R09.03.01.03 · 任务小类

预约、登记、计费与编码

Scheduling, registration, billing & coding

20 条本项目编写的提案 · 分类 v1.1 · 新增基准运行 0 次。下方验证方式与部分得分规则是设计，不是执行结果。

典型应用: OpenEMR · Epic Cadence/Resolute · Tebra
小类 GUI 需求标签: G2 · GUI 必要

任务提案 · 20

展开查看完整原文与建议检查方式；两种界面均保留提案英文原文。

R09.03.01.03-T01 Register a new patient with primary and secondary insurance in OpenEMR

原始指令

In sandbox OpenEMR (login in input/creds.txt), register the new synthetic patient from intake form input/intake_form.pdf: demographics, contact, emergency contact, primary insurance (commercial) and secondary insurance (Medicare) with subscriber details and effective dates. Avoid creating a duplicate if the patient already exists.

平台: web · 任意系统（网页）
应用: OpenEMR
交互表面: brow · 浏览器
GUI 需求 · 任务设定: G2 · GUI 必要
GUI 需求 · 普通权限: G2 · GUI 必要
交互原语: type · 文字与表单 click · 指向与点击 vis · 视觉判断
工作产物: WP08 · 应用 / 系统状态
条件: 未声明
提案难度: 2 / 5

建议验证方式

patient_data and insurance_data rows: 18 demographic fields and 2 insurance records exact (payer, policy/group, subscriber relationship, effective date, primary/secondary order); exactly one patient with that name+DOB. The agent gets no OpenEMR API/OAuth scopes or database credentials, so records must be created in the web UI session.

建议部分得分

45% demographics; 40% two insurances in correct order; 15% no duplicate

R09.03.01.03-T02 Book twice-weekly physical therapy visits around a holiday in OpenEMR

原始指令

In sandbox OpenEMR schedule synthetic patient MRN 403120 for physical therapy with provider 'PT Test' every Monday and Thursday at 15:00 (45 min) for 3 weeks starting 2026-11-02. The clinic is closed on 2026-11-26 (Thanksgiving); book the next open day at 15:00 instead.

平台: web · 任意系统（网页）
应用: OpenEMR
交互表面: brow · 浏览器
GUI 需求 · 任务设定: G2 · GUI 必要
GUI 需求 · 普通权限: G2 · GUI 必要
交互原语: click · 指向与点击 type · 文字与表单 drag · 拖放
工作产物: WP08 · 应用 / 系统状态
条件: 未声明
提案难度: 3 / 5

建议验证方式

openemr_postcalendar_events: 6 appointments with exact dates/times/duration/category/provider; none on 2026-11-26 and the replacement on 2026-11-27 15:00; no double-booking with existing PT slots. The agent account has no REST/FHIR client credentials, the APIs are disabled in Globals and direct DB access is firewalled; web access logs confirm browser-session changes only.

建议部分得分

50% correct appointments (proportional); 25% holiday handled; 25% no conflicts

R09.03.01.03-T03 Code an office visit and generate a professional claim in OpenEMR

原始指令

For today's encounter of synthetic patient MRN 403188 in sandbox OpenEMR, enter fee-sheet codes CPT 99214 with ICD-10 E11.65 and I10 (diagnosis pointers A, B), add CPT 83036 for the in-office HbA1c, justify, and generate an 837P batch in the Billing Manager to output/claims/.

平台: web · 任意系统（网页）
应用: OpenEMR
交互表面: brow · 浏览器
GUI 需求 · 任务设定: G2 · GUI 必要
GUI 需求 · 普通权限: G2 · GUI 必要
交互原语: click · 指向与点击 type · 文字与表单
工作产物: WP08 · 应用 / 系统状态
条件: 未声明
提案难度: 3 / 5

建议验证方式

billing table lines exact; generated X12 837P parsed: CLM, HI (ABK/ABF) and SV1 segments with codes, charges from the fee schedule and pointers exact; claim status 'billed'. The agent account has no REST/FHIR client credentials, the APIs are disabled in Globals and direct DB access is firewalled; web access logs confirm browser-session changes only.

