| 6 | Patient Summary:
Age/Sex: 57, Female
Visit Date: 01/03/2024
Chief Complaint:
Gall stones, T2DM on glucophage 500 mg bid, no known drug allergies.
Previous surgeries: appendectomy, right forea... | Ultrasound of the abdomen, CBC, renal profile, liver function profile, C-Reactive Protein, Amylase. were requested but no CPT codes mapped with them.
I would prefer that the history mentions that only these specific surgeries were done, as gallstones can be a direct complication of bariatric surgeries (eg sleeve gasterctomy) which are not covered by insurance.
recommendations of laproscopic choleycystectomy without mentioning the ultrasound findings? guidlines entails that gallstone should be a minimum of 4mm for surgery.
medications were given to the patient but was not provided in the claim details which is crucial and should include the following:
prescription, duration dosage, brand name and chemical name.
Renal profile was requested with no indication other than the patient being diabetic, which could be rejected if patient did the test in the past 3 months | 2024-09-29 08:40:03 | Standard |
| 7 | Patient Summary:
Age/Sex: 33, Male
Visit Date: 02/03/2024
Chief Complaint:
Follow-up for mixed hyperlipidemia and fibromyalgia.
The patient is doing better.
Allergies:
No known allergies.... | simple case for follow up and medication refil.
medications prescribed should be as per MOH drug list format.
| 2024-09-28 19:35:27 | Standard |
| 8 | Patient Summary:
Age/Sex: 12, Male
Visit Date: 02/03/2024
Chief Complaint:
Left ankle pain since morning, with a history of trauma during play 3 days ago.
Fever in the morning.
Vitals:
Te... | prolactonin will be rejected as it is not first line, cbc and crp should be checked first and based on their results, it may be considered.
usually with trauma/injury cases (although not applicable in this case but if the processor practices scrunity) will require the following details: where (to exclude work related injuries as it is not covered) when (to evaluate the duration and onset of the condition and match it with the history and presenting signs and symptoms) how (to exclude self inflicted injuries, and match it with signs and sympotoms)
wrong cpt mapped as 29075 is for upper limbs, case is for lower limb (ankle) | 2024-09-28 19:42:03 | Standard |
| 9 | Patient Summary:
Age/Sex: 50, Male
Visit Date: 03/03/2024
Chief Complaint:
Cough, mucus, right eye discharge, symptoms started 2 days ago.
Vitals:
Temperature: 36.9°C, Heart Rate: 85 bpm,... | ICD H10.13 is for bilateral while history ditcates left eye only.
ESR not indicated with CRP
Creatinine may be rejected, can be considered with patients age.
Zinc is not indicated in this case and not covered by most insurance policies
medications should be in MOH drug list format.
| 2024-09-28 19:52:04 | Standard |
| 10 | Patient Summary:
Age/Sex: 40, Female
Visit Date: 03/03/2024
Chief Complaint:
Bilateral lower limb swelling (mainly in the evening), palpitations, no chest pain.
Vitals:
Temperature: 36.5°... | HbA1C may be rejected as no history of diabetes and RBS/FBS was not done initially.
patient is on crestor (for lipids) history did not mention but recommendations were given
medications should follow MOH drug list format
patient has palpitations but no ecg (especially with bilateral lower limbs swelling) or tsh was recommended | 2024-09-28 19:58:17 | Standard |
| 11 | Patient Summary:
Age/Sex: 41, Male
Visit Date: 07/03/2024
Chief Complaint:
Type 2 diabetes since 2011, fatty liver, low vitamin D.
Vitals:
Temperature: 35.8°C, Heart Rate: 73 bpm, O2 Sat:... | low vitamin d levels mentioned in history but previous report details was not shared (to follow vitamin d testing guidelines) and no signs or symptoms related to vitamin d deficiency were mentioned.
| 2024-09-28 20:00:45 | Standard |
| 12 | Patient Summary:
Age/Sex: 36, Female
Visit Date: 05/03/2024
Chief Complaint:
Follow-up for anemia, vitamin D deficiency, and hypercholesterolemia.
