308 lines
10 KiB
Plaintext
308 lines
10 KiB
Plaintext
English French Notes Complete/Exclude
|
|
to specify the CPT codes to be included on the report.
|
|
If the Range method is chosen, you will asked for one or more
|
|
ranges of CPT codes. (e.g. from 11000 to 11999)
|
|
If the Individual method is chosen, you will be asked to select
|
|
one or more specific CPT codes.
|
|
Start of CPT Range #
|
|
End of CPT Range #
|
|
Start can't be after the End
|
|
Note: Additional data printed if device supports 130+ characters
|
|
for Payments with Finalized Dates from
|
|
and all CPT Codes
|
|
and CPT Codes:
|
|
No payments found that match criteria.
|
|
REPORT TOTALS
|
|
COST/SAVINGS FROM RBRVS FEE SCHEDULE
|
|
CPT CODE-
|
|
Total Occurrences
|
|
Payments at RBRVS
|
|
Estimated Payments if RBRVS was not used
|
|
Est. Savings
|
|
75th Percentile
|
|
Usual & Customary*
|
|
from RBRVS
|
|
Patient has been deleted from the Patient file, cannot create transaction!
|
|
Delete MRA has been created!
|
|
CPT Modifier(s):
|
|
Sorry,only the clerk who entered the payment
|
|
or a supervisor can edit this payment.
|
|
Sorry, only the Supervisor can edit a payment once the batch has been released.
|
|
Sorry,you cannot edit a payment once the batch has been Finalized.
|
|
Exit ('^') allowed now
|
|
FPPS CLAIM ID was changed. Updating lines on invoice...
|
|
FPPS LINE ITEM must be entered for each line on the invoice.
|
|
SVC DATE:
|
|
REV. CODE:
|
|
AMT CLAIMED:
|
|
Select Fee Patient:
|
|
No payments for this patient!
|
|
TRAVEL PAYMENTS:
|
|
Check #:
|
|
Paid:
|
|
Vendor ID:
|
|
MEDICAL PAYMENT HISTORY
|
|
('*' Reimb. to Patient '+' Cancel. Activity '#' Voided Payment)
|
|
(paid symbol: 'R' RBRVS 'F' 75th percentile 'C' contract 'M' Mill Bill
|
|
Svc Date
|
|
Rev.Code
|
|
Units
|
|
Patient Account No.
|
|
Amt Claimed
|
|
Amt Paid
|
|
Adj Code
|
|
Adj Amount
|
|
Remit Remark
|
|
VoucherDt
|
|
You must be a Fee supervisor to use this option.
|
|
Select Invoice number:
|
|
Select Prescription # :
|
|
Payment not voided!
|
|
Payment already voided!
|
|
Is this the prescription you want to
|
|
Cancel the void on
|
|
Void
|
|
Answer 'Yes' if you want to
|
|
Void
|
|
this prescription.
|
|
Patient also has Inpatient Report(s) of Contact with the following date(s):
|
|
Fee site parameters must be initialized!!
|
|
Are you sure you want to enter a new invoice
|
|
Invoice # assigned is:
|
|
Vendor is flagged for Austin deletion!
|
|
Want to edit Vendor data
|
|
Date Correct Invoice Received:
|
|
Vendor Invoice Date:
|
|
Pharmacy Invoice #:
|
|
DATE PRESCRIPTION FILLED:
|
|
Date Prescription Filled is
|
|
prior to
|
|
later than
|
|
authorization period!!
|
|
Select PRESCRIPTION NUMBER
|
|
Prescription referred to Pharmacy Service for determination.
|
|
Since you didn't enter any line items
|
|
has been Deleted!!
|
|
Invoice No.:
|
|
Invoice Total: $
|
|
Want to enter another Invoice
|
|
Incomplete prescription entry. Deleted.
|
|
No prescriptions currently in this invoice.
|
|
Vendor Name:
|
|
Patient I.D.
|
|
Fill Date
|
|
There already is a prescription number entered, from this vendor,
|
|
for that fill date. The invoice number is
|
|
Do you want to continue a previously entered Invoice
|
|
Want to list previously entered line items
|
|
This prescription number already exsists in this invoice.
|
|
Do you wish to enter this prescription again
|
|
You do not have access to the Fee Invoice File, contact your IRM Service.
