HIPAA patient management

The HIPAA Patient Management template was created to help medical facilities track and manage patient personal, insurance, and payment information, as well as visits, services rendered, and future appointments.

• Built-in Fields
• Service Type (title)—Single-line character field.
• Priority—Drop-down field.
• Status—Drop-down field. Values are: Open, Need More Info, Await Approval, Pending, Closed.
• Description—Multi-line character field.
• Workspace Fields—Up to 100 custom Workspace Fields can be created (no limit in SQL/Access versions) to record information about the incident. Contact information is tracked in the Address Book (see below). Here are some suggested fields for tracking and managing HIPAA Issues.
• Appointment Date (date/time)  
• Provider (drop-down) —Dr. A, Dr. B, Dr. C, Dr. D
• Detail of Service (date/time field)—Multi-line character field.
• Service Code (drop-down) —A0130, A4206, B4034, E1399, H0025, S5100
• Pre-Authorization Number (character field)
• Reminder Call Made (checkbox field)
• Reason for Cancellation (drop-down) —No-Show, Emergency, Scheduling Error, Other
• Cost of Service (character field)
• Copay Received (checkbox field)
• Payment Method (drop-down) —Cash, Check, Credit
• Check Number (character field)
• Credit Card Type (drop-down) —Visa, Discover, American Express, MasterCard
• Cost of Service (character field)
• Credit Card Number (character field)
• Expiration Date (date field)
• Address Book—The Address Book is a sub-database that contains all of the contact information for your organization members. Each record in the Address Book is called a “Contact”. Organization members are referred to as “Contacts” in FootPrints. The Address Book can contain up to 100 fields (SQL/Access versions are unlimited) for employee data, including Name, Department, Phone number, Email address, etc.
• Suggested Address Book Fields
• Last Name (character field)
• Middle Name (character field)
• First Name (character field)
• Patient ID (character field)
• Home Phone (character field)
• Work Phone (character field)
• Address (character field)
• City (character field)
• State (drop-down field)
• Zip (character field)
• Employer (character field)
• DOB (date field)
• SS# (character field)
• Gender (drop-down field)—Female, Male
• Marital Status (drop-down field)—Married, Single, Widowed, Divorced, Separated,  Unknown
• Default Provider (drop-down field)—01-Dr. Jane Smith, 02-Dr. Mark Jones, 03-David Sanders
• Allergies (character field)
• Medications (character field)
• Insurance Company (drop-down field)—Aetna, BCBS, United Healthcare, Cigna
• Group # (character field)
• ID (character field)
• Deductible (character field)
• Copay Amount (character field)
• Relationship to Policy Holder (drop-down field)—Self, Spouse, Parent
• Policy Holder Name (character field)
• Address (Policy Holder) (character field)
• City (Policy Holder) (character field)
• State (Policy Holder) (drop-down field)
• Zip(Policy Holder) (character field)
• SS# (Policy Holder) (character field)
• DOB (Policy Holder) (date field)
• Employer (Policy Holder) (character field)