Vitals:
Temperature: 37°C, Heart Rate: 8... | vitamin d rejected, no indication as per presenting sings and symptoms, no previous report details
| 2024-09-28 20:02:39 | Standard |
| 13 | Patient Summary:
Age/Sex: 11, Female
Visit Date: 04/03/2024
Chief Complaint:
Headache, nausea, vomiting, chest pain, abdominal pain.
Vitals:
Temperature: 37.3°C, Blood Pressure: 101/63 mm... | CT brain rejected as not first line in diagnoning an acute case of headache.
no tests we ordered for the other complaints ( cbc, crp, h pylori and electrolytes)
| 2024-09-28 20:10:58 | Standard |
| 14 | Patient Summary:
Age/Sex: 14, Female
Visit Date: 13/03/2024
Chief Complaint:
Follow-up for anemia.
Vitals:
Temperature: 37.1°C, Height: 146.5 cm, Weight: 36.9 kg, BMI: 17.
Initial Diagno... | previous vitamin d levels required with supplementation history for repeat test. no presenting signs and symptoms suggesting vitamin d def | 2024-09-28 20:13:06 | Standard |
| 15 | Patient Summary:
Age/Sex: 37, Female
Visit Date: 05/03/2024
Chief Complaint:
Previous 3 C-sections, trying to conceive, ovulation issues.
Vitals:
Temperature: 36°C, Heart Rate: 66 bpm, O2... | trying to concieve = rejected, anything related to contraception and fertility is not covered.
pap smear rejected as screening
ultra co-q and ovacre are not covered as a policy exclusion | 2024-09-28 20:15:47 | Standard |
| 16 | Chief Complaint
Recorded by Dr. SABA NOORI ABDULHASSAN ABDULHASSAN, Employee License No: 14076, on 03/03/2024 at 19:06:17
37 y, P4+1
Previous 3 LSCS, LCB 2018
1 miscarriage (24 weeks)
No contrace... | infertility not covered, requested tests not covered, screening tests not covered
claim rejected | 2024-09-28 20:18:56 | Standard |
| 17 | Chief Complaint
Recorded by Dr. ALI ABDULMUNAEM AL SABBBAGH, Employee License No: 6865, on 04/03/2024
The patient, a 2-year-old female, presented with acute onset of frequent vomiting (more than 10 ... | good claim, no commnets | 2024-09-28 20:21:03 | Standard |
| 18 | Chief Complaint
Recorded by Dr. FARID YOUSEF ZIDAN, Employee License No: 10348, on 11/03/2024 at 12:00:27
Follow up after investigation
Vitamin D deficiency, Urea breath test positive (68)
Aller... | hexibo (probiotic) and eucarbon (not FDA Approved) not covered
vitamin d withour repoorts | 2024-09-28 20:26:41 | Standard |
| 19 | Chief Complaint
Recorded by Dr. HALA A. AL SHAIKH, Employee License No: 5721, on 04/03/2024 at 10:36:38
17 years and 5 months old girl
Type 1 Diabetes Mellitus (DM) diagnosed in April 2011
On Insu... | considered an autoimmune condition which most policies does not cover.
claim may be rejected accordingly | 2024-09-28 20:28:30 | Standard |
| 20 | Chief Complaint
Recorded by Dr. ZAID SAHEB MOHAMMED SEDAAI, Employee License No: 10371, on 05/03/2024 at 17:20:40
Chief Complaints:
CAD
Hypertension (HTN)
Diabetes Mellitus (DM)
Dyslipidemia (... | surgery suggested with no investigations (ecg, echo, tmt, troponin)
medications adjustement is fine, with the supportive labs. | 2024-09-28 21:25:45 | Standard |
| 21 | Chief Complaint
Recorded by Dr. HALA A. AL SHAIKH, Employee License No: 5721, on 04/03/2024 at 10:36:38
17 years and 5 months old girl
Type 1 Diabetes Mellitus (DM) diagnosed in April 2011
On Insu... | type 1 diabetes is an autoimmune condition, most policies dont covere autoimmune.
