English French Notes Complete/Exclude Tran. Date Print Pending Transaction List Answer or Dates are not appropriate. NOT AN ACTIVE ACCOUNT ! THIS ACCOUNT ALREADY HAS A REPAYMENT PLAN ! NO REPAYMENT PLAN! NO REPAYMENT PLAN ! NOTHING CHANGED ! NUMBER OF PAYMENTS WILL BE THIS NUMBER SHOULD BE LESS THAN 60 !, CHECK THE INPUT AGAIN DUE DATE OF 1ST PAYMENT: THE REPAYMENT PLAN HAS BEEN ESTABLISHED. Repayment Plan Profile ( r - Bill is Currently Referred ) CATEGORY LISTING FOR BILLS REPORT Sort Criteria for Date Prepared: Princpal Preprd ****NO RECORDS TO PRINT**** SUBCOUNT: Do you wish to queue this report MAS RECONCILIATION REPORT @DATE BILL PREPARED,@CATEGORY:INTERNAL(TYPE),@CURRENT STATUS:STATUS NUMBER 3RD PARTY ACTIVE REFERRAL REPORT DEBTOR;S2,PATIENT,RC/DOJ REFERRAL DATE,@CURRENT STATUS:STATUS NUMBER,@CATEGORY:INTERNAL(TYPE) DATE REFERRED TO RC DEBTOR;S1,@RC/DOJ REFERRAL DATE,@RC/DOJ REFERRAL CODE ACCOUNTS RECEIVABLE REFERRED TO RC DATE REFERRED TO DOJ ACCOUNTS RECEIVABLE REFERRED TO DOJ DATE RC TRANSACTION CREATED +TRANSACTION TYPE;S2,@DATE ENTERED REGIONAL COUNSEL DEBT COLLECTION REPORT FROM DATE DOJ TRANSACTION CREATED +TRANSACTION TYPE;S2,@RC DOJ CODE,@DATE ENTERED DEPARTMENT OF JUSTICE DEBT COLLECTION REPORT FROM DATE REFERRED TO RC/DOJ REFERRED TP TORT & WORKER'S COMP AR REPORT DEBTOR;S1,@REFERRAL DATE,@CURRENT STATUS:STATUS NUMBER,@CATEGORY:CATEGORY NUMBER This report should be run on or AFTER the first Wednesday of the month. Make sure your facility has received the monthly offset information from the DMC to insure the accuracy of this report. Enter DMC Report to print: 1 - All Patients 2 - Single Patient Enter '1' to print DMC information for ALL patients. Enter '2' to print DMC information about a single patient. REFERRED DMC DEBTS @DATE SENT TO DMC,+@INTERNAL(DEBTOR);S2 @DATE SENT TO DMC,+DEBTOR;S2 @DATE SENT TO DMC,+@INTERNAL(DEBTOR) Are you sure you want to return this bill to the Service Answer 'Y' or 'YES' if you want to return this bill to the service that originated it, answer 'N' or 'NO' if not Do you want to return this bill to the service again You should audit this amended bill ! Do you want to print the amended bill data Answer 'Y' or 'YES' if you want to print the data, answer 'N' or 'NO' if not. Print Amended Bill OK!, The Bill is active now, you may need to do the following: | 1. If the bill has been cancelled in the service, run the option 'Decrease Adjustment' to decrease the balance to 0. The status of the bill will be changed to CANCELLATION automatically. | 2. If the amended bill needs to change the original amount, | use 'Adjustment to AR' option. | 3. If the debtor's address has been changed in the amended bill, | use 'Edit Debtor's Address' option. PRCAY PAYMENT SUP This bill has been APPROVED but an FMS document was NOT created Do you want to CREATE the document now This bill is ready for the Certifying Official's approval. It has been reviewed by This bill has not been reviewed for approval yet. It must be signed by a refunder to be ready for the Certifying Official's approval. AUTHORIZED FISCAL USER MUST CHANGE STATUS