308 lines
12 KiB
Plaintext
308 lines
12 KiB
Plaintext
English French Notes Complete/Exclude
|
|
The 'AMOUNT PAID' has been altered on the Fee Payment Voucher Document
|
|
in FMS for the following payments:
|
|
>>> For detailed payment information use the appropriate payment output. <<<
|
|
Payment has been cancelled for the following line items:
|
|
>>> For detailed check information use the Check Display output. <<<
|
|
Check Number:
|
|
Date of Service:
|
|
Invoice Number:
|
|
From Date:
|
|
To Date:
|
|
for travel on
|
|
Select Fee Vendor:
|
|
FEE Program
|
|
Patient ID:
|
|
Vendor ID:
|
|
FEE PROGRAM:
|
|
('*' Reimb. to Patient '+' Cancel. Activity '#' Voided Payment)
|
|
There are no payments on file for
|
|
for specified date range:
|
|
and selected Fee Program(s):
|
|
and ALL Fee programs
|
|
There are no outpatient payments on file for specified date range
|
|
and selected Fee programs
|
|
Primary Dx:
|
|
Obl.#:
|
|
FEE PROGRAM:
|
|
CPT-MOD
|
|
Voucher
|
|
Rx:
|
|
Pat. ID:
|
|
Vendor:
|
|
>>> ANCILLARY SERVICE PAYMENTS <<<
|
|
SERVICE CONNECTED?
|
|
Primary Service Facility
|
|
Include (P)atient Co-pays / (I)nsurance / (B)oth
|
|
Select type of recover to include
|
|
P - include only recover from patient copays
|
|
I - include only recover from insurance
|
|
B - include both
|
|
Include (M)eans Test Co-pays /(L)TC Co-pays /(B)oth
|
|
Select services to include
|
|
M - include only Means Test copays
|
|
L - include only LTC copays
|
|
MeansTest
|
|
There are no potential cost recoveries on file
|
|
for specified date range:
|
|
and selected Primary Service Area(s):
|
|
and ALL Primary Service Areas
|
|
POTENTIAL COST RECOVERY REPORT
|
|
Cost recover from insurance.
|
|
Cost recover from means testing
|
|
and insurance.
|
|
Cost recover from LTC co-pay
|
|
Cost recover from insurance,
|
|
1010EC Missing for LTC Patient.
|
|
Cost Recover from insurance and
|
|
Potential Cost Recover from LTC co-pay.
|
|
>>> Cost recover from
|
|
means testing
|
|
and insurance
|
|
Payments for veteran
|
|
There are no payments to this vendor for this patient.
|
|
RX #
|
|
'*' Reimb. to Patient '+' Cancel. Activity '#' Voided Payment
|
|
>>>Amount paid altered to $
|
|
>>>Check cancelled on:
|
|
Press 'ENTER' to
|
|
view next selection
|
|
return to list
|
|
No check found for this line item.
|
|
Line item #
|
|
number on file for this entry
|
|
MERGE PAIRS EXCLUDED DUE TO BOTH HAVE FEE BASIS ID CARDS
|
|
MERGE PAIR Patient records
|
|
both have FB ID card numbers. Please cancel one of the IDs and resubmit the Merge Pair
|
|
*** DUZ and DUZ(0) must be defined as a valid user to initialize. ***
|
|
Routine XPDUTL, part of Kernel Tool Kit 7.2 was not found on
|
|
your system. This must be installed prior to installing this
|
|
version of Fee Basis.
|
|
You must have Fee Basis Version 3.0 installed prior to installing version 3.5
|
|
CONTRACT HOSPITAL
|
|
NON-VA HOSPITAL
|
|
Check your package file for the
|
|
entry. Unable to determine version.
|
|
Your version of the
|
|
must be at least
|
|
to install this version of FEE.
|
|
|
|
Want to select patient from DHCP Patient File
|
|
Enter LAST NAME
|
|
Enter last name of patient. Answer must be 3 to 20 characters in length
|
|
Enter FIRST INITIAL
|
|
Enter MIDDLE INITIAL
|
|
Patient ID Number
|
|
Answer must contain 9 numbers. Pseudo-SSN not allowed
|
|
Sex of Patient
|
|
Want to select a vendor from DHCP Fee Basis Vendor file
|
|
Vendor must have a Medicare ID number to send to the pricer.
|
|
Select Vendor Name
|
|
Enter Medicare ID Number
|
|
State of Vendor
|
|
Admitting Authority
|
|
Disposition Code
|
|
Is this a Patient Reimbursement
|
|
Payment by Medicare or Other Federal Agency
|
|
Must enter at least a primary diagnosis.
|
|
Billed Charges
|
|
Amount Claimed
|
|
Obligation Number
|
|
Case sent to pricer.
