Appointment Information Data Field Descriptions for Form and Label Templates

Data Fields	Description
Appointment Date	Appointment Date
Appointment Details	Appointment Details
Appointment Event	Appointment Event
Appointment ID (Barcode)	Appointment ID Barcode
Appointment Number	Appointment Number
*Appointment Resource	Appointment Resource
Appointment Time	Appointment Time
Future Appointment <1-25> Date Future Appointment <1-25> Event Future Appointment <1-25> Location Address Future Appointment <1-25> Location City, State Zip Future Appointment <1-25> Location Name Future Appointment <1-25> Location Phone Future Appointment <1-25> Resource Future Appointment <1-25> Time Note: These fields use the next 25 future appointment after the appointment you are printing from.	Future Appointment <1-25> Date Future Appointment <1-25> Event Future Appointment <1-25> Location Address Future Appointment <1-25> Location City, State Zip Future Appointment <1-25> Location Name Future Appointment <1-25> Location Phone Future Appointment <1-25> Resource Future Appointment <1-25> Time
Marketing Comments	Marketing Comments
Marketing Data	Marketing Data
Marketing Plan	Marketing Plan
Primary Appointment Payer	Primary Appointment Payer
Secondary Appointment Payer	Secondary Appointment Payer
Tertiary Appointment Payer	Tertiary Appointment Payer
Appt User-Defined <1-8> Name Note: These data fields use the eight User-Defined fields, which are defined in the Appt Scheduling Practice Preferences for current and future appointments.	Appt User-Defined <1-8> Name
Future Appointment <1-25> Appt User-Defined <1-8> Note: Each Appt User-Defined field can have up to 25 future appointments.	Future Appointment <1-25> Appt User-Defined <1-8> Name
Print Outguide?	Print Outguide?
Future Appointment <1-25> Print Outguide?	Future Appointment <1-25> Print Outguide?
Appt User-Def 1 Master List	Appt User-Def 1 Master List
Appt User-Def <1-25> User-Def 1 Master List	Appt User-Def <1-25> User-Def 1 Master List

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Encounter Information Data Field Descriptions for Form and Label Templates

The following table lists the Data Repository data fields and sub-data fields for encounter information. The sub-data fields are Encounter Primary, Encounter Secondary, and Encounter Tertiary. Encounter Information is represented by the data field icon. Data Fields Admitting Physician Enc Rendering Prov Address 1 Enc Rendering Prov Address 2 Enc Rendering Prov City Enc Rendering Prov City, State Zip Enc Rendering Prov State Enc Rendering Prov Zip Encounter Adjustments Encounter Admit Date Encounter Admit Time Encounter All Insurance Balance Encounter Attending Encounter Authorization Nbr Primary Encounter Authorization Nbr Secondary Encounter Authorization Nbr Tertiary Encounter Balance Encounter Balance (including unposted transactions) Encounter Charges Encounter Complaint Encounter Date Encounter Discharge Date Encounter Discharge Time Encounter Facility Address Encounter Facility Fax Number Encounter Facility Name Encounter Facility Phone Number Encounter ID (Barcode) Encounter Ins

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Appointment/Encounter Information Data Field Descriptions for Form and Label Templates

The following table lists the Data Repository data fields for appointment/encounter information. Appointment/Encounter Information is represented by the data field icon. Data Fields Description Encounter Appointment Date Encounter Appointment Date Location Address Appointment Location Location Address 2 Location Address 2 Location City, State Zip Appointment Location City, State Zip *Location Name Appointment Location Name Location Phone Appointment Location Phone Number Referring Physician Referring Physician Rendering Physician Rendering Physician Rendering Provider Address 1 Rendering Provider Address 1 Rendering Provider Address 2 Rendering Provider Address 2 Rendering Provider Business Phone Rendering Provider Business Phone Rendering Provider City, State Zip Rendering Provider City, State Zip Parent topic: Data Field Descriptions for Form, Form Enhanced, and Label Templates

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Patient Information Data Fields in Form and Label Templates