建议部分得分

40% fee-sheet lines and pointers; 40% 837P segments; 20% claim status

R09.03.01.03-T04 Post an ERA payment with contractual adjustments in OpenEMR

原始指令

In sandbox OpenEMR, post the electronic remittance input/era_835.txt (one check, 4 claims) via the ERA posting screen or manual payment entry: payments, CO-45 contractual adjustments, PR-1/PR-2 patient responsibility. Leave patient balances for patient-responsibility amounts.

平台: web · 任意系统（网页）
应用: OpenEMR
交互表面: brow · 浏览器
GUI 需求 · 任务设定: G2 · GUI 必要
GUI 需求 · 普通权限: G2 · GUI 必要
交互原语: click · 指向与点击 type · 文字与表单 vis · 视觉判断
工作产物: WP08 · 应用 / 系统状态
条件: 未声明
提案难度: 3 / 5

建议验证方式

ar_session and ar_activity rows: check total exact; per claim line paid, adjustment and reason codes exact; resulting insurance balance 0 and patient balances equal PR amounts. The agent account has no REST/FHIR client credentials, the APIs are disabled in Globals and direct DB access is firewalled; web access logs confirm browser-session changes only.

建议部分得分

25% session created; 45% line postings; 30% resulting balances

R09.03.01.03-T05 Reschedule appointments during a provider's leave in Tebra

原始指令

In the Tebra sandbox practice, Dr. Test Lee is on leave 2026-11-09 to 2026-11-13. Move each of her 5 booked appointments to the first open slot of the same visit type with Dr. Test Ahmed in the following week, keeping the patient's preferred time of day in the notes, and mark each with reason 'Provider leave'.

平台: web · 任意系统（网页）
应用: Tebra
交互表面: brow · 浏览器
GUI 需求 · 任务设定: G2 · GUI 必要
GUI 需求 · 普通权限: G2 · GUI 必要
交互原语: drag · 拖放 click · 指向与点击 nav · 平移 / 缩放 / 滚动
工作产物: WP08 · 应用 / 系统状态
条件: 未声明
提案难度: 3 / 5

建议验证方式

Sandbox DB/export: 5 appointments moved to Dr. Ahmed in the target week, visit types preserved, time of day matches preference (AM/PM), first open slot rule satisfied, reason text present; no appointments left in the leave week. Patient reminders disabled in sandbox. No Tebra API customer key is issued and the VM has no shell; the audit trail must show web-session edits.

建议部分得分

30% moved off leave week; 30% first-open-slot rule; 20% preferences; 20% reasons

R09.03.01.03-T06 Schedule a multi-resource MRI with nurse prep in Epic Cadence training

原始指令

In the Epic Cadence training environment schedule synthetic patient 'Test, Paula' MRN E1007011 for a contrast MRI brain that needs an MRI room, a contrast-certified nurse for IV start 30 min before, and creatinine within 30 days (check results). Choose the earliest slot satisfying all resources next week and attach the prep instructions.

平台: win · Windows
应用: Epic Cadence/Resolute
交互表面: desk · 桌面 GUI
GUI 需求 · 任务设定: G2 · GUI 必要
GUI 需求 · 普通权限: G3 · 仅 GUI
交互原语: click · 指向与点击 nav · 平移 / 缩放 / 滚动 vis · 视觉判断
工作产物: WP08 · 应用 / 系统状态
条件: licensed · 授权专业软件
提案难度: 4 / 5

建议验证方式

Training extract: linked appointments (nurse IV start then MRI) with correct resources and offset; earliest feasible slot per seeded availability; creatinine check documented (or lab ordered if stale); prep instruction attached. The Epic training client runs in a pixel-only Citrix session with no FHIR or Interconnect credentials issued, so the work can be done only through Hyperspace screens.

建议部分得分

30% both appointments linked; 30% earliest feasible slot; 20% creatinine handled; 20% instructions

R09.03.01.03-T07 Merge duplicate patient charts in OpenEMR

原始指令

Sandbox OpenEMR has two charts for synthetic patient 'Darnell Whitfield' (PIDs 3301 and 3317) with encounters, documents and insurance split between them. Using the Merge Patients tool, merge 3317 into 3301 after confirming they are the same person, keeping the more recent address and phone. Do not merge PID 3322 (a different Darnell Whitfield).

