| 1 | FBDOC ;ALBISC\TET - ROUTINE DOCUMENTATION ;10/9/92  11:24
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| 2 |  ;;3.5;FEE BASIS;**48**;JAN 30, 1995
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| 3 |  ;;Per VHA Directive 10-93-142, this routine should not be modified.
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| 4 |  ;Routine contains documentation of other routines.  Name sets
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| 5 |  ;  of routines are indicated in line label.
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| 6 | FBPCR ;
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| 7 |  ;POTENTIAL COST RECOVERY REPORT
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| 8 |  ;user selects primary service areas and date range.
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| 9 |  ;The user is able to filter data to include Copays or Insurance only
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| 10 |  ;related information:
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| 11 |  ;   Include (P)atient Co-pays / (I)nsurance / (B)oth
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| 12 |  ;If the user selects (P) or (B),the following prompt will allow 
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| 13 |  ;the user to include Mean Test or LTC copays only or Both:
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| 14 |  ;   Include (M)eans Test Co-pays /(L)TC Co-pays /(B)oth
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| 15 |  ;output will sort by primary service area, patient, program, vendor, date.
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| 16 |  ;only those that are means test category c/agree to pay deductible
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| 17 |  ;  or for non-service connected treatment are printed, as well as
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| 18 |  ;  insurance information.
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| 19 |  ;Since 7/5/2002 all LTC related payments are flagged in the report with 
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| 20 |  ;appropriate messages. If the veteran doesn't have LTC test on file then
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| 21 |  ;the LTC related payment is flagged with "1010EC missing" message.
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| 22 |  ;
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| 23 |  ;outpatient info - program 2 - fbpcr2 uses date finalized for date range sort
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| 24 |  ;      o for each service on a treatment date the value of the
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| 25 |  ;        'service connected y/n' field is checked.
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| 26 |  ;        if no, flag to collect from insurance is set.
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| 27 |  ;      o for the INITIAL TREATMENT DATE, checks if patient was cat c 
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| 28 |  ;        and agreed to pay deductible or was not exempt from LTC copay.
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| 29 |  ;        if true, then software uses IB call to determine if patient
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| 30 |  ;        is insured on treatment date
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| 31 |  ;       o if service is for C&P, or both of the above two flags are 
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| 32 |  ;         negative, record is bypassed.
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| 33 |  ;pharmacy info - program 3 - fbpcr3 uses date certified for payment for date range sort
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| 34 |  ;       o for each invoice number, RX number for a patient within the
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| 35 |  ;         specified date range, the value of the rx fill date field is
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| 36 |  ;         obtained and checked against the authorization in the fee 
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| 37 |  ;         patient file.  a check is made to see if the value of the
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| 38 |  ;         potential cost recovery field is yes for an authorization
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| 39 |  ;         which encompasses the fill date.
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| 40 |  ;         if yes, then software uses IB call to determine if patient
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| 41 |  ;         is insured on date certified for payment
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| 42 |  ;       o for date certified for payment, checks if patient was cat c
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| 43 |  ;         and agreed to pay deductible. if true, flag to collect from
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| 44 |  ;         patient is set.
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| 45 |  ;       o if both of the above two flags are negative, record is bypassed.
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| 46 |  ;ch/cnh info - programs 6 and 7 - fbpcr67* uses date finalized for date range sort
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| 47 |  ;       o for each record, for a patient within the specified date
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| 48 |  ;         range, the value of the treatment from date is obtained
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| 49 |  ;         and checked against the authorization in the fee patient file.
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| 50 |  ;         a check is made to see if the value of the potential cost
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| 51 |  ;         recovery field is yes for an authorization which encompasses
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| 52 |  ;         the treatment from date.
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| 53 |  ;         if yes, then software uses IB call to determine if patient
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| 54 |  ;         is insured on date certified for payment.
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| 55 |  ;       o for TREATMENT FROM DATE and TREATMENT TO DATE, checks if 
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| 56 |  ;         patient was cat c and agreed to pay deductible or was not 
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| 57 |  ;         exempt from LTC copay. if true, flag to collect from patient
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| 58 |  ;         is set.
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| 59 |  ;       o if both of the above two flags are negative, record is bypassed.
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