ࡱ>  JL?@ABCDEFGHI FbjbjR|R| 004>00*****4***h&+$J. *V=D H@HHHK U4.Y;======$\a*ZJ@KZZa**HHvZ*H*H;Z;ݟHV x(|[)N'0krݟݟ"*(ZZZZZZZaaZZZZZZZZZZZZZZZZ0 P): Department of Veterans Affairs Prosthetics Basics User Manual  Version 3.0 Revised October 2016 May 2004 Department of Veterans Affairs Office of Information and Technology Enterprise Program Management Office Revision History DateVersionDescriptionAuthor10/2016RMPR*3.0*178Added new option RMPR GIP STOCK to Purchasing Menu (p.  HYPERLINK \l "p6" 6)L. Behuniak, VA PM B. Thomas, TW08/2014RMPR*3.0*168Updates for ICD-10 Updated title page New ICD-10 screen capture (p.47)T. Bennett, VA PM R. Wilson, HP PM R. Wilder, TW08/2011RMPR*3*167Modify text when referencing Form 1358. See page 88.M Anthony, PM C Arceneaux, TW3/01/2010RMPR*3*150Added new option EDIT 2319 (Vendor, QTY, Cost) April Scott, PM Gary Werner, TW5/19/2004Initial Version 3.0 Table of Contents  TOC \h \z \t "Chapter Title,1,Map Title,2"  HYPERLINK \l "_Toc395634640" Prosthetics Basics User Manual  PAGEREF _Toc395634640 \h 1  HYPERLINK \l "_Toc395634641" Section 1: Understanding Main Menu Features  PAGEREF _Toc395634641 \h 1  HYPERLINK \l "_Toc395634642" Overview  PAGEREF _Toc395634642 \h 1  HYPERLINK \l "_Toc395634643" Purchasing Menu (PU)  PAGEREF _Toc395634643 \h 5  HYPERLINK \l "_Toc395634644" Purchasing Menu (PU)  PAGEREF _Toc395634644 \h 9  HYPERLINK \l "_Toc395634645" Display/Print Menu (DD)  PAGEREF _Toc395634645 \h 10  HYPERLINK \l "_Toc395634646" Utilities Menu (UT)  PAGEREF _Toc395634646 \h 12  HYPERLINK \l "_Toc395634647" Suspense Menu (SU)  PAGEREF _Toc395634647 \h 13  HYPERLINK \l "_Toc395634648" Correspondence Menu (CO)  PAGEREF _Toc395634648 \h 15  HYPERLINK \l "_Toc395634649" Scheduled Meetings and Home/Liaison Visits Menu (SC)  PAGEREF _Toc395634649 \h 16  HYPERLINK \l "_Toc395634650" Process Form 2529-3 (PS)  PAGEREF _Toc395634650 \h 18  HYPERLINK \l "_Toc395634651" Eligibility Inquiry (EL) Menu  PAGEREF _Toc395634651 \h 19  HYPERLINK \l "_Toc395634652" PSC/Entitlement Records (ET) Menu  PAGEREF _Toc395634652 \h 22  HYPERLINK \l "_Toc395634653" Home Oxygen Main Menu (HO)  PAGEREF _Toc395634653 \h 23  HYPERLINK \l "_Toc395634654" Pros Inventory Main (INV)  PAGEREF _Toc395634654 \h 25  HYPERLINK \l "_Toc395634655" NPPD Tools Menu (ND)  PAGEREF _Toc395634655 \h 28  HYPERLINK \l "_Toc395634656" Section 2: Display/Print Menu  PAGEREF _Toc395634656 \h 31  HYPERLINK \l "_Toc395634657" Overview  PAGEREF _Toc395634657 \h 31  HYPERLINK \l "_Toc395634658" Display/Print Menu Option Descriptions  PAGEREF _Toc395634658 \h 33  HYPERLINK \l "_Toc395634659" Display/Print Patient 2319 (23)  PAGEREF _Toc395634659 \h 35  HYPERLINK \l "_Toc395634660" View and Print the Patient 2319  PAGEREF _Toc395634660 \h 36  HYPERLINK \l "_Toc395634661" View Patient Demographics  PAGEREF _Toc395634661 \h 38  HYPERLINK \l "_Toc395634662" View Clinic Enrollments/Correspondence  PAGEREF _Toc395634662 \h 40  HYPERLINK \l "_Toc395634663" View Letters/Correspondence on File  PAGEREF _Toc395634663 \h 42  HYPERLINK \l "_Toc395634664" View Entitlement Information  PAGEREF _Toc395634664 \h 45  HYPERLINK \l "_Toc395634665" View Appliance Transactions  PAGEREF _Toc395634665 \h 46  HYPERLINK \l "_Toc395634666" View Auto Adaptive Information  PAGEREF _Toc395634666 \h 48  HYPERLINK \l "_Toc395634667" View Critical Comments  PAGEREF _Toc395634667 \h 49  HYPERLINK \l "_Toc395634668" Add/Edit Disability Codes  PAGEREF _Toc395634668 \h 50  HYPERLINK \l "_Toc395634669" View Home Oxygen Items  PAGEREF _Toc395634669 \h 53  HYPERLINK \l "_Toc395634670" Transaction Inquiry (TI)  PAGEREF _Toc395634670 \h 54  HYPERLINK \l "_Toc395634671" View a Transaction  PAGEREF _Toc395634671 \h 54  HYPERLINK \l "_Toc395634672" Print All Prosthetic Items (IP)  PAGEREF _Toc395634672 \h 56  HYPERLINK \l "_Toc395634673" Overview  PAGEREF _Toc395634673 \h 56  HYPERLINK \l "_Toc395634674" View the Prosthetic Item Master List  PAGEREF _Toc395634674 \h 57  HYPERLINK \l "_Toc395634675" Print Prosthetic Billings for MAS (BI)  PAGEREF _Toc395634675 \h 58  HYPERLINK \l "_Toc395634676" Overview  PAGEREF _Toc395634676 \h 58  HYPERLINK \l "_Toc395634677" View Prosthetic Billing Information  PAGEREF _Toc395634677 \h 60  HYPERLINK \l "_Toc395634678" Item History (IH)  PAGEREF _Toc395634678 \h 62  HYPERLINK \l "_Toc395634679" View Item History  PAGEREF _Toc395634679 \h 62  HYPERLINK \l "_Toc395634680" View Item History Within a Date Range  PAGEREF _Toc395634680 \h 63  HYPERLINK \l "_Toc395634681" Search for Recalled Item (SE)  PAGEREF _Toc395634681 \h 64  HYPERLINK \l "_Toc395634682" Overview  PAGEREF _Toc395634682 \h 64  HYPERLINK \l "_Toc395634683" Search by Serial Number or Lot Number  PAGEREF _Toc395634683 \h 65  HYPERLINK \l "_Toc395634684" Search by Item Number  PAGEREF _Toc395634684 \h 66  HYPERLINK \l "_Toc395634685" Site Parameter Inquiry (SI)  PAGEREF _Toc395634685 \h 68  HYPERLINK \l "_Toc395634686" Overview  PAGEREF _Toc395634686 \h 68  HYPERLINK \l "_Toc395634687" Vendor Inquiry (VI)  PAGEREF _Toc395634687 \h 69  HYPERLINK \l "_Toc395634688" Overview  PAGEREF _Toc395634688 \h 69  HYPERLINK \l "_Toc395634689" Vendor Inquiry Screen Output  PAGEREF _Toc395634689 \h 70  HYPERLINK \l "_Toc395634690" Section 3: Purchasing Menu (PU)  PAGEREF _Toc395634690 \h 71  HYPERLINK \l "_Toc395634691" Overview  PAGEREF _Toc395634691 \h 71  HYPERLINK \l "_Toc395634692" List Open 1358 Prosthetic Transactions (LI)  PAGEREF _Toc395634692 \h 74  HYPERLINK \l "_Toc395634693" Close Out (CO)  PAGEREF _Toc395634693 \h 76  HYPERLINK \l "_Toc395634694" Enter New Request (EN)  PAGEREF _Toc395634694 \h 77  HYPERLINK \l "_Toc395634695" Overview  PAGEREF _Toc395634695 \h 77  HYPERLINK \l "_Toc395634696" Enter a 2421 Form (24)  PAGEREF _Toc395634696 \h 78  