Referral request - data classification Patient information – Patient demographics, covered by MU2...
-
Upload
jean-phillips -
Category
Documents
-
view
221 -
download
4
Transcript of Referral request - data classification Patient information – Patient demographics, covered by MU2...
Referral request - data classification
• Patient information– Patient demographics, covered by MU2 and CCDA
requirements– Patient identifier (Med Rec Number)
• As known to the sender• Common for both sender and receiver• As known to the receiver
– Two elements from spreadsheed don’t belong• SSN should not be used for healthcare• Medicare # - this is administrative information, belongs to
insurance information
Referral request - data classification
• Referral administrative information– Referral Identifier (not present in the spreadsheet)– Referral Date– Referral Approval obtained– Insurance information (multiple insurance policies/kinds
possible) – usually covered in ADT or X12 messages• Kind (primary, secondary, Medicare/Medicaid, Worker’s comp)• Policy number• Group number• Insurance member ID (e.g. Medicare #)• Guarantor/Subscriber/Insured demographics
Referral request - data classification
• Referring provider (sender) information• Receiving provider information• Patient’s PCP (if different from sender and
receiver)– Information provided by provider directories• Provider identifier
– Direct address– NPI #
• Provider demographics• Provider organization
Referral request - data classification
• Clinical information– Reason for referral– MU2 specified clinical information• Problems• Medications• Allergies• Relevant lab results
– Additional clinical information (depending on specialty)