308 lines
12 KiB
Plaintext
308 lines
12 KiB
Plaintext
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English French Notes Complete/Exclude
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This claim is not associated with another claim.
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Do you wish to disassociate claim from the above group
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Other claims exist for the same veteran and episode of care.
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Do you wish to associate this new claim with one from the above listing
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Select the claim to which you wish to associate
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Do you want to automatically link this claim with another group
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Start date cannot be in the future.
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End date cannot be prior to the Start date.
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MILLENNIUM ACT EMERGENCY CARE
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SUMMARY REPORT
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RUN DATE:
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Total Number Claims Received:
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Total Dollars Claims Received:
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Total Claimants:
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Total Claims Paid:
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Total Dollars Claims Paid:
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Total Dollars Suspended:
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Total Number Claims Rejected:
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Total Dollars Claims Rejected:
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REASONS REJECTED
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Total Number Claims Pending:
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Total Dollars Claims Pending:
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Average Processing Time:
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Unauthorized Claims Expiring on or before
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Sort by
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STATUS LISTING OF MILL BILL (1725) CLAIMS
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STATUS LISTING OF UNAUTH. NON-MILL BILL CLAIMS
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OTHER PARTY:
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Treatment From:
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Treatment To:
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Select to whom payment should be made
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Unauthorized claim must be Approved or Approved to Stabilization
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in order to make a payment.
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Fee program is community nursing home.
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Payments should not be authorized.
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Is this an ancillary payment
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No authorization associated with this 583!
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Authorization does not pertain to the selected unauthorized claim.
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Authorization Fee program differs from Fee program in Unauthorized Claim.
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< UNAUTHORIZED CLAIM >
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The following information has been requested:
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OTHER Reason
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;SIGNED STATEMENT FROM CLAIMANT
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Print 38 CFR 17.1002 and 17.1003 text on letter
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Enter NO if the text of the regulations should not be printed on the
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letter that requests additional information from the claimant.
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PRINT REGS
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Receiving
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UNAUTHORIZED CLAIM DISPOSITION AND STATUS STATISTICS
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CATEGORY OF DISPOSITION
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TYPE OF
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COVA APPEAL
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TOTAL DISPOSITIONED
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TOTAL NOT DISPOSITIONED
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TOTAL CLAIMS
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STATUS OF CLAIMS NOT DISPOSITIONED
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# OF CLAIMS
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TOTAL DOLLARS APPROVED BY PSA:
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Date Range Selected:
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UPDATE UNAUTH CLAIM
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Deleting authorization...
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Discharge type is missing! Enter using the Re-open Unauthorized Claim option.
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Claim has been dispositioned to DISAPPROVED
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with disapproval reason of '
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Enter selection
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Nothing found which meets the criteria.
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Select from the following:
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Enter RETURN for more, or Select
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You have selected the above. OK
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FBSADD(
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FBSTA(
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No entry has been made to the New Person file.
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If a new entry is needed, enter the name within quotes.
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Select unauthorized claim
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You may select the claim by entering the vendor, veteran or other party.
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Payments on file!
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You must hold the supervisor's key to edit any data other than Amount Approved.
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PRIMARY CLAIM:
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Authorization From/To dates are missing.
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Disposition has not been updated.
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When entering in this disposition, please include these dates.
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DISPOSITIONED:
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No:
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Enter M to include only 38 U.S.C. 1725 claims.
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Enter N to exclude 38 U.S.C. 1725 claims.
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Enter A for all.
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Want to add NEW insurance data
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Answer 'Yes' if you want to add a new insurance company for this patient.
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You are not allowed to edit current insurance information.
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However, you will be given the opportunity to send a bulletin to MCCR
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if insurance information is incorrect.
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Are there any discrepancies with insurance data on file
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A 'Yes' answer will send a bulletin to MCCR
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Enter description of change
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FB INSURANCE CHANGE
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CODE NOT FOUND IN FILE
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STATUS NOT AVAILABLE FOR SPECIFIED DATE
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Select ADJUSTMENT REASON
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Select a HIPAA Adjustment (suspense) Reason Code
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Adjustment reason codes explain why the amount paid differs
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from the amount claimed.
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ADJUSTMENT REASON
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Enter a HIPAA Adjustment (suspense) Reason Code
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ERROR: A new reason would exceed maximum number (
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) allowed for this invoice.