HYPERLINK \l "_Toc395634697" Enter a 2520 Transaction without Printing 10-55 (25)  PAGEREF _Toc395634697 \h 91  HYPERLINK \l "_Toc395634698" 10-55 PSC Form (10)  PAGEREF _Toc395634698 \h 93  HYPERLINK \l "_Toc395634699" 2914 Eyeglass Record (29)  PAGEREF _Toc395634699 \h 96  HYPERLINK \l "_Toc395634700" Appendix A Online Help  PAGEREF _Toc395634700 \h 98  HYPERLINK \l "_Toc395634701" Appendix B - Glossary  PAGEREF _Toc395634701 \h 99  Prosthetics Basics User Manual Section 1: Understanding Main Menu Features Overview AudienceThe Prosthetics Basics User Manual is for new Prosthetics users of the Prosthetics Sensory Aids Service (PSAS) system including Purchasing Agents and any other new end user on the system. This manual will provide a general overview of the entire system as well as step-by-step instructions of the more frequently used menus and options. Main MenuThe main menu for Prosthetics is the following - the Prosthetics Officials Menu: Prosthetics Officials MenuPUPurchasingDDDisplay/PrintUTUtilitiesAMAMISSUSuspenseCOCorrespondenceSCScheduled Meetings & Home/Liaison VisitsPSProcess Form 2529-3ELEligibility InquiryETPSC/Entitlement RecordsHOHome Oxygen Main MenuINVPros Inventory MainNDNPPD ToolsVRVerify/Repair Purchase Card Form In this manualThe following are the sections in this manual. TopicSee PageSection 1: Understanding Main Menu Features1Section 2: Display/Print Menu (DD)24Section 3: Purchasing Menu (PU)58Appendix A Online Help82Appendix B - Glossary83 Continued on next page styleref "Map Title"Overview, Continued Menu OptionsBelow are the Prosthetic Officials Main Menu options, the option name for each, the synonym, and a description of each. To display this information, type three question marks at the following prompt: Select Prosthetic Official's Menu Option: ???  Menu OptionSynonymOption NameDescriptionPurchasingPURMPR PURCHAS-ING MENUPurchasing menu, sub-menu of Prosthetic Clerk/Official master menus.Display/PrintDDRMPR DISPLAY/PRINTDisplay/Print menu for Prosthetic Clerks and Officials. This is a sub-menu of Prosthetic Clerks and Officials master menus.UtilitiesUTRMPR UTILITIESThis is the Prosthetics Utility Menu.AMISAMRMPR MGMT REPORTSAMIS data is generated from this menu option.SuspenseSURMPR SUSPENSE MENUThis is the menu for Suspense Options.CorrespondenceCORMPR CORR MAINThis is the main menu for Correspondence.Scheduled Meetings & Home/Liaison VisitsSCRMPR SCHED-H/L VISITSThis is the main menu for Scheduled Meetings and Home Liaison Visits.Eligibility InquiryELRMPR ELG INQThis option is an eligibility inquiry into the MAS PATIENT file (#2).PSC/ Entitlement RecordsETRMPR ENTITLE-MENT/PSCThis is the menu for Prosthetic Service Card and Entitlement Records.Home Oxygen Main MenuHORMPO-MENU-MAINThis menu helps you manage your home oxygen program. It tracks costs of services, helps you manage billings, and alerts you when it is time to send letters to patients (e.g., prescription expiration).NPPD ToolsNDRMPR NPPD TOOLSThis option contains all tools associated with the National Prosthetic Patient Database. Continued on next page styleref "Map Title"Overview, Continued Menu Options (continued)Below are the Prosthetic Officials Main Menu options, the option name for each, the synonym, and a description of each. Menu OptionSynonymOption NameDescriptionProcess Form 2529-3PSRMPR 2529-3 MAINMain Menu for Prosthetics Lab ModulePros Inventory MainINVRMPR INV MAINProsthetic generic inventory system.NPPD ToolsNDRMPR NPPD TOOLSTools for the National Prosthetics Patient DatabaseVerify/Repair Purchase Card FormVRRMPR Verify/ Repair PC NumberTemporary option used to fix reconciliations of Purchase Card orders. Purchasing Menu (PU) Menu option descriptionsBelow are the Purchasing Menu (PU) options, the synonym, option name and a description of each. Menu OptionSynonymOption NameDescriptionEnter New RequestENRMPR ENT REQUESTSThis is the sub-menu for entering prosthetic purchasing requests that link with IFCAP. Stock IssuesSIRMPR STOCK ISSThis is the Stock Issue Menu Options.ReprintsRPRMPR REPRINTSThis is the Reprint Menu for Prosthetic Purchasing Forms.Record 2237 Purchase to 10-2319RERMPR ENT 2237This option will record the information from a VAF 2237 to a patients VAF 10-219 record.Edit/Delete 2237 from 10-2319EDRMPR 2319 EDTThis option will edit or delete information posted from a VAF 2237 record to a patients VAF 10-2319.Cancel a TransactionCARMPR CANCELThis option will cancel purchasing transactions that have not been closed out.Close OutCORMPR CLOSE-OUTThis is locked with RMPRSUPERVISOR. This option is used to close out transactions when invoices are received from the vendor. This will update the actual VAF 1358 account balance.Cancel Purchase Card TransactionCPCRMPR4 PCCThis option will cancel the Purchase Card Transaction and remove the purchase from the Patients 10-2319 Record.Reconcile/Close Out Purchase Card TransactionCPORMPR4 CLOSE OUTThis option is used to close out purchasing transactions that used the Purchase Card. This option will not post to IFCAP 1358.Generic Inventory Stock IssuesGIPRMPR GIP STOCKThis option allows sites to issue prosthetics stock that is maintained by the IFCAP Generic Inventory Package (GIP) rather than the prosthetics inventory Package (PIP).