Division of Health Care Finance and Policy FY2005 Outpatient Hospital Emergency Department Database 2025

1. Click 'Get Form' to open it in the editor.
2. Begin by entering the 'Filing Org ID' which identifies your hospital. This is crucial for accurate data submission.
3. Fill in the 'Patient's Date of Birth' and 'Registration Date'. Ensure these dates are valid as they are essential for age calculations.
4. Complete the 'Type of Visit' field by selecting from options such as Emergency, Urgent, or Non-Urgent based on the patient's condition.
5. Input the 'Charges' associated with the visit. This should be rounded to the nearest dollar and must not be zero unless specific conditions apply.
6. Review all entries for accuracy, especially fields like 'Departure Status' and 'Source of Visit', as these impact data quality assessments.
7. Once completed, save your form and submit it through our platform for processing. Ensure you receive a confirmation of submission.

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