English	French	Notes	Complete/Exclude
WAITING SINCE			
MAIL MESSAGE #			
MINIMUM # OF DAYS MSGS WAITING TO BE FILED: 			
Enter the minimum number of days a message has been waiting to be filed			
before it appears on this report			
REPORT OF EDI MSGS PENDING TOO LONG TO BE FILED			
TOTAL # OF MESSAGES WAITING OVER 			
 TO BE FILED: 			
EDI MESSAGES WAITING TO BE FILED OVER 			
MESSAGE TYPE			
IN CURRENT			
MESSAGE #			
STATUS SINCE			
DO YOU WANT TO INCLUDE A LIST OF BILLS WITH EACH BATCH?: 			
Enter the first 10-digit batch number you want included on the report			
Start with BATCH #: 			
Must enter a 10-digit batch #			
Enter the last 10-digit batch number you want included on the report			
Go to BATCH #: 			
Enter the first date you want to include on the report			
Start with LAST TRANSMIT DATE: 			
Must enter a valid date			
Enter the last date you want to include on the report			
Go to LAST TRANSMIT DATE: 			
Select BATCH STATUS: 			
EDI 837 BATCH DETAIL LIST			
Rejected?: 			
Resubmit: 			
 Batch Type : 			
Mail Msg: 			
 Received in Austin?: 			
 Status Date: 			
Date Recorded: 			
 First Sent : 			
 Last Sent  : 			
Number    Transmit Status            Resubmit Batch #			
* = NOT RESUBMITTED			
Number    Transmit Status			
            Resubmit Batch #			
BATCH DETAIL LIST			
This report provides a list of claims held in a			
Ready for Extract status.  Users can select all bills			
in a Ready for extract status or only those trapped due to			
the EDI Parameters being turned off.			
This report requires a 132 column printer.			
IB - EDI Claims in Waiting Transmission Status			
Your task number			
 has been queued.			
There are no EDI records			
 in a ready for extract status			
Total EDI Bills 			
Total MRA Bills 			
Total bills 			
Your EDI site parameter setting is incomplete.			
Please contact your coordinator.			
Your site parameters are set to allow EDI transmissions			
There is no need to run this report.			
Trapped 			
 Claims Ready for Extract			
Inpt/			
Inst/			
Opt			
Prof			
Statement Date			
Do you want to print a list of:			
     1 - All bills in Ready for Extract status			
     2 - Bills trapped due to EDI paramater being turned off			
IB - EDI/MRA Claims in Rescue Process			
There are no records to print			
Claims in Rescue Process			
Stmt Date			
Ins Co.			
IB-HOLD			
IBCE ELEC REPORT DISP			
IBREP DISP			
IBREP DISP1			
No reports available for dispositioning			
REPORT: 			
RACUBOTH RUCH			
EDI RETURN MESSAGE ROUTER ERROR			
             Return Message Code: 			
Return Message Date: 			
    Message Time: 			
Update Date: 			
     Update Time: 			
Return Message File #(s): 			
Mailman Message #: 			
cannot be determined			
Msg Line: 			
Return Message Text:			
ERROR+			
S.IBCE MESSAGES SERVER			
***  NEW PAGE  ***			
*** END OF PAGE ***			
I:G.IB EDI SUPERVISOR			
Status message received for batch 			
PAYID=			
PAYER ID RETURNED IS DIFFERENT THAN PAYER ID ON FILE			
BILL #     : 			
PAYER      : 			
BILL TYPE  : 			
ID ON FILE : 			
ID RETURNED: 			
   Please determine which id number is correct and correct the id in the			
insurance file for this payer, if needed			
