| 1 | English French  Notes   Complete/Exclude
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| 2 | Units Paid =                    
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| 3 |   Therefore, fee schedule amount increased to $                 
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| 4 |   Fee schedule not complied on per unit basis so amount not adjusted for units.                 
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| 5 | AMOUNT PAID:                    
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| 6 | You must be a holder of the 'FBAASUPERVISOR' key to                     
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| 7 | exceed the Fee Schedule. Entering an up-arrow ('^') will                        
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| 8 | delete the payment or you can accept the default.                       
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| 9 | Entering an '^' will delete this payment!                       
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| 10 | Do you want to delete? No//                     
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| 11 | Enter a dollar amount that does not exceed the amount claimed.                  
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| 12 | Entering an '^' will delete the payment.                        
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| 13 | Only the holder of the 'FBAASUPERVISOR' key may exceed the                      
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| 14 | Fee Schedule.                   
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| 15 | Confidential Communication address until:                       
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| 16 | Line 1:                         
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| 17 | Line 3:                         
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| 18 | WARNING: The Confidential address is NOT active for the Billing Category.                       
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| 19 | Want to edit Confidential Address data                  
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| 20 | Want to add Confidential Address data                   
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| 21 | Is this line item for a contracted service                      
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| 22 | Answering no indicates that interest will not be paid for this line item.                       
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| 23 | Required Response!                      
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| 24 | Vendor has been flagged for Austin deletion!                    
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| 25 | Want to Edit data                       
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| 26 | Want a new Invoice number assigned                      
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| 27 | Invoice #                       
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| 28 |  assigned to this Invoice                       
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| 29 | Select Invoice number                   
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| 30 | Select one of the previously entered Invoice #'s                        
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| 31 | Only previously entered invoices in the same batch may be selected!                     
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| 32 | Current Total: $                        
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| 33 | Enter Date Correct Invoice Received or Last Date of Service                     
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| 34 | (whichever is later):                   
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| 35 | Invoice date is earlier than Patient's Authorization date!!                     
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| 36 | Enter Vendor Invoice Date:                      
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| 37 | Vendor's invoice date is later than the date you received it!!                  
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| 38 |  for travel already entered for this date of service                    
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| 39 | Total already paid on ID Card for month:   $                    
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| 40 |    Maximum allowed: $                   
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| 41 | Total already paid on All/Other for month: $                    
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| 42 | Want this payment stored as a Medical Denial                    
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| 43 | Enter 'Yes' to store payment entry as a denial and send a Suspension letter.  Enter 'No' to have nothing happen.                        
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| 44 | Entering an '^' will delete                     
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| 45 | .  Are you sure you want to delete?                     
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| 46 | Warning Patient already at maximum allowed for month of service                 
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| 47 | You have reached the maximum number of payments for a Batch!                    
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| 48 | You must select another Batch for entering Payments!                    
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| 49 | exceed the Fee Schedule.                        
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| 50 | This payment CANNOT be edited.  The batch the payment is in                     
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| 51 | has been Vouchered.  You may void the payment with the Void Payment option.                     
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| 52 | Suspense code is required!                      
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| 53 | Incomplete payment entry deleted.                       
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| 54 | Vendor has no prior payments for this patient                   
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| 55 | That number not valid for this vendor!                  
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| 56 | Cannot select this Vendor at this time                  
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| 57 | Date of Service:                        
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| 58 | Enter the date the Vendor provided the service to the Patient.                  
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| 59 | The date must be prior to the date the invoice is received.                     
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| 60 | PRIMARY DIAGNOSIS                       
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| 61 | You must use the Enter Payment option for CPT codes that have a                 
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| 62 | Fee Schedule set equal to zero.                 
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| 63 | Enter Amount Paid:  $                   
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| 64 | exceed the FEE Schedule.  Enter an '^' to quit or accept the default.                   
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| 65 | The answer to the following will apply to all payments entered via this option.                 
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| 66 | Are payments for contracted services                    
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| 67 | Answering yes indicates interest will be paid.                  
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| 68 | A fee schedule is not used for contracted services.                     
