| 1 | English French  Notes   Complete/Exclude
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| 2 | Tran. Date                      
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| 3 | Print Pending Transaction List                  
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| 4 | Answer <YES> or <NO>                    
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| 5 |   Dates are not appropriate.                    
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| 6 | NOT AN ACTIVE ACCOUNT !                 
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| 7 | THIS ACCOUNT ALREADY HAS A REPAYMENT PLAN !                     
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| 8 | NO REPAYMENT PLAN!                      
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| 9 | NO REPAYMENT PLAN !                     
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| 10 | NOTHING CHANGED !                       
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| 11 | NUMBER OF PAYMENTS WILL BE                      
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| 12 | THIS NUMBER SHOULD BE LESS THAN 60 !, CHECK THE INPUT AGAIN                     
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| 13 | DUE DATE OF 1ST PAYMENT:                        
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| 14 | THE REPAYMENT PLAN HAS BEEN ESTABLISHED.                        
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| 15 | Repayment Plan Profile                  
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| 16 | ( r - Bill is Currently Referred )                      
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| 17 | CATEGORY LISTING FOR BILLS REPORT                       
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| 18 | Sort Criteria for Date Prepared:                        
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| 19 | Princpal                        
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| 20 | Preprd                  
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| 21 | ****NO RECORDS TO PRINT****                     
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| 22 | SUBCOUNT:                       
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| 23 | Do you wish to queue this report                        
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| 24 | MAS RECONCILIATION REPORT                       
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| 25 | @DATE BILL PREPARED,@CATEGORY:INTERNAL(TYPE),@CURRENT STATUS:STATUS NUMBER                      
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| 26 | 3RD PARTY ACTIVE REFERRAL REPORT                        
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| 27 | DEBTOR;S2,PATIENT,RC/DOJ REFERRAL DATE,@CURRENT STATUS:STATUS NUMBER,@CATEGORY:INTERNAL(TYPE)                   
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| 28 | DATE REFERRED TO RC                     
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| 29 | DEBTOR;S1,@RC/DOJ REFERRAL DATE,@RC/DOJ REFERRAL CODE                   
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| 30 | ACCOUNTS RECEIVABLE REFERRED TO RC                      
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| 31 | DATE REFERRED TO DOJ                    
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| 32 | ACCOUNTS RECEIVABLE REFERRED TO DOJ                     
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| 33 | DATE RC TRANSACTION CREATED                     
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| 34 | +TRANSACTION TYPE;S2,@DATE ENTERED                      
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| 35 | REGIONAL COUNSEL DEBT COLLECTION REPORT FROM                    
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| 36 | DATE DOJ TRANSACTION CREATED                    
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| 37 | +TRANSACTION TYPE;S2,@RC DOJ CODE,@DATE ENTERED                 
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| 38 | DEPARTMENT OF JUSTICE DEBT COLLECTION REPORT FROM                       
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| 39 | DATE REFERRED TO RC/DOJ                 
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| 40 | REFERRED TP TORT & WORKER'S COMP AR REPORT                      
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| 41 | DEBTOR;S1,@REFERRAL DATE,@CURRENT STATUS:STATUS NUMBER,@CATEGORY:CATEGORY NUMBER                        
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| 42 | This report should be run on or AFTER the first Wednesday of the month.                 
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| 43 | Make sure your facility has received the monthly offset information from                        
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| 44 | the DMC to insure the accuracy of this report.                  
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| 45 | Enter DMC Report to print:                      
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| 46 | 1 - All Patients                        
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| 47 | 2 - Single Patient                      
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| 48 | Enter '1' to print DMC information for ALL patients.                    
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| 49 | Enter '2' to print DMC information about a single patient.                      
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| 50 | REFERRED DMC DEBTS                      
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| 51 | @DATE SENT TO DMC,+@INTERNAL(DEBTOR);S2                 
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| 52 | @DATE SENT TO DMC,+DEBTOR;S2                    
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| 53 | @DATE SENT TO DMC,+@INTERNAL(DEBTOR)                    
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| 54 | Are you sure you want to return this bill to the Service                        
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| 55 | Answer 'Y' or 'YES' if you want to return this bill to the service that originated it, answer 'N' or 'NO' if not                        
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| 56 | Do you want to return this bill to the service again                    
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| 57 | You should audit this amended bill !                    
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| 58 | Do you want to print the amended bill data                      
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| 59 | Answer 'Y' or 'YES' if you want to print the data, answer 'N' or 'NO' if not.                   
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| 60 | Print Amended Bill                      
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| 61 | OK!, The Bill is active now, you may need to do the following:                  
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| 62 | |  1. If the bill has been cancelled in the service, run the option                     
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| 63 | 'Decrease Adjustment' to decrease the balance to 0. The                 
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| 64 | status of the bill will be changed to CANCELLATION automatically.                       
