308 lines
12 KiB
Plaintext
308 lines
12 KiB
Plaintext
English French Notes Complete/Exclude
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INSURED'S ADDRESS STREET
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PATIENT ADDRESS CITY
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INSURED'S ADDRESS CITY
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PT ZIP CODE
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INS ZIP CODE
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OTHER INSURED'S NAME
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INSURED'S POLICY GROUP
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OTHER POLICY NUMBER
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INSURED'S EMPLOYER
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OTHER'S EMPLOYER
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INSURANCE PLAN NAME
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OTHER'S INSURANCE PLAN
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REFERRING PHYSICIAN
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PHYSICIAN ID
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BC/BS#
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FEDERAL TAX ID
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PAT ACCT#
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AGENT CASHIER (999) 999-9999
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CITY, STATE ZIP
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PRINT UB-92 BILL
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NO SOMETHING
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OP VISIT DATE(S) BILLED:
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ADDITIONAL DIAGNOSIS CODES:
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PROSTHETIC ITEMS:
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PRINT TEST BILL
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*** UB-92 TEST PATTERN ***
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BN XXX
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TAX# XXXX
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PT SHORT ADDRESS
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RESPONSIBLE PARTY'S NAME
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REV CODE description
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Name of Payer 1
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Provider #
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Name of Payer 2
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Name of Payer 3
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Insured's Name 1
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Insurance #
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Group Name
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Insured's Name 2
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Insured's Name 3
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Treatment Auth. Cd
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Employer Name
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Employer Location
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Dx Cd
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ADMT DX
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Attending Phys. ID#
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Other Phys. ID#
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Patient ID#: xxx-xx-xxxx
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Bill Type: xxx xxxxxx
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UB 92 TEST PATTERN
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Provider Representative DATE
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Transmittable Bill can NOT be printed until transmitted
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This is a Transmittable Bill that has already been transmitted
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WANT TO PRINT THIS BILL ADDENDUM ANYWAY
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OUTPUT DEVICE:
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DAYS SUPPLY:
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REFILL DATE
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DAYS SUPPLY
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NDC #
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***TASK STOPPED BY USER***
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Default printer in billing not defined for the
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, none will print!
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There are no Authorized but not Printed bills to print!
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Z:ZIP;I:INSURANCE COMPANY NAME;P:PATIENT NAME;
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This option prints all non-transmittable bills with a Status of Authorized in the order requested. The printed bills may be sorted by: Zip Code, Insurance Company Name, and Patient name.
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First Sort Bills By
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Enter the field that the bills should be sorted on within
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. Press return if the order already entered is sufficient.
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Then Sort Bills By
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Begin printing bills
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Enter 'Y'es to begin printing of all authorized non-transmittable bills.
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... bills not printed!
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BATCH PRINT AUTHORIZED THIRD PARTY BILLS
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BATCH PRINTING
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The following bill(s) were not printed due to errors indicated.
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PRINT BILL ERRORS
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One or more bills were not printed. Check your mail for details
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NOT ADDED TO FILE 351.9
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Select ClaimsManager Bill:
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IBCI CLAIMSMANAGER ASSIGN
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*** RECORD IS LOCKED ***
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Another user is currently editing this bill.
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IBCI CLAIMSMANAGER WK BROWSE
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IBCI CLAIMSMANAGER CLERK WK
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ClaimsManager Error Report
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There are no errors currently recorded in the ClaimsManager
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file. There is no data to report.
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IBCICME ERROR CODES
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ALL Error Codes in the ClaimsManager File
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Please Select the Error Codes to include
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This response must be a list or range.
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For example, 1,3,5 or 2-4,8
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If you include #1, then all codes will be included
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regardless of what you enter here.
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SELECTED ERRCODES
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ALL ERRCODES
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DISPLAY ERROR TEXT
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Do you want to see the ClaimsManager Error Messages for these bills
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Enter YES if you would like to see the full description of the error
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including all lines of error message text.
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Enter NO if you do not want to see this information.
