Scheduling and Registration (Specialty Hospital) Training Guide

Transcription

1 Scheduling and Registratin (Specialty Hspital) Visin 4.3 (December 2012) Training Guide SurceMedical

2 Learning Center f Excellence Last change made: January Surce Medical Slutins, Inc. All Rights Reserved. N part f these materials may be reprduced r transmitted in any frm r by any means, electrnic r mechanical, including phtcpy, recrding r any infrmatin strage and retrieval system, withut the express permissin f Surce Medical Slutins, Inc. This dcument is intended fr use with Surce Medical Slutins licensed sftware. Visin is a registered trademark f Surce Medical Slutins, Inc. All ther prducts r cmpany names are used fr identificatin purpses nly and may be trademarks f their respective wners. CPT cdes, descriptins, and material nly are cpyright 2000 American Medical Assciatin (AMA). All rights reserved. N fee schedules, basic units, related values r related listings are included in CPT. AMA des nt directly r indirectly practice medicine r dispense medical services. AMA assumes n liability fr data cntained r nt cntained herein. The respnsibility fr the cntent f any "Natinal Crrect Cding Plicy" included in this prduct is with the Health Care Financing Administratin and n endrsement by the AMA is intended r shuld be implied. The AMA disclaims respnsibility fr any cnsequences r liabilities attributable t r related t any use, nn-use r interpretatin f infrmatin cntained in this prduct. The images, descriptins, and examples used in the dcumentatin are illustratins nly and nt meant t track ne patient thrughut the data entry prcess. All patients and patient data are fr illustrative purpses nly and d nt represent actual patients. Any reference t an actual persn is purely cincidental. Material in this publicatin is subject t change withut ntice. If yu detect any errrs r missins, r have cmments r suggestins fr changes, please the Learning Center f Excellence cntact at lce@surcemed.net. Surce Medical Slutins, Inc. Attn: Learning Center f Excellence 866 Nrth Main Street Ext. Wallingfrd, CT Fax Page 2

3 Table f Cntents Visin Basics... 4 Lgging In... 4 System Wide Features... 5 Pre-Registratin and Scheduling... 6 The Daily View... 6 Demgraphics Tab... 7 Case Tab Payment Prfiles Tab Case Cntacts Tab Visit Cntacts Tab Assigning an Inpatient t a Rm Pre-Registratin withut Scheduling Registering an Outpatient Admitting an Inpatient Transferring: Outpatient t Inpatient Transferring: Inpatients between Rms Patient Rm Daily and Weekly View Adding Additinal Cases t an existing Visit Canceling r Discntinuing a Case Page 3

4 Visin Basics Befre we begin, there are a few basics that shuld be reviewed abut the Visin sftware. Understanding these basic features will help yu better understand the mre cmplex features f the system. Lgging In Lgging int Visin requires a Username and Passwrd. After duble clicking n the Visin icn, yu will see the abve screen where yur persnal Username and Passwrd are entered. After entering bth the Username and Passwrd, click Lg in. Keep in mind, the Username and Passwrd are case sensitive and the system may require a change t the Passwrd n a peridic basis. Depending n yur facility s settings, the system may r may nt allw the same passwrd t be used again. Be aware that if the Username and/r Passwrd are repeatedly entered incrrectly r if a user has exceeded the time span fr system inactivity, the accunt will becme lcked and will need t be unlcked by the system s administratr. The number f attempts a user will have when entering a passwrd and the time span fr inactivity are determined by the facility s settings. Page 4

5 System Wide Features Arrw 1: The first arrw at the tp pints t the sftware header, which displays the Surce Medical sftware that yu are currently using. Yu will als find the designated fur letter supprt cde fr yur facility. Fr example if yur surgery center was System Test Ambulatry Surgery Center, yu may see n yur tp rw Visin TASC. Yu will need this fur letter supprt cde whenever yu cntact the Visin Supprt Team. Arrw 2: The secnd arrw pints t the tlbar that list all f the general categries f the Visin system. By left clicking n any f these tlbar headers, yu will see a list f specific mdules in the system yu can pen. Fr example, if yu were t left click n the Financial tlbar header yu wuld find links t mdules such as Charge Review r Payments & Adjustments. Arrw 3: The third arrw pints twards the picture icns that are direct links t the specific mdules in the Visin system. These are quick and easy ways t get t these mdules if yu knw exactly where yu want t g. Fr example, instead f left clicking n the Financial tlbar fllwed by left clicking Charge Review, yu may simply left click n the Charge icn. Nt all mdules are accessible frm the picture icns. Arrw 4: The furth arrw pints t the Visin Managers. Left clicking n any f the given managers will pen that manager, which will have a number f picture icns. Like the picture icns frm Arrw 3, these icns are direct links t the specific mdules. Arrw 5: The fifth arrw pints t the Open Windws. In the abve screen, yu will see that there are currently n pen windws. As yu pen different mdules in the system, a link t that pen mdule will appear in the Open Windws bx. Always be aware f what windws yu have pened s that yu can avid ptentially duplicating yur wrk. Page 5

