English	French	Notes	Complete/Exclude
TRANSMIT OVERDUE ABSENCE BULLETIN			
Y - To search for inpatients overdue from AA, UA and PASS and transmit			
bulletin to select mailgroup.			
N - If you don't wish to search for overdue absences.			
OVERDUE ABSENCES AS OF 			
  ...BACKGROUND SEARCH QUEUED!!			
Select AMIS 334-341 MONTH/YEAR: 			
Results already exist for this month. Do you wish to recalculate			
Enter 'YES' to recalculate monthly totals, or 'NO' to print.			
Beginning			
End			
 of month statistics are missing for ward 			
Ward not included in AMIS 			
AMIS 			
INTERMEDIATE MEDICINE			
REHABILITATION MED			
BLIND REHABILITATION			
SPINAL CORD INJURY			
FOR THIS SEGMENT FIELDS SHOULD BALANCE AS FOLLOWS:			
Fields 009 and 010 prior period plus 001,002,003 current period			
less fields 004 thru 008 current period must equal fields			
009 and 010 current period.			
*** This segment 			
has Not been Balanced			
is Out of Balance			
Press RETURN to continue or '^' to stop 			
Select AMIS 345-346 MONTH/YEAR: 			
NURSING HOME			
less fields 005 thru 008 current period must equal fields			
No admissions on file, will check scheduled admissions			
Since an admission was not chosen, scheduled admissions for this patient will be checked			
No scheduled admissions on file			
This report requires 132 column output			
NO ADDRESS ON FILE			
PRINT THIRD PARTY REVIEW			
YES - If you wish to print Third Party Review Sheet			
NO  - If you don't want to print Third Party Review Sheet			
Beneficiary Travel Claim Information <Screen 1>			
Claim Date: 			
PT ID: 			
Address: 			
SC%: 			
 Other Elig.: 			
Disabilities:			
Income: 			
Source of Income:  			
MEANS TEST			
COPAY TEST			
INCOME SCREENING			
VA CHECK			
No. of Dependents: 			
MT Status: 			
 NOT APPLICABLE			
MEANS TEST 			
BT Income: 			
NOT RECORDED			
Certified Eligible: 			
Date Certified: 			
* * * NOTE * * PATIENT HAS BEEN CERTIFIED INELIGIBLE BASED ON INCOME			
 * * * * Discrepancy exists in incomes reported, please verify * * * *			
VERSION 1.0 OF BENEFICIARY TRAVEL HAS NOT BEEN LOADED.			
>> Environment check complete and okay.			
   Updating PACKAGE File...			
  No PACKAGE entry defined - Cannot update!			
     Updating PACKAGE file complete.			
Re-indexing 'BB' cross-reference.			
Beneficiary Travel			
     SHORT DESCRIPTION field complete.			
     DESCRIPTION field complete.			
     FILE field complete.			
     FIELD field complete.			
VERSION 5.3 OF REGISTRATION HAS NOT BEEN LOADED.			
BENEFICIARY TRAVEL			
REGISTRATION PACKAGE HAS NOT BEEN FOUND			
CONTACT - PIMS National VISTA Support Team for assistance!			
Visits For: 			
 * * * * ADMITTED ON THIS DATE * * * *			
 * * * * DISCHARGED ON THIS DATE * * * *			
 * * * * CURRENTLY AN INPATIENT * * * *			
 * * * INPATIENT STATUS * * *			
 Admitted On: 			
Ward Location: 			
Discharge Date: 			
Appointments: 			
NONE RECORDED FOR THIS DATE			
PATIENT/DATE			
Elig for Visit:			
Appt Type:			
Clinic Stop: 			
NO-SHOW			
Past Claims: NONE RECORDED			
Date/Time			
Account			
Deductible			
Amt. Paid			
Past Claims: 			
>> WARNING! No ACCOUNT TYPE for this claim, Please correct through Claim Enter/Edit!			