claimkit should alert the same to confirm coverage before proceeding | 2024-09-29 05:17:38 | Standard |
| 22 | Chief Complaint
Recorded by Dr. ZAID SAHEB MOHAMMED SEDAAI, Employee License No: 10371, on 04/03/2024 at 11:43:44
Chief Complaints:
Headache
Body dryness
Poor sleep
General tiredness
Palpitat... | wrong icd R22.9
vitamin d and b12 and calcium rejected as screening and not indicated, not related to the presenting signs and symptoms
psychiatric related issues to be confirmed with policy coverage as usually it is excluded | 2024-09-29 05:22:32 | Standard |
| 23 | Chief Complaint
Recorded by Dr. SAEED IQBAL, Employee License No: 6020, on 04/03/2024 at 11:54:42
Chief Complaints:
Cough
Cold
Flu
Leg and bone pains
On steroids for more than 2 years
Feel... | cbc report could be asked to justify the request for TIBC
claimkit should extract the medications prescribed from the history and add it in the summary/pdf | 2024-09-29 05:26:35 | Standard |
| 24 | Chief Complaint
Recorded by Dr. FOROUGH RADFAR, Employee License No: 248906, on 06/03/2024 at 10:57:03
Chief Complaints:
Married for 1 year and 2 months
Complains of abnormal periods, delayed fo... | icd Z01.419 for ultrasound request instead of cpt 76856
ferose prescribed without checking blood tests = rejected | 2024-09-29 05:32:29 | Standard |
| 25 | Chief Complaint
Recorded by Dr. SARA MOHAMMED FADLY FAHMY, Employee License No: 17154, on 11/03/2024 at 14:04:11
27 years old
Married for 3 years
No pregnancies
Using natural contraception
Reg... | Polycystic Ovarian Syndrome not covered under most insurance policies
folliculometry not covered as infertility related
oligiocare,. co q10 and pregnacre conception not covered.
| 2024-09-29 05:37:06 | Standard |
| 26 | Patient Information:
MRN: 301688
Episode No: 315908
Patient Name: Layan Mahmood Al Harthi
Provider Name: Dr. Mohd Jaffer Sajwani
Encounter No: 226885
Visit ID: VST0307473
Visit Date: 22/02/20... | cpt code for ultrasound KUB should be generated by claimkit | 2024-09-29 05:48:03 | Standard |
| 27 | Patient Information:
MRN: 305741
Episode No: 320423
Patient Name: Ahmed Saud Al-Bartamani
Provider Name: Dr. Manish Dhabalia
Encounter No: 152929
Visit ID: VST0311633
Visit Date: 06/03/2024
... | no indications for CT and MRI
no initial radiology tests (usg)
no details of injury/trauma
no physical examinaiton findings provided (hawkins, neers, jobbe's ect..)
claim rejected | 2024-09-29 05:50:37 | Standard |
| 28 | Chief Complaint
Recorded by Dr. HALA ZEINELABDIN IBRAHIM EL IMAM, Employee License No: 17907, on 04/03/2024 at 17:20:35
Dizziness, chest discomfort since morning
21 years old, no comorbidities
F... | betadine throat spray rejected as a standard exclusion
other diagnostic tests should be considered (eg. crp & electrolytes )
renal profile could be rejected in this case | 2024-09-29 06:02:24 | Standard |
| 29 | Chief Complaint
Recorded by Dr. ALAA MOHAMMAD AHMAD, Employee License No: 13741, on 04/03/2024 at 12:17:11
Chief Complaints:
Recurrent UTI, started a few years ago
2-3 episodes per year, last ep... | preventetive treatments are not covered under insurance, urovaxam
urine routine required to support the diagnosis and urine culture to confirm and identify the bacterial strand for appropriate prescription
| 2024-09-29 08:20:03 | Standard |
| 30 | Chief Complaint
Recorded by Dr. HALA ZEINELABDIN IBRAHIM EL IMAM, Employee License No: 17907, on 04/03/2024 at 22:51:46
Left loin pain, dysuria, nausea since morning
28 years old, hypothyroidism ... | wrong cpt mapped CPT Code: 87086 is for urine culture, not urine analysis,
only one diagnosis mentioned, there should be primary diagnosis (unspecidied renal colic) and secondary diagnosis as well
diagnostic provedures should have their equivalent cpt codes.