6 Pre-Registratin and Scheduling Patients are frequently pre-registered in visin during the scheduling prcess. The prcess utlined in the next few pages results in a patient with a Pre-Registered Visit with a scheduled prcedure. Patient prcedures are scheduled frm the Daily View. The Daily View is pened by clicking the Sched icn in the quick-launch tlbar r by clicking Daily View in the Scheduling Manager. The Daily View The Daily View has clumns representing the individual rms and rws that represent the time. The Daily View always pens t current date, which is adjusted in the lwer left hand crner f the windw. Visin als has a Weekly View and a Year-at-a-Glance View which are accessed frm the Scheduling Manager. Page 6

7 Frm the Daily View, click and drag the muse cursr t highlight apprpriate amunt f time fr the prcedure being scheduled and right-click in the highlighted area; select New Appintment frm the menu. Search fr the patient using the Name field by entering the Last, First Name (partial searchs are allwed), Date f Birth (XX/XX/XXXX), Scial Security Number (XXX-XX-XXXX), r Medical Recrd Number. If the patient is in the system select their name frm the drp dwn and select the prper Visit Type such as Inpatient, Outpatient, r Observatin.. If the patient is nt already in the system, skip the Name field and just select a Visit Type. Once the visit type is selected, the new patient s name is entered in the apprpriate fields n the Demgraphics Tab. While wrking thrugh case scheduling and pre-registratin, keep in mind that, thrughut Visin, fields in bld are required in rder t save infrmatin. All tabs f the Appintment mdule have tw buttns that appear at the bttm f the windw: Save Saves any changes made. Cancel Discards any changes made. Demgraphics Tab The Demgraphics tab prvides fields fr entering patient infrmatin, such as First and Last Name, DOB (Date f Birth), Gender, Address, and Phne Number. Page 7

8 Last Name Enter the patient s Last Name. First Name Enter the patient s First Name. MI Middle Initial: Enter r edit as necessary. Suffix Enter r edit as necessary. (i.e.: Jr., M.D., etc.) DOB Enter the patient s Date f Birth, Visin will frmat this text autmatically. MRN The Medical Recrd Number is usually set t be autmatically assigned by Visin. It is nt recmmended that the user edit r change this field. Accunt ID This is the same as the MRN by default but can be edited if needed. Sc. Sec. # - Enter the patient s Scial Security Number. Age This is calculated by Visin nce the Date f Birth is entered, and is read-nly. Maiden Name Can be entered if necessary. Alias The patient s preferred name, r nickname, can be entered here if applicable. Partner Enter the patient s partner. This is free text and des nt link t the Persn table. Patient Expired Pp-up windw where yu track the date and cause f death fr deceased patients. Nte: This date cannt be remved. Marital Status Select the apprpriate marital status frm the drp dwn list. Ethnicity Select the apprpriate ethnicity frm the drp dwn list, if applicable. Gender Select the apprpriate gender frm the drp dwn list. View/Scan ID Card This area is where the patient s ID card, such as a Driver s License, can be stred. Please see SurceMedical s current Hardware and System Requirements Guide fr infrmatin regarding supprted scanner types and requirements. Race - Select the apprpriate race frm the drp dwn list. Religin - Select the apprpriate religin frm the drp dwn list. Language Select the apprpriate language frm the drp dwn list. This pulls frm the Language Library. Interpreter available? Check this bx if an interpreter will be needed. Page 8

