities: Enter RETURN to continue or '' to exit: [20;1H[1;1H[J[2J[H ZZ PATIENT,TEST ONE 000-00-3322 JAN 24,1945 =============================================================================
COORDINATING MASTER OF RECORD: VOE OFFICE INSTITUTION OLD
Unemployable: NO
Status : PATIENT HAS NO INPATIENT OR LODGER ACTIVITY IN THE COMPUTER
Future Appointments: NONE
Remarks:
Date of Death Information
Date of Death: Source of Notification: Updated Date/Time: Last Edited By:
Enter RETURN to continue or '' to exit: [20;1H[1;1H[J[2J[H ZZ PATIENT,TEST ONE 000-00-3322 JAN 24,1945 =============================================================================
COORDINATING MASTER OF RECORD: VOE OFFICE INSTITUTION OLD
Do you want to edit Patient Data? Yes Y (Yes) Do you want to validate/edit the Patient's Address? N (No) [8;1H[1;1H[J[2J[H PATIENT DEMOGRAPHIC DATA, SCREEN <1> ZZ PATIENT,TEST ONE; 000-00-3322 VISTA OFFICE EHR ===============================================================================
Reg Dt: 5/11/06
[1] Name: ZZ PATIENT,TEST ONE SS: 000-00-3322
DOB: JAN 24,1945
Family: ZZ PATIENT HRN: Sex: FEMALE
Given: TEST [2] Alias: < No alias entries on file >
Middle: ONE Prefix: Suffix: Degree:
[3] Remarks: NO REMARKS ENTERED FOR THIS PATIENT [4] Permanent Address: [5] Temporary Address:
12 WAYLAND AVE NO TEMPORARY ADDRESS BROOKLYN,NY 11234
County: KINGS (047) County: NOT APPLICABLE
Phone: UNANSWERED Phone: NOT APPLICABLE
Office: UNANSWERED From/To: NOT APPLICABLE
Alt Ph: Bad Addr:
<RET> to CONTINUE, 1-5 or ALL to EDIT, N for screen N or '' to QUIT: 1 FAMILY (LAST) NAME: ZZ PATIENT GIVEN (FIRST) NAME: TEST MIDDLE NAME: ONE PREFIX: SUFFIX: DEGREE: SOCIAL SECURITY NUMBER: 000003322 000003322 DATE OF BIRTH: 01/24/1945 SEX: FEMALE FEMALE MULTIPLE BIRTH INDICATOR: NO[10;1H[1;1H[J[2J[H PATIENT DEMOGRAPHIC DATA, SCREEN <1> ZZ PATIENT,TEST ONE; 000-00-3322 VISTA OFFICE EHR ===============================================================================
Reg Dt: 5/11/06
[1] Name: ZZ PATIENT,TEST ONE SS: 000-00-3322
DOB: JAN 24,1945
Family: ZZ PATIENT HRN: Sex: FEMALE
Given: TEST [2] Alias: < No alias entries on file >
Middle: ONE Prefix: Suffix: Degree:
[3] Remarks: NO REMARKS ENTERED FOR THIS PATIENT [4] Permanent Address: [5] Temporary Address:
12 WAYLAND AVE NO TEMPORARY ADDRESS BROOKLYN,NY 11234
County: KINGS (047) County: NOT APPLICABLE
Phone: UNANSWERED Phone: NOT APPLICABLE
Office: UNANSWERED From/To: NOT APPLICABLE
Alt Ph: Bad Addr:
<RET> to CONTINUE, 1-5 or ALL to EDIT, N for screen N or '' to QUIT: [24;1H[1;1H[J[2J[H ADDITIONAL PATIENT DEMOGRAPHIC DATA, SCREEN <1.1> ZZ PATIENT,TEST ONE; 000-00-3322 VISTA OFFICE EHR =============================================================================== [1]Confidential Address
NO CONFIDENTIAL ADDRESS
From/To: NOT APPLICABLE
[2] Cell Phone: UNANSWERED
Pager #: UNANSWERED
Email Address: UNANSWERED
<RET> to CONTINUE, 1-2 or ALL to EDIT, N for screen N or '' to QUIT: [22;1H[1;1H[J[2J[H PATIENT DATA, SCREEN <2> ZZ PATIENT,TEST ONE; 000-00-3322 VISTA OFFICE EHR =============================================================================== [1] Marital: MARRIED POB: LAS VEGAS, NEVADA
Religion: UNANSWERED Father: UNANSWERED
SCI: UNANSWERED Mother: UNANSWERED
Mom's Maiden: FRED,
[2] Previous Care Date Location of Previous Care
------------------ ------------------------- NONE INDICATED NONE INDICATED Veteran:
Interpreter Language:
[3] Ethnicity: UNANSWERED
Race: UNANSWERED
<4> Date of Death Information
Date of Death: Source of Notification: Updated Date/Time: Last Edited By:
[5] Emergency Response: <RET> to CONTINUE, 1,2,3,5 or ALL to EDIT, N for screen N or '' to QUIT: [23;1H[1;1H[J[2J[H EMERGENCY CONTACT DATA, SCREEN <3> ZZ PATIENT,TEST ONE; 000-00-3322 VISTA OFFICE EHR =============================================================================== [1] NOK: UNANSWERED [2] NOK-2: UNANSWERED
Relation: UNANSWERED Relation: UNANSWERED
Phone: UNANSWERED Phone: UNANSWERED
Work Phone: UNANSWERED Work Phone: UNANSWERED
[3] E-Cont.: UNANSWERED [4] E2-Cont.: UNANSWERED
Relation: UNANSWERED Relation: UNANSWERED
Phone: UNANSWERED Phone: UNANSWERED
Work Phone: UNANSWERED Work Phone: UNANSWERED
[5] Designee: UNANSWERED Relation: UNANSWERED
Phone: UNANSWERED Work Phone: UNANSWERED
[6]Year arrived in U.S.: Mother's Country of Birth: Father's Country of Birth:
<RET> to CONTINUE, 1-6 or ALL to EDIT, N for screen N or '' to QUIT: 1 K-NAME OF PRIMARY NOK: PATIENT ZZ PATIENT, MARY K-RELATIONSHIP TO PATIENT: K-ADDRESS SAME AS PATIENT'S?: NO Y YES K-WORK PHONE NUMBER: 206 645 9876[2;1H[1;1H[J[2J[H EMERGENCY CONTACT DATA, SCREEN <3> ZZ PATIENT,TEST ONE; 000-00-3322 VISTA OFFICE EHR =============================================================================== [1] NOK: ZZ PATIENT,MARY [2] NOK-2: UNANSWERED
Relation: UNANSWERED Relation: UNANSWERED
12 WAYLAND AVE BROOKLYN,NY 11234
Phone: UNANSWERED Phone: UNANSWERED
Work Phone: 206 645 9876 Work Phone: UNANSWERED
[3] E-Cont.: UNANSWERED [4] E2-Cont.: UNANSWERED
Relation: UNANSWERED Relation: UNANSWERED
Phone: UNANSWERED Phone: UNANSWERED
Work Phone: UNANSWERED Work Phone: UNANSWERED
[5] Designee: UNANSWERED Relation: UNANSWERED
Phone: UNANSWERED Work Phone: UNANSWERED
[6]Year arrived in U.S.: Mother's Country of Birth: Father's Country of Birth:
<RET> to CONTINUE, 1-6 or ALL to EDIT, N for screen N or '' to QUIT: 1 K-NAME OF PRIMARY NOK: ZZ PATIENT,MARY ZZ PATIENT , THOMAS P K-RELATIONSHIP TO PATIENT: HUSBAND K-ADDRESS SAME AS PATIENT'S?: NO Y YES K-WORK PHONE NUMBER: 206 5438765 Z9206 206-987-6543[2;1H[1;1H[J[2J[H EMERGENCY CONTACT DATA, SCREEN <3> ZZ PATIENT,TEST ONE; 000-00-3322 VISTA OFFICE EHR =============================================================================== [1] NOK: ZZ PATIENT,THOMAS P [2] NOK-2: UNANSWERED
Relation: HUSBAND Relation: UNANSWERED
12 WAYLAND AVE BROOKLYN,NY 11234
Phone: UNANSWERED Phone: UNANSWERED
Work Phone: 206-987-6543 Work Phone: UNANSWERED
[3] E-Cont.: UNANSWERED [4] E2-Cont.: UNANSWERED
Relation: UNANSWERED Relation: UNANSWERED
Phone: UNANSWERED Phone: UNANSWERED
Work Phone: UNANSWERED Work Phone: UNANSWERED
[5] Designee: UNANSWERED Relation: UNANSWERED
Phone: UNANSWERED Work Phone: UNANSWERED
[6]Year arrived in U.S.: Mother's Country of Birth: Father's Country of Birth:
<RET> to CONTINUE, 1-6 or ALL to EDIT, N for screen N or '' to QUIT: 3 E-EMER. CONTACT SAME AS NOK?: NO Y YES[23;1H[1;1H[J[2J[H EMERGENCY CONTACT DATA, SCREEN <3> ZZ PATIENT,TEST ONE; 000-00-3322 VISTA OFFICE EHR =============================================================================== [1] NOK: ZZ PATIENT,THOMAS P [2] NOK-2: UNANSWERED