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| 65 | |  2.  If the amended bill needs to change the original amount,                 
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| 66 | |      use 'Adjustment to AR' option.                   
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| 67 | |  3.  If the debtor's address has been changed in the amended bill,                    
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| 68 | |      use 'Edit Debtor's Address' option.                      
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| 69 | PRCAY PAYMENT SUP                       
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| 70 | This bill has been APPROVED                     
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| 71 |  but an FMS document was NOT created                    
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| 72 | Do you want to CREATE the document now                  
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| 73 | This bill is ready for the Certifying Official's approval.                      
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| 74 | It has been reviewed by                         
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| 75 | This bill has not been reviewed for approval yet.                       
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| 76 | It must be signed by a refunder to be                   
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| 77 | ready for the Certifying Official's approval.                   
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| 78 | AUTHORIZED FISCAL USER MUST CHANGE STATUS OF BILL TO 'REFUND REVIEW'                    
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| 79 | Do you want to review the prepayment bill at this time                  
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| 80 | Do you want to change the status to 'REFUND REVIEW' at this time                        
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| 81 | Status Changed to 'REFUND REVIEW'                       
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| 82 | Do you want to make any adjustments to the refund amount now                    
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| 83 | Bill status is no longer REFUND REVIEW.  It has changed to                      
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| 84 | Do you want to send the refund to the certifying official for approval now                      
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| 85 | DUPLICATE AUTHORIZER!                   
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| 86 | UNAUTHORIZED TO SIGN AS CERTIFYING OFFICER                      
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| 87 | Sign as the 'REFUNDED BY' person                        
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| 88 | This refund must first be approved by the refunder.                     
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| 89 | If you sign as the 'Refunded By' person, you CANNOT                     
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| 90 | sign as the Certifying Officer.                 
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| 91 | REFUND AMOUNT OUT-OF-BALANCE!                   
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| 92 | DID NOT APPROVE REFUND                  
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| 93 |  <APPROVED BY REFUNDER>                 
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| 94 | REFUND APPROVAL SIGNATURES                      
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| 95 | Certifying Officer:                     
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| 96 |     Signed on:                  
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| 97 |  <APPROVED BY CERTIFYING OFFICER>                       
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| 98 | This Accounts Receivable doesn't have an excess payment !                       
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| 99 | Status Changed to 'CANCELLATION'                        
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| 100 | No other transactions may be made to the bill now.                      
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| 101 | THIS BILL NUMBER ENTRY IN FILE 430 IS CORRUPTED                 
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| 102 | NO PROCESSING CAN CONTINUE - SEE IRM                    
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| 103 | THIS DOCUMENT SEEMS TO HAVE ALREADY BEEN SENT TO FMS-                   
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| 104 | IT CANNOT BE RESENT UNLESS FMS REJECTS IT.                      
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| 105 | Creating an FMS Overcollection Payment Voucher . . .                    
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| 106 | THIS PATIENT DOES NOT HAVE A VALID ADDRESS.                     
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| 107 | AN FMS DOCUMENT CANNOT BE CREATED WITHOUT A VALID ADDRESS.                      
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| 108 | AN ENTRY WAS NOT MADE IN THE STACKER FILE.                      
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| 109 | PLEASE RE-SELECT THE BILL IN THE APPROVE OPTION.                        
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| 110 | AN AR DOC REF CANNOT BE CREATED BECAUSE THE FOLLOWING ERROR HAS OCCURRED -                      
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| 111 | Creating a REFUNDED transaction for bill number:                        
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| 112 |  . . .                  
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| 113 | Bill is now in REFUNDED status.                 
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| 114 | Is this a TOP Refund                    
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| 115 | Enter 'YES' only if this is a refund of a payment from TOP                      
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| 116 | There is no valid trace number entered for this debtor                  
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| 117 | Cannot process as TOP refund.                   
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| 118 | TOP REFUND DOCUMENT WILL BE SENT WITH NEXT TOP TRANSMISSION                     
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| 119 | THIS BILL HAS NOT BEEN APPROVED!                        
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| 120 | THIS DOCUMENT IS EITHER NOT READY FOR FMS OR HAS ALREADY BEEN ACCEPTED.                 
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| 121 | Select the output device:                       
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| 122 | REFUNDS PENDING CERTIFYING OFFICIAL'S APPROVAL                  
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| 123 | Press Return to continue or                     
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| 124 | REVIEWED DATE                   
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| 125 | Enter Transaction START Date:                   
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| 126 | Enter Transaction END Date:                     
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| 127 | Prepayment Posting Report                       
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| 128 | PAYMNT (FULL)                   
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| 129 | PAYMNT (PART)                   
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| 130 | **ERROR MESSAGE: Corresponding Transaction not found!                   
