English	French	Notes	Complete/Exclude
Review Status: 			
Insurance Seq: 			
Last Edited : 			
Last Edit By : 			
New Pat. Nm.: 			
New Pat. Id  : 			
PAYER INFORMATION:			
Payer Name   : 			
Payer Id    : 			
ICN          : 			
Cross Ovr ID : 			
Cross Ovr Nm: 			
CLAIM LEVEL PAY STATUS:			
Tot Submitted Chrg: 			
Covered Amt       : 			
Payer Paid Amt    : 			
Patient Resp. Amt : 			
Discount Amt      : 			
Per Day Limit Amt : 			
Tax Amt           : 			
Tot Before Tax Amt: 			
Total Allowed Amt : 			
Negative Reimb Amt: 			
Discharge Fraction: 			
DRG Code Used     :			
DRG Weight Used   :			
Reimburse Rate    : 			
HCPCS Pay Amt     : 			
Esrd Paid Amt     : 			
Non-Pay Prof Comp : 			
CLAIM LEVEL ADJUSTMENTS:			
 GROUP CODE: 			
REASON CODE: 			
REVIEW DATA:			
  REVIEW DATE/TIME: 			
 **A/R CORRECTED PAYMENT DATA:			
   TOTAL AMT PD: 			
N-ALL INSURED PT RELATION			
Pt. Relation : 			
N-ALL INSURED FULL NAMES			
Insured Name: 			
N-ALL INSURANCE NUMBER			
Insured ID  			
FLD NAME			
Invalid entry #			
 Field not found!!			
N-STATEMENT COVERS FROM DATE			
DIC(81.3			
N-UB92 LOCATION OF CARE			
N-UB92 BILL CLASSIFICATION			
N-UB92 TIMEFRAME OF BILL			
LM-UB			
Warning:** REV CODE UNITS < #PROCEDURES, THEY MUST BE =			
Warning:** REV CODE UNITS > #PROCEDURES, THEY MUST BE=: 			
Rx#			
RX: 			
NDC: 			
NOC: 			
**** ERROR - NO PROC LINK TO REV CODE FOR DRUG: RX#: 			
DX-E			
OFFSET AMOUNT: 			
Prosthetic: 			
RX-UB92			
PRESCRIPTION REFILLS:			
 days supply 			
NDC #: 			
PROS-UB92			
PROSTHETIC REFILLS:			
NON-SERV			
FILE LOCKED ... TRY AGAIN LATER			
New Rule's TYPE OF RULE: 			
YOU ARE ADDING A RULE THAT WILL ONLY ALLOW THE TRANSMISSION OF BILLS WHOSE			
  FORM TYPE IS INCLUDED IN THIS RULE.			
New Rule's TRANSMISSION TYPE: 			
APPLY RULE ONLY TO BILLS THAT ARE (I)NSTITUTIONAL, (P)ROFESSIONAL, OR (B)OTH: 			
ONLY TRANSMIT (I)NSTITUTIONAL, (P)ROFESSIONAL, OR (B)OTH: 			
APPLY RULE ONLY TO BILLS THAT ARE (I)NPATIENT, (O)UTPATIENT, OR (B)OTH: 			
THIS RULE WILL ONLY APPLY TO BILLS THAT MATCH ALL OF THE FOLLOWING CONDITIONS:			
BILL IS 			
AN 			
EITHER AN EDI OR MRA			
 BILL AND IS ALSO 			
AN INSTITUTIONAL^A PROFESSIONAL			
EITHER A PROFESSIONAL OR INSTITUTIONAL			
AND 			
IS ALSO AN 			
IS EITHER AN INPATIENT OR OUTPATIENT			
NOTE: RULE WILL BE IGNORED FOR ANY BILLS THAT DO NOT MATCH ALL THE CONDITIONS			
BILL IS AN MRA BILL			
AND IS ALSO 			
AND ALSO HAS A NEXT INSURANCE THAT HAS BEEN INCLUDED IN THE			
'INSURANCE COMPANIES INCLUDED' LIST FOR THIS RULE.			
NOTE: THIS RULE WILL BE IGNORED FOR ANY BILL THAT DOES NOT MATCH			
      ALL OF THESE CONDITIONS.			
THE EFFECT OF THIS RULE WILL BE: IF A BILL MATCHES ALL OF THE ABOVE CONDITIONS,			
THE REQUEST AND RECEIPT OF AN MRA WILL NOT BE ALLOWED.			
IS THIS CORRECT? 			
