# Presentation: 513048

## Patient Registration  Version 7.0

- Edward Gartner
- Information Technology Support Center

## Page 1

- CHS Eligibility field moved from Page 2
- New Marital Status Field
- Location of Home moved from Page 9
- New Message Phone Number

## Slide 3

## Page 2

- Other Tribes moved from Page 12
- New Fields for Mother’s Employer
- New Fields for Father’s Employer
- New Race Field
- New Number in Household Field
- New Total Household Income Field

## Slide 5

## Page 3

- Next of Kin Fields moved from Page 10

## Slide 7

## Page 4 – Insurance Summary Page

- Used to prioritize coverage by category
- Medical, Dental, Pharmacy, Vision, Mental Health, Accident/Tort, Workmens Comp
- Combines pages 4,5,6 and 7
- Currently being developed

## IHS REGISTRATION EDITOR  (page 4)                         ALBUQUERQUE HOSPITAL

- ==============================================================================
- CHAVEZ,HENRIETTA     (last updated: JUL 07, 1999)HRN #: 1072    (CHS & DIRECT)
- ==============================================================================
-                      **Insurance Summary – General Sequencing**
- ------------------------------------------------------------------------------
**SEQ **   INSURER                 PLAN                    ELIG BEGIN    ELIG END
-          SUBSCRIBER              SUBSCRIBER
- ------------------------------------------------------------------------------
-  1    MEDICARE                  PART A                 10/01/1983 -
-         CHAVEZ,HENRIETTA R       505841107A
-  2    MEDICARE                  PART B                 10/01/1983 –
-         CHAVEZ,HENRIETTA R       505841107A
-  3    BC/BS OF MARYLAND         HIGH                   01/20/2002 -
-         CHAVEZ,LARRY             123234345
-  4    ARIZONA MEDICAID          1H MN/MI MCR           04/01/2002 –
-         CHAVEZ,HENRIETTA R       A56232356
-  X    PRESBYTERIAN HEALTH PLAN  HMO                    09/15/1997 – 06/30/2001
-         CHAVEZ,LARRY             123234345
-  X    NEW MEXICO MEDICAID       029 STANDARD           01/01/2002 – 03/30/2002
-         CHAVEZ,HENRIETTA R       505841107

- ENTER: (<S>equence, <A>dd insurer, <E>dit insurer, <T>oggle)

## Medicare & Railroad Retirement Pages

- New MPS Signature Fields
- New QMB/SLMB Fields
- New Plan Name Fields
- Accommodates Medicare Part C plans
- New Card Copy on File Field
- New Primary Care Provider Field

## Slide 11

## Medicaid Pages

- New Card Copy on File Field
- New Primary Care Provider Field
- Currently Under Development

## Slide 13

## Private Insurance Pages

- Insurer address display
- Free-text policy holder field
- Ability to add additional coverage type
- New Card Copy Fields
- New Primary Care Provider Fields
- Currently under development

## Page 4d                       Private Insurance  	     ALBUQUERQUE HOSPITAL

- ===============================================================================
- JONES,LISA B   (updated: JUL 05, 2000)                            CHART #: 1999
- ===============================================================================
- 1) Policy Holder.: JONES,LISA              |5) Grp Name.: PHILIPS
- 2) Policy or SSN.: 69810632-01             |   Group No.: 174600
- 3) Effective Date: 6/1/1999                |6) Coverage.: Medical
- 4) Expire Date...:                         |7) Card Copy: Y   Date: 04/14/2002
- -Insurer---------------------------------Certification Info--------------------
- UNITED HEALTHCARE                      |8) Pre-Cert:
-  PO BOX 30555                          |   Date....:
-  SALT LAKE CITY, UT  84130-0555        |9) Contact.:
-  (800)638-0035   |Ins Type: Private Insurance |PCP: DARNELLI,STEPHEN MD
- ---------HOLDER'S DEMOGRAPHICS---------|---------HOLDER'S EMPLOYER INFO--------
- 8)  Sex.: FEMALE                       |12) Status..: RETIRED
- 9)  DOB.: 12/10/1914                   |13) Employer: PHILIPS SEMICONDUCTORS
- ----Policy Members----PC--Member #-----HRN------Rel--------From/Thru-----------
- 13) JONES,CHIPPER     01  698106032-02 T00002   PARENTS    06/1/1999
- 14) JONES,LISA MARIE  04  698106032-01 2893     SELF       06/1/1999-10/01/2000
- ===============================================================================
-       ENTER DESIRED ACTION (<E>dit Data, <A>dd Member, <D>elete Member):

## Veterans Page

- New Field for Description of VA  Disability
- New Field for Valid VA Card

## Slide 17

## Death Information / Other Names Page

- No Changes

## Slide 19

## Business Office / CHS Notes Pages

- New Pages exclusively for CHS Notes and Business Office notes
- Current notes (Page 11) will become Business Office Notes page
- Security Keys Assigned

## Slide 21

## Slide 22

## Document Summary Page

- New Fields – CHS Eligibility
- Reasons dependant on type of eligibility
- New Fields for Status of Medical Record
- New Fields for Benefit Coordinators
- New Fields for Release of Information
- New Fields for Assignment of Benefits

## Status of CHS & Direct

## Status of Direct Only

## Status of Ineligible

## Status of Pending