English French Notes Complete/Exclude (CLAIM LEVEL CLAIM ADJUSTMENT DATA) (CLAIM LEVEL MEDICARE INPATIENT ADJUDICATION DATA) (CLAIM LEVEL MEDICARE ADJUDICATION DATA) (CLAIM LEVEL MEDICARE ADJUDICATION DATA REMARKS) (CLAIM LEVEL SERVICE LINE DATA) (CLAIM LEVEL SERVICE LINE DATA (CONTINUED)) (CLAIM LEVEL SERVICE LINE ADJUSTMENT DATA) G.RCDPE PAYMENTS EXCEPTIONS An EEOB record for bill was transferred to ERA TRACE #: This message is to inform you this transfer was **** You must make the appropriate funds transfers manually Contact this site if the EEOB is not ACCEPTED or REJECTED in a timely manner Try another site or contact your IMPLEMENTATION MANAGER to reconcile this EDI LBOX TRANSFERRED EEOB POSTMASTER@FOC-AUSTIN.VA.GOV An electronic transmission ( ) has been received by the EDI Lockbox system that did not originate from the Austin system. This message WILL NOT be stored on your system and may be a breach of security. Please contact your IRM with the following information: The message was sent from The text received in the message is: EDI LBOX - ERA/EFT NOT FROM AUSTIN SELECT REPORT ENTER THE EARLIEST TRANSFERRED FROM/TO DATE TO INCLUDE ON THE REPORT ENTER THE LATEST TRANSFERRED FROM/TO DATE TO INCLUDE ON THE REPORT AR - EDI LOCKBOX TRANSFERRED EEOB REPORT RCDPE_TROUT RCDPE_TRIN NOT REC'D NOT ACCPTD ** THERE WERE NO EEOBs TRANSFERRED OUT WITHIN THE DATE RANGE SELECTED TOTAL # EEOBs NOT CONFIRMED AS 'RECEIVED' BY OTHER SITES: TOTAL # EEOBs STILL JUST 'RECEIVED' BY OTHER SITES: TOTAL # EEOBs ACCEPTED BY OTHER SITES: TOTAL # EEOBs NOT ACCEPTED BY OTHER SITES: ** THERE WERE NO EEOBs TRANSFERRED 'IN' WITHIN THE DATE RANGE SELECTED TOTAL # EEOBs YOU ACCEPTED: TOTAL # EEOBs STILL PENDING: EDI LOCKBOX EEOBs TRANSFERRED TRANS DT TRANS EEOB DATE Select EFT RECORD (Unmatched to an ERA): THIS ERA ALREADY HAS A RECEIPT - YOU MAY ONLY VIEW ITS SCRATCH PAD THIS ERA IS FROM CHAMPVA (HAC) - ARE YOU SURE YOU WANT TO CONTINUE?: NO WORKLIST SCRATCH PAD ENTRY EXISTS FOR THIS ERA DO YOU WANT TO CREATE ONE NOW?: PAYMENT METHOD CODE REPORTED: NO PAYMENT METHOD CODE REPORTED THIS ERA HAS NO PAYMENT ASSOCIATED WITH IT AND CAN BE MARKED AS 'MATCH-0 PAYMENT' TO REMOVE IT FROM THE ERA AGING REPORT IF NO PAPER CHECK OR EFT IS EXPECTED TO BE RECEIVED FOR THIS ERA DO NOT RESPOND YES HERE UNLESS YOU ARE SURE THRE WILL BE NO EFT OR PAPER CHECK TO BE RECEIVED FOR THIS 0-PAYMENT ERA DO YOU WANT TO DO THIS?: THIS ERA DOES NOT HAVE A MATCHING EFT ENTER THE NUMBER OF THE PAPER CHECK YOU RECEIVED FOR THIS ERA: THERE MUST EITHER BE A PAPER CHECK OR AN EFT FOR THIS ERA CHECK# ) MATCHED TO PAPER CHECK IS THIS CORRECT?: NO WORKLIST ENTRY EXISTS FOR THIS ERA - PRESS RETURN TO CONTINUE RCDPE EOB WORKLIST ERA Entry #: Payer Name/ID: Total Amt Pd: EFT #/TRACE #: PAPER CHECK #: *** RECEIPT ALREADY CREATED ( RCDPE-EOB_WLDX RCDPE-EOB_WL RC_SORTPARM RC_BILL THIS ACTION IS NOT AVAILABLE SINCE THE ERA ALREADY HAS A RECEIPT. SELECT PARAMETERS