THE RULE WILL BE APPLIED AND THE BILL WILL NOT BE TRANSMITTED IF:			
 - THE RULE APPLIES TO ALL INSURANCE COMPANIES			
 - THE RULE 'APPLIES TO' ONLY SPECIFIC INSURANCE COMPANIES AND THE BILL'S			
   INSURANCE COMPANY APPEARS ON THE RULE'S 'INCLUDE LIST'			
 - THE RULE 'EXCLUDES' SPECIFIC INSURANCE COMPANIES AND THE BILL'S			
   INSURANCE COMPANY DOES NOT APPEAR ON THE RULE'S 'EXCLUDE LIST'			
 - THE RULE HAS NO BILL TYPE RESTRICTIONS OR APPLIES TO ALL BILL TYPES			
 - THE RULE IS RESTRICTED TO CERTAIN BILL TYPES AND THE BILL'S BILL TYPE IS			
   INCLUDED FOR THE RULE OR IS NOT EXCLUDED FOR THE RULE			
NEXT 			
BILL TYPE			
 TO EXCLUDE			
Enter the bill types to include/exclude.  To include, enter the			
3 digit bill type.  To exclude, precede the 3 digit bill type with a minus (-)			
You may use 'X' as a wild card.  Use XXX to include all bill types.			
If XXX is entered, the rest of the entries must be bill type exclusions.			
The current bill types entered for this rule are:			
  ALL BILL TYPES INCLUDED - ONLY EXCLUSIONS ALLOWED NOW			
Warning ... this rule will not work unless you enter at least one bill type			
Timed out or '^' entered ... bill types not added			
INSURANCE CO OPTION: 			
Select Insurance Co to 			
clude for this rule: 			
Entries deleted!			
Warning ... no insurance companies entered			
Cannot add this bill type restrictions because:			
In order to exclude, you must include at least one bill type including the			
 excluded bill type first			
You already have 'XXX' (all bill types) - can only EXCLUDE bill types now			
You have already entered this bill type			
You have included and excluded the same bill type			
*  WARNING -  MAKING CHANGES TO THE TRANSMISSION    *			
*  RULES USING THIS OPTION CAN SERIOUSLY AFFECT THE *			
*  SITE'S ABILITY TO BILL.  BE EXTREMELY CAUTIOUS   *			
*  WHEN USING THIS OPTION.                          *			
IBCE RULES			
     FORM    TRANSMIT   INSURANCE  RULE			
 #   TYPE      TYPE       OPTION   NUM    SHORT DESCRIPTION			
ACTIVE DATE    INACTIVE DATE			
IBCE-RULE			
IBCE-RULEDX			
EDI ONLY			
MRA ONLY			
BOTH EDI/MRA			
Rule #'s followed by an * are currently inactive			
Only currently active rules are displayed			
 Transmission Rules Found			
RULE TYPE '			
' DOES NOT ALLOW BILL TYPE RESTRICTIONS			
PRESS RETURN 			
IBCE-BTDX			
Bill Type Restriction #			
IBCE-BT			
Warning ... no insurance companies chosen to 			
@RULE NUMBER			
TRANSMISSION RULE(s) HAVE BEEN SUCCESSFULLY FILED			
NO TRANSMISSION RULES ADDED			
CANNOT BE AFTER RULE'S INACTIVE DATE OF 			
CANNOT BE BEFORE RULE'S ACTIVE DATE OF 			
MUST BE PRIOR TO BILL TYPE'S INACTIVE DATE OF 			
MUST BE AFTER BILL TYPE'S ACTIVE DATE OF 			
CHANGE WOULD INVALIDATE BILL TYPE RESTRICTION DATE			
IBCE RULE BT RESTRICT			
BILL TYPE RESTRICTIONS FOR RULE #			
Transmit type: 			
EDI 			
MRA 			
  Form Type    : 			
  Ins Co Option: 			
ALL    			
Active Date  : 			
  Inactive Date: 			
    No Bill Type Restrictions Found			
THE BILL TYPE RESTRICTION(S) WAS/WERE DELETED			
Bill type			
 not deleted - deleting 			
this restriction			
these restrictions			
 would cause an inconsistency			
Press return: 			
Missing Parameters			
No base file found for form 			
No data found for required field 			
Max # lines or occurrences exceeded (			
BILL-SEARCH			
FILEMAN FIELD: 			
NOT A PRINTABLE FORM!!			
