| [604] | 1 | English French Notes Complete/Exclude
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| 2 | PRIMARY PROVIDER #
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| 3 | SECONDARY PROVIDER #
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| 4 | TERTIARY PROVIDER #
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| 5 | MAILING ADDRESS STREET
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| 6 | MAILING ADDRESS STREET2
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| 7 | MAILING ADDRESS STREET3
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| 8 | MAILING ADDRESS CITY
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| 9 | MAILING ADDRESS STATE
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| 10 | MAILING ADDRESS ZIP CODE
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| 11 | NON-PTF ADMISSION HOUR
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| 12 | ACCIDENT HOUR
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| 13 | 1:PHYSICIAN REFERRAL;2:CLINIC REFERRAL;3:HMO REFERRAL;4:TRANSFER FROM HOSPITAL;5:TRANSFER FROM SKILLED NURSING FAC.;6:TRANSFER FROM OTHER HEALTH CARE FAC.;7:EMERGENCY ROOM;8:COURT/LAW ENFORCEMENT;9:INFO NOT AVAILABLE;
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| 14 | 1:EMERGENCY;2:URGENT;3:ELECTIVE;
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| 15 | SNF/SA CARE
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| 16 | DGCR(399.1,
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| 17 | DISCHARGE STATUS
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| 18 | OCCURRENCE CODE
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| 19 | CONDITION CODE
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| 20 | PROCEDURE CODING METHOD
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| 21 | 4:CPT-4;5:HCPCS (HCFA COMMON PROCEDURE CODING SYSTEM);9:ICD-9-CM;
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| 22 | VALUE CODE
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| 23 | START DATE
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| 24 | OP VISITS DATE(S)
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| 25 | Event date can no longer be edited...cancel and submit a new bill if necessary.
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| 26 | MDX#
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| 27 | LOCATION OF CARE
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| 28 | 1:HOSPITAL - INPT OR OPT (INCLUDES CLINICS);2:SKILLED NURSING (NHCU);3:HOME HEALTH AGENCY;7:CLINIC (ONLY INDEPENDENT/SATELITE);8:SPEC. FACILITY HOSP/AMB SURG CTR;
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| 29 | BILL CLASSIFICATION
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| 30 | ** The 'BILL CLASSIFICATION' must be consistent with the 'LOCATION OF CARE.'
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| 31 | TIMEFRAME OF BILL
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| 32 | 1:ADMIT THRU DISCHARGE;2:INTERIM - 1ST CLAIM;3:INTERIM - CONTINUING CLAIM;4:INTERIM - LAST CLAIM;5:LATE CHARGES ONLY;6:ADJUSTMENT CLAIM;7:REPLACEMENT CLAIM;8:VOID/CANCEL PRIOR CLAIM;O:NON-PAY/ZERO CLAIM;
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| 33 | COVERED DAYS
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| 34 | NJ4,0
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| 35 | NON-COVERED DAYS
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| 36 | CO-INSURANCE DAYS
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| 37 | BILL CHARGE TYPE
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| 38 | 1:INSTITUTIONAL;2:PROFESSIONAL;
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| 39 | IS THIS A SENSITIVE RECORD?
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| 40 | ASSIGNMENT OF BENEFITS
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| 41 | Yy1
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| 42 | POWER OF ATTORNEY COMPLETED?
