English French Notes Complete/Exclude these apply to both billed and unbilled episode reports. 1 - Include Episodes with a RNB: (default excludes episodes with a RNB) 2 - Include Only Episodes with a RNB: (default is No) 3 - Combine Divisions: (default is separate report for each Division) 4 - Sort by Terminal Digit: (default sort alphabetically by Patient Name) 5 - Select Range of Pat Names or Term Digits or Ins Company: (default is all) Terminal Digit Sort: the output will be sorted by the 8th and 9th digits and then the 6th and 7th digits of the patient's SSN {Reason Not Billable}: if episodes with RNB are included then inpatient episodes with all movements SC are included on the report All of the optional print fields apply to the patient and if chosen will print once for each patient on the report. Indications of the Insurance Coverage and Riders, Policy Comments, and Group Comments are only printed if they exist for the policy/plan. IBCONSC-1 *** Margin width of this output is 132 *** *** This output should be queued *** *** If queued, Outpatient Visits in Claims Tracking will be updated first *** IB - Patients with Insurance and Outpatient IBCONSC-2 *Veterans with Reimbursable Insurance and OUTPATIENT Appointments INPATIENT : All Divisions Combined - Divisions Combined: This report will generate a list of insurance plans by company. It will help you identify duplicates and verify patient coverage. You must select one, many (up to 20) or all of the insurance companies; anywhere from one to all of the plans under each company; and whether to include the patient policies (subscribers) under each plan. The number of plans you select is independent for each company you are including, but subscriber selection is the same (all or none) for all companies and plans within a report. Regardless of how you run the report, the number of subscribers per plan will be included. No plans selected! IB - LIST OF PLANS BY INSURANCE COMPANY insurance company Insurance Company # ...building a list of plans... SELECT REPORT (1 OR 2): 1. List Insurance Plans by Company 2. List Insurance Plans by Company With Subscriber Information Ins. Companies;2:2. List Only Ins. Companies That You Select There are insurance companies associated with plans. 1. List All 2. List Only Ins. Companies That You Select Enter a code from the list: 1 or 2. Only insurance companies with one or more plans can be selected. plans. List all plans for each company If you say yes, the report will list all of the plans for each company. If you selected 2. List Insurance Plans by Company With Subscriber Information and 1. List All this will result in the most complete report possible. However, it may take awhile to run. If you say no, you must make plan selections for each individual company (anywhere from one plan to all). Ins. Co.: ACTIVE COMPANY Number of Plans Selected = Total Subscribers Under Selected Plans = LIST OF PLANS BY INSURANCE COMPANY WITH SUBSCRIBER INFORMATION PLAN TOTAL= SUBSCRIBER TOTAL= BEN. SUBSCRIBER NAME/ID USED? GROUP NAME GROUP OR IND ACTIVE/INACTIVE ANN. BEN? BEN. USED? GROUP #: ANNUAL BENEFITS ON FILE: BENEFITS USED ON FILE: GROUP OR IND: ACTIVE?: NO. SUBSCRIBERS: This report will sort through insurance policies in the patient file and print patients, bills, and payments with an insurance policy source of information equal to pre-registration. Since this report has to loop through all patients and check all insurance policies, it is recommended this report be queued. Pre-Registration Source Report DATE* IBCN* End with Date: END DATE MUST BE GREATER THAN OR EQUAL TO THE START DATE. *** Selected date range from TOTAL NEW POLICIES IDENTIFIED WITH PRE-REGISTRATION: TOTAL INPATIENT BILLS COUNT: TOTAL INPATIENT PAYMENT COUNT: TOTAL OUTPATIENT BILLS COUNT: TOTAL OUTPATIENT PAYMENT COUNT: * Next to bill indicates bill is canceled and not used in totals * Next to payment indicates payment is canceled and not used in totals PRE-REGISTRATION SOURCE REPORT FOR THE DATE RANGE: Patient Source = Pre-Registration Source Date Bills Entered Bill Date Payments Collected Tran Number THERE ARE MORE THAN TEN VISITS DURING THE PERIOD THAT THIS STATEMENT COVERS. Select visits to include in this bill (1- Maximum of 30 visits allowed per bill! The visits already on the bill along with those selected total more than 30. THIS INSURANCE COMPANY WILL ONLY ACCEPT ONE VISIT PER BILL. YOU HAVE SELECTED VISIT(S) NUMBERED- Enter 'Y'es to include these visits. Enter 'N'o to reselect. Can't add OP Visit Date of Only 1 visit date allowed on bills with Amb. Surg. Codes! Adding OP Visit Date of <<>> VISIT DATE ELIG/MT BILL# - TYPE STOP CD/CLINIC Press return to continue, to exit display, or or a list or range separated with commas The number(s) must correspond to a visit. NO OUTPATIENT VISITS FOUND DURING THE PERIOD COVERED BY THIS STATEMENT ADMITTING/SCREENING OUTPATIENT VISIT DATE the total amount billed. Please note that you may no longer opt to transmit this report to the MCCR Program Office in VACO using You must select a date range in which bills to be used in the totals will be selected. Enter Start Date on Bill Search: Enter End Date on Bill Search: Enter number of insurance carriers to rank: Would you like this report sent to the MCCR Program Office RANK INSURANCE CARRIERS This report uses the date the bill was first printed to determine if the bill should be included in the accumulative total. Please enter the lower date range for the first printed date, which should be a past date on or after 10/1/86, or '^' to exit. Please enter the upper date range for the first printed date, which should be a past date on or after , or '^' to exit. This report will rank any number of insurance carriers (from 1 to 1000) for the total amount billed within a date range. Please enter a number between 1 and 1000, or '^' to exit. After the new fiscal year begins, this report should be generated for the previous fiscal year and transmitted to the MCCR Program Office. The data will be compiled nationally to determine which insurance