308 lines
12 KiB
Plaintext
308 lines
12 KiB
Plaintext
English French Notes Complete/Exclude
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Appeal Address Information
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Alternate Name:
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Street line 1:
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Street line 2:
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Street line 3:
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Insurance Policy Information
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Pre-Cert Phone:
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Subscriber Name:
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Subscriber ID:
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Entered By:
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Entered On:
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Last Edited On:
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WARNING: I detected you changed the Action on this review and deleted
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data associated with the previous action.
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WARNING: This patient has the following multiple Next Review Dates:
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TYPE OF CONTACT
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NEXT REV. DATE
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Denials and Appeals for:
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EV DATE
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You can only appeal a denial or an penalty.
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Select Appeal Date
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Must first delete appeals associate* d with Denials
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Expanded Appeal/Denial for:
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Claims Tracking Entries for:
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for Visits beginning on:
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IBTRE HR MENU
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IBTRE IR MENU
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IBTRE BI MENU
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IBTRE MENU
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*=Current Admission
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There are Hospital Reviews associated with this entry.
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There are Insurance Reviews associated with this entry.
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Number of Hospital Reviews Deleted:
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Number of Insurance Reviews Deleted:
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You do not have access to delete entries. See your application coordinator.
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Select Tracking Type:
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Enter any Date!
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If the patient was an inpatient on that date the system will use the
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correct admission date. If you are tracking an admissions at another
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facility you may enter that date. Enter '??' to get a list of the
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last 10 admissions for this patient.
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WARNING: This appears to be a one day stay.
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WARNING: Patient does not appear to be an inpatient on this date!
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No admission was found for this date, enter 'Yes' if you want to add this anyway, or 'No' if you do not wish to track this date.
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Okay to Add Claims Tracking entry for Admission Date
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Time is Required.
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Enter the Outpatient Visit Date.
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If no scheduled visit is found you will be given a warning. Enter
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'??' to get a list of scheduled visits between
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Use the change date range action to change listing of scheduled Visits.
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Outpatient Visit Date
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WARNING: No Visit information for this Patient for this date.
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Okay to Add Claims Tracking entry for Visit Date
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Enter date of the scheduled admission.
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If you use the scheduled admission package to schedule admissions
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you may enter '??' to get a list of scheduled admissions between
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. Use the change date range action
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to change listing of scheduled admissions.
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This should be a future scheduled admission.
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Scheduled Admission Date
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Okay to Add Claims Tracking entry for Scheduled Adm. Date
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Patient an inpatient on this date, using inpatient admission.
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Nothing Added
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No Admissions to Choose From.
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No Outpatient Visits to Choose From.
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No Scheduled Admissions to Choose From.
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Clinical Information comes from the parent package.
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Can not add diagnosis to outpatient visits prior to Check-out.
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You can only enter an admitting diagnosis for an admission
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You can only enter a diagnosis for an admission
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Return
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Select Diagnosis:
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Next Diagnosis:
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is not active for the service date (
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is already a diagnosis.
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You must use the add/edit action on Check-out to add procedures to Outpatient Encounters.
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You can only enter a procedure for an admission
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Warning! The Procedure Code
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is inactive on this date!
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Press <Enter> to continue
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Procedure Date
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Next Procedure Date
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The Procedure Date cannot be earlier than Admission (
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is not active for the procedure date (
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is already a procedure.
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to Edit
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, or 'A' to Add
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Can not add provider to outpatient visits prior to Check-out.