* *Patch RMPR*3.0*178 configures VistA to allow the Prosthetics Department to use GIP instead of PIP. It automatically updates inventory in IFCAP GIP. However, when items issued are from an INVENTORY POINT linked to a Point of Use (POU) supply cabinet, option does not update the inventory, since special cabinets automatically update GIP inventory balances, via HL7 messaging, when stock is removed. This option also checks the DynaMed System Parameter flag to determine if the site is running DynaMed, and if so this option will abort. Sites using DynaMed should continue to use PIP until a solution is implemented for DynaMed and GIP. Continued on next page styleref "Map Title"Purchasing Menu (PU), Continued Menu option descriptions (continued)Below are the Purchasing Menu (PU) options, the synonym, option name and a description of each. Menu OptionSynonymOption NameDescriptionEdit 2319ED2RMPR EDIT 2319This option will allow limited editing of purchasing and stock issue transactions recorded on a patients VAF 10-2319.EDIT 2319 (Vendor, QTY, Cost) ED2CRMPR EDIT 2319 VENDOR/QTY/COST This option will allow users with the RMPRSUPERVISOR key to edit Vendor, Qty & cost.Edit Purchase Card TransactionEDPCRMPR4 EDPCThis option will edit the 2421PC form once it has been created.Add Historical DataHIRMPR HIS DATAThis option will allow posting an item to the patients VAF 10-2319 without counting on AMIS.Delete Historical DataHIDRMPR HIS DELThis option deletes historical data.List Open 1358 Prosthetic TransactionsLIRMPR PRINT OPEN TRANSThis option lists VAF 1358 transactions that have not been closed out.List Open 1358 Transactions by InitiatorLIIRMPR PRINT OPEN TRANS INITThis option will print open 1358 transactions in the Prosthetics package, sorted by initiator.List Open Purchase Card TransactionsLPCRMPR4 LIST OPNThis menu will print all open Purchase Card Transactions. The Purchase Card Number will be encrypted, except for the creator and supervisor.List Open Purchase Card Transactions by InitiatorLPCIRMPR4 LIST OPEN BY INITThis option will print the open Purchase Card Transactions by Initiator, sorted by transaction date. Purchasing Menu (PU) Menu option descriptionsBelow are the Purchasing Menu (PU) options, the synonym, option name and a description of each. Menu OptionSynonymOption NameDescriptionPurchase Card Summary SheetLPSRMPR4 PC SUMThis option displays the Purchase Card Summary by Card Number. It will list the open and closed obligations. Display/Print Menu (DD) Menu option descriptionsBelow are the Display/Print Menu (DD) options, the synonym, option name and a description of each. Menu OptionSynonymOption NameDescriptionDisplay/Print Patient 231923RMPR PRINT 2319Display/print a patient's VAF 10-2319. Transaction InquiryTIRMPR 1358 INQInquiry to single purchasing transaction. Print All Prosthetic ItemsIPRMPR PRINT ALL ITEMSThis option prints all Prosthetic Item Master records along with their new and repair AMIS codes. Lab AMIS codes are not printed with this version of Prosthetics. Print Prosthetic Billings for MASBIRMPR PRINT BILLPrints all NSC (non-service connected) items issued to patients for billing purposes. Item HistoryIHRMPR ITEM HISTORYPrints an item history of all purchases made for this item. Search for Recalled ItemSERMPR PRINT RECALLSearches the RECORD OF PROS APPLIANCE/ REPAIR file (#660) for recalled item. Site Parameter InquirySIRMPR SITE INQThis menu option should be used to review your local site information. Vendor InquiryVIRMPR INQ VENDThis option is an inquiry to the IFCAP VENDOR file (#440).  Utilities Menu (UT) Menu option descriptionsBelow are the Utilities Menu options, the synonym, option name and a description of each. Menu OptionSynonymOption NameDescriptionAdd/Edit Patient to ProstheticsAPRMPR ADD PATIENTThis option will add a new patient to the PROSTHETICS PATIENT file (#665). You may also edit existing patient data using this option.Enter Prosthetic Disability Code to 2319DISRMPR DIS ENTRYThis will add or delete Disability Codes to be counted on AMIS.Delete Prosthetic Disability Code from 2319REMRMPR DEL CODEMark Disability Code from patient's VAF 10-2319 as deactivated.Enter/Edit Prosthetic Item MasterENRMPR ADD ITEM MASTERThis option adds a new Item Record to File 661, PROS ITEM MASTER.IFCAP UtilitiesIFRMPR VEN/ITEMMenu for IFCAP Vendor and Item Edit options.Purge Obsolete DataPGERMPR PURGE MENUThis is the Purge Menu.Flag Item as Returned/CondemnedRCRMPR RETURNThis will place items as returned, condemned, turned-in, lost or broken. To review this data once entered, review the patient's VAF 10-2319 record on the third screen.Edit Returned/ Condemned ItemRERMPR RETURNED EDITThis option will allow users to edit or delete items that have been flagged as returned or condemned.Enter/Edit Site ParametersSPRMPR SITE MENUTo enter/edit station Prosthetics site parameters. Suspense Menu (SU) Menu option descriptionsA Suspense Request (through the Suspense Menu) is a request for service or an item that is tracked by a five-day Delayed Order Report. The five workday policy refers to the process or time it takes from receiving the order in Prosthetics to the time an initial action on a request or the time the request is fulfilled has been taken. If this process takes more than five workdays, it is flagged on the report for monitoring and reporting purposes. It is also denoted in the Suspense list by an asterisk. Menu option descriptionsBelow are the Suspense Menu options, the synonym, option name and a description of each. Menu OptionSynonymOption NameDescriptionAdd Suspense RecordASRMPR ADD SUSPENSEAdds a new Suspense Record to the PROSTHETIC SUSPENSE file (#668). The patient need not be in the PROSTHETICS PATIENT file (#665). Close Suspense RecordCSRMPR CLOSE SUSPENSEThis will close out the suspense record, and flag it as completed. Edit Suspense RecordESRMPR SUSPENSE EDITThis option will edit a suspense record for a patient. Inquire to Individual Suspense RecordISRMPR INQ SUSPENSEThis option will display the complete Suspense Record for a veteran. Print Closed Suspense RecordsPCRMPR SUSPENSE PRINT CLOSEDThis will print the closed suspense records for a date range. Print Open Suspense RecordsPORMPR SUSPENSE PRINTThis option will list all open suspense records. Continued on next page styleref "Map Title"Suspense Menu (SU), Continued Menu option descriptions (continued)Below are the Suspense Menu options, the synonym, option name and a description of each. Menu OptionSynonymOption NameDescriptionPrint 5 Day Old Suspense ReportPRRMPR SUSPENSE PRINT 5 DAY OLDThis option prints all suspense records over 5 working days old. Print Suspense StatisticsSTRMPR SUSPENSE STATPrints statistics from the PROSTHETICS SUSPENSE file (#668). Suspense ProcessingSPRMPR SUSP MENUThis is the List Manager version of Suspense Processing, to be used with Consult Tracking.  