Medical Services

The register of Medical Services contains all medical services that can be included in packages of benefits of insurance products administered and remunerated by the health insurance scheme. Administration of the register of medical services is restricted to users with the system role of Scheme Administrator or with a role including an access to Administration/Medical Services.

Pre-conditions

A medical service may only be added or thereafter edited or deleted, after the approval of the management of the scheme administration.

Medical Services Control Page

The Medical Services Control Page is the central point for all medical service administration. By having Access to this panel, it is possible to add, edit, delete and search. The panel is divided into four panels (Img. 66)
  1. Search Panel

    The Search Panel allows a user to select specific criteria to minimise the search results. In the case of medical services the following search options are available which can be used alone or in combination with each other.

    Code

    Type in the beginning of; or the full Code; to search for medical services with a Code, which starts with or matches completely, the typed text.

    Name

    Type in the beginning of; or the full Name to search for medical services with a Name, which starts with or matches completely, the typed text.

    Type

    Select the Type; from the list of types (Preventive, Curative) by clicking on the arrow on the right of the selector, to select medical services of a specific type.

    Show Historical Values

    Click on Show Historical Values to see historical records matching the selected criteria. Historical records are displayed in the result greyed out to distinguish them from current records (Img. 67)

    ../../_images/med_service_history.png

    Img. 67 Historical records - Result Panel

    Search Button

    Once the criteria have been entered, use the search button to filter the records, the results will appear in the result panel.

  2. Result Panel

    The Result Panel displays a list of all medical services found, matching the selected Criteria in the search panel.

    The number of rows per page is limited to 10 by default but one can use the “Rows per page” drop-down in the bottom right of the search results. If there are more rows to display, one can use the page navigation. (Img. 68)

    ../../_images/79_pagination.png

    Img. 68 Page selector- Result Panel

Medical Service Page

  1. Data Entry

    ../../_images/med_service_new.png

    Img. 69 Medical Service Page

    Code

    Enter the code for the medical service. Mandatory, 6 characters.

    Name

    Enter the name of the medical service. Mandatory, 100 characters maximum.

    Category

    Choose the category (Surgery, Consultation, Delivery, Antenatal, Other) which the medical service belongs to.

    Type

    Choose one from the options available (Preventive, Curative), the type of the medical service. Mandatory.

    Level

    Select from the list (Simple Service, Visit, Day of Stay, Hospital Case), the level for the medical service. Mandatory.

    Price

    Enter the price a general price that can be overloaded in pricelists. Full general price (including potential cost sharing of an insuree) for the medical service. Mandatory.

    Care Type

    Choose one from the options available (Out-patient, In-patient, Both), the limitation of provision of the medical service to the specific type of health care. Mandatory.

    Frequency

    Enter the limitation of frequency of provision in a number of days within which a medical service can be provided to a patient not more than once. If the frequency is zero, there is no limitation. Note: By default the frequency is 0.

    Patient

    Choose one or a combination of the options available, to specify which patient type the medical service is applicable to. Note: By default all patient options are checked (selected).

  2. Saving

    Once all mandatory data is entered, clicking on the Save button will save the record. The user will be re-directed back to the Medical Services Control Page, with the newly saved record displayed and selected in the result panel. A message confirming that the medical service has been saved will appear on the Information Panel.

  3. Mandatory data

    If mandatory data is not entered at the time the user clicks the Save button, a message will appear in the Information Panel, and the data field will take the focus (by an asterisk on the right of the corresponding data field).

  4. Cancel

    By clicking on the Cancel button, the user will be re-directed to the Medical Services Control Page.

Adding a Medical Service

Click on the Add button to re-direct to the Medical Service Page.

When the page opens all entry fields are empty. See the Medical Service Page for information on the data entry and mandatory fields.

Editing a Medical Service

Double-click on a row to re-direct to the Medical Service Page.

The page will open with the current information loaded into the data entry fields. See the Medical Service Page for information on the data entry and mandatory fields.

Deleting a Medical Service

Click on the Cancel button to delete the currently selected record; the user is re-directed the Medical Services Control Page.

Before deleting a confirmation popup (Img. 70) is displayed, which requires the user to confirm if the action should really be carried out?

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Img. 70 Delete confirmation- Button Panel

When a medical service is deleted, all records retaining to the deleted medical service will still be available by selecting historical records.