ID

17247

Description

Formulare für die vertragsärztliche Versorgung Freigabe durch Dezernat 4 - Ärztliche Leistungen und Versorgungsstruktur Geschäftsbereich Sicherstellung und Versorgungsstruktur Abteilung Sicherstellung Herbert-Lewin-Platz 2 10623 Berlin Tel: + 49 (0) 30 - 4005 -1418 Fax: + 49 (0) 30 - 4005 - 271418 Email: SJohn@KBV.de Web: www.kbv.de Quelle: http://www.kbv.de/html/formulare.php Forms for contract medical care Released by Department 4 - Medical treatment and structure of supply, division ensurance and structure of supply, department ensurance Herbert-Lewin-Platz 2 10623 Berlin Tel: + 49 (0) 30 - 4005 -1418 Fax: + 49 (0) 30 - 4005 - 271418 Email: SJohn@KBV.de Web: www.kbv.de Source: http://www.kbv.de/html/formulare.php

Link

www.kbv.de

Keywords

Versions (1)
  1. 9/2/16 9/2/16 -
Uploaded on

September 2, 2016

DOI

To request one please log in.

License

Creative Commons BY-NC 3.0
Model comments :

You can comment on the data model here. Via the speech bubbles at the itemgroups and items you can add comments to those specificially.

Back to model comments
Itemgroup comments for :

Item comments for :

  • Newest
  • Oldest
  • Popular
  • Newest
    • Newest
    • Oldest
    • Popular

    No comments

    In order to download data models you must be logged in. Please log in or register for free.

    Refusal of benefits for psychotherapy

    German

    Refusal of benefits for psychotherapy

    1 forms  
    Briefkopf
    Description

    Briefkopf

    Name der Krankenversicherung
    Description

    Health Insurance name

    Data type

    text

    Alias
    UMLS CUI [1]
    C0021682
    Nachname
    Description

    Patient surname

    Data type

    text

    Alias
    UMLS CUI [1]
    C0421448
    Patientenname
    Description

    Patient Name

    Data type

    text

    Alias
    UMLS CUI [1]
    C1299487
    Adresse des Patienten
    Description

    Patient address

    Data type

    text

    Alias
    UMLS CUI [1]
    C0421449
    Patient Geburtsdatum
    Description

    Patient Birth Date

    Data type

    date

    Alias
    UMLS CUI [1]
    C0421451
    Kostenträgerkennung
    Description

    Insurance ID

    Data type

    integer

    Alias
    UMLS CUI [1]
    C1547687
    Versichertennummer
    Description

    Insurance number

    Data type

    integer

    Alias
    UMLS CUI [1]
    C1549712
    Status
    Description

    Status

    Data type

    integer

    Alias
    UMLS CUI [1]
    C0449438
    Betriebsstättennummer
    Description

    Facility number

    Data type

    integer

    Alias
    UMLS CUI [1]
    C1549700
    Arzt- Nr.
    Description

    Physician ID number

    Data type

    integer

    Alias
    UMLS CUI [1]
    C1548646
    Datum
    Description

    Date

    Data type

    date

    Alias
    UMLS CUI [1]
    C0011008
    Name und Anschrift des Therapeuten
    Description

    Name and address of the psychotherapist

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C0557555
    UMLS CUI [1,2]
    C1442065
    Kassenmitarbeiter
    Description

    Contact person

    Data type

    text

    Alias
    UMLS CUI [1]
    C0337611
    Telefon Durchwahl
    Description

    Phone number

    Data type

    integer

    Alias
    UMLS CUI [1]
    C1515258
    Ablehnung
    Description

    Ablehnung

    Nachname
    Description

    Patient surname

    Data type

    text

    Alias
    UMLS CUI [1]
    C0421448
    Patientenname
    Description

    Patient Name

    Data type

    text

    Alias
    UMLS CUI [1]
    C1299487
    Adresse des Patienten
    Description

    Patient address

    Data type

    text

    Alias
    UMLS CUI [1]
    C0421449
    Patient Geburtsdatum
    Description

    Patient Birth Date

    Data type

    date

    Alias
    UMLS CUI [1]
    C0421451
    Die Leistungspflicht für die beantragte Psychotherapie ist nicht gegeben. Der Patient wurde von dieser Entscheidung unterrichted.
    Description