平台: web · 任意系统（网页）
应用: OpenEMR
交互表面: brow · 浏览器
GUI 需求 · 任务设定: G2 · GUI 必要
GUI 需求 · 普通权限: G2 · GUI 必要
交互原语: click · 指向与点击 vis · 视觉判断 type · 文字与表单
工作产物: WP08 · 应用 / 系统状态
条件: risk · 高风险 / 不可逆
提案难度: 3 / 5

建议验证方式

After merge: PID 3301 owns all encounters, documents and insurance previously on 3317 (row counts and IDs); 3317 removed/marked merged; demographics have the newer address/phone; 3322 untouched. The agent account has no REST/FHIR client credentials, the APIs are disabled in Globals and direct DB access is firewalled; web access logs confirm browser-session changes only.

建议部分得分

45% records moved; 20% demographics; 20% source chart retired; 15% 3322 untouched

R09.03.01.03-T08 Assign E/M levels and ICD-10 codes to five visit notes

原始指令

In sandbox OpenEMR open 5 unbilled encounters for synthetic patients (list in input/encounters.txt). Read each note and enter the office E/M code (99202-99215) using 2021 medical-decision-making rules and up to 4 ICD-10-CM codes in the fee sheet, then justify. Do not generate claims.

平台: web · 任意系统（网页）
应用: OpenEMR
交互表面: brow · 浏览器
GUI 需求 · 任务设定: G2 · GUI 必要
GUI 需求 · 普通权限: G2 · GUI 必要
交互原语: nav · 平移 / 缩放 / 滚动 vis · 视觉判断 click · 指向与点击
工作产物: WP08 · 应用 / 系统状态
条件: 未声明
提案难度: 4 / 5

建议验证方式

Per encounter: E/M code exact vs certified-coder gold (adjacent level 50%); ICD-10 set F1 vs gold; no claims generated. The agent account has no REST/FHIR client credentials, the APIs are disabled in Globals and direct DB access is firewalled; web access logs confirm browser-session changes only.

建议部分得分

50% E/M levels; 40% ICD-10 F1; 10% no claims generated

R09.03.01.03-T09 Rework a denied claim with a missing modifier and resubmit

原始指令

In sandbox OpenEMR, claim for synthetic MRN 403255 (DOS 2026-09-18) was denied CO-4 (modifier inconsistent/missing) on input/era_denial.txt. Review the encounter, add modifier 25 to the E/M line billed with the same-day procedure, set claim frequency code 7 with the original claim number, and resubmit to the sandbox clearinghouse.

平台: web · 任意系统（网页）
应用: OpenEMR
交互表面: brow · 浏览器
GUI 需求 · 任务设定: G2 · GUI 必要
GUI 需求 · 普通权限: G2 · GUI 必要
交互原语: click · 指向与点击 type · 文字与表单 vis · 视觉判断
工作产物: WP08 · 应用 / 系统状态
条件: risk · 高风险 / 不可逆
提案难度: 4 / 5

建议验证方式

New 837P in clearinghouse sandbox: SV1 modifier 25 on the E/M line only; CLM05-3 = 7; REF*F8 with the original claim ID; other lines unchanged. The agent account has no REST/FHIR client credentials, the APIs are disabled in Globals and direct DB access is firewalled; web access logs confirm browser-session changes only.

建议部分得分

40% modifier on correct line; 30% frequency code and original reference; 30% resubmitted cleanly

R09.03.01.03-T10 Run an insurance eligibility check and update the copay in Tebra

原始指令

In the Tebra sandbox, run a real-time eligibility check for synthetic patient 'Nguyen, Bao' for tomorrow's visit, read the returned 271 benefits (office-visit copay and deductible remaining), and update the patient's policy copay field and an appointment note with the deductible remaining.

平台: web · 任意系统（网页）
应用: Tebra
交互表面: brow · 浏览器
GUI 需求 · 任务设定: G2 · GUI 必要
GUI 需求 · 普通权限: G2 · GUI 必要
交互原语: click · 指向与点击 type · 文字与表单 vis · 视觉判断
工作产物: WP08 · 应用 / 系统状态
条件: 未声明
提案难度: 2 / 5

建议验证方式

Eligibility request logged in sandbox clearinghouse; policy copay equals the 271 value; appointment note contains the deductible amount exactly. No Tebra (Kareo) API customer key is issued for the sandbox and the VM has no shell, so changes can only come from the browser session; the sandbox audit trail confirms web-session edits.