Relation: HUSBAND Relation: UNANSWERED
12 WAYLAND AVE BROOKLYN,NY 11234
Phone: UNANSWERED Phone: UNANSWERED
Work Phone: 206-987-6543 Work Phone: UNANSWERED
[3] E-Cont.: ZZ PATIENT,THOMAS P [4] E2-Cont.: UNANSWERED
Relation: HUSBAND Relation: UNANSWERED
12 WAYLAND AVE BROOKLYN,NY 11234
Phone: UNANSWERED Phone: UNANSWERED
Work Phone: 206-987-6543 Work Phone: UNANSWERED
[5] Designee: UNANSWERED Relation: UNANSWERED
Phone: UNANSWERED Work Phone: UNANSWERED
[6]Year arrived in U.S.: Mother's Country of Birth: Father's Country of Birth:
<RET> to CONTINUE, 1-6 or ALL to EDIT, N for screen N or '' to QUIT: [24;1H[1;1H[J[2J[H APPLICANT/SPOUSE EMPLOYMENT DATA, SCREEN <4> ZZ PATIENT,TEST ONE; 000-00-3322 VISTA OFFICE EHR =============================================================================== [1] Employer: UNANSWERED [2] Spouse's: UNANSWERED
Occupation: NOE Occupation: UNANSWERED
Status: UNKNOWN Status: UNANSWERED
Retired Dt.: NOT APPLICABLE Retired Dt.: NOT APPLICABLE
<RET> to CONTINUE, 1-2 or ALL to EDIT, N for screen N or '' to QUIT: [22;1H[1;1H[J[2J[H INSURANCE DATA, SCREEN <5> ZZ PATIENT,TEST ONE; 000-00-3322 VISTA OFFICE EHR =============================================================================== [1] Covered by Health Insurance: NO
Insurance COB Subscriber ID Group Holder Effective Expires ===========================================================================
No Insurance Information
[2] Eligible for MEDICAID: UNANSWERED
[3] Medicaid Number:
<RET> to CONTINUE, 1-3 or ALL to EDIT, N for screen N or '' to QUIT: [22;1H[1;1H[J[2J[H ELIGIBILITY STATUS DATA, SCREEN <7> ZZ PATIENT,TEST ONE; 000-00-3322 VISTA OFFICE EHR =============================================================================== [1] Patient Type: VISTA OFFICE EHR Veteran: NO
Svc Connected: N/A SC Percent: N/A Rated Incomp.: UNANSWERED
Claim Number: UNANSWERED
Folder Loc.: UNANSWERED
[2] Aid & Attendance: UNANSWERED Housebound: UNANSWERED
VA Pension: UNANSWERED VA Disability: UNANSWERED
Total Check Amount: NOT APPLICABLE
GI Insurance: UNANSWERED Amount: UNANSWERED
[3] Primary Elig Code: REIMBURSABLE INSURANCE
Other Elig Code(s): NO ADDITIONAL ELIGIBILITIES IDENTIFIED
Period of Service: OTHER REIMBURS. (NON-VET)
<4> Service Connected Conditions as stated by applicant
--------------------------------------------------- NONE STATED
<RET> to CONTINUE, 1-3 or ALL to EDIT, N for screen N or '' to QUIT: 1 TYPE: VISTA OFFICE EHR VETERAN (Y/N)?: NO SERVICE CONNECTED?: NO RATED INCOMPETENT?: CLAIM NUMBER: CLAIM FOLDER LOCATION: [4;1H[1;1H[J[2J[H ELIGIBILITY STATUS DATA, SCREEN <7> ZZ PATIENT,TEST ONE; 000-00-3322 VISTA OFFICE EHR =============================================================================== [1] Patient Type: VISTA OFFICE EHR Veteran: NO
Svc Connected: N/A SC Percent: N/A Rated Incomp.: UNANSWERED
Claim Number: UNANSWERED
Folder Loc.: UNANSWERED
[2] Aid & Attendance: UNANSWERED Housebound: UNANSWERED
VA Pension: UNANSWERED VA Disability: UNANSWERED
Total Check Amount: NOT APPLICABLE
GI Insurance: UNANSWERED Amount: UNANSWERED
[3] Primary Elig Code: REIMBURSABLE INSURANCE
Other Elig Code(s): NO ADDITIONAL ELIGIBILITIES IDENTIFIED
Period of Service: OTHER REIMBURS. (NON-VET)
<4> Service Connected Conditions as stated by applicant
--------------------------------------------------- NONE STATED
<RET> to CONTINUE, 1-3 or ALL to EDIT, N for screen N or '' to QUIT: 3 PRIMARY ELIGIBILITY CODE: REIMBURSABLE INSURANCE
?
Select from the available list the eligibility code which best defines this applicant's primary entitlement to care. For more detailed information, enter ??. Applicable code based on veteran or non-veteran status.
Answer with ELIGIBILITY CODE NAME, or VA CODE NUMBER, or
MAS ELIGIBILITY CODE, or SYNONYM
Do you want the entire ELIGIBILITY CODE List? Y (Yes)
Choose from: EHR PATIENT 8 8 NON-VETERAN HUMANITARIAN EMERGENCY 6 6 NON-VETERAN SITE SPECIFIC CODE #1 1 1 NON-VETERAN
PRIMARY ELIGIBILITY CODE: REIMBURSABLE INSURANCE
EHR PATIENT 8 8 NON-VETERAN
Select ELIGIBILITY: EHR PATIENT
ELIGIBILITY: EHR PATIENT
Select ELIGIBILITY: PERIOD OF SERVICE: OTHER REIMBURS. (NON-VET) T
Current Eligibility Code: EHR PATIENT ?? Current Eligibility Code: EHR PATIENT Select from the available listing the period of service which best classifies this patient. POS must be compatible with Eligibility Code
PERIOD OF SERVICE: OTHER REIMBURS. (NON-VET) ?
Select from the available listing the period of service which best classifies this patient. POS must be compatible with Eligibility Code
Answer with PERIOD OF SERVICE NAME, or ABBREVIATION, or CODE, or
SYNONYM
Do you want the entire PERIOD OF SERVICE List? Y (Yes)
Choose from:
Current Eligibility Code: EHR PATIENT
PERIOD OF SERVICE: OTHER REIMBURS. (NON-VET) EHR
Current Eligibility Code: EHR PATIENT ?? Current Eligibility Code: EHR PATIENT Select from the available listing the period of service which best classifies this patient. POS must be compatible with Eligibility Code
PERIOD OF SERVICE: OTHER REIMBURS. (NON-VET) ?
Select from the available listing the period of service which best classifies this patient. POS must be compatible with Eligibility Code
Answer with PERIOD OF SERVICE NAME, or ABBREVIATION, or CODE, or
SYNONYM
Do you want the entire PERIOD OF SERVICE List? Y (Yes)
Choose from:
Current Eligibility Code: EHR PATIENT
PERIOD OF SERVICE: OTHER REIMBURS. (NON-VET) [5;1H[1;1H[J[2J[H ELIGIBILITY STATUS DATA, SCREEN <7> ZZ PATIENT,TEST ONE; 1 VISTA OFFICE EHR =============================================================================== [1] Patient Type: VISTA OFFICE EHR Veteran: NO
Svc Connected: N/A SC Percent: N/A Rated Incomp.: UNANSWERED
Claim Number: UNANSWERED
Folder Loc.: UNANSWERED
[2] Aid & Attendance: UNANSWERED Housebound: UNANSWERED
VA Pension: UNANSWERED VA Disability: UNANSWERED
Total Check Amount: NOT APPLICABLE
GI Insurance: UNANSWERED Amount: UNANSWERED
[3] Primary Elig Code: EHR PATIENT
Other Elig Code(s): NO ADDITIONAL ELIGIBILITIES IDENTIFIED
Period of Service: OTHER REIMBURS. (NON-VET)
<4> Service Connected Conditions as stated by applicant
--------------------------------------------------- NONE STATED
<RET> to CONTINUE, 1-3 or ALL to EDIT, N for screen N or '' to QUIT: 3 PRIMARY ELIGIBILITY CODE: EHR PATIENT Select ELIGIBILITY: EHR PATIENT
ELIGIBILITY: EHR PATIENT
Select ELIGIBILITY: PERIOD OF SERVICE: OTHER REIMBURS. (NON-VET) ?