Beneficiary Travel Claim Information <Display>			
 Depart From: 			
To: 			
Cert. Date: 			
Account: 			
REVIEW VISIT			
Most Econ. Cost: 			
Attend/Payee: 			
Meals & Lodging: 			
One Way/			
CoreFLS			
Carrier			
CoreFLS Carrier: 			
Carrier: 			
Ferry, Bridges, Etc.: 			
Round Trip: 			
ONE WAY			
ROUND TRIP			
Auth. Person: 			
Total Mileage Amount: 			
Mileage/			
Applied Deductible: 			
One Way: 			
Amount Payable: 			
Remarks: 			
MILEAGE REMARKS: 			
;@9;9;S DGBTDE=X S:DGBTDE>DGBTTC DGBTDE=DGBTTC,DGBTFLAG=2 S:DGBTDE>DGBTDRM DGBTDE=DGBTDRM,DGBTFLAG=1			
 DEDUCTIBLE AMOUNT HAS BEEN CHANGED 			
DEDUCTIBLE AMOUNT CAN NOT EXCEED THE TOTAL COSTS FOR THIS CLAIM			
DEDUCTIBLE FOR THIS CLAIM CAN NOT EXCEED THE AMOUNT REMAINING FOR THIS MONTH			
This needs to be printed at 132 columns			
, DESIGNEE OF CERTIFYING OFFICIAL			
VA FORM 70-3542d			
TASK #			
|  VOUCHER FOR CASH REIMBURSEMENT OF BENEFICIARY TRAVEL EXPENSES |			
| 2.  Name and Address of Issuing Health Care Facility			
  1.  Patient Data Card Information			
| 3.  Fiscal Symbols			
| 4.  From (Place of Departure)			
| 6.  Miles Traveled			
| 7.  Authorized Mileage Rate:			
| 8.  Mileage Allowance (Item 6 X Item 7)			
 per mile			
| 9.  Meals & Lodging Costs   |			
| 11.  Total (Sum of 8, 9, and 10)			
| 12.  Most Economical			
| 13.  Total (Sum of 9 and 12)			
| 14.  AMOUNT CLAIMED AND PAYABLE *			
|      Public Trans. Costs			
 APPLIED DEDUCTIBLE			
| * The amount payable will be the amount entered in Item 11 or Item 13, whichever is less.  Exception:  If public transportation			
|   is not reasonably accessible or would be medically inadvisable, the amount payable will be the amount entered in item 11.			
|  I CERTIFY THAT THE CLAIMANT REPORTED FOR AN AUTHORIZED SERVICE ON THE DATE SHOWN.  (Authority VA Regulation 6100 & PL 100-322)			
| 15.  Date/Time of Claim			
| 16.  Signature of Certifying Official			
|  I have neither obtained transportation at Government expense nor through the use of Government request, tickets, or tokens;			
|  and have not used any Government-owned conveyance or incurred any expenses which may be presented as charges against the			
|  Dept. of Veterans Affairs for transportation, meals, or lodging in connection with my authorized travel that is not herein			
|  claimed.  I hereby claim the amount entered in Item 14 above.  I certify that the claim is correct and just and that payment			
|  has not been received.			
|  I hereby acknowledge receipt, in  cash  or  check to be mailed, of the amount in Item 14 above, in full payment of this claim.			
| 17.  Signature of Payee			
REMARKS:  			
ACCOUNT: 			
  REVIEW VISIT			
AUDIT BLOCK			
AMOUNT PAID FOUND CORRECT			
Auditor's Initials			
VA Form 70-3542d			
DO YOU WANT TO QUERY CoreFLS FOR A VENDOR			
SITE_CODE			
** COMMUNICATIONS SERVICE LIBRARY (CSL) PACKAGE NOT INSTALLED **			
** CoreFLS national database query **			
** LOCAL VENDOR (#392.31) File updated. **			
Unsuccessful Query!			
** CoreFLS Query **			
**COREFLS Vendor interface is not active.			
No Problems were found in the Distance Data.			
Enter Departure City			
Enter the name for the departure city			
Name must be free text, 1-30 characters in length			
FILE IN USE, PLEASE TRY AGAIN LATER			
Enter another division for this departure city			
Enter a 'Y'es to add or enter another division, or 'N'o to exit to the Departure City prompt			
CITY OR TOWN			
THE MILEAGE FOR THE SELECTED DIVISION WILL BE USED AS THE			
DEFAULT MILEAGE FOR THIS DEPARTURE CITY.			
Enter the CITY as the point of origin.  The MILEAGE/ONE-WAY			
is the distance from the CITY to the Medical Center Division.			
INCOMPLETE INFORMATION WAS ENTERED, BOTH THE STATE AND ZIP CODE			
ARE REQUIRED, RECORD DELETED			
You can either correct these problems, or add a new departure city.			
CORRECT PROBLEMS			
***WARNING...MEDICAL CENTER DIVISION FILE IS NOT SET UP			
>> ONE OR MORE ADDITIONAL INFORMATION FIELDS NEED TO BE COMPLETED			
>> ONE OR MORE ZIP CODES ARE MISSING			
>> ONE OR MORE DEFAULT MILEAGES ARE MISSING OR SET TO ZERO			
WARNING...MEDICAL CENTER DIVISION FILE IS NOT SET UP			
USE THE ADT PARAMETER OPTION FILE TO SET UP DIVISION			
Select DIVISION: 			
***WARNING...BENE TRAVEL PARAMETERS HAVE NOT BEEN SET UP			
USE THE BENEFICIARY TRAVEL PARAMETER RATES ENTER/EDIT OPTION TO PROPERLY INITIALIZE			
Eligibility is missing from registration and is required to continue.			
