| DESCRIPTION |
This option is intended to identify costs for fee services which may be
Insurance information is also displayed/printed.
The user is able to filter data to include Copays or Insurance only
related information using prompt:
Include (P)atient Co-pays / (I)nsurance / (B)oth
If the user selects (P) or (B),the following propmpt 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
able to be recovered.
Since July 5,2002 all LTC related payments are flagged in the report with an
appropriate message. If the veteran doesn't have LTC test on file then
the LTC related payment is flagged with "1010EC missing" message.
Outpatient program (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 set to no, then
software uses IB call to determine if patient is insured on
treatment date
o Check is also made if patient was Cat C and agreed to pay deductible
or was not exempt from LTC copay on INITIAL TREATMENT DATE. If true,
flag to collect from patient is set.
o If service is for C&P, or both of the above two flags are negative,
the record is bypassed.
Pharmacy program (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 DATE PRESCRIPTION FILLED field is obtained
The user selects the primary service facility(s) and date range. All
and checked against the authorization in the FEE BASIS 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 RX FILL DATE.
If yes, then software uses IB call to determine if patient
is insured on date certified for payment.
o Check is also made if patient was Cat C and agreed to pay deductible
on DATE PRESCRIPTION FILLED 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.
active fee programs are reviewed for the selected search criteria.
CH/CNH program (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 BASIS PATIENT file.
A check is made to see if the value of the POTENTIAL COST RECOVERY
field is set to yes for an authorization which encompasses the
TREATMENT FROM DATE. If yes, then software uses IB call to determine
if patient is insured on FROM/TO dates.
o Check is also made if patient was Cat C and agreed to pay deductible
or was not exempt from LTC copay on TREATMENT FROM DATE or
The data is sorted by division, patient, fee program, and vendor and date.
TREATMENT TO DATE. If true on at least one of those dates,
flag to collect from patient is set.
o If both of the above two flags are negative, record is bypassed.
The data displayed/printed is similar to the payment outputs, only for
patients that are means test category C/agree to pay deductible or
not exempt from LTC copay or for non-service connected treatment.
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