|
Name |
Type |
Discontinued? |
|
1 |
PAT_ENC_CSN_ID |
NUMERIC |
No |
|
|
|
The unique contact serial number for this contact. This number is unique across all patient encounters in your system. If you use IntraConnect, this is the Unique Contact Identifier (UCI). |
|
|
2 |
CONTACT_DATE |
DATETIME |
No |
|
|
|
The date of this contact in calendar format. |
|
|
3 |
SUPPLIED_BY |
VARCHAR |
No |
|
|
|
The name of the person who supplied the information for the Medicare Secondary Payor questionnaire (MSPQ). |
|
|
4 |
RELATION_PAT_C_NAME |
VARCHAR |
No |
|
|
|
The category ID for the relationship to the patient of the person who supplied the information for the MSPQ. |
May contain organization-specific values: Yes |
Category Entries: |
Self |
Spouse |
Other |
|
|
5 |
PAT_RETIRE_DATE |
DATETIME |
No |
|
|
|
The date of retirement for the patient. |
|
|
6 |
MSP_USER |
VARCHAR |
No |
|
|
|
The name of the user who last accessed the Medicare Secondary Payor Questionnaire (MSPQ) for this contact. |
|
|
7 |
LAST_ACCESS_DATE |
DATETIME |
No |
|
|
|
The date and time that the Medicare Secondary Payor Questionnaire (MSPQ) for this contact was last accessed. |
|
|
8 |
NA_HEALTH_BEN_YN_NAME |
VARCHAR |
No |
|
|
|
Indicates whether the patient is eligible for Native American healthcare benefits. Y indicates that the patient is eligible for Native American healthcare benefits. N indicates that the patient is not eligible for Native American healthcare benefits. A null value indicates this item was not filled out. |
May contain organization-specific values: No |
Category Entries: |
Yes |
No |
|
|
9 |
NA_RESERVATION_C_NAME |
VARCHAR |
No |
|
|
|
The Native American reservation category ID for the Medicare Secondary Payor questionnaire (MSPQ). |
May contain organization-specific values: Yes |
No Entries Defined |
|
|
10 |
IS_ACCIDENT_C_NAME |
VARCHAR |
No |
|
|
|
Indicates whether the patient has been in an accident. |
May contain organization-specific values: Yes |
Category Entries: |
Yes |
No |
|
|
11 |
IS_CVG_VET_BEN_C_NAME |
VARCHAR |
No |
|
|
|
Indicates whether the Department of Veterans Affairs (DVA) authorized and agreed to pay for care at this facility or the patient would like the DVA to be contacted for such authorization. |
May contain organization-specific values: Yes |
Category Entries: |
Yes |
No |
|
|
12 |
IS_OVER_100_EMP_C_NAME |
VARCHAR |
No |
|
|
|
Indicates whether the patient's Group Health Plan (GHP) is sponsored by an employer with 100 or more employees. |
May contain organization-specific values: Yes |
Category Entries: |
Yes |
No |
|
|
13 |
IS_NON_ERSD_C_NAME |
VARCHAR |
No |
|
|
|
Indicates whether the patient is entitled to Medicare because of disability other than End Stage Renal Disease. |
May contain organization-specific values: Yes |
Category Entries: |
Yes |
No |
|
|
14 |
IS_BLACK_LUNG_C_NAME |
VARCHAR |
No |
|
|
|
Indicates whether the patient is entitled to benefits under the Black Lung Program. |
May contain organization-specific values: Yes |
Category Entries: |
Yes |
No |
|
|
15 |
IS_CVD_EGHP_C_NAME |
VARCHAR |
No |
|
|
|
If the patient has employer group health plan (EGHP) coverage based on own or family member's current or former employment. |
May contain organization-specific values: No |
Category Entries: |
Yes, covered by current employer's EGHP |
Yes, covered by a former employer's EGHP |
No |
|
|
16 |
IS_END_STAGE_RNL_C_NAME |
VARCHAR |
No |
|
|
|
Indicates whether the patient is entitled to Medicare because of End Stage Renal Disease. |
May contain organization-specific values: Yes |
Category Entries: |
Yes |
No |
|
|
17 |
IS_NONWORK_ACC_C_NAME |