|
|
Rejected
|
|
Invoice Number:
|
|
Date Received:
|
|
Invoice Date:
|
|
Patient Account #:
|
|
AMT CLAIMED
|
|
AMT PAID
|
|
BATCH NO.
|
|
VOUCHER DATE
|
|
Other Suspension Description
|
|
AMT CLAIMED
|
|
ADJ AMT
|
|
REMIT RMK
|
|
Please enter a whole number! Alpha characters and puctuation are invalid
|
|
Answer must be numeric
|
|
Select Batch for this Invoice:
|
|
Invoice Closed out!!
|
|
Batch selected established by another user, choose another.
|
|
Batch selected is NOT a Pharmacy type batch, choose another.
|
|
Batch selected not in Open status, choose another.
|
|
Batch has reached maximum allowable payment entries!
|
|
Now openning another batch for you.
|
|
That Batch already has maximum allowable payment items!
|
|
Invoice Totals: $
|
|
New Batch to closeout invoice is:
|
|
Select Pharmacy Vendor:
|
|
** PHARMACY VENDOR LOOK-UP **
|
|
ID #:
|
|
Chain #:
|
|
Strength
|
|
Claimed
|
|
Date Finalized
|
|
Are you sure you want to create a '
|
|
Add
|
|
Change
|
|
Reinstate
|
|
' type MRA for this patient
|
|
MRA deleted.
|
|
Transaction Created!
|
|
Old Card
|
|
Pt.ID
|
|
Change Date
|
|
There are no Fee Basis prescriptions Pending Pharmacy review
|
|
Fee Prescription(s) Pending Pharmacy review
|
|
Want to review some now
|
|
No more prescriptions pending review!
|
|
>> PATIENT REIMBURSEMENT <<
|
|
Prescription #:
|
|
Fill Date:
|
|
Is Prescription for an Authorized Condition
|
|
A 'No' answer will deny payment.
|
|
Was a Generic Drug issued to patient
|
|
A 'No' answer alerts FEE to pay the generic equivalent, if one exists.
|
|
Enter VA Generic Drug equivalent
|
|
Match the drug entered by FEE to an entry in the VA Drug file.
|
|
Is this an emergency medication
|
|
A 'No' answer will DENY payment.
|
|
Optional Pharmacy Remarks
|
|
>>> PRESCRIPTION REVIEW <<<
|
|
Rx for Authorized condition:
|
|
Emergency Medication:
|
|
Generic Drug Issued:
|
|
Generic Drug Name:
|
|
Current list of Adjustments:
|
|
Code:
|
|
Group:
|
|
Current list of Remittance Remarks:
|
|
Optional Pharmacy Remarks:
|
|
Want to edit prior to release
|
|
Want to review another Prescription
|
|
Enter Invoice number you wish to make a determination on. Must
|
|
be an invoice which is 'Pending Determination' status.
|
|
Someone is editing that invoice now!
|
|
Select Suspense Code
|
|
Suspension Description
|
|
Suspension description is required for a suspense code of 'OTHER'.
|
|
Patient has no Pharmacy payment history.
|
|
FPPS Line Item:
|
|
PHARMACY PAYMENT HISTORY
|
|
Pt ID:
|
|
ID #
|
|
Chain #
|
|
Date Certified
|
|
Paid
|
|
None on File
|
|
Telephone
|
|
Personal
|
|
VA Office
|
|
SSN #
|
|
>> REPORT OF CONTACT <<
|
|
Name of Veteran
|
|
Telephone No. of Vet.
|
|
Date of Contact
|
|
Address of Veteran
|
|
Type of Contact
|
|
Person Contacted
|
|
Telephone Number of
|
|
Person Contacted
|
|
Brief statement of information requested and given
|
|
Division or Section
|
|
Executed by(signature and title)
|
|
VA form 119
|
|
There are no Reports of Contact on line for this patient.
|
|
Fee Purge is not running!
|
|
Total Payment Line Items to be Purged:
|
|
Number of Line Items Purged as of now:
|
|
Not Transmitted
|
|
FEE BASIS VENDORS AWAITING AUSTIN APPROVAL
|
|
DATE TRANSMITTED TO AUSTIN
|
|
There are no venders awaiting Austin approval.
