OID - Order Defaults - Insurance

Insurance driven defaults

This SSMT category enables Orderable Item defaults and behavior to be driven by Insurance. The data and behavior that is available to be customized by Insurance Class are those items that will vary based on the patient's insurance.

• Financial Auth Requirements
• Duplicate Checking Interval w/ units

Columns

• HDROrder Code - This is prepopulated if you extract the dictionary first. This is the code or unique identifier that the Lab Vendor specifies in their compendium.

    Storage Location:  This is used for identification purposes
    Data Type:  VarChar(10)
    Possible Values:  Free Text

• Orderable Item - This is the Ordername and is prepopulated when extracted first

• Sequence - This is the sequence number. For new rows, set this number to '0' and SSMT will generate a sequence value. For rows that were extracted, edited, and being reloaded, do not change this value. If it gets changed on accident, simply reset it to '0' and SSMT will reassign it a new sequence number.

• InsuranceClassEntryCode - This value is found in the first column of the "Insurance" SSMT category.

• FinancialAuthorizationStatus - If an Insurance class requires Financial Authorization for an Orderable (or a whole Orderable Class), this field should be set to 'Needed'. The default value is 'Not Needed'. When set to 'Needed', the Fin Auth field in Order Details reads 'Needed'. When the order is placed, the status becomes 'Needs Info - Financial Authorization'. This prompts either a worklist item or a task that routes to a support staff worklist. To satisy the requirement and make the Order an Active status, enter a Fin Auth # or change the status to 'Not Needed' or 'Denied'. See image for context.

DuplicateCheckingInterval DuplicateCheckingIntervalUnits ApplyBelow