308 lines
12 KiB
Plaintext
308 lines
12 KiB
Plaintext
English French Notes Complete/Exclude
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** CURRENT PERSONAL RIDERS **
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None Indicated
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* BENEFITS USED *
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** OPT DEDUCTIBLES **
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Ded Met?:
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Amt of Ded Met ($):
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Pre-exist Cond:
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MH Ded (Opt) Met?:
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Coord of Ben Data:
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Amt of MH Ded Met ($):
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Amt Lifet Max Used ($):
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Amt MH Lifet Max Used ($):
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** INPT DEDUCTIBLES **
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MH Ded (Inpt) Met?:
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You may enter the 'Source of Information' that will be filed with all
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Medicare insurance coverage policies that are created.
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Enter Source of Information
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Patient Expired on
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This patient has more than one Part A policy. Please edit in Ins Mgmt.
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This patient has more than one Part B policy. Please edit in Ins Mgmt.
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* No Part A changes made...
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* No Part B changes made...
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<Could not create new policy at this time. Try Later!>
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Error: Medicare (WNR) ... not setup properly
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Verify Medicare (WNR) Part
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Coverage Now
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Enter 'No' to not Verify Coverage at this time.
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COVERAGE VERIFIED.
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added to Insurance Buffer File.
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Warning: Could not add new policy Part
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in Buffer File.
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Is this Data Correct
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Enter 'No' to edit Medicare Card information
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Error: Standard Medicare (WNR) Insurance Company not setup properly.
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Error: Standard Medicare (WNR) plan PART A not setup properly.
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Error: Standard Medicare (WNR) plan PART B not setup properly.
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NAME OF BENEFICIARY
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Enter the Name of Beneficiary (Last name, First) from the Medicare Insurance Card. This name should be 3 to 30 characters in length.
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HOSPITAL INSURANCE (PART A) EFFECTIVE DATE
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Enter PART A Effective Date if shown on Medicare Insurance Card.
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MEDICAL INSURANCE (PART B) EFFECTIVE DATE
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Enter PART B Effective Date if shown on Medicare Insurance Card.
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No data can be filed without Part A or B Effective Dates.
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COORDINATION OF BENEFITS:
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Enter the Coordination of Benefits as Primary, Secondary, or Tertiary.
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Enter the Medicare Claim Number (Subscriber ID) exactly as it appears
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on the Medicare Insurance Card, including ALL characters. Valid HICN
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formats are: 1-3 alpha characters followed by 6 or 9 digits, or
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9 digits followed by 1 alpha character optionally followed by another
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IB-MRA
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IB-MRA-CNT
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Bills Found for Selected Ins. Co.:
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Bills for Outpatient Visits:
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Bills for Inpatient Visits:
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Subtotals by Selected Ins. Co.:
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Bills with Procedures and Diagnosis:
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Bills with Diagnosis Codes Only:
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Bills with Procedure Codes Only:
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Bills with No Proc. or Diag. Codes:
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Bills Canceled before Completion:
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Bills Never Printed:
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Bills with wrong Rate Type:
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Bills with wrong Who's Responsible:
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Bills w/ wrong Bill Classification:
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Bills for Prescriptions:
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Bills for Prosthetics:
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Bills with Patients Not Alive:
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Bills Meeting Criteria for MRA:
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Outpatient Bills Meeting Criteria:
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Inpatient Bills Meeting Criteria:
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Bill Meeting Criteria and Referred:
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There are no summary records to print.
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Insurance Company:
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Calendar Year of Bill:
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Type of Bill:
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There are no detail records to print.
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Possible Medicare Remittance Advice Claims
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Detail Report
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Totals Report
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Bill No.
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Bill From-To
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Date Printed
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Amount Billed
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Amount Collected
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IB Status
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Billed
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Coll
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Total Amount No. Amount
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Number Billed Coll Collected
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IB MRA ANALYSIS REPORT FOR
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ACTIVITY := $$MRA-ANALYSIS$$
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SITE := $$
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SUMMARY DATA :=
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INSURANCE COMPANY TOTALS :=
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ANNUAL DATA :=
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Build MRA Extract
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Your user number (DUZ) must be defined before proceeding!
