| [604] | 1 | English French Notes Complete/Exclude
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| 2 | Form Locator
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| 3 | Tx Auth. Code :
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| 4 | Bill Remark :
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| 5 | Pri:
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| 6 | Tx Auth. Code(s) :
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| 7 | Admitting Dx :
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| 8 | Admission Source :
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| 9 | (OLD PROV DATA)
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| 10 | Form Locator 2 :
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| 11 | Form Locator 11 :
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| 12 | Form Locator 31 :
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| 13 | Form Locator 56 :
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| 14 | Form Locator 78 :
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| 15 | Force To Print? :
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| 16 | NOT TRANSMITTABLE
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| 17 | Provider ID Maint : (Edit Provider ID information)
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| 18 | Unable To Work From:
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| 19 | Unable To Work To :
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| 20 | Admitting Dx :
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| 21 | ICN/DCN(s) :
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| 22 | Tx Auth. Code(s) :
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| 23 | (OLD BOX 31 DATA)
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| 24 | Non-VA Facility :
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| 25 | Form Locator 19 :
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| 26 | Homebound :
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| 27 | Date Last Seen :
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| 28 | Spec Prog Indicator:
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| 29 | Print Main Facility Box 32:
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| 30 | Force To Print? :
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| 31 | **Warning** Credentials differ from those found in NEW PERSON or IB NON VA
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| 32 | BILLING PROVIDER file (
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| 33 | Changes will print local, but only credentials on file transmit
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| 34 | Primary^Secondary^Tertiary
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| 35 | ins co requires care unit
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| 36 | for this claim
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| 37 | No local screen has been defined for this form type
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| 38 | Bill must have insurance co or resp institution to use this screen
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| 39 | No local data fields are needed for this bill type/insurance company
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| 40 | DR(1,399,
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| 41 | DR(2,2)
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| 42 | DR(2,2,
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| 43 | of data,
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| 44 | '^N' to jump to screen #N (see
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| 45 | Special help screens:
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| 46 | Enter '?SC' to view SC Status and Rated Disabilities.
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| 47 | Enter '?INS' to view the patients insurance policies.
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| 48 | Enter '?PRV' to view provider specific information.
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| 49 | Enter '?PRC' to view all procedures on the bill and related data.
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| 50 | Enter '?CHG' to view all items on the bill with potential charges.
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| 51 | Enter '?CPT' to view all charges for selected CPT codes and bill type.
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| 52 | Enter '?HCFA' to view how block 24 will print on a HCFA 1500.
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| 53 | Enter '?INC' to execute the edits & view the bill inconsistencies.
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| 54 | Enter '?CLA' to view the ClaimsManager options.
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| 55 | PRESS <RETURN> KEY
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| 56 | to RETURN to SCREEN
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| 57 | DATA GROUPS ON PARAMETER SCREEN
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| 58 | to RETURN to PARAMETER SCREEN
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| 59 | Patient Employer Name, Address^Spouse Employer Name, Address
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| 60 | Payer Information^Provider Numbers^Mailing Address
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| 61 | Admission Information^Discharge Information^Diagnosis Code(s)^Coding Method, Inpt Proc Code(s)^Occurrence Code(s)^Condition Code(s)^Value Code(s)
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| 62 | Event Date^Outpatient Diagnosis^Outpatient Visits^Coding Method, Opt. Pro. Code(s)^Occurrence Code(s)^Condtion Code(s)
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| 63 | Bill Type, Covered/Non-Covered Days^R.O.I., Assignment of Benefits^Statement Covers Period^Bedsection, Length of Stay^Revenue Code(s), Offset, Total^Rate Schedule(s)^Prior Payments/Claims
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| 64 | Bill Remark^Form Locator 2^Form Locator 9^Form Locator 27^Form Locator 45^Form Locator 92^Form Locator 93^Tx Auth. Code
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| 65 | Locally defined fields
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| 66 | Bill Remark, ICN/DCN's, Tx Auth. Code, Admit Diagnosis/Source^Providers^Form Locator 2 and 11^Form Locator 31^Form Locator 56, 57, and 78^Force to Print
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| 67 | Period Unable to Work^Admit Dx, ICN/DCN, Tx/Prior Auth. Code^Providers^Non-VA Facility^Form Locator 19^Force to Print
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| 68 | Fed Tax #, BC/BS #, MAS Svc Pointer^Bill Signer, Billing Supervisor^Security Parameters, Outpatient CPT parameters ^Remarks, Mailgroups^Agent Cashier Address/Phone
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| 69 | Demographic^Employment^Payer^Inpatient Event^Outpatient Event^Inpatient Billing - General^Outpatient Billing - General^Billing - Specific^Locally Defined
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| 70 | Example of diagnoses, procedures and charges printing on the HCFA 1500
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| 71 | BOX 19 DATA:
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| 72 | This is a display of provider specific information.