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| 43 | STATEMENT COVERS FROM
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| 44 | STATEMENT COVERS TO
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| 45 | DISCHARGE BEDSECTION
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| 46 | LENGTH OF STAY
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| 47 | REVENUE CODE
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| 48 | MR*P399.2'
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| 49 | RNJ8,2
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| 50 | RNJ6,0X
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| 51 | UNITS OF SERVICE
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| 52 | RNJ9,2XI
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| 53 | NON-COVERED CHARGE
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| 54 | 1:INPT BS;2:OPT VST DT;3:RX;4:CPT;5:PROS;6:DRG;9:UNASSOCIATED;
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| 55 | OFFSET AMOUNT
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| 56 | OFFSET DESCRIPTION
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| 57 | RNJ10,2
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| 58 | NJ11,2
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| 59 | PRIMARY PRIOR PAYMENT
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| 60 | PRIOR PAYMENT(S)
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| 61 | SECONDARY PRIOR PAYMENT
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| 62 | TERTIARY PRIOR PAYMENT
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| 63 | UB92 FORM LOCATOR 49
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| 64 | RX PROCEDURE
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| 65 | AUTO ADDED CHARGE - NO CHANGE TO TYPE/COMPONENT
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| 66 | BILL COMMENT
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| 67 | FORM LOCATOR 2
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| 68 | FORM LOCATOR 9
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| 69 | FORM LOCATOR 27
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| 70 | FORM LOCATOR 45
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| 71 | FORM LOCATOR 92
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| 72 | FORM LOCATOR 93
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| 73 | TREATMENT AUTHORIZATION CODE
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| 74 | UF3;4
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| 75 | PRIMARY INSURANCE ICN/DCN
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| 76 | UF3;5
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| 77 | SECONDARY INSURANCE ICN/DCN
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| 78 | UF3;6
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| 79 | TERTIARY INSURANCE ICN/DCN
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| 80 | PRIMARY AUTHORIZATION CODE
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| 81 | SECONDARY AUTHORIZATION CODE
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| 82 | TERTIARY AUTHORIZATION CODE
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| 83 | 1:REFERRING;2:OPERATING;3:RENDERING;4:ATTENDING;9:OTHER;
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| 84 | UF3;1
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| 85 | UF3;2
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| 86 | FORM LOCATOR 11
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| 87 | UF3;3
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| 88 | FORM LOCATOR 31
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| 89 | UF3;7
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| 90 | FORM LOCATOR 56
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| 91 | UF31;2
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| 92 | FORM LOCATOR 78
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| 93 | MR*S
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| 94 | PERFORMED BY
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| 95 | Prov Specialty On File:
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| 96 | Provider Specialty On File:
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| 97 | PRIMARY PROV ID CARE UNIT
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| 98 | IBA(355.96,
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| 99 | TX;8
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| 100 | FORCE CLAIM TO PRINT
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| 101 | 0:NO FORCED PRINT;1:FORCE LOCAL PRINT;2:FORCE CLEARINGHOUSE PRINT;
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| 102 | NO FORCED PRINT
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| 103 | SECONDRY PROV ID CARE UNIT
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| 104 | TERTIARY PROV ID CARE UNIT
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| 105 | PRIMARY INS CO ID NUMBER
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| 106 | SECONDARY INS CO ID NUMBER
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| 107 | TERTIARY INS CO ID NUMBER
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| 108 | REFERRING PROVIDER STATE
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| 109 | UNABLE TO WORK FROM
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| 110 | UNABLE TO WORK TO
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| 111 | FORM LOCATOR 37C
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| 112 | NON-VA FACILITY
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| 113 | NVA_FC
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| 114 | NVA_FC-0
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| 115 | NON-VA CARE TYPE
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| 116 | 1:FEE BASIS, NON-LAB;2:FEE BASIS, LAB;3:NON-FEE BASIS, NON-LAB;4:NON-FEE BASIS, LAB;
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| 117 | NON-VA CARE ID #
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| 118 | UF31;3
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| 119 | FORM LOC 19-UNSPECIFIED DATA
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| 120 | DATE LAST SEEN
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| 121 | SPECIAL PROGRAM INDICATOR
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| 122 | UF2;2
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| 123 | PRINT FACILITY DATA IN BOX 32
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| 124 | REFERRING PROV STATE
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| 125 | AUTHORIZE BILL GENERATION?
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| 126 | REASON(S) DISAPPROVED-INITIAL
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| 127 | DGCR(399.4,
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| 128 | TX;6
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| 129 | REQUEST MRA NOW?