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This program extracts data from the AR and IB packages and
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sends it to the VA CFO office for analysis. A background job
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called 'IB-Compile MRA statistics' will be queued to run at a time
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you choose. A file will be created with the extracted info
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will have to be FTPed to a designated IP address. The file will
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This extract must be run on the Legacy sites as well as
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the Primary site if you are an integrated database facility.
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Volume/Directory (or return to accept the default directory)
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Enter using format VA3$:[ANONYMOUS.PUB]
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Unable to determine default directory. Please enter one.
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Unable to create file in specified volume/directory
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You must enter the list of Insurance Companies to be included in this extract first
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Enter Start Date for MRA Extract:
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Jan. 1,1995
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Enter the earliest date for which Means test charges will be extracted
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Enter End Date for MRA Extract:
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Dec. 31, 1996
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Enter the latest date for which Means test charges will be extracted
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This will automatically be tasked to run. Upon completion of the extract A mail message will be sent to you.
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IB-Compile MRA statistics
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Job queued (
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Task not queued!
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INS(
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Completion of MRA Extract
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IB PACKAGE
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The MRA Extract has been completed and data stored in file:
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This file must be sent via FTP to the following address:
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MRA EXTRACT OPEN ERROR
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The file for the MRA extract could not be opened.
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The job will need to be requeued
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Build statistics on Insurance Companies that are withholding Medicare
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Supplemental Policy Payments.
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You didn't select anything to do! Try again.
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the data will be sent to you.
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Print Report, [S]ummary, [D]etail, [None]:
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Select whether you want to print a summary report, a detail report, or No report. A detail report will list every claim. No report will automatically send data for national rollup.
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Send Data for National Rollup
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Answer 'Yes' if you wish to send a report for national rollup purposes or answer 'No' if you just want to print a report.
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Create a list of Insurance Companies for the MRA Extract
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No Entries have been made.
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The Following Entries have been made:
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IBCNS-ERR
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Check Patient file Insurance Type Group Plan consistency
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I'm going to check the Insurance company for each patient policy with the
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Insurance company in the associated Group Plan file.
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This will take a while, please queue this job to a device. I'll print
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a report when I'm done.
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Update any Inconsistencies
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Enter YES if you want any inconsistencies updated, enter NO if you just want the report.
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IB - v2 PATIENT FILE DOUBLE CHECK
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and a + for each entry updated
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IBCNS-ERR1
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IBCNS-ERR2
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IBCNS-ERR3
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No Errors Found!
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Policy is missing group Plan
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Dangling insurance node detected
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Group Plan is with different insurance company
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Patients with Incorrect Group Plans
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INSURANCE CO.
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OLD PLAN
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NEW PLAN
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....task stoped at user request
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Warning: Insurance Company selected already on file for this patient.
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The previous entry is active.
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The WHOSE INSURANCE are the same.
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The Effective and Expiration dates may cover overlapping dates.
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The Group Plans are the same.
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WHOSE INSURANCE is Spouse, patient marital Status Inconsistent.
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WHOSE INSURANCE is Spouse but no Employer listed.
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Warning: There is another policy with the same Group Name.
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Expanded Policy Information for:
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Comment -- Patient Policy
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Comment -- Group Plan
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Effective Dates & Source
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Effective Date:
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Source of Info:
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Policy Not Billable:
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Subscriber's Employer Information
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Emp Sponsored Plan:
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Employment Status:
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Retirement Date:
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Claims to Employer:
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Yes, Send to Employer
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No, Send to Insurance Company
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If ROI applies, make sure current consent is signed.
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Patient doesn't have Insurance
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Select Patient Policy:
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Insurance Contact (last)
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Person Contacted:
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Method of Contact:
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Call Ref. No.:
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Contact Date:
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Plan Information
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Is Group Plan:
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Group Name:
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Group Number:
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Type of Plan:
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Plan Category:
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Electronic Type:
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Plan Filing TF:
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Insurance Number:
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Insurance Company
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City/State:
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Billing Ph:
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Precert Ph:
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Insured Person's Information (use Subscriber Update action)
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St/Zip:
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Subscriber Information
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Whose Insurance:
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Subscriber Name:
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Coord. Benefits:
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Prim Prov Phone:
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Last Verified By:
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Last Verified On:
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Personal Riders
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You can now enter a contact and relate it to a Claims Tracking Admission entry.