建议部分得分

30% eligibility check run; 40% copay updated; 30% deductible note

R09.03.01.03-T11 Build a superbill with injection J-codes, units and modifiers

原始指令

For today's encounter of synthetic MRN 403301 in sandbox OpenEMR, enter fee-sheet lines from input/procedure_log.txt: 99213-25, 20610-RT, J1030 methylprednisolone 40 mg x2 units, J2001 lidocaine per 10 mg x5 units, linked to diagnoses M17.11 and E11.9 with correct pointers. Save and justify.

平台: web · 任意系统（网页）
应用: OpenEMR
交互表面: brow · 浏览器
GUI 需求 · 任务设定: G2 · GUI 必要
GUI 需求 · 普通权限: G2 · GUI 必要
交互原语: click · 指向与点击 type · 文字与表单
工作产物: WP08 · 应用 / 系统状态
条件: 未声明
提案难度: 3 / 5

建议验证方式

billing rows: codes, modifiers, units and pointer mapping exact; fees equal fee schedule x units; justify flags set. The agent account has no REST/FHIR client credentials, the APIs are disabled in Globals and direct DB access is firewalled; web access logs confirm browser-session changes only.

建议部分得分

40% codes and modifiers; 30% units; 30% diagnosis pointers

R09.03.01.03-T12 Clear a workqueue of six claim edits in Epic Resolute training

原始指令

In the Epic Resolute PB training environment, open claim edit workqueue 'PB CLAIM EDITS - TRAIN'. Resolve the 6 claims by fixing each edit (missing referring provider, invalid diagnosis order, NCCI bundling needing modifier 59, wrong place of service, missing NDC, expired authorization number) per input/edit_guide.pdf, and release them.

平台: win · Windows
应用: Epic Cadence/Resolute
交互表面: desk · 桌面 GUI
GUI 需求 · 任务设定: G2 · GUI 必要
GUI 需求 · 普通权限: G3 · 仅 GUI
交互原语: click · 指向与点击 nav · 平移 / 缩放 / 滚动 type · 文字与表单
工作产物: WP08 · 应用 / 系统状态
条件: licensed · 授权专业软件 long · 长流程
提案难度: 5 / 5

建议验证方式

Training extract: 6 claims released with the specific corrected field each; workqueue empty; no unrelated fields changed; the bundling case uses modifier 59/XS only on the right line. The Epic training client runs in a pixel-only Citrix session with no FHIR or Interconnect credentials issued, so the work can be done only through Hyperspace screens.

建议部分得分

90% six claims fixed and released (equal share each); 10% no collateral changes

R09.03.01.03-T13 Generate patient statements for balances over 30 days in OpenEMR

原始指令

In sandbox OpenEMR, generate patient statements (Billing > Patient Statements) for all patients whose patient-responsibility balance is older than 30 days and greater than $10, using the 'Standard' template, and save the batch PDF to output/statements.pdf.

平台: web · 任意系统（网页）
应用: OpenEMR
交互表面: brow · 浏览器
GUI 需求 · 任务设定: G2 · GUI 必要
GUI 需求 · 普通权限: G2 · GUI 必要
交互原语: click · 指向与点击 nav · 平移 / 缩放 / 滚动
工作产物: WP08 · 应用 / 系统状态
条件: 未声明
提案难度: 2 / 5

建议验证方式

PDF text parsed: statement set equals the gold patient list (12) with balances exact; statement dates recorded in DB for those patients only. The agent account has no REST/FHIR client credentials, the APIs are disabled in Globals and direct DB access is firewalled; web access logs confirm browser-session changes only.

建议部分得分

60% correct patient set; 30% balances; 10% DB statement dates

R09.03.01.03-T14 Block a provider's schedule for a conference and move conflicts

原始指令

In sandbox OpenEMR, block Dr. Test Ortiz's calendar 2026-11-18 08:00-17:00 for 'Conference' and move the 7 conflicting appointments to her open slots on 2026-11-19 or 2026-11-20 (same duration and category), dragging them in the calendar view; flag each patient record with a recall note 'rescheduled - conference'.