carriers are the largest customers of VA. The compiled data will assist the Program Office in planning for future electronic billing systems. Even if you are planning to transmit a report to the Program Office, you should run this report once without transmitting to check the results. You may then re-run the report and transmit it centrally. CARRIER UNKNOWN Total Amount Billed to all Ranked Carriers: Sending the report in a bulletin to the MCCR Program Office... Ranking Of The Top Insurance Carriers By Total Amount Billed ** - denotes an inactive company Rank Insurance Carrier Total Amt Billed REPOINT PATIENTS TO The routine will delete the REPOINT PATIENTS TO field of the entry in the INSURANCE COMPANY file (#36) if the field entry is pointing back to itself (same IEN). A dot (.) will appear for every 50 records processed. records changed. RANKING INSURANCE CARRIERS Page: 1 of 1 PRQC IBINS: DUZ(0) must also be defined to run this routine. S.PRQC SERVER IBINS@ISC-ALBANY.VA.GOV This job will compile a ranking of all your insurance carriers by the total number of claims billed from . The compilation will be uploaded into a mail message and sent to the MCCR National Database where it will be re-formatted in a PC-downloadable format and sent to the MCCR Program Office. This mail message will also be sent to you. *** Please note *** You appear to be executing this routine in a test account. The mail message will only be sent to you. Do you want to queue this job now IB - RANKING CARRIERS (FROM IRM) INPATIENT BEDSECTION STAY INPATIENT DRG Updating Bill Mailing Address IBCRC-INDT Charge calculated Miles SubUnits with a Base Charge= Removing old Revenue Codes and Rate Schedules... Updating Revenue Codes and Charges Rev Code Bedsection Adding RC FACILITY Multiple Surgical Procedure Discount Primary/Secondary Discount RC PHYSICIAN Rate Schedules available for an Inpatient Enter the number (1- ) preceding the Rate Schedule/Charge Sets that apply to this bill. All associated charges will be added to the bill. * - these charges are available to be added to this bill if selected here, but will not be added when the bills charges are automatically calculated. s - the items these charges are associated with must be specifically selected here, they do not relate to any item on the bill. If the bill's charge type is exclusively institutional or professional then only sets of charges with a corresponding type will be added when the bills charges are automatically calculated. On this screen these charges will be displayed in the first set and used as the selection default. Select Schedule Charges to ADD to the bill: , there are No Rate Schedules with charges defined Therefore charges can not be calculated for this bill ( Select items from to add to the bill's charges: No items selected, press return to continue The following items have been selected to add to the bill's charges: Add these Charges to the Bill Charge: Total: Enter the number of units of service (accommodation days, miles, treatments, etc.) rendered to or for this patient for this service. This is the number times this service was provided to the patient. This number will be multiplied by the service CHARGE to determine the TOTAL charges for this service. Enter a positive whole number. Enter the division where this service took place. This Charge Set has a Billing Region, therefore all services must be associated with one of that region's divisions for a charge to be applied. Only Divisions associated with the Charge Sets Billing Region will be allowed. If the correct division is not in the list then this service does not have a charge in this set, enter '^'. The bills Default Division is: Enter the Revenue Code to associate with this charge on the bill. The Charge Set Default Revenue Code is The Charge Item Default Revenue Code is IBCRC-PTF IBCRC-DIV IBCRCSx Items and Charges on this Bill ( Auto Add) Charge Set Div RvCd >>> Bill Division is Freestanding Non-Provider with Professional Charges only. ) not billed using DRG Nursing , use SNF. Observa , use Procedures. Search for Procedure Charges for No Rate Schedules with Procedure charges assigned to this bill. no charge found... **** INACTIVATE CHARGES FOR ALL CURRENTLY INACTIVE CPTS **** For all Charge Sets based on CPT procedures, this option will add an Inactive Date to each Charge Item that is a currently Inactive CPT code. All charges for currently Inactive CPT codes will become inactive on the CPT Inactive Date. Is this correct, do you want to continue None inactivated Beginning Inactivations charges inactivated BILLING RATE Charges for Inactive CPT's Charges for Inactive CPT's **** DELETE INACTIVE CHARGE ITEMS FROM A CHARGE SET **** For a given Charge Set, this option allows deletion of all chargable items that have been inactivated or replaced before a certain date. Since all charges for a billing rate and date range may be deleted with this option, caution is advised. The Charge Set to delete Charge items from: Delete ALL charges for this Charge Set RC- Enter Yes to delete the Charge Set and it's links with Rate Schedules and Special Groups. The sets Region will also be deleted if not associated with another set. Also delete the Charge Set All charges inactive before this date will be deleted: Select INACTIVE DATE No deletions All charges inactive before will be deleted. Beginning Deletions charges deleted. Charges (to be deleted) in inactive before (ALL CHARGES IN SET) Delete Charges Report Charges to be deleted , Region Deleted CAUTION: This is a standard file with entries released nationally, do not add or modify unless necessary. Changing the Name or AR Category or if it is a Third Party rate type will effect processing of claims. Enter/Edit a Rate Type: #################### #################### #################### #################### #################### #################### #################### #################### #################### #################### #################### #################### #################### #################### ####################