Select from the available listing the period of service which best classifies this patient. POS must be compatible with Eligibility Code
Answer with PERIOD OF SERVICE NAME, or ABBREVIATION, or CODE, or
SYNONYM
Do you want the entire PERIOD OF SERVICE List? Y (Yes)
Choose from:
Current Eligibility Code: EHR PATIENT
PERIOD OF SERVICE: OTHER REIMBURS. (NON-VET) [5;1H[1;1H[J[2J[H ELIGIBILITY STATUS DATA, SCREEN <7> ZZ PATIENT,TEST ONE; 1 VISTA OFFICE EHR =============================================================================== [1] Patient Type: VISTA OFFICE EHR Veteran: NO
Svc Connected: N/A SC Percent: N/A Rated Incomp.: UNANSWERED
Claim Number: UNANSWERED
Folder Loc.: UNANSWERED
[2] Aid & Attendance: UNANSWERED Housebound: UNANSWERED
VA Pension: UNANSWERED VA Disability: UNANSWERED
Total Check Amount: NOT APPLICABLE
GI Insurance: UNANSWERED Amount: UNANSWERED
[3] Primary Elig Code: EHR PATIENT
Other Elig Code(s): NO ADDITIONAL ELIGIBILITIES IDENTIFIED
Period of Service: OTHER REIMBURS. (NON-VET)
<4> Service Connected Conditions as stated by applicant
--------------------------------------------------- NONE STATED
<RET> to CONTINUE, 1-3 or ALL to EDIT, N for screen N or '' to QUIT: ...HMMM, HOLD ON... [?25l [1;1H[1;1H[J[2J[H [4m [1m [1;1HDependents Module[m[4m [1;31HMay 14, 2011@23:06:42 Page: 1 of 1 [m[1;1H
FAMILY DEMOGRAPHIC DATA, SCREEN <8>
Patient: ZZ PATIENT,TEST ONE (1) Outpatient [3;1H [4m
MT Patient/Dependent Relationship Active Address
[m [4;1H
1 ZZ PATIENT,TEST ONE SELF *
Married Last Year: Unanswered
[14;1H
[7m
Enter ?? for more actions
[m [16;1H[J7[16;24r8 [4m 7[1;31HMay 14, 2011@23:06:428 [m [15;1H[14;1H
DA Spouse/Dependent Add MT Marital/Dependent Info ES Spouse Demographic AD Add to Means/Copay Test DD Dependent Demographic RE Remove from Means/Copay Test DP Delete Dependent ED Expand Dependent[J [?25h Select Action: Quit QUIT 7[1;24r8[m[m[6;1H[1;1H[J[2J[H7[1;24r8[m[m[1;1H[1;1H[J[2J[H[1;1H[1;1H[J[2J[H ADMISSION INFORMATION, SCREEN <12> ZZ PATIENT,TEST ONE; 1 VISTA OFFICE EHR ===============================================================================
NO ADMISSION DATA ON FILE FOR THIS PATIENT!!
<RET> to CONTINUE, N for screen N or '' to QUIT: [22;1H[1;1H[J[2J[H APPLICATION INFORMATION, SCREEN <13> ZZ PATIENT,TEST ONE; 1 VISTA OFFICE EHR =============================================================================== <1> Registered: FEB 9,2005@16:18 by 'DEWAYNE,ROBERT (#9)'
Applied for: OUTPATIENT MEDICAL
Dispositioned: OPEN DISPOSITION Type of Disp.: OPEN DISPOSITION
<RET> to CONTINUE, N for screen N or '' to QUIT: [22;1H[1;1H[J[2J[H APPOINTMENT INFORMATION, SCREEN <14> ZZ PATIENT,TEST ONE; 1 VISTA OFFICE EHR =============================================================================== <1> Enrollment Clinics: NOT ACTIVELY ENROLLED IN ANY CLINICS AT THIS TIME
<2> Pending Appt's: NO PENDING APPOINTMENTS ON FILE
<RET> to QUIT, N for screen N or '' to QUIT: [22;1H[1;1H[J[2J[H LOCAL REGISTRATION QUESTIONS ================================================================================
Please Answer these questions
Checking data for consistency...
===> 1 inconsistency found in 0 seconds...
===> 1 inconsistency filed in 0 seconds...[11;1H[1;1H[J[2J[H ZZ PATIENT,TEST ONE (000-00-3322) JAN 24,1945 ============================================================================== 8 - ADDRESS DATA INCOMPLETE
DO YOU WANT TO UPDATE THESE INCONSISTENCIES NOW? Yes (Yes) COUNTRY: UNITED STATES UNITED STATES USA United States STREET ADDRESS [LINE 1]: 12 WAYLAND AVE 12 WAYLAND AVE STREET ADDRESS [LINE 2]: ZIP+4: 11234 11234
Select one of the following:
1 BROOKLYN*
CITY: BROOKLYN 1 BROOKLYN* STATE: NEW YORK COUNTY: KINGS PHONE NUMBER [CELLULAR]: 206-987-6543 BAD ADDRESS INDICATOR:
[OLD ADDRESS] 12 WAYLAND AVE
BROOKLYN,NEW YORK 11234
County: KINGS 047
Bad Addr:
[NEW ADDRESS] 12 WAYLAND AVE
BROOKLYN,NEW YORK 11234 UNITED STATES
County: KINGS 047
Bad Addr:
Are you sure that you want to save the above changes? YES Change saved. Press ENTER to continue:
Checking data for consistency...
===> No inconsistencies found in 0 seconds...
===> Removing patient from Inconsistency file...
Select PATIENT NAME: ZZ PAT
1 ZZ PATIENT,TEST ONE <A> F 01-24-1945 000003322 1 2 ZZ PATIENT,TEST THREE <CA> M 01-15-1968 3 3 ZZ PATIENT,TEST TWO <A> M 12-25-1957 2
CHOOSE 1-3: 2
ZZ PATIENT,TEST THREE <CA> M 01-15-1968 3
Press ENTER to continue [1;1H[1;1H[J[2J[H ZZ PATIENT,TEST THREE JAN 15,1968 =============================================================================
COORDINATING MASTER OF RECORD: OFFICE OF INFORMATION SRV CNTR
Address: 123 ANYWHERE Temporary: NO TEMPORARY ADDRESS
AVON,IN 46123
County: HENDRICKS (063) From/To: NOT APPLICABLE
Phone: UNSPECIFIED Phone: NOT APPLICABLE
Office: UNSPECIFIED
Cell: UNSPECIFIED
E-mail: UNSPECIFIED
Bad Addr:
Confidential Address: Confidential Address Categories:
NO CONFIDENTIAL ADDRESS
From/To: NOT APPLICABLE
Primary Eligibility: REIMBURSABLE INSURANCE (NOT VERIFIED) Other Eligibilities: Enter RETURN to continue or '' to exit: [20;1H[1;1H[J[2J[H ZZ PATIENT,TEST THREE JAN 15,1968 =============================================================================
COORDINATING MASTER OF RECORD: OFFICE OF INFORMATION SRV CNTR
Unemployable: NO
Status : PATIENT HAS NO INPATIENT OR LODGER ACTIVITY IN THE COMPUTER
Future Appointments: NONE
Remarks:
Date of Death Information
Date of Death: Source of Notification: Updated Date/Time: Last Edited By:
Enter RETURN to continue or '' to exit: [20;1H[1;1H[J[2J[H ZZ PATIENT,TEST THREE JAN 15,1968 =============================================================================
COORDINATING MASTER OF RECORD: OFFICE OF INFORMATION SRV CNTR
Do you want to edit Patient Data? Yes (Yes) Do you want to validate/edit the Patient's Address? N (No) [8;1H[1;1H[J[2J[H PATIENT DEMOGRAPHIC DATA, SCREEN <1> ZZ PATIENT,TEST THREE; -- VISTA OFFICE EHR ===============================================================================
Reg Dt:
[1] Name: ZZ PATIENT,TEST THREE SS: --
DOB: JAN 15,1968
Family: ZZ PATIENT HRN: Sex: MALE
Given: TEST [2] Alias: < No alias entries on file >
Middle: THREE Prefix: Suffix: Degree:
[3] Remarks: NO REMARKS ENTERED FOR THIS PATIENT [4] Permanent Address: [5] Temporary Address:
123 ANYWHERE NO TEMPORARY ADDRESS AVON,IN 46123
