English French Notes Complete/Exclude ** CURRENT PERSONAL RIDERS ** None Indicated * BENEFITS USED * ** OPT DEDUCTIBLES ** Ded Met?: Amt of Ded Met ($): Pre-exist Cond: MH Ded (Opt) Met?: Coord of Ben Data: Amt of MH Ded Met ($): Amt Lifet Max Used ($): Amt MH Lifet Max Used ($): ** INPT DEDUCTIBLES ** MH Ded (Inpt) Met?: You may enter the 'Source of Information' that will be filed with all Medicare insurance coverage policies that are created. Enter Source of Information Patient Expired on This patient has more than one Part A policy. Please edit in Ins Mgmt. This patient has more than one Part B policy. Please edit in Ins Mgmt. * No Part A changes made... * No Part B changes made... Error: Medicare (WNR) ... not setup properly Verify Medicare (WNR) Part Coverage Now Enter 'No' to not Verify Coverage at this time. COVERAGE VERIFIED. added to Insurance Buffer File. Warning: Could not add new policy Part in Buffer File. Is this Data Correct Enter 'No' to edit Medicare Card information Error: Standard Medicare (WNR) Insurance Company not setup properly. Error: Standard Medicare (WNR) plan PART A not setup properly. Error: Standard Medicare (WNR) plan PART B not setup properly. NAME OF BENEFICIARY Enter the Name of Beneficiary (Last name, First) from the Medicare Insurance Card. This name should be 3 to 30 characters in length. HOSPITAL INSURANCE (PART A) EFFECTIVE DATE Enter PART A Effective Date if shown on Medicare Insurance Card. MEDICAL INSURANCE (PART B) EFFECTIVE DATE Enter PART B Effective Date if shown on Medicare Insurance Card. No data can be filed without Part A or B Effective Dates. COORDINATION OF BENEFITS: Enter the Coordination of Benefits as Primary, Secondary, or Tertiary. Enter the Medicare Claim Number (Subscriber ID) exactly as it appears on the Medicare Insurance Card, including ALL characters. Valid HICN formats are: 1-3 alpha characters followed by 6 or 9 digits, or 9 digits followed by 1 alpha character optionally followed by another IB-MRA IB-MRA-CNT Bills Found for Selected Ins. Co.: Bills for Outpatient Visits: Bills for Inpatient Visits: Subtotals by Selected Ins. Co.: Bills with Procedures and Diagnosis: Bills with Diagnosis Codes Only: Bills with Procedure Codes Only: Bills with No Proc. or Diag. Codes: Bills Canceled before Completion: Bills Never Printed: Bills with wrong Rate Type: Bills with wrong Who's Responsible: Bills w/ wrong Bill Classification: Bills for Prescriptions: Bills for Prosthetics: Bills with Patients Not Alive: Bills Meeting Criteria for MRA: Outpatient Bills Meeting Criteria: Inpatient Bills Meeting Criteria: Bill Meeting Criteria and Referred: There are no summary records to print. Insurance Company: Calendar Year of Bill: Type of Bill: There are no detail records to print. Possible Medicare Remittance Advice Claims Detail Report Totals Report Bill No. Bill From-To Date Printed Amount Billed Amount Collected IB Status Billed Coll Total Amount No. Amount Number Billed Coll Collected IB MRA ANALYSIS REPORT FOR ACTIVITY := $$MRA-ANALYSIS$$ SITE := $$ SUMMARY DATA := INSURANCE COMPANY TOTALS := ANNUAL DATA := Build MRA Extract Your user number (DUZ) must be defined before proceeding! This program extracts data from the AR and IB packages and sends it to the VA CFO office for analysis. A background job called 'IB-Compile MRA statistics' will be queued to run at a time you choose. A file will be created with the extracted info will have to be FTPed to a designated IP address. The file will This extract must be run on the Legacy sites as well as the Primary site if you are an integrated database facility. Volume/Directory (or return to accept the default directory) Enter using format VA3$:[ANONYMOUS.PUB] Unable to determine default directory. Please enter one. Unable to create file in specified volume/directory You must enter the list of Insurance Companies to be included in this extract first Enter Start Date for MRA Extract: Jan. 1,1995 Enter the earliest date for which Means test charges will be extracted Enter End Date for MRA Extract: Dec. 31, 1996 Enter the latest date for which Means test charges will be extracted This will automatically be tasked to run. Upon completion of the extract A mail message will be sent to you. IB-Compile MRA statistics Job queued ( Task not queued! INS( Completion of MRA Extract IB PACKAGE The MRA Extract has been completed and data stored in file: This file must be sent via FTP to the following address: MRA EXTRACT OPEN ERROR The file for the MRA extract could not be opened. The job will need to be requeued Build statistics on Insurance Companies that are withholding Medicare Supplemental Policy Payments. You didn't select anything to do! Try again. the data will be sent to you. Print Report, [S]ummary, [D]etail, [None]: Select whether you want to print a summary report, a detail report, or No report. A detail report will list every claim. No report will automatically send data for national rollup. Send Data for National Rollup Answer 'Yes' if you wish to send a report for national rollup purposes or answer 'No' if you just want to print a report. Create a list of Insurance Companies for the MRA Extract No Entries have been made. The Following Entries have been made: IBCNS-ERR Check Patient file Insurance Type Group Plan consistency I'm going to check the Insurance company for each patient policy with the Insurance company in the associated Group Plan file. This will take a while, please queue this job to a device. I'll print a