[604] | 1 | English French Notes Complete/Exclude
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| 2 | INSURED'S ADDRESS STREET
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| 3 | PATIENT ADDRESS CITY
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| 4 | INSURED'S ADDRESS CITY
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| 5 | PT ZIP CODE
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| 6 | INS ZIP CODE
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| 7 | OTHER INSURED'S NAME
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| 8 | INSURED'S POLICY GROUP
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| 9 | OTHER POLICY NUMBER
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| 10 | INSURED'S EMPLOYER
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| 11 | OTHER'S EMPLOYER
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| 12 | INSURANCE PLAN NAME
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| 13 | OTHER'S INSURANCE PLAN
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| 14 | REFERRING PHYSICIAN
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| 15 | PHYSICIAN ID
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| 16 | BC/BS#
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| 17 | FEDERAL TAX ID
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| 18 | PAT ACCT#
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| 19 | AGENT CASHIER (999) 999-9999
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| 20 | CITY, STATE ZIP
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| 21 | PRINT UB-92 BILL
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| 22 | NO SOMETHING
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| 23 | OP VISIT DATE(S) BILLED:
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| 24 | ADDITIONAL DIAGNOSIS CODES:
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| 25 | PROSTHETIC ITEMS:
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| 26 | PRINT TEST BILL
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| 27 | *** UB-92 TEST PATTERN ***
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| 28 | BN XXX
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| 29 | TAX# XXXX
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| 30 | PT SHORT ADDRESS
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| 31 | RESPONSIBLE PARTY'S NAME
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| 32 | REV CODE description
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| 33 | Name of Payer 1
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| 34 | Provider #
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| 35 | Name of Payer 2
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| 36 | Name of Payer 3
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| 37 | Insured's Name 1
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| 38 | Insurance #
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| 39 | Group Name
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| 40 | Insured's Name 2
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| 41 | Insured's Name 3
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| 42 | Treatment Auth. Cd
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| 43 | Employer Name
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| 44 | Employer Location
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| 45 | Dx Cd
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| 46 | ADMT DX
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| 47 | Attending Phys. ID#
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| 48 | Other Phys. ID#
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| 49 | Patient ID#: xxx-xx-xxxx
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| 50 | Bill Type: xxx xxxxxx
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| 51 | UB 92 TEST PATTERN
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| 52 | Provider Representative DATE
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| 53 | Transmittable Bill can NOT be printed until transmitted
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| 54 | This is a Transmittable Bill that has already been transmitted
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| 55 | WANT TO PRINT THIS BILL ADDENDUM ANYWAY
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| 56 | OUTPUT DEVICE:
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| 57 | DAYS SUPPLY:
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| 58 | REFILL DATE
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| 59 | DAYS SUPPLY
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| 60 | NDC #
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| 61 | ***TASK STOPPED BY USER***
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| 62 | Default printer in billing not defined for the
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| 63 | , none will print!
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| 64 | There are no Authorized but not Printed bills to print!
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| 65 | Z:ZIP;I:INSURANCE COMPANY NAME;P:PATIENT NAME;
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| 66 | This option prints all non-transmittable bills with a Status of Authorized in the order requested. The printed bills may be sorted by: Zip Code, Insurance Company Name, and Patient name.
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| 67 | First Sort Bills By
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| 68 | Enter the field that the bills should be sorted on within
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| 69 | . Press return if the order already entered is sufficient.
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| 70 | Then Sort Bills By
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| 71 | Begin printing bills
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| 72 | Enter 'Y'es to begin printing of all authorized non-transmittable bills.
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| 73 | ... bills not printed!
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| 74 | BATCH PRINT AUTHORIZED THIRD PARTY BILLS
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| 75 | BATCH PRINTING
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| 76 | The following bill(s) were not printed due to errors indicated.
