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FORMAT and FILE SPECIFICATIONS for ONLINE TRANSMISSION: EMERGENCY CARE and AMBULATORY SURGERY DATA Effective with encounters occurring on or after January 1, 2019Version 2.1Revised July 2019ED and
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To fill out emergency care and ambulatory forms, follow these steps: 1. Begin by collecting all the necessary personal information such as name, date of birth, address, and contact details.
02
Next, provide details about the emergency contact person, their relationship to the patient, and their contact information.
03
Fill out the medical history section accurately, including any allergies, chronic illnesses, or previous surgeries.
04
Mention the current symptoms or reasons for seeking emergency care or ambulatory services.
05
Specify any medications that the patient is currently taking or any recent changes in medication.
06
If applicable, provide information about health insurance coverage and policy details.
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Review the filled-out form for any errors or omissions before submitting it to the healthcare provider.
08
If necessary, seek assistance from healthcare staff or ask for clarification if you have any doubts or difficulties in filling out the form.

Who needs emergency care and ambulatory?

01
Emergency care and ambulatory services are needed by individuals who require immediate medical attention for severe injuries or life-threatening conditions.
02
This includes individuals experiencing severe chest pain, sudden loss of consciousness, severe bleeding, difficulty in breathing, suspected stroke symptoms, severe trauma, or any other medical condition that necessitates urgent evaluation and treatment.
03
Ambulatory services are utilized by individuals who need medical attention or monitoring but do not require immediate emergency care. This includes individuals seeking routine check-ups, non-life-threatening injuries, minor illnesses, or pre-planned medical procedures.
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Emergency care and ambulatory services are medical services provided on an outpatient basis for individuals who need immediate medical attention but do not require hospital admission.
Healthcare facilities and providers who offer emergency care and ambulatory services are required to report this information.
Emergency care and ambulatory reports can be filled out electronically or through paper forms provided by the relevant health authorities.
The purpose of emergency care and ambulatory reporting is to ensure timely and accurate documentation of the care provided to patients in urgent situations.
Information such as patient demographics, medical diagnosis, treatment provided, and outcome of the visit must be reported on emergency care and ambulatory forms.
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