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You can only enter and admitting provider for an admission
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Admitting Physician
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You can only enter a provider for an admission
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Admitting Provider:
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Next Provider:
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Expanded Claims Tracking Info for:
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IBTRED HR MENU
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IBTRED IR MENU
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IBTRED BI MENU
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IBTRED MENU
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Clinical Information
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Admitting Diag:
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Primary Diag:
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1st Procedure:
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2nd Procedure:
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Billing Information
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Episode Billable:
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Non-Billable Reason:
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Next Bill Date:
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Work. Comp/OWCP/Tort:
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Initial Bill:
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Bill Status:
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Additional Comment:
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Total Charges: $
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Amount Paid: $
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Treatment Authorization Info
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No. Days Approved:
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Second Opinion Required:
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Second Opinion Obtained:
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Hospital Reviews Entered
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Insurance Reviews Entered
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Service Connected Conditions:
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Review Information
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Insurance Claim:
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Follow-up Type:
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Random Sample:
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Special Condition:
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Local Addition:
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Hospital Reviewer:
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(May include multiple visit dates)
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Assign Reason Not Billable to Claims Tracking Entry
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Add New Claims Tracking entry
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Enter 'YES' if you wish to add a new claims tracking entry so that it can be assigned a reason not billable, answer 'NO' if you do not wish to add a new entry.
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Updating claims tracking ...
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entry re-linked.
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Remote Query for insurance sent.
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no action taken.
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entry inactivated.
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UR Random Sample Patient Selection
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The following Patient has been selected as a UR Random Sample case on
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Admission Date:
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CT Entry ID:
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Ward Location:
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Admitting DX:
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Type of Admit:
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I'm sorry, Tracking of Prescription Refills is currrently turned off.
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Select the Date Range of Rx Refills to Add to Claims Tracking.
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Begin date is before Claims Tracking Start Date, changed to
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I'll automatically change the end date to 3 days prior to the date queued to run.
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I'm going to automatically queue this off and send you a
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mail message when complete.
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IB - Add Rx Refills to Claims Tracking
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(Selected end date of
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automatically changed to
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SERVICE NOT COVERED
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NOT INSURED
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NEEDS SC DETERMINATION
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SC TREATMENT
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INVALID PRESCRIPTION ENTRY
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REFILL ON VISIT DATE
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PRESCRIPTION DELETED
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PRESCRIPTION NOT RELEASED
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DRUG NOT BILLABLE
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Rx Refills added to Claims Tracking Complete
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The process to automatically add Rx Refills has successfully completed.
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Start Date:
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End Date:
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Total Rx fills checked:
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Total NSC Rx fills Added:
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Total SC Rx fills Added:
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*The fills added as SC require determination and editing to be billed
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I'm sorry, Tracking of Outpatient Encounters is currrently turned off.
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Select the Date Range of Opt. Encounters to Add to Claims Tracking.
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IB - Add Opt Encounters to Claims Tracking
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NON-BILLABLE APPOINTMENT TYPE
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ENV. CONTAM.
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NON-BILLABLE CLINIC
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NON-BILLABLE STOP CODE
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Outpatient Encounters added to Claims Tracking Complete
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The process to automatically add Opt Encounters has successfully completed.
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Total Encounters Checked:
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Total Encounters Added:
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Total Non-billable Encounters Added:
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*The SC, Agent Orange, Environmental Contaminate, Ionizing Radiation and
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Military Sexual Trauma visits have been added for insured patients but
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automatically indicated as not billable
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I'm sorry, Tracking of Prosthetics is currrently turned off.
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Select the Date Range of Prosthetics to Add to Claims Tracking.
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IB - Add Prosthetics to Claims Tracking
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Prothetic Items added to Claims Tracking Complete
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The process to automatically add Prosthetic Items has successfully completed.
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Start Date:
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End Date:
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Total Prosthetics Items checked:
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Total NSC Prosthetic Items Added:
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Total SC Prosthetic Items Added:
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*The items added as SC require determination and editing to be billed
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The following claims tracking patient's admission has been deleted from the
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movement file (405). The patient's entry in the claims tracking file (356)
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has been set to inactive. If the same patient is admitted to the hospital
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with an admission date 5 days before or after the original admission date
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the patient's entry in the claims tracking file (356) will be reactivated.