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| 77 | PRINT BILL ERRORS
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| 78 | One or more bills were not printed. Check your mail for details
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| 79 | NOT ADDED TO FILE 351.9
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| 80 | Select ClaimsManager Bill:
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| 81 | IBCI CLAIMSMANAGER ASSIGN
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| 82 | *** RECORD IS LOCKED ***
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| 83 | Another user is currently editing this bill.
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| 84 | IBCI CLAIMSMANAGER WK BROWSE
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| 85 | IBCI CLAIMSMANAGER CLERK WK
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| 86 | ClaimsManager Error Report
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| 87 | There are no errors currently recorded in the ClaimsManager
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| 88 | file. There is no data to report.
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| 89 | IBCICME ERROR CODES
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| 90 | ALL Error Codes in the ClaimsManager File
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| 91 | Please Select the Error Codes to include
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| 92 | This response must be a list or range.
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| 93 | For example, 1,3,5 or 2-4,8
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| 94 | If you include #1, then all codes will be included
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| 95 | regardless of what you enter here.
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| 96 | SELECTED ERRCODES
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| 97 | ALL ERRCODES
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| 98 | DISPLAY ERROR TEXT
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| 99 | Do you want to see the ClaimsManager Error Messages for these bills
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| 100 | Enter YES if you would like to see the full description of the error
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| 101 | including all lines of error message text.
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| 102 | Enter NO if you do not want to see this information.
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| 103 | ERROR DISPLAY TYPE
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| 104 | 1:Display all ClaimsManager Errors for a Bill;
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| 105 | 2:Display all Bills for a ClaimsManager Error Code
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| 106 | Select the Error Display Type
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| 107 | The answer to this question will determine how the Bills and Errors
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| 108 | are displayed on the report.
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| 109 | Select option 1 if you want to display all of the ClaimsManager
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| 110 | errors for each bill that appears on the report. These errors will
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| 111 | appear together with the bill.
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| 112 | Select option 2 if you want to break this report out by ClaimsManager
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| 113 | error code. In this case, you will see separate sections for each
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| 114 | error code and all bills in which a particular error code is present.
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| 115 | Remember that the bills and errors are still subject to the other
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| 116 | selection and sort criteria that you enter.
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| 117 | RPTSPECS(
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| 118 | ~~~ NO INSURANCE ~~~
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| 119 | Terminal Digit
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| 120 | Dollar Impact
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| 121 | Bill Number
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| 122 | Total # Claims
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| 123 | Total # Errors
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| 124 | ClaimsManager Detailed Error Report sort by
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| 125 | Page :
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| 126 | Detailed Report
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| 127 | BILL NO.
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| 128 | ERROR CODES
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| 129 | CM STATUS
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| 130 | ClaimsManager Audit Error Report for
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| 131 | Summary Report
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| 132 | CM Error Message:
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| 133 | ClaimsManager Status Report
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| 134 | Do you want to exit out of this option entirely
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| 135 | Enter YES to immediately exit out of this option.
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| 136 | Enter NO to return to the previous question.
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| 137 | Select Date Range by
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| 138 | Please enter the type of date on which you would like to report.
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| 139 | The Event Date is the date on which the services were performed.
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| 140 | The Entered Date is the date on which the bill was Entered into VistA.
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| 141 | Enter the beginning
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| 142 | Enter the ending
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| 143 | 1:All ClaimsManager Statuses;
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| 144 | 2:One Specific ClaimsManager Status;
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| 145 | 3:Any ClaimsManager Status (Bill is still Editable)
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| 146 | Select the ClaimsManager Status Option
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| 147 | Option 1 - All ClaimsManager Statuses - indicates that all bills
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| 148 | will be included on the report regardless of ClaimsManager
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| 149 | Option 2 - One Specific ClaimsManager Status - will allow you to
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| 150 | choose a ClaimsManager status and only bills with this specific
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| 151 | status will be included on the report.
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| 152 | Option 3 - Any ClaimsManager Status (Bill is still Editable) -
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| 153 | will only select those bills that are still open for editing in
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| 154 | the IB Enter/Edit Billing Information option.