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| 130 | TX;2
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| 131 | LAST ELECTRONIC EXTRACT DATE
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| 132 | DATE LAST PRINTED
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| 133 | MP399.4'
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| 134 | Updating file 399.1 MCCR UTILITY with new occurrence codes...
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| 135 | RZD FOR STATE ASSIGNMENT
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| 136 | RZD FOR NATIONAL ASSIGNMENT
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| 137 | Occurrence Codes added (#399.1)
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| 138 | *** Code Added ***
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| 139 | NO DIAGNOSTIC MEASURE REPORTS FOUND FOR OCT 2003.
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| 140 | DIAGNOSTIC MEASURES DATA ALREADY SENT FOR OCT 2003.
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| 141 | Setting status of UNBILLED REPORT for OCT 2003 to complete.
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| 142 | Transmitting diagnostic measure reports for OCT 2003.
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| 143 | Post-install complete.
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| 144 | >>> Updating the IVM Center domain in the IB SITE PARAMETERS (#350.9) file...
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| 145 | G.IVM REPORTS@IVM.VA.GOV
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| 146 | IB OUTPUT MANAGEMENT REPORTS
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| 147 | IB OUTPUT IVM BILLING ACTIVITY
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| 148 | <<< Adding IB OUTPUT IVM BILLING ACTIVITY option to IB OUTPUT MANAGEMENT
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| 149 | REPORTS menu...
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| 150 | <<< Post init complete!
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| 151 | <<< Adding new entry to BILL FORM TYPE for IB REPORTS!
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| 152 | IB UNBILLED AMOUNTS
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| 153 | This mail group will be automatically mailed the IB Unbilled Amounts
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| 154 | report each month.
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| 155 | You may add members at this time.
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| 156 | <<< Mail Group (
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| 157 | ) CREATION FAILED !!!
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| 158 | <<< Updating your IB Site Parameters
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| 159 | 6.25///IB UNBILLED AMOUNTS;6.24///0
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| 160 | Patch PRCA*4*24 or PRCA*4.5*6 does not appear to be installed! Please
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| 161 | install the appropriate patch and then re-run this initialization.
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| 162 | IBCNS QUIT
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| 163 | >>> Deleting protocol IBCNS QUIT as an item of IBCNSC INSURANCE CO...
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| 164 | (It will be added back in momentarily)
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| 165 | IBCNSJ PLAN LOOKUP
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| 166 | IBCNSP POLICY MENU
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| 167 | for protocol '
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| 168 | IBCNS EXPANDED POLICY^1^^80^5^17^1^1^Policy^IBCNSP POLICY MENU^Patient Policy Information^1
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| 169 | 'IBCNS PLAN LOOKUP' List Template...
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| 170 | IBCNS PLAN LOOKUP^1^^80^7^19^1^1^Plan^IBCNSJ PLAN LOOKUP^Insurance Plan Lookup^1^^1
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| 171 | IBCN INSURANCE MGMT MENU
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| 172 | IBCN LIST PLANS BY INS CO
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| 173 | >>> Adding IBCN LIST PLANS BY INS CO option to the IBCN INSURANCE MGMT MENU...
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| 174 | >>> Building the 'ACCP' cross-reference for file #355.3 ...
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| 175 | (I'll write a dot for every 100 entries processed)
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| 176 | Note that
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| 177 | group plan
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| 178 | had the individual policy pointer removed.
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| 179 | >>> Queuing off a job to clean up various insurance files...
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| 180 | (You'll get a message when the job is completed)
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| 181 | IB - PATCH IB*2*28 POST INIT - INSURANCE CLEAN-UP
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| 182 | The job has been queued. The task number is
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| 183 | Unable to queue this job. Please run FIX^IBYAPT1 at any time.
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| 184 | Patch IB*2*28 Insurance Clean-up Completion
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| 185 | The Insurance Files clean-up job has completed.
