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Forms - Prescriptions

Paper Form Pull Fields - Prescriptions
Prescriptions pull fields are to be used with the 'Rx' Form Type and will pull data onto paper form templates. Prescriptions pull field categories include:

  • Custom Fields
  • Info
  • Medication
  • Office
  • Patient
  • Patient Allergies
  • Provider

 

Custom Fields

  • Custom Optional: This field will allow the User to manually type data directly onto a paper form when attempting to print said form. This field can be ignored and the form will print without data.
  • Custom Required: This field will allow the User to manually type data directly onto a paper form when attempting to print said form. This field cannot be ignored and MUST contain data before the form will be allowed to print.

 

Info

  • ID: This will display a unique, ascending numeric identifier for each Prescription that is printed.
  • Message: This will display a prewritten patient message that includes the Office Phone number of the office selected from the 'Office' popup found in the selected Prescription record located in the Rx Ability.  The message itself does not have a data entry point and cannot be edited.  The Phone Number will pull from the 'Phone' field located in the selected office Reference.

    "Please read the instructions you receive with your medication very carefully. If you have any questions, please call us at (XXX) XXX-XXXX. If you develop any reaction from this medication please call us immediately."

 

Medication

  • Additional Sig: This will reflect the data as entered in the 'Additional Sig' field found in the selected patient prescription's Rx Window located in the Rx Ability.
  • Brand: This will display the Name of the medication as selected from the 'Medication' field found in the selected patient prescription's Rx Window located in the Rx Ability. 
  • Comments: This will reflect the data as entered in the 'Comments' field located in the selected medication's Reference > Info.
  • Date: This will reflect the current date.
  • Dispense: This will reflect the data as entered in the 'Dispense' field found in the selected patient prescription's Rx Window located in the Rx Ability.
  • Dose Calculation: This will reflect the data as selected from the 'Dose Calc' popup found in the selected patient prescription's Rx Window located in the Rx Ability.
  • Drug Form: This will reflect the data as selected from the 'Drug Form' popup found in the selected patient prescription's Rx Window located in the Rx Ability.
  • Duration: This will reflect the data as entered in the 'Duration' field found in the selected patient prescription's Rx Window located in the Rx Ability.
  • Frequency: This will reflect the data as selected from the 'Frequency' popup found in the selected patient prescription's Rx Window located in the Rx Ability.
  • Generic: This will reflect the data as entered in the 'Generic' field located in the selected medication's Reference > Detail.
    [Note: Nonfunctional]
  • Interactions: This will reflect the data as entered in the 'Interactions' field located in the selected medication's Reference > Info.
  • May Substitute: This will display "May Substitute" or "No Substitutions - Medically Necessary" respective to having selected or deselected the 'May Substitute' checkbox found in the selected patient prescription's Rx Window located in the Rx Ability.
  • May Substitute (True/False): This is a "True/False" pull field that will display an 'X' respective to having selected the 'May Substitute' checkbox found in the selected patient prescription's Rx Window located in the Rx Ability.
    [Note: Functionality is dependent upon pull field formatting. If formatted for "True", an 'X' will display when the checkbox is selected. If formatted for "False", an 'X' will display when the checkbox is deselected.]
  • National Drug Code: This will reflect the data as found/selected from the 'National Drug Code' field found in the selected patient prescription's Rx Window located in the Rx Ability.
  • Prescribed Date: This will reflect the date as entered in the 'Prescribed Date' field found in the selected patient prescription's Rx Window located in the Rx Ability.
    [Note: If a date is not entered in this field it will default to the current date.]
  • Refills: This will reflect the data as entered in the 'Refills' field found in the selected patient prescription's Rx Window located in the Rx Ability.
  • Route: This will reflect the data as selected from the 'Route' popup found in the selected patient prescription's Rx Window located in the Rx Ability.
  • Side Effects: This will reflect the data as entered in the 'Side Effects' field located in the selected medication's Reference > Info.
  • Sig: This will display a Prescription Sig generated by entering/selecting data from the 'Take/Drug Form/Route/Frequency/Duration/Dispense/Refills' fields found found in the selected patient prescription's Rx Window located in the Rx Ability.
  • Special Instructions:  This will reflect the data as entered in the 'Special Instructions / Note to Pharmacist' field found in the selected patient prescription's Rx Window located in the Rx Ability.
  • Started Date: This will reflect the date as entered in the 'Started Date' field found in the selected patient prescription's Rx Window located in the Rx Ability.
  • Status: This will display the selected patient prescription's Status as "Active".
    [Note: Inactive medications CANNOT be printed.]
  • Take: This will reflect the data as entered in the 'Take' field found in the selected patient prescription's Rx Window located in the Rx Ability.

 

Office

  • City: This will display the City of the office selected from the 'Office' popup found in the selected patient prescription's Rx Window. This data will pull from the 'City' field located in the selected office's Reference.
    [Note: This field is inaccessible and can only be changed or updated by the Accounting Department.]
  • Extension: This will display the Phone Extension of the office selected from the 'Office' popup found in the selected patient prescription's Rx Window. This data will pull from the 'Extension' field located in the selected office's Reference.
  • Facility City: This will display the City of the Office's facility for the office selected from the 'Office' popup found in the selected patient prescription's Rx Window. This data will pull from the 'City' field found in the Reference of the facility selected from the Facility table located in the selected office's Reference.
  • Facility Code: This will display the Tax ID of the Office's facility for the office selected from the 'Office' popup found in the selected patient prescription's Rx Window. This data will pull from the 'Facility Tax ID' field found in the Reference of the facility selected from the Facility table located in the selected office's Reference.
  • Facility Code 2: This will display the Secondary Facility ID of the Office's facility for the office selected from the 'Office' popup found in the selected patient prescription's Rx Window. This data will pull from the 'Secondary Facility ID' field found in the Reference of the facility selected from the Facility table located in the selected office's Reference.
  • Facility Name: This will display the Name of the Office's facility for the office selected from the 'Office' popup found in the selected patient prescription's Rx Window. This data will pull from the 'Facility Name' field found in the Reference of the facility selected from the Facility table located in the selected office's Reference.
  • Facility National Provider ID: This will display the NPI of the Office's facility for the office selected from the 'Office' popup found in the selected patient prescription's Rx Window. This data will pull from the 'National Provider ID (NPI)' field found in the Reference of the facility selected from the Facility table located in the selected office's Reference.
  • Facility Phone: This will display the Phone Number of the Office's facility for the office selected from the 'Office' popup found in the selected patient prescription's Rx Window. This data will pull from the 'Phone' field found in the Reference of the facility selected from the Facility table located in the selected office's Reference.
  • Facility State: This will display the State of the Office's facility for the office selected from the 'Office' popup found in the selected patient prescription's Rx Window. This data will pull from the 'State' field found in the Reference of the facility selected from the Facility table located in the selected office's Reference.
  • Facility Street Address: This will display the Street Address of the Office's facility for the office selected from the 'Office' popup found in the selected patient prescription's Rx Window. This data will pull from the 'Street Address' field found in the Reference of the facility selected from the Facility table located in the selected office's Reference.
  • Facility Suite: This will display the Suite Number of the Office's facility for the office selected from the 'Office' popup found in the selected patient prescription's Rx Window. This data will pull from the 'Suite' field found in the Reference of the facility selected from the Facility table located in the selected office's Reference.
  • Facility Zip Code: This will display the Zip Code of the Office's facility for the office selected from the 'Office' popup found in the selected patient prescription's Rx Window. This data will pull from the 'National Provider ID (NPI)' field found in the Reference of the facility selected from the Facility table located in the selected office's Reference.
  • Fax: This will display the Fax Number of the office selected from the 'Office' popup found in the selected patient prescription's Rx Window. This data will pull from the 'Fax' field located in the selected office's Reference.
  • Group NPI Number: This will display the Group NPI of the office selected from the 'Office' popup found in the selected patient prescription's Rx Window. This data will pull from the 'Group National Provider ID Number' field located in the selected office's Reference.
  • ID: This will display the Office ID of the office selected from the 'Office' popup found in the selected patient prescription's Rx Window. This data will pull from the 'Office ID' field located in the selected office's Reference.
  • Is Person: This is a "True/False" pull field that will display an 'X' respective to having selected the 'Office Name refers to an individual' checkbox located in the Reference for the Office selected from the 'Office' popup found in the selected patient prescription's Rx Window.
    [Note: Functionality is dependent upon pull field formatting. If formatted for "True", an 'X' will display when the checkbox is selected. If formatted for "False", an 'X' will display when the checkbox is deselected.]
  • Name: This will display the Name of the office selected from the 'Office' popup found in the selected patient prescription's Rx Window. This data will pull from the 'Office Name' field located in the selected office's Reference.
    [Note: This field is inaccessible and can only be changed or updated by the Accounting Department.]
  • Office Federal Number: This will display the Tax ID of the office selected from the 'Office' popup found in the selected patient prescription's Rx Window. This data will pull from the 'Federal Tax ID' field located in the selected office's Reference.
  • Office Letter Head: This will display the City, State, and Zip Code of the office selected from the 'Office' popup found in the selected patient prescription's Rx Window. This data will pull from the 'City', 'State', and 'Zip Code' fields located in the selected office's Reference.
    [Note: 1) These fields are inaccessible and can only be changed or updated by the Accounting Department. 2) Nonfunctional.]
  • Phone: This will display the Phone Number of the office selected from the 'Office' popup found in the selected patient prescription's Rx Window. This data will pull from the 'Phone' field of the selected office's Reference.
  • State: This will display the State of the office selected from the 'Office' popup found in the selected patient prescription's Rx Window. This data will pull from the 'State' field of the selected office's Reference.
    [Note: This field is inaccessible and can only be changed or updated by the Accounting Department.]
  • Street Address: This will display the Street Address of the office selected from the 'Office' popup found in the selected patient prescription's Rx Window. This data will pull from the 'Street Address' field located in the selected office's Reference.
    [Note: This field is inaccessible and can only be changed or updated by the Accounting Department.]
  • Suite: This will display the Suite Number of the office selected from the 'Office' popup found in the selected patient prescription's Rx Window. This data will pull from the 'Suite' field of the selected office's Reference.
    [Note: This field is inaccessible and can only be changed or updated by the Accounting Department.]
  • Type Of Bill: This will display the Type Of Bill data of the office selected form the 'Office' popup found in the selected patient prescription's Rx Window. This data will pull from the 'Type Of Bill' field located in the selected office's Reference.
  • Zip Code: This will display the Zip Code of the office selected from the 'Office' popup found in the selected patient prescription's Rx Window. This data will pull from the 'Zip Code' field located in the selected office's Reference.
    [Note: This field is inaccessible and can only be changed or updated by the Accounting Department.]