Correspondence Menu (CO) Menu option descriptionsBelow are the Correspondence Menu options, the synonym, option name and a description of each. Menu OptionSynonymOption NameDescriptionCreate a LetterCRRMPR CORR CREATECreates new letter for Prosthetics.Delete Patient Correspondence LetterDERMPR CORR DELETEDeletes correspondence letter from the PROS LETTER TRANSACTION file (#665.4). Add/Edit Correspondence Skeleton LetterEDRMPR CORR EDITThis option allows Prosthetics managers to edit the basic skeleton letters (FORM LETTER TYPE). Print/Display Patient Correspondence LetterPRRMPR CORR VIEWView correspondence letter. Print Correspondence Skeleton LetterPSRMPR CORR PRINTAllows printing of a correspondence letter.  Scheduled Meetings and Home/Liaison Visits Menu (SC) Menu option descriptionsBelow are the Scheduled Meetings and Home/Liaison Visits (SC) Menu options, the synonym, option name and a description of each. Menu OptionSynonymOption NameDescriptionPull over Scheduled Clinic VisitsPLRMPR PULL SCHEDThis option will allow scheduling clinic visits to be pulled over to VAF 10-2527.Edit Form 10-2527 Information25RMPR EDIT 2527Enter referral and action information to patient's clinic visits. Delete Scheduled Prosthetic Clinic VisitsDLRMPR SCHED DELThis option will allow the user to delete Prosthetics clinic visits that have been pulled over to the VAF 10-2527.Enter/Edit Closed Time for Clinic VisitsCARMPR CLOSE APPClinic team member may enter or change time that a scheduled clinic appointment was actually completed. Appointment Roster and Action SheetAPRMPR PRT 2527Prints VAF 10-2527 for single clinic after information has been pulled over from MAS scheduled clinic visits. Open Home/Liaison VisitsOPRMPR H/L OPENOpen home or liaison visits for Prosthetics. Close Home/Liaison VisitsCORMPR H/L CLOSEClose open home or liaison visits by entering the date closed and the total hours of the visit. Edit/Delete Home/Liaison VisitsEDRMPR H/L EDITEdit/delete home or liaison visits.Print Closed Home/Liaison VisitsPCRMPR H/L PRINT CLOSEDPrint closed home/liaison visits.Print Open Home/Liaison VisitsPORMPR H/L PRINT OPENPrint open home or liaison visits. Process Form 2529-3 (PS) Menu option descriptionsBelow are the Process Form 2529-3 Menu options, the synonym, option name and a description of each. Menu OptionSynonymOption NameDescription2529-3 Request MenuRQRMPR 2529-3This menu will be used by the Prosthetics administrative personnel to enter, edit, print and close out VAF 10-2529-3 requests. Prosthetic Lab MenuLBRMPR LAB MENUThis is the main menu for Prosthetic Laboratory Technicians.  Eligibility Inquiry (EL) Menu Menu option descriptionsThe Eligibility Inquiry is an option and does not have submenu options. The following is an example of this option Screen sample PU Purchasing ... DD Display/Print ... UT Utilities ... AM AMIS ... SU Suspense ... CO Correspondence ... SC Scheduled Meetings and Home/Liaison Visits ... PS Process Form 2529-3 ... EL Eligibility Inquiry ET PSC/Entitlement Records ... HO Home Oxygen Main Menu ... INV Pros Inventory Main ... ND NPPD Tools ... OC CoreFLS Order Control VR VERIFY/REPAIR PURCHASE CARD NUMBER Select Prosthetic Official's Menu Option: EL Eligibility Inquiry SITE: Hines Development System// Select PATIENT NAME: PROSPATIENT,ONE 1-1-30 000000001 NO PILL Enrollment Priority: Category: IN PROCESS End Date: *** Patient Requires a Means Test *** Primary Means Test Required from FEB 13,2002 Enter to continue. PROSPATIENT,ONE SSN:000-00-0001 DOB: JAN 1,1930 CLAIM# Phone: PHONE Phone: Current Address: Primary Next of Kin Address: 1ST LINE OF STREET ADDRESS SECOND LINE OF STREET ADDRESS Patient Type: PILL Period of Service: OTHER OR NONE Primary Eligibility Code: Status: REQUIRED NSC Eligibility Status: Receiving A&A Benefits? NO Receiving Housebound Benefits? NO Receiving Social Security? NO Receiving VA Pension? NO Receiving Military Retirement? NO Receiving VA Disability? NO Patient Name: PROSPATIENT,ONE SSN: 000-00-0001 MAS Disability Code(s): *POW? NO Enter `^`to exit, or `return` to continue:  Continued on next page  STYLEREF "Map Title" Eligibility Inquiry (EL) Menu, Continued Example (continued)The Eligibility Inquiry also provides Last Movement Actions, Pending Appointments, and letters on file. You can select a Letter on File to be viewed. Enter the number of the letter to display and press at the Device prompts. Screen sample (continued)PROSPATIENT,ONE SSN: 000-00-0001 DOB: JAN 1,1930 CLAIM# Last Movement Actions Trans. Type: TRANSFER Trans. Type: ADMISSION Date: SEP 11,1995@15:04:29 Date: SEP 11,1995@14:59:18 Type of Movement: Type of Movement: INTERWARD TRANSFER DIRECT Ward: 1AS Ward: 5NM Physician: PROSPROVIDER,ONE Physician: PROSPROVIDER,TWO Diagnosis: SICK Diagnosis: SICK Clinic Enrollments Clinic Enrollment Date OPT or AC MCGILL,TEST MAR 21,2000@13:11 OPT Pending Appointments Appt. Date Clinic Status Type MAR 1,2004@09:15 PROSTHETICS INPATIENT APPOINTMENTREGULAR SITE: Hines Development System// Letters on file: # Patient Type of letter Employee Date of letter ------------------------------------------------------------------------------ 1 PROSPATIENT,ONE TEST PROSPROVIDER,THREE JUN 03, 2003 2 PROSPATIENT,ONE ADP FL 10-90 PROSPROVIDER,THREE JUN 02, 2003 3 PROSPATIENT,ONE TEST PROSPROVIDER,THREE FEB 08, 2002 4 PROSPATIENT,ONE HO 30 DAY TEST PROSPROVIDER,THREE FEB 08, 2002 5 PROSPATIENT,ONE HO 30 DAY TEST PROSPROVIDER,THREE FEB 08, 2002 Enter '^' to stop or Enter a number (1-5): 2 DEVICE: HOME// TELNET Right Margin: 80// Continued on next page  STYLEREF "Map Title" Eligibility Inquiry (EL) Menu, Continued Letter on FileBelow is the Letter on File that you selected to view for the specific patient displayed.  