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| 155 | Please choose a ClaimsManager Status
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| 156 | Do you want to see ClaimsManager comments associated with these bills
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| 157 | Enter YES if you would like to see the comments which are stored in the
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| 158 | ClaimsManager file (#351.9) for each bill on this report.
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| 159 | Enter NO if you do not want to see these comments.
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| 160 | Do you want to include one specific Assigned to person or All?
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| 161 | Please enter 1 or A
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| 162 | Enter '1' to indicate that you only want to include one specific
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| 163 | Assigned to person on this report. You will then be asked
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| 164 | to select this person.
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| 165 | Enter 'A' to indicate that you want to include all Assigned to
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| 166 | people on this report. You will then be asked if you want
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| 167 | to sort by the Assigned to person.
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| 168 | Invalid response ... Please enter '1' or 'A'
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| 169 | Do you want the primary sort by the Assigned To person
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| 170 | Enter YES if you would like the bills on this report primarily
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| 171 | sorted by the Assigned To person. If a bill is not assigned
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| 172 | to anyone, then the word
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| 173 | Enter NO if you would like to choose a different primary sort.
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| 174 | Enter the Assigned to person to include:
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| 175 | 1:Terminal Digit;
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| 176 | 2:Insurance Company Name;
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| 177 | 3:Patient Last Name;
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| 178 | 4:Total Charges;
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| 179 | 5:Bill Number
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| 180 | Please enter the
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| 181 | sort criteria
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| 182 | Please enter the report type
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| 183 | The Detailed report will show the breakout of bills &
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| 184 | a summary based on the criteria that you selected.
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| 185 | The Summary report will show the total amount of bills
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| 186 | based on the criteria that you selected.
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| 187 | *** This report is 132 characters wide ***
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| 188 | IBCI ClaimsManager Status Report
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| 189 | IBCI ClaimsManager Error Report
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| 190 | ClaimsManager Status Report sort by
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| 191 | ClaimsManager Bill Totals by ClaimsManager Status
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| 192 | ClaimsManager Worksheet Report
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| 193 | ClaimsManager does not have a Claims Worksheet on file for this Claim.
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| 194 | Claim No:
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| 195 | Not on File
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| 196 | Please verify that you entered the correct patient.
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| 197 | Another user is currently using this option.
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| 198 | ClaimsManager is not working right now.
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| 199 | IBCI CLAIMSMANAGER SKIP LIST
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| 200 | Welcome to ClaimsManager Bill Processing
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| 201 | This ListMan will display all skipped bills for processing
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| 202 | PR/TX
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| 203 | PT_NAME
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| 204 | EVENT_DATE
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| 205 | No Skipped Claims to Send to ClaimsManager.
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| 206 | You may select one or more claims, or a range.
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| 207 | You may choose a single bill, a list of bills (i.e. 2,5,9,12), a range
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| 208 | of bills (i.e. 3-8), or any combination of these (i.e. 1,3,5,8-12). Only
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| 209 | the bills you select here will be sent to ClaimsManager.
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| 210 | The following bills were sent to ClaimsManager from the Multiple Claim Send
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| 211 | option. ClaimsManager did not find any errors with them. These bills have
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| 212 | passed both the IB edit checks and the ClaimsManager edit checks. They are
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| 213 | ready to be authorized. Please review the bills for which you are responsible
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| 214 | (if any) and take the appropriate action.
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| 215 | BILL# PATIENT NAME PID DATE CHARGES USER NAME
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| 216 | ClaimsManager Clean Claims
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| 217 | There are no claims to send ...
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| 218 | Sending claims ... please wait.
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| 219 | 'Send All Bills to ClaimsManager' will send all claims listed
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| 220 | to ClaimsManager for processing.
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| 221 | 'Send All Non Auth Bills to ClaimsManager' will send only
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| 222 | Non-Authorized claims to ClaimsManager for processing.
