N.Y. Comp. Codes R. & Regs. tit. 10, § 446.23 – Ambulatory care statistics.

(1) How many ambulance vehicles do you operate?
(2) Report the total trips made.
(3) Report the number of unnecessary trips.
(4) Report the disposition of patients.
1. (i) Transfers.
2. (ii) Admissions.
3. (iii) Emergency room only.
4. (iv) Other hospital.
5. (v) Not removed.
6. (vi) D.O.A.
7. (vii) All other dispositions.
  (b) Outpatient Department Visits by Clinic (account 6720)
(1) Report each clinic operated by the facility separately.
(2) Refer to section 443.5(b) of this Article for a partial listing.
(3) Report total clinic visits:
1. (i) Exclude Community Mental Health Center.
2. (ii) Exclude Free Standing Clinic.
(4) Clinic visits with physician contact.
(5) Clinic visits with non-physician contact.
(6) Number of patients treated—unduplicated count.
(c) Free Standing Clinics (accounts 6870, 6880 and 6890).
(1) Name and address.
(2) Funding source (OEO, Title II, etc.).
(3) Type (family, pediatric, etc.).
(4) When is clinic open?
1. (i) Evenings.
2. (ii) Weekends.
(5) Walk-in patients:
1. (i) Do you maintain a screening clinic?
2. (ii) If so, is it part of a general clinic?
3. (iii) If not, how are patients assigned?
(6) Number of patients on annual clinic register.
(7) Number of visits during the year by pay classification:
1. (i) Medicaid.
2. (ii) Medicare.
3. (iii) Compensation.
4. (iv) Blue Cross.
5. (v) Commercial insurance.
6. (vi) Free.
7. (vii) Self-pay in full.
8. (viii) All other.
(8) Emergency room:
1. (i) Do you operate one at this Free Standing Clinic?
2. (ii) If so, report number of visits during reporting period.
(9) Each separate Free Standing Clinic must be reported separately.
(d) Ambulatory Service (account 6720)
(1) Do you have organized clinics at your main hospital facility?
(2) Do you have a Ghetto Medicine Contract?
(3) Do you have a pre-admission testing program?
1. (i) Report number of patients treated in prior reporting period.
2. (ii) Report number of patients treated in current reporting period.
(4) Do you have an ambulatory surgical program?
1. (i) Report number of procedures in prior reporting period.
2. (ii) Report number of procedures in current reporting period.
(5) Do you operate evening clinic sessions?
(6) Do you operate weekend clinic sessions?
(7) Do you maintain a screening clinic for:
1. (i) New patients to be seen by a physician?
2. (ii) If so, is the screening clinic part of a general clinic?
  (e) Private (Referred) Ambulatory Patients.
(1) Do you provide for the care of private (referred) ambulatory patients (patients referred by their physician, for specific ancillary services[s], from his private office)?
(2) Report the number of visits for the current reporting period.
(f) Mental Health Services.
(1) Do you provide this service on an ambulatory basis?
(2) If so, are these services provided under contract, in whole or in part, with the Community Mental Health Board?
(3) If so, are these part of an organized Community Mental Health Center?

(a) Ambulance Service (account 6850).