FOR SELECTING AN ERA ERA POSTING STATUS: ERA-EFT MATCH STATUS: LIMIT THE SELECTION TO A DATE RANGE WHEN THE ERA WAS RECEIVED?: EARLIEST DATE: LATEST DATE: SELECT THE ENTRY THAT HAS A LINE YOU NEED TO SPLIT/EDIT THIS ENTRY HAS NO LINES AVAILABLE TO EDIT/SPLIT Enter the line # that you want to split or edit: WHICH LINE OF ENTRY DO YOU WANT TO SPLIT/EDIT?: DOES NOT EXIST - TRY AGAIN HAS BEEN USED IN A DISTRIBUTE ADJ ACTION AND CAN'T BE EDITED RCDPE_SPLIT_REBLD INCLUDING EXPANDED DETAIL WILL SIGNIFICANTLY INCREASE THE SIZE OF THIS REPORT IF YOU CHOOSE TO INCLUDE IT, ALL PAYMENT DETAILS FOR EACH EEOB WILL BE LISTED. IF YOU WANT JUST SUMMARY DATA FOR EACH EEOB, DO NOT INCLUDE IT. DO YOU WANT TO INCLUDE EXPANDED EEOB DETAIL?: AR - Print ERA From Worklist RC_SUMRAW RC_SUMOUT RC_SUMALL **ERA LEVEL ADJUSTMENTS** **EXCEPTION RESOLUTION LOG DATA** EDI LOCKBOX WORKLIST - ERA DETAIL EEOB Seq # On ERA: Net Payment Amt: EEOB TRANSFERRED TO ***ADJUSTMENT AT ERA LEVEL *** ADJUSTMENT LINE FOR TOTALS MISMATCH Patient/Last 4: ***CLAIM NOT FOUND IN YOUR AR *** Billed Amt: Amt To Post: Claim Bal: Svc Dt: Rx Copay: Means Tst: Payment Amt: Total Adjustments: Receipt Comment: ADJUSTMENTS: Distributed adj dec for retraction Adjustment distribution to balance receipt: ERA payment adjusted from Non-specific payment (ref# Non-specific retraction (ref# REVIEW NOTES: (LAST REVIEW STATUS SET BY: RC_VALMBG AR - Print EEOB Detail from Worklist RC* PRCA_EOB1 ERA LEVEL ADJUSTMENT # ADJUSTMENT REFERENCE #: ADJUSTMENT REASON CODE: ADJUSTMENT AMOUNT: *** NOT IDENTIFIED IN A/R **** PRCA EDI LOCKBOX CHARGES YOU DO NOT HAVE THE KEY NEEDED TO ACCESS THIS OPTION. EDI LOCKBOX EEOB DETAIL FROM WORKLIST ERA NUMBER: ERA TRACE #: INS COMPANY: RETURN TO CONTINUE THIS BILL IS NOT IDENTIFIED IN YOUR A/R THIS FUNCTION IS NOT AVAILABLE ... RETURN TO CONTINUE THIS IS AN ERA LEVEL ADJUSTMENT - NO DATA EXISTS FOR IT IN YOUR AR RCDPE_EOB_SPLIT_OK YOU HAVE NOT FILED THESE CHANGES DO YOU WANT TO FILE THEM BEFORE YOU EXIT?: RCDPE_SPLIT_FILE RCDPE EOB RESEARCH THIS RECEIPT IS NOT ASSOCIATED WITH AN ERA RECORD - PRESS RETURN TO CONTINUE NO ERA WORKLIST EXISTS FOR THIS ERA - PRESS RETURN TO CONTINUE THIS ACTION NOT CURRENTLY AVAILABLE - PRESS RETURN TO CONTINUE RCDPE_SPLIT THIS IS AN ERA-LEVEL ADJUSTMENT - ONLY THE ADJUSTMENT COMMENT CAN BE EDITED NOTE: THIS LINE HAS AN ADJUSTMENT RECORD ASSOCIATED WITH IT RCDPE EOB WORKLIST SPLIT RCDPE_EOB_SPLIT RCDPE_EOB_SPLITDX **** TOTAL AMOUNTS ENTERED DO NOT MATCH THE ORIGINAL AMOUNTS **** (NOT IN A/R) ENTER THE CLAIM # TO WHICH THE PAYMENT OR ADJUSTMENT WILL BE APPLIED. THE CLAIM # DOES NOT HAVE TO EXIST IN YOUR AR IF THE PAYMENT/ADJUSTMENT BELONGS TO ANOTHER SITE. YOU MUST SPLIT THE ENTIRE AMOUNT OF THE LINE. PAYMENT IS LEFT ADJ IS LEFT DO YOU WANT TO ABORT THIS SPLIT NOW?: THIS CLAIM WAS NOT FOUND IN YOUR AR. DO YOU WANT TO CONTINUE?: >>Current claim balance is: SINCE THIS LINE HAS AN ADJUSTMENT, THE AMOUNT