STEPOFFAITH

ACCESS DATABASE: WITH THE FOLLOWING FIELDS: MAIN RECORD NAME(LAST,FIRST, MI), ADDRESS (ADDRESS,CITY,STATE,ZIP) TELE: AGE: SEX: SSN: PRIMARY INSURANCE: SECONDARY INSURANCE: OTHER INSURANCE: (DROP DOWN) MEDICAID: MEDICARE: OTHER: DIAGNOSIS CODE(S)1-4: NOTE FOUR DIAGNISIS CODE BOXES: RESIDENCE: BILL TO: Additional Fields DATE OF SERVICE: TYPE OF SERVICE(DROP DOWN): (GROUP, ASSESSMENT, REASSESSMENT, OTHER) DOCTOR: DROP DOWN NOTES: UP TO 500 CHARACTERS (IF SERVICE TYPE IS GROUP) THEN A FIELD CALLED (GROUP TOPIC): IS NEEDED ALSO RECORD INPUT WILL BE DONE FROM A PAGE THAT LAYS OUT FROM THE FIELDS IN MAIN RECORD AREA ABOVE NEED TO TRACK (DATE OF SERVICE) AND TO PULL REPORTS BY DATE OR NAME OR TYPE OF SERVICE: INPUT MY LOGO ON THE TOP LEFT OF MAIN ENTRY PAGE MOST OF THE ADDRESSES ARE THE SAME, THERE MAY BE 200 NAMES BUT THEY LIVE IN 12 HOMES, CREATE A LINK THAT ALLOWS A DROP DOWN THAT FOR (RESIDENCE) AND WHEN DATA FILLED IT LOADS ADDRESS AND TELEPHONE FIELDS AND NEED TO INPUT MY LOGO TOP LEFT OF PAGE BILL TO: (FIELD FORMULAE) WHEN PRIMARY INSURANCE IS MEDICARD ONLY TWO SERVICE DATES CAN BE ACCEPTED IN A WEEK, WHEN PRIMARY IS MEDICARE ONLY FIVE SERVICE DATES CAN BE ACCEPTED IN WEEK: WHEN PRIMARY IS MEDICAID AND SECONDARY IS MEDICARE ALL VISITS AFTER TWO IN A WEEK ARE BILLED TO SECONDARY WEEKS RUN SUNDAY TO SATURDAY NOTES: REQUIRE DIGITAL SIGNATURE (OPTIONAL) IF ITS NOT SIMPLE