308 lines
12 KiB
Plaintext
308 lines
12 KiB
Plaintext
English French Notes Complete/Exclude
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PSC Category:
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Item:
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Unit Cost :
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Actual Unit Cost:
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Serial #:
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Patient Category:
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Type of Transaction:
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Special Category:
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Appliance/Repair:
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Item Remarks:
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Brief Description:
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Extended Description:
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(Example, PO number), or Bank Authorization Number (6 digit number).
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ERROR** This transaction was not posted to 2319, please contact your IRM..
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Ready to Reconcile and Close-Out Transaction
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You may now Close-out and Post this Transaction. Please answer Yes or No.
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Transaction NOT Closed-Out!
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** No Item selected..
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2R~UNIT COST;
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4R~UNIT OF ISSUE;7;11////C
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DO YOU WANT TO ADD A DUPLICATE ITEM?
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***** NOT CLOSED-OUT !!!!
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**** NOT CLOSED-OUT!! ****
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**** TRANSACTION NOT CLOSED-OUT!! ****
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Enter Next Transaction to Close-out, or <RETURN> to continue.
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INCOMPLETE RECORD..file 664..entry..
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...PLEASE CONTACT YOUR IRM or CANCEL THIS ENTRY!!!
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UNKNOWN 2319 RECORD TO UPDATE, 2319 NOT UPDATED!
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This Transaction has already been CLOSED!
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This Transaction has been CANCELED!
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Updated
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10-2319 record for this Veteran
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Would You like to Edit another Entry (Y/N)
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NOT DELIVERED/ACCEPTED
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RMPR FCP MANAGER
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SUB TOTAL:
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NO ITEMS ON FILE
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AMIS:
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NO CODE FOR THIS ITEM
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PSAS HCPCS CODE:
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UNIT COST:
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ITEM COST:
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SPEC/LEG
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Enter '^' to Quit Display, <Return> to Continue :
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This report lists Open Purchase Card Transactions created in the
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Prosthetics Package.
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This report is sorted by Transaction Date and Initiator.
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The PC # column is the abbreviated Purchase Card Transaction Number,
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Example: 644-PC546, would display as 546.
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OPEN 2421PC TRANSACTIONS
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Item Cost
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Open 2421PC Transactions
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...now posting to file 660...
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**** POSTING TO 2319 FOR ITEM..
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PLEASE RUN CLOSE-OUT OPTION AGAIN...
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Select Transaction or Patient Name:
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<REQUEST QUEUED>
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<REQUEST NOT QUEUED>
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OMB Number 2900-0188
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Estimated Burden: 4 minutes
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***ORIGINAL COPY AND COMMERCIAL INVOICE MUST BE SUBMITTED***
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TO THE VAMC PROSTHETIC ACTIVITY LISTED BELOW
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Prosthetic Authorization for Items or Services
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1. Name and Address of Vendor
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2. Name and Address of VA Facility
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NO STATE ON FILE
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3. Veterans Name (Last, First, MI)
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4. Date of Authorization
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5. Veterans Address
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6. Date Required
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9. Authority For Issuance CFR 17.115
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CHARGE MEDICAL APPROPRIATION
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7. Claim Number
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10. Statistical Data
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11. FOB Point
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13. Delivery Time
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14. Delivery To:
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15. DESCRIPTION OF ITEMS OR SERVICES AUTHORIZED
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ITEM NUMBER
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DESCRIPTION/NOMENCLATURE
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***SEE ATTACHED CONTINUATION SHEET FOR ITEM DESCRIPTION(S)***
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CONTINUATION OF PURCHASE CARD
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16. Contract Number:
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Discount $
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Shipping:
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17. Signature of
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19. Signature and Title of
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Requesting Official
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Contracting/Accountable Officer
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Order and Receipt Action
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21. Order Number
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22. Date of Order
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23. Date Item Received
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24. Date Delivered
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25. The articles or services listed herein have been received, or rendered
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ordered in the quantity and quality specified orginally or as shown by
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authenticated changes, except as noted.
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Signature of Veteran or VA Official
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VOUCHER AUDIT BLOCK (For use by VA Facility only)
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Bank Authorization Number:
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Acct. Symbol
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ADP Form 10-2421PC APR 1991
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52.224-2 PRIVACY ACT (APR 1984)
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(a) The Contractor agrees to---
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(1) Comply with the Privacy Act of 1974 (the Act) and the agency rules and
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regulations issued under the Act in the design, development, or operation
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of any system of records on individuals to accomplish an agency function when
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the contract specifically identifies---
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(i) The systems of records: and
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(ii) The design, development, or operation work that the contractor is to
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(2) Include the Privacy Act notification contained in this contract in every
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solicitation and resulting subcontract and in every subcontract awarded without
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a solicitation, when the work statement in the proposed subcontract required the
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redesign, development, or operation of a system of records on individuals that
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is subject to the Act; and
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(3) Include this clause, including this subparagraph (3), in all subcontracts
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awarded under this contract which requires the design, development, or opera-
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tion of such a system of records.