平台: web · 任意系统（网页）
应用: OpenEMR
交互表面: brow · 浏览器
GUI 需求 · 任务设定: G2 · GUI 必要
GUI 需求 · 普通权限: G2 · GUI 必要
交互原语: drag · 拖放 click · 指向与点击 nav · 平移 / 缩放 / 滚动
工作产物: WP08 · 应用 / 系统状态
条件: 未声明
提案难度: 3 / 5

建议验证方式

Calendar: block event exact; 7 appointments moved to the allowed days without overlaps, durations/categories preserved; 7 notes present; nothing left on 2026-11-18. The agent account has no REST/FHIR client credentials, the APIs are disabled in Globals and direct DB access is firewalled; web access logs confirm browser-session changes only.

建议部分得分

15% block created; 50% appointments moved validly; 20% no overlaps; 15% notes

R09.03.01.03-T15 Load a new payer fee schedule and re-price unbilled charges in Tebra

原始指令

In the Tebra sandbox, create the 2027 contracted fee schedule for payer 'Test Health Plan' from input/fee_schedule_2027.xlsx (40 CPT codes), effective 2027-01-01, then re-price the 9 unbilled charges with dates of service in January 2027 to the new allowed amounts.

平台: web · 任意系统（网页）
应用: Tebra
交互表面: brow · 浏览器
GUI 需求 · 任务设定: G2 · GUI 必要
GUI 需求 · 普通权限: G2 · GUI 必要
交互原语: type · 文字与表单 click · 指向与点击 multi · 跨应用
工作产物: WP08 · 应用 / 系统状态
条件: long · 长流程
提案难度: 4 / 5

建议验证方式

Fee schedule with 40 codes and amounts exact and effective date; 9 charges show the new expected allowed amounts; charges from 2026 unchanged. No Tebra (Kareo) API customer key is issued for the sandbox and the VM has no shell, so changes can only come from the browser session; the sandbox audit trail confirms web-session edits.

建议部分得分

50% fee schedule entries; 10% effective date; 30% re-priced charges; 10% older charges untouched

R09.03.01.03-T16 Bill a secondary payer with coordination-of-benefits data

原始指令

In sandbox OpenEMR, the primary payer paid claim for synthetic MRN 403402 (DOS 2026-09-30) per input/era_primary.txt. Post it, then generate the secondary claim to Medicare with the primary's paid amount, adjustments (CAS) and payer details in the COB loops, and submit to the sandbox clearinghouse.

平台: web · 任意系统（网页）
应用: OpenEMR
交互表面: brow · 浏览器
GUI 需求 · 任务设定: G2 · GUI 必要
GUI 需求 · 普通权限: G2 · GUI 必要
交互原语: click · 指向与点击 type · 文字与表单 vis · 视觉判断
工作产物: WP08 · 应用 / 系统状态
条件: risk · 高风险 / 不可逆
提案难度: 5 / 5

建议验证方式

Secondary 837P parsed: SBR*S, 2320 loop with primary payer ID, AMT*D paid amount, CAS segments matching the ERA, 2430 line-level adjudication; primary payment posted correctly first. The agent account has no REST/FHIR client credentials, the APIs are disabled in Globals and direct DB access is firewalled; web access logs confirm browser-session changes only.

建议部分得分

25% primary posted; 25% secondary claim generated; 35% COB loop values; 15% submitted

R09.03.01.03-T17 Audit twenty coded encounters for upcoding

原始指令

In sandbox OpenEMR, review the 20 encounters in input/audit_list.txt (notes and billed E/M codes). For each, decide whether the billed level is supported under 2021 E/M rules; record findings in output/audit.csv (encounter, billed, supported level, verdict) and add a billing note to each unsupported encounter. Do not change codes.

