Data Elements for Emergency Department Systems - Release 1.0 (Centers for Disease Control and Prevention, 1997, 274 p.): SECTION 3

Data Elements for Emergency Department Systems - Release 1.0 (Centers for Disease Control and Prevention, 1997, 274 p.)

SECTION 3 - ED PAYMENT DATA

		3.01 INSURANCE COVERAGE OR OTHER EXPECTED SOURCE OF PAYMENT
		3.02 INSURANCE COMPANY
		3.03 INSURANCE COMPANY ADDRESS
		3.04 INSURANCE PLAN TYPE
		3.05 INSURANCE POLICY ID
		3.06 ED PAYMENT AUTHORIZATION REQUIREMENT
		3.08 DATE/TIME OF ED PAYMENT AUTHORIZATION ATTEMPT
		3.09 ED PAYMENT AUTHORIZATION DECISION
		3.10 DATE/TIME OF ED PAYMENT AUTHORIZATION DECISION
		3.11 ENTITY CONTACTED TO AUTHORIZE ED PAYMENT
		3.12 ED PAYMENT AUTHORIZATION CODE
		3.13 PERSON CONTACTED TO AUTHORIZE ED PAYMENT
		3.14 TELEPHONE NUMBER OF ENTITY OR PERSON CONTACTED TO AUTHORIZE ED PAYMENT
		3.15 TOTAL ED FACILITY CHARGES
		3.16 TOTAL ED PROFESSIONAL FEES