FBDOC ;ALBISC\TET - ROUTINE DOCUMENTATION ;10/9/92 11:24
;;3.5;FEE BASIS;**48**;JAN 30, 1995
;;Per VHA Directive 10-93-142, this routine should not be modified.
;Routine contains documentation of other routines. Name sets
; of routines are indicated in line label.
FBPCR ;
;POTENTIAL COST RECOVERY REPORT
;user selects primary service areas and date range.
;The user is able to filter data to include Copays or Insurance only
;related information:
; Include (P)atient Co-pays / (I)nsurance / (B)oth
;If the user selects (P) or (B),the following prompt will allow
;the user to include Mean Test or LTC copays only or Both:
; Include (M)eans Test Co-pays /(L)TC Co-pays /(B)oth
;output will sort by primary service area, patient, program, vendor, date.
;only those that are means test category c/agree to pay deductible
; or for non-service connected treatment are printed, as well as
; insurance information.
;Since 7/5/2002 all LTC related payments are flagged in the report with
;appropriate messages. If the veteran doesn't have LTC test on file then
;the LTC related payment is flagged with "1010EC missing" message.
;
;outpatient info - program 2 - fbpcr2 uses date finalized for date range sort
; o for each service on a treatment date the value of the
; 'service connected y/n' field is checked.
; if no, flag to collect from insurance is set.
; o for the INITIAL TREATMENT DATE, checks if patient was cat c
; and agreed to pay deductible or was not exempt from LTC copay.
; if true, then software uses IB call to determine if patient
; is insured on treatment date
; o if service is for C&P, or both of the above two flags are
; negative, record is bypassed.
;pharmacy info - program 3 - fbpcr3 uses date certified for payment for date range sort
; o for each invoice number, RX number for a patient within the
; specified date range, the value of the rx fill date field is
; obtained and checked against the authorization in the fee
; patient file. a check is made to see if the value of the
; potential cost recovery field is yes for an authorization
; which encompasses the fill date.
; if yes, then software uses IB call to determine if patient
; is insured on date certified for payment
; o for date certified for payment, checks if patient was cat c
; and agreed to pay deductible. if true, flag to collect from
; patient is set.
; o if both of the above two flags are negative, record is bypassed.
;ch/cnh info - programs 6 and 7 - fbpcr67* uses date finalized for date range sort
; o for each record, for a patient within the specified date
; range, the value of the treatment from date is obtained
; and checked against the authorization in the fee patient file.
; a check is made to see if the value of the potential cost
; recovery field is yes for an authorization which encompasses
; the treatment from date.
; if yes, then software uses IB call to determine if patient
; is insured on date certified for payment.
; o for TREATMENT FROM DATE and TREATMENT TO DATE, checks if
; patient was cat c and agreed to pay deductible or was not
; exempt from LTC copay. if true, flag to collect from patient
; is set.
; o if both of the above two flags are negative, record is bypassed.
--- Routine Detail --- with STRUCTURED ROUTINE LISTING ---[H[J[2J[HFBDOC 3577 printed Nov 22, 2024@17:08:27 Page 2
FBDOC ;ALBISC\TET - ROUTINE DOCUMENTATION ;10/9/92 11:24
+1 ;;3.5;FEE BASIS;**48**;JAN 30, 1995
+2 ;;Per VHA Directive 10-93-142, this routine should not be modified.
+3 ;Routine contains documentation of other routines. Name sets
+4 ; of routines are indicated in line label.
FBPCR ;
+1 ;POTENTIAL COST RECOVERY REPORT
+2 ;user selects primary service areas and date range.
+3 ;The user is able to filter data to include Copays or Insurance only
+4 ;related information:
+5 ; Include (P)atient Co-pays / (I)nsurance / (B)oth
+6 ;If the user selects (P) or (B),the following prompt will allow
+7 ;the user to include Mean Test or LTC copays only or Both:
+8 ; Include (M)eans Test Co-pays /(L)TC Co-pays /(B)oth
+9 ;output will sort by primary service area, patient, program, vendor, date.
+10 ;only those that are means test category c/agree to pay deductible
+11 ; or for non-service connected treatment are printed, as well as
+12 ; insurance information.
+13 ;Since 7/5/2002 all LTC related payments are flagged in the report with
+14 ;appropriate messages. If the veteran doesn't have LTC test on file then
+15 ;the LTC related payment is flagged with "1010EC missing" message.
+16 ;
+17 ;outpatient info - program 2 - fbpcr2 uses date finalized for date range sort
+18 ; o for each service on a treatment date the value of the
+19 ; 'service connected y/n' field is checked.
+20 ; if no, flag to collect from insurance is set.
+21 ; o for the INITIAL TREATMENT DATE, checks if patient was cat c
+22 ; and agreed to pay deductible or was not exempt from LTC copay.
+23 ; if true, then software uses IB call to determine if patient
+24 ; is insured on treatment date
+25 ; o if service is for C&P, or both of the above two flags are
+26 ; negative, record is bypassed.
+27 ;pharmacy info - program 3 - fbpcr3 uses date certified for payment for date range sort
+28 ; o for each invoice number, RX number for a patient within the
+29 ; specified date range, the value of the rx fill date field is
+30 ; obtained and checked against the authorization in the fee
+31 ; patient file. a check is made to see if the value of the
+32 ; potential cost recovery field is yes for an authorization
+33 ; which encompasses the fill date.
+34 ; if yes, then software uses IB call to determine if patient
+35 ; is insured on date certified for payment
+36 ; o for date certified for payment, checks if patient was cat c
+37 ; and agreed to pay deductible. if true, flag to collect from
+38 ; patient is set.
+39 ; o if both of the above two flags are negative, record is bypassed.
+40 ;ch/cnh info - programs 6 and 7 - fbpcr67* uses date finalized for date range sort
+41 ; o for each record, for a patient within the specified date
+42 ; range, the value of the treatment from date is obtained
+43 ; and checked against the authorization in the fee patient file.
+44 ; a check is made to see if the value of the potential cost
+45 ; recovery field is yes for an authorization which encompasses
+46 ; the treatment from date.
+47 ; if yes, then software uses IB call to determine if patient
+48 ; is insured on date certified for payment.
+49 ; o for TREATMENT FROM DATE and TREATMENT TO DATE, checks if
+50 ; patient was cat c and agreed to pay deductible or was not
+51 ; exempt from LTC copay. if true, flag to collect from patient
+52 ; is set.
+53 ; o if both of the above two flags are negative, record is bypassed.