report when I'm done. Update any Inconsistencies Enter YES if you want any inconsistencies updated, enter NO if you just want the report. IB - v2 PATIENT FILE DOUBLE CHECK and a + for each entry updated IBCNS-ERR1 IBCNS-ERR2 IBCNS-ERR3 No Errors Found! Policy is missing group Plan Dangling insurance node detected Group Plan is with different insurance company Patients with Incorrect Group Plans INSURANCE CO. OLD PLAN NEW PLAN ....task stoped at user request Warning: Insurance Company selected already on file for this patient. The previous entry is active. The WHOSE INSURANCE are the same. The Effective and Expiration dates may cover overlapping dates. The Group Plans are the same. WHOSE INSURANCE is Spouse, patient marital Status Inconsistent. WHOSE INSURANCE is Spouse but no Employer listed. Warning: There is another policy with the same Group Name. Expanded Policy Information for: Comment -- Patient Policy Comment -- Group Plan Effective Dates & Source Effective Date: Source of Info: Policy Not Billable: Subscriber's Employer Information Emp Sponsored Plan: Employment Status: Retirement Date: Claims to Employer: Yes, Send to Employer No, Send to Insurance Company If ROI applies, make sure current consent is signed. Patient doesn't have Insurance Select Patient Policy: Insurance Contact (last) Person Contacted: Method of Contact: Call Ref. No.: Contact Date: Plan Information Is Group Plan: Group Name: Group Number: Type of Plan: Plan Category: Electronic Type: Plan Filing TF: Insurance Number: Insurance Company City/State: Billing Ph: Precert Ph: Insured Person's Information (use Subscriber Update action) St/Zip: Subscriber Information Whose Insurance: Subscriber Name: Coord. Benefits: Prim Prov Phone: Last Verified By: Last Verified On: Personal Riders You can now enter a contact and relate it to a Claims Tracking Admission entry. Select RELATED ADMISSION DATE: Warning: This contact is not associated with any care in Claims Tracking. You may only edit or view this contact using this action. Select Contact Date: Print [C]T Summary [W]ork Sheet (UR) [N]one [B]oth: You may choose print a UR work sheet, a summary from claims tracking (of this episode), both or nothing. IB - Print UR from Ins review Claims Tracking Summary Can't identify the plan! Please note that this plan is inactive! This plan is currently defined as a This Individual Plan has more than one subscriber! There is more than one subscriber to this Group Plan. The plan cannot be changed to an individual plan. Do you wish to change this plan to a Enter 'YES' to change this plan, or enter 'NO' to leave it as is. No change was made. Changing the plan to a Covered By Health Insurance indicates 'YES' but none currently Active. Please Review! Insurance conversion not complete, NO EDITING ALLOWED INVALID ENTRY, DELETE AND RE-ENTER, NO EDITING ALLOWED GROUP INSURANCE PLAN REQUIRED BUT NOT ENTERED *** If ROI applies, make sure current consent is signed! *** You may now enter a brief comment about this patient's policy You may now enter comments about this Group Plan that pertains to all Patients Current Personal Riders: Are you adding a new Annual Benefits YEAR IB ZZZZZ You cannot add a new Benefits Used BENEFIT YEAR Are you adding a new Benefits Used YEAR IBCNS PLAN LOOKUP No plans were identified for this company. Precerts: You may only select a single plan! This plan is not allowed for selection! Would you like to select any other plans If you wish to select plans from other screens, please answer 'YES'. Otherwise, answer 'NO'. ACTIVE DUTY Select SPONSOR: New sponsors must be in the format LAST,FIRST. ' as a new SPONSOR Unable to add a new sponsor! .01 NAME;.02 DATE OF BIRTH;.03 SOCIAL SECURITY NUMBER .02 MILITARY STATUS;.03 BRANCH;.04 RANK The person ' ' is not currently the sponsor of this patient. Okay to add this person as the patient's sponsor Please enter 'YES' to add this person as the patient's sponsor, or 'NO' to select a new sponsor. MOVE SUBSCRIBERS OF ONE PLAN TO ANOTHER PLAN This option may be used to move subscribers from a selected Plan to a different Plan. The plans may be associated with the same Insurance Company or a different one. Plan and Annual Benefit information may be moved as well. Users of this option should be knowledgeable of the VistA Patient Insurance management options. Press any key to continue. plan, subscribers were moved from, is already inactive. Do you wish to inactivate 's plan subscribers were moved from If you wish to inactivate the old plan, enter 'Yes' - otherwise, enter 'No.' The plan has been inactivated. Do you wish to delete this plan If you wish to delete the old plan, enter 'Yes' - otherwise, enter 'No.' The plan has been deleted. You may add a new Plan at this time or select an existing Plan. Insurance Company receiving subscribers must have a Plan. You may select an existing Plan from a list or enter a specific Plan. Do you wish to enter a specific plan The look-up facility to select a group plan has been enhanced to use the List Manager. Enter 'NO' if you wish to select a plan from this look-up, or 'YES' to directly enter a plan. * No plan selected! Select a GROUP PLAN: MOVE SUBSCRIBERS FROM Select the Insurance Company and Plan to move subscribers FROM. Collecting Subscribers ... * This plan has no subscribers! This plan has subscribers. All subscribers will be moved. MOVE SUBSCRIBERS TO You must move the subscribers to an active insurance company! 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