Phase 2 Discharge Summary (NYP2DS)

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Form Details

• Form Properties
  1. Form Title: Phase 2 Discharge Summary
  2. Start from an Existing Form – No
  3. Copyrighted Form – No
  4. Billable Progress Note – No
  5. Have multiple versions open at same time – No
  6. Open Blank on new version – Yes
• Required Fields – Yes
• Lookup Tables – None
• Pre-Fill Logic – Yes
  1. Organization Name will prefill from Setup → Program/Billing Defaults → Company Info Tab.
  2. Program Name will prefill from the Program the patient enrolled in.
  3. Diagnoses on Axis Tab will prefill from diagnosis listed in ICD 10 Diagnosis Table (Administration → ICD 10/DSM 5) or most recent signed and locked Diagnosis form/tab.
• Fill to Logic – Yes
  1. Diagnosis tab will fill any new Diagnosis or Assessment forms and the read-only Diagnosis tab in Patient Details.
• Signatures
  1. Individual’s Signature
     • Sig type: Patient
  2. Parent/Guardian Signature
     • Sig type: Any
     • Defaults to N/A checked.
  3. Staff Signature
     • Sig type: Any
     • Route-To is available.
  4. Supervisor/Professional Staff/QHP Signature
     • Credential required to sign: Supervisor/Professional Staff/QHP.
     • Title will fill from title entered in user setup (see eCR University – Users).
     • Defaults to N/A checked.
     • Signature required.
     • Route To functionality is available.

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Legal Status Tab

• The Organization Name will prefill from the Program/Billing Defaults/Company Info.
• The Program Name will prefill from the Program the patient is enrolled in.

See Billing/Program Defaults - Glossary

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Outcomes Tab

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Diagnosis Tab

• The Diagnosis will prefill from the most recently entered diagnosis or you can select a diagnosis from the diagnosis table.
• Select a specifier from the specifier lookup table.

• Must Select a primary Diagnosis.
• ICD 10 Diagnosis Code – Will pull from diagnosis listed in ICD 10 Diagnosis table (Administration → ICD10/DSM5) or most recent previously completed diagnosis form/tab.
• Specifier – Set up Specifier Lookup table (Specifiers – ICD10) in Lookup Manager (see Lookup Manager - Table of Contents).

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Referrals Tab

Medications Tab

• Selecting NONE Prescribed/Given under Medications, including Over the Counter at Discharge will grey out the Medication table.
• Selecting Not Applicable under Financial/Benefit Status will grey out the text box.

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Signatures Tab

1. Signature Type Credentials
   • Individual’s Signature
     • Sig type: Patient
   • Parent/Guardian Signature
     • Sig type: Any
     • Defaults to N/A checked.
   • If lacking signature of individual/Parent/Guardian, provide reason for non-participation.
   • Staff Signature
     • Sig type: Any
     • Route-To is available.
   • e. Supervisor/Professional Staff/QHP Signature
     • Credential required to sign: Supervisor/Professional Staff/QHP.
     • Title will fill from title entered in user setup (see eCR University – Users).
     • Defaults to N/A checked.
     • Signature required.
     • Route To functionality is available.

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