This database keeps track of all medical events in your family. Use this database to record pertinent information, such as diagnosis and instructions, to keep a medical history for each family member, and to track insurance billing and payment.
How to use this solution
For each medical event, record the family member, condition, and date. Then use the tabs to enter and view information for the medical provider, treatment, and insurance information.
To see a medical history fo
r each person in the family, run the Medical History report.
How to customize this solution
Create a separate file to hold information on each of the family's regular medical providers and another one for insurance carriers. Then use lookups to quickly and accurately enter information in the Medical Provider and Insurance areas. By using lookups rather than relations, each record will retain the historical data, even if the doctor moves or the insurance information changes.
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ZIP CodeB
Phone NumberB
Date CreatedB
Date ModifiedB
Medical ProviderB
Family MemberB
Date of OnsetB
Medical NeedB
InstructionsB
ResolutionB
7A TreatmentB
Invoice IDB
Claim SubmittedB
Ins Claim NumB
Treatment AmntB
Ins Paid AmountB
Patient AmountB
InsurerB
Ins Group NumB
Ins Policy NumB
Ins Policy HldrB
CA DiagnosisB
Referred ByB
Date of InvoiceB
FA ConditionB
InfoB
Last LayoutB
"AiA%Form View - Medical Need and Provider
A List View
Medical History
Information
Report Menu
@QA#Form View - Treatment and Diagnosis
@IA!Form View - Insurance and Billing
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Medical Need
Date of Onset
Medical Provider
Referred By
Phone
ZIP Code
Address
Treatment Facility
j Condition
Family Member
Medical Need &
Provider
Insurance &
Billing
Treatment &
DiagnosisOwn
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View As
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Medical Need
Date of Onset
Medical Provider
Referred By
Phone
ZIP Code
Address
Treatment Facility
j Condition
Family Member
Medical Need &
Provider
Insurance &
Billing
Treatment &
Diagnosis
o/Enter data for Medical Provider & Family Member
Medical HistoryB
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Q ConditionR
Medical ProviderS
Family MemberT
DateU
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Info_2Click to see more information for a Medical record
InformationB
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Resolution
Instructions
h Diagnosis
i Treatment
Medical Provider
Onset
Family Member
n Condition
Medical Need
Page ##
Medical History
Report MenuB
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Info for this Solution
e Family Medical Records solutionP
Info for this Solution
Your Own
ReportB
Your Own
ReportC
Your Own
ReportD
Medical HistoryE
Your Own
ButtonF
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InfoK>Click on any of these buttons to preview the respective reportL
Select a report
ButtonF
ReportsG
View As
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View As
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InfoK>Click on any of these buttons to preview the respective reportL
Select a report
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d Diagnosis
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Family Member
Medical Need &
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Insurance &
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Treatment &
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l$Enter data for Treatment & Diagnosis
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Patient Amount:
Paid by Insurance:
Total Amount:
Invoice ID
Invoice Date
Billing
Claim Number
Policy Holder
Group Number
Policy Number
Insurer
h Insurance
j Condition
Family Member
Medical Need &
Providerur Own
Button
Your Own
Button
Record
Delete
Record
Record
Reports
View As
View As
Close
Patient Amount:
Paid by Insurance:
Total Amount:
Invoice ID
Invoice Date
Billing
Claim Number
Policy Holder
Group Number
Policy Number
Insurer
h Insurance
j Condition
Family Member
Medical Need &
Provider
Insurance &
Billing
Treatment &
Diagnosis
o"Enter data for Insurance & Billing
3/1/94O
3343 Lark Ln.P
Mountain ViewQ
94040U
415-555-7801X
10/19/95Y
10/19/95_
Dr. Pesnerj
Routine eye exam.y
31684z
Claim Submitted{
438527|
Living Well
33683
20/20 Vision.
Pediatrician
3/1/94
Eye Exam
4/2/94G
Redwood Medical CenterO
542A Sansome St.P
Redwood CityQ
94062U
415-555-8714X
10/19/95Y
10/19/95_
Dr. Howardj
Sallyn
3/28/94q
Treatment of rash.t$Apply prescribed lotion twice daily.u
Cleared up in one week.y
2283z
Claim Submitted{
438562|
Living Well
33683
4/2/94
Poison Oak Rash
4/5/94O
454 BroadwayP
Redwood CityQ
94062U
415-555-9272X
10/19/95Y
10/19/95_
Dr. Lonniganj
Routine Physical Examy
1396z
Claim Submitted{
438785|
Living Well
33683
Good bill of health.
4/5/94
Physical Exam
6/18/94G
Redwood Medical CenterO
539A Sansome St.P
Redwood CityQ
94062U
415-555-1011X
10/19/95Y
10/19/95_
Dr. Martinezj
6/17/94
Your Own
ButtonB
ReportsC
View As
ListD
View As
FormE
CloseF
Sort by Medical Provider
Sort by Condition or Illness
Sort for Medical History
Open Script
Dial Phone
Cancel
Specify Field
Use Dialing Preferences
Phone Number
Field Value
Number
A List View
Information
Report Menu
)=400
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RIZRULER
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) = 0
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ER_DRAWH
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) = 1
Information
List View
Report Menu
Sort by Date
Sort by Patient
Sort by Medical Provider
Sort by Condition or Illness
Sort for Medical History
Medical History
Open Script
Dial Phone
Sort by Date
Sort by Patient
Medical History
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t@Cut down on salt and caffeine, and begin daily exercise program.w
Electrocardiogram, Chest X-Raysy
51681z
Claim Submitted{
438785|
214.4~
Good Hands Health Care
13065
446825
Knight Sheet Metal Corp.
Borderline high blood pressure.
6/18/94
Heart Palpitations
7/14/94G
Redwood Medical CenterO
539A Sansome St.P
Redwood CityQ
94062U
415-555-1011X
10/19/95Y
10/19/95_
Dr. Martinezj
6/17/94t4Continue modified diet and regular exercise program.y
52003z
Claim Submitted{
439684|
Good Hands Health Care
13065
446825
Knight Sheet Metal Corp.
Blood pressure improved.
7/14/94
Heart Palpitations
8/25/94G
Redwood HospitalO
548 The AlamedaP
Redwood CityQ
94062U
415-555-6717X
10/19/95Y
10/19/95_ Dr. Singhj
8/25/94qAEmergency medical treatment. Tom broke leg in motorbike accident.t0Stay off leg as much as possible. Keep cast dry.w
Leg X-Rays. Set leg in cast.y
100106z
Claim Submitted{
442680|
948.63}
853.77
Living Well
33683
C*Multiple fractures in both thigh and shin.
9/1/94
Broken Leg
9/11/94G
Redwood HospitalO
548 The AlamedaP
Redwood CityQ
94062U
415-555-6717X
10/19/95Y
10/19/95_ Dr. Singhj
8/25/94q#Take Tom to doctor to examine cast.t0Stay off leg as much as possible. Keep cast dry.w
Leg X-Rays.y
101048z
Claim Submitted{
445740|
Living Well
33683
Bones are healing well.
9/14/94
Broken Leg
10/1/94G
Redwood HospitalO
548 The AlamedaP
Redwood CityQ
94062U
415-555-6717X
10/19/95Y
10/19/95_ Dr. Singhj
8/25/94q
Remove cast.t@Light exercise for next two weeks. No heavy exercise until then.w
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