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ERROR DISPLAY TYPE
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1:Display all ClaimsManager Errors for a Bill;
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2:Display all Bills for a ClaimsManager Error Code
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Select the Error Display Type
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The answer to this question will determine how the Bills and Errors
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are displayed on the report.
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Select option 1 if you want to display all of the ClaimsManager
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errors for each bill that appears on the report. These errors will
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appear together with the bill.
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Select option 2 if you want to break this report out by ClaimsManager
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error code. In this case, you will see separate sections for each
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error code and all bills in which a particular error code is present.
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Remember that the bills and errors are still subject to the other
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selection and sort criteria that you enter.
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RPTSPECS(
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~~~ NO INSURANCE ~~~
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Terminal Digit
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Dollar Impact
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Bill Number
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Total # Claims
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Total # Errors
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ClaimsManager Detailed Error Report sort by
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Page :
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Detailed Report
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BILL NO.
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ERROR CODES
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CM STATUS
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ClaimsManager Audit Error Report for
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Summary Report
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CM Error Message:
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ClaimsManager Status Report
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Do you want to exit out of this option entirely
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Enter YES to immediately exit out of this option.
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Enter NO to return to the previous question.
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Select Date Range by
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Please enter the type of date on which you would like to report.
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The Event Date is the date on which the services were performed.
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The Entered Date is the date on which the bill was Entered into VistA.
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Enter the beginning
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Enter the ending
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1:All ClaimsManager Statuses;
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2:One Specific ClaimsManager Status;
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3:Any ClaimsManager Status (Bill is still Editable)
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Select the ClaimsManager Status Option
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Option 1 - All ClaimsManager Statuses - indicates that all bills
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will be included on the report regardless of ClaimsManager
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Option 2 - One Specific ClaimsManager Status - will allow you to
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choose a ClaimsManager status and only bills with this specific
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status will be included on the report.
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Option 3 - Any ClaimsManager Status (Bill is still Editable) -
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will only select those bills that are still open for editing in
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the IB Enter/Edit Billing Information option.
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Please choose a ClaimsManager Status
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Do you want to see ClaimsManager comments associated with these bills
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Enter YES if you would like to see the comments which are stored in the
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ClaimsManager file (#351.9) for each bill on this report.
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Enter NO if you do not want to see these comments.
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Do you want to include one specific Assigned to person or All?
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Please enter 1 or A
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Enter '1' to indicate that you only want to include one specific
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Assigned to person on this report. You will then be asked
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to select this person.
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Enter 'A' to indicate that you want to include all Assigned to
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people on this report. You will then be asked if you want
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to sort by the Assigned to person.
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Invalid response ... Please enter '1' or 'A'
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Do you want the primary sort by the Assigned To person
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Enter YES if you would like the bills on this report primarily
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sorted by the Assigned To person. If a bill is not assigned
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to anyone, then the word
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Enter NO if you would like to choose a different primary sort.
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Enter the Assigned to person to include:
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1:Terminal Digit;
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2:Insurance Company Name;
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3:Patient Last Name;
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4:Total Charges;
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5:Bill Number
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Please enter the
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sort criteria
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Please enter the report type
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The Detailed report will show the breakout of bills &
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a summary based on the criteria that you selected.
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The Summary report will show the total amount of bills
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based on the criteria that you selected.
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*** This report is 132 characters wide ***
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IBCI ClaimsManager Status Report
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IBCI ClaimsManager Error Report
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ClaimsManager Status Report sort by
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ClaimsManager Bill Totals by ClaimsManager Status
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ClaimsManager Worksheet Report
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ClaimsManager does not have a Claims Worksheet on file for this Claim.
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Claim No:
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Not on File
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Please verify that you entered the correct patient.
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Another user is currently using this option.
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ClaimsManager is not working right now.
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IBCI CLAIMSMANAGER SKIP LIST
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Welcome to ClaimsManager Bill Processing
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This ListMan will display all skipped bills for processing
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PR/TX
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PT_NAME
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EVENT_DATE
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No Skipped Claims to Send to ClaimsManager.