County: HENDRICKS (063) County: NOT APPLICABLE
Phone: UNANSWERED Phone: NOT APPLICABLE
Office: UNANSWERED From/To: NOT APPLICABLE
Alt Ph: Bad Addr:
<RET> to CONTINUE, 1-5 or ALL to EDIT, N for screen N or '' to QUIT: 1 FAMILY (LAST) NAME: ZZ PATIENT GIVEN (FIRST) NAME: TEST MIDDLE NAME: THREE PREFIX: SUFFIX: DEGREE: SOCIAL SECURITY NUMBER: P 769011568P PSEUDO SSN REASON: NO SSN ASSIGNED DATE OF BIRTH: 01/15/1968 SEX: MALE MALE MULTIPLE BIRTH INDICATOR: NO
WARNING!**
The edits you are about to make, may potentially change the identity of this patient. Please verify that you have selected the correct patient and ensure that supporting documentation exists for these changes. If you continue with these edits, an alert will be generated and sent to your Supervisor and ADPAC, notifying them of the changes. Do you wish to continue and save your edits:? NO YES[20;1H[1;1H[J[2J[H PATIENT DEMOGRAPHIC DATA, SCREEN <1> ZZ PATIENT,TEST THREE; 769-01-1568P VISTA OFFICE EHR ===============================================================================
Reg Dt: 5/14/11
[1] Name: ZZ PATIENT,TEST THREE SS: 769-01-1568P
DOB: JAN 15,1968 PSSN Reason: No SSN Assigned
Family: ZZ PATIENT HRN: Sex: MALE
Given: TEST [2] Alias: < No alias entries on file >
Middle: THREE Prefix: Suffix: Degree:
[3] Remarks: NO REMARKS ENTERED FOR THIS PATIENT [4] Permanent Address: [5] Temporary Address:
123 ANYWHERE NO TEMPORARY ADDRESS AVON,IN 46123
County: HENDRICKS (063) County: NOT APPLICABLE
Phone: UNANSWERED Phone: NOT APPLICABLE
Office: UNANSWERED From/To: NOT APPLICABLE
Alt Ph: Bad Addr:
<RET> to CONTINUE, 1-5 or ALL to EDIT, N for screen N or '' to QUIT: [24;1H[1;1H[J[2J[H ADDITIONAL PATIENT DEMOGRAPHIC DATA, SCREEN <1.1> ZZ PATIENT,TEST THREE; 769-01-1568P VISTA OFFICE EHR =============================================================================== [1]Confidential Address
NO CONFIDENTIAL ADDRESS
From/To: NOT APPLICABLE
[2] Cell Phone: UNANSWERED
Pager #: UNANSWERED
Email Address: UNANSWERED
<RET> to CONTINUE, 1-2 or ALL to EDIT, N for screen N or '' to QUIT: [22;1H[1;1H[J[2J[H PATIENT DATA, SCREEN <2> ZZ PATIENT,TEST THREE; 769-01-1568P VISTA OFFICE EHR =============================================================================== [1] Marital: UNKNOWN POB: MIAMI, FLORIDA
Religion: UNANSWERED Father: UNANSWERED
SCI: UNANSWERED Mother: UNANSWERED
Mom's Maiden: NITWIT,
[2] Previous Care Date Location of Previous Care
------------------ ------------------------- NONE INDICATED NONE INDICATED Veteran:
Interpreter Language:
[3] Ethnicity: UNANSWERED
Race: UNANSWERED
<4> Date of Death Information
Date of Death: Source of Notification: Updated Date/Time: Last Edited By:
[5] Emergency Response: <RET> to CONTINUE, 1,2,3,5 or ALL to EDIT, N for screen N or '' to QUIT: [23;1H[1;1H[J[2J[H EMERGENCY CONTACT DATA, SCREEN <3> ZZ PATIENT,TEST THREE; 769-01-1568P VISTA OFFICE EHR =============================================================================== [1] NOK: CLAUSE,SANTA [2] NOK-2: UNANSWERED
Relation: FRIEND Relation: UNANSWERED
STREET ADDRESS UNKNOWN UNK. CITY/STATE
Phone: UNANSWERED Phone: UNANSWERED
Work Phone: UNANSWERED Work Phone: UNANSWERED
[3] E-Cont.: UNANSWERED [4] E2-Cont.: UNANSWERED
Relation: UNANSWERED Relation: UNANSWERED
Phone: UNANSWERED Phone: UNANSWERED
Work Phone: UNANSWERED Work Phone: UNANSWERED
[5] Designee: UNANSWERED Relation: UNANSWERED
Phone: UNANSWERED Work Phone: UNANSWERED
[6]Year arrived in U.S.: Mother's Country of Birth: Father's Country of Birth:
<RET> to CONTINUE, 1-6 or ALL to EDIT, N for screen N or '' to QUIT: [22;1H[1;1H[J[2J[H APPLICANT/SPOUSE EMPLOYMENT DATA, SCREEN <4> ZZ PATIENT,TEST THREE; 769-01-1568P VISTA OFFICE EHR =============================================================================== [1] Employer: UNANSWERED <2> Spouse's: NOT APPLICABLE
Occupation: UNEMPLOYED
Status: UNKNOWN
Retired Dt.: NOT APPLICABLE
<RET> to CONTINUE, 1 or ALL to EDIT, N for screen N or '' to QUIT: [22;1H[1;1H[J[2J[H INSURANCE DATA, SCREEN <5> ZZ PATIENT,TEST THREE; 769-01-1568P VISTA OFFICE EHR =============================================================================== [1] Covered by Health Insurance: NO
Insurance COB Subscriber ID Group Holder Effective Expires ===========================================================================
No Insurance Information
[2] Eligible for MEDICAID: UNANSWERED
[3] Medicaid Number:
<RET> to CONTINUE, 1-3 or ALL to EDIT, N for screen N or '' to QUIT: [22;1H[1;1H[J[2J[H ELIGIBILITY STATUS DATA, SCREEN <7> ZZ PATIENT,TEST THREE; 769-01-1568P VISTA OFFICE EHR =============================================================================== [1] Patient Type: VISTA OFFICE EHR Veteran: NO
Svc Connected: N/A SC Percent: N/A Rated Incomp.: UNANSWERED
Claim Number: UNANSWERED
Folder Loc.: UNANSWERED
[2] Aid & Attendance: UNANSWERED Housebound: UNANSWERED
VA Pension: UNANSWERED VA Disability: UNANSWERED
Total Check Amount: NOT APPLICABLE
GI Insurance: UNANSWERED Amount: UNANSWERED
[3] Primary Elig Code: REIMBURSABLE INSURANCE
Other Elig Code(s): NO ADDITIONAL ELIGIBILITIES IDENTIFIED
Period of Service: OTHER REIMBURS. (NON-VET)
<4> Service Connected Conditions as stated by applicant
--------------------------------------------------- NONE STATED
<RET> to CONTINUE, 1-3 or ALL to EDIT, N for screen N or '' to QUIT: ...SORRY, LET ME PUT YOU ON 'HOLD' FOR A SECOND... [?25l [1;1H[1;1H[J[2J[H [4m [1m [1;1HDependents Module[m[4m [1;31HMay 14, 2011@23:08:43 Page: 1 of 1 [m[1;1H
FAMILY DEMOGRAPHIC DATA, SCREEN <8>
Patient: ZZ PATIENT,TEST THREE (769-01-1568P) Outpatient [3;1H [4m
MT Patient/Dependent Relationship Active Address
[m [4;1H
1 ZZ PATIENT,TEST THREE SELF *
Married Last Year: Unanswered
[14;1H
[7m
Enter ?? for more actions
[m [16;1H[J7[16;24r8 [4m 7[1;31HMay 14, 2011@23:08:438 [m [15;1H[14;1H
DA Spouse/Dependent Add MT Marital/Dependent Info ES Spouse Demographic AD Add to Means/Copay Test DD Dependent Demographic RE Remove from Means/Copay Test DP Delete Dependent ED Expand Dependent[J [?25h Select Action: Quit Q Q 7[1;24r8[m[m[6;1H[1;1H[J[2J[H7[1;24r8[m[m[1;1H[1;1H[J[2J[H[1;1H[1;1H[J[2J[H ADMISSION INFORMATION, SCREEN <12> ZZ PATIENT,TEST THREE; 769-01-1568P VISTA OFFICE EHR ===============================================================================
NO ADMISSION DATA ON FILE FOR THIS PATIENT!!