chronic gonadotriphin and beta hcg not indicated as per LMP date, maternity coverage should be confirmed
| 2024-09-29 08:28:09 | Standard |
| 31 | Chief Complaint
Recorded by Dr. MOHAMED REDHA MOOSA YOOSUF AL LAWATI, Employee License No: 13921, on 05/03/2024
The patient, a 60-year-old female, visited Internal Medicine on 05/03/2024 for diabe... | specific tests requested should have cpt codes
secondary diagnosis with ICD should be provided (hypertension, hypthyroidism, hyperlipidemia) otherwise their medications and related tests will be rejected | 2024-09-29 08:31:18 | Standard |
| 32 | Chief Complaint
Recorded by Dr. ZAINAB ALI, Employee License No: 11070, on 04/03/2024 at 12:31:31
PCOS (Polycystic Ovarian Syndrome)
Duphaston taken for two months and then stopped
Now Primolut ... | PCOS not covered as a standard exclusion, which includes the treatments as well.
whole claim will be rejected.
diagnostic requests should be mapped with their equivalent cpt codes | 2024-09-29 08:35:47 | Standard |
| 33 | Chief Complaint
Recorded by Dr. ELENA LUKANSKAJA, Employee License No: 13555, on 05/03/2024 at 10:09:55
Follow-up
Complains of lower abdominal pain, spotting from the vagina
LMP: 10/02/2024, tod... | CPT Code 76856 (Ultrasound, pelvic) under the symptoms where it should be under the diagnostic requests
nothing else to note | 2024-09-29 08:39:32 | Standard |
| 34 | Chief Complaint
Recorded by Dr. ADIL AL GHAFRI, Employee License No: 261, on 05/03/2024 at 18:45:17
Follow-up OPD visit
56-year-old female with the following background:
No comorbidities
Query IA (... | | 2024-09-28 11:49:20 | Standard |
| 35 | Chief Complaint
Recorded by Dr. JUMA AL LAWATI, Employee License No: 15749, on 05/03/2024 at 11:20:08
Complaints:
Heartburn
Itching in the perianal area
History of Present Illness:
Few days history o... | | 2024-09-28 11:49:43 | Standard |
| 36 | Chief Complaint
Recorded by Dr. MOHAMED REDHA MOOSA YOOSUF AL LAWATI, Employee License No: 13921, on 05/03/2024
The patient, a 60-year-old female, visited the Internal Medicine department on 05/03/20... | | 2024-09-28 11:50:10 | Standard |
| 37 | Allergies
Recorded by Not Selected. JACOB PHILIP, on 11-Dec-2021
No Known Allergies
Triage Details
Recorded by Ms. NEETHU JOJI, on 28-Oct-2023
Triage Code: T3
Triage Category: URGENT
Acuity: Attend ... | | 2024-09-28 11:50:31 | Standard |
| 38 | Chief Complaint
Recorded by Dr. MOHAMED REDHA MOOSA YOOSUF AL LAWATI, Employee License No: 13921, on 05/03/2024
The patient, a 29-year-old male, visited the Internal Medicine department on 05/03/2024... | | 2024-09-28 11:51:21 | Standard |
| 39 | Chief Complaint
Recorded by Dr. JUMA AL LAWATI, Employee License No: 15749, on 05/03/2024 at 11:20:08
Complaints of heartburn and itching in the perianal area
Few days history of heartburn, no alarm ... | | 2024-09-28 11:51:39 | Standard |
| 40 | Chief Complaint
Recorded by Dr. BASHIR AHMED BHAT, Employee License No: 12550, on 05/03/2024 at 17:00:57
Difficulty in walking with pain in the right leg around the knee area
No fever
