Efficiency App

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Provider

RenderingProvider

Attending Rendering

Attending Doctor

Assigned Social Worker

Assigned Mental Health Worker

Consultant Reason

PatientDemographicInformation

Prefer Refer As

Facility

AdmissionDate

Submit Claim

Room Department

Room

BedNumber

idNumber

CheckNumber

ResubmissionCode

PA Number

Chief Complaint

Ed Admission

Identifying Information

past medical history

If you don't find the Past Medical History, type below

Title

developmental history

Past Psych History

pph diagnoses

pph hospitalizations

pph age on first hospitalization

pph last hospitalization

Past Medications

allergies

If you don't find the Allergy, type below

Title

Social History

family extended family

family children

family siblings

family parents

Family History

substance abuse history

trauma history

Forensic History

special accomodations dietary restrictions description

special accomodations medical problems description

special accomodations physical handicapped description

special accomodations due to

liabilities

assets and strengths

physical complaints pain location

physical complaints

abnormal movements

gait and station

AdmittingDiagnosis

Primary Diagnosis

Secondary Diagnosis

Personality Disorders

Medical Problems

Interpersonal Problems

Level of Functioning

itp psychosocial stressors

itp behavioral plan

itp problems to be addressed

prognosis

risk factors

Length Of Stay

Length Of Stay Notes

Days Approved

Days Denied

Denied Reasons

Days Appealed

Days Recovered

Approved LOS

Anticipated Discharge Date

Clear

Discharge Date

Clear

Disposition Category

Disposition

Follow Up Consent

Inpatient Certificate

Inpatient Certificate Reasons

itp behavioral plan text

Arrival Facility

Arrival Status

Sex Offender

Current Chemotherapy

Blood Transfusion

Ventilators

Call

ClaimSubmitStatus

Still Facility

Export MSE

Export ROS

Psych Cleared

Medical Cleared

Patient Accepted

Call Back

Covid19

Covid19 Date Drawn

Clear

Observation Notification

partial hospitalization program

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