Screen sample (continued) REQUEST FOR QUOTATION Date: Feb 12, 2004 TO: FROM: PROSVENDOR,ONE Hines Development System TEST 2 HINES, IL 60142 Vendor Phone #: Veteran: PROSPATIENT,ONE SSN: 000000001 Your firm is being considered for the following: An estimate on the above-listed item(s) is requested. YOUR QUOTATION DOES NOT CONSTITUTE A PURCHASE ORDER. Upon completion of the esti- mate, return the original to the Veterans Affairs facility indicated above and retain a copy for your files. If approved, a purchase order will be prepared and forwarded to you. Sincerely, PROSPROVIDER,FOUR CHIEF Screen sample (continued) VENDOR'S ESTIMATE (To be completed by Vendor) ---------------------------------------------------------------------- | Article or Service |Quantity| Unit |Unit Cost|Total Cost| ---------------------------------------------------------------------- | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | ---------------------------------------------------------------------- | Vendor: Contract number (if applicable) | | Address: | | City: | | State: Zip: | | Telephone: | | Date: Signature & Title of Company Official| | Note:List Terms/Discounts if Applicable | ---------------------------------------------------------------------- FL 10-90 ADP Would you like to see more letters? No// (No) Do you wish to create a correspondence letter? No// (No) PSC/Entitlement Records (ET) Menu Menu option descriptionsBelow are the PSC/Entitlement Records (ET) Menu options, the synonym, option name and a description of each. Menu OptionSynonymOption NameDescriptionAdd/Edit Clothing AllowanceACRMPR CLOTHINGAdds a Clothing Allowance for a patient. Add/Edit Prosthetic Service CardPSRMPR ADD PSCThis option will add a Prosthetic Service Card to the patients VAF 10-2319 record. Enter/Edit Auto Adaptive InfoAURMPR AUTOThis option is the main menu to enter/edit auto-adaptive equipment purchased for the patient. This allows adding a new Vehicle of Record, adding van modifications, new items, and editing of items and repairs. Record Other Patient InformationRORMPR ADD ODThis option allows a free-text word processing area for storage of other information needed by service on the patient's VAF 10-2319 record. Information such as eye color, hair color, patient's station, etc. is included.  Home Oxygen Main Menu (HO) Menu option descriptionsBelow are the Home Oxygen Main Menu (HO) options, the synonym, option name and a description of each. Menu OptionSynonymOption NameDescriptionAdd/Edit Home Oxygen PatientEDRMPO ADD/EDIT PATThis option allows the user to add patients to the Prosthetics Patient file, edit demographics (e.g., therapy activation date and eligibility for home oxygen services), and document prescription and billing equipment data.Billing TransactionsBTRMPO BILLING TRANSACTIONSThis option allows you to edit bills for a specific month, accept those transactions, and post them. Generate LettersLERMPO LIST/PRINT MANAGERThis option creates a list of patients who are due to receive letters and prints the letters. Home Oxygen Patient Template UpdateTURMPO HO PAT TEMPLATE UPDAThis is a utility for updating vendor, HCPCS, FCP, item, and unit cost of all Home Oxygen patients in a particular station at once. Only the patient template is changed, not the monthly billing. If the monthly billing is already been created for a certain month, changes on the template will not affect the billing cycle.  Continued on next page  STYLEREF "Map Title" Home Oxygen Main Menu (HO), Continued Menu option descriptionsBelow are the Home Oxygen Main Menu (HO) options, the synonym, option name and a description of each. Menu OptionSynonymOption NameDescriptionInactivate/Activate Oxygen PatientINRMPO INACT/ACTThis is an option to deactivate and activate/reactivate home oxygen patients. Purchase Card Sign OffSORMPO PO SIGN OFFOnce a billing is accepted and posted, this option can be used to sign off on the billing. ReportsRERMPO-RPT-MAINMENUThis menu contains reports on active and inactive home oxygen patients, addresses, prescription reports, billing discrepancies, etc. Site Parameters Enter/EditSIRMPO SITE EEThis option is used to define those parameters specific to the site such as: letters that should be generated and default prescription expiration dates. Verify Posted Billing TransactionsPBRMPO POST 2319This option posts all Home Oxygen billing transactions for a selected month for bills posted in IFCAP but not in Patient 2319 records. It will loop through all the records for the MONTH and VENDOR entered.  Pros Inventory Main (INV) Menu option descriptionsBelow are the Pros Inventory Main (INV) Menu options, the synonym, option name and a description of each. Menu OptionSynonymOption NameDescriptionAdd Inventory LOCATION or ITEMSAERMPR INV ADDThis is an option to add a Location, HCPCS or ITEMS for inventory. Users can edit item fields under this option. Deactivate Inventory LocationDERMPR INV DEACTIVATEThis option is only given to the holder of RMPRMANGAER key. It requires the electronic signatures of 2 users holding this key to be entered before a location can be deactivated. Edit Inventory ItemsEIRMPR INV EDITThis option is for editing an Inventory Location or Items. You can only edit an Item or Location that has already been set-up. Edit Inventory LocationELRMPR INV EDIT LOCATIONThis option is for editing an existing inventory location.Inventory ReportsRPRMPR INV REPORTSVarious Inventory reports are available through this option. Order Item from Supply or VendorOIRMPR INV ORDERThis is an option to record that an Item has been ordered. This option will not automatically order an item from Supply or Vendor.  