    Obligation refused

    Data type

    boolean

    Alias
    UMLS CUI [1]
    C0557187
    Eine Ausfertigung der gutachterlichen Stellungnahme wurde Ihnen vom Gutachter übersandt.
    Description

    Assessor report

    Data type

    boolean

    Alias
    UMLS CUI [1,1]
    C0401804
    UMLS CUI [1,2]
    C0242278
    Unterschrift
    Description

    Signature

    Data type

    text

    Alias
    UMLS CUI [1]
    C1519316
    Back to the top of the page

    Similar models

    Refusal of benefits for psychotherapy

    1 forms
    Name
    Type
    Description | Question | Decode (Coded Value)
    Data type
    Alias
    Item Group
    Briefkopf
    Health Insurance name
    Item
    Name der Krankenversicherung
    text
    C0021682 (UMLS CUI [1])
    Patient surname
    Item
    Nachname
    text
    C0421448 (UMLS CUI [1])
    Patient Name
    Item
    Patientenname
    text
    C1299487 (UMLS CUI [1])
    Patient address
    Item
    Adresse des Patienten
    text
    C0421449 (UMLS CUI [1])
    Patient Birth Date
    Item
    Patient Geburtsdatum
    date
    C0421451 (UMLS CUI [1])
    Insurance ID
    Item
    Kostenträgerkennung
    integer
    C1547687 (UMLS CUI [1])
    Insurance number
    Item
    Versichertennummer
    integer
    C1549712 (UMLS CUI [1])
    Status
    Item
    Status
    integer
    C0449438 (UMLS CUI [1])
    Facility number
    Item
    Betriebsstättennummer
    integer
    C1549700 (UMLS CUI [1])
    Physician ID number
    Item
    Arzt- Nr.
    integer
    C1548646 (UMLS CUI [1])
    Date
    Item
    Datum
    date
    C0011008 (UMLS CUI [1])
    Name and address of the psychotherapist
    Item
    Name und Anschrift des Therapeuten
    text
    C0557555 (UMLS CUI [1,1])
    C1442065 (UMLS CUI [1,2])
    Contact person
    Item
    Kassenmitarbeiter
    text
    C0337611 (UMLS CUI [1])
    Phone number
    Item
    Telefon Durchwahl
    integer
    C1515258 (UMLS CUI [1])
    Item Group
    Ablehnung
    Patient surname
    Item
    Nachname
    text
    C0421448 (UMLS CUI [1])
    Patient Name
    Item
    Patientenname
    text
    C1299487 (UMLS CUI [1])
    Patient address
    Item
    Adresse des Patienten
    text
    C0421449 (UMLS CUI [1])
    Patient Birth Date
    Item
    Patient Geburtsdatum
    date
    C0421451 (UMLS CUI [1])
    Obligation refused
    Item
    Die Leistungspflicht für die beantragte Psychotherapie ist nicht gegeben. Der Patient wurde von dieser Entscheidung unterrichted.
    boolean
    C0557187 (UMLS CUI [1])
    Assessor report
    Item
    Eine Ausfertigung der gutachterlichen Stellungnahme wurde Ihnen vom Gutachter übersandt.
    boolean
    C0401804 (UMLS CUI [1,1])
    C0242278 (UMLS CUI [1,2])
    Signature
    Item
    Unterschrift
    text
    C1519316 (UMLS CUI [1])
    Back to the top of the page 

    Help

    Do you need help on how to use the search function? Please watch the corresponding tutorial video for more details and learn how to use the search function most efficiently.

    Watch Tutorial