The following table lists the Data Repository data fields for Patient Information. Data Fields Description Alternate Phone Patient's alternate phone number Note: This field pulls the phone number from the Alternate Phone field on Add/Modify Patient Information > Demographics. Alternate Phone Ext. Patient's alternate phone extension number Note: This field pulls the extension number from the Ext field next to the Alternate Phone field on Add/Modify Patient Information > Demographics. *Birth Date Date of birth (mandatory) *Birth Date(mmddyy) Date of birth in the mmddyy format Chart Details Marketing Co... Chart Details Marketing Comments Chart Details Marketing Data Chart Details Marketing Data Chart Details Marketing Plan Chart Details Marketing Plan Correspondence Language Patient's preferred correspondence language Day Phone Patient's daytime phone number Note: This field pulls the phone number from the Day Phone field on Add/Modify Patient Information > Demographics. Day Phone Ext. P

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Case Management Information Data Field Descriptions

The following table describes the Data Repository fields for Case Management information. Data Fields Description Accident Description Accident description Auth Number Authorization number Case Contact Address 1 Address of case contact Case Contact Address 2 Address of case contact Case Contact City City of case contact Case Contact Name Case contact's name Case Contact Phone Case contact's number Case Contact Phone Ext Extension of case contact's address Case Contact State State associated with case contact's address Case Contact Zip ZIP code associated with case contact's address Case Description Case description Case Employer Full Name Full name of the case employer Case Number Case number Case Status Case status Cond Related to Emp Cond related to employer Disabled From Disabled from Disabled To Disabled to Effective Date Effective date Expiration Date Expiration date Guarantor Name of the guarantor Guarantor with Prefix/Suffix Name of the guarantor with prefix, such as Mr. and suf

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Appointment Information Data Field Descriptions for Form and Label Templates

The following table lists the Data Repository data fields for Appointment Information. Appointment Information is represented by the data field icon. Data Fields Description Appointment Date Appointment Date Appointment Details Appointment Details Appointment Event Appointment Event Appointment ID (Barcode) Appointment ID Barcode Appointment Number Appointment Number *Appointment Resource Appointment Resource Appointment Time Appointment Time Future Appointment <1-25> Date Future Appointment <1-25> Event Future Appointment <1-25> Location Address Future Appointment <1-25> Location City, State Zip Future Appointment <1-25> Location Name Future Appointment <1-25> Location Phone Future Appointment <1-25> Resource Future Appointment <1-25> Time Note: These fields use the next 25 future appointment after the appointment you are printing from. Future Appointment <1-25> Date Future Appointment <1-25> Event Future Appointment <1-25> Location Address Future Appointment <1-25> Location City, Sta

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Data Field Descriptions for Form, Form Enhanced, and Label Templates

Tables in the the following sections list the available data fields in the Data Repository that you can use to customize your form templates and label templates. The * icon indicates that there is more than one data field format option to choose from for this data field. Refer to the table in the following section for the exact data fields that have multiple format options and an explanation of each format. The + icon indicates that any user-defined patient providers that you set up for use in the Provider Practice Preferences will be added to and will appear in the data repository. The ++ icon indicates that any user-defined fields that you set up for use in the Practice Preferences window will be added to and will appear in the data repository. Account Information Data Field Descriptions for Form and Label Templates Data Repository data fields description for Account Information. Appointment Information Data Field Descriptions for Form and Label Templates Data Repository data fields

Appointment Information Data Field Descriptions for Form and Label Templates

Recommendations

Encounter Information Data Field Descriptions for Form and Label Templates

Appointment/Encounter Information Data Field Descriptions for Form and Label Templates

Patient Information Data Fields in Form and Label Templates

Case Management Information Data Field Descriptions

Appointment Information Data Field Descriptions for Form and Label Templates

Data Field Descriptions for Form, Form Enhanced, and Label Templates

Encounter Information Data Field Descriptions for Form and Label Templates

Appointment/Encounter Information Data Field Descriptions for Form and Label Templates

Patient Information Data Fields in Form and Label Templates

Case Management Information Data Field Descriptions

Appointment Information Data Field Descriptions for Form and Label Templates

Data Field Descriptions for Form, Form Enhanced, and Label Templates