|
|
Starting Post Init FBPST35
|
|
Completed FBPST35
|
|
Post-Init FBPST35A has already been run.
|
|
Beginning FBPST35A....
|
|
CONVERSION OF DENIALS FILES
|
|
Now I will move any Medical Denial information you wish to keep into the
|
|
Fee Basis Payment File (#162). I will then remove the Fee Basis Medical
|
|
Denials file (#163) and the Fee Basis Pharmacy Denials file (#163.1).
|
|
Do you want to keep any Medical Denials that are presently stored in the
|
|
Fee Basis Medical Denials file (#163)
|
|
Answering yes will move the denials to file #162, no will delete them
|
|
You may elect to merge all of your Fee Basis Medical Denials. If you
|
|
choose not to retain all denials, you will be prompted to select a
|
|
STARTING DATE to retain denials. Denials from the starting date to the
|
|
present date will be merged into file #162.
|
|
Do you wish to retain all Medical Denials
|
|
Select date to retain denials
|
|
Beginning merge
|
|
Deleting the Fee Basis Medical Denials file (#163)...
|
|
Deleting the Fee Basis Pharmacy Denials file (#163.1)...
|
|
Cleaning up DD nodes...
|
|
Completed FBPST35A
|
|
Unable to complete the FBPST35A Post-Init routine. To complete this
|
|
process, run ^FBPST35A as soon as possible.
|
|
Beginning FBPST35B ....
|
|
CONVERSION OF FEE BASIS FEE SCHEDULE FILE (#163.99)
|
|
Completed FBPST35B
|
|
The following vendors with invalid ID's have been placed in delete status:
|
|
FEE BASIS VENDOR CORRECTIONS CLEANUP
|
|
FBTEXT(
|
|
FBPST35C has previously run to completion!
|
|
Beginning FBPST35C
|
|
REMOVAL OF FIELDS PREVIOUSLY STARRED FOR DELETION.
|
|
Do you want me to task this job in the background for you
|
|
Answerring 'YES' will run the job in the background and send you a bulletin
|
|
when completed. Answerring 'NO' will run the job now (no
|
|
bulletin will be sent).
|
|
Required response!
|
|
Routine FBPST35 to remove obsolete fields has been tasked.
|
|
Deleting any data remaining in the obsolete fields.
|
|
Deleting field #
|
|
from file #
|
|
Completed FBPST35C
|
|
Post initialization routine FBPST35C has run to completion.
|
|
FEE BASIS POST-INIT COMPLETE
|
|
Are you finished editing prescriptions on invoice
|
|
AUTH. NOT ADDED
|
|
AUTH IS AUSTIN DELETED. USE THE REINSTATE OPTION TO CHANGE IT.
|
|
(No Editing)
|
|
OK to DELETE the
|
|
ERROR. STATE HOME not found in FEE BASIS PROGRAM (#161.8) file.
|
|
Unable to process State Home authorization. Please contact IRM.
|
|
ERROR ADDING TO #161
|
|
ANOTHER USER IS EDITING THIS PATIENT & PROGRAM. PLEASE TRY AGAIN LATER.
|
|
Enter FROM DATE:
|
|
Enter TO DATE:
|
|
The specified dates conflict with other authorization(s).
|
|
Please specify different dates for this authorization or
|
|
remove the conflcit by first editing the other authorization(s).
|
|
Conflict with FROM DATE
|
|
PURPOSE OF VISIT
|
|
**Austin Deleted** - Use Reinstate to reuse this From Date
|
|
For ALL Purpose of Visits? Y/N
|
|
Select one or more Purpose of Visits
|
|
Active Authorizations Report
|
|
No active authorizations found during period.
|
|
for POV:
|
|
TOTAL DAY(S) FOR POV WITHIN REPORT PERIOD:
|
|
ACTIVE AUTHORIZATIONS by POV, Vendor, Patient
|
|
TRANSFER TO VA
|
|
VA(200
|
|
Disposition to Cancel/Withdrawn.
|
|
Use the Delete Unauthorized Claim option.
|
|
Select a printer device name.
|
|
NOTE: This is not a pointer field, the exact name must be entered.
|
|
Printer name:
|
|
Location:
|
|
TREATMENT FROM:
|
|
TREATMENT TO:
|
|
Cannot delete Authorization because payments already exist!
|
|
Cannot delete Authorization because a 7078/583 entry has already been established!
|
|
No data on file.
|
|
Select the claim which you would like to display
|
|
< PENDING INFORMATION >
|
|
< PAYMENTS ON FILE >
|
|
< ASSOCIATED CLAIMS >
|
|
Fee Program
|
|
ASSOCIATED INVOICES
|
|
Do you wish to edit
|
|
Do you wish to display return address
|
|
POTENTIAL DUPLICATES
|
|
No.