ENTERED HERE SHOULD BE THE CORRECTED AMOUNT THE PAYER INDICATED THEY SHOULD HAVE PAID FOR THE CLAIM ENTER THE AMT FROM THE PAYMENT TOTAL FOR THIS LINE ( THAT APPLIES TO THIS CLAIM. THE PAYMENT AMOUNT ALREADY USED FOR THIS LINE SPLIT IS: LEAVING A BALANCE TO DISTRIBUTE OF: THE TOTAL PAYMENTS ENTERED DURING THIS SPLIT MUST EQUAL THE ORIGINAL LINE PAYMENT AMOUNT OF $ PAYMENT AMOUNT TO APPLY TO THIS CLAIM: THIS LINE CONTAINS AN ADJUSTMENT AMOUNT OF $ THIS AMT IS USUALLY THE AMT THE PAYER PREVIOUSLY PAID ON A CLAIM WHICH THEY HAVE NOW AMENDED. IF THERE WAS AN AMT PREVIOUSLY PAID FOR THIS CLAIM, ENTER THAT AMOUNT AS A NEGATIVE AMOUNT HERE. ENTER THE AMT FROM THE ADJUSTMENT TOTAL FOR THIS LINE ( THAT APPLIES TO THIS CLAIM. THE ADJUSTMENT AMOUNT ALREADY USED FOR THIS LINE SPLIT IS LEAVING A BALANCE OF TO DISTRIBUTE ENTER IT AS THE NEGATIVE OF THE AMT THE PAYER PREVIOUSLY PAID ON THIS CLAIM THE TOTAL ADJUSTMENTS ENTERED DURING THIS SPLIT MUST EQUAL THE ORIGINAL LINE ADJUSTMENT AMOUNT OF $ RECEIPT LINE COMMENT: Comment will be deleted AND ADJUSTMENTS DO NOT MATCH THE ORIGINAL AMOUNT(s): ORIG PAY AMT: ORIG ADJ AMT: AMT ENTERED: AMT ENTERED: ;.05////0;.06////0;.09////RETRACTED FUNDS DEDUCTED FROM OTHER PAYMENT ON THIS ERA PROBLEM ADDING ADJUSTMENT - NO DISTRIBUTION PERFORMED THIS ERA ALREADY HAS A RECEIPT - - NO RECEIPT CREATED THIS ACTION WILL CREATE THE RECEIPT FOR THIS ERA. ONCE THE RECEIPT IS CREATED HERE, NO MORE AUTOMATIC ADJUSTMENTS MAY BE MADE FOR THIS ERA. ARE YOU SURE YOU ARE READY TO CREATE THIS RECEIPT?: NO RECEIPT CREATED - PRESS RETURN TO CONTINUE AT LEAST ONE LINE ITEM WAS FOUND WITH A NEGATIVE PAYMENT AMOUNT NO RECEIPT CAN BE CREATED - PRESS RETURN TO CONTINUE NO RECEIPT CAN BE CREATED - NO POSTABLE LINE ITEMS WERE FOUND A PROBLEM WAS ENCOUNTERED ADDING THE RECEIPT - NO RECEIPT ADDED THE FOLLOWING PROBLEMS OCCURRED WHILE ADDING THE RECEIPT: DO YOU WANT TO GO TO RECEIPT PROCESSING NOW? RECEIPT HAS BEEN CREATED FOR THIS ERA THE FOLLOWING LINES HAVE A NET PAYMENT LESS THAN 0. THESE LINES MUST HAVE THIS NEGATIVE AMOUNT DISTRIBUTED TO OTHER LINE(S) IN THE ERA BEFORE A RECEIPT CAN BE CREATED. RCDPE EOB RECEIPT PREVIEW RCDPE_EOB_PREVIEW Dec adj $ PAYMENTS (LINES FOR RECEIPT): ZERO DOLLAR PAYMENTS: LINES WITH NEGATIVE BALANCES STILL NEEDING TO BE DISTRIBUTED: TOTALS MISMATCH ADJ DO YOU WANT TO PRINT/VIEW THE ERA FIRST?: THIS IS NOT A VALID ACTION FOR AN ERA FROM HAC THIS WILL CREATE A RECEIPT THAT WILL MOVE THE FUNDS ($ FOR THIS ENTIRE ERA TO YOUR SUSPENSE ACCOUNT THIS WILL CREATE AND POST A RECEIPT FOR $0.00 FOR THIS ERA ***ALL POSTINGS TO A/R FOR ANY CLAIMS IN THIS ERA MUST BE DONE MANUALLY*** ENTER A 1-60 CHARACTER COMMENT TO BE PLACED ON THE RECEIPT: REF ERA #: NO ACTION TAKEN - RETURN TO CONTINUE: DO YOU WANT TO TURN DISPLAY REVIEW DATA ON?: NO LINES EXIST NEEDING ADJUSTMENT DISTRIBUTION NO VALID LINES EXIST ON THIS ERA WHERE A DISTRIBUTION CAN BE MADE SELECT A LINE THAT NEEDS AN ADJUSTMENT