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| 69 | Denial                  
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| 70 | Payment                 
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| 71 |  Data Entered for Patient                       
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| 72 | TOTAL PAYMENTS:                         
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| 73 | TOTAL PATIENTS:                         
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| 74 | AVE. PAID FOR A PAYMENT:                        
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| 75 | AVE. PAID FOR A PATIENT:                        
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| 76 | OUTPATIENT COST REPORT                  
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| 77 | AMOUNT PAID                     
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| 78 | There are No Closed Batches that have not been Certified!                       
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| 79 | FEE BATCHES PENDING RELEASE                     
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| 80 | Clerk Who Opened                        
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| 81 | FCP-Obligation #                        
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| 82 | Are you sure you want to reject all line items in this batch                    
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| 83 | Enter reason for rejecting (2-40 characters)                    
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| 84 | Please enter the reason this item was rejected                  
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| 85 | All items in batch flagged as rejected!!                        
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| 86 | Total dollars/Line count of batch is equal zero!                        
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| 87 | *** Patient Died on                     
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| 88 | Pt.ID:                  
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| 89 | TEL:                    
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| 90 | CLAIM #:                        
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| 91 | Primary Elig. Code:                     
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| 92 | Fee ID Card #:                  
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| 93 | Fee Card Issue Date:                    
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| 94 | AUTHORIZATIONS:                 
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| 95 | FR:                     
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| 96 | VENDOR:                         
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| 97 | Authorization Type:                     
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| 98 | Outpatient -                    
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| 99 | Short Term                      
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| 100 | Home Health                     
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| 101 | ID Card                 
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| 102 | Purpose of Visit:                       
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| 103 | FB583(                  
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| 104 | >> Unauthorized Claim <<                        
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| 105 | PSA:                    
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| 106 | >> DELETE MRA SENT TO AUSTIN ON -                       
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| 107 | VENDOR CONTACTS:                        
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| 108 | Not Found                       
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| 109 | There are No Open Batches!                      
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| 110 | Dt Open                 
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| 111 | Obligation #                    
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| 112 | Pharmacy                        
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| 113 | Travel                  
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| 114 | Unable to delete, vendor is Awaiting Austin Approval.                   
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| 115 | Are you sure you want to place this vendor in delete status                     
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| 116 | Not Deleted                     
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| 117 | Vendor flagged for deletion!                    
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| 118 | Unable to delete vendor record at this time.                    
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| 119 | Select Invoice #:                       
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| 120 | DATE RX FILLED:                         
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| 121 | You cannot edit a payment once released by a supervisor.                        
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| 122 | You cannot edit an invoice when the batch has a status of transmitted                   
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| 123 | or vouchered.                   
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| 124 | EDI Claim from FPPS was changed.  Updating each Rx on invoice...                        
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| 125 | Since EDI Claim from FPPS was changed from NO to YES, the                       
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| 126 | FPPS LINE ITEM must be entered for each Rx on the invoice.                      
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| 127 | Finished updating FPPS LINE ITEM on each Rx.                    
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| 128 | Select Site:                    
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| 129 | Date of Travel is                       
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| 130 | prior to                        
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| 131 |  authorization date.                    
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| 132 | Travel Payment entry not complete.   Deleting entry...                  
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| 133 | You must hold the FBAASUPERVISOR security key to use this option!                       
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| 134 | Select Invoice Number                   
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| 135 | Invoice                         
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| 136 |  has not been transmitted to FPPS.                      
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| 137 | Only EDI Claims can be selected!                        
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| 138 | Can not change EDI from YES to NO on invoice that has been sent to FPPS!                        
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| 139 | Are you finished entering patients for this invoice                     
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| 140 | Are you finished entering vendors for this patient                      
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| 141 | Vendor =                        
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| 142 | Select DATE OF SERVICE:                         
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| 143 | Are you finished entering dates for this patient                        
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| 144 | Are you finished entering services for this date                        
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| 145 | Line is not on invoice                  
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| 146 | Enter date of service                   
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| 147 | Note: Date is prior to VA implementation of RBRVS fee schedule (9/1/99).                        