 

Patient

  • Account ID: Upon creation, every new patient account will receive a unique numeric identifier including an additional numeric identifier for every patient tied to that account. This pull field will display the numeric account identifier that was assigned to the account at the moment of creation less the patient identifier.
  • Address State: This will reflect the data as entered in the 'State' field located in Patients > Patient.
  • Address, City: This will reflect the data as entered in the 'City' field located in Patients > Patient.
  • Address, Country: This will reflect the data as entered in the 'Country' field located in Patients > Patient.
  • Address, Street: This will reflect the data as entered in the 'Street Address' field located in Patients > Patient.
  • Address, Suite/Apt#: This will reflect the data as entered in the 'Suite/Apt. Number' field located in Patients > Patient.
  • Address, Zip Code: This will reflect the data as entered in the 'Zip Code' field located in Patients > Patient.
  • Age: This will display the Age of the patient as determined by the date of birth as entered in the 'Birth Date' field located in Patients > Patient.
  • Alert 1: This will display the first Alert record listed in Patients > Patient > Alerts. This data will pull from the 'Patient Alert Description' field located in the selected alert's Reference.
  • Alert 2: This will display the second Alert record listed in Patients > Patient > Alerts. This data will pull from the 'Patient Alert Description' field located in the selected alert's Reference.
  • Alert 3: This will display the third Alert record listed in Patients > Patient > Alerts. This data will pull from the 'Patient Alert Description' field located in the selected alert's Reference.
  • Alert 4: This will display the fourth Alert record listed in Patients > Patient > Alerts. This data will pull from the 'Patient Alert Description' field located in the selected alert's Reference.
  • Alert 5: This will display the fifth Alert record listed in Patients > Patient > Alerts. This data will pull from the 'Patient Alert Description' field located in the selected alert's Reference.
  • Alert 6: This will display the sixth Alert record listed in Patients > Patient > Alerts. This data will pull from the 'Patient Alert Description' field located in the selected alert's Reference.
  • Alert 7: This will display the seventh Alert record listed in Patients > Patient > Alerts. This data will pull from the 'Patient Alert Description' field located in the selected alert's Reference.
  • Alert 8: This will display the eighth Alert record listed in Patients > Patient > Alerts. This data will pull from the 'Patient Alert Description' field located in the selected alert's Reference.
  • Allergy Date Last Checked: This will reflect the date as entered in the 'Last' field located in Patients > Clinical > Allergy.
  • BMI: This will display the patient's Body Mass Index (rounded to the nearest decimal) for the most recent set of vital signs added to Patients > Clinical > Vitals. This data will pull from the 'BMI' field located in the selected record's Vitals Window.
    [Note: 1) The most recent set of vitals is determined by the last record listed in the Vitals tab (most recent date entered in the 'Date Measured' field located in the Vital's Window). 2) nonfunctional.]
  • BP Diastolic: This will display the Diastolic Blood Pressure for the most recent set of vital signs added to Patients > Clinical > Vitals. This data will pull from the rightmost 'Blood Pressure' field (Systolic / Diastolic) located in the selected record's Vitals Window.
    [Note: 1) The most recent set of vitals is determined by the last record listed in the Vitals tab (most recent date entered in the 'Date Measured' field located in the Vital's Window). 2) nonfunctional.]
  • BP Systolic: This will display the Systolic Blood Pressure for the most recent set of vital signs added to the Vitals table located in Patients > Clinical > Vitals. This data will pull from the leftmost 'Blood Pressure' field (Systolic / Diastolic) located in the selected record's Vitals Window.
    [Note: 1) The most recent set of vitals is determined by the last record listed in the Vitals tab (most recent date entered in the 'Date Measured' field located in the Vital's Window). 2) nonfunctional.]
  • Birth Time: This will display the time as entered in the 'Birth Time' field located in the Details window of the 'Birth Date' field located in Patients > Patient.
  • Birthday: This will reflect the date as entered in the 'Birth Date' field located in Patients > Patient.
  • Cause of Death Code: This will display the diagnosis code reflective of the Cause of Death selected from the 'Cause of Death' field located in Patients > Patient > Alerts.
  • Cause of Death Description: This will display the specific description reflective of the Cause of Death selected from the 'Cause of Death' field located in Patients > Patient > Alerts.
  • Cessation Counseling Date: This will display the date that cessation counseling was offered to the patient for the most recently updated Cessation record listed in Patients > Clinical > Smoking (first listed record). This data will pull from the 'Date Offered' field located in the selected records's Smoking Status Window.
  • Cessation Counseling Offered: This is a "True/False" pull field that will display an 'X' respective to having selected the 'Cessation Counseling Offered' checkbox located in the Smoking Status Window of the most recently updated Smoking Status record located in Patients > Clinical > Smoking (first listed record).
    [Note: Functionality is dependent upon pull field formatting. If formatted for "True" an 'X' will display when the checkbox is selected. If formatted for "False" an 'X' will display when the checkbox is not selected.]
  • Chart #: This will reflect the data as entered in the 'Chart #' field located in Patients > Patient.
  • Custom 1: This will display the first Custom record listed in Patients > Patient > Custom. This data will pull from the 'Custom Description' field located in the selected record's Reference.
  • Custom 2: This will display the second Custom record listed in Patients > Patient > Custom. This data will pull from the 'Custom Description' located in the selected record's Reference.
  • Custom 3: This will display the third Custom record listed in Patients > Patient > Custom. This data will pull from the 'Custom Description' located in the selected record's Reference.
  • Custom 4: This will display the fourth Custom record listed in Patients > Patient > Custom. This data will pull from the 'Custom Description' located in the selected record's Reference.
  • Custom 5: This will display the fifth Custom record listed in Patients > Patient > Custom. This data will pull from the 'Custom Description' located in the selected record's Reference.
  • Custom 6: This will display the sixth Custom record listed in Patients > Patient > Custom. This data will pull from the 'Custom Description' located in the selected record's Reference.
  • Custom 7: This will display the seventh Custom record listed in Patients > Patient > Custom. This data will pull from the 'Custom Description' located in the selected record's Reference
  • Custom 8: This will display the eighth Custom record in Patients > Patient > Custom. This data will pull from the 'Custom Description' located in the selected record's Reference.
  • Date: This will display the date the patient's vital signs were measured for the most recent set of vital signs added to Patients > Clinical > Vitals. This data will pull from the 'Date Measured' field located the selected entry's Vitals Window.
    [Note: 1) The most recent set of vitals is determined by the last record listed in the Vitals tab (most recent date entered in the 'Date Measured' field located in the Vital's Window). 2) nonfunctional.]
  • Date of Death: This will reflect the date as entered in the 'Date of Death' field located in Patients > Patient > Alerts.
  • Display ID: Upon creation, every new patient account will receive a unique numeric identifier including a numeric identifier for every patient tied to that account. This pull field will display the full numeric account identifier and numeric patient identifier that were assigned at the moment of creation.
  • EPSTD (Early Periodic Screening Diagnosis and Treatment): This is a "True/False" pull field that will display an 'X' respective to having selected the 'EPSDT' checkbox located in Patients > Patient > Insurance.
    [Note: Functionality is dependent upon pull field formatting. If formatted for "True", an 'X' will display when the checkbox is selected. If formatted for "False", an 'X' will display when the checkbox is deselected.]
  • Email: This will reflect the data as entered in the 'Email Address' field located in Patients > Patient.
  • Emergency Contact 1 First Name: This will display the First Name of the first Emergency Contact record listed in Patients > Patient > Emergency. This data will pull from the 'First Name' field located in the selected record's Emergency Contact Window.
    [Note: The order of the listed emergency contacts is determined by dragging and dropping the entries into the desired order.]
  • Emergency Contact 1 Last Name: This will display the Last Name of the first Emergency Contact record listed in Patients > Patient > Emergency. This data will pull from the 'Last Name' field located in the selected record's Emergency Contact Window.