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(b) In the event of violations of the Act, a civil action may be brought ag-
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ainst the agency involved when the violation concerns the design, development or
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operation of a system of records on individuals to accomplish an agency function,
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and criminal penalties may be imposed upon the officers or employees of the ag-
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ency when the violation concerns the operation of a system of records on indivi-
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duals to accomplish an agency function. For purposes of the Act, when the con-
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tract is for the operation of a system of records on individuals to accomplish
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an agency function, the Contractor is considered to be an employee of the agen-
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Operation of a system of records,
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as used in this clause, means per-
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formance of any of the activities associated with maintaining the system of re-
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cords, including the collection, use, and dissemination of records.
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Record,
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as used in this clause, means any item, collection, or grouping
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of information about an individual that is maintained by an agency, including,
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but not limited to, education, financial transactions, medical history, and
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criminal or employment history and that contains the person's name, or the iden-
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tifying number, symbol, or other identifying particular assigned to the indivi-
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dual, such as a fingerprint or voiceprint or a photograph.
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System of records on individuals
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as used in this clause, means a
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group of any records under the control of any agency from which information is
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retrieved by the name of the individual or by some identifying number, symbol,
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or other identifying particular assigned to the individual.
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MR.
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MS.
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In reply refer to:
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Accounting Symbol
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This is to notify you that the items listed below were ordered
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for you on
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. Delivery of this equipment is expected
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on or about
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in 30 days from the order date.
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If you do not receive it within 5 days of the expected date,
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please contact
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, of my staff, at
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17;16;8////^S X=$G(RMTYPE);9////^S X=$G(RMCAT);10////^S X=$G(RMSPE);1R~BRIEF DESCRIPTION OF ITEM (for Vendor);
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17;8TYPE OF TRANSACTION;9PATIENT CATEGORY;S RMPRDIS=+$P(^RMPR(664,DA(1),1,DA,0),U,10);S Y=$S(RMPRDIS=4:
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);@2;3QTY;2;4UNIT OF ISSUE;11////C;
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;@1;10SPECIAL CATEGORY;S Y=
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Enter the IFCAP Site used with the Purchase Card Module
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The following site you select will be used on all your
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Purchase Card Transactions in IFCAP only.
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Prosthetics PIP Extract
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G.RMPR SERVER
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The Prosthetics PIP Inventory Data was transmitted to PSAS HQ today.
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The dates used for Days On-Hand, and Days Average Usage Rate calculations
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The server was activated by
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No HQ mail address is defined in your PROSTHETICS SITE
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PARAMETERS file for the PIP report. The PIP report
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will not be run. Please contact your system administrator
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or enter a NOIS in Forum for the NVS Team.
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VHACOPSASPIPReport@med.va.gov
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No Records to Print !!
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GRAND TOTAL $ VALUE ISSUED (Used) =
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GRAND TOTAL $ VALUE ON-HAND (Used) =
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GRAND TOTAL $ VALUE ISSUED (New) =
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GRAND TOTAL $ VALUE ON-HAND (New) =
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PROSTHETIC INVENTORY ITEM DETAIL REPORT
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calendar days ]
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HCPCS PSAS/ITEM
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HCPCS DESCRIPTION
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NPPD LINE
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NPPD GROUP
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V.A.(Used) Total| COM. (New) Total| Total |Days Ave | Stock On-Hand| Days |Total $ Value On-Hand
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Issue $ Value| Issue $ Value| Issue |Usage Rate| Used New | On-Hand| Used New
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INVENTORY REPORT
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RMPRSEL(
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Select inventory report level of detail
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Ending date should not precede start date
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Select NPPD line(s) within the above group
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NPPD Lines for Group:
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Choose HCPCS selection option
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Select HCPCS
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You need at least 132 columns for this report.
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Please use a device capable of this requirement.
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100:WHEELCHAIRS AND ACCESSORIES
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200:ARTIFICIAL LEGS
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300:ARTIFICIAL ARMS AND TERMINAL DEVICES
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400:BRACES AND ORTHOTICS
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600:NEUROSENSORY AIDS
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800:OXYGEN AND RESPIRATORY
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900:MEDICAL EQUIPMENT
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910:ALL OTHER SUPPLIES AND EQUIPMENT
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920:HOME DIALYSIS PROGRAM
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930:ADAPTIVE EQUIPMENT
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960:SURGICAL IMPLANTS
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Processing report.......
