| DESCRIPTION |
This Accounts Receivable option is used to schedule the DMC Debt Validity
X will be the value entered in the "NUMBER OF DAYS FOR DMC REPORTS"
(#8.02) field of the AR SITE PARAMETER (#342) file. If this value isn't
entered the report will default to bills from episodes of care for the
past 365 days. This parameter can be edited using the Enter/Edit DMC
Report # Days for Episodes of Care [RCDMC EDIT DMC REPORT # OF DAY]
option.
Authorized billing staff can use the report to ensure that all bills
meeting the above criteria are reviewed and if necessary the appropriate
action is taken as follows:
Report to run on a recurring basis with out user intervention. The report
Bill is appropriate - Update the Debt Validity Status field to 'YES'
in order that the bill is referred to DMC via
the automated process if all other DMC criteria
is met
Bill is inappropriate - Update the Debt Validity Status Field to 'NO'
and staff will cancel the bill using existing
functionality
Inappropriate bill sent to DMC - Staff to initiate action to cancel
DMC collection or refund payments
using existing functionality
is used to assist users in focusing on reviewing the legitimacy of first
The scheduled report can only be printed in the detailed format and it
should be sent to a device that is 132 characters wide.
The report will include the following data elements:
Data Elements From File #
------------------------------- ---------------------------------
Veteran's Name #2 (Patient File)
SSN (Last 4 digits) #2
Claim Number(CXXXXXXXX) #2
party bills for veterans who are SC 50% to 100% or in receipt of VA
Claim Location(Station Number) #2
Eligibility/Effective Date #2
Bill Number #430 (Accounts Receivable)
RX Fill/Re-Fill Date. File #52 pointed to by File #350
Outpatient Visit Date File #409.68 pointed to by file #350
Discharge Date File #405 pointed to by file #350
AR Status(Open/Active/Suspended) #430
DMC Referral Date #430
DMC Debt Valid (Null/PENDING) #430
Pension benefits. The report contains information on veterans who meet the
Summary at bottom of report:
Total Number of Bills Referred
Total Number of unique veterans referred
Total AR Dollars referred
Total Number of Bills
Total Number of unique veterans
Total AR Dollars
above criteria and have bills for episodes of care within the previous X
Note: When the veteran is not Service Connected 50% to 100% and is not
Receiving a VA Pension the new software will also include the
functionality to consider a veteran as Receiving a VA Pension if he/she is
receiving A&A or Housebound Benefits.
days with a DMC Debt Valid field not flagged as 'YES' or 'NO' and for
which the Current Status is Active, Open or Suspended.
|