OF BILL TO 'REFUND REVIEW' Do you want to review the prepayment bill at this time Do you want to change the status to 'REFUND REVIEW' at this time Status Changed to 'REFUND REVIEW' Do you want to make any adjustments to the refund amount now Bill status is no longer REFUND REVIEW. It has changed to Do you want to send the refund to the certifying official for approval now DUPLICATE AUTHORIZER! UNAUTHORIZED TO SIGN AS CERTIFYING OFFICER Sign as the 'REFUNDED BY' person This refund must first be approved by the refunder. If you sign as the 'Refunded By' person, you CANNOT sign as the Certifying Officer. REFUND AMOUNT OUT-OF-BALANCE! DID NOT APPROVE REFUND REFUND APPROVAL SIGNATURES Certifying Officer: Signed on: This Accounts Receivable doesn't have an excess payment ! Status Changed to 'CANCELLATION' No other transactions may be made to the bill now. THIS BILL NUMBER ENTRY IN FILE 430 IS CORRUPTED NO PROCESSING CAN CONTINUE - SEE IRM THIS DOCUMENT SEEMS TO HAVE ALREADY BEEN SENT TO FMS- IT CANNOT BE RESENT UNLESS FMS REJECTS IT. Creating an FMS Overcollection Payment Voucher . . . THIS PATIENT DOES NOT HAVE A VALID ADDRESS. AN FMS DOCUMENT CANNOT BE CREATED WITHOUT A VALID ADDRESS. AN ENTRY WAS NOT MADE IN THE STACKER FILE. PLEASE RE-SELECT THE BILL IN THE APPROVE OPTION. AN AR DOC REF CANNOT BE CREATED BECAUSE THE FOLLOWING ERROR HAS OCCURRED - Creating a REFUNDED transaction for bill number: . . . Bill is now in REFUNDED status. Is this a TOP Refund Enter 'YES' only if this is a refund of a payment from TOP There is no valid trace number entered for this debtor Cannot process as TOP refund. TOP REFUND DOCUMENT WILL BE SENT WITH NEXT TOP TRANSMISSION THIS BILL HAS NOT BEEN APPROVED! THIS DOCUMENT IS EITHER NOT READY FOR FMS OR HAS ALREADY BEEN ACCEPTED. Select the output device: REFUNDS PENDING CERTIFYING OFFICIAL'S APPROVAL Press Return to continue or REVIEWED DATE Enter Transaction START Date: Enter Transaction END Date: Prepayment Posting Report PAYMNT (FULL) PAYMNT (PART) **ERROR MESSAGE: Corresponding Transaction not found! **ERROR MESSAGE: Unbalanced Transaction Amounts * - Include the payment amount on an FMS ET document Background Payment Posting from Prepayment Receivables Reporting period: Tran. Corresponding Tran. No. NO REPAYMENT PLAN FOR THIS ACCOUNT. NO PAYMENT DATA! PRCA( Repayment Plan Statement THE DATE DOES NOT MATCH !, PLEASE CHECK REPAYMENT PROFILE. Enter the date the statement was printed: STATEMENT OF ACCOUNTS RECEIVABLE DISTRIBUTION OF PAYMENT | FILE NO./SSN NAME OF PERSON ENTITLED COLLECT. | OF PAYMENT | BALANCE DUE | AFTER PAYMENT BALANCE DUE SHOULD BE PAID IN FULL BY TO AVOID ADDITIONAL CHARGES. * Detach and return with your next payment to: FOR PROPER CREDIT TO YOUR ACCOUNT, PLEASE DETACH AND RETURN WITH YOUR PAYMENT | PAYMENT REMITTANCE | | *FILE NO/SSAN | NAME OF DEBTOR | AMOUNT ENCLOSED |TEL.NO | | ENTER YOUR CURRENT ADDRESS BELOW ONLY IF THE ONE ABOVE IS INCORRECT. | | PLEASE INCLUDE YOUR ZIP CODE. | | | | *PLEASE INCLUDE THIS NUMBER ON YOUR CHECK OR MONEY ORDER | -1^PRCA004^AR Package 'busy' while trying to add