60 lines
3.4 KiB
Mathematica
60 lines
3.4 KiB
Mathematica
FBDOC ;ALBISC\TET - ROUTINE DOCUMENTATION ;10/9/92 11:24
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;;3.5;FEE BASIS;**48**;JAN 30, 1995
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;;Per VHA Directive 10-93-142, this routine should not be modified.
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;Routine contains documentation of other routines. Name sets
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; of routines are indicated in line label.
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FBPCR ;
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;POTENTIAL COST RECOVERY REPORT
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;user selects primary service areas and date range.
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;The user is able to filter data to include Copays or Insurance only
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;related information:
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; Include (P)atient Co-pays / (I)nsurance / (B)oth
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;If the user selects (P) or (B),the following prompt will allow
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;the user to include Mean Test or LTC copays only or Both:
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; Include (M)eans Test Co-pays /(L)TC Co-pays /(B)oth
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;output will sort by primary service area, patient, program, vendor, date.
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;only those that are means test category c/agree to pay deductible
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; or for non-service connected treatment are printed, as well as
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; insurance information.
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;Since 7/5/2002 all LTC related payments are flagged in the report with
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;appropriate messages. If the veteran doesn't have LTC test on file then
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;the LTC related payment is flagged with "1010EC missing" message.
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;
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;outpatient info - program 2 - fbpcr2 uses date finalized for date range sort
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; o for each service on a treatment date the value of the
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; 'service connected y/n' field is checked.
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; if no, flag to collect from insurance is set.
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; o for the INITIAL TREATMENT DATE, checks if patient was cat c
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; and agreed to pay deductible or was not exempt from LTC copay.
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; if true, then software uses IB call to determine if patient
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; is insured on treatment date
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; o if service is for C&P, or both of the above two flags are
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; negative, record is bypassed.
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;pharmacy info - program 3 - fbpcr3 uses date certified for payment for date range sort
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; o for each invoice number, RX number for a patient within the
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; specified date range, the value of the rx fill date field is
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; obtained and checked against the authorization in the fee
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; patient file. a check is made to see if the value of the
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; potential cost recovery field is yes for an authorization
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; which encompasses the fill date.
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; if yes, then software uses IB call to determine if patient
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; is insured on date certified for payment
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; o for date certified for payment, checks if patient was cat c
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; and agreed to pay deductible. if true, flag to collect from
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; patient is set.
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; o if both of the above two flags are negative, record is bypassed.
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;ch/cnh info - programs 6 and 7 - fbpcr67* uses date finalized for date range sort
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; o for each record, for a patient within the specified date
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; range, the value of the treatment from date is obtained
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; and checked against the authorization in the fee patient file.
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; a check is made to see if the value of the potential cost
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; recovery field is yes for an authorization which encompasses
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; the treatment from date.
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; if yes, then software uses IB call to determine if patient
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; is insured on date certified for payment.
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; o for TREATMENT FROM DATE and TREATMENT TO DATE, checks if
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; patient was cat c and agreed to pay deductible or was not
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; exempt from LTC copay. if true, flag to collect from patient
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; is set.
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; o if both of the above two flags are negative, record is bypassed.
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