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| 186 | Number of AGNA cross references in file #355.3 deleted:
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| 187 | Number of AGNU cross references in file #355.3 deleted:
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| 188 | Number of errant Annual Benefits in file #355.4 deleted:
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| 189 | Number of errant Benefits Used in file #355.5 deleted:
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| 190 | Number of errant Personal Riders in file #355.7 deleted:
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| 191 | Number of Insurance Reviews in file #356.2 repointed:
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| 192 | DUZ(0) must also be defined to run this initialization.
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| 193 | >> ACCOUNTS RECEIVABLE CATEGORY (430.2) '
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| 194 | ' not found.
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| 195 | Patch PRCA*4*15 or PRCA*4.5*1 does not appear to be installed! Please install
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| 196 | the appropriate patch and then re-run this initialization.
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| 197 | CHAMPVA REIMB. INS.
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| 198 | DG CHAMPVA PER DIEM NEW
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| 199 | DG CHAMPVA PER DIEM CANCEL
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| 200 | DG CHAMPVA PER DIEM UPDATE
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| 201 | >> RATE TYPE (399.3) '
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| 202 | >> ACTION TYPE (350.1) '
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| 203 | Required file entries are missing. You should determine why you do not
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| 204 | have these entries before continuing. They should have been installed
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| 205 | with the installation of IB v2.0.
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| 206 | ' is not Inactive.
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| 207 | ' already has a pointer
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| 208 | to an ACCOUNTS RECEIVABLE CATEGORY (430.2).
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| 209 | This RATE TYPE will be re-pointed to a new CATEGORY in this installation.
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| 210 | RATE TYPE entries have changed since the release of IB 2.0. You should
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| 211 | determine why these entries may have changed, and then inactivate
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| 212 | the Rate Types again, before re-running the initialization.
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| 213 | CHAMPVA PER DIEM
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| 214 | >>> Initializing Billing Parameters for CHAMPVA Billing...
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| 215 | >>> Unable to initialize your CHAMPVA billing parameters!
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| 216 | Please call your ISC for assistance.
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| 217 | >>> It appears as if you are re-running the initialization.
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| 218 | The CHAMPVA Billing parameters were not updated.
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| 219 | >> The two CHAMPVA RATE TYPES have been activated and linked to an
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| 220 | ACCOUNTS RECEIVABLE CATEGORY...
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| 221 | >> The Patient Billing CHAMPVA Action Types have been updated...
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| 222 | >> Added new CHAMPVA Subsistence rate, effective 10/1/94...
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| 223 | .01///IB CHAMPVA RATE/INSURER;.02///Rate Type and Primary Carrier's Type of Coverage do not both match CHAMPVA.
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| 224 | >>> IB085 - CHAMPVA Rate/Insurer match error added to IB ERROR file.
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| 225 | >>> Installing List Template...
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| 226 | BILL#^49^8^Bill #
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| 227 | >>> Adding the Reminder Letter into the IB FORM LETTER (#354.6) file...
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| 228 | Unable to add the letter! Contact your supporting ISC for assistance.
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| 229 | Income Test Reminder Letter^2^15
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| 230 | The VA is required by law to charge veterans who receive medications
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| 231 | on an outpatient basis for the treatment of nonservice-connected
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| 232 | conditions, a copayment of $2.00 for each 30-day (or less) supply
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| 233 | of medication provided. Based on the income information requested
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| 234 | each year, some veterans may be exempt from the copayment.
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| 235 | Our records indicate that your medication copayment exemption
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| 236 | status will expire on |VAR(
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| 237 | <enter a third paragraph which provides instructions to the veteran>
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| 238 | <enter a signature title if desired>
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| 239 | Department of Veterans Affairs Medical Center
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| 240 | <enter the facility street here>
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| 241 | <enter the facility city/state/zip here>
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| 242 | IB RX EXEMPTION MENU
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| 243 | IB RX REPRINT REMINDER
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| 244 | >>> Adding IB RX REPRINT REMINDER option to the IB RX EXEMPTION MENU...
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| 245 | APD3 cross reference already exists - not rebuilt
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| 246 | >>> Building the 'APD3' cross-reference for file #399 ...