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NPPD_GROUP
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NPPD_LINE
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HCPC_CODE
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HCPC_ITEM
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ISSUE COST
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INVENTORY_IEN
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HCPC_IEN
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PIP DETAIL ITEM REPORT
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PIP HCPCS SUMMARY REPORT
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PIP NPPD LINE SUMMARY REPORT
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PIP NPPD GROUP SUMMARY REPORT
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GRAND TOTAL $ VALUE ISSUED (Used) = $
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GRAND TOTAL $ VALUE ON-HAND (Used) = $
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GRAND TOTAL $ VALUE ISSUED (New) = $
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GRAND TOTAL $ VALUE ON-HAND (New) = $
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HCPCS DESCRIPTION
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NPPD LINE
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NPPD GROUP
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V.A.(Used) Total| COM. (New) Total| Total |Days Ave | Stock On-Hand| Days |Total $ Value On-Hand
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PROSTHETIC INVENTORY HCPCS SUMMARY REPORT
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PROSTHETIC INVENTORY NPPD GROUP/LINE REPORT
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GRAND TOTAL $ VALUE ON-HAND =
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PROSTHETIC INVENTORY NPPD GROUP REPORT
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ENTIRE SUMMARY
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..Duplicate HCPCS
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STOCK ITEM REPORT
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RMPRI(
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Processing report......
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*** ISSUE and STOCK CONTROL RECORD - PROSTHETICS STOCK ITEMS ***
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*** Dollar Value of HCPCS Issued
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*** Dollar Value of Item Issued
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No Item Statistics for HCPCS:
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...for this date range !!!
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NO DATA AT THIS DATE RANGE!!!!
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Enter 'ALL' for all Locations or 'RETURN' to select individual Locations:
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Select Location
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..Duplicate Location
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PROSTHETIC INVENTORY LOCATION SUMMARY
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Processing report.....
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*** PROSTHETICS INVENTORY BALANCE BY LOCATION ***
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NO DATA !!!!
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Enter 'ALL' for all HCPCS or 'RETURN' to select individual HCPCS:
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*** PROSTHETICS INVENTORY BALANCE BY HCPCS ***
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NO DATA !!!!!
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Enter 'ALL' for all Lab Employees or 'RETURN' to select individual names:
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Select EMPLOYEE
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..Duplicate employee name
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PROS LAB ITEM SUMMARY
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PROSTHETICS LAB ITEM SUMMARY BY EMPLOYEE
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TIME SPENT(hr)
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No Lab data for Employee:
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....for this date range !!!
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NO DATA FOR THIS DATE RANGE!!!
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Adding Item to a Location.....
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Enter Pros Location:
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Record in use. Try again later...
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Select HCPCS to ADD
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** No HCPCS Selected or Unable to Select Inactive HCPCS...
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Enter Item to Add:
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22R;23R~TOTAL COST OF QUANTITY;24;25R;26;27
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Added/Updated by
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Delete an Inventory Location.....
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This option now requires the electronic signatures of 2 users
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holding the RMPRMANAGER key to be entered before a location
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Are you sure you want to DELETE this LOCATION (Y/N)
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Nothing Deleted..
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Location is deleted!!!!
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Pease ask another user with the RMPRMANAGER key to
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enter their user name and electronic signature.
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Enter user name of 2nd manager:
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The 2nd manager must be different to the manager logged on.
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The 2nd manager does not have the correct security key set up.
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The above location contains
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types of items
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with a total quantity of
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and cost of $
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Editing an Inventory Item in a Location.....
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Location has been edited from '
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Select HCPCS to EDIT:
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** No HCPCS selected...
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Enter PSAS Item to Edit:
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29;22R;23R~TOTAL COST OF QUANTITY;24;25R;26;27
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This will DELETE all HCPCS and ITEMS under this LOCATION...
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Ordering ITEM from Supply or Vendor....
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Select HCPCS to ORDER:
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Enter Item to ORDER:
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Quantity to Order
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*** Item was not ordered....
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Enter quantity 1 to 99999..
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Order from supply or vendor
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was ordered....
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*** Receiving Item from Supply, Vendor or Veteran...
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Enter Receiving Location:
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Select HCPCS to RECEIVE:
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Enter Item to RECEIVE:
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#################### #################### ####################
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#################### #################### ####################
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#################### #################### ####################
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#################### #################### ####################
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#################### #################### ####################
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