BILL DOES NOT EXIST			
DEPT VETERANS AFFAIRS			
VETERANS AFFAIRS,DEPT			
IBCE LOCAL FORMS LIST			
    No Local Forms Currently On File			
Form Number: 			
Base File  : 			
Format Type: 			
Form Length: 			
Associated With National Form: 			
Entry Pre-processor : 			
 (defined for associated 'parent' form)			
Entry Post-processor: 			
Form Pre-processor  : 			
Form Post-processor : 			
Output Logic        : 			
(Use formatter default)			
Extract Logic       : 			
LOCAL FORM: 			
Enter a new LOCAL FORM NAME: 			
Enter the name that you want your new local form to be referenced by			
Enter form number (must be > 9999): 			
Enter the internal entry number that will be assigned to this form			
Another user has taken this number ... please select a new one.			
MUST HAVE A BASE FILE!!			
MUST HAVE A FORMAT TYPE!!			
WANT TO ASSOCIATE THIS FORM WITH A NATIONAL FORM			
FORM NOT ASSOCIATED WITH ANY NATIONAL FORM			
WANT TO COPY ALL FIELDS FROM AN EXISTING FORM			
Select FORM TO COPY FROM: 			
ARE YOU SURE YOU WANT TO MAKE THIS COPY			
This may take a little while ... please be patient while I build your new form			
Field copy completed - 			
 fields copied			
IBCE FORM FIELDS LIST			
Exit option entirely			
A form with this name already exists			
A form with this number already exists			
Select LOCAL DATA ELEMENT Name: 			
ONLY NATIONAL FIELDS CAN BEGIN WITH 'N-'			
Are you sure you want to DELETE LOCAL FORM - 			
If you choose to delete this form, the form's field content definitions will also be deleted			
    No Fields Currently Defined For Form			
Bill Form: 			
Associated With Nat. Form: 			
Not Associated With A National Form			
OVERRIDE AN EXISTING FIELD			
Can Only Over-ride a NATIONAL form field			
Can't Over-ride a form field that is an over-ride itself			
Form field definition will not allow override			
Over-riding Form Field # 			
IS THIS OK			
COPY OVER THE DATA ELEMENT AND OUTPUT FORMAT FROM THE ORIGINAL FLD			
MUST HAVE A PAGE/SEQ			
MUST HAVE A FIRST LINE #			
MUST HAVE A STARTING COLUMN			
Form field: (#			
 is a NATIONAL form field			
EDIT A NATIONAL FIELD FROM			
 FORM FIELD			
'S CONTENT DEFINITION NOW			
...Please define CONTENT of field...			
Definition of Form Field: (#			
Defining content of form field: (#			
Select a DATA ELEMENT: 			
FORM FIELD #: 			
YOU CANNOT 			
 A NATIONALLY ASSOCIATED LOCAL FORM			
 - REDEFINE THE FIELD'S CONTENT BY USING A LOCAL FORM FIELD TO OVERRIDE			
DELETE NATIONAL FIELDS FROM			
Can't delete this field until all fields associated with it are deleted			
If you delete this form field, its content definition will			
   also be deleted			
Form Field #			
The following problem			
 exist for this definition:			
  * DATA ELEMENT			
 OR SCREEN PROMPT 			
FOR FIELD IS MISSING - NO DATA WILL BE OUTPUT			
  * MORE THAN ONE OVERRIDE FLD DEFINITION EXISTS FOR THE ASSOC FIELD FOR:			
INS CO: 			
BILL TYPE: 			
WANT TO RE-EDIT THIS RECORD NOW?			
 Form Field: 			
First Line: 			
Col/Pc: 			
Pad: 			
   Bill Type: 			
Data Element: 			
 Scrn Prompt: 			
 Edit Status: 			
 Fileman Fld: 			
Constant Val: 			
Extract Code:			
 Format Code:			
National/Loc: 			
   Base File: 			
OUTPUT FORMATTER - FORM: 			
OUTPUT FORMATTER: 			
Output Device: 			
PRINT FORM: 			
Do you want to queue this transmission			
Do you want to run this job without queuing it now			
Please enter the date and time to execute this job...			
<RET> or '^' to QUIT  or 1-			
 to EDIT: 			
delimiters.  The elements that are editable are assigned a group number			
enclosed in brackets 			
 while those without group numbers are not.			
PRESS <RETURN> KEY to RETURN to SCREEN 			
Send transmission to your mailbox			
Enter a mail queue name: 			
This is the mailman queue where the formatted test record should be sent			
Message 			
 is no longer in return message file			
This message has already been scheduled for update.  Task # is: 			
Message status (			
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