9 Address, Phne Number, and Address After entering the address, phne number r address, click the Save buttn at the bttm f the sectin. Or click Cancel t discard any changes made. Edits are made by clicking the entry frm the grid. All entries will default t Active and Primary. Type Select frm the Type drp dwn list. This type allws distinctin between entries. Active and Primary Radi Buttns These will autmatically be checked by Visin, but may be unchecked if nt applicable t the particular entry. Bad Address Indicates if the address is bad. Address 1 Enter data as necessary fr the first line f the address. Address 2 If necessary, enter additinal data here such as an apartment number. City Enter the zip cde fr the address, if it des nt appear in the list, use CTRL+L t add it t the Cities library. Zip/Pstal Cde Autmatically filled is based n the data in the Cities Library. Zip +4 If the 4 digit extensin f the zip cde is required by yur facility, enter it here. State/Prvince and Cunty/Regin This will aut ppulate based n data in the Cities Library. Phne Number Enter the patient s phne number. Visin frmats this text autmatically; parentheses and dashes are nt allwed in the phne number field. Ext. Enter the line extensin, if applicable. This field is free-text. Enter patient s address. Emplyer Select the crrect emplyer frm the drp dwn list. CTRL+L can be used t add a new Emplyer t the Emplyers Library. This is nt a free text field. EIN Enter the patient s Emplyer Identificatin Number here if needed. Jb Status Select the apprpriate status frm the drp dwn list. Occupatin This is a free text field. Enter data as necessary. Student Status Select the necessary status frm the drp dwn list. Page 9

10 Cllectr A staff member can be selected as the Cllectr assigned t this patient s accunt frm the drp dwn list. This field pulls frm the Staff library. Patient Class A Patient Class can be selected t grup patients. These are established in the Patient Grups Library, and are used fr custm reprts nly. Patient Grups Right-click and select Add t attach patient grups. These are established in the Patient Grups Library. Eligible fr Patient Bill? Dictated by the patient grup(s) selected. MRSA/VRE This feature wrks with the Chart Manager. Select if apprpriate. Case Tab The Case tab is nly available when adding r editing an appintment and prvides fields fr entering infrmatin regarding the prcedure that is being scheduled fr the patient. Last Name, First Name, MI and DOB This infrmatin pulls frm what is entered n the Demgraphics tab. Date f Service, Rm, Start and End times and Duratin These fields ppulate accrding t the selectin made n the Daily View. Changes can be made t these entries at any time. Page 10

11 Clean Up If desired, select the apprpriate amunt f time needed fr rm clean-up. This time appears grayed ut n the scheduling grid. Clean-up time minutes can be preset in Settings. Ttal This is the ttal time fr the prcedure and clean-up time. This is the time that will be reflected n the scheduling grid. Surgen Select the primary surgen fr the case frm the drp dwn list. Case Type Select the Case Type, this list is filtered by the Visit Type. Filter Prcedure Selectin by Preference Cards This ptin, when selected, will limit the Prcedures t thse attached t the Preference Card nly. Preference Cards sectin Click n the dwn arrw t the right f the Card #1 line t see a list f the Preference Cards in the system fr the selected surgen. Select the card frm the list. Up t three may be selected fr a single case. NOTE: Histrical times will nt be calculated fr cases with multiple preference cards. Prcedure 1 Select the Prcedure frm the drp-dwn. This pulls frm the Prcedure library. Surgen This field will default with the name f the surgen selected fr the case. The surgen fr the primary prcedure and the surgen fr the case must match; ther prcedures may have different surgens, if applicable. Assistant If applicable, select an Assistant Surgen frm the drp dwn list. Bdy Side Click the desired radi buttn, NA, L (Left), R (Right), r B (Bilateral). Nte: This is used as a cmmunicatin tl within the system nly and des nt set mdifiers fr submissin n claim frms, nr des it print n the schedule. Descriptin This field ppulates with the descriptin f the Prcedure selected in the Prcedure 1 field abve. This default descriptin may be edited if desired. Prcedure 2 Cmplete fr a secnd prcedure as described abve. Additinal Prcedures This sectin allws entering f additinal prcedures. T use, rightclick and select Add frm the pp-up menu. Diagnsis Cdes #1, #2, #3 Enter the Pre-Admitting DX cdes if knwn. Anesthesia Type Select the desired Anesthesia Type frm the drp dwn menu Anesthesilgist Select the Anesthesilgist frm the drp dwn menu. Equipment This pulls required equipment fr cnflict checking frm the selected preference card(s). Additinal items are added by right clicking and selecting Add. Staff This pulls required staff fr cnflict checking frm the selected preference card(s). Additinal staff is added by right clicking and selecting Add. Page 11