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| 73 | Select PROVIDER NAME:
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| 74 | Signature Name:
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| 75 | Signature Title:
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| 76 | None Active on
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| 77 | Person Class:
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| 78 | PROVIDER TYPE:
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| 79 | RC Provider Group:
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| 80 | SC Status and Rated Disabilities for
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| 81 | SC At Time Of Care:
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| 82 | DO YOU WISH TO ADD/EDIT INSURANCE COMPANY DATA FOR THIS PATIENT
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| 83 | YES - And I'll prompt you so that you may add insurance data to the PATIENT
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| 84 | file for this patient.
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| 85 | NO - To bypass this editing of the PATIENT file.
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| 86 | If you updated insurance information for any policy which is already specified
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| 87 | as either a PRIMARY, SECONDARY or TERIARY for this billing episode, you will
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| 88 | need to press the <RETURN> key through the following prompts in order to insure
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| 89 | that these new values are properly stored. If you fail to do so, i.e.,
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| 90 | enter an up-arrow, the new values will not be stored as part of this billing
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| 91 | If a procedure is linked as a prescription to a rev code, it cannot be deleted
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| 92 | - Enter the alphanumeric designation of your choice from
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| 93 | the display (e.g. 'A1') to input one of the codes shown
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| 94 | above into this billing record.
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| 95 | - Enter the name or code number of an
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| 96 | ICD DIAGNOSIS
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| 97 | not displayed above to input a
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| 98 | in the PTF record into this billing record, or '??' for
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| 99 | a list of all
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| 100 | CODES.
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| 101 | - Enter <RETURN> to accept the default
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| 102 | DIAGNOSIS
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| 103 | PROCEDURE
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| 104 | '^' to abort.
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| 105 | No Codes Entered!
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| 106 | Procedures Assigned to this Bill
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| 107 | NO ENTRY FOUND^
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| 108 | to EDIT,
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| 109 | '^N' for screen N, or '^' to QUIT:
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| 110 | SAVE THE VALUE OF $T
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| 111 | [NOT REQUIRED]
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| 112 | W Z Q
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| 113 | IOINHI;IOINLOW;IOINORM
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| 114 | HELP SCREEN
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| 115 | SCREEN <
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| 116 | Inpat
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| 117 | Outpat
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| 118 | CITY/STATE UNKNOWN
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| 119 | Patient has no ACTIVE PTF RECORDS for this event date.
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| 120 | A 'PTF NUMBER' is required for inpatient billing records.
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| 121 | Select the appropriate billing record from the above listing by number.
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| 122 | This patient is only
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| 123 | years old!!
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| 124 | This patient is a MALE!! Condition code 18 applies only to FEMALES!!
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| 125 | Choose only ACTIVE Revenue Codes!!
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| 126 | Only ACTIVE Revenue Codes may be selected!!
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| 127 | NOT A VALID CHOICE!
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| 128 | LEFT AGAINST MEDICAL ADVICE
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| 129 | DISCHARGED TO ANOTHER SHORT-TERM GENERAL HOSPITAL
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| 130 | NO BLUE CROSS/SHIELD PROVIDER NUMBERS IDENTIFIED TO SELECT FROM!
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| 131 | OR
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| 132 | ENTER BLUE CROSS/SHIELD PROVIDER # (BETWEEN 3-13 CHARACTERS)
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| 133 | Revenue Code Listing
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| 134 | Non-Cov
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| 135 | Link Missing
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| 136 | Current modifier
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| 137 | Exceeds 'Total Charges' for this bill.
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| 138 | Edit revenue codes/from-to dates if appropriate.
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| 139 | START WITH DATE ENTERED:
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| 140 | GO TO DATE ENTERED:
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| 141 | bill IFN ^ bill date (stm to) ^ bill rate group
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| 142 | ) exists for Rx #
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| 143 | and refill date
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| 144 | Cannot precede the 'EVENT DATE'!