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| 247 | (I'll write a dot for every 500 entries processed)
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| 248 | Begin:
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| 249 | End:
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| 250 | entries processed in
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| 251 | >>> Correcting the spelling of the entry 'ADMISSION TO CIRCUMENT SLOWNESS'
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| 252 | (code 3.03) in file #356.4 ...
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| 253 | This entry is not cross-referenced correctly!
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| 254 | Please contact IRMFO Customer Service staff for assistance.
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| 255 | This entry could not be found!
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| 256 | .01////ADMISSION TO CIRCUMVENT SLOWNESS
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| 257 | >>> I need to queue a job to clean up the 'Name of Insured' fields in
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| 258 | the PATIENT (#2) and BILL/CLAIMS (#399) files...
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| 259 | IB - CORRECT 'NAME OF INSURED' VALUES
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| 260 | Please note that you will receive a mail message when this job has completed.
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| 261 | Job Completion - Correct 'Name of Insured' Fields
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| 262 | INTEGRATED BILLING
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| 263 | The job to correct the 'Name of Insured' fields in files #2 and #399
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| 264 | has completed.
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| 265 | Number of policies corrected in file #2:
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| 266 | Number of bills corrected in file #399:
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| 267 | Patch IB*2*6 does not appear to be installed! Please
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| 268 | install this patch and then re-run this initialization.
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| 269 | Patch IB*2*8 does not appear to be installed! Please
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| 270 | Patch IB*2*13 does not appear to be installed! Please
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| 271 | Patch IB*2*23 does not appear to be installed! Please
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| 272 | Patch IB*2*40 does not appear to be installed! Please
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| 273 | Patch IB*2*45 does not appear to be installed! Please
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| 274 | IBCNSP ADD COMMENT
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| 275 | IBCNSP EDIT ALL
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| 276 | IBCNSJ CHANGE PLAN
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| 277 | >>> Deleting protocol
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| 278 | as an item of
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| 279 | (It will be re-added in a moment)
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| 280 | IBCNSC PLAN LIST
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| 281 | IBCNSC PLAN DETAIL
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| 282 | >>> Rebuilding ^XUTL for protocol '
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| 283 | >>> Adding records to INSURANCE RIDERS file for new limitation categories...
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| 284 | INPATIENT COVERAGE
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| 285 | OUTPATIENT COVERAGE
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| 286 | PRESCRIPTION COVERAGE
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| 287 | >>> Updating PLAN LIMITATION CATEGORY file with insurance rider info...
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| 288 | 'IBCNS INS CO PLAN DETAIL' List Template ...
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| 289 | IBCNS INS CO PLAN DETAIL^1^^80^5^17^1^1^Plan^IBCNSC PLAN DETAIL^View/Edit Plan
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| 290 | 'IBCNS PLAN LIST' List Template ...
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| 291 | IBCNS PLAN LIST^1^^80^6^19^1^1^Plan^IBCNSC PLAN LIST^Insurance Plan List^1^^1
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| 292 | Post-Install Complete
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| 293 | *** REASON NOT BILLABLE of 'NON-BILLABLE CLINIC' already exists in FILE #356.8, new entry NOT added.
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| 294 | <<< Adding new REASON NOT BILLABLE of 'NON-BILLABLE CLINIC' to file #356.8
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| 295 | **** Unable to add new entry to FILE #356.8, contact Field Support ****
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| 296 | <<< Updating entries in NON-BILLABLE CLINIC STOP CODES (#352.3) file
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| 297 | <<< Adding TP Non-billable Stops to NON-BILLABLE CLINIC STOP CODES (#352.3) file
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| 298 | *** Could not add entry
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| 299 | IB*2*148 Post-Install Complete
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| 300 | >> Inactivating Charges for Inactive CPT codes, Please Wait...
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| 301 | Charges Inactivated.
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| 302 | >> Removing Charges Sets that have no Charges Assigned...
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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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