12 Payment Prfiles Tab The Payment Prfiles tab prvides fields fr entering the patient s insurance carrier infrmatin. Current Prfiles This is a list f all the payment prfiles fr this patient. Each Prfile listed is managed in the fur sectins belw the Current Prfiles bx. When a new patient is added t the system, Visin creates a Default prfile. Alng the right-hand side f the Current Prfile the Add buttn will create an entire new prfile, Update allws editing f the infrmatin assciated with the highlighted Prfile, and Remve deactivates the highlighted Prfile. Payment Prfile Infrmatin The descriptin f the prfile always defaults t Default Prfile Date f Prfile s creatin - the internal payment prfile number. This default descriptin can be edited. The Active checkbx activates r deactivates the Payment Prfile. Visits This is a list f visits attached t the selected payment prfile. Payers All patients will have a Payer Self Pay with the rle f Self and this payer cannt be mdified. T add Payers t a Payment Prfile, click Add. The Payer Infrmatin screen pens. Payer Select the apprpriate Payer frm the drp-dwn list. This list pulls frm the Payers Library, t add a Payer t this library click Ctrl+L. Claim Destinatin Select the apprpriate Claim Destinatin frm the drp-dwn list. This list will ppulate with nly claim destinatins related t the selected Payer. This pulls frm the Payer Claim Destinatins Library, t add a claim destinatin t this library click Ctrl+L. Page 12

13 Payer Rle This will default t the first available rle. If Primary insurance already exists n this prfile, the next Payer will appear as Secndary. The ther rles are Tertiary, Additinal, Inactive, and Self. Insurance ID Enter the number frm the patient s insurance card here. Grup Name Enter a grup name frm the insurance card, if any. Grup Number Enter a grup number frm the insurance card, if any. Effective/Expiratin Date Enter the effective and/r expiratin dates frm the insurance card, if any. Insured (Subscriber) If the insurance subscriber is nt the patient, chsing a relatinship in the Patient Relatin t Insured field will make the ther fields available fr editing. Visin will cmpare the name yu enter with all ther names in the system. If a similar name is fund, a windw will pp up prviding a list t chse frm. If the persn is nt listed, chse Create new Persn and add their infrmatin in the fields prvided. Once cmpleted, click Save. View/Scan Card This area is where the patient s insurance ID card can be stred. Please see SurceMedical s current Hardware and System Requirements Guide fr infrmatin regarding supprted scanner types and requirements. Page 13

14 Guarantrs This is the persn respnsible fr the balance f the charges after the insurance has paid. The primary defaults t the patient. Click n Add, Update, r Remve t make sure the crrect primary guarantr is set fr this payment prfile. Case Cntacts Tab The Case Cntacts tab displays a list f all cases that are attached t the visit. This tab cntains the read-nly value fr the case s Case Number, which is used t distinguish between cases in the Chart Manager. Lcate pens the Daily View t the selected appintment s date f service. Page 14

15 Visit Cntacts Tab The Visit Cntacts tab prvides fields fr entering infrmatin specific t the visit. The Attending Prvider and Purpse f Visit are required in rder t establish the visit and save the appintment. Attending Prvider Select the attending prvider, this list pulls frm the Prvider library. Primary/Referring/Family Select necessary prvider names frm the drp dwn list. CTRL+L can be used t add a new name t the Prvider Library. Admissin/Pririty Type, Pint f Origin/Surce f Admissin Chse the Admissin/Pririty type, Pint f Origin/Surce f Admissin type fr this visit. These can als be set in settings t particular values. Purpse f Visit This is a free-text field t describe the purpse f the visit. Payment Prfiles This is the Payment Prfile that is attached t the case and can be changed if necessary. Health Infrmatin Allws fr tracking f sending and receiving f Electrnic Health Recrds. Page 15