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You may select one or more claims, or a range.
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You may choose a single bill, a list of bills (i.e. 2,5,9,12), a range
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of bills (i.e. 3-8), or any combination of these (i.e. 1,3,5,8-12). Only
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the bills you select here will be sent to ClaimsManager.
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The following bills were sent to ClaimsManager from the Multiple Claim Send
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option. ClaimsManager did not find any errors with them. These bills have
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passed both the IB edit checks and the ClaimsManager edit checks. They are
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ready to be authorized. Please review the bills for which you are responsible
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(if any) and take the appropriate action.
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BILL# PATIENT NAME PID DATE CHARGES USER NAME
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ClaimsManager Clean Claims
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There are no claims to send ...
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Sending claims ... please wait.
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'Send All Bills to ClaimsManager' will send all claims listed
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to ClaimsManager for processing.
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'Send All Non Auth Bills to ClaimsManager' will send only
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Non-Authorized claims to ClaimsManager for processing.
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'Select Bills to send to ClaimsManager' allows individual and
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multiple selection of claims before sending
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claims to ClaimsManager for processing.
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IBCI CLAIMSMANAGER MGR WK
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Coder:
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Line:
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Error Level:
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ClaimsManager Error:
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No ERRORS defined for claim EVENT DATE:
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No Errors found by ClaimsManager.
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Are you sure you want to Override the errors of this bill
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Are you sure you want to Exit the ClaimsManager Interface process
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IBCINPT.DAT
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This option is responsible for creating the NPT file
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(New Patient History) for the ClaimsManager application from Ingenix.
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A 3 year history is needed so this option will extract claims data
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This process may take several minutes.
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Do you wish to proceed
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The file that will be created is called
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You may specify a valid directory location (path) for this file.
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After this file has been created, it needs to be accessible to the
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ClaimsManager application. This can be done either through network
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connections or by manually moving it to the ClaimsManager server.
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FOr
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Please enter the directory location (path) for
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Enter the location where the file should be created.
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Enter the full path specification up to, but not including,
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the filename. This includes any trailing slashes or brackets.
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If the operating system allows shortcuts, you can use them.
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Examples of valid paths include:
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VMS USER$:[SCRATCH]
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is not a valid directory location or path.
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Please press
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for more assistance.
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The full file specification including path and filename is:
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OK to begin
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The compile process has completed successfully.
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The number of bills that were reviewed is
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The number of records that will be in the NPT file is
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All that's left to do is to copy these records into the NPT file.
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The NPT file creation process is complete!
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IBCIPAY.DAT
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for the ClaimsManager application from Ingenix. This
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is a listing of the Insurance Companies that are currently
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stored in VistA.
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please wait
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There are
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records in the Payor File.
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The Payor File creation process is complete!
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VistA-ClaimsManager Interface Options
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ClaimsManager is only available for HCFA 1500 claims.
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The form type of the bill you're editing
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The charge type of this bill is
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Select option or press RETURN to continue
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The VistA-ClaimsManager Interface is not currently working.
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This bill is no longer editable. The ClaimsManager interface
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Test Send functionality is not available for this bill.
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ClaimsManager found
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with this bill.
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Press RETURN to view the error
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There was a communications failure:
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Please report these errors to your system manager.
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This bill was NOT successfully analyzed by ClaimsManager.
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There are no errors recorded in the file.
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Times sent to ClaimsManager:
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Last sent date/time:
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Last sent by:
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Date/time Entered:
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Date/time Last Edited:
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Assigned to:
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Biller:
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TEST-
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Sending
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to ClaimsManager
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No Errors found by ClaimsManager
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Communications Error - Not Sent to ClaimsManager
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There are no line items associated with this claim.
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ClaimsManager cannot process without line items. Please
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enter the line item data and resend.
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... Claim has been CANCELLED in ClaimsManager.
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#################### #################### ####################
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#################### #################### ####################
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#################### #################### ####################
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#################### #################### ####################
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#################### #################### ####################
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