 ALREADY EXISTS - CAN'T HAVE BOTH ON ONE BILL			
IBA(355.93			
N-CURRENT INS POLICY TYPE			
Another user has locked this record - try again later			
ONLY SELECT TO CLOSE THE TRANSMIT RECORDS IF YOU KNOW THESE ARE THE FINAL			
  ELECTRONIC MESSAGES YOU WILL RECEIVE FOR ALL THE BILLS REFERENCED BY			
  THESE MESSAGES			
DO YOU WANT TO AUTOMATICALLY CLOSE THE TRANSMIT RECORDS FOR ANY MESSAGES			
 THAT AREN'T REJECTS?: 			
DO YOU WANT TO SEE EACH MESSAGE BEFORE MARKING IT REVIEWED?: 			
IF YOU OPT TO SEE EACH MESSAGE, YOU CAN CONTROL WHETHER OR NOT THE MESSAGE			
  IS MARKED AS REVIEWED			
 AND, FOR NON-REJECTS, WHETHER OR NOT TO CLOSE THE			
  TRANSMIT RECORD FOR THE BILL			
OK TO MARK REVIEWED?: 			
IF YOU ENTER YES, THIS MESSAGE WILL BE MARKED REVIEWED			
IF YOU ENTER NO, THIS MESSAGE WILL NOT BE ALTERED			
IF YOU ENTER AN ^, THIS MESSAGE WILL NOT BE ALTERED & NONE OF THE			
   REMAINING MESSAGES WILL BE PROCESSED			
OK TO CLOSE THIS BILL'S TRANSMIT RECORD?: 			
THIS IS A REJECTION ... ARE YOU SURE YOU WANT TO MARK IT REVIEWED?: 			
   MESSAGES FOLLOWING THIS ONE WILL BE PROCESSED			
CLAIM SENT TO PAYER			
CLAIM REJECTED			
Seq #: 			
  Bill number: 			
LAST SELECTION PROCESSED			
N-PRIOR PAYMENTS			
 PRINT CENTER			
N-PATIENT STATUS			
N-SOURCE OF ADMISSION			
N-OTH INSURANCE PRIOR PAYMENT			
N-EOB ENTRIES			
Adding occurrence code 24 and primary insurance rejection date to bill			
Adding value code			
 for reporting of bill's prior payments			
N-CURR INSURED DEMOGRAPHICS			
N-OTH INSURED DEMOGRAPHICS			
Adding occurrence code '			
 insurance subscriber's date of birth			
N-DATE LAST SEEN			
Date Last Seen:			
N-REFERRING PROVIDER ID			
Homebound			
N-ASSIGN OF BENEFITS INDICATOR			
Nn0			
Patient refuses to assign benefits			
NOC Drug:			
Testing for hearing aid			
Attending physician,not hospice employee			
Last Xray:			
Level of Sublux:			
N-SPECIAL PROGRAM			
Medicare demonstration project for lung volume reduction surgery study			
N-HCFA 1500 BOX 19 RAW DATA			
N-BILL REMARKS			
DISPLAY THE FULL HCFA 1500 BOX 19?: 			
Bill: 			
VARIABLE TO DISPLAY (IBXDATA): 			
BAD VARIABLE NAME			
   *** NO DATA TO DISPLAY			
Remember to run this for flds that set up pre-requisite data (if any) first			
Form Field: 			
N-SPECIALTY CODE			
N-ALL PROVIDERS			
PRV-82			
DEPT OF VETERANS AFFAIRS			
SELECT 1-			
Enter your selection for procedure from 1 to 			
There were more than 			
 matches found.  Please try again with more specific input			
N-ATT/REND PROVIDER ID			
  WANT TO CHANGE THE 			
 PROVIDER'S FUNCTION TO 			
IF YOU ANSWER YES HERE, YOU WILL MAKE THE PROVIDER FUNCTIONS CONSISTENT			
  WITH THE FORM TYPE OF THE BILL			
 FUNCTION DOES NOT BELONG ON THIS BILL TYPE & MUST BE DELETED			
This bill is 			
The valid provider functions for this bill are:			
 - ALREADY ON BILL			
 - NOT ON BILL			
Select Rx for this charge: 			
Enter an Rx# for this revenue code			
 The Rx must not already have an associated revenue code			
PROCEDURE #			
 HAS BEEN ASSOCIATED WITH THIS MANUAL CHARGE			
Respond YES if this revenue code charge specifically references the data for			
  a particular procedure that was manually entered on the previous screen.			