<RET> to CONTINUE, N for screen N or '' to QUIT: [22;1H[1;1H[J[2J[H APPLICATION INFORMATION, SCREEN <13> ZZ PATIENT,TEST THREE; 769-01-1568P VISTA OFFICE EHR =============================================================================== <1> Registered: MAY 9,2005@09:07 by 'DEWAYNE,ROBERT (#9)'
Applied for: OUTPATIENT MEDICAL
Dispositioned: OPEN DISPOSITION Type of Disp.: OPEN DISPOSITION
<RET> to CONTINUE, N for screen N or '' to QUIT: [22;1H[1;1H[J[2J[H LOCAL REGISTRATION QUESTIONS ================================================================================
Please Answer these questions
Checking data for consistency...
===> 1 inconsistency found in 0 seconds...
===> 1 inconsistency filed in 0 seconds...[11;1H[1;1H[J[2J[H ZZ PATIENT,TEST THREE (769-01-1568P) JAN 15,1968 ============================================================================== 8 - ADDRESS DATA INCOMPLETE
DO YOU WANT TO UPDATE THESE INCONSISTENCIES NOW? Yes (Yes) COUNTRY: UNITED STATES UNITED STATES USA United States STREET ADDRESS [LINE 1]: 123 ANYWHERE 123 ANYWHERE STREET ADDRESS [LINE 2]: ZIP+4: 46123 46123
Select one of the following:
1 AVON*
CITY: AVON 1 AVON* STATE: INDIANA COUNTY: HENDRICKS PHONE NUMBER [CELLULAR]: 206 -876-5432 BAD ADDRESS INDICATOR:
[OLD ADDRESS] 123 ANYWHERE
AVON,INDIANA 46123
County: HENDRICKS 063
Bad Addr:
[NEW ADDRESS] 123 ANYWHERE
AVON,INDIANA 46123 UNITED STATES
County: HENDRICKS 063
Bad Addr:
Are you sure that you want to save the above changes? YES Change saved. Press ENTER to continue:
Checking data for consistency...
===> No inconsistencies found in 0 seconds...
===> Removing patient from Inconsistency file...
Select PATIENT NAME:
DA Disposition an Application EN Patient Enrollment PHH Purple Heart Request History PHS Purple Heart Status Report
Add/Edit/Delete Catastrophic Disability Collateral Patient Register Combat Vet Status Report Death Entry Delete a Registration Disposition Log Edit Edit Inconsistent Data for a Patient Eligibility Inquiry for Patient Billing Eligibility Verification Enter/Edit Patient Security Level Load/Edit Patient Data Means Test User Menu ... Patient Inquiry Preregistration Menu ... Print Patient Wristband Pseudo SSN Report (Patient) Register a Patient Report - All Address Change with Rx
Press 'RETURN' to continue, '' to stop:
Report - All Address Changes Report - All Patients flagged with a Bad Address Report - Patient Catastrophic Edits Unsupported CV End Dates Report View Patient Address View Registration Data
You have 99 new messages. (Last arrival: 05/14/11@23:08)
[7mYou've got PRIORITY mail!
[m Select Registration Menu Option: REGister a Patient
Select PATIENT NAME:
ZZ PATIENT,TEST THREE <CA> M 01-15-1968 769011568P 3
Press ENTER to continue
Please verify or update the following information:
HEALTH RECORD NO.: 357696 357696 Select ALIAS: [20;1H[1;1H[J[2J[H ZZ PATIENT,TEST THREE 769-01-1568P JAN 15,1968 =============================================================================
COORDINATING MASTER OF RECORD: OFFICE OF INFORMATION SRV CNTR
Address: 123 ANYWHERE Temporary: NO TEMPORARY ADDRESS
AVON,IN 46123 UNITED STATES
County: HENDRICKS (063) From/To: NOT APPLICABLE
Phone: UNSPECIFIED Phone: NOT APPLICABLE
Office: UNSPECIFIED
Cell: 206-876-5432
E-mail: UNSPECIFIED
Bad Addr:
Confidential Address: Confidential Address Categories:
NO CONFIDENTIAL ADDRESS
From/To: NOT APPLICABLE
Primary Eligibility: REIMBURSABLE INSURANCE (NOT VERIFIED) Other Eligibilities: Enter RETURN to continue or '' to exit: [20;1H[1;1H[J[2J[H ZZ PATIENT,TEST THREE 769-01-1568P JAN 15,1968 =============================================================================
COORDINATING MASTER OF RECORD: OFFICE OF INFORMATION SRV CNTR
Unemployable: NO
Status : PATIENT HAS NO INPATIENT OR LODGER ACTIVITY IN THE COMPUTER
Future Appointments: NONE
Remarks:
Date of Death Information
Date of Death: Source of Notification: Updated Date/Time: Last Edited By:
Enter RETURN to continue or '' to exit: [20;1H[1;1H[J[2J[H ZZ PATIENT,TEST THREE 769-01-1568P JAN 15,1968 =============================================================================
COORDINATING MASTER OF RECORD: OFFICE OF INFORMATION SRV CNTR
Do you want to edit Patient Data? Yes N (No) Do you want to validate/edit the Patient's Address? N (No)
Checking data for consistency...
===> No inconsistencies found in 0 seconds...
There is still an open disposition--register aborted.
Select PATIENT NAME:
DA Disposition an Application EN Patient Enrollment PHH Purple Heart Request History PHS Purple Heart Status Report
Add/Edit/Delete Catastrophic Disability Collateral Patient Register Combat Vet Status Report Death Entry Delete a Registration Disposition Log Edit Edit Inconsistent Data for a Patient Eligibility Inquiry for Patient Billing Eligibility Verification Enter/Edit Patient Security Level Load/Edit Patient Data Means Test User Menu ... Patient Inquiry Preregistration Menu ... Print Patient Wristband Pseudo SSN Report (Patient) Register a Patient Report - All Address Change with Rx
Press 'RETURN' to continue, '' to stop:
Report - All Address Changes Report - All Patients flagged with a Bad Address Report - Patient Catastrophic Edits Unsupported CV End Dates Report View Patient Address View Registration Data
[7mYou've got PRIORITY mail!
[m Select Registration Menu Option: DISP
1 Disposition an Application 2 Disposition Log Edit
CHOOSE 1-2: 1 Disposition an Application
Disposition PATIENT:
DA Disposition an Application EN Patient Enrollment PHH Purple Heart Request History PHS Purple Heart Status Report
Add/Edit/Delete Catastrophic Disability Collateral Patient Register Combat Vet Status Report Death Entry Delete a Registration Disposition Log Edit Edit Inconsistent Data for a Patient Eligibility Inquiry for Patient Billing Eligibility Verification Enter/Edit Patient Security Level Load/Edit Patient Data Means Test User Menu ... Patient Inquiry Preregistration Menu ... Print Patient Wristband Pseudo SSN Report (Patient) Register a Patient Report - All Address Change with Rx
Press 'RETURN' to continue, '' to stop:
Report - All Address Changes Report - All Patients flagged with a Bad Address Report - Patient Catastrophic Edits Unsupported CV End Dates Report View Patient Address View Registration Data
[7mYou've got PRIORITY mail!
[m Select Registration Menu Option: DISP
1 Disposition an Application 2 Disposition Log Edit
CHOOSE 1-2: 2 Disposition Log Edit
Select PATIENT NAME:
ZZ PATIENT,TEST THREE <CA> M 01-15-1968 769011568P 357696
3
Registration date/time: ?
- 05/09/2005@09:07
Enter the date and time, Entry #, or 'L' for the last registration,
to select the registration you wish to edit
Registration date/time: 1 05/09/2005@09:07
STATUS: UNSCHEDULED TYPE OF BENEFIT APPLIED FOR: OUTPATIENT MEDICAL
TYPE OF CARE APPLIED FOR: ALL OTHER REGISTRATION ELIGIBILITY CODE: REIMBURSABLE INSURANCE
?
ONLY ELIGIBILITIES WHICH HAVE BEEN ASSIGNED TO THIS PATIENT!
Answer with ELIGIBILITY CODE NAME, or VA CODE NUMBER, or
MAS ELIGIBILITY CODE, or SYNONYM
Do you want the entire ELIGIBILITY CODE List? Y (Yes)
Choose from: HUMANITARIAN EMERGENCY 6 6 NON-VETERAN REIMBURSABLE INSURANCE 8 8 NON-VETERAN
REGISTRATION ELIGIBILITY CODE: REIMBURSABLE INSURANCE
FACILITY APPLYING TO: EHR OFFICE NEED RELATED TO AN ACCIDENT: NO NEED RELATED TO OCCUPATION: NO
Updating eligibility status for this registration...
Disposition on AMIS Segment 420 - SEGMENT NAME UNKNOWN ??