    [Note: The order of the listed emergency contacts is determined by dragging and dropping the entries into the desired order.]
  • Emergency Contact 1 Phone: This will display the Phone Number of the first Emergency Contact record listed in Patients > Patient > Emergency. This data will pull from the 'Phone' field located in the selected record's Emergency Contact Window.
    [Note: The order of the listed emergency contacts is determined by dragging and dropping the entries into the desired order.]
  • Emergency Contact 1 Relationship: This will display the Relationship of the first Emergency Contact record listed in Patients > Patient > Emergency. This pull field will reflect the data selected from the 'Relationship to Patient' field located in the selected record's Emergency Contact Window.
    [Note: The order of the listed emergency contacts is determined by dragging and dropping the entries into the desired order.]
  • Emergency Contact 2 First Name: This will display the First Name of the second Emergency Contact record listed in Patients > Patient > Emergency. This data will pull from the 'First Name' field located in the selected record's Emergency Contact Window.
    [Note: The order of the listed emergency contacts is determined by dragging and dropping the entries into the desired order.]
  • Emergency Contact 2 Last Name: This will display the Last Name of the second Emergency Contact record listed in Patients > Patient > Emergency. This data will pull from the 'Last Name' field of the selected record's Emergency Contact Window.
    [Note: The order of the listed emergency contacts is determined by dragging and dropping the entries into the desired order.]
  • Emergency Contact 2 Phone: This will display the Phone Number of the second Emergency Contact record listed in Patients > Patient > Emergency. This data will pull from the 'Phone' field located in the selected record's Emergency Contact Window.
    [Note: The order of the listed emergency contacts is determined by dragging and dropping the entries into the desired order.]
  • Emergency Contact 2 Relationship: This will display the Relationship of the second Emergency Contact record listed in Patients > Patient > Emergency. This pull field will reflect the data selected from the 'Relationship to Patient' field located in the selected record's Emergency Contact Window.
    [Note: The order of the listed emergency contacts is determined by dragging and dropping the entries into the desired order.]
  • Emergency Contact 3 First Name: This will display the First Name of the third Emergency Contact record listed in Patients > Patient > Emergency. This data will pull from the 'First Name' field of the selected record's Emergency Contact Window.
    [Note: The order of the listed emergency contacts is determined by dragging and dropping the entries into the desired order.]
  • Emergency Contact 3 Last Name: This will display the Last Name of the third Emergency Contact record listed in Patients > Patient > Emergency. This data will pull from the 'Last Name' field of the selected record's Emergency Contact Window.
    [Note: The order of the listed emergency contacts is determined by dragging and dropping the entries into the desired order.]
  • Emergency Contact 3 Phone: This will display the Phone Number of the third Emergency Contact record listed in Patients > Patient > Emergency. This data will pull from the 'Phone' field located in the selected record's Emergency Contact Window.
    [Note: The order of the listed emergency contacts is determined by dragging and dropping the entries into the desired order.]
  • Emergency Contact 3 Relationship: This will display the Relationship of the third Emergency Contact record listed in Patients > Patient > Emergency. This pull field will reflect the data selected from the 'Relationship to Patient' field located in the selected record's Emergency Contact Window.
    [Note: The order of the listed emergency contacts is determined by dragging and dropping the entries into the desired order.]
  • Emergency Contact 4 First Name: This will display the First Name of the fourth Emergency Contact record listed in Patients > Patient > Emergency. This data will pull from the 'First Name' field of the selected record's Emergency Contact Window.
    [Note: The order of the listed emergency contacts is determined by dragging and dropping the entries into the desired order.]
  • Emergency Contact 4 Last Name: This will display the Last Name of the fourth Emergency Contact record listed in Patients > Patient > Emergency. This data will pull from the 'Last Name' field of the selected record's Emergency Contact Window.
    [Note: The order of the listed emergency contacts is determined by dragging and dropping the entries into the desired order.]
  • Emergency Contact 4 Phone: This will display the Phone Number of the fourth Emergency Contact record listed in Patients > Patient > Emergency. This data will pull from the 'Phone' field located in the selected record's Emergency Contact Window.
    [Note: The order of the listed emergency contacts is determined by dragging and dropping the entries into the desired order.]
  • Emergency Contact 4 Relationship: This will display the Relationship of the fourth Emergency Contact record listed in Patients > Patient > Emergency. This pull field will reflect the data selected from the 'Relationship to Patient' field located in the selected record's Emergency Contact Window.
    [Note: The order of the listed emergency contacts is determined by dragging and dropping the entries into the desired order.]
  • Employment: This will display the numeric code reflective of the selected employment status found in the 'Employment' popup located in Patients > Patient.
  • Employment (Text): This will reflect the Employment Status as selected from the 'Employment' popup located in Patients > Patient.
  • Ethnicity: This will reflect the Ethnicity as selected from the 'Ethnicity' popup located Patients > Patient > Race/Ethnicity.
  • Exception: This will reflect the Exception as selected from the 'Patient Exception' popup located in Patients > Patient > CDA.
    [Note: The 'Use Canadian Claim Fields' checkbox MUST be selected from Preferences > Localization.]
  • Exception - Is Disabled: This will display an 'X' respective to having selected "Disabled" from the 'Patient Exception' popup located in Patients > Patient > CDA.
    [Note: 1) The 'Use Canadian Claim Fields' checkbox MUST be selected from Preferences > Localization. 2) Pull field formatting MUST be set to "Text".]
  • Exception - Is Disabled Student: This will display an 'X' respective to having selected "Disabled Student" from the 'Patient Exception' popup located in Patients > Patient > CDA.
    [Note: 1) The 'Use Canadian Claim Fields' checkbox MUST be selected from Preferences > Localization. 2) Pull field formatting MUST be set to "Text".]
  • Family Planning: This is a "True/False" pull field that will display an 'X' respective to having selected the 'Family Planning' checkbox located in Patients > Patient > Insurance.
    [Note: Functionality is dependent upon pull field formatting. If formatted for "True" an 'X' will display when the checkbox is selected. If formatted for "False" an 'X' will display when the checkbox is not selected.]
  • Fee Schedule Name: This will display the Fee Schedule Name as selected from the 'Fee Schedule' popup located in Patients > Patient.
  • Follow Up/Recall 1 Frequency: This will reflect the Recall Frequency number as displayed/entered in the 'Frequency' field of the first Recall record listed in Patients > Patient > Recalls/Follow-ups. This data will pull from the 'Frequency In Days' field located in the selected recall's Reference but can be edited from the Recalls/Follow-ups tab.
    [Note: The order of the listed recalls is determined by dragging and dropping the entries into the desired order.]
  • Follow Up/Recall 1 Last Visit: This will reflect the date as displayed/entered in the 'Last Visit' field of the first Recall record listed in Patients > Patient > Recalls/Follow-ups. This field will default to the date the selected recall was created on but can be edited.
    [Note: The order of the listed recalls is determined by dragging and dropping the entries into the desired order.]
  • Follow Up/Recall 1 Next Visit: This will reflect the date as displayed/entered in the 'Next Visit' field of the first Recall record listed in Patients > Patient > Recalls/Follow-ups. This field will default to the date as determined by the last visit date plus the frequency number of the selected recall but can be edited.
    [Note: The order of the listed recalls is determined by dragging and dropping the entries into the desired order.]
  • Follow Up/Recall 1 Notes: This will reflect the data as entered in the 'Notes' field of the first Recall record listed in Patients > Patient > Recalls/Follow-ups.
    [Note: The order of the listed recalls is determined by dragging and dropping the entries into the desired order.]
  • Follow Up/Recall 1 Type: This will display the Recall Type as found under the 'Type' column of the first Recall record listed in Patients > Patient > Recalls. This data will pull from the 'Recall' field of the selected recall's Reference.
    [Note: The order of the listed recalls is determined by dragging and dropping the entries into the desired order.]