Continued on next page  STYLEREF "Map Title" Pros Inventory Main (INV), Continued Menu options continuedBelow are the Pros Inventory Main (INV) Menu options, the synonym, option name and a description of each. Menu OptionSynonymOption NameDescriptionReceive Item from Supply, Vendor or PatientRCRMPR INV RECEIVEThis is an option to record that an Item has been received and entered into the Prosthetics Inventory. Receiving an Item in Supply through the IFCAP package does not update the Prosthetics Inventory module. This option has to be done separately for an Item to be received and recorded in the Prosthetics module. Reconcile Item BalanceUPRMPR INV RECON-CILEThis is an option to reconcile or update Items in Prosthetics Inventory. Users can update the Quantity, Total Cost, Vendor, Unit of Issue, Re-order Level and Description. Remove/Deactivate HCPCS/Item from InventoryRERMPR INV REMOVE HCPCS/ ITEMThis option removes/ deactivates inventory item(s) from the Prosthetics Inventory Program. Once an item has been removed/ deactivated, that item is not accessible. Only users with RMPRMANAGER key can access this option. Transfer Stock Between LocationsTRRMPR INV TRANThis is an option to transfer an Item to a different Location. In order to transfer an Item, it must be set-up to both Locations. User can transfer all Quantities or certain Quantities. This option does not remove an item from a location if all quantities have been transferred. NPPD Tools Menu (ND) Menu option descriptionsBelow are the NPPD Tools Menu (ND) options, the synonym, option name and a description of each. Menu OptionSynonymOption NameDescriptionAdd/Edit HCPCS SynonymsAERMPR ADD/EDIT HCPCS SYNONYMThis option will only edit the DESCRIPTION and SYNONYM in the Prosthetics HCPCS file.DSS HCPCS HistoryHHRMPR HCPCS HISTORYThis menu will display all HCPCS issued on a Patient's 2319 records for a date range.HCPCS InquiryINQRMPR NPPD INQYou can look up one HCPCS at a time with this option.NPPD Detail DisplayRMPR NPPD GUIFor users to be able to use the NPPD Detail Display GUI front-end, this option must be on either their primary or secondary menu options. This option has also been placed on RMPR NPPD TOOLS to give users who have access to the current NPPD options, access to NPPD GUI Detail Display. Note: 'B' type option for use after installation of RMPR*3*71. 'B' type options are not visible to roll & scroll users.Print 2529-3 Single LineLSLRMPR NPPDL PRL LThis option will print a single line, either New or Repair in Detail format for the form type 2529-3 only. This is the Lab. Continued on next page  STYLEREF "Map Title" NPPD Tools Menu (ND), Continued Menu option descriptionsBelow are the NPPD Tools Menu (ND) options, the synonym, option name and a description of each. Menu OptionSynonymOption NameDescriptionPrint 2529-3 WorksheetsLPRTRMPR NPPDL PRTThis option provides both Summary and Detail worksheets. They are divided into the following two basic parts with a station summary of each: * New Activities * Repair Activities The above are further broken down by each mapped NPPD Group with a summary of each. Within each NPPD Group, there is an NPPD Line with a summary. The Detail display adds an itemized listing for each NPPD Line within the NPPD Group, so every transaction for the date range selected is displayed. It is recommended to send this report to a device that will print a 132-right margin. This will not only ensure that you get the entire report, it will also expand the length of some of the data (e.g., Item and HCPCS DESCRIPTION on the Detail Worksheet) to make it more legible.Print NPPD Single Line DetailSLRMPR NPPD PRL LThis option will print a single line, either New or Repair in Detail format. Continued on next page  STYLEREF "Map Title" NPPD Tools Menu (ND), Continued Menu option descriptionsBelow are the NPPD Tools Menu (ND) options, the synonym, option name and a description of each. Menu OptionSynonymOption NameDescriptionPrint NPPD WorksheetsPRTRMPR NPPD PRTPrinting functionality.Print PSAS HCPCS ListMAPRMPR NPPD LISTPrinting functionality.PSAS HCPCS HistoryPHRMPR PSAS HCPCS HISTORYView history of PSAS HCPCS.Quick Edit 2319 RecordQED2RMPR NPPD QUICK EDITThis menu is a quick edit of the 2319 Record. This will allow you to select a record by the number displayed on the detail NPPD report for quick corrections. Section 2: Display/Print Menu Overview IntroductionThe Display/Print (DD) menu is a sub-menu of Prosthetic Clerks and Officials master menus. The internal option name is: RMPR DISPLAY/ PRINT, and the synonym is: DD. The audience for this feature is Prosthetics Clerks as well as Officials. Menu OptionBelow is the Prosthetic Officials Menu. SynonymMenu OptionPUPurchasingDDDisplay/PrintUTUtilitiesAMAMISSUSuspense COCorrespondenceSCScheduled Meeting and Home/Liaison Visits PSProcess Form 2529-3ELEligibility InquiryETPSC/Entitlement Records HOHome Oxygen Main MenuINVPros Inventory Main NDNPPD Tool  In this sectionThe following chapters are in this section: TopicSee PageDisplay/Print Menu Option Descriptions25Display/Print Patient 2319 (23)26Transaction Inquiry (TI)42Print All Prosthetic Items (IP)44Print Prosthetics Billings for MAS (BI)46Item History (IH)49Search for Recalled Item (SE)51Site Parameter