Idea: Linking claims referral cases
Content
Summary
Linking claims of a person across different facilities for the same illness episode (referal cases)
openIMIS tracks claims related to an individual using the individual's identifier. In addition to the request to have the system track claims for an individual for an illness episode (OSD - 29), could the system also track referral chains so complete treatment chain can be observed in the dataset. This feature should allow a facility to know easily whether the patient was referred (currently this has to be entered manually -
Other, referral and emergency drop down selected during claim submission) and from where, ideally also see the relevant case history from the referred facility and accordingly apply co-payments etc. according to the agreed business rules. Nepal has a similar need but not clear whether they have been able to automate this or whether they have a work around for this..
Overview
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Function | Linking claim referral cases |
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Prioritisation
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Source
This was the idea mentioned during interviews with various stakeholders in February 2021.
Github: 
GitHub - openimis/client-fe_js
Value in adding illness episode as an entity in different contexts that provides a linkage between different visits (claims) to same or different facility for the same illness episode. So this can be seen by health facility treating the patient and for claims reviewer to also see the links while deciding on claims.