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Select RELATED ADMISSION DATE:
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Warning: This contact is not associated with any care in Claims Tracking.
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You may only edit or view this contact using this action.
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Select Contact Date:
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Print [C]T Summary [W]ork Sheet (UR) [N]one [B]oth:
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You may choose print a UR work sheet, a summary from claims tracking (of this episode), both or nothing.
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IB - Print UR from Ins review
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Claims Tracking Summary
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Can't identify the plan!
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Please note that this plan is inactive!
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This plan is currently defined as a
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This Individual Plan has more than one subscriber!
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There is more than one subscriber to this Group Plan. The plan cannot
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be changed to an individual plan.
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Do you wish to change this plan to a
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Enter 'YES' to change this plan, or enter 'NO' to leave it as is.
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No change was made.
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Changing the plan to a
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Covered By Health Insurance indicates 'YES' but none currently Active.
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Please Review!
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Insurance conversion not complete, NO EDITING ALLOWED
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INVALID ENTRY, DELETE AND RE-ENTER, NO EDITING ALLOWED
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<DELETED> GROUP INSURANCE PLAN REQUIRED BUT NOT ENTERED
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*** If ROI applies, make sure current consent is signed! ***
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You may now enter a brief comment about this patient's policy
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You may now enter comments about this Group Plan that pertains to all Patients
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Current Personal Riders:
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Are you adding a new Annual Benefits YEAR
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IB ZZZZZ
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You cannot add a new Benefits Used BENEFIT YEAR
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Are you adding a new Benefits Used YEAR
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IBCNS PLAN LOOKUP
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No plans were identified for this company.
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<not filed>
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Precerts:
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<no street address>
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<no city>
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<no state>
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You may only select a single plan!
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This plan is not allowed for selection!
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Would you like to select any other plans
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If you wish to select plans from other screens, please answer 'YES'. Otherwise, answer 'NO'.
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ACTIVE DUTY
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Select SPONSOR:
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New sponsors must be in the format LAST,FIRST.
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' as a new SPONSOR
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Unable to add a new sponsor!
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.01 NAME;.02 DATE OF BIRTH;.03 SOCIAL SECURITY NUMBER
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.02 MILITARY STATUS;.03 BRANCH;.04 RANK
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The person '
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' is not currently the sponsor of this patient.
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Okay to add this person as the patient's sponsor
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Please enter 'YES' to add this person as the patient's sponsor, or 'NO' to select a new sponsor.
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MOVE SUBSCRIBERS OF ONE PLAN TO ANOTHER PLAN
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This option may be used to move subscribers from a selected Plan
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to a different Plan. The plans may be associated with the same
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Insurance Company or a different one. Plan and Annual Benefit
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information may be moved as well. Users of this option should
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be knowledgeable of the VistA Patient Insurance management options.
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Press any key to continue.
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plan, subscribers were moved from, is already inactive.
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Do you wish to inactivate
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's plan subscribers were moved from
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If you wish to inactivate the old plan, enter 'Yes' - otherwise, enter 'No.'
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<The old plan is still active>
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The plan has been inactivated.
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Do you wish to delete this plan
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If you wish to delete the old plan, enter 'Yes' - otherwise, enter 'No.'
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The plan has been deleted.
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<No Insurance Company selected>
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You may add a new Plan at this time or select an existing Plan.
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Insurance Company receiving subscribers must have a Plan.
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You may select an existing Plan from a list or enter a specific Plan.
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Do you wish to enter a specific plan
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The look-up facility to select a group plan has been enhanced to use the List Manager. Enter 'NO' if you wish to select a plan from this look-up, or 'YES' to directly enter a plan.
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* No plan selected!
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Select a GROUP PLAN:
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MOVE SUBSCRIBERS FROM
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Select the Insurance Company and Plan to move subscribers FROM.
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Collecting Subscribers ...
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* This plan has no subscribers!
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This plan has
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subscribers. All subscribers will be moved.
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MOVE SUBSCRIBERS TO
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You must move the subscribers to an active insurance company!
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You must move the subscribers to a different plan!
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<Not Specified>
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#################### #################### ####################
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#################### #################### ####################
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#################### #################### ####################
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#################### #################### ####################
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#################### #################### ####################
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