16 Manager If a staff member frm the facility is assigned as a case manager, select them here. Attrney Select an attrney if necessary. If the name des nt appear in the drp dwn, add them as the emergency cntact first. Saving will make the attrney available frm the drp dwn menu; yu may then verwrite the Emergency cntact if needed. Advance Directive Plicy Review/Executed Allws yu t track Advance Directive Plicy. Pregnant/Expected Date f Cnfinement Allws yu t keep track f a patient s pregnancy status. Patient s Rights Reviewed/Disclsure f Ownership Check bxes t track. Emergency Cntact Use the Persn search field t see if the cntact name is already in the system and select that name. If the cntact name is nt is the system, cmplete the sectin belw with the necessary infrmatin. Page 16

17 Assigning an Inpatient t a Rm Inpatients ccupy Patient Rms in Visin. If an inpatient Visit Type is selected fr the visit, the Pre- Registratin and Registratin mdules display a Rm tab. Clicking Inpatient Rm Search pens a search utility t lcate available patient rms. 1. Use the Frm and Thrugh fields t identify the date range fr the patient stay and enter the anticipated Check In and Check Out times n thse days. 2. Select SemiPrivate, Private r bth in the Rm Types list t identify the type f rm being reserved fr the patient. 3. When searching SemiPrivate rms yu can chse t incrprate a Gender Check r an Age Check int the search parameters. 4. Click Search. 5. Available rms appear in the Rms list; highlight the rm t reserve fr the patient. 6. Click Select t cnfirm that rm assignment r click Cancel t discard the assignment. Page 17

18 Once the patient is assigned t a patient rm the assignment appears n the visit s Rm tab: Pre-Registratin withut Scheduling Visin prvides the ptin fr pre-registering a patient withut scheduling a prcedure. This typically ccurs fr patients entering the facility fr an ER visit, fr direct admissins t the nursing flr and fr utpatient bservatins. The Pre-Registratin mdule is accessed by clicking the Pre-Reg quick launch icn. Pre-Registering a patient results in a Pre-Registered visit with n scheduled prcedures. Search fr the patient using the Name field by entering the Last, First Name (partial searchs are allwed), Date f Birth (XX/XX/XXXX), Scial Security Number (XXX-XX-XXXX), r Medical Recrd Number. If the patient is in the system select their name frm the drp dwn and select the prper Visit Type such as Inpatient, Outpatient, r Observatin.. If the patient is nt already in the system, skip the Name field and just select a Visit Type: nce the visit type is selected, the new patient s name is entered in the apprpriate fields n the Demgraphics Tab. The prcess fr pre-registering a patient withut scheduling a prcedure is the same as described in the prir sectin (Pre-Registratin with Scheduling) with the exceptin that the case tab des nt appear, and thus is nt cmpleted. The Demgraphics, Payment Prfile, Case Cntacts, Visit Cntacts, and Rm (fr inpatients nly) tabs are displayed and are filled ut as described in the previus sectins. Page 18

19 Registering an Outpatient Outpatient registratin ccurs when the patient arrives at the facility. Registratin Dates and Times are nly entered in the Patient Registratin which is accessed by clicking the Patient icn n the quick launch tlbar. Search fr the patient using the Name field by entering the Last, First Name (partial searchs are allwed), Date f Birth (XX/XX/XXXX), Scial Security Number (XXX-XX-XXXX), r Medical Recrd Number. After the Patient is selected chse the apprpriate visit frm the Visit drp-dwn. The visit status is listed as Pre-Registered. Review the infrmatin entered n the Demgraphics, Payment Prfiles and Visit Cntacts tabs fr accuracy. The fields fr the patient s registratin date and time appear n the Visit Cntacts tab. Enter these values t change the patient s Visit Status t Registered. With the exceptin f these fields the Demgraphics, Payment Prfile, Case Cntacts, and Visit Cntacts tabs appear the same as described in the previus sectins. Page 19

20 Admitting an Inpatient Inpatient admissin ccurs when the patient arrives at the facility. Admissin Dates and Times are nly entered in the Patient Registratin which is accessed by clicking the Patient icn n the quick launch tlbar. Search fr the patient using the Name field by entering the Last, First Name (partial searchs are allwed), Date f Birth (XX/XX/XXXX), Scial Security Number (XXX-XX-XXXX), r Medical Recrd Number. After the Patient is selected chse the apprpriate visit frm the Visit drp-dwn. The visit status is listed as Pre-Registered. Review the infrmatin entered n the Demgraphics, Payment Prfiles and Visit Cntacts tabs fr accuracy. The fields fr the patient s admissin date and time appear n the Admissin tab. Enter these values t change the patient s Visit Status t Admitted. The Demgraphics, Payment Prfile, Case Cntacts, and Visit Cntacts tabs appear the same as described in the previus sectins. Page 20

