Complete listing of all data points passed to the Kipu EMR from the Kipu CRM upon the transfer of a treatment opportunity, please see below:
*Dated 5/20/2024
Patient Demographics
- First Name
- Middle Name
- Last Name
- Preferred Name
- Date of Birth
- Marital Status
- Primary Phone Number
- Pronouns
- Preferred Language
- Preferred Contact Method
- Race
- The value must match 1:1 between CRM & EMR
- Ethnicity
- The value must match 1:1 between CRM & EMR
- Date of Death
- Sobriety Date
- Social Security Number
- Billing Type Address (line 1, line 2, city, state, zip, country)
- Alternative Address (Mailing or Physical)
- Employer Name
- Employer Phone
- Gender
- Gender Identity
- First Contact Date (Based on the contact date documented on the initial treatment opportunity on file for the patient).
- Care Coordinator (represented as Rep on Intake Call)
- 1st Contact Name
- 1st Contact Phone
- 1st contact relationship
- Occupation
- Payment Method
- Client ID
- OTO (aka "One Time Only")
Insurance Data
- Insurance Company Name
- Effective Date
- Subscriber Full Name
- Subscriber SSN
- Subscriber Gender
- Subscriber DOB
- Group Number
- Subscriber Address (Line 1, Line 2, City, State, Zip, Country)
- Member ID
- Subscriber Relationship
- Insurance Category
- External Payor ID
- Group Plan Name
- Insurance Type
- Payor Shortcode
- Insurance Plan Period
- Plan Type
- Subscriber Employer
- Rx Name
- Rx Group
- Rx Bin
- Rx PCN
- Precertification Company
- Precertification Phone
- Insurance Card Images (Front & Back)
Patient Contacts
- Full Name
- Relationship
- Contact Type
- Primary Phone Number
- Address Details (Line 1, Line 2)
- Notes
Treatment Opportunity Data
- Estimated Program
- Proposed Facility
- Estimated Facility (takes precedent over proposed facility)
- Sobriety Date
- Bed
- Actual Discharge To
- Estimated Admit Date
- Estimated Discharge Date