AMOUNT DISTRIBUTED: THE FOLLOWING LINE(S) HAVE AN ADJUSTMENT THAT CAUSED A NEGATIVE NET PAYMENT. IN ORDER TO BALANCE THE RECEIPT AND THE DEPOSIT, THESE AMOUNTS WILL NEED TO BE DISTRIBUTED TO OTHER LINE(S) THIS LINE DOES NOT EXIST FOR THIS ERA THIS LINE DOESN'T NEED AN ADJUSTMENT DISTRIBUTION PLEASE ENTER THE ENTIRE LINE # (Such as: 1.001) AMOUNT NEEDED TO DISTRIBUTE: THE ERA DOES NOT HAVE ENOUGH VALID PAYMENTS TO OFFSET THIS DISTRIBUTION SELECT A LINE TO DISTRIBUTE THE ADJUSTMENT AMOUNT TO: THE FOLLOWING LINE(S) HAVE A NET PAYMENT THAT CAN BE USED TO OFFSET THE NEGATIVE NET PAYMENT FOR LINE On hold exists THIS LINE CANNOT BE USED FOR AN ADJUSTMENT DISTRIBUTION Warning - on-hold exists for this claim LINE BALANCE: THE LINE SELECTED IS AN ADDITIONAL PAYMENT LINE, NOT SPECIFIC TO A CLAIM THE AMT WILL BE DISTRIBUTED, BUT A DECREASE ADJUSTMENT WILL NOT BE PERFORMED ADJUSTMENT AMOUNT TO DISTRIBUTE: THIS IS THE AMOUNT OF THE ADJUSTMENT THAT SHOULD BE APPLIED TO THIS PAYMENT LINE. THE AMT ENTERED MUST BE BETWEEN .01 AND NO AMOUNT WAS ENTERED - TRY AGAIN LATER USER ABORT - PRESS RETURN TO CONTINUE DECREASE ADJ COMMENT (1-60 CHARACTERS): RETRACTED FOR ERA ADJ # CLAIM THIS ACTION WILL DELETE AND REBUILD THIS EEOB WORKLIST SCRATCH PAD ENTRY ALL EDITS/SPLITS/ADJUSTMENTS PREVIOUSLY ENTERED FOR THIS ERA WILL BE ERASED ARE YOU SURE YOU WANT TO DO THIS?: THIS ERA MUST BE MOVED TO SUSPENSE THIS ERA'S RECEIPT MUST BE ENTERED MANUALLY DECREASE ADJUSTMENT TYPE OF ADJUSTMENT: Claim balance is now: PLEASE NOTE: This will not be reflected in the worklist until the worklist is closed and reopened TOTALS MISMATCH^^ TOTALS MISMATCH ORDER OF PAYMENTS: THIS DEPOSIT WAS OPENED MORE THAN ONE WEEK AGO ( ARE YOU SURE YOU WANT TO USE THIS DEPOSIT?: is no longer in exception file This record has already been scheduled for update. Task # is: This message has an invalid 'type' - can't update File update has been tasked (# File update could not be tasked. Please try again later!!! DO YOU WANT TO INCLUDE DATA THE WAY IT WAS RECEIVED (RAW DATA)?: AR - Print EEOB Exception Message **EXCEPTION MESSAGES** **RAW DATA** RCDPEX-EOBDX This action will PERMANENTLY delete an EDI Lockbox message from your system * This EDI Lockbox message is about to be PERMANENTLY deleted!! * RAW MESSAGE DATA: ARE YOU DELETING THIS BECAUSE THE EEOB DOES NOT BELONG TO YOUR SITE?: IF YOU RESPOND YES TO THIS QUESTION, A REJECT MESSAGE WILL BE SENT BACK TO THE SENDING SITE FOR THIS EEOB Electronic EDI Lockbox message EDI LBOX MESSAGE DELETED UPDATE DATA BASE FROM EEOB EXCEPTION PROCESSING Another user is editing this entry ... please try again later #################### #################### #################### #################### #################### #################### #################### #################### #################### #################### #################### #################### #################### #################### ####################