  • Follow Up/Recall 2 Frequency: This will reflect the Recall Frequency number as displayed/entered in the 'Frequency' field of the second Recall record listed in Patients > Patient > Recalls/Follow-ups. This data will pull from the 'Frequency In Days' field located in the selected recall's Reference but can be edited from the Recalls/Follow-ups tab.
    [Note: The order of the listed recalls is determined by dragging and dropping the entries into the desired order.]
  • Follow Up/Recall 2 Last Visit: This will reflect the date as displayed/entered in the 'Last Visit' field of the second Recall record listed in Patients > Patient > Recalls/Follow-ups. This field will default to the date the selected recall was created on but can be edited.
    [Note: The order of the listed recalls is determined by dragging and dropping the entries into the desired order.]
  • Follow Up/Recall 2 Next Visit: This will reflect the date as displayed/entered in the 'Next Visit' field of the second Recall record listed in Patients > Patient > Recalls/Follow-ups. This field will default to the date as determined by the last visit date plus the frequency number of the selected recall but can be edited.
    [Note: The order of the listed recalls is determined by dragging and dropping the entries into the desired order.]
  • Follow Up/Recall 2 Notes: This will reflect the data as entered in the 'Notes' field of the second Recall record listed in Patients > Patient > Recalls/Follow-ups.
    [Note: The order of the listed recalls is determined by dragging and dropping the entries into the desired order.]
  • Follow Up/Recall 2 Type: This will display the Recall Type as found under the 'Type' column of the second Recall record listed in Patients > Patient > Recalls/Follow-ups. This data will pull from the 'Recall' field of the selected recall's Reference.
    [Note: The order of the listed recalls is determined by dragging and dropping the entries into the desired order.]
  • Follow Up/Recall 3 Frequency: This will reflect the Recall Frequency number as displayed/entered in the 'Frequency' field of the third Recall record listed in Patients > Patient > Recalls/Follow-ups. This data will pull from the 'Frequency In Days' field located in the selected recall's Reference but can be edited from the Recalls/Follow-ups tab.
    [Note: The order of the listed recalls is determined by dragging and dropping the entries into the desired order.]
  • Follow Up/Recall 3 Last Visit: This will reflect the date as displayed/entered in the 'Last Visit' field of the third Recall record listed in Patients > Patient > Recalls/Follow-ups. This field will default to the date the selected recall was created on but can be edited.
    [Note: The order of the listed recalls is determined by dragging and dropping the entries into the desired order.]
  • Follow Up/Recall 3 Next Visit: This will reflect the date as displayed/entered in the 'Next Visit' field of the third Recall record listed in Patients > Patient > Recalls/Follow-ups. This field will default to the date as determined by the last visit date plus the frequency number of the selected recall but can be edited.
    [Note: The order of the listed recalls is determined by dragging and dropping the entries into the desired order.]
  • Follow Up/Recall 3 Notes: This will reflect the data as entered in the 'Notes' field of the third Recall record listed in Patients > Patient > Recalls/Follow-ups.
    [Note: The order of the listed recalls is determined by dragging and dropping the entries into the desired order.]
  • Follow Up/Recall 3 Type: This will display the Recall Type as found under the 'Type' column of the third Recall record listed in Patients > Patient > Recalls/Follow-ups. This data will pull from the 'Recall' field of the selected recall's Reference.
    [Note: The order of the listed recalls is determined by dragging and dropping the entries into the desired order.]
  • Follow Up/Recall 4 Frequency: This will reflect the Recall Frequency number as displayed/entered in the 'Frequency' field of the fourth Recall record listed in Patients > Patient > Recalls/Follow-ups. This data will pull from the 'Frequency In Days' field located in the selected recall's Reference but can be edited from the Recalls/Follow-ups tab.
    [Note: The order of the listed recalls is determined by dragging and dropping the entries into the desired order.]
  • Follow Up/Recall 4 Last Visit: This will reflect the date as displayed/entered in the 'Last Visit' field of the fourth Recall record listed in Patients > Patient > Recalls/Follow-ups. This field will default to the date the selected recall was created on but can be edited.
    [Note: The order of the listed recalls is determined by dragging and dropping the entries into the desired order.]
  • Follow Up/Recall 4 Next Visit: This will reflect the date as displayed/entered in the 'Next Visit' field of the fourth Recall record listed in Patients > Patient > Recalls/Follow-ups. This field will default to the date as determined by the last visit date plus the frequency number of the selected recall but can be edited.
    [Note: The order of the listed recalls is determined by dragging and dropping the entries into the desired order.]
  • Follow Up/Recall 4 Notes: This will reflect the data as entered in the 'Notes' field of the fourth Recall record listed in Patients > Patient > Recalls/Follow-ups.
    [Note: The order of the listed recalls is determined by dragging and dropping the entries into the desired order.]
  • Follow Up/Recall 4 Type: This will display the Recall Type as found under the 'Type' column of the fourth Recall record listed in Patients > Patient > Recalls/Follow-ups. This data will pull from the 'Recall' field of the selected recall's Reference.
    [Note: The order of the listed recalls is determined by dragging and dropping the entries into the desired order.]
  • Follow Up/Recall 5 Frequency: This will reflect the Recall Frequency number as displayed/entered in the 'Frequency' field of the fifth Recall record listed in Patients > Patient > Recalls/Follow-ups. This data will pull from the 'Frequency In Days' field located in the selected recall's Reference but can be edited from the Recalls/Follow-ups tab.
    [Note: The order of the listed recalls is determined by dragging and dropping the entries into the desired order.]
  • Follow Up/Recall 5 Last Visit: This will reflect the date as displayed/entered in the 'Last Visit' field of the fifth Recall record listed in Patients > Patient > Recalls/Follow-ups. This field will default to the date the selected recall was created on but can be edited.
    [Note: The order of the listed recalls is determined by dragging and dropping the entries into the desired order.]
  • Follow Up/Recall 5 Next Visit: This will reflect the date as displayed/entered in the 'Next Visit' field of the fifth Recall record listed in Patients > Patient > Recalls/Follow-ups. This field will default to the date as determined by the last visit date plus the frequency number of the selected recall but can be edited.
    [Note: The order of the listed recalls is determined by dragging and dropping the entries into the desired order.]
  • Follow Up/Recall 5 Notes: This will reflect the data as entered in the 'Notes' field of the fifth Recall record listed in Patients > Patient > Recalls/Follow-ups.
    [Note: The order of the listed recalls is determined by dragging and dropping the entries into the desired order.]
  • Follow Up/Recall 5 Type: This will display the Recall Type as found under the 'Type' column of the fifth Recall record listed in Patients > Patient > Recalls/Follow-ups. This data will pull from the 'Recall' field of the selected recall's Reference.
    [Note: The order of the listed recalls is determined by dragging and dropping the entries into the desired order.]
  • Follow Up/Recall 6 Frequency: This will reflect the Recall Frequency number as displayed/entered in the 'Frequency' field of the sixth Recall record listed in Patients > Patient > Recalls/Follow-ups. This data will pull from the 'Frequency In Days' field located in the selected recall's Reference but can be edited from the Recalls/Follow-ups tab.
    [Note: The order of the listed recalls is determined by dragging and dropping the entries into the desired order.]
  • Follow Up/Recall 6 Last Visit: This will reflect the date as displayed/entered in the 'Last Visit' field of the sixth Recall record listed in Patients > Patient > Recalls/Follow-ups. This field will default to the date the selected recall was created on but can be edited.
    [Note: The order of the listed recalls is determined by dragging and dropping the entries into the desired order.]
  • Follow Up/Recall 6 Next Visit: This will reflect the date as displayed/entered in the 'Next Visit' field of the sixth Recall record listed in Patients > Patient > Recalls/Follow-ups. This field will default to the date as determined by the last visit date plus the frequency number of the selected recall but can be edited.
    [Note: The order of the listed recalls is determined by dragging and dropping the entries into the desired order.]
  • Follow Up/Recall 6 Notes: This will reflect the data as entered in the 'Notes' field of the sixth Recall record listed in Patients > Patient > Recalls/Follow-ups.
    [Note: The order of the listed recalls is determined by dragging and dropping the entries into the desired order.]
  • Follow Up/Recall 6 Type: This will display the Recall Type as found under the 'Type' column of the sixth Recall record listed in Patients > Patient > Recalls/Follow-ups. This data will pull from the 'Recall' field of the selected recall's Reference.