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Claims Tracking Entry:
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Claims Tracking ID:
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Original Admission Date:
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=============== ADMISSION DATA ===============
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UR Claims Tracking Admission Deleted
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ADMISSION MOVEMENT
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The following claims tracking entry has been relinked to an admission and is
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no longer inactive as of
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Claims Tracking Patient Relinked/Reactivated
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11///Entry created by major change in specialty.
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Claims Tracking Parameter Enter Edit
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Header line 1:
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Header line 2:
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Header line 3:
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Track Inpatient:
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Track Outpatient:
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Track Rx:
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Track Prosthetics:
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Reports can Add CT:
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Medicine Sample:
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Surgery Sample:
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Surgery Admissions:
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Psych Sample:
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Psych Admissions:
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Pending Reviews Option
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List of PENDING WORK for:
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IBTRPR HR MENU
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IBTRPR IR MENU
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IBTRPR MENU
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ASSIGNED TO
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'+' indicates both Hosp. and Ins. Reviews on List
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Sort Reviews By [A]ssigned to [D]ue date [P]atient [T]ype [W]ard:
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Select how you would like your pending reviews sorted. The choices are by
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who they are Assigned to, by Due date, by Patient, by Type of review, or
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by current Ward of the patient.
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The default is by patient. Normally if sorted by other than patient, the list will be sorted within your choice by patient.
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Print Pending [A]dmission Reviews [C]ontinued Stay Reviews [B]oth:
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If you only want to list your pending Admission Reviews (pre-certs, urgent admissions etc.) enter 'A'. If you want to list only your pending Continued Stay Reviews enter 'C', or enter 'B' to see all pending reviews.
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Print [Y]our own [U]nassigned plus your own [A]ll:
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If you only want to list Your own pending Reviews enter 'Y', if you want to list unassigned reviews plus your own pending Reviews enter 'U', or enter 'A' to see all pending reviews.
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Hosp Reviews
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ADD NEXT REV.
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EDIT REVIEW
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Unassigned
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Ins. Reviews
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ZZ!@#$%^&*()_+
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REVIEW EDITOR
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COMMUNICATIONS EDITOR
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Removing Next Review Date from entry #
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worksheet not available
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Hospital Review Entries for:
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RV DATE
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RV REASON
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Select VISIT:
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Random Sample
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Local Addition
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There are no Claims Tracking entries for this patient.
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Outpatient Procedures should be entered using Add/Edit action in
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Appointment Management.
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Provider information for Prescriptions comes from the pharmacy package silly.
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Provider information for Prosthetics comes from the prothetics package silly.
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Answer 'Yes' to compute and store a new interim drg, answer 'No' to quit.
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Ready to compute New Interim DRG
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DRG computes to:
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Current Interim DRGs on File:
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This doesn't appear to be an admission or outpatient visit.
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I don't know how to review this.
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You have already entered a Review for this Outpatient Encounter.
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Use Quick Edit to Edit.
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DUH, Nothing Added!
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There must be an admission review first
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Adding a Continued Stay Review for Review Day
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Adding an Admission Review
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Adding an Outpatient Visit Review
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Add Next Review
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Answer 'Yes' if you want to continue adding the review for the next day or answer 'No' if you are done for now.
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Is next Review exactly the Same
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Answer 'Yes' if you want the next review to be exactly the same (I'll update the day for review automatically) or answer 'No' if you wish to edit the review now.
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Expanded Review for:
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Interim DRG:
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Days Remaining:
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Review Comments
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Review Type:
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Review Date:
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Special Unit Information
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D/C Screen Met:
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Special Unit SI:
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Special Unit IS:
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Status Information
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Review Status:
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Entered on:
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Completed by:
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Completed on:
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Criteria Information
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Day of Review:
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Severity of Ill:
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Intensity of Svc:
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Dschg Screen Met:
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Acute Care Dschg:
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#################### #################### ####################
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#################### #################### ####################
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#################### #################### ####################
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#################### #################### ####################
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#################### #################### ####################
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