FBDOC ;ALBISC\TET - ROUTINE DOCUMENTATION ;10/9/92 11:24 ;;3.5;FEE BASIS;**48**;JAN 30, 1995 ;;Per VHA Directive 10-93-142, this routine should not be modified. ;Routine contains documentation of other routines. Name sets ; of routines are indicated in line label. FBPCR ; ;POTENTIAL COST RECOVERY REPORT ;user selects primary service areas and date range. ;The user is able to filter data to include Copays or Insurance only ;related information: ; Include (P)atient Co-pays / (I)nsurance / (B)oth ;If the user selects (P) or (B),the following prompt will allow ;the user to include Mean Test or LTC copays only or Both: ; Include (M)eans Test Co-pays /(L)TC Co-pays /(B)oth ;output will sort by primary service area, patient, program, vendor, date. ;only those that are means test category c/agree to pay deductible ; or for non-service connected treatment are printed, as well as ; insurance information. ;Since 7/5/2002 all LTC related payments are flagged in the report with ;appropriate messages. If the veteran doesn't have LTC test on file then ;the LTC related payment is flagged with "1010EC missing" message. ; ;outpatient info - program 2 - fbpcr2 uses date finalized for date range sort ; o for each service on a treatment date the value of the ; 'service connected y/n' field is checked. ; if no, flag to collect from insurance is set. ; o for the INITIAL TREATMENT DATE, checks if patient was cat c ; and agreed to pay deductible or was not exempt from LTC copay. ; if true, then software uses IB call to determine if patient ; is insured on treatment date ; o if service is for C&P, or both of the above two flags are ; negative, record is bypassed. ;pharmacy info - program 3 - fbpcr3 uses date certified for payment for date range sort ; o for each invoice number, RX number for a patient within the ; specified date range, the value of the rx fill date field is ; obtained and checked against the authorization in the fee ; patient file. a check is made to see if the value of the ; potential cost recovery field is yes for an authorization ; which encompasses the fill date. ; if yes, then software uses IB call to determine if patient ; is insured on date certified for payment ; o for date certified for payment, checks if patient was cat c ; and agreed to pay deductible. if true, flag to collect from ; patient is set. ; o if both of the above two flags are negative, record is bypassed. ;ch/cnh info - programs 6 and 7 - fbpcr67* uses date finalized for date range sort ; o for each record, for a patient within the specified date ; range, the value of the treatment from date is obtained ; and checked against the authorization in the fee patient file. ; a check is made to see if the value of the potential cost ; recovery field is yes for an authorization which encompasses ; the treatment from date. ; if yes, then software uses IB call to determine if patient ; is insured on date certified for payment. ; o for TREATMENT FROM DATE and TREATMENT TO DATE, checks if ; patient was cat c and agreed to pay deductible or was not ; exempt from LTC copay. if true, flag to collect from patient ; is set. ; o if both of the above two flags are negative, record is bypassed.