Select PATIENT NAME:
DA Disposition an Application EN Patient Enrollment PHH Purple Heart Request History PHS Purple Heart Status Report
Add/Edit/Delete Catastrophic Disability Collateral Patient Register Combat Vet Status Report Death Entry Delete a Registration Disposition Log Edit Edit Inconsistent Data for a Patient Eligibility Inquiry for Patient Billing Eligibility Verification Enter/Edit Patient Security Level Load/Edit Patient Data Means Test User Menu ... Patient Inquiry Preregistration Menu ... Print Patient Wristband Pseudo SSN Report (Patient) Register a Patient Report - All Address Change with Rx
Press 'RETURN' to continue, '' to stop:
Report - All Address Changes Report - All Patients flagged with a Bad Address Report - Patient Catastrophic Edits Unsupported CV End Dates Report View Patient Address View Registration Data
[7mYou've got PRIORITY mail!
[m Select Registration Menu Option: DISP
1 Disposition an Application 2 Disposition Log Edit
CHOOSE 1-2: 1 Disposition an Application
Disposition PATIENT:
ZZ PATIENT,TEST THREE <CA> M 01-15-1968 769011568P 357696
3
LOG DATE TYPE OF BENEFIT APPLIED FOR
05/09/2005@09:07 OUTPATIENT MEDICAL
STATUS: UNSCHEDULED TYPE OF BENEFIT APPLIED FOR: OUTPATIENT MEDICAL TYPE OF CARE APPLIED FOR: ALL OTHER REGISTRATION ELIGIBILITY CODE: REIMBURSABLE INSURANCE
LOG OUT DATE TIME: NOW
- Disposition deleted *
Disposition PATIENT:
DA Disposition an Application EN Patient Enrollment PHH Purple Heart Request History PHS Purple Heart Status Report
Add/Edit/Delete Catastrophic Disability Collateral Patient Register Combat Vet Status Report Death Entry Delete a Registration Disposition Log Edit Edit Inconsistent Data for a Patient Eligibility Inquiry for Patient Billing Eligibility Verification Enter/Edit Patient Security Level Load/Edit Patient Data Means Test User Menu ... Patient Inquiry Preregistration Menu ... Print Patient Wristband Pseudo SSN Report (Patient) Register a Patient Report - All Address Change with Rx
Press 'RETURN' to continue, '' to stop:
Report - All Address Changes Report - All Patients flagged with a Bad Address Report - Patient Catastrophic Edits Unsupported CV End Dates Report View Patient Address View Registration Data
[7mYou've got PRIORITY mail!
[m Select Registration Menu Option: LOad/Edit Patient Data
Select PATIENT NAME:
DA Disposition an Application EN Patient Enrollment PHH Purple Heart Request History PHS Purple Heart Status Report
Add/Edit/Delete Catastrophic Disability Collateral Patient Register Combat Vet Status Report Death Entry Delete a Registration Disposition Log Edit Edit Inconsistent Data for a Patient Eligibility Inquiry for Patient Billing Eligibility Verification Enter/Edit Patient Security Level Load/Edit Patient Data Means Test User Menu ... Patient Inquiry Preregistration Menu ... Print Patient Wristband Pseudo SSN Report (Patient) Register a Patient Report - All Address Change with Rx
Press 'RETURN' to continue, '' to stop:
Report - All Address Changes Report - All Patients flagged with a Bad Address Report - Patient Catastrophic Edits Unsupported CV End Dates Report View Patient Address View Registration Data
[7mYou've got PRIORITY mail!
[m Select Registration Menu Option: DISP
1 Disposition an Application 2 Disposition Log Edit
CHOOSE 1-2: 2 Disposition Log Edit
Select PATIENT NAME:
ZZ PATIENT,TEST THREE <CA> M 01-15-1968 769011568P 357696
3
Registration date/time: 1 05/09/2005@09:07
STATUS: UNSCHEDULED
Updating eligibility status for this registration...
Disposition on AMIS Segment 420 - SEGMENT NAME UNKNOWN ??
Select PATIENT NAME:
DA Disposition an Application EN Patient Enrollment PHH Purple Heart Request History PHS Purple Heart Status Report
Add/Edit/Delete Catastrophic Disability Collateral Patient Register Combat Vet Status Report Death Entry Delete a Registration Disposition Log Edit Edit Inconsistent Data for a Patient Eligibility Inquiry for Patient Billing Eligibility Verification Enter/Edit Patient Security Level Load/Edit Patient Data Means Test User Menu ... Patient Inquiry Preregistration Menu ... Print Patient Wristband Pseudo SSN Report (Patient) Register a Patient Report - All Address Change with Rx
Press 'RETURN' to continue, '' to stop: DE
Report - All Address Changes Report - All Patients flagged with a Bad Address Report - Patient Catastrophic Edits Unsupported CV End Dates Report View Patient Address View Registration Data
[7mYou've got PRIORITY mail!
[m Select Registration Menu Option: DELete a Registration
Select PATIENT NAME:
ZZ PATIENT,TEST THREE <CA> M 01-15-1968 769011568P 357696
3
LOG IN DATE/TIME: MAY 09, 2005@09:07
STATUS: UNSCHEDULED TYPE OF BENEFIT APPLIED FOR: OUTPATIEN
T MEDICAL
FACILITY APPLYING TO: EHR OFFICE WHO ENTERED 10/10: DEWAYNE,ROBERT ACTIVE: ACTIVE TYPE OF CARE APPLIED FOR: ALL OTHER REGISTRATION ELIGIBILITY CODE: REIMBUR
SABLE INSURANCE
ELIG VERIFIED AT REGISTRATION: NO SC AT REGISTRATION: NO
Are you sure you want to delete this registration? No Y (Yes) Deleted.
Select PATIENT NAME:
??
Select PATIENT NAME:
DA Disposition an Application EN Patient Enrollment PHH Purple Heart Request History PHS Purple Heart Status Report
Add/Edit/Delete Catastrophic Disability Collateral Patient Register Combat Vet Status Report Death Entry Delete a Registration Disposition Log Edit Edit Inconsistent Data for a Patient Eligibility Inquiry for Patient Billing Eligibility Verification Enter/Edit Patient Security Level Load/Edit Patient Data Means Test User Menu ... Patient Inquiry Preregistration Menu ... Print Patient Wristband Pseudo SSN Report (Patient) Register a Patient Report - All Address Change with Rx
Press 'RETURN' to continue, '' to stop:
Report - All Address Changes Report - All Patients flagged with a Bad Address Report - Patient Catastrophic Edits Unsupported CV End Dates Report View Patient Address View Registration Data
[7mYou've got PRIORITY mail!
[m Select Registration Menu Option: REGister a Patient
Select PATIENT NAME:
ZZ PATIENT,TEST THREE <CA> M 01-15-1968 769011568P 357696
3
Press ENTER to continue
Please verify or update the following information:
HEALTH RECORD NO.: 357696 357696 Select ALIAS: [11;1H[1;1H[J[2J[H ZZ PATIENT,TEST THREE 769-01-1568P JAN 15,1968 =============================================================================
COORDINATING MASTER OF RECORD: OFFICE OF INFORMATION SRV CNTR
Address: 123 ANYWHERE Temporary: NO TEMPORARY ADDRESS
AVON,IN 46123 UNITED STATES
County: HENDRICKS (063) From/To: NOT APPLICABLE
Phone: UNSPECIFIED Phone: NOT APPLICABLE
Office: UNSPECIFIED
Cell: 206-876-5432
E-mail: UNSPECIFIED
Bad Addr:
Confidential Address: Confidential Address Categories:
NO CONFIDENTIAL ADDRESS
From/To: NOT APPLICABLE
Primary Eligibility: REIMBURSABLE INSURANCE (NOT VERIFIED) Other Eligibilities: Enter RETURN to continue or '' to exit: [20;1H[1;1H[J[2J[H ZZ PATIENT,TEST THREE 769-01-1568P JAN 15,1968 =============================================================================
COORDINATING MASTER OF RECORD: OFFICE OF INFORMATION SRV CNTR
Unemployable: NO
Status : PATIENT HAS NO INPATIENT OR LODGER ACTIVITY IN THE COMPUTER
Future Appointments: NONE
Remarks:
Date of Death Information
Date of Death: Source of Notification: Updated Date/Time: Last Edited By:
Enter RETURN to continue or '' to exit: [20;1H[1;1H[J[2J[H ZZ PATIENT,TEST THREE 769-01-1568P JAN 15,1968 =============================================================================
COORDINATING MASTER OF RECORD: OFFICE OF INFORMATION SRV CNTR
Do you want to edit Patient Data? Yes (Yes) Do you want to validate/edit the Patient's Address? B ??