21 Transferring: Outpatient t Inpatient T transfer patients frm Outpatient t Inpatient, pen the Transfer mdule by selecting it frm the Registratin menu. Search fr the patient using the Name field by entering the Last, First Name (partial searchs are allwed), Date f Birth (XX/XX/XXXX), Scial Security Number (XXX-XX-XXXX), r Medical Recrd Number. Once the Patient is selected chse the apprpriate Visit frm the drp-dwn. The patient s infrmatin ppulates int the gray bx and Outpatient appears as the Visit Type in the Current clumn. Chse Inpatient as the new Visit Type in the Subsequent clumn. Click Save t cnfirm the transfer, r Cancel t discard the changes. NOTE: Dn t frget t g t Registratin r Pre-Registratin afterwards t assign the inpatient rm fr the patient. Page 21

22 Transferring: Inpatients between Rms T transfer an inpatient frm ne rm t anther, pen the Transfer mdule by selecting it frm the Registratin menu. Search fr the patient using the Name field by entering the Last, First Name (partial searchs are allwed), Date f Birth (XX/XX/XXXX), Scial Security Number (XXX-XX-XXXX), r Medical Recrd Number. Once the Patient is selected chse the apprpriate Visit frm the drp-dwn. The patient s infrmatin ppulates int the gray bx and Inpatient appears as the Visit Type in the Current clumn. Click Rm Search t pen the search utility used t lcate available patient rms. Page 22

23 1. Use the Frm and Thrugh fields t identify the date range fr the patient stay and enter the anticipated Check In and Check Out times n thse days. 2. Select SemiPrivate, Private r bth in the Rm Types list t identify the type f rm being reserved fr the patient. 3. When searching SemiPrivate rms yu can chse t incrprate a Gender Check r an Age Check int the search parameters. 4. Click Search. 5. Available rms appear in the Rms list; highlight the rm t reserve fr the patient. 6. Click Select t cnfirm that rm assignment r click Cancel t discard the assignment. Click Save in the transfer windw t cnfirm the transfer, r Cancel t discard the changes. Page 23

24 Patient Rm Daily and Weekly View The Patient Rm Daily and Patient Rm Weekly View are accessed frm the Scheduling Manager. These views shw thse patients that have been assigned a patient rm via the pre-registratin r registratin prcess. As with the Daily View the clumns represent the individual rms whereas the rws reflect the time. NOTE: Patients are nt scheduled directly frm this view. Page 24

25 Adding Additinal Cases t an existing Visit Additinal appintments are added t an existing Visit by scheduling a new case via the Daily View. Frm the Daily View, drag the apprpriate amunt f time fr the prcedure and right-click; select New Appintment frm the ppup windw. Search fr the patient using the Name field by entering the Last, First Name (partial searchs are allwed), Date f Birth (XX/XX/XXXX), Scial Security Number (XXX-XX-XXXX), r Medical Recrd Number. Select the patient s name frm the drp dwn. Select the Visit that this case is being attached t in the Visits drp dwn. The multiple cases attached t the Visit will share the Demgraphics, Payment Prfile, Visit Cntacts, and Rm (fr inpatient visits nly). They will, hwever, have unique infrmatin entered n the Case tabs. These tabs are described in the pening sectins f this guide. The Case Cntacts tab displays a list f all cases that are attached t a selected visit. Canceling r Discntinuing a Case Canceling and Discntinuing cases is dne n the Daily View. A case fr which any arrival r rm times have been entered cannt be canceled and must be Discntinued. Open the Daily View and lcate the case t be canceled r discntinued, then right click and select Cancel Appintment r Discntinue Case. The labels that are used in the windw that pens varies slightly based n whether a case is being canceled r discntinued, but the functin f each are therwise identical. Select the Cancel r Release Cde r the Discntinue Cde, the ptins that appear in these lists are created in the Variances library. A free-text field fr the Reasn fr Cancellatin r Reasn fr Discntinue is used t enter any additinal ntes. When cancelling r discntinuing an inpatient case, the ptin t cancel the inpatient rm reservatin assciated with their visit is als presented. Page 25