| # | Name | Location | Type | Details | Index | Description |
|---|---|---|---|---|---|---|
| .01 | log in date/time | 0;1 | DATE-TIME | ADIS | The date/time the patient was registered using the 'Register a Patient' option in ADT should be entered into this field. Registrations must be entered using the ADT module and should not be entered or edited using VA FileMan options. | |
| .2 | 10-10t registration | 0;20 | BOOLEAN | 0:NO 1:YES | Was the patient registered using the 10-10T | |
| 1 | status(+) | 0;2 | SET OF CODES | 0:10/10 VISIT 1:UNSCHEDULED 2:APPLICATION WITHOUT EXAM | ter the appropriate code indicating the status of the patient's visit. Enter 0 if this patient had a 1010 visit (application for care). Enter 1 if the patient's visit was not scheduled. Enter 2 if no exam was needed. This data is used by the AMIS 400 series reports. | |
| 2 | type of benefit applied for(+) | 0;3 | SET OF CODES | 1:HOSPITAL 2:DOMICILIARY 3:OUTPATIENT MEDICAL 4:OUTPATIENT DENTAL 5:NURSING HOME CARE | Enter the type of care this patient has applied for whether it be inpatient (dom, hospital, or nursing home) or outpatient (dental, or non-dental). | |
| 2.1 | type of care applied for(+) | 0;11 | SET OF CODES | 1:DENTAL 2:PLASTIC SURGERY 3:STERILIZATION 4:PREGNANCY 5:ALL OTHER | Enter the type of care that the patient is requesting service for. If the patient will be receiving treatment for plastic surgery, dental care, sterilization, or pregnancy, enter that choice. Otherwise, enter all other. | |
| 3 | facility applying to | 0;4 | POINTER | 40.8 | Enter the facility (division) at which this patient will be receiving care. This is a pointer to the MEDICAL CENTER DIVISION file. | |
| 4 | who entered 10/10 | 0;5 | POINTER | 200 | The user who entered the registration (1010 application) for this patient will automatically be stored in this field. This field can be used for tracking purposes. It should NOT be edited. | |
| 5 | log out date time(+) | 0;6 | DATE-TIME | Enter in this field the date/time the patient was dispositioned. | ||
| 6 | disposition(+) | 0;7 | POINTER | 37 | Enter the type of disposition this patient had. Choose from the available list whether the patient was scheduled for a future appointment, admitted to your facility or another facility, or was released from care without exam, for example. Many other choices also exist. | |
| 8 | reason for late disposition | 0;8 | POINTER | 30 | As part of the 'MAS Parameter Entry/Edit' option, a site can determine how may hours must elapse before a disposition is considered to be entered late. If the time between the registration (log-in) date/time and the disposition (log-out) date/time is found to be more than the number of hours specified in the MAS parameters, the user will be prompted with a reason for the late disposition. This is a pointer to the DISPOSITION LATE REASON file. | |
| 9 | who dispositioned | 0;9 | POINTER | 200 | When a user dispositions a patient, the name of the user will automatically be entered into this field. This field can be used for tracking purposes at the site and should not be edited. | |
| 10 | description of incident | 1;1 | FREE TEXT | If the patient was injured in an accident, a brief description (from 3-250 characters) should be entered detailing what caused the injury. | ||
| 12 | *eligible for medicaid | 0;12 | BOOLEAN | 0:NO 1:YES | If this patient is eligible for medicaid, enter yes in this field. Otherwise, entere no. This field is used for billing purposes. | |
| 13 | registration eligibility code(+) | 0;13 | POINTER | 8 | When a patient is registered, the user registering the patient will be asked for the patient's eligibility under which they are receiving care. The default will be the primary eligibility code. However, if the patient also has other entitled eligibilities (employee, for example), one of the other eligibilities may also be entered. | |
| 14 | elig verified at registration(+) | 0;14 | BOOLEAN | 0:NO 1:YES | If the eligibility was verified at the time of registration, this field will be YES. Otherwise, it will be NO. | |
| 15 | sc at registration(+) | 0;15 | BOOLEAN | 0:NO 1:YES | If the patient being registered was SC (as determined by the SERVICE CONNECTED? field on screen 7 of registration) at the time this application was entered, YES will be stuffed into this field. Otherwise NO will be filled in here. | |
| 16 | sc% at registration(+) | 0;16 | NUMERIC | If the patient was service connected at the time of this registration (as determined by the SERVICE CONNECTED? field on registration screen 7), the service connected percentage should be entered here. The default value will be the percentage entered on registration screen 7. | ||
| 17 | amis 420 segment | 0;17 | POINTER | 391.1 | The AMIS 400 series reports are generated based on data in the DISPOSITION LOG-IN DATE/TIME multiple. When an application is dispositioned, it is deterined by the module which AMIS segment (401-420) this registration should fall into. This information is created automatically by the MAS module. | |
| 18 | outpatient encounter | 0;18 | POINTER | 409.68 | ||