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| 131 | **ERROR MESSAGE: Unbalanced Transaction Amounts                 
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| 132 | * - Include the payment amount on an FMS ET document                    
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| 133 | Background Payment Posting from Prepayment Receivables                  
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| 134 | Reporting period:                       
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| 135 | Tran.                   
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| 136 | Corresponding                   
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| 137 | Tran. No.                       
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| 138 | NO REPAYMENT PLAN FOR THIS ACCOUNT.                     
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| 139 | NO PAYMENT DATA!                        
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| 140 | PRCA(                   
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| 141 | Repayment Plan Statement                        
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| 142 | THE DATE DOES NOT MATCH !, PLEASE CHECK REPAYMENT PROFILE.                      
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| 143 | Enter the date the statement was printed:                       
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| 144 | STATEMENT OF ACCOUNTS RECEIVABLE                        
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| 145 | DISTRIBUTION OF PAYMENT                 
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| 146 | | FILE NO./SSN                  
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| 147 | NAME OF PERSON ENTITLED                 
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| 148 | COLLECT.                        
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| 149 | | OF PAYMENT                    
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| 150 | | BALANCE DUE                   
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| 151 | | AFTER PAYMENT                 
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| 152 | BALANCE DUE SHOULD BE PAID IN FULL BY                   
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| 153 | TO AVOID ADDITIONAL CHARGES.                    
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| 154 | * Detach and return with your next payment to:                  
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| 155 |  FOR PROPER CREDIT TO YOUR ACCOUNT, PLEASE DETACH AND RETURN WITH YOUR PAYMENT                  
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| 156 |  |                          PAYMENT REMITTANCE                               |                  
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| 157 |  | *FILE NO/SSAN | NAME OF DEBTOR               | AMOUNT ENCLOSED   |TEL.NO  |                  
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| 158 |  | ENTER YOUR CURRENT ADDRESS BELOW ONLY IF THE ONE ABOVE IS INCORRECT.      |                  
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| 159 |  | PLEASE INCLUDE YOUR ZIP CODE.                                             |                  
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| 160 |  |                                                                           |                  
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| 161 |  | *PLEASE INCLUDE THIS NUMBER ON YOUR CHECK OR MONEY ORDER                  |                  
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| 162 | -1^PRCA004^AR Package 'busy' while trying to add transaction.                   
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| 163 | A decrease adjustment for bill #                        
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| 164 |  has been automatically                 
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| 165 | Automatic Adj:                  
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| 166 | ****** NOTICE: A decrease adjustment for bill #                 
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| 167 |  needs to be manually                   
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| 168 | Manual Adj:                     
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| 169 | applied in the amount of $                      
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| 170 | Please review bill for proper application of the unapplied amount of $                  
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| 171 | Data sent from Service                  
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| 172 |  Adjustment by:                         
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| 173 | Bill status is                  
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| 174 |  with a balance of $                    
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| 175 |  *WARNING*  There is outstanding administrative charges of $                    
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| 176 |             An adjustment of administrative charges MAY need to be done.                        
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| 177 | AutoAUTO                        
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| 178 | Auto Dec.:                      
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| 179 | THE ACCOUNT WILL BE INCOMPLETE.                 
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| 180 | *** APPROVED AND RELEASED TO ACCOUNTING ***                     
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| 181 |  ...Bill Number '                       
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| 182 | Your Electronic Signature Code is undefined.                    
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| 183 | Enter Electronic Signature Code:                        
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| 184 |     <Signature verified>                        
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| 185 |  <Signature Failed>                     
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| 186 | Enter in your Electronic Signature Code, 6 to 20 characters.                    
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| 187 | Type of care is missing                 
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| 188 | Type of care is not in expected format                  
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| 189 | Patient is missing                      
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| 190 | Patient is undefined                    
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| 191 | -1^2nd insurance company is undefined                   
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| 192 | -1^3rd insurance company is undefined                   
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| 193 |  is not in expected format                      
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| 194 | PRCA(430.3,                     
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| 195 | PRCA(430.2,                     
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| 196 | RCD(340,                        
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| 197 | INSURED NAME                    
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| 198 | INSURED SEX                     
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| 199 | M:MALE;F:FEMALE;U:UNKNOWN;                      
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| 200 | CERT SSN HIC ID NO.                     