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| 145 | Cannot bill for future treatment!
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| 146 | Can't be greater than date of specified Procedures!
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| 147 | 'Start Date' must be specified first!
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| 148 | Cannot preceed the 'Start Date'!
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| 149 | Must be in same fiscal year!
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| 150 | Must be in same calendar year!
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| 151 | Can't be less than date of specified Procedures!
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| 152 | No 'Start Date' on file...can't enter OP visit dates...
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| 153 | No 'End Date' on file...can't enter OP visit dates...
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| 154 | Can't enter a visit date prior to 'Start Date'...
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| 155 | Can't enter a visit date later than 'End Date'...
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| 156 | Can Not Precede Bill Start Date!
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| 157 | Can not be after Bill End Date!
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| 158 | ) exists for visit date (
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| 159 | MR.
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| 160 | MS.
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| 161 | MRS.
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| 162 | IB-BS
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| 163 | IB-ASC
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| 164 | IB-PTF
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| 165 | Removing old Revenue Codes.
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| 166 | Editing
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| 167 | Updating Revenue Codes
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| 168 | REV. CODE
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| 169 | ) exists overlapping this date range.
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| 170 | Site param does not allow entry of non-PTF procedures
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| 171 | SINCE THE PROCEDURE CODING METHOD HAS BEEN CHANGED, DO YOU WANT TO DELETE ALL
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| 172 | PROCEDURE CODES IN THIS BILL
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| 173 | If you answer 'Yes', all procedure codes will be DELETED from this bill.
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| 174 | Procedure Entry:
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| 175 | Select PROCEDURE DATE
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| 176 | Select PROCEDURE:
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| 177 | Warning: Procedure code is inactive on this date
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| 178 | The Procedure code is inactive on
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| 179 | Please select another Procedure.
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| 180 | Date must be within STATEMENT COVERS FROM and STATEMENT COVERS TO period.
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| 181 | Enter a date between
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| 182 | EDIT HCFA 1500 SPECIAL PROGRAM FIELDS and BOX 19?:
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| 183 | Respond YES only if you need to add/edit data for chiropratic visits,
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| 184 | EPSDT care, or if billing for HOSPICE and attending is not a hospice employee.
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| 185 | OK to add CPT codes to Visits file
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| 186 | Adding Procedures to PCE...
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| 187 | IB DATA
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| 188 | Procedures in
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| 189 | were added okay.
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| 190 | were not added - error code is
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| 191 | Bill has no ICD DIAGNOSIS.
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| 192 | <<<ASSOCIATED ICD-9 DIAGNOSIS>>>
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| 193 | There are no diagnoses associated with this bill.
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| 194 | *** Please select procedure diagnoses by number to left of diagnosis code ***
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| 195 | Current Values:
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| 196 | Dx
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| 197 | Associated Diagnosis (
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| 198 | Please enter one of the following billing diagnoses by number at left of code:
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| 199 | You may also enter '^' to exit, '@' to delete a procedure diagnosis, or
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| 200 | <CR> to accept a current value or skip a prompt.
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| 201 | RC-OPT FAC
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| 202 | RC-PHYSICI
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| 203 | Modifier 26
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| 204 | Deleted from
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| 205 | Added to
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| 206 | CPT procedures.
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| 207 | Modifier TC Deleted from all Procedures (
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| 208 | Procedures Deleted (
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| 209 | Modifier 26 Procedures Added (
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| 210 | CPT-CLN
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| 211 | replaced by
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| 212 | CANCEL WITHOUT EXAM
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| 213 | ADMIT THRU DISCHARGE
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| 214 | FIRST CLAIM
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| 215 | CONTINUING CLAIM
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| 216 | LAST CLAIM
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| 217 | LATE CHARGE(S)
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| 218 | ZERO CLAIM
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| 219 | Deleting old synonym for the Purge Conversion Log action..........
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| 220 | IBDFC PURGE CONVERSION LOG
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| 221 | Cleaning up corrupt second piece of global ^IBE(357,IFN,2,0)
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| 222 | AICS 3.0 Installation Requirements:
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| 223 | >>> Environment check failed. Installation will not be allowed.
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| 224 | >>> Environment is Ok
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| 225 | >>> Checking Environment:
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| 226 | Can not proceed. XPDABORT is inappropriately defined.