    [Note: The order of the listed recalls is determined by dragging and dropping the entries into the desired order.]
  • Follow Up/Recall 7 Frequency: This will reflect the Recall Frequency number as displayed/entered in the 'Frequency' field of the seventh Recall record listed in Patients > Patient > Recalls/Follow-ups. This data will pull from the 'Frequency In Days' field located in the selected recall's Reference but can be edited from the Recalls/Follow-ups tab.
    [Note: The order of the listed recalls is determined by dragging and dropping the entries into the desired order.]
  • Follow Up/Recall 7 Last Visit: This will reflect the date as displayed/entered in the 'Last Visit' field of the seventh Recall record listed in Patients > Patient > Recalls/Follow-ups. This field will default to the date the selected recall was created on but can be edited.
    [Note: The order of the listed recalls is determined by dragging and dropping the entries into the desired order.]
  • Follow Up/Recall 7 Next Visit: This will reflect the date as displayed/entered in the 'Next Visit' field of the seventh Recall record listed in Patients > Patient > Recalls/Follow-ups. This field will default to the date as determined by the last visit date plus the frequency number of the selected recall but can be edited.
    [Note: The order of the listed recalls is determined by dragging and dropping the entries into the desired order.]
  • Follow Up/Recall 7 Notes: This will reflect the data as entered in the 'Notes' field of the seventh Recall record listed in Patients > Patient > Recalls/Follow-ups.
    [Note: The order of the listed recalls is determined by dragging and dropping the entries into the desired order.]
  • Follow Up/Recall 7 Type: This will display the Recall Type as found under the 'Type' column of the seventh recall Recall listed in Patients > Patient > Recalls/Follow-ups. This data will pull from the 'Recall' field of the selected recall's Reference. [Note: The order of the listed recalls is determined by dragging and dropping the entries into the desired order.]
  • Follow Up/Recall 8 Frequency: This will reflect the Recall Frequency number as displayed/entered in the 'Frequency' field of the eighth Recall record in Patients > Patient > Recalls/Follow-ups. This data will pull from the 'Frequency In Days' field located in the selected recall's Reference but can be edited from the Recalls/Follow-ups tab.
    [Note: The order of the listed recalls is determined by dragging and dropping the entries into the desired order.]
  • Follow Up/Recall 8 Last Visit: This will reflect the date as displayed/entered in the 'Last Visit' field of the eighth Recall record listed in Patients > Patient > Recalls/Follow-ups. This field will default to the date the selected recall was created on but can be edited.
    [Note: The order of the listed recalls is determined by dragging and dropping the entries into the desired order.]
  • Follow Up/Recall 8 Next Visit: This will reflect the date as displayed/entered in the 'Next Visit' field of the eighth Recall record listed Patients > Patient > Recalls/Follow-ups. This field will default to the date as determined by the last visit date plus the frequency number of the selected recall but can be edited.
    [Note: The order of the listed recalls is determined by dragging and dropping the entries into the desired order.]
  • Follow Up/Recall 8 Notes: This will reflect the data as entered in the 'Notes' field of the eighth Recall record listed in Patients > Patient > Recalls/Follow-ups.
    [Note: The order of the listed recalls is determined by dragging and dropping the entries into the desired order.]
  • Follow Up/Recall 8 Type: This will display the Recall Type as found under the 'Type' column of the eighth Recall record listed Patients > Patient > Recalls/Follow-ups. This data will pull from the 'Recall' field of the selected recall's Reference.
    [Note: The order of the listed recalls is determined by dragging and dropping the entries into the desired order.]
  • Follow Up/Recall Appointment: This will display the date of the scheduled Recall Appointment for the first Recall record listed in Patients > Patient > Recalls/Follow-ups.
    [Note: The order of the listed recalls is determined by dragging and dropping the entries into the desired order.]
  • Follow Up/Recall Appointment Note: This will display the Notes of the scheduled recall appointment for the first Recall record in Patients > Patient > Recalls/Follow-ups. This data will pull from the 'Notes' field located in the Appointment Detail Window of the scheduled appointment for the selected recall.
    [Note: The order of the listed recalls is determined by dragging and dropping the entries into the desired order.]
  • Follow Up/Recall Appointment Time: This will display the Appointment Start Time of the scheduled recall appointment for the first Recall record listed in Patients > Patient > Recalls/Follow-ups.
    [Note: The order of the listed recalls is determined by dragging and dropping the entries into the desired order.]
  • Follow Up/Recall Appointment Frequency: This will reflect the data as displayed/entered in the 'Frequency' field of the first Recall record listed in Patients > Patient > Recalls/Follow-ups (after being tied to a scheduled appointment). This data will pull from the 'Frequency In Days' field located in the selected recall's Reference but can be edited from the Recalls/Follow-ups tab.
    [Note: The order of the listed recalls is determined by dragging and dropping the entries into the desired order.]
  • Follow Up/Recall Last Recall: This will reflect the date as displayed/entered in the 'Last Visit' field of the Recall record with the most recent last visit date listed in Patients > Patient > Recalls/Follow-ups. This field will default to the date the selected recall was created on but can be edited.
    [Note: The order of the listed recalls is determined by dragging and dropping the entries into the desired order.]
  • Follow Up/Recall Next Recall: This will reflect the date as displayed/entered in the 'Next Visit' field of the Recall record with the closest next visit date listed in Patients > Patient > Recalls/Follow-ups. This field will default to the date as determined by the last visit date plus the frequency number of the selected recall but can be edited.
    [Note: The order of the listed recalls is determined by dragging and dropping the entries into the desired order.]
  • Follow Up/Recall Recall: This will display the date as found under the 'Recall Date' column of the first Recall record listed in Patients > Patient > Recalls/Follow-ups.
    [Note: The order of the listed recalls is determined by dragging and dropping the entries into the desired order.]
  • Follow Up/Recall Type: This will display the Recall Type as found under the 'Type' column of the first Recall record listed in Patients > Patient > Recalls/Follow-ups.
    [Note: The order of the listed recalls is determined by dragging and dropping the entries into the desired order.]
  • Formatted Age: This will display the Age of the patient followed by a 'y' as determined by the date of birth as entered in the 'Birth Date' field located in Patients > Patient.
  • Gender Pronoun (He/She): This will display "he" or "she" respective to having selected "Male" or "Female" from the 'Sex' popup located in Patients > Patient.
  • Gender Pronoun (Him/Her): This will display "him" or "her" respective to having selected "Male" or "Female" from the 'Sex' popup located in Patients > Patient.
  • Gender Pronoun (His/Her): This will display "his" or "hers" respective to having selected "Male" or "Female" from the 'Sex' popup located in Patients > Patient.
  • HIPAA Release: This will reflect the data as selected from the 'HIPAA Release' popup located in Patients > Patient > Insurance.
  • HIPAA Release Date: This will reflect the date as entered in the 'Date' field located in Patients > Patient > Insurance. 
  • Heart Rate: This will display the Heart Rate as found under the 'Heart Rate' column of the most recent set of vital signs entered in the Vitals table located in Patients > Clinical > Vitals. This data will pull from the 'Heart Rate' field located in the selected entry's Vitals Window.
    [Note: 1) The most recent set of vitals is determined by the last record listed in the Vitals tab (most recent date entered in the 'Date Measured' field located in the Vital's Window). 2) nonfunctional.]
  • Height: This will display the Height as found under the 'Height/Length' column of the most recent set of vital signs entered in the Vitals table located in Patients > Clinical > Vitals. This data will pull from the 'Length/Height' field located in the selected entry's Vitals Window.
    [Note: 1) The most recent set of vitals is determined by the last record listed in the Vitals tab (most recent date entered in the 'Date Measured' field located in the Vital's Window). 2) nonfunctional.]
  • Home Phone: This will reflect the data as entered in a 'Number' field located in Patients > Patient.
    [Note: The 'Number' field's adjoining 'Type' popup MUST be set to "Home Phone".]
  • Home Phone Extension: This will reflect the data as entered in an 'Ext' field located in Patients > Patient.
    [Note: The 'Ext' field's adjoining 'Type' popup MUST be set to "Home Phone".]
  • Hygienist First Name: This will display the First Name of the hygienist selected from the 'Preferred Hygienist' popup located in Patients > Patient. This data will pull from the 'First' field located in the selected hygienist's Reference.