  For outpatient UB92 bills, associating a manual revenue code charge with			
  a procedure is the only way to print a modifier in box 44			
SHOULD A PROCEDURE ENTRY BE ASSOCIATED WITH THIS CHARGE?: 			
Respond YES if you no longer want this revenue code charge to reference a			
  specific manually entered procedure			
DELETE THE EXISTING PROCEDURE ASSOCIATION?: 			
SELECT A PROCEDURE ENTRY: 			
Enter a manually-added CPT procedure to associate with this charge			
IBCE EXTR STATUS MANAGEMENT			
Claims in need of rescue process			
This function is not necessary.			
No records trapped in a Ready for Extract status found			
Authorizing bill...			
This option will display the EDI extract data for a bill.			
There is no entry in the EDI Transmit Bill file for this bill number.			
There is no batch # for this bill.  It has not been transmitted.			
INCLUDE FIELDS WITH NO DATA?: 			
Transmitted Bill Extract Data			
Your task number 			
Inpt			
Oupt			
  (NO DATA - RECORD NOT SENT)			
EDI Transmitted Bill Extract Data			
UB-82			
FOLLOW-UP AR FORM 			
BILL ADDENDUM FOR 			
BILL FORM TYPE NOT COMPLETE FOR			
QUEUEING OF 			
DG*			
*** COPY OF ORIGINAL BILL ***			
*** SECOND NOTICE ***			
*** THIRD NOTICE ***			
MEDICARE ESRD			
IB-RC			
Dept. Veterans Affairs			
Bill Type: 			
INPATIENT CARE			
ADDITIONAL PROCEDURE CODES:			
LESS 			
OP VISIT DATE(S) BILLED              			
MISSING INPUT VARIABLES			
BILL NON-EXISTANT			
BILL CANCELLED			
BILL STATUS INAPPROPRIATE			
For your information, even though the patient may be otherwise eligible			
for Medicare, no payment may be made under Medicare to any Federal provider			
of medical care or services and may not be used as a reason for non-payment.			
Please make your check payable to the Department of Veterans Affairs and			
send to the address listed above.			
The undersigned certifies that treatment rendered is not for a			
service connected disability.			
IBCF1TP-1			
IB - TEST UB-82 PRINT			
IBCF1TP-2			
*** UB-82 TEST PATTERN ***			
AGENT CASHIER			
AGENT CASHIER STREET			
CITY STATE  ZIP			
PHONE #			
BC/BS #			
FED TAX #			
PATIENT ADDRESS			
PT DOB			
ADM DT			
MAILING ADDRESS NAME			
STREET ADDRESS 1			
STREET ADDRESS 3			
000 DAYS MEDICAL CARE			
REV CODE 			
PAYER 			
INSURED NAME 			
POLICY # 			
GROUP NAME 			
GROUP # 			
EMPLOYER NAME			
CITY  STATE  ZIP			
PRINCIPAL DIAGNOSIS			
PRINCIPAL PROCEDURE			
TX. AUTH.			
XXXX XXXXXXX			
UB-82 TEST PATTERN			
**TEST PATTERN**			
UB-82 SIGNER NAME			
UB-82 SIGNER TITLE			
PRINT HCFA1500			
N-PRINT BILL SUBMIT STATUS			
ONSET OF SYMPTOMS/ILLNESS			
PUBLIC LAW 99-272/SECTION 1729 TITLE 38			
PUBLIC LAW 99-272			
Dept. Of Veterans Affairs			
THE UNDERSIGNED CERTIFIES TREATMENT IS NOT FOR A SERVICE-CONNECTED CONDITION			
proc^division^basc flag^bedsection^rev code^unit chrg^Rx seq #			
proc^division^basc flag^dx^pos^tos^modifier^unit chrg^Rx seq #			
proc^division^basc^dx^pos^tos^modifier(s)^unit chrg^purchased chg			
AUX-X			
not for SC			
IBCF2TP-1			
IB - TEST HCFA 1500 PRINT			
IBCF2TP-2			
INSURANCE CARRIER NAME			
CARRIER ADDRESS LINE 1			
CARRIER ADDRESS LINE 2			
CARRIER ADDRESS LINE 3			
CARRIER CITY, STATE ZIP			
SUBSCRIBER ID#			
MM DD YY			
INSURED'S NAME			
PATIENT ADDRESS STREET			
####################	####################	####################	
####################	####################	####################	
####################	####################	####################	
####################	####################	####################	
####################	####################	####################	