平台: web · 任意系统（网页）
应用: OpenEMR
交互表面: brow · 浏览器
GUI 需求 · 任务设定: G2 · GUI 必要
GUI 需求 · 普通权限: G2 · GUI 必要
交互原语: nav · 平移 / 缩放 / 滚动 vis · 视觉判断 type · 文字与表单
工作产物: WP12 · 答案 / 决策
条件: long · 长流程
提案难度: 4 / 5

建议验证方式

Verdicts compared with certified-coder gold: F1 for 'unsupported' >=0.8; supported level exact on >=70%; billing notes on flagged encounters; billed codes unchanged. The agent account has no REST/FHIR client credentials, the APIs are disabled in Globals and direct DB access is firewalled; web access logs confirm browser-session changes only.

建议部分得分

50% unsupported-detection F1; 25% supported levels; 15% notes; 10% codes unchanged

R09.03.01.03-T18 Control pair of T03: generate the 837P claim with a script

原始指令

Control pair of T03. From the encounter data in input/encounter_403188.json and the fee schedule CSV, write output/make837.py that produces a valid X12 5010 837P file output/claim.837 with the same codes, charges and diagnosis pointers as T03, passing a 5010 syntax validator.

平台: lin · Linux mac · macOS
应用: Python
交互表面: term · 终端
GUI 需求 · 任务设定: CL · CLI 足够
GUI 需求 · 普通权限: CL · CLI 足够
交互原语: code · 代码与命令
工作产物: WP06 · 代码 / 工程
条件: 未声明
提案难度: 3 / 5

建议验证方式

Same segment checks as T03 (CLM, HI, SV1, pointers, charges) plus X12 envelope and 5010 validator passing; allows a GUI-vs-script comparison.

建议部分得分

30% valid envelope; 40% claim segments; 30% validator clean

R09.03.01.03-T19 Apply a mid-year insurance change and rebill affected claims

原始指令

Synthetic patient MRN 403477 switched plans effective 2026-08-01, but 3 claims after that date went to the old payer and were denied (input/era_denials.txt). In sandbox OpenEMR, end-date the old policy 2026-07-31, add the new policy, post the denials with zero payment, and rebill the 3 claims to the new payer.

平台: web · 任意系统（网页）
应用: OpenEMR
交互表面: brow · 浏览器
GUI 需求 · 任务设定: G2 · GUI 必要
GUI 需求 · 普通权限: G2 · GUI 必要
交互原语: click · 指向与点击 type · 文字与表单 vis · 视觉判断
工作产物: WP08 · 应用 / 系统状态
条件: hidden · 隐藏 / 过期状态
提案难度: 4 / 5

建议验证方式

insurance_data: old policy end date, new policy effective date and details exact; denials posted with reason codes; 3 new 837P claims to the new payer ID; claims before August unchanged. The agent account has no REST/FHIR client credentials, the APIs are disabled in Globals and direct DB access is firewalled; web access logs confirm browser-session changes only.

建议部分得分

30% policy dates; 20% new policy details; 20% denials posted; 30% rebilled claims

R09.03.01.03-T20 Run an AR aging report and reconcile bucket totals

原始指令

In sandbox OpenEMR run the Collections/AR aging report as of 2026-10-31 by payer category, export it to output/ar_aging.csv, and write output/ar_summary.json with totals for 0-30, 31-60, 61-90, 91-120 and >120 days, split insurance vs patient responsibility.

平台: web · 任意系统（网页）
应用: OpenEMR
交互表面: brow · 浏览器
GUI 需求 · 任务设定: G2 · GUI 必要
GUI 需求 · 普通权限: G2 · GUI 必要
交互原语: click · 指向与点击 nav · 平移 / 缩放 / 滚动 type · 文字与表单
工作产物: WP02 · 记录 / 表格
条件: 未声明
提案难度: 3 / 5

建议验证方式

Bucket totals exact vs gold computed from seeded ledger; CSV row count equals open claims; split by responsibility exact. The agent account has no REST/FHIR client credentials, the APIs are disabled in Globals and direct DB access is firewalled; web access logs confirm browser-session changes only.

建议部分得分

30% export; 50% bucket totals; 20% responsibility split

已有研究映射

以下沿用研究目录中的基准与小类映射，不是逐题标注、执行记录或产品背书。

Vals AI professional agentic benchmarks

预约、登记、计费与编码

任务提案 · 20

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原始指令

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原始指令

建议验证方式

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已有研究映射

同工作流族的小类