  • Hygienist ID: This will display the User ID of the hygienist selected from the 'Preferred Hygienist' popup located in Patients > Patient. This data will pull from the 'User ID' field located in the selected hygienist's Reference.
  • Hygienist Last Name: This will display the Last Name of the hygienist selected from the 'Preferred Hygienist' popup located in Patients > Patient. This data will pull from the 'Last' field located in the selected hygienist's Reference.
  • Hygienist Middle Name: This will display the Middle Name of the hygienist selected from the 'Preferred Hygienist' popup located in Patients > Patient. This data will pull from the 'Middle' field located in the selected hygienist's Reference.
  • Is Employed: This is a "True/False" pull field that will display an 'X' respective to having selected "Employed", "Self-Employed", or "Active Military" from the 'Employment' popup located in Patients > Patient.
    [Note: Functionality is dependent upon pull field formatting. If formatted for "True" an 'X' will display when any of these items are selected. If formatted for "False" an 'X' will display when none of these items are selected.]
  • Is Female: This is a "True/False" pull field that will display an 'X' respective to having selected "Female" from the 'Sex' popup located in Patients > Patient.
    [Note: Functionality is dependent upon pull field formatting. If formatted for "True" an 'X' will display when "Female" is selected. If formatted for "False" an 'X' will display when "Male" is selected.]
  • Is Full Time Student: This is a "True/False" pull field that will display an 'X' respective to having selected "Full-Time Student" from the 'Employment' popup located in Patients > Patient.
    [Note: Functionality is dependent upon pull field formatting. If formatted for "True" an 'X' will display when "Full-Time Student" is selected. If formatted for "False" an 'X' will display when "Full-Time Student" is not selected.]
  • Is Male: This is a "True/False" pull field that will display an 'X' respective to having selected "Male" from the 'Sex' popup located in Patients > Patient.
    [Note: Functionality is dependent upon pull field formatting. If formatted for "True" an 'X' will display when "Male" is selected. If formatted for "False" an 'X' will display when "Female" is selected.]
  • Is Marital Status Other: This is a "True/False" pull field that will display an 'X' respective to having selected "Legally Separated", "Divorced", "Widowed", "Unknown", or "Partner" from the 'Marital Status' popup located in Patients > Patient.
    [Note: Functionality is dependent upon pull field formatting. If formatted for "True" an 'X' will display when any of these items are selected. If formatted for "False" an 'X' will display when none of these items are selected.]
  • Is Married: This is a "True/False" pull field that will display an 'X' respective to having selected "Married" from the 'Marital Status' popup located in Patients > Patient.
    [Note: Functionality is dependent upon pull field formatting. If formatted for "True" an 'X' will display when "Married" is selected. If formatted for "False" an 'X' will display when "Married" is not selected.]
  • Is Part Time Student: This is a "True/False" pull field that will display an 'X' respective to having selected "Part-Time Student" from the 'Employment' popup located in Patients > Patient.
    [Note: Functionality is dependent upon pull field formatting. If formatted for "True" an 'X' will display when "Part-Time Student" is selected. If formatted for "False" an 'X' will display when "Part-Time Student" is not selected.]
  • Is Single: This is a "True/False" pull field that will display an 'X' respective to having selected "Single" from the 'Marital Status' popup located in Patients > Patient.
    [Note: Functionality is dependent upon pull field formatting. If formatted for "True" an 'X' will display when "Single" is selected. If formatted for "False" an 'X' will display when "Single" is not selected.]
  • Last Appointment: This will display the date of the patient's most recent past appointment, starting with the current date.
  • Last Appointment Time: This will display the Appointment Start Time of the patient's most recent past appointment, starting with the current date.
  • Last Visit: This will reflect the Procedure Date as entered in the 'Procedure Date' field located in the Charge Window of most recent charge on the patient's ledger.
  • Marital Status (S/M/X/D/W/P/U): This will display a letter respective to having selected "Single (S)", "Married (M)", "Legally Separated (X)", "Divorced (D)", "Widowed (W)", "Partner (P)", or "Unknown (U)" from the 'Marital Status' popup located in Patients > Patient.
  • Medicare Expiration: This will reflect the date as entered in the 'Medicare Expiration' field located in Patients > Patient.
    [Note: "Medicare" MUST be selected from the 'SSN/Medicare' popup located in Preferences > Localization.]
  • Mobile Phone: This will reflect the data as entered in a 'Number' field located in Patients > Patient.
    [Note: The 'Number' field's adjoining 'Type' popup MUST be set to "Mobile Phone".]
  • Mobile Phone Extension: This will reflect the data as entered in an 'Ext' field located in Patients > Patient.
    [Note: The 'Ext' field's adjoining 'Type' popup MUST be set to "Mobile Phone".]
  • Name: This will reflect the data as entered in the 'First Name', 'Middle Name', and 'Last Name' fields located in Patients > Patient.
    [Note: This pull field will display the data as "first name, middle initial, last name (John X. Doe).]
  • Name (Last, First Mi): This will reflect the data as entered in the 'First Name', 'Middle Name', and 'Last Name' fields located in Patients > Patient.
    [Note: This pull field will display the data as "last name, first name, middle initial (Doe, John X.).]
  • Name, First: This will reflect the data as entered in the 'First Name' field located in Patients > Patient.
  • Name, Last: This will reflect the data as entered in the 'Last Name' field located in Patients > Patient.
  • Name, Maiden: This will reflect the data as entered in the 'Maiden Name' field located in Patients > Patient.
  • Name, Middle: This will reflect the data as entered in the 'Middle Name' field located in Patients > Patient.
  • Name, Nickname: This will reflect the data as entered in the 'Nickname' field located in Patients > Patient.
  • Name, Prefix: This will reflect the data as entered in the 'Prefix' field located in Patients > Patient.
  • Name, Suffix: This will reflect the data as entered in the 'Suffix' field located in Patients > Patient.
  • New Patient Date: This will reflect the date as entered in the 'New Patient Date' located in Patients > Patient.
  • Next Appointment: This will display the Appointment Date of the patient's next scheduled appointment in the future excluding the current date.
  • Next Appointment Time: This will display the Appointment Start Time of the patient's next scheduled appointment in the future, excluding the current date.
  • Notes: This will reflect the data as entered in the 'Notes' field located Patients > Patient > Notes.
  • Office ID: This will display the Office ID of the office selected from the 'Office' popup located in Patients > Patient. This data will pull from the 'Office ID' field located in the selected office's Reference.
  • Office Name: This will display the Name of the office selected from the 'Office' popup located in Patients > Patient. This data will pull from the 'Office Name' field located in the selected office's Reference.
    [Note: This field is inaccessible and MUST be changed or updated through the Accounting Department.]
  • Other Phone: This will reflect the data as entered in a 'Number' field located in Patients > Patient.
    [Note: The 'Number' field's adjoining 'Type' popup MUST be set to "Other Phone".]
  • Other Phone Extension: This will reflect the data as entered in an 'Ext' field located in Patients > Patient.
    [Note: The 'Ext' field's adjoining 'Type' popup MUST be set to "Other Phone".]
  • Patient Balance 120 Days: This will display the total past due Account Balance for any charges that are between 121 and 150 days old.
    [Note: Aging is determined starting from the procedure date.]
  • Patient Balance 120 Plus Days: This will display the total past due Account Balance for any open charges that are over 120 days old.
    [Note: Aging is determined starting from the procedure date.]
  • Patient Balance 150 Plus Days: This will display the total past due Account Balance for any open charges that are over 150 days old.
    [Note: Aging is determined starting from the procedure date.]
  • Patient Balance 30 Days: This will display the total past due Account Balance for any open charges that are between 31 and 60 days old.
    [Note: Aging is determined starting from the procedure date.]
  • Patient Balance 60 Days: This will display the total past due Account Balance for any open charges that are between 61 and 90 days old.
    [Note: Aging is determined starting from the procedure date.]
  • Patient Balance 90 Days: This will display the total past due Account Balance for any open charges that are between 91 and 120 days old.
    [Note: Aging is determined starting from the procedure date.]
  • Patient Balance Current: This will display the total Account Balance for any open charges that are between 1 and 30 days old.
    [Note: Aging is determined starting from the procedure date.]
