Service Information. Service Visit Date Mode of service Face-to face, telephone, etc. Responsibility for payment Used to exclude federal govt., WCB, etc. Main and secondary diagnoses ICD10-CA codes Main and other interventions and attributes CCI procedure codes and attributes Type of Anesthetic Identifies the type used for interventions (general, spinal, local, etc.) Provider types NACRS code assigned to provider type (MD, Dentist, RN, etc.) Doctor name and identifier Physician specific information Admit via Ambulance Used if a Client is brought to the service delivery site by ambulance Institution from and institution to Used when a Client is transferred from or to another acute care facility Visit disposition Discharged, admitted, left without being seen, etc. Schedule “D” Appendix 2 Additional Elements Required for Data Management (XXX) Client Identifying Information Province Client‟s Home Province AB, BC, SK, MB, NL, PE, NS, NB, QC, ON, NT, YT, NU, US, OC (Other Country), NR (Unsp. Non-resident) Service Information Facility Code AHS provided code that indicates service being provided. Facility Fee Dollar value of service being provided Alberta Health Physician Fee Billing Code Alberta Health Physician Service Fee code that further defines facility code Regional standard format and submission method remains as is via excel file and email. NOTE: Submission method may be adjusted in accordance with security standards of AHS. Schedule “D” Appendix 3
Service Information. ● Service Visit Date ● Mode of service Face-to face, telephone, etc. ● Responsibility for payment Used to exclude federal govt., WCB, etc. ● Main and secondary diagnoses ICD10-CA codes ● Main and other interventions and attributes CCI procedure codes and attributes ● Type of Anesthetic Identifies the type used for interventions (general, spinal, local, etc.) ● Provider types NACRS code assigned to provider type (MD, Dentist, RN, etc.) ● Doctor name and identifier Practitioner specific information ● Admit via Ambulance Used if a Client is brought to the service delivery site by ambulance ● Institution from and institution to Used when a Client is transferred from or to another acute care facility ● Visit disposition Discharged, admitted, left without being seen, etc. ● Gestational Age for Therapeutic Abortion Cases (applicable to pregnancy termination only) -Gestational age reported in weeks. Client Identifying Information
Service Information. Service Visit Date Mode of service Face-to face, telephone, etc. Responsibility for payment Used to exclude federal govt., WCB, etc. Main and secondary diagnoses ICD10-CA codes Main and other interventions and attributes CCI procedure codes and attributes Type of Anesthetic Identifies the type used for interventions (general, spinal, local, etc.) Provider types NACRS code assigned to provider type (MD, Dentist, RN, etc.) Doctor name and identifier Physician specific information Admit via Ambulance Used if a Client is brought to the service delivery site by ambulance Institution from and institution to Used when a Client is transferred from or to another acute care facility Visit disposition Discharged, admitted, left without being seen, etc. Regional standard format and submission method to be used. NOTE: Reporting requirements will be adjusted in accordance with changes required of AHS by Alberta Health and Wellness. Schedule “D” Appendix 2 Additional Elements Required for Data Management (XXX) Client Identifying Information Province Client‟s Home Province AB, BC, SK, MB, NL, PE, NS, NB, QC, ON, NT, YT, NU, US, OC (Other Country), NR (Unsp. Non-resident) Service Information Facility Code AHS provided code that indicates service being provided. Facility Fee Dollar value of service being provided Alberta Health Physician Fee Billing Code Alberta Health Physician Service Fee code that further defines facility code Regional standard format and submission method remains as is via excel file and email. NOTE: Submission method may be adjusted in accordance with security standards of AHS. Schedule “D” Appendix 3
Service Information. D11.1 You must make available, to Residents and their families/whānau or nominated representatives (if any), Persons who are prospective Residents and their families/whānau or nominated representatives (if any), and any service who refers prospective Residents to providers, information regarding the Services that you must provide under the terms of this Agreement.
Service Information. Our core business is the provision of notarial services to individuals and businesses in Central London and throughout England and Wales. We also offer translation and document legalisation services, either as standalone services or in conjunction with our notarial services. For more information on our services, including the key stages for those services and the likely timescales for each key stage, please visit our website at xxxxx://xxx.xxxxxxx.xxx/Notary- Services-Translation-Legalisation, or contact one of our notaries.
Service Information. Area to be serviced: SAN CLEMENTE LIBRARY Type of facility: Public Library Library Stacks Employee Restrooms Staff Offices Reading Areas Staff Break Room Book Store Public Restrooms Volume of Usage: Library Stacks Moderately Heavy Staff Offices Moderate Staff Break Room Moderate Public Restrooms Moderately Heavy Employee Restrooms Moderate Reading Areas Moderately Heavy Book Store Moderate
Service Information. Service Visit Date Mode of service Face-to face, telephone, etc. Responsibility for payment Used to exclude federal govt., WCB, etc. Main and secondary diagnoses ICD10-CA codes Main and other interventions and attributes CCI procedure codes and attributes Type of Anesthetic Identifies the type used for interventions (general, spinal, local, etc.) Provider types NACRS code assigned to provider type (MD, Dentist, RN, etc.) Doctor name and identifier Physician specific information Admit via Ambulance Used if a Client is brought to the service delivery site by ambulance Institution from and institution to Used when a Client is transferred from or to another acute care facility Visit disposition Discharged, admitted, left without being seen, etc. Schedule “D” Appendix 2 Additional Elements Required for Data Management (XXX) Client Identifying Information Province Client’s Home Province AB, BC, SK, MB, NL, PE, NS, NB, QC, ON, NT, YT, NU, US, OC (Other Country), NR (Unsp. Non-resident) Service Information Facility Code AHS provided code that indicates service being provided. Facility Fee Dollar value of service being provided Alberta Health Physician Fee Billing Code Alberta Health Physician Service Fee code that further defines facility code Regional standard format and submission method remains as is via excel file and email. NOTE: Submission method may be adjusted in accordance with security standards of AHS. Schedule “D” Appendix 3
Service Information. (1) The Provider must have available for Eligible Persons and other interested parties information that describes:
Service Information. Service Visit Date • Mode of service Face-to face, telephone, etc. • Responsibility for payment Used to exclude federal govt., WCB, etc. • Main and secondary diagnoses ICD10-CA codes • Main and other interventions and attributes CCI procedure codes and attributes • Type of Anesthetic Identifies the type used for interventions (general, spinal, local, etc.) • Provider types NACRS code assigned to provider type (MD, Dentist, RN, etc.) • Doctor name and identifier Practitioner specific information • Admit via Ambulance Used if a Client is brought to the service delivery site by ambulance • Institution from and institution to Used when a Client is transferred from or to another acute care facility • Visit disposition Discharged, admitted, left without being seen, etc. • Gestational Age for Therapeutic Abortion Cases (applicable to pregnancy termination only) Gestational age reported in weeks. Additional Elements Required for Data Management (XXX) Client Identifying Information • Province Client’s Home Province AB, BC, SK, MB, NL, PE, NS, NB, QC, ON, NT, YT, NU, US, OC (Other Country), NR (Unsp. Non-resident) Service Information • Facility Code AHS provided code that indicates service being provided. • Facility Fee Dollar value of service being provided • Alberta Health Practitioner Fee Billing Code Alberta Health Practitioner Service Fee code that further defines facility code Regional standard format and submission method remains as is via excel file and email. NOTE: Submission method may be adjusted in accordance with security standards of AHS.
Service Information. D11.1 You must make available to Subsidised Residents and their families, Persons who are prospective Residents and their families, and any service who refers prospective Residents to providers, information regarding the Services that you must provide under the terms of this Agreement.