transaction. A decrease adjustment for bill # has been automatically Automatic Adj: ****** NOTICE: A decrease adjustment for bill # needs to be manually Manual Adj: applied in the amount of $ Please review bill for proper application of the unapplied amount of $ Data sent from Service Adjustment by: Bill status is with a balance of $ *WARNING* There is outstanding administrative charges of $ An adjustment of administrative charges MAY need to be done. AutoAUTO Auto Dec.: THE ACCOUNT WILL BE INCOMPLETE. *** APPROVED AND RELEASED TO ACCOUNTING *** ...Bill Number ' Your Electronic Signature Code is undefined. Enter Electronic Signature Code: Enter in your Electronic Signature Code, 6 to 20 characters. Type of care is missing Type of care is not in expected format Patient is missing Patient is undefined -1^2nd insurance company is undefined -1^3rd insurance company is undefined is not in expected format PRCA(430.3, PRCA(430.2, RCD(340, INSURED NAME INSURED SEX M:MALE;F:FEMALE;U:UNKNOWN; CERT SSN HIC ID NO. EMPLOYEE ID NUMBER EMPLOYER LOCATION SECONDARY INSURANCE CARRIER TERTIARY INSURANCE CARRIER BILL RESULTING FROM PRCA(430.6, RNJ9,2X TOTAL ORIGINAL AMOUNT PRINCIPAL BALANCE INTEREST BALANCE ADMINISTRATIVE COST BALANCE LAST INT/ADM CHARGE DATE MRFX# APPROPRIATION SYMBOL RNJ9,2 FY ORIGINAL AMOUNT CURRENT PRIN. BAL. FOR THIS FISCAL YEAR RP430'X PRCA(430, TRANSACTION DATE RP430.3'X TRANSACTION TYPE TRANS. AMOUNT PROCESSED BY APPROVING OFFICIAL (SERVICE) RECEIVABLE CODE 0:DEFAULT;1:FEDERAL;2:NON-FEDERAL;3:OWCP; A/R Document Status Inquiry Last Update: DATE BILL PREPARED: RECEIVABLE CODE: BILL N0.: TRANSACTION DATE: TOTAL TRANS. AMOUNT: IRS LOC. COST: CREDIT REP.COST: DMV LOC.COST: CONSUMER REP.AGENCY COST: MARSHAL FEE: BILL NO.: ADJUSTMENT AMOUNT: ADJUSTMENT DATE: ADJUSTMENT NO.: ADJ.AMOUNT PRIN.BAL.(ADJUSTED) Brief Comment: Follow-up Date: TRANS. TRANS.AMOUNT PRIN.AMOUNT CONTROL POINT: APPROPR. SYMBOL ALD CODE BILL RESULTING FROM: ABLE TO PAY: ABLE TO LOCATE: DMV LOCA. CHECK: POSTAL LOC. DATE SENT: POSTAL LOC. DATE REC'D: IRS ABLE TO LOCATE: IRS LOC. DATE SENT: IRS LOC. DATE REC'D: CREDIT REP. ABLE TO PAY: CREDIT REPT. DATE SENT: CREDIT REP. DATE REC'D: PATIENT FOLDER REVIEWED: DATE FOLDER REVIEWED: LETTER1: ACCOUNTS RECEIVABLE PROFILE CURRENT STATUS: CP: DATE BILL PREPARED: TRANSACTIONS: MEANS TEST ACCOUNTS RECEIVABLE PROFILE CARE: FUND (APPROPRIATION): 3RD PARTY ACCOUNTS RECEIVABLE PROFILE TYPE OF CARE: DATES OF SERVICE: 3RD PARTY: EMPLOYEE ID SECONDARY INSURANCE COMPANY: TERTIARY INSUANCE COMPANY: << BILL RETURNED FROM AR >> PAYER: PREV. STATUS: CURR. STATUS: ORIGINAL AMOUNT: SERVICE: APPROV. BY: RETN'D BY: RETN'D REASON: NEW ACCOUNTS RECEIVABLE BILL NO.: CATEGORY: GL NO.: SIGNATURE CODE: TRANSACTION NO.: CATEGORY: TRANS.DATE: TRANS.TYPE: APPROP.SYMBOL #################### #################### #################### #################### #################### #################### #################### #################### #################### #################### #################### #################### #################### #################### ####################