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| 223 | 'Select Bills to send to ClaimsManager' allows individual and
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| 224 | multiple selection of claims before sending
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| 225 | claims to ClaimsManager for processing.
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| 226 | IBCI CLAIMSMANAGER MGR WK
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| 227 | Coder:
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| 228 | Line:
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| 229 | Error Level:
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| 230 | ClaimsManager Error:
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| 231 | No ERRORS defined for claim EVENT DATE:
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| 232 | No Errors found by ClaimsManager.
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| 233 | Are you sure you want to Override the errors of this bill
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| 234 | Are you sure you want to Exit the ClaimsManager Interface process
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| 235 | IBCINPT.DAT
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| 236 | This option is responsible for creating the NPT file
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| 237 | (New Patient History) for the ClaimsManager application from Ingenix.
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| 238 | A 3 year history is needed so this option will extract claims data
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| 239 | This process may take several minutes.
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| 240 | Do you wish to proceed
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| 241 | The file that will be created is called
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| 242 | You may specify a valid directory location (path) for this file.
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| 243 | After this file has been created, it needs to be accessible to the
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| 244 | ClaimsManager application. This can be done either through network
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| 245 | connections or by manually moving it to the ClaimsManager server.
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| 246 | FOr
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| 247 | Please enter the directory location (path) for
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| 248 | Enter the location where the file should be created.
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| 249 | Enter the full path specification up to, but not including,
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| 250 | the filename. This includes any trailing slashes or brackets.
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| 251 | If the operating system allows shortcuts, you can use them.
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| 252 | Examples of valid paths include:
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| 253 | VMS USER$:[SCRATCH]
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| 254 | is not a valid directory location or path.
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| 255 | Please press
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| 256 | for more assistance.
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| 257 | The full file specification including path and filename is:
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| 258 | OK to begin
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| 259 | The compile process has completed successfully.
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| 260 | The number of bills that were reviewed is
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| 261 | The number of records that will be in the NPT file is
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| 262 | All that's left to do is to copy these records into the NPT file.
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| 263 | The NPT file creation process is complete!
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| 264 | IBCIPAY.DAT
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| 265 | for the ClaimsManager application from Ingenix. This
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| 266 | is a listing of the Insurance Companies that are currently
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| 267 | stored in VistA.
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| 268 | please wait
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| 269 | There are
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| 270 | records in the Payor File.
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| 271 | The Payor File creation process is complete!
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| 272 | VistA-ClaimsManager Interface Options
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| 273 | ClaimsManager is only available for HCFA 1500 claims.
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| 274 | The form type of the bill you're editing
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| 275 | The charge type of this bill is
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| 276 | Select option or press RETURN to continue
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| 277 | The VistA-ClaimsManager Interface is not currently working.
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| 278 | This bill is no longer editable. The ClaimsManager interface
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| 279 | Test Send functionality is not available for this bill.
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| 280 | ClaimsManager found
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| 281 | with this bill.
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| 282 | Press RETURN to view the error
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| 283 | There was a communications failure:
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| 284 | Please report these errors to your system manager.
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| 285 | This bill was NOT successfully analyzed by ClaimsManager.
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| 286 | There are no errors recorded in the file.
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| 287 | Times sent to ClaimsManager:
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| 288 | Last sent date/time:
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| 289 | Last sent by:
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| 290 | Date/time Entered:
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| 291 | Date/time Last Edited:
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| 292 | Assigned to:
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| 293 | Biller:
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| 294 | TEST-
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| 295 | Sending
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| 296 | to ClaimsManager
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| 297 | No Errors found by ClaimsManager
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| 298 | Communications Error - Not Sent to ClaimsManager
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| 299 | There are no line items associated with this claim.
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| 300 | ClaimsManager cannot process without line items. Please
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| 301 | enter the line item data and resend.
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| 302 | ... Claim has been CANCELLED in ClaimsManager.
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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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