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| 148 | Enter Fee Basis Vendor [optional]                       
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| 149 | Place of Service:                       
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| 150 | NON-FACILITY                    
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| 151 | Error: Can't determine if facility or non-facility setting                      
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| 152 | Amount to Pay: $                        
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| 153 |    from the                     
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| 154 | Missing CPT                     
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| 155 | Invalid Date of Service                 
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| 156 |  GPCIs are not on file for this zip code.                       
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| 157 | Do you want to enter a different zip code                       
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| 158 | Geographic Practice Cost Index (GPCI) values are                        
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| 159 | needed for calculation of the RBRVS physician fee                       
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| 160 | schedule amount. There are not any GPCI values on                       
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| 161 | file for the specified year and zip code.                       
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| 162 | Answer YES to enter a different zip code.                       
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| 163 | Time entry is required!                 
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| 164 | CPT missing                     
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| 165 | Date of Service missing                 
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| 166 | Missing ZIP Code                        
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| 167 | Missing Facility Flag                   
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| 168 | Could not determine GPCIs                       
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| 169 | Could not determine the conversion factor                       
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| 170 | There are no Invoices pending completion!                       
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| 171 | Pharmacy Invoices Pending MAS completion                        
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| 172 | No invoices Pending MAS completion.                     
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| 173 | Want to complete one of them now                        
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| 174 | Invoice No:                     
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| 175 |  line items to be completed                     
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| 176 | Service Provided                        
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| 177 | The Current Procedural Terminology Code (CPT Code) as                   
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| 178 | specified on the vendors invoice identifying the service                        
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| 179 | the vendor provided to the veteran.                     
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| 180 | SURE YOU WANT TO DELETE THE ENTIRE SERVICE PROVIDED                     
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| 181 |      CPT code inactive on date of service (                     
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| 182 | Select CPT MODIFIER                     
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| 183 | Current list of modifiers:                      
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| 184 |   CPT MODIFIER                  
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| 185 |      CPT Modifier inactive on date of service (                 
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| 186 |      Change was not accepted because the new value is already on the list.                      
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| 187 | Major Category:                         
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| 188 | Sub-Category:                   
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| 189 | Modifiers:                      
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| 190 | Detail Description                      
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| 191 | Modifiers are used to better describe the service (CPT)                 
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| 192 | rendered. Modifier(s) will be combined with the CPT code                        
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| 193 | for Fee Schedule calculations and to check for duplicate                        
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| 194 | payment entry.                  
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| 195 | Amount Claimed:  $                      
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| 196 | Enter the amount being claimed by the vendor                    
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| 197 | Is $                    
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| 198 |  correct for Amount Claimed                     
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| 199 |  correct for Amount Paid                        
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| 200 | Invalid Date of Service.                        
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| 201 | Code already exists for that date!  Want to add another service for the SAME DATE                       
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| 202 |  more line items!                       
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| 203 | Enter date to use for CPT/ICD checks and fee schedule calc                      
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| 204 | Enter a date. This date will be used when checking for                  
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| 205 | an active CPT/Modifier/ICD code. Also, the fee schedule                 
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| 206 | amount will be computed based on this date.                     
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| 207 | Enter '^' to exit.                      
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| 208 | Amount Paid: $                  
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| 209 | Amount paid cannot be greater than the amount claimed.                  
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| 210 |   CPT Code                      
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| 211 |  inactive on date of service.                   
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| 212 |   CPT Modifier                  
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| 213 |   Warning: The fee schedule amount (                    
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| 214 | ) for this date of service                      
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| 215 |   differs from the initial fee schedule amount (                        
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| 216 |   Amount paid (                 
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| 217 | ) exceeds the fee schedule amount.                      
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| 218 |   You must be a holder of the 'FBAASUPERVISOR' key in order                     
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| 219 |   to exceed the Fee Schedule.                   
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| 220 |   You may want to separately process this date of service.                      
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| 221 | Amount Suspended: $                     
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| 222 | Press Return if $                       
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| 223 |  is Amount Suspended, otherwise enter correct suspension amount                 
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| 224 | Invalid entry, enter a number between .01 and 999999                    
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| 225 |  correct for Amount Suspended                   
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| 226 | Suspension Description:                         
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| 227 | Description of Suspense is required.                    
