ViewSavedBills - NOVOHUB Provider

View Saved Bills

Filter:

Select year

Select month

Year	Month	No of Bills	Total Amount	Date Created	Action

*The submit button will be available at the end of the month

Enrollee Name	Policy Number	Enrollee Verification Code	Treatment	Amount	Actions

Enrollee Details:

Full Name

Company

Subsidiary

Enrollee Age

Gender

Provider Details:

Encounter Type

Service Type

Doctor Details:

Name of Doctor

ID Number

Area of Specialization

Date Signed

Specialist Details (if any):

Name of Specialist

Specialist Phone No.

Area of Specialization

Date Signed

Treatment Details:

Verification Code

Authorization Code (if any)

Date of Service

Duration of Treatment

Date of Admission

Date of Discharge

Referral Code

Treatment Given

Selected Diagnosis

First Diagnosis

First Differential Diagnosis

Check To Edit First Diagnosis:

Second Diagnosis

Second Differential Diagnosis

Check To Edit Second Diagnosis:

Edit Diagnosis

First Diagnosis

First Differential Diagnosis(Optional)

Second Diagnosis (Optional)

Second Differential Diagnosis(Optional)

Service Details:

Select Service

Description

Duration

Amount

Total Service Amount

Services	Description	Duration	Amount	Actions

Drug Details:

Select Drug

Description

Dosage

Amount

Total Amount

Drug	Description	Dosage	Amount	Actions

Total Claims Details:

Total Amount

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