|
|
Current extension date is
|
|
Confirm entry of
|
|
as the new extension date for the claim
|
|
New extension date is equal to existing extension date. No change made.
|
|
.02////^S X=DUZ;.03///INCOMPLETE UNAUTHORIZED CLAIM;.04///^S X=FBEXTD
|
|
ERROR ADDING EXTENSION
|
|
Vendor information is required for disposition.
|
|
Patient Type Code is required for disposition.
|
|
Shall other claims be updated to same veteran & treat. from/to dates
|
|
Shall all other claims be updated to the disposition
|
|
& auth. from/to dates
|
|
Shall all other claims be updated to the auth. from/to dates
|
|
Shall disapproval reason apply to all other claims
|
|
Are you sure you wish to delete
|
|
Shall all of these claims be deleted
|
|
Deleting claim
|
|
and associated claims not dispositioned ...
|
|
Select VETERAN
|
|
Select FEE VENDOR
|
|
Is this claim being considered under Millennium Act 38 U.S.C. 1725 (Y/N)
|
|
Is the unauthorized claim complete for the FEE PROGRAM
|
|
Checking for potential duplicates...
|
|
Checking eligibility...
|
|
Patient is not a veteran.
|
|
Are you sure you wish to enter a new unauthorized claim
|
|
... Deleting incomplete record.
|
|
An unauthorized claim is considered complete (or valid)
|
|
if all the necessary information has been received.
|
|
A claim can never be considered complete if it is missing
|
|
form 10-583 or form 10-583 is incomplete.
|
|
Some examples of other items which are needed are:
|
|
Copies of actual bills
|
|
Original paid receipt
|
|
Itemized invoice/UB82
|
|
Medical records or signature for release
|
|
Diagnostic/Procedure code(s)
|
|
Enter Y(es) if complete, N(o) if incomplete.
|
|
Enter Y(es) if all required information has been submitted,
|
|
N(o) if the claim is incomplete.
|
|
The disposition for the selected claim is
|
|
At least one other claim in this group has been dispositioned.
|
|
The existing disposition(s) in the group follow:
|
|
Would you like this claim to be dispositioned
|
|
Would you like to change the disposition
|
|
to another
|
|
The claim cannot be dispositioned.
|
|
Patient Type Code is required to disposition the claim.
|
|
Do you want to specify the Patient Type Code for the claim
|
|
No Patient Type for master claim.
|
|
No Patient Type for secondary claim.
|
|
Master claim doesn't have any Patient Type Code
|
|
Do you want to enter Patient Type Code for the master claim
|
|
Master claim has Patient Type Code :
|
|
Do you want to use the same Patient Type for the secondary claim
|
|
Unauthorized Claims Dispositioned to 'ABANDONED'
|
|
Treatment
|
|
Select the date range within which an unauthorized claim will expire.
|
|
Unauthorized
|
|
Mill Bill (1725)
|
|
NON-Mill Bill
|
|
Claims Due to Expire between
|
|
No claims will expire within selected date range.
|
|
AUTO PRINT UNAUTH CLAIM LETTER
|
|
Do you wish to reprint letters for a date range
|
|
Select Yes to reprint letters for a date range; No to reprint a specific letter.
|
|
Should the expiration date be updated
|
|
Answer Yes to update the expiration date based upon today's printout, No to only reprint the letter but not change the date when the information is due.
|
|
Queue to print on:
|
|
REPRINT UNAUTH CLAIM LETTERS
|
|
FBARY(
|
|
BATCH UNAUTH CLAIM LETTERS
|
|
Enter NUMBER OF COPIES for each letter
|
|
Print all types of letters
|
|
Enter YES to print all types of letters. Enter NO to
|
|
just print letters of one specific type.
|
|
VENDOR:
|
|
VETERAN:
|
|
In Reply Refer To:
|
|
Reason(s) for not approving
|
|
SIGNED STATEMENT FROM CLAIMANT
|
|
REGARDING:
|
|
EPISODE OF CARE:
|
|
Authorized from:
|
|
Authorized to:
|
|
Amount approved:
|
|
Itemized list follows:
|
|
*Reason(s) for Suspension
|
|
(4) Other. Specific reason immediately follows item.
|
|
Discharge Date
|
|
Amt Approved
|
|
Suspend*
|
|
Reason for Suspension:
|
|
Service Date
|
|
RX Date
|
|
Drug Name:
|
|
This claim has other claims associated with it
|
|
and, therefore, can not be associated to another.
|
|
Select the unauthorized claim to which this one should be associated:
|
|
This option will allow you to disassociate a claim.
|
|
#################### #################### ####################
|
|
#################### #################### ####################
|
|
#################### #################### ####################
|
|
#################### #################### ####################
|
|
#################### #################### ####################
|