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| 228 | Service connected condition                     
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| 229 | Respond by answering 'Yes' or 'No'.                     
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| 230 | No transmitted MRA's currently on file!                 
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| 231 | FBAA PURGE TRANSMITTED MRA'S                    
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| 232 | Purge Veteran and Vendor MRA's transmitted PRIOR to:                    
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| 233 | Deleting....                    
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| 234 | Total Veteran MRA's deleted:                    
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| 235 | Total Vendor MRA's deleted:                     
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| 236 | Purpose of Visit Code 55 (MST) not found.  Can't print the MST report.                  
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| 237 | From Date                       
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| 238 | To Date:                        
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| 239 | Summary or Detail Output                        
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| 240 | Enter D to print veteran, authorization, and payment details.                   
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| 241 | Enter S to just print a report summary.                 
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| 242 | Enter a code from the list.                     
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| 243 | MST Report                      
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| 244 | FBDT*                   
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| 245 | No MST authorizations found during period.                      
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| 246 | Patient ID:                     
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| 247 | Gender:                         
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| 248 | Authorization #:                        
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| 249 | No finalized payments on file.                  
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| 250 | Svc Date:                       
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| 251 | CPT-MOD:                        
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| 252 | DIAG:                   
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| 253 | AMT PAID:                       
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| 254 | Vendor ID:                      
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| 255 | MST                     
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| 256 | Detailed                        
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| 257 | REPORT SUMMARY                  
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| 258 | Gender                  
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| 259 | Average Paid                    
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| 260 |  Per Patient                    
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| 261 |   Per Visit                     
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| 262 | Notes:  (1) # Unique Patients represents patients having one or more MST                        
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| 263 |             authorizations that overlap the period being reported.                      
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| 264 |         (2) # Visits and Total Payments are obtained from any finalized                 
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| 265 |             payment(s) that are linked to the MST authorizations and have a                     
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| 266 |             date of service within the period being reported.                   
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| 267 | Unspec.                 
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| 268 | Site Parameters have not been entered. Must be entered                  
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| 269 | before using this option                        
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| 270 | Want to create a Medical batch                  
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| 271 | Want to create a Pharmacy Batch                 
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| 272 | Want to create a Travel Batch                   
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| 273 | Travel Batch number assigned is:                        
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| 274 | Medical Batch number assigned is:                       
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| 275 | Pharmacy Batch number assigned is:                      
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| 276 | Want to create a Community Nursing Home batch                   
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| 277 | Batch number assigned is:                       
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| 278 | Select Obligation Number:                       
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| 279 | Batch #                         
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| 280 |  deleted because Obligation number was not selected!                    
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| 281 | You must be an authorized user in IFCAP package to select an obligation.                        
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| 282 | Want to create a Contract Hospital Batch                        
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| 283 | Want to create an Ancillary Payment Medical Batch                       
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| 284 | Batch was not created!                  
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| 285 | Vendor has no prior claims                      
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| 286 | Sorry, that payment is not in the Batch you selected!                   
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| 287 | Are you sure you want to delete this payment record                     
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| 288 | Payment record Deleted!                 
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| 289 | CPT:                    
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| 290 |  - INACTIVE on                  
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| 291 | MOD:                    
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| 292 | *** DATE RANGE SELECTION ***                    
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| 293 | Enter fiscal year or date range within fiscal year.                     
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| 294 |   Beginning Date :                      
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| 295 |   Ending Date :                         
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| 296 |  Dates must be within a fiscal year.                    
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| 297 | Card No.                        
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| 298 | Patient SSN                     
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| 299 | Issue Date                      
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| 300 | Include all CPT codes                   
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| 301 | Choose a method to specify CPT Codes                    
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| 302 | You must choose one of the two methods that can be used                 
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| 303 | ####################    ####################    ####################    
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| 304 | ####################    ####################    ####################    
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| 305 | ####################    ####################    ####################    
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| 306 | ####################    ####################    ####################    
 | 
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| 307 | ####################    ####################    ####################    
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