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Financial Eligibility widget

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The Financial Eligibility widget displays financial eligibility records entered for a client. This includes financial eligibility, cross episodic financial eligibility and family financial eligibility records.

The following fields should be displayed in the widget:

  • Order (aka Billing Order)
  • Guarantor
  • Episode Number
  • Program
  • Verify  (Yes or No to indicate FE verification)
  • Start End
  • End Date
  • Policy #  (indicator if missing info or blank and plan is billable for the financial class)

The items should be listed in order by Episode, Number, Billing Order, and Guarantor.

If you click on the Guarantor link in the list, the applicable Financial Eligibility, Cross Episode Financial Eligibility, or Family Financial Eligibility form display for the selected client.

Any fields missing required information will be indicated in red to alert you.

Widget SQL Statement

Because this widget was modified to include all the different financial eligibility types, it was handled in cache code and therefore no SQL code is available. However, if you want to use the queries to create separate individual widgets (Standard FE, Cross Episode FE, Family FE) you could use the following SQL statements to create you own widget to meet your organization's needs.

Standard Financial Eligibility

Select:  EP.PATID, EP.EPISODE_NUMBER, EP.program_value, GOEP.guarantor_order_number, GOEP.GUARANTOR_ID, GEMP.eligibility_verified_value, GUAR.customize_guar_plan_value, GEMP.cov_effective_date, GEMP.cov_expiration_date, SUBS.subs_policy, SUBS.subs_ss_number, GUAR.guar_phone_number, DEMO.patient_ssn, DEMO.date_of_birth, EP.preadmit_admission_date, GOEP.e_unique_id FROM SYSTEM.episode_history EP INNER JOIN SYSTEM.patient_current_demographics DEMO ON ((EP.PATID=DEMO.PATID) AND (EP.FACILITY=DEMO.FACILITY)) WHERE EP.FACILITY=?FACILITY AND EP.date_of_discharge IS NULL AND EP.user_row_access_code = '1' AND EP.PATID = ?PATID ORDER BY EP.EPISODE_NUMBER DESC, GOEP.guarantor_order_number

Cross-Episode Financial Eligibility

Select:  GONOEP.PATID, GONOEP.guarantor_order_number, GONOEP.GUARANTOR_ID, GEMP.eligibility_verified_value, GUAR.customize_guar_plan_value, GEMP.cov_effective_date, GEMP.cov_expiration_date, SUBS.subs_policy, SUBS.subs_ss_number, GUAR.guar_phone_number, DEMO.patient_ssn, DEMO.date_of_birth, '' as preadmit_admission_date, GONOEP.por_unique_id FROM SYSTEM.billing_guar_order_no_ep GONOEP WHERE GONOEP.FACILITY=?FACILITY AND GONOEP.PATID = ?PATID ORDER BY GONOEP.guarantor_order_number

Family Financial Eligibility

Select:  GOF.FAMID, GOF.PATID, GOF.guarantor_order_number, GOF.GUARANTOR_ID, GEMP.eligibility_verified_value, GUAR.customize_guar_plan_value, GEMP.cov_effective_date, GEMP.cov_expiration_date, GOF.policy_number AS subs_policy, SUBS.subs_ss_number, GUAR.guar_phone_number, DEMO.patient_ssn, DEMO.date_of_birth, '' as preadmit_admission_date, GOF.por_unique_id FROM SYSTEM.patient_family_history FAMH INNER JOIN SYSTEM.family_member_guar_order GOF ON (GOF.PATID=FAMH.PATID AND GOF.FAMID=FAMH.FAMID AND GOF.FACILITY=FAMH.FACILITY) WHERE GOF.FACILITY=?FACILITY AND FAMH.start_date_of_member <= CURRENT_DATE AND (FAMH.end_date_of_member IS NULL OR FAMH.end_date_of_member >=CURRENT_DATE)  AND FAMH.PATID = ?PATID ORDER BY GOF.guarantor_order_number