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Select a reason code on the current list instead.
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ADJUSTMENT GROUP
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ADJUSTMENT AMOUNT:
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ERROR: Must account for $
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more to cover the total amount suspended.
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The current sum of adjustments is $
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The total amount suspended is $
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ERROR: Maximum number of adjustment reasons (
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) have been exceeded.
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(reason deleted)
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Select REMITTANCE REMARK
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Select a HIPAA Remittance Remark Code.
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Select a remittance remark code to provide non-financial
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information critical to understanding the adjudication of the claim.
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If necessary, a code on the current list can be selected and changed.
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ERROR: Maximum number of remittance remark codes (
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Is this an EDI Claim from the FPPS system
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The FPPS CLAIM ID must be entered for EDI claims!
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Does this VistA invoice cover all line items on the FPPS Claim
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FPPS LINE ITEM:
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This response must be a number or a list or range, e.g., 1,3,5 or 2-4,8.
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'^' NOT ALLOWED
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Enter the line item sequence number associated with this charge. Each
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charge on the FPPS invoice document will have a line item sequence number
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associated with it. A line item can be entered individually or a group of
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charges from multiple lines can be entered. If all line items in a group
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are in numerical sequence, you may enter the first line item sequence
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number followed by a hyphen and the last line item sequence number. If
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the grouped charges are not in sequential order, each line item must be
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entered individually, followed by a comma.
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(Awaiting Austin Approval)
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(Vendor in Delete Status)
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Examining the FEE BASIS PATIENT file...
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FEE BASIS PATIENTs were evaluated.
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Of these,
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will be included in the next daily transmission to HEC.
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This utility can be run anytime to detect claims that don't have all
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the required information. The user is able to specify a starting date
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for the report. If the date is specified then the utility shows only
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the claims that were received on this date or later.
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Do you want to specify the starting date for the report?
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Please answer Yes or No.
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Starting date for the report:
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Enter a date in proper format.
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The following claims have been completed or dispositioned without
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supplying all required information. It is necessary to review them
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in order to supply the claims with all missed information.
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=== STARTING DATE:
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=== DISPOSITIONED CLAIMS ===
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without VENDOR information (
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without PATIENT TYPE information (
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without VENDOR and PATIENT TYPE information (
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=== NON-DISPOSITIONED CLAIMS ===
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Claim Date Patient Vendor Submitted by
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FB*3.5*27 Install: Claims w/o all necessary information.
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--Updating file 162.96
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ERROR ADDING NEW ZIP
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ERROR ADDING 2001 for
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---Update of file 162.96 complete
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--Updating file 162.98
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TABLE YEAR NOT IN FILE SKIPPING INPUT RECORD
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ERROR ADDING MOD
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---Update of file 162.98 complete
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--Updating file 162.97
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ERROR ADDING NEW CPT
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ERROR ADDING 2001 RVU'S for
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CPT NOT IN FILE SKIPPING CPT
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CY NOT IN FILE SKIPPING CPT
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---Update of file 162.97 complete
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Updating selected POVs in the FEE BASIS PURPOSE OF VISIT (161.82) file...
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ERROR: Fee Program with IEN 2 is not OUTPATIENT.
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Purpose of Visits could not be updated.
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ERROR: Fee Program with IEN 7 is not CONTRACT NURSING HOME.
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ERROR ADDING POV WITH CODE
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Filing conversion factor for RBRVS 2002 fee schedule.
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Recompilation of [FBAA AUTHORIZATION] Input Template:
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Request Queued
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DG*5.3*134
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SERVED MEALS Date:
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** Input must be for a date before today in order to collect ADT data!
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Calculating Census Values ...
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Starting Date:
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[Must Start before Today!]
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Ending Date:
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[Must End before Today!]
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[End before Start?]
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The report requires a 132 column printer.
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Print on Device:
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Avg.
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MEALS SERVED ON INPATIENT BASIS
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MEALS SERVED TO OTHERS
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| TOTAL| SERVED TRAYS DATA
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| NURSING HOME CU
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| Inp. Abs. Meal| Inp. Abs. Meal| Inp. Abs. Meal| | Outp. Paid Grat.| | | Cafe NPO Trays
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Sun Mon Tue Wed Thu Fri Sat
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| Opt. Emp. Paid OOD Vol. Grt. Total | Opt. Emp. Paid OOD Vol. Grt. Total | Opt. Emp. Paid OOD Vol. Grt. Total |
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STAFFING DATA Date:
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** Date must not be in the future!