  • Patient Balance Total: This will display the total Account Balance.
  • Patient Portion Balance 120 Days: This will display the total past due Patient Portion balance for any charges that are between 121 and 150 days old.
    [Note: Aging is determined starting from the procedure date.]
  • Patient Portion Balance 120 Plus Days: This will display the total past due Patient Portion balance for any open charges that are over 120 days old.
    [Note: Aging is determined starting from the procedure date.]
  • Patient Portion Balance 150 Plus Days: This will display the total past due Patient Portion balance for any open charges that are over 150 days old.
    [Note: Aging is determined starting from the procedure date.]
  • Patient Portion Balance 30 Days: This will display the total past due Patient Portion balance for any open charges that are between 31 and 60 days old.
    [Note: Aging is determined starting from the procedure date.]
  • Patient Portion Balance 60 Days: This will display the total past due Patient Portion balance for any open charges that are between 61 and 90 days old.
    [Note: Aging is determined starting from the procedure date.]
  • Patient Portion Balance 90 Days: This will display the total past due Patient Portion balance for any open charges that are between 91 and 120 days old.
    [Note: Aging is determined starting from the procedure date.]
  • Patient Portion Balance Current: This will display the total Patient Portion balance for any open charges that are between 1 and 30 days old.
    [Note: Aging is determined starting from the procedure date.]
  • Patient Portion Balance Total: This will display the total Patient Portion balance.
  • Patients Recent Image: This will display the selected patient's most recent Patient Photo located in Attachments > Patient Photos.
    [Note: The patient's photos may also be found in the Patient Photo popup button located below the sidebar.]
  • Preferred Language: This will reflect the Language as selected from the 'Preferred Language' popup located in Patients > Patient.
  • Primary Relationship: This will reflect the Relationship as selected from the 'Relationship to Primary' popup located in Patients > Patient.
  • Provider First Name: This will display the First Name of the provider selected from the 'Provider' popup located in Patients > Patient. This data will pull from the 'First' field located in the selected provider's User Reference.
  • Provider ID: This will display the Provider ID of the provider selected from the 'Provider' popup located in Patients > Patient. This data will pull from the 'User ID' field located in the selected provider's User Reference > User Information.
  • Provider Last Name: This will display the Last Name of the provider selected from the 'Provider' popup located in Patients > Patient. This data will pull from the 'Last' field located in the selected provider's User Reference.
  • Provider Middle Name: This will display the Middle Name of the provider selected from the 'Provider' popup located in Patients > Patient. This data will pull from the 'Middle' field located in the selected provider's User Reference.
  • Provider Prof. Title: This will display the Professional Title of the provider selected from the 'Provider' popup located in Patients > Patient. This data will pull from the 'Professional Title' field located in the selected provider's User Reference.
  • Race: This will display any Race listed in Patients > Patient > Race/Ethnicity.
    [Note: The order of the listed races is determined by dragging and dropping the entries into the desired order.]
  • Respiration: This will display the Respiration Rate as found under the 'Respiration Rate' column of the most recent set of vital signs entered in the Vitals table located in Patients > Clinical > Vitals. This data will pull from the 'Respiration rate' field located in the selected entry's Vitals Window.
    [Note: 1) The most recent set of vitals is determined by the last record listed in the Vitals tab (most recent date entered in the 'Date Measured' field located in the Vital's Window). 2) nonfunctional.]
  • SPO2: This will display the Peripheral Capillary Oxygen Saturation as found under the 'Sp 02' column  of the most recent set of vital signs entered in the Vitals table located in Patients > Clinical > Vitals. This data will pull from the 'Sp 02' field located in the selected entry's Vitals Window.
    [Note: 1) The most recent set of vitals is determined by the last record listed in the Vitals tab (most recent date entered in the 'Date Measured' field located in the Vital's Window). 2) nonfunctional.]
  • SSN: This will reflect the data as entered in the 'Social Security' field located in Patients > Patient.
  • SSN Last 4: This will reflect last 4 digits of the SSN as entered in the 'Social Security' filed located in Patients > Patient.
  • School City: This will reflect the data as entered in the 'City' field located in Patients > Patient > CDA.
    [Note: The 'Use Canadian Claim Fields' checkbox MUST be selected from Preferences > Localization.]
  • School Name: This will reflect the data as entered in the 'School Name' field located in Patients > Patient > CDA.
    [Note: The 'Use Canadian Claim Fields' checkbox MUST be selected from Preferences > Localization.]
  • School State: This will reflect the data as entered in the 'State' field located in Patients > Patient > CDA.
    [Note: The 'Use Canadian Claim Fields' checkbox MUST be selected from Preferences > Localization.]
  • School Street Address: This will reflect the data as entered in the 'Street Address' field located in Patients > Patient > CDA.
    [Note: The 'Use Canadian Claim Fields' checkbox MUST be selected from Preferences > Localization.]
  • School Suite: This will reflect the data as entered in the 'Suite/Apt #' field located in Patients > Patient > CDA.
    [Note: The 'Use Canadian Claim Fields' checkbox MUST be selected from Preferences > Localization.]
  • School Zip Code: This will reflect the data as entered in the 'Zip/Postal Code' field located in Patients > Patient > CDA.
    [Note: The 'Use Canadian Claim Fields' checkbox MUST be selected from Preferences > Localization.]
  • Secondary Relationship: This will reflect the relationship as selected from the 'Relationship to Secondary' popup located in Patients > Patient.
  • Sex: This will display a numeric code reflective of the data selected from the 'Sex' popup located in Patients > Patient.
    • Male: 0
    • Female: 1
    • Unknown: 2
  • Sex (M/F): This will display an 'M' or an 'F' respective to having selected "Male" or "Female" from the 'Sex' popup located in Patients > Patient.
  • Sex (male/female): This will display "male" or "female" respective to having selected "Male" or "Female" from the 'Sex' popup located in Patients > Patient.
  • Smoking Quit Date: This will reflect the date as displayed in the 'Quit Date' column of the first status listed in Patients > Clinical > Smoking. This data will pull from the 'End Date' field located in the selected entry's Smoking Status Window.
    [Note: The first smoking status listed is determined by the most recent smoking status entry or update.]
  • Smoking Start Date: This will reflect the date as displayed in the 'Start Date' column of the first status listed in Patients > Clinical > Smoking. This data will pull from the 'Start Date' field located in the selected entry's Smoking Status Window.
    [Note: The first smoking status listed is determined by the most recent smoking status entry or update.]
  • Smoking Status: This will reflect the data as displayed in the 'Smoking Status' column of the first status listed in Patients > Clinical > Smoking. This data will pull from the 'Smoking Status' popup located in the selected entry's Smoking Status Window.
    [Note: The first smoking status listed is determined by the most recent smoking status entry or update.]
  • Smoking Status Updated: This will reflect the date as displayed in the 'Start Date' column of the most recently updated entry listed in Patients > Clinical > Smoking.
    [Note: The first smoking status listed is determined is by the most recent smoking status entry or update.]
  • Temperature: This will display the Body Temperature as found under the 'Temperature' column of the most recent set of vital signs entered in the Vitals t located in Patients > Clinical > Vitals. This data will pull from the 'Temp' field located in the selected entry's Vitals Window.
    [Note: 1) The most recent set of vitals is determined by the last record listed in the Vitals tab (most recent date entered in the 'Date Measured' field located in the Vital's Window). 2) nonfunctional.]
  • Weight: This will display the Weight as found under the 'Weight' column of the most recent set of vital signs entered in the Vitals table located in Patients > Clinical > Vitals. This data will pull from the 'Weight' field located in the selected entry's Vitals Window.
    [Note: The most recent set of vitals is determined by the last record listed in the Vitals tab (most recent date entered in the 'Date Measured' field located in the Vital's Window).]
  • Work Phone: This will reflect the data as entered in a 'Number' field located in Patients > Patient.
    [Note: The 'Number' field's adjoining 'Type' popup MUST be set to "Work Phone".]
  • Work Phone Extension: This will reflect the data as entered in an 'Ext' field located in Patients > Patient.
    [Note: The 'Ext' field's adjoining 'Type' popup MUST be set to "Work Phone".]