Inquiry (SI)55 Display/Print Menu Option Descriptions Menu Option descriptionsBelow are the Display/Print Menu options with the option name and a description of each. Display/Print Menu23Display/Print Patient 2319TITransaction InquiryIPPrint All Prosthetic ItemsBIPrint Prosthetic Billings for MASIHItem HistorySE Search for Recall by Lot/Serial NumberSISite Parameter InquiryVIVendor Inquiry Menu OptionSynonymOption NameDescriptionDisplay/Print Patient 231923RMPR PRINT 2319Display/print a patients VAF 10-2319 (Note the 2319 contains more than eligibility)Transaction InquiryTIRMPR 1358 INQInquiry to single purchasing transaction.Print All Prosthetic ItemsIPRMPR PRINT ALL ITEMSThis option prints all Prosthetic Item Master records along with their new and repair AMIS codes. Lab AMIS codes are not printed with this version of Prosthetics.Print Prosthetic Billings for MASBIRMPR PRINT BILLPrints all NSC (non-service connected) items issued to patients for billing purposes.Item HistoryIHRMPR ITEM HISTORYPrints an item history of all purchases made for this item.Search for Recalled ItemSERMPR PRINT RECALLSearches the RECORD OF PROS APPLIANCE/REPAIR file (#660) for recalled item.Site Parameter InquirySIRMPR SITE INQThis menu option should be used to review your local site information.Vendor InquiryVIRMPR INQ VENThis option is an inquiry to the IFCAP VENDOR file (#440). Display/Print Patient 2319 (23) IntroductionYou can view or print the 10-2319 Prosthetics Veteran patient information from the Display/Print Patient 2319 (23) option. You will be prompted to select a patient. You will also be prompted for a device to print the Patient 10-2319. You have the choice to send the report to a printer by entering a printer at the Device prompt or view selected portions of the 2319 on your terminal screen. Note: Output to a printer will produce a different display than when it is sent to a terminal screen as you have a choice of which eligibility screens to view versus the printout will print the entire Patient 2319. OptionsHere are the screens that you can view from the patients 2319: Patient Demographics Clinic Enrollments/Correspondence Entitlement Information Appliance Transactions Auto Adaptive Information Critical Comments Add/Edit Disability Code Home Oxygen Items In this chapterThe following topics are in this chapter: TopicSee PageView and Print the Patient 231927View/Print Patient Demographics29View Clinic Enrollments/Correspondence30View Letters/Correspondence on File31View Entitlement Information33View Appliance Transactions34View Auto Adaptive Information36View Critical Comments37Add/Edit Disability Codes38View Home Oxygen Items41 View and Print the Patient 2319 Display the 2319You can display the 10-2319 Prosthetics Veteran record using the Display/Print Patient 2319 (23) Menu option. StepsTo display or print the 10-2319 Prosthetics Veteran record, follow these steps: StepAction1At the Select Display/Print Option prompt, type 23 to access the Display/Print Patient 2319 (23) option.2At the Site: prompt, press to accept the default setting or type a ? to display a list and select a site from the list.3At the Select Prosthetic Patient prompt, enter a Prosthetic patient name with the LAST NAME,FIRST NAME format.4Press to continue.5Patient identification information displays. : At the OK? Yes// prompt, press to continue.  2319 Screen 23 Display/Print Patient 2319 TI Transaction Inquiry IP Print All Prosthetic Items BI Print Prosthetic Billings for MAS IH Item History SE Search for Recalled Item SI Site Parameter Inquiry VI Vendor Inquiry Select Display/Print Option: 23 Display/Print Patient 2319 SITE: SUPPORT ISC// 499 Select PROSTHETIC PATIENT: PROSPATIENT,ONE PROSPATIENT,ONE 1-1-30 000000001 ...OK? Yes// (Yes) HINES, IL Continued on next page styleref "Map Title"View and Print the Patient 2319, Continued Printing vs. Displaying the 2319Printing is different than viewing the 2319 on your terminal! If you elect to print the 2319 information by entering SLAVE or another printer device, the entire Record of Appliances and Repairs prints out. Steps (continued)To display or print the 10-2319 Prosthetics Veteran record, follow these steps: StepAction6The system displays the Device: Home// prompt. Press twice to display information to your terminal screen or type SLAVE to print the information to your personal printer. You can print the information to another printer by typing the printer ID. 7The system displays: Right Margin: 80// (unless you requested to print to a printer using the SLAVE entry). Press to continue.8The Disability Codes display for the selected patient and you are given a choice of information to view, edit or print from the patients 2319. 2319 Screen (continued)DEVICE: HOME// TELNET Right Margin: 80// *Comments on File. Current Disability Codes are: COS/B EMPLOYEE NSC AMP/LAE SC VIETNAM S/C Select one of the following 1 PATIENT DEMOGRAPHICS 2 CLINIC ENROLLMENTS/CORRESPONDENCE 3 ENTITLEMENT INFORMATION 4 APPLIANCE TRANSACTIONS 5 AUTO ADAPTIVE INFORMATION 6 CRITICAL COMMENTS 7 ADD/EDIT DISABILITY CODE 8 HOME OXYGEN ITEMS Enter 10-2319 screen to VIEW (1-8),'^' to EXIT, or 'return' to continue :  View Patient Demographics Function descriptionYou can view the patients demographics by entering 1 at the Enter 10-2319 screen to VIEW... This includes the patients name, social security number, date of birth, address and phone, eligibility and benefits, and claim number, which is shown at the top of the 2319 form.  