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| 201 | EMPLOYEE ID NUMBER                      
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| 202 | EMPLOYER LOCATION                       
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| 203 | SECONDARY INSURANCE CARRIER                     
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| 204 | TERTIARY INSURANCE CARRIER                      
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| 205 | BILL RESULTING FROM                     
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| 206 | PRCA(430.6,                     
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| 207 | RNJ9,2X                 
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| 208 | TOTAL ORIGINAL AMOUNT                   
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| 209 | PRINCIPAL BALANCE                       
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| 210 | INTEREST BALANCE                        
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| 211 | ADMINISTRATIVE COST BALANCE                     
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| 212 | LAST INT/ADM CHARGE DATE                        
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| 213 | MRFX#                   
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| 214 | APPROPRIATION SYMBOL                    
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| 215 | RNJ9,2                  
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| 216 | FY ORIGINAL AMOUNT                      
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| 217 | CURRENT PRIN. BAL. FOR THIS FISCAL YEAR                 
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| 218 | RP430'X                 
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| 219 | PRCA(430,                       
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| 220 | TRANSACTION DATE                        
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| 221 | RP430.3'X                       
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| 222 | TRANSACTION TYPE                        
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| 223 | TRANS. AMOUNT                   
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| 224 | PROCESSED BY                    
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| 225 | APPROVING OFFICIAL (SERVICE)                    
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| 226 | RECEIVABLE CODE                 
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| 227 | 0:DEFAULT;1:FEDERAL;2:NON-FEDERAL;3:OWCP;                       
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| 228 | A/R Document Status Inquiry                     
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| 229 | Last Update:                    
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| 230 | DATE BILL PREPARED:                     
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| 231 | RECEIVABLE CODE:                        
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| 232 | BILL N0.:                       
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| 233 | TRANSACTION DATE:                       
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| 234 | TOTAL TRANS. AMOUNT:                    
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| 235 | IRS LOC. COST:                  
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| 236 | CREDIT REP.COST:                        
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| 237 | DMV LOC.COST:                   
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| 238 | CONSUMER REP.AGENCY COST:                       
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| 239 | MARSHAL FEE:                    
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| 240 | BILL NO.:                       
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| 241 | ADJUSTMENT AMOUNT:                      
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| 242 | ADJUSTMENT DATE:                        
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| 243 | ADJUSTMENT NO.:                         
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| 244 | ADJ.AMOUNT                      
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| 245 | PRIN.BAL.(ADJUSTED)                     
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| 246 | Brief Comment:                  
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| 247 | Follow-up Date:                         
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| 248 | TRANS.                  
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| 249 | TRANS.AMOUNT                    
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| 250 | PRIN.AMOUNT                     
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| 251 | CONTROL POINT:                  
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| 252 | APPROPR. SYMBOL                 
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| 253 | ALD CODE                        
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| 254 | BILL RESULTING FROM:                    
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| 255 | ABLE TO PAY:                    
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| 256 | ABLE TO LOCATE:                 
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| 257 | DMV LOCA. CHECK:                        
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| 258 | POSTAL LOC. DATE SENT:                  
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| 259 | POSTAL LOC. DATE REC'D:                 
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| 260 | IRS ABLE TO LOCATE:                     
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| 261 | IRS LOC. DATE SENT:                     
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| 262 | IRS LOC. DATE REC'D:                    
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| 263 | CREDIT REP. ABLE TO PAY:                        
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| 264 | CREDIT REPT. DATE SENT:                 
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| 265 | CREDIT REP. DATE REC'D:                 
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| 266 | PATIENT FOLDER REVIEWED:                        
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| 267 | DATE FOLDER REVIEWED:                   
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| 268 | LETTER1:                        
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| 269 |  ACCOUNTS RECEIVABLE PROFILE                    
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| 270 | CURRENT STATUS:                         
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| 271 | CP:                     
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| 272 | DATE BILL PREPARED:                     
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| 273 | TRANSACTIONS:                   
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| 274 |  MEANS TEST ACCOUNTS RECEIVABLE PROFILE                 
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| 275 | CARE:                   
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| 276 | FUND (APPROPRIATION):                   
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| 277 |  3RD PARTY ACCOUNTS RECEIVABLE PROFILE                  
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| 278 | TYPE OF CARE:                   
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| 279 | DATES OF SERVICE:                       
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| 280 | 3RD PARTY:                      
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| 281 | EMPLOYEE ID                     
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| 282 | SECONDARY INSURANCE COMPANY:                    
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| 283 | TERTIARY INSUANCE COMPANY:                      
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| 284 | << BILL RETURNED FROM AR >>                     
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| 285 | PAYER:                  
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| 286 | PREV. STATUS:                   
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| 287 | CURR. STATUS:                   
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| 288 | ORIGINAL AMOUNT:                        
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| 289 | SERVICE:                        
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| 290 | APPROV. BY:                     
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| 291 | RETN'D BY:                      
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| 292 | RETN'D REASON:                  
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| 293 | NEW ACCOUNTS RECEIVABLE                 
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| 294 | BILL NO.:                       
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| 295 | CATEGORY:                       
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| 296 | GL NO.:                 
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| 297 | SIGNATURE CODE:                 
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| 298 | TRANSACTION NO.:                        
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| 299 | CATEGORY:                       
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| 300 | TRANS.DATE:                     
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| 301 | TRANS.TYPE:                     
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| 302 | APPROP.SYMBOL                   
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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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