English French Notes Complete/Exclude Units Paid = Therefore, fee schedule amount increased to $ Fee schedule not complied on per unit basis so amount not adjusted for units. AMOUNT PAID: You must be a holder of the 'FBAASUPERVISOR' key to exceed the Fee Schedule. Entering an up-arrow ('^') will delete the payment or you can accept the default. Entering an '^' will delete this payment! Do you want to delete? No// Enter a dollar amount that does not exceed the amount claimed. Entering an '^' will delete the payment. Only the holder of the 'FBAASUPERVISOR' key may exceed the Fee Schedule. Confidential Communication address until: Line 1: Line 3: WARNING: The Confidential address is NOT active for the Billing Category. Want to edit Confidential Address data Want to add Confidential Address data Is this line item for a contracted service Answering no indicates that interest will not be paid for this line item. Required Response! Vendor has been flagged for Austin deletion! Want to Edit data Want a new Invoice number assigned Invoice # assigned to this Invoice Select Invoice number Select one of the previously entered Invoice #'s Only previously entered invoices in the same batch may be selected! Current Total: $ Enter Date Correct Invoice Received or Last Date of Service (whichever is later): Invoice date is earlier than Patient's Authorization date!! Enter Vendor Invoice Date: Vendor's invoice date is later than the date you received it!! for travel already entered for this date of service Total already paid on ID Card for month: $ Maximum allowed: $ Total already paid on All/Other for month: $ Want this payment stored as a Medical Denial Enter 'Yes' to store payment entry as a denial and send a Suspension letter. Enter 'No' to have nothing happen. Entering an '^' will delete . Are you sure you want to delete? Warning Patient already at maximum allowed for month of service You have reached the maximum number of payments for a Batch! You must select another Batch for entering Payments! exceed the Fee Schedule. This payment CANNOT be edited. The batch the payment is in has been Vouchered. You may void the payment with the Void Payment option. Suspense code is required! Incomplete payment entry deleted. Vendor has no prior payments for this patient That number not valid for this vendor! Cannot select this Vendor at this time Date of Service: Enter the date the Vendor provided the service to the Patient. The date must be prior to the date the invoice is received. PRIMARY DIAGNOSIS You must use the Enter Payment option for CPT codes that have a Fee Schedule set equal to zero. Enter Amount Paid: $ exceed the FEE Schedule. Enter an '^' to quit or accept the default. The answer to the following will apply to all payments entered via this option. Are payments for contracted services Answering yes indicates interest will be paid. A fee schedule is not used for contracted services. Denial Payment Data Entered for Patient TOTAL PAYMENTS: TOTAL PATIENTS: AVE. PAID FOR A PAYMENT: AVE. PAID FOR A PATIENT: OUTPATIENT COST REPORT AMOUNT PAID There are No Closed Batches that have not been Certified! FEE BATCHES PENDING RELEASE Clerk Who Opened FCP-Obligation # Are you sure you want to reject all line items in this batch Enter reason for rejecting (2-40 characters) Please enter the reason this item was rejected All items in batch flagged as rejected!! Total dollars/Line count of batch is equal zero! *** Patient Died on Pt.ID: TEL: CLAIM #: Primary Elig. Code: Fee ID Card #: Fee Card Issue Date: AUTHORIZATIONS: FR: VENDOR: Authorization Type: Outpatient - Short Term Home Health ID Card Purpose of Visit: FB583( >> Unauthorized Claim << PSA: >> DELETE MRA SENT TO AUSTIN ON - VENDOR CONTACTS: Not Found There are No Open Batches! Dt Open Obligation # Pharmacy Travel Unable to delete, vendor is Awaiting Austin Approval. Are you sure you want to place this vendor in delete status Not Deleted Vendor flagged for deletion! Unable to delete vendor record at this time. Select Invoice #: DATE RX FILLED: You cannot edit a payment once released by a supervisor. You cannot edit an invoice when the batch has a status of transmitted or vouchered. EDI Claim from FPPS was changed. Updating each Rx on invoice... Since EDI Claim from FPPS was changed from NO to YES, the FPPS LINE ITEM must be entered for each Rx on the invoice. Finished updating FPPS LINE ITEM on each Rx. Select Site: Date of Travel is prior to authorization date. Travel Payment entry not complete. Deleting entry... You must hold the FBAASUPERVISOR security key to use this option! Select Invoice Number Invoice has not been transmitted to FPPS. Only EDI Claims can be selected! Can not change EDI from YES to NO on invoice that has been sent to FPPS! Are you finished entering patients for this invoice Are you finished entering vendors for this patient Vendor = Select DATE OF SERVICE: Are you finished entering dates for this patient Are you finished entering services for this date Line is not on invoice Enter date of service Note: Date is prior to VA implementation of RBRVS fee schedule (9/1/99). Enter Fee Basis