|
|
Batch has been Re-opened!
|
|
Rejects deleted from batch
|
|
Sorry, only Supervisor can Delete reject flag!
|
|
No items rejected in this batch!
|
|
Want line items listed
|
|
Want to delete rejection codes for the entire Batch
|
|
Want to delete rejection code for any line items
|
|
Invalid entry, must enter a number between 1 and
|
|
or an '^' to exit!
|
|
No payments in this batch for that patient!
|
|
Delete Reject flag for all items for this patient
|
|
Delete reject for which line item
|
|
You already deleted that one!!
|
|
Are you sure you want to delete reject for item number
|
|
Item Deleted.
|
|
Want to delete another
|
|
If you answer 'Yes' to this question, all payment items in this batch
|
|
will be flagged as rejected! If you answer 'No', you will be asked if you
|
|
want to reject specific line items!
|
|
Delete reject flag for which line item
|
|
You already did that one !!
|
|
Are you sure you want to delete the reject on item number
|
|
Are you sure you want to delete reject code for all rejected items in this batch
|
|
Reject codes for all items have been deleted!
|
|
There is a problem with your 1358. Unable to delete reject flag!
|
|
No payments rejected in this batch for that patient!
|
|
You just deleted that one!!
|
|
Delete Reject code for all items for this patient
|
|
Delete reject code for which line item
|
|
Reject code deleted!
|
|
No 7078 on file for invoice
|
|
. Could not determine 1358.
|
|
No Rejects Pending!
|
|
Batch Number:
|
|
Voucher Date:
|
|
Voucherer:
|
|
Reject Reason:
|
|
Old Batch #:
|
|
REJECTS PENDING ACTION
|
|
Re-transmit MRA's for which date:
|
|
No MRA's were transmitted on that date!
|
|
Re-Transmitting
|
|
Want to print this Report of Contact
|
|
Select Batch with Rejects:
|
|
Select New Batch number:
|
|
Want to re-initiate all rejected items in the Batch
|
|
'Yes' will re-initiate all rejected payment items for this batch, 'No' will prompt for re-initiation of specific line items
|
|
Want to re-initiate any line items
|
|
Re-initiate which line item
|
|
You already did that one!!
|
|
Are you sure you want to re-initiate line item number
|
|
Item Re-initiated.
|
|
Want to re-initiate another
|
|
FYI: Invoice
|
|
was split since entire invoice did not move to the new batch.
|
|
Re-initiated lines are being assigned a new invoice number of
|
|
Enter the batch number to which the rejected items you re-initiate will
|
|
be assigned to. It must be an open batch and assigned to you.
|
|
The obligation number from the batch with rejects
|
|
is not the same as the new batch selected !
|
|
Re-Initiate which line item
|
|
New Batch for Rejects is:
|
|
Are you sure you want to re-initiate all line items in this batch
|
|
All rejected items have been re-initiated!
|
|
All rejected items (except for voided payments) have been re-initiated!
|
|
New Batch selected does not have enough room to fit the
|
|
rejects pending from batch
|
|
has a status of VOID. Please delete the VOID
|
|
before re-initiating this rejected payment.
|
|
You just did that one!!
|
|
Line Re-initiated.
|
|
Are you sure you want to re-initiate item number:
|
|
Reject code deleted.
|
|
This report produces a 132 character output.
|
|
There are no batches Pending Release!
|
|
Try releasing batch at another time.
|
|
Batch needs to be released to Pricer first.
|
|
Release of batch
|
|
Sorry, only Supervisor can Release batch!
|
|
Do you want to Release Batch as Correct
|
|
Batch has NOT been Released!
|
|
Batch has been Released!
|
|
This batch CANNOT be released. Check your 1358.
|
|
1358 not available for posting!
|
|
No invoices found for this batch. Unable to release.
|
|
FB7078(
|
|
No associated 7078 for invoice
|
|
. Unable to release batch.
|
|
Unable to locate reference number on 1358. Run Post Commitments for
|
|
Obligation option.
|
|
STA #-OBLIGATION #-REF #
|
|
A new batch, number
|
|
#################### #################### ####################
|
|
#################### #################### ####################
|
|
#################### #################### ####################
|
|
#################### #################### ####################
|
|
#################### #################### ####################
|