| 19 | encounter conversion status | 0;19 | SET OF CODES | 0:NOT CONVERTED 1:CONVERTED | This field indicates whether or not this disposition was converted during the ACRP Database Conversion (SD*5.3*211). The field is set to '1' after the disposition has been converted by the conversion software. | |
| 20 | need related to occupation(+) | 2;1 | SET OF CODES | Y:YES N:NO U:UNKNOWN | If the need for care is related to an injury or condition acquired while the patient was performing work-related duties, yes should be entered here. Otherwise, no should be entered. | |
| 21 | workmen's comp claim filed | 2;2 | BOOLEAN | Y:YES N:NO | If the injury or condition for which this patient is being treated occurred while performing duties necessary for his/her job and the patient entered a workmen's compensation claim for this injury or condition, enter yes here. Otherwise, enter no. | |
| 22 | workmen's comp claim number | 2;3 | FREE TEXT | If this patient is being seen for an injury or condition s/he received while performing work related duties and s/he filed a claim with workmen's compensation, enter the claim number here. Otherwise, leave this field blank. | ||
| 23 | need related to an accident(+) | 2;4 | SET OF CODES | Y:YES N:NO U:UNKNOWN | If the injury or condition for which this patient is being treated was the result of an accident, enter yes here. Otherwise, answer no. | |
| 24 | injury caused by | 2;5 | FREE TEXT | If the reason this patient is being seen at the medical center is due to an injury sustained, enter what caused the injury. Otherwise, leave this field blank. | ||
| 25 | injuring parties insurance | 2;6 | POINTER | 36 | If the reason this patient is being seen at this medical center is due to an injury sustained and there is a liable party, enter that party's insurance policy number. Otherwise, leave this field blank. | |
| 26 | filed against injuring party | 2;7 | BOOLEAN | Y:YES N:NO | If this patient is being seen is due to an injury resulting from another person's negligence, enter yes here if a claim has been filed against the other party's insurance company. Otherwise, answer no. | |
| 30 | attorney's name | 3;1 | FREE TEXT | Enter the attorney's name in 'LAST,FIRST MIDDLE SUFFIX' format. This value must be 3-30 characters in length and may contain only uppercase alpha characters, spaces, apostrophes, hyphens and one comma. All other characters and parenthetical text will be removed. | ||
| 31 | a-address 1 | 3;2 | FREE TEXT | If the patient is being treated for an injury sustained due to the negligence of another and the patient has an attorney covering the incident, enter the first line the street address for the attorney. | ||
| 32 | a-address 2 | 3;3 | FREE TEXT | If the patient is being treated for an injury sustained due to the negligence of another and the patient has an attorney covering the incident, enter the second line of the street address for the attorney. | ||
| 33 | a-address 3 | 3;4 | FREE TEXT | If the patient is being treated for an injury sustained due to the negligence of another and the patient has an attorney covering the incident, enter the third line of the street address for the attorney. | ||
| 34 | a-city | 3;5 | FREE TEXT | If the patient is being treated for an injury sustained due to the negligence of another and the patient has an attorney covering the incident, enter the city where the attorney practices. | ||
| 35 | a-state | 3;6 | POINTER | 5 | If the patient is being treated for an injury sustained due to the negligence of another and the patient has an attorney covering the incident, enter the the state where the attorney practices. | |
| 36 | a-zip code | 3;7 | FREE TEXT | If the patient is being treated for an injury sustained due to the negligence of another and the patient has an attorney covering the incident, enter the zip code of the attorney's address. | ||
| 37 | a-phone | 3;8 | FREE TEXT | If the patient is being treated for an injury sustained due to the negligence of another and the patient has an attorney covering the incident, enter the the attorney's business phone number. | ||
| 38 | a-zip+4 | 3;9 | FREE TEXT | If the patient is being treated for an injury sustained due to the negligence of another and the patient has an attorney covering the incident, enter the zip code of the attorney's address. Answer with either the 5 digit format (e.g. 12345) or the nine digit format (e.g. 12345-6789 or 123456789). | ||
| 50 | active | 0;10 | SET OF CODES | 1:ACTIVE | ADA | If this registration is currently active (not dispostioned) a 1 will be stored in this field. Otherwise, the field should be left blank. |
| 99 | programmers use | COMPUTED | Used to speed reporting in Multidivisional Facilities. Fileman can not sort by same field twice | |||
| 100.21 | attorney's name components | 0;21 | POINTER | 20 | ||
| 11500.01 | ods at registration? | ODS;1 | BOOLEAN | 1:YES 0:NO | Enter yes if this patient was an ODS patient at the time of this registration. Otherwise, respond no. this registration. Otherwise, respond no. | |
| 11500.02 | ods registration entry | ODS;2 | POINTER | 11500.4 | AODSR | Enter the entry in the ODS REGISTRATIONS file which corresponds to this registration. |
Error: Invalid Global File Type: 2.101