1. Total Healthcare Database
myHealth™
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2. CURRENT USER Secure Login
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6. myHealth™ myHealth™ PERSONAL PROFILE Help LOG OUT Contact Career
NAME: DAVID MUNIC
SSN:
TELEPHONE:
ADDRESS: RAILROAD AVE
RIDGEFIELD NJ 07657
DOB: 02/29/1967
GENDER: M
MARITAL STATUS: MARRIED
LANGUAGE: ENGLISH
ETHNICITY:
EMERGENCY CONTACT:
RELATIONSHIP TO CONTACT: BROTHER
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Occupation:
Mobile #:
Policy: ACTIVE effective 10/1/09
PPO
Name of Plan:
My Id #:
Policy Type: Family Coverage
Group #:
Deductible:
Group Name: ABC Corp
Primary Insurance
Secondary Insurance
PPO
Name of Plan:
My Id #:
Policy Type: Family Coverage
Group #:
Deductible:
Group Name: XYZ Corp
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7. PERSONAL PROFILE – MEDICAL HISTORY
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PERSONAL PROFILE – MEDICAL HISTORY
Check all that apply
Have you ever had or do you currently have:
Heart Disease
Diabetes
High Blood Pressure
Stroke
Peripheral Artery Disease
Kidney Disease
Hepatitis A
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Hepatitis C
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COPD
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STD’s
Coronary Artery Disease
Ulcerative Colitis
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8. myHealth™ myHealth™ ADVANCE SORT / SEARCH Help LOG OUT Contact Career
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9. SAMPLE OUTPUT - RESULTS WHEN SORTED BY DATE
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SAMPLE OUTPUT - RESULTS WHEN SORTED BY DATE
DATE
DOCTORS
CHARGES
AMT. PAID BY INS
BALANCE DUE
1/10/2010
Judeith William
200.00
180.00
20.00
1/3/2010
Sheral Parker
300.00
260.00
40.00
1/25/2010
880.00
800.00
80.00
FOR EXAMPLE: SORT ALL VISIT IN 2010
DATE
DOCTORS
CHARGES
AMT. PAID BY INS
BALANCE DUE
3/6/2007
William Cole
200.00
180.00
20.00
2/12/2007
Sheral Parker
500.00
400.00
100.00
5/8/2006
Judeith William
700.00 -
4/10/2006
Neil Bacchus
380.00
12/15/2006
George Kazal
375.00
25.00
FOR EXAMPLE: SORT ALL VISIT IN 2006 & 2007
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10. SAMPLE OUTPUT - RESULTS WHEN SORTED BY DOCTOR
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SAMPLE OUTPUT - RESULTS WHEN SORTED BY DOCTOR
DATE
DOCTORS
CHARGES
AMT. PAID BY INS
BALANCE DUE
5/5/2009
Adam Smith
700.00 -
10/10/2008
600.00
550.00
50.00
SORT ALL VISITS BY ADAM SMITH
DATE
DOCTORS
CHARGES
AMT. PAID BY INS
BALANCE DUE
5/5/2009
Adam Smith
700.00 -
10/10/2008
600.00
550.00
50.00
2/3/2009
George Kazal
1,200.00
12/15/2006
400.00
375.00
25.00
SORT ALL VISITS BY ADAM SMITH & GEORGE KAZAL
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11. SAMPLE OUTPUT - RESULTS WHEN SORTED BY DATE & DOCTOR
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SAMPLE OUTPUT - RESULTS WHEN SORTED BY DATE & DOCTOR
DATE
DOCTORS
CHARGES
AMT. PAID BY INS
BALANCE DUE
5/5/2009
Adam Smith
700 -
2/3/2009
George Kazal
1,200.00
SORT ALL RECORDS FOR ADAM SMITH & GEORGE KAZAL FOR 2009
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12. MEDICAL RECORD SUMMARY
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MEDICAL RECORD SUMMARY
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Reason for Visit
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Total Cost
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13. DETAILED MEDICAL RECORDS
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DETAILED MEDICAL RECORDS
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Print Displayed Table
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Reason for Visit
Doctor’s Notes (PDF)
Prescriptions (PDF)
Lab Test (PDF)
Image Data (X-Ray, etc.) (TIF)
Follow-up Visit (Date)
Sample Output Screen for common fields – Detailed Medical Records
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14. Request an appointment Request a refill on current prescription
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PPO
EMPIRE BC/BS
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DESCRIBE YOUR SYMPTOMS
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15. Request an appointment Request a refill on current prescription
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SELECT A DATE
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16. Request an appointment Request a refill on current prescription
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17. myHealth™ Contact Name: ID # Email: Tel #: Comments:
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Comments:
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