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| 227 | Environment checks OK
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| 228 | >>> Checking PACKAGE File Entries:
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| 229 | Checking for required patch
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| 230 | not found!!
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| 231 | >>> Checking BUILD File Entries:
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| 232 | Missing Required Package File Entry (Package/Patch):
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| 233 | ...Ok - in Package File
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| 234 | DG SELECT ICD-9 DIAGNOSIS CODE
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| 235 | PX INPUT EXAMS
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| 236 | PX INPUT VISIT CLASSIFICATION
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| 237 | >>> Now Attempting to automatically update Tool Kit forms and Tool Kit Blocks.
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| 238 | Moving Block '
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| 239 | ' from import/export to Tool Kit
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| 240 | Moving Form '
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| 241 | ' from import export utility to AICS
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| 242 | >>> Tool Kit Forms and Blocks are already installed.
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| 243 | >>> Tool Kit Forms sent (4):
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| 244 | >>> Tool Kit Blocks sent (28):
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| 245 | CLINICAL LEXICON ENTRY^P757.01'^LEX(757.01,^2;2^Q
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| 246 | CLINICAL LEXICON^P757.01'^LEX(757.01,^2;2^Q
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| 247 | >>> AICS Data Dictionaries updated to use Lexicon Utility version 2.0
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| 248 | >>> Form Specs being deleted and recreated for scanning.
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| 249 | INPUT DIAGNOSIS CODE (ICD9)
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| 250 | DIAGNOSIS/PROBLEM
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| 251 | DIAGNOSIS/PROBLEM^1^13^14^2^^^
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| 252 | >>> Updating Package Interface Entry for INPUT DIAGNOSIS CODE (ICD9)
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| 253 | INPUT PROVIDER
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| 254 | PX INPUT PATIENT ACTIVE PROBLE
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| 255 | >>> Deleting Fields *'d for Deletion in Package Interface file (357.6)
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| 256 | IBD RESOURCE
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| 257 | >>> Adding Resouce Device 'IBD RESOURCE' for scanning.
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| 258 | 1////IBD RESOURCE;.02////NA;2///RESOURCE
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| 259 | LIST OF FORMS READY FOR IMPORT OR EXPORT
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| 260 | (** there are
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| 261 | toolkit blocks in the work space **)
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| 262 | This form was created with version
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| 263 | Export Notes For
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| 264 | This action requires PROGRAMMER ACCESS!
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| 265 | The work space must be cleared before the INITS are run. Is that okay?
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| 266 | In order for you to import forms from another site the other site must have
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| 267 | prepared and sent you inits created using the import/export facility.
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| 268 | What is the name of the init routine that contains the forms that you want to
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| 269 | That routine does not exist!
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| 270 | Using the DIFROM action requires PROGRAMMER ACCESS!
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| 271 | There is nothing in the work space to export!
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| 272 | LIST OF TOOLKIT BLOCKS READY FOR IMPORT OR EXPORT
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| 273 | forms in the work space **)
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| 274 | What type of block do you want to export?
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| 275 | NOW CHOOSE THE BLOCK TO COPY!
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| 276 | New Toolkit Block Name:
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| 277 | Enter a unique name for the toolkit block up to 30 characters
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| 278 | There is already a toolkit block with that name! The name should be unique.
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| 279 | Moving Form '
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| 280 | ' to import export utility
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| 281 | Moving Block '
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| 282 | ' from form '
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| 283 | ' to utility
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| 284 | IBDE CLN
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| 285 | >>> Now checking the PACKAGE INTERFACE file for inappropriate data qualifiers.
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| 286 | IBD(357.98,
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| 287 | >> WARNING: The following interfaces use the PROBLEM node to transmit data
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| 288 | Package Interface
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| 289 | Contact Customer Support for assistance updating the package interface file.
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| 290 | >> Summary of the Package Interface Check:
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| 291 | No required changes were found.
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| 292 | A total of
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| 293 | removed from Package Interface Entries.
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| 294 | The PCE DIM data fields for
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| 295 | Package Interface
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| 296 | Allowable Qualifier
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| 297 | The Package Interface
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| 298 | an invalid qualifier of
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| 299 | a duplicate qualifier of
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| 300 | a bad qualifier of
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| 301 | not deleted, PCE DIM NODE='PROBLEM'
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| 302 | The PCE Device Interface Data Updated.
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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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