VARCHAR |
No |
|
|
|
Indicates whether the illness or injury is the result of a non work-related accident. |
May contain organization-specific values: No |
Category Entries: |
Yes |
No |
|
|
18 |
IS_WORKERS_COMP_C_NAME |
VARCHAR |
No |
|
|
|
Indicates whether the illness or injury is covered by workers' compensation. |
May contain organization-specific values: No |
Category Entries: |
Yes |
No |
|
|
19 |
IS_OTHER_EMPLYD_C_NAME |
VARCHAR |
No |
|
|
|
Indicates whether the spouse or other family member is currently employed. |
May contain organization-specific values: No |
Category Entries: |
Yes |
No |
No, Never Employed |
No, Retired |
Yes, but Retired from Previous Employment |
No, but Not Retired |
No, Not Married (single, divorced, widowed) |
|
|
20 |
IS_PAT_EMPLYD_C_NAME |
VARCHAR |
No |
|
|
|
Indicates whether the patient is currently employed. |
May contain organization-specific values: No |
Category Entries: |
Yes |
No |
No, Never Employed |
No, Retired |
Yes, but Retired from Previous Employment |
No, but Not Retired |
|
|
21 |
IS_PAT_SPSE_RET_C_NAME |
VARCHAR |
No |
|
|
|
Indicates whether the patient or spouse is retired. |
The category values for this column were already listed for column: IS_OVER_100_EMP_C_NAME |
|
|
22 |
IS_PHS_C_NAME |
VARCHAR |
No |
|
|
|
Indicates whether the services are covered by a Public Health Service or Research Program. |
May contain organization-specific values: No |
Category Entries: |
Yes |
No |
|
|
23 |
IS_VET_BEN_C_NAME |
VARCHAR |
No |
|
|
|
Indicates whether patient is entitled to benefits under the Department of Veterans Affairs. |
May contain organization-specific values: Yes |
Category Entries: |
Yes |
No |
|
|
24 |
IS_OVER_20_EMP_C |
VARCHAR |
No |
|
|
|
Indicates whether the patient's Group Health Plan (GHP) is sponsored by an employer with 20 or more employees. |
May contain organization-specific values: No |
Category Entries: |
Yes |
No |
|
|
25 |
MSP_COMPLTN_USER_ID |
VARCHAR |
No |
|
|
|
The unique ID of the user who last completed the Medicare Secondary Payor Questionnaire (MSPQ) for this contact. |
|
|
26 |
MSP_COMPLTN_USER_ID_NAME |
VARCHAR |
No |
|
|
|
The name of the user record. This name may be hidden. |
|
|
27 |
MSP_COMPLETE_DATE |
DATETIME |
No |
|
|
|
The date when the Medicare Secondary Payor Questionnaire (MSPQ) was last opened and completed. |
|
|
28 |
MSP_STATUS_C_NAME |
VARCHAR |
No |
|
|
|
The Completion Status category number for the Medicare Secondary Payor Questionnaire (MSPQ). |
May contain organization-specific values: Yes |
Category Entries: |
Blank |
Complete |
Partial |
|
|
29 |
IS_AGE_ENTITLED_YN |
VARCHAR |
No |
|
|
|
Indicates whether the patient is entitled to benefits based on age. |
May contain organization-specific values: No |
Category Entries: |
Yes |
No |
|
|
30 |
IS_PRVSN_APPLY_YN |
VARCHAR |
No |
|
|
|
Indicates whether the patient is entitled to benefits based on the working aged or disability provision. |
The category values for this column were already listed for column: IS_AGE_ENTITLED_YN |
|
|
31 |
IS_DUAL_ENTITLED_YN |
VARCHAR |
No |
|
|
|
Indicates whether the patient is entitled to Medicare based on a combination of either ESRD and age, or ESRD and disability. |
The category values for this column were already listed for column: IS_AGE_ENTITLED_YN |
|
|
32 |
SOURCE_ORGANIZATION_ID |
NUMERIC |
No |
|
|
|
Holds the DXO of the Epic instance that this MSP info came from. |
|
|
33 |
SOURCE_ORGANIZATION_ID_EXTERNAL_NAME |
VARCHAR |
No |
|
|
|
Organization's external name used as the display name on forms and user interfaces. |
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