Answer with 'Yes' or 'No': N (No)
[9;1H[1;1H[J[2J[H PATIENT DEMOGRAPHIC DATA, SCREEN <1> ZZ PATIENT,TEST THREE; 769-01-1568P VISTA OFFICE EHR ===============================================================================
Reg Dt: 5/14/11
[1] Name: ZZ PATIENT,TEST THREE SS: 769-01-1568P
DOB: JAN 15,1968 PSSN Reason: No SSN Assigned
Family: ZZ PATIENT HRN: 357696 Sex: MALE
Given: TEST [2] Alias: < No alias entries on file >
Middle: THREE Prefix: Suffix: Degree:
[3] Remarks: NO REMARKS ENTERED FOR THIS PATIENT [4] Permanent Address: [5] Temporary Address:
123 ANYWHERE NO TEMPORARY ADDRESS AVON,IN 46123 UNITED STATES
County: HENDRICKS (063) County: NOT APPLICABLE
Phone: UNANSWERED Phone: NOT APPLICABLE
Office: UNANSWERED From/To: NOT APPLICABLE
Alt Ph: 206-876-5432 Bad Addr:
<RET> to CONTINUE, 1-5 or ALL to EDIT, N for screen N or '' to QUIT: [24;1H[1;1H[J[2J[H LOCAL REGISTRATION QUESTIONS ================================================================================
Please Answer these questions
Checking data for consistency...
===> No inconsistencies found in 0 seconds...
Is the patient currently being followed in a clinic for the same condition? Y
(Yes)
Is the patient to be examined in the medical center today? Yes Y (Yes)
Registration login date/time: NOW (MAY 14,2011@23:12) FACILITY APPLYING TO: EHR OFFICE 050 REGISTRATION ELIGIBILITY CODE: REIMBURSABLE INSURANCE
EHR ??
ONLY ELIGIBILITIES WHICH HAVE BEEN ASSIGNED TO THIS PATIENT!
REGISTRATION ELIGIBILITY CODE: REIMBURSABLE INSURANCE
8 8 NON-VETERAN
Updating eligibility status for this registration...
NEED RELATED TO AN ACCIDENT: N NO NEED RELATED TO OCCUPATION: N NO
PRINT 10-10EZ? YES NO ROUTING SLIP? Yes N (No)
Select PATIENT NAME:
ZZ PATIENT,TEST THREE <CA> M 01-15-1968 769011568P 357696
3
Press ENTER to continue
Please verify or update the following information:
HEALTH RECORD NO.: 357696 357696 Select ALIAS: [18;1H[1;1H[J[2J[H ZZ PATIENT,TEST THREE 769-01-1568P JAN 15,1968 =============================================================================
COORDINATING MASTER OF RECORD: OFFICE OF INFORMATION SRV CNTR
Address: 123 ANYWHERE Temporary: NO TEMPORARY ADDRESS
AVON,IN 46123 UNITED STATES
County: HENDRICKS (063) From/To: NOT APPLICABLE
Phone: UNSPECIFIED Phone: NOT APPLICABLE
Office: UNSPECIFIED
Cell: 206-876-5432
E-mail: UNSPECIFIED
Bad Addr:
Confidential Address: Confidential Address Categories:
NO CONFIDENTIAL ADDRESS
From/To: NOT APPLICABLE
Primary Eligibility: REIMBURSABLE INSURANCE (NOT VERIFIED) Other Eligibilities: Enter RETURN to continue or '' to exit:
Select PATIENT NAME:
DA Disposition an Application EN Patient Enrollment PHH Purple Heart Request History PHS Purple Heart Status Report
Add/Edit/Delete Catastrophic Disability Collateral Patient Register Combat Vet Status Report Death Entry Delete a Registration Disposition Log Edit Edit Inconsistent Data for a Patient Eligibility Inquiry for Patient Billing Eligibility Verification Enter/Edit Patient Security Level Load/Edit Patient Data Means Test User Menu ... Patient Inquiry Preregistration Menu ... Print Patient Wristband Pseudo SSN Report (Patient) Register a Patient Report - All Address Change with Rx
Press 'RETURN' to continue, '' to stop:
Report - All Address Changes Report - All Patients flagged with a Bad Address Report - Patient Catastrophic Edits Unsupported CV End Dates Report View Patient Address View Registration Data
[7mYou've got PRIORITY mail!
[m Select Registration Menu Option: DISP
1 Disposition an Application 2 Disposition Log Edit
CHOOSE 1-2: 1 Disposition an Application
Disposition PATIENT:
ZZ PATIENT,TEST THREE <CA> M 01-15-1968 769011568P 357696
3
LOG DATE TYPE OF BENEFIT APPLIED FOR
05/14/2011@23:12 OUTPATIENT MEDICAL
STATUS: UNSCHEDULED ?
Enter '0' if this is a 10/10 visit for AMIS, '1' if this is an unscheduled visit, or '2' if this is an application without exam. Choose from:
0 10/10 VISIT 1 UNSCHEDULED 2 APPLICATION WITHOUT EXAM
STATUS: UNSCHEDULED 2 APPLICATION WITHOUT EXAM TYPE OF BENEFIT APPLIED FOR: OUTPATIENT MEDICAL TYPE OF CARE APPLIED FOR: ALL OTHER REGISTRATION ELIGIBILITY CODE: REIMBURSABLE INSURANCE
LOG OUT DATE TIME: NOW (MAY 14, 2011@23:13)
Select the type of disposition: ?
Answer with DISPOSITION NAME, or ABBREVIATION, or SYNONYM Do you want the entire DISPOSITION List? Y (Yes)
Choose from: CANCEL WITH EXAM CANCEL WITHOUT EXAM COMMUNITY RESOURCES DEAD ON ARRIVAL DOMICILIARY ADMISSION DOMICILIARY WAITING LIST FAILED TO COOPERATE/COMPLETED FEE BASIS REFERAL, OTHER HOSPITAL ADMISSION HOSPITAL WAITING LIST IN NEED OF DOMICILIARY IN NEED OF NURSING HOME CARE INELIGIBLE-DISP COMMUNITY INELIGIBLE-DISP OTHER KEEP PREVIOUSLY SCHEDULED APPT LOW PRIORITY-DISP COMMUNITY LOW PRIORITY-DISP FEE BASIS LOW PRIORITY-DISP OTHER LOW PRIORITY-DISP OTHER VA NO CARE OR TREATMENT REQUIRED '' TO STOP:
Select the type of disposition: K NO CARE OR TREATMENT REQUIRED
Updating eligibility status for this registration...
Disposition on AMIS Segment 420 - SEGMENT NAME UNKNOWN ??
* Registration dispositioned *
Disposition PATIENT:
DA Disposition an Application EN Patient Enrollment PHH Purple Heart Request History PHS Purple Heart Status Report
Add/Edit/Delete Catastrophic Disability Collateral Patient Register Combat Vet Status Report Death Entry Delete a Registration Disposition Log Edit Edit Inconsistent Data for a Patient Eligibility Inquiry for Patient Billing Eligibility Verification Enter/Edit Patient Security Level Load/Edit Patient Data Means Test User Menu ... Patient Inquiry Preregistration Menu ... Print Patient Wristband Pseudo SSN Report (Patient) Register a Patient Report - All Address Change with Rx
Press 'RETURN' to continue, '' to stop:
Report - All Address Changes Report - All Patients flagged with a Bad Address Report - Patient Catastrophic Edits Unsupported CV End Dates Report View Patient Address View Registration Data
[7mYou've got PRIORITY mail!
[m Select Registration Menu Option:
[7mYou've got PRIORITY mail!
[m
Do you really want to halt? YES
Logged out at May 14, 2011 11:17 pm
GTM>[?1h=s[C [C S[C [CD[CU[CP[C Z[C=[C9[C [CD[C [C[CX[CU[CP[C[?1l>
Setting up programmer environment This is a TEST account.
Terminal Type set to: C-VT100
You have 99 new messages. Select OPTION NAME: BED
1 BED AVAILABILITY DG BED AVAILABILITY Bed Availability 2 BED CONTROL MENU DG BED CONTROL Bed Control Menu 3 BED OUT-OF-SERVICE DATE ENTER/ DGPM EDIT OOS BEDS Bed Out-of-Servi
ce Date Enter/Edit
4 BEDSECTION WORKLOAD ECTS BEDSECTION Bedsection Workload 5 BEDSECRALWKL RA LWKLBEDSEC PTF Bedsection Report
CHOOSE 1-5: 2 DG BED CONTROL Bed Control Menu
Admit a Patient Cancel a Scheduled Admission Check-in Lodger Delete Waiting List Entry Detailed Inpatient Inquiry Discharge a Patient DRG Calculation Extended Bed Control Lodger Check-out Provider Change Schedule an Admission Seriously Ill List Entry Switch Bed Transfer a Patient Treating Specialty Transfer Waiting List Entry/Edit
[7mYou've got PRIORITY mail!