No history of t... | | 2024-09-28 11:51:56 | Standard |
| 41 | Chief Complaint
Recorded by Dr. ADIL AL GHAFRI, Employee License No: 261, on 05/03/2024 at 18:45:17
Follow-up OPD visit
56-year-old female with the following background:
No comorbidities
Query IA (In... | | 2024-09-28 11:52:14 | Standard |
| 42 | Chief Complaint
Recorded by Dr. FARID YOUSEF ZIDAN, Employee License No: 10348, on 05/03/2024 at 17:08:17
Follow-up for his condition
BP: 166/89, HR: 85
His condition is good
No edema
Blood sugar is ... | | 2024-09-28 11:52:31 | Standard |
| 43 | Chief Complaint
Recorded by Dr. ZAID SAHEB MOHAMMED SEDAAI, Employee License No: 10371, on 05/03/2024 at 09:29:00
Smoker, non-alcoholic
Chief Complaints:
General tiredness, body aches, poor sleep, ch... | | 2024-09-28 11:52:52 | Standard |
| 44 | Chief Complaint
Recorded by Dr. SALIM AL HARTHY, Employee License No: 360, on 14/02/2024
The patient, a 37-year-old female, visited the Gastroenterology department on 14/02/2024 at 17:10:08 for abdom... | | 2024-09-28 11:53:36 | Standard |
| 45 | Chief Complaint
Recorded by Dr. HALA A. AL SHAIKH, Employee License No: 5721, on 06/03/2024 at 10:45:50
11 years and 10 months old girl
Complaining of on and off headaches and fatigue for the past 6 ... | | 2024-09-28 11:54:28 | Standard |
| 46 | Chief Complaint
Recorded by Dr. FOROUGH RADFAR, Employee License No: 248906, on 04/03/2024 at 14:35:30
P2, both deliveries by NVD (Normal Vaginal Delivery), last delivery 18 years ago
LMP: 29/01/2024... | | 2024-09-28 11:55:25 | Standard |
| 47 | Chief Complaint
Recorded by Dr. HILAL NASSER AL-MUSALHI, Employee License No: 255, on 14/02/2024 at 16:51:53
37-year-old married woman with a past medical history (PMH) of gestational diabetes mellit... | | 2024-09-28 11:55:51 | Standard |
| 48 | Chief Complaint
Recorded by Dr. HILAL NASSER AL-MUSALHI, Employee License No: 255, on 06/03/2024 at 17:17:07
Type 2 Diabetes Mellitus (DM) diagnosed in April 2014
Vitamin D3 deficiency
Reflow 15 mmol... | | 2024-09-28 11:56:10 | Standard |
| 49 | Chief Complaint
Recorded by Dr. HILAL NASSER AL-MUSALHI, Employee License No: 255, on 06/03/2024 at 15:49:01
Hashimoto's thyroiditis with Anti-TPO-Ab > 1300
On Metformin as per advice from gynecologi... | | 2024-09-28 11:57:03 | Standard |
| 50 | Chief Complaint
Recorded by Dr. HILAL NASSER AL-MUSALHI, Employee License No: 255, on 14/02/2024 at 16:51:53
37-year-old married lady with a past medical history (PMH) of gestational diabetes mellitu... | | 2024-09-28 11:57:30 | Standard |
| 51 | Chief Complaint
Recorded by Dr. HILAL NASSER AL-MUSALHI, Employee License No: 255, on 06/03/2024 at 17:17:07
Type 2 DM (Diabetes Mellitus) diagnosed in April 2014
Vitamin D3 deficiency
Reflow: 15 mmo... | | 2024-09-28 11:58:21 | Standard |
| 52 | Chief Complaint
Recorded by Dr. SABAH AWAD, Employee License No: 21379, on 06/03/2024 at 20:04:15
9-year-old boy
No PMHx, no drug allergies
Chief complaint: Epigastric abdominal cramps, nausea, vomit... | | 2024-09-28 11:58:42 | Standard |
| 53 | No report | No feedback provided | 2024-10-30 18:11:58 | Unknown |