Continue processing claim			
Sorry, enter 'Y'es or RETURN to continue procesing claim, 'N'o to exit			
Complete claim for 			
SORRY, '^' NOT ALLOWED			
ENTER 'Y'ES OR 'N'O			
INSTITUTION HAS NOT BEEN DEFINED FOR 			
USE THE ADT PARAMETER OPTION TO UPDATE			
INSTITUTION ADDRESS NOT ENTERED.  PLEASE UPDATE USING THE INSTITUTION FILE ENTER/EDIT			
Enter a 'P' to display Past CLAIM dates for editing.			
Time is required when adding a new CLAIM.			
Select TRAVEL CLAIM DATE/TIME			
There are other claims on this date.			
Select by number to edit or <RETURN> to add a new CLAIM.			
Select 1			
, or <RETURN> to add a new claim: 			
Select, by number, one of the displayed claim dates: 			
Are you sure you want to add a new claim			
Enter 'YES' to add a new claim, or 'NO' not to add the claim.			
There are no entries on file for this patient			
Select CLAIM			
Type '^' to exit date list, or <RETURN> to display more dates			
Entering a '^' will exit the Past CLAIM list, entering <RETURN> will continue to scroll through past dates.			
Select a Past CLAIM date by number, or enter 'N' for NOW.			
INVALID ENTRY!			
Time is required when adding a new CLAIM date.			
If there is more than one claim per date, select by number to edit.			
Please wait, Checking Mileage ...			
DEFAULT MILEAGE USED			
Module has not been properly initialized - to continue you should first complete			
the parameters			
Beneficiary Travel Claim Information <Enter/Edit>			
Another user is editing this entry.			
Select ELIGIBILITY			
SORRY, '^' NOT ALLOWED!!			
ELIGIBILITY REQUIRED.			
Choose by NUMBER the primary eligibility or other entitled eligibilities			
Choose 1-			
Enter choice from those displayed			
Select ELIGIBILITY: 			
Select ACCOUNT: 			
ACCOUNT IS REQUIRED!!			
;9;S DGBTDE=X S:DGBTDE>DGBTTC DGBTDE=DGBTTC,DGBTFlAG=2 S:DGBTDE>DGBTDRM DGBTDE=DGBTDRM,DGBTFLAG=1			
Primary and other entitled eligibilities for patient:			
Last Certification: 			
Eligible: 			
Amount Certified: 			
'A'DD A NEW DATE, 'E'DIT EXISTING OR 'Q'UIT: 			
ENTER    A - to 'A'dd a new certification date			
E - to 'E'dit an existing entry for this patient			
Select CERTIFICATION DATE: 			
There is already a certification for 			
Only one certification per date is necessary.			
REPORTED MEANS TEST INCOME: 			
There are no computer entries on file for this patient.			
Enter the date of annual certification.			
Time is required when adding a new certification date.			
Future dates are not allowed.			
New travel rates are determined each fiscal year.  The rates should be			
entered each year with the effective date of Oct 1.			
Changing values for the current or past fiscal years could result in changes			
to the claims already entered.			
Select EFFECTIVE DATE			
ACCOUNT TYPES are determined by Fiscal Service and have a direct impact			
on the type of questions asked in the Beneficiary Travel CLAIM ENTER/EDIT			
DO NOT add to this file unless so instructed by Fiscal Service.			
Select ACCOUNT			
You are about to enter/edit Bene Travel account types.  Although			
this process is now decentralized, changes and additions should be			
made with extreme care.			
Would you like to Enter/Edit another ACCOUNT			
ENTER DEDUCTIBLE AMOUNT/			
Type a dollar amount between 0 and 			
 with up to 2 decimal places.			
  -- Deductible exceeds limit.			
The effective date must start on the fiscal year, Oct 1.			
<I>nformation, <D>isplay claim, <E>dit claim,			
 <P>rint form,			
Quit			
Do you want to delete this claim			
This claim is incomplete and is now being deleted.....			
You may choose from the following: 			
<I>nformation - to view the two informational screens			
<D>isplay - to view this claim			
<E>d it - to change this claim			
<P>rint - to print form 70-3542d (132 columns)			
<Q>uit - to exit from this option			
ADD:			
PH:			
NO:			
FAX:			
****THIS VENDOR IS INACTIVE			
INTERN'L			
Enter beginning date: 			
Enter ending date: 			
The ending date cannot be before the beginning date			
Future dates are not allowed			
Sort output by: 			
Select one from the above list			
Sort Bene Travel claims by one of the following:			
   A for Account			
   C for Carrier			
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