[m Select Bed Control Menu Option: ADMIT a Patient
Admit PATIENT: ZZPA PAT
1 ZZ PATIENT,TEST ONE <A> F 01-24-1945 000003322 1 2 ZZ PATIENT,TEST THREE <CA> M 01-15-1968 769011568P 357696
3
3 ZZ PATIENT,TEST TWO <A> M 12-25-1957 2
CHOOSE 1-3: 2
ZZ PATIENT,TEST THREE <CA> M 01-15-1968 769011568P 357696
3
Means Test not required based on available information
Status : PATIENT HAS NO INPATIENT OR LODGER ACTIVITY IN THE COMPUTER
Religion : Marital Status : UNKNOWN Eligibility : REIMBURSABLE INSURANCE (NOT VERIFIED)
<C>ontinue, <M>ore, or <Q>uit? CONTINUE CONTINUE
Select ADMISSION DATE: NOW 5/12/11@9AM (MAY 12, 2011@09:00:00)
SURE YOU WANT TO ADD 'MAY 12,2011@09:00' AS A NEW ADMISSION DATE? Y (Yes) DOES THE PATIENT WISH TO BE EXCLUDED FROM THE FACILITY DIRECTORY?: N NO ADMITTING REGULATION: EMERGENCY FOR PUBLIC 17.46(c)(1) TYPE OF ADMISSION: DIRECT ADMISSION ACTIVE DIAGNOSIS [SHORT]: test TESTGIN TESTING WARD LOCATION: 1w
1 1W OBSERVATION 2 1W 1 WEST
CHOOSE 1-2: 2 1 WEST ROOM-BED: ?
Enter the ROOM-BED to which this patient is assigned. Only those unoccupied beds on ward selected
CHOOSE FROM
1A101-B 1A101-A 1A102-A 1A102-B 1A103-A 1A103-B 1A104-A 1A104-B
Select from the above listing the bed you wish to assign this patient. Enter two question marks for a more detailed list of available beds. ROOM-BED: 1a104-a FACILITY TREATING SPECIALTY: ?
Enter the TREATING SPECIALTY assigned to this patient with this movement. This must be an active treating specialty. Allows only active treating specialties.
Answer with FACILITY TREATING SPECIALTY NAME Do you want the entire FACILITY TREATING SPECIALTY List? y (Yes)
Choose from: ANESTHESIOLOGY ANESTHESIOLOGY BLIND REHAB OBSERVATION BLIND REHAB OBSERVATION CARDIAC INTENSIVE CARE UNIT CARDIAC INTENSIVE CARE UNIT CARDIAC SURGERY CARDIAC SURGERY ICU DOMICILIARY CHV DOMICILIARY CHV GRECC-GEM-REHAB GRECC-GEM-REHAB GRECC-MED GRECC-MED LONG STAY GRECC-NHCU LONG STAY GRECC-NHCU MEDICAL ICU MEDICAL ICU ICU MEDICAL OBSERVATION MEDICAL OBSERVATION GEN MEDICINE GENERAL(ACUTE MEDICINE) MED NEUROLOGY OBSERVATION NEUROLOGY OBSERVATION NH HOSPICE NH HOSPICE NH LONG STAY DEMENTIA CARE NH LONG STAY DEMENTIA CARE NH LONG STAY MAINTENANCE CARE NH LONG STAY MAINTENANCE CARE NH LONG STAY PSYCHIATRIC CARE NH LONG STAY PSYCHIATRIC CARE NH LONG STAY SKILLED NURSING NH LONG STAY SKILLED NURSING NH LONG STAY SPINAL CORD INJ NH LONG STAY SPINAL CORD INJ NH RESPITE CARE (NHCU) NH RESPITE CARE (NHCU) NH SHORT STAY DEMENTIA CARE NH SHORT STAY DEMENTIA CARE '' TO STOP:
NH SHORT STAY MAINTENANCE NH SHORT STAY MAINTENANCE NH SHORT STAY PSYCHIATRIC CARE NH SHORT STAY PSYCHIATRIC CARE NH SHORT STAY REHABILITATION NH SHORT STAY REHABILITATION NH SHORT STAY RESTORATIVE NH SHORT STAY RESTORATIVE NH SHORT STAY SKILLED NURSING NH SHORT STAY SKILLED NURSING PEDIATRICS PEDIATRICS PED PM&R TRANSITIONAL REHAB PM&R TRANSITIONAL REHAB PSYCHIATRIC OBSERVATION PSYCHIATRIC OBSERVATION REHAB MEDICINE OBSERVATION REHAB MEDICINE OBSERVATION SHORT STAY GRECC-GEM-NHCU SHORT STAY GRECC-GEM-NHCU SHORT STAY GRECC-NHCU SHORT STAY GRECC-NHCU SPINAL CORD INJURY OBSERVATION SPINAL CORD INJURY OBSERVATION SURGICAL OBSERVATION SURGICAL OBSERVATION SURGICAL STEPDOWN SURGICAL STEPDOWN TELEMETRY TELEMETRY TELE TRANSPLANTATION TRANSPLANTATION
FACILITY TREATING SPECIALTY: tl TELEMETRY TELEMETRY TELE PRIMARY PHYSICIAN: DOCTOR,TEN Physician ATTENDING PHYSICIAN: DOCTORE, ,ONE DO Physician DIAGNOSIS: TESTING
Edit? NO
SOURCE OF ADMISSION: ?
Enter the source of admission from the available entries. Note: 3E only valid with active Psych Med Center suffix, 4E only valid with active VA Domiciliary suffix, 5D only valid with active VA Nursing Home suffix. (4E and 5D require Transferring Suffix entry also)
Answer with SOURCE OF ADMISSION PTF CODE, or NAME Do you want the entire SOURCE OF ADMISSION List? Y (Yes)
Choose from: 1D VA NURSING HOME CARE UNIT HOSPITAL 1E VA DOMICILLARY HOSPITAL 1G CONTRACT CNH (UNDER VA AUSPICES) HOSPITAL 1H COMMUNITY NURSING HOME NOT UNDER VA AUSPICES HOSPITAL 1J GOVNT(NON FED) MENTAL HOSP NOT UNDER VA AUSPICES HOSPITAL 1K ALL OTHER NON VA HOSP NOT UNDER VA AUSPICES HOSPITAL 1L STATE HOME (DOM OR NHC) HOSPITAL 1M OTHER DIRECT HOSPITAL 1P OUTPATIENT TREATMENT HOSPITAL 1R RESEARCH - VETERAN HOSPITAL 1S RESEARCH NON-VETERAN HOSPITAL 1T OBSERVATION AND EXAMINATION HOSPITAL 2A NON-VETERAN OTHER THAN MILITARY HOSPITAL 2B MILITARY PERS NOT DIRECTLY FROM MILT HOSP HOSPITAL 2C MILITARY PERS BY TRANSFER FROM A MILT HOSP HOSPITAL 3A TRANSFER IN FROM ANOTHER VA HOSPITAL HOSPITAL 3B TRANSFER IN FROM OTH FED HOSP UNDER VA AUSP HOSPITAL 3C TRANS IN FROM ANY OTHER NON-VA HOSP UNDER VA AUSP HOSPITAL 3D TRANS FROM VAMC TO MILITARY FAC. UNDER VA AUSP MILITARY HOSPITA
L
'' TO STOP:
SOURCE OF ADMISSION: 1P OUTPATIENT TREATMENT HOSPITAL Patient Admitted
Notify NURSING ADP Coordinator and Site Manager that this patient was not
admitted into the NURSING Service because NURSING Site parameters were not updated. CONDITION: SERIOUSLY ILL @
Do you want to print a Patient Wristband? YES NO Updating PTF Record #5... Now updating ward MPCR information...completed.
Updating automated team lists...completed. MAS Patient Movement - Activating Mental Health Update
Starting Mental Health Update... No MH actions taken... done... Executing HL7 ADT Messaging Executing HL7 ADT Messaging (RAI/MDS)
...Inpatient Medications check... ...discontinuing Inpatient Medication orders....done... Entering a request in the HINQ suspense file...completed.
Updating visit status...completed.
Admit PATIENT:
Admit a Patient Cancel a Scheduled Admission Check-in Lodger Delete Waiting List Entry Detailed Inpatient Inquiry Discharge a Patient DRG Calculation Extended Bed Control Lodger Check-out Provider Change Schedule an Admission Seriously Ill List Entry Switch Bed Transfer a Patient Treating Specialty Transfer Waiting List Entry/Edit
[7mYou've got PRIORITY mail!
[m Select Bed Control Menu Option: halt
Logged out at May 14, 2011 11:53 pm]0;wvehr3-09@gtm: ~ wvehr3-09@gtm:~$