Vendor [optional] Place of Service: NON-FACILITY Error: Can't determine if facility or non-facility setting Amount to Pay: $ from the Missing CPT Invalid Date of Service GPCIs are not on file for this zip code. Do you want to enter a different zip code Geographic Practice Cost Index (GPCI) values are needed for calculation of the RBRVS physician fee schedule amount. There are not any GPCI values on file for the specified year and zip code. Answer YES to enter a different zip code. Time entry is required! CPT missing Date of Service missing Missing ZIP Code Missing Facility Flag Could not determine GPCIs Could not determine the conversion factor There are no Invoices pending completion! Pharmacy Invoices Pending MAS completion No invoices Pending MAS completion. Want to complete one of them now Invoice No: line items to be completed Service Provided The Current Procedural Terminology Code (CPT Code) as specified on the vendors invoice identifying the service the vendor provided to the veteran. SURE YOU WANT TO DELETE THE ENTIRE SERVICE PROVIDED CPT code inactive on date of service ( Select CPT MODIFIER Current list of modifiers: CPT MODIFIER CPT Modifier inactive on date of service ( Change was not accepted because the new value is already on the list. Major Category: Sub-Category: Modifiers: Detail Description Modifiers are used to better describe the service (CPT) rendered. Modifier(s) will be combined with the CPT code for Fee Schedule calculations and to check for duplicate payment entry. Amount Claimed: $ Enter the amount being claimed by the vendor Is $ correct for Amount Claimed correct for Amount Paid Invalid Date of Service. Code already exists for that date! Want to add another service for the SAME DATE more line items! Enter date to use for CPT/ICD checks and fee schedule calc Enter a date. This date will be used when checking for an active CPT/Modifier/ICD code. Also, the fee schedule amount will be computed based on this date. Enter '^' to exit. Amount Paid: $ Amount paid cannot be greater than the amount claimed. CPT Code inactive on date of service. CPT Modifier Warning: The fee schedule amount ( ) for this date of service differs from the initial fee schedule amount ( Amount paid ( ) exceeds the fee schedule amount. You must be a holder of the 'FBAASUPERVISOR' key in order to exceed the Fee Schedule. You may want to separately process this date of service. Amount Suspended: $ Press Return if $ is Amount Suspended, otherwise enter correct suspension amount Invalid entry, enter a number between .01 and 999999 correct for Amount Suspended Suspension Description: Description of Suspense is required. Service connected condition Respond by answering 'Yes' or 'No'. No transmitted MRA's currently on file! FBAA PURGE TRANSMITTED MRA'S Purge Veteran and Vendor MRA's transmitted PRIOR to: Deleting.... Total Veteran MRA's deleted: Total Vendor MRA's deleted: Purpose of Visit Code 55 (MST) not found. Can't print the MST report. From Date To Date: Summary or Detail Output Enter D to print veteran, authorization, and payment details. Enter S to just print a report summary. Enter a code from the list. MST Report FBDT* No MST authorizations found during period. Patient ID: Gender: Authorization #: No finalized payments on file. Svc Date: CPT-MOD: DIAG: AMT PAID: Vendor ID: MST Detailed REPORT SUMMARY Gender Average Paid Per Patient Per Visit Notes: (1) # Unique Patients represents patients having one or more MST authorizations that overlap the period being reported. (2) # Visits and Total Payments are obtained from any finalized payment(s) that are linked to the MST authorizations and have a date of service within the period being reported. Unspec. Site Parameters have not been entered. Must be entered before using this option Want to create a Medical batch Want to create a Pharmacy Batch Want to create a Travel Batch Travel Batch number assigned is: Medical Batch number assigned is: Pharmacy Batch number assigned is: Want to create a Community Nursing Home batch Batch number assigned is: Select Obligation Number: Batch # deleted because Obligation number was not selected! You must be an authorized user in IFCAP package to select an obligation. Want to create a Contract Hospital Batch Want to create an Ancillary Payment Medical Batch Batch was not created! Vendor has no prior claims Sorry, that payment is not in the Batch you selected! Are you sure you want to delete this payment record Payment record Deleted! CPT: - INACTIVE on MOD: *** DATE RANGE SELECTION *** Enter fiscal year or date range within fiscal year. Beginning Date : Ending Date : Dates must be within a fiscal year. Card No. Patient SSN Issue Date Include all CPT codes Choose a method to specify CPT Codes You must choose one of the two methods that can be used #################### #################### #################### #################### #################### #################### #################### #################### #################### #################### #################### #################### #################### #################### ####################