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Chris Allan

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Inpatient

ADT : Insurance Details

Pre-Admit / Admit

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Insurance Details

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Patient Pathway

Patient ID :

008988 (007860)

Centurion House, 3rd Floor,	Phone : 989-876-7760
37 Jewry Street,	Work Phone : 989-876-4456
London	Email : Chris.Allan@email.com
EC3N 2ER

Patient Name :

Mr. Chris J Allan

NHS Number :

0078777

Date of Birth :

02/03/1974

Gender :

Male

Insurer :

CAB Havering

Policy Number :

008975555

Status :

PreAdmission Cancelled

Date :

12/05/2016 13:30

Cancelled by :

Robert White (24/07/2014)

Reason :

Patient do not want to continue treatment

Notes :

Booked via Choose and Book

Insurer Details

Insurer :

Band :

Insurer :

Policy / Membership Number :

Start Date :

End Date :

Verified Date :

Covered Amount :

Assessment Details

Assessment / Subscriber Number :

Assessment / Subscriber Number :

Confirmation Date :

Coverage Valid Up to Date :

Insurance Status :

Claim Form Status :

Third Party Involved :

Double Insurance :

Covered Clinic Functions

Outpatient Visits :

Consultation / Basic Bloods / X-Rays

MRI

CT

Follow Up Consultations :

Consultation

Physiotherapy

Number of Sessions :

Inpatient

Assessment Notes

Notes :