 

Patient Allergies
Number of items to display and row offset determined by Form Rules.
[Note: Default Form Rules: Max Items - 1; Row Offset - 0.00]

  • Allergy: This will display the Allergy Description as found under the 'Allergy' column for any active Allergy record as listed in Patients > Clinical > Allergy.
    [Note: The order of the listed allergies is determined by dragging and dropping the entries into the desired order when the 'Allergy' popup is set to "All".]
  • Allergy Date Last Checked: This will reflect the date as entered in the 'Last' field located in Patients > Clinical > Allergy.
  • Allergy Identified Date: This will reflect the date as entered in the 'Identified Date' field for any active Allergy record listed in Patients > Clinical > Allergy.
    [Note: The order of the listed allergies is determined by dragging and dropping the entries into the desired order when the 'Allergy' popup is set to "All".]
  • Allergy Note: This will reflect the data as entered in any 'Notes' field for any active Allergy record listed in Patients > Clinical > Allergy.
    [Note: The order of the listed allergies is determined by dragging and dropping the entries into the desired order when the 'Allergy' popup is set to "All".]
  • Allergy Reaction: This will reflect the data as entered in any 'Reactions Description' field for any active Allergy record listed in Patients > Clinical > Allergy.
    [Note: The order of the listed allergies is determined by dragging and dropping the entries into the desired order when the 'Allergy' popup is set to "All".]
  • Allergy Severity: This will reflect the data as selected from any 'Severity' popup for any active Allergy record listed in Patients > Clinical > Allergy.
    [Note: The order of the listed allergies is determined by dragging and dropping the entries into the desired order when the 'Allergy' popup is set to "All".]
  • Allergy Status: This will reflect the data as selected from any 'Status' popup for any active Allergy record listed in Patients > Clinical > Allergy.
    [Note: The order of the listed allergies is determined by dragging and dropping the entries into the desired order when the 'Allergy' popup is set to "All".]

 

Provider

  • ABN Number: This will display the ABN Number for the provider selected from the 'Provider' popup located in Patients > Patient. This data will pull from the 'ABN' field located in the selected provider's User Reference > Provider > Additional Credentials.
  • CLIA: This will display the CLIA data for the provider selected from the 'Provider' popup located in Patients > Patient. This data will pull from the 'CLIA' field located in the selected provider's User Reference > Provider > Claim Credentials.
  • DEA Number: This will display the DEA Number for the provider selected from the 'Provider' popup located in Patients > Patient. This data will pull from the 'DEA' field located in the selected provider's User Reference > Provider > Additional Credentials.
  • DPS Number: This will display the DPS Number for the provider selected from the 'Provider' popup located in Patients > Patient. This data will pull from the 'DPS' field located in the selected provider's User Reference > Provider > Additional Credentials.
  • Eclaim Tax ID: This is a "True/False" pull field that will display an 'X' respective to having selected "Use Federal ID Number" from the 'Provider Tax ID on Claims' popup located in References > Users > Provider > Claim Credentials for the provider selected from the 'Provider' popup located in Patients > Patient.
    [Note: Functionality is dependent upon pull field formatting. If formatted for "True" an 'X' will display when "Use Federal ID Number" is selected. If formatted for "False" an 'X' will display when "Use Social Security Number" is selected.]
  • Federal Number: This will display the Federal Number for the provider  selected from the 'Provider' popup located in Patients > Patient. This data will pull from the 'Federal' field located in the selected provider's User Reference > Provider > Claim Credentials.
  • Form Name: This will display the Form Name data for the provider selected from the 'Provider' popup located in Patients > Patient. This data will pull from the 'Name Printed in Box 33 HCFA' (DDS: 'Name Printed in Box 53 of Insurance Form') field located in the selected provider's User Reference > Provider.
  • Hospital Number: This will display the Hospital Number for the provider selected from the 'Provider' popup located in Patients > Patient. This data will pull form the 'Hospital' field locate in the selected provider's User Reference > Provider > Additional Credentials.
  • ID: This will display the User ID for the provider selected from the 'Provider" popup located in Patients > Patient. This data will pull from the 'User ID' field located in the selected provider's User Reference > User Information.
  • Name, First: This will display the First Name of the provider selected from the 'Provider' popup located in Patients > Patient. This data will pull from the 'First' field located in the selected provider's User Reference.
  • Name, Last: This will display the Last Name of the provider selected from the 'Provider' popup located in Patients > Patient. This data will pull from the 'Last' field located in the selected provider's User Reference.
  • Name, Middle: This will display the Middle Name of the provider selected from the 'Provider' popup located in Patients > Patient. This data will pull from the 'Middle' field located in the selected provider's User Reference.
  • Name, Professional Title: This will display the Professional Title for the provider selected from the 'Provider' popup located in Patients > Patient. This data will pull from the 'Professional Title' field located in the selected provider's User Reference.
  • Name, Suffix: This will display the Suffix for the provider selected from the 'Provider' popup located in thePatients > Patient. This data will pull from the 'Suffix' field located in the selected provider's User Reference.
  • National Provider ID: This will display the NPI Number for the provider selected from the 'Provider' popup located in Patients > Patient. This data will pull from the 'National Provider ID (NPI)' field located in the selected provider's User Reference > Provider > Claim Credentials.
  • Other Number 1: This will display the Other 1 data for the provider selected from the 'Provider' popup located in Patients > Patient. This data will pull from the 'Other 1' field located in the selected provider's User Reference > Provider > Additional Credentials.
  • Other Number 2: This will display the Other 2 data for the provider selected from the 'Provider' popup located in Patients > Patient. This data will pull from the 'Other 2' field located in the selected provider's User Reference > Provider > Additional Credentials.
  • Other Number 3: This will display the Other 3 data for the provider selected from the 'Provider' popup located in Patients > Patient. This data will pull from the 'Other 3' field located in the selected provider's User Reference > Provider > Additional Credentials.
  • Other Number 4: This will display the Other 4 data for the provider selected from the 'Provider' popup located in Patients > Patient. This data will pull from the 'Other 4' field located in the selected provider's User Reference > Provider > Additional Credentials.
  • Other Number 5: This will display the Other 5 data for the provider selected from the 'Provider' popup located in Patients > Patient. This data will pull from the 'Other 5' field located in the selected provider's User Reference > Provider > Additional Credentials.
  • Phone: This will display the Phone Number for the provider selected from the 'Provider' popup located in Patients > Patient. This data will pull from the 'Phone' field located in the selected provider's User Reference > User Information.
  • Phone Extension: This will display the Phone Extension Number for the provider selected from the 'Provider' popup located in Patients > Patient. This data will pull from the 'Ext' field located in the selected provider's User Reference > User Information.
  • Provider Letter Head: This will display the Professional Title, First Name and Last Name of the provider selected from the 'Provider' popup located in Patients > Patient; followed by the full address of the office selected from the 'Office' popup located in Patients > Patient.  This data will pull from the 'Professional Title', 'First', and 'Last' pull fields located in the selected provider's User Reference, and the 'Street Address', 'Suite', 'City', 'State', and 'Zip Code' fields located in the selected office's Reference.
    [Note: The office fields are inaccessible and can only be changed or updated by the Accounting Department.]
  • Provider Number: This will display the Provider Number for the provider selected from the 'Provider' popup located in Patients > Patient. This data will pull from the 'Provider' field located in the selected provider's User Reference > Provider > Additional Credentials.
  • SSN: This will display the Social Security Number of the provider selected from the 'Provider' popup located in Patients > Patient. This data will pull from the 'SSN' field located in the selected provider's User Reference > Provider > Claim Credentials.
  • Specialty: This will display the Taxonomy Code for the provider selected from the 'Provider' popup located in Patients > Patient. This data will pull from the 'Provider Taxonomy (Specialty)' field located in the selected provider's User Reference > Provider > Claim Credentials.
  • State License Number: This will display the State License Number for the provider selected from the 'Provider' popup located in Patients > Patient. This data will pull from the 'State License Number' field located in the selected provider's User Reference > Provider > Claim Credentials.
  • Sub ID: This will display the Sub ID for the provider selected from the 'Provider' popup located in Patients > Patient. This data will pull from the 'Sub ID' field located in the selected provider's User Reference > Provider > Claim Credentials.
  • Title XIX Exception Code: This will display the Title XIX Exception Code for the provider selected from the 'Provider' popup located in Patients > Patient. This data will pull from the 'Title SA Exception Code Box 25D' field located in the selected provider's User Reference > Provider > Claim Credentials.
  • UPIN: This will display the UPIN data for the provider selected from the 'Provider' popup located in Patients > Patient. This data will pull from the 'UPIN' field located in the selected provider's User Reference > Provider > Additional Credentials.
  • Unique Number: This will display the Unique Number for the provider selected from the 'Provider' popup located in Patients > Patient. This data will pull from the 'Unique' field located in the selected provider's User Reference > Provider > Additional Credentials.
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