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Avg.
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Adjustment for Unscheduled and Intermittent
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UNS/INT Total
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Adjusted Measured FTEE
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Avg Measured FTEE
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Man Minutes/Meal:
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Enter/Edit Facility Data?
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Enter/Edit Specialized Medical Programs?
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Enter Station Number:
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Enter Qtr/Yr:
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Do Not Enter Dates.
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Answer Qtr 1-4 and Yr as Qtr/Yr.
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Yr CANNOT be greater than now.
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Answer Qtr 1-4 and Yr as 4 digit year, ie 2001.
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Example: 4/2001 for 4th quarter, year 2001.
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Qtr/Yr must not be greater than default.
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Enter YR:
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Do Not Enter Future Year.
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Enter Year Only.
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CMR Cost
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REGION:
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RPM CLASSIFICATION:
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COMPLEXITY LEVEL:
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MULTI DIVISION FACILITY:
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COOK CHILL FOODS:
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DIETETIC INTERNSHIP/PROGRAMS:
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VA SPONSORED DIETETIC INTERNSHIP
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AFFILIATED AP4
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AFFILIATED DIETETIC INTERNSHIP
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AFFILIATED CUP
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VA SPONSORED AP4
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AFFILIATED DIETETIC TECHNICIAN
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FUNDED NUTRITION RESEARCH
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UNFUNDED NUTRITION RESEARCH
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SPECIALIZED MEDICAL PROGRAMS:
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PRIMARY DELIVERY SYSTEM:
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ASSIGNED CLINICAL FTEE
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*** SITE NOT FOUND IN ^XMB GLOBAL ***
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TYPE OF SERVICE SUMMARY
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Average Daily Meals Served
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By Type of Service
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% of Workload
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Bedside Tray
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Cafeteria
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Dining Room Tray
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Another user is editing the entry.
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Hospital
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Nursing Home
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Domicillary
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Total Inpatient Days
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OUTPATIENTS TREATED
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Hospital Clinic
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Satellite Location
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Total Outpatients Treated
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SERVED MEALS SUMMARY
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1st Qtr 2nd Qtr 3rd Qtr 4th Qtr Yearly
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Total Served Meals
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Average Daily Meals
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INPATIENT DAYS OF CARE
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NUTRITION STATUS SUMMARY
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Total Encounters
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CLINICAL ENCOUNTER CATEGORY SUMMARY
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1st Qtr
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2nd Qtr
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3rd Qtr
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4th Qtr
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Clinical Categories
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Tot Units % Tot Units % Tot Units % Tot Units % Tot Units %
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Select SUNDAY Date:
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.. Date Not Within Qtr
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..Date Not Within Qtr
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Total Diets
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Change Numbers of Modified Diets and Total Diets for that week? Y//
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Answer YES or NO
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Sun Mon Tues Wed Thur Fri Sat
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Enter string of characters for desired days of week: e.g., MWF
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Select the Day of Week you wish to change the data on:
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Please enter the desired days of the week.
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Sun Mon Tues Wed Thur Fri Sat
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Change # of Modified Diets for
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Enter an amount greater than 0 but less than 999999999
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Change # of Total Diets for
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Error - Illegal Character or Repeated Day.
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MODIFIED DIET SUMMARY
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YTD Avg
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Week Average Modified Diet
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Enter Date Nutritive Analysis was taken:
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[Date Is Not Within the Fiscal Year!]
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Date Taken:
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Calories^%CHO^%PRO^%FAT^Mg CHOL^Mg Na
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Nutritive Analysis 7 Days Average Regular Menu
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Change the number of Specialty Staffing?
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Specialty Staffing
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Staff Certified Diabetes Educators (CDE):
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Staff Certified in Nutrition Support:
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Staff Registered Clinical Dietetic Technicians:
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Staff With Clinical Privileges (Not Scope of Practice):
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SUPPORT STAFF
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#################### #################### ####################
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#################### #################### ####################
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#################### #################### ####################
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#################### #################### ####################
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#################### #################### ####################
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