StepsTo view patient demographics, follow these steps: StepAction1Type 1 to select the Patient Demographics screen at the prompt, and press .2The patient demographics display as shown below.3Press to continue. If there is no entry for POW?, you may enter it at this time or press the key to accept a default of NO.4The current Disability Codes display if available. Patient Demographics Screen Output Disability CodesSelect one of the following: 1 PATIENT DEMOGRAPHICS 2 CLINIC ENROLLMENTS/CORRESPONDENCE 3 ENTITLEMENT INFORMATION 4 APPLIANCE TRANSACTIONS 5 AUTO ADAPTIVE INFORMATION 6 CRITICAL COMMENTS 7 ADD/EDIT DISABILITY CODE 8 HOME OXYGEN ITEMS Enter 10-2319 screen to VIEW (1-8),'^' to EXIT, or 'return' to continue : 1 PATIENT DEMOGRAPHICS PROSPATIENT,ONE SSN: 000000001 DOB: JAN 1,1930 CLAIM# Phone: Phone: Current Address: Primary Next of Kin Address: ABC STREET CHICAGO, ILLINOIS 60000 Patient Type: PILL Period of Service: OTHER OR NONE Primary Eligibility Code: Status: REQUIRED NSC Eligibility Status: Receiving A&A Benefits? NO Receiving Housebound Benefits? NO Receiving Social Security? NO Receiving VA Pension? NO Receiving Military Retirement? NO Receiving VA Disability? NO Prosthetic Disability Code(s): COS/B-NSC AMP/LAE-SC Enter RETURN to continue or '^' to exit: *POW? NO Enter return to continue or `^` to exit: Current Disability Codes are: COS/B EMPLOYEE NSC AMP/LAE SC VIETNAM S/C ORTH/PLS INPATIENT S/C View Clinic Enrollments/Correspondence Function descriptionYou can view the clinic enrollments and correspondence for the patient by selecting to view screen 2.  StepsTo view clinic enrollments and correspondence for a veteran, follow these steps: StepAction1Type 2 at the prompt: Enter 10-2319 screen to VIEW (1-8) to select the Clinic Enrollments/Correspondence (2) screen.2The following information displays: Last Movement Actions, Clinic Enrollments, and Pending Appointments.3Press at the Would you like to see more clinics? No// prompt to accept the default setting or Y for Yes. Note: This prompt may not appear if there arent many clinics.4Press to continue.5To view correspondence, see next page, View Letters on File. Clinic Enrollment/ Correspondence ScreenSelect one of the following: 1 PATIENT DEMOGRAPHICS 2 CLINIC ENROLLMENTS/CORRESPONDENCE 3 ENTITLEMENT INFORMATION 4 APPLIANCE TRANSACTIONS 5 AUTO ADAPTIVE INFORMATION 6 CRITICAL COMMENTS 7 ADD/EDIT DISABILITY CODE 8 HOME OXYGEN ITEMS Enter 10-2319 screen to VIEW (1-8),'^' to EXIT, or 'return' to continue : 2 CLINIC ENROLLMENTS/CORRESPONDENCE PROSPATIENT,TWO SSN: 000-00-0002 DOB: FEB 28,1949 CLAIM# Last Movement Actions Trans. Type: DISCHARGE Trans. Type: ADMISSION Date: JAN 12,1997@08:00 Date: JUN 5,1996@12:47:34 Type of Movement: Type of Movement: REGULAR OPT-SC Ward: 2AS Ward: 2AS Physician: PROSPROVIDER,FIVE Physician: PROSPROVIDER,FIVE Diagnosis: SOB Diagnosis: SOB Clinic Enrollments Clinic Enrollment Date OPT or AC HOUSE/A MAY 17,1994 OPT TEST1 NOV 1,1994@11:10 OPT Would you like to see more clinics? No// n (No) Pending Appointments No Pending Appointments for this Patient Enter RETURN to continue or '^' to exit:  View Letters/Correspondence on File Clinic EnrollmentsYou can also view the letters on file for the patient using Clinic Enrollments/Correspondence (2). Steps (continued)To view letters on file for a patient, follow these steps: StepAction6The letter listings on file display for a patient if available. 7The Enter a number prompt displays to view a letter. Type the number of the letter you want to view or print and press 8The DEVICE: HOME// prompt displays. Press to continue to view the letter or enter a printer device. This example shows you how to view the letter.9Press again after the Right Margin: 80// prompt. Letters on FileLetters on file: # Patient Type of letter Employee Date of letter ------------------------------------------------------------------------------ 1 PROSPATIENT,ONE ADP FL 10-90 PROSPROVIDER,THREE DEC 16, 1999 2 PROSPATIENT,ONE HO 30 DAY TEST PROSPROVIDER,THREE FEB 08, 2002 3 PROSPATIENT,ONE HO 30 DAY TEST PROSPROVIDER,THREE FEB 08, 2002 Enter '^' to stop or Enter a number (1-3):1 DEVICE: HOME// TELNET Right Margin: 80// REQUEST FOR QUOTATION Date: Mar 13, 2000 TO: VENDOR NAME FROM: PROSVENDOR,ONE 7000 SOUTH ST SUPPORT ISC CHICAGO, ILLINOIS 60620 CHICAGO, IL 60619 Vendor Phone #: (555) Veteran: PROSPATIENT,ONE SSN: 000000001 Your firm is being considered for the following: PROSTHETIC LEG An estimate on the above-listed item(s) is requested. YOUR QUOTATION DOES NOT CONSTITUTE A PURCHASE ORDER. Upon completion of the esti- mate, return the original to the Veterans Affairs facility indicated above and retain a copy for your files. If approved, a purchase order will be prepared and forwarded to you. Sincerely, PROSPROVIDER,SIX, ACTING CHIEF, PROSTHETICS SERVICE CHIEF Continued on next page styleref "Map Title"View Letters/Correspondence on File, Continued OutputA letter on file sample is shown below for a patients Vendor Estimate. Steps (continued)To view letters on file, continue to follow these steps: StepAction10The letter(s) displays if available for a patient. 11At the Would you like to see more letters? No// prompt, press to accept the default of No. If you want to view more letters that are on file, type Y for Yes.12At the Do You wish to create a correspondence letter? No// prompt, press to accept the default setting or type Y for Yes. (See the Correspondence section for instructions.)13The Suspense Menu may display for you to enter a request for a Prosthetic item or service (depending on the settings at your site). Sample Letter Screen VENDOR'S ESTIMATE (To be completed by Vendor) ---------------------------------------------------------------------- | Article or Service |Quantity| Unit |Unit Cost|Total Cost| ---------------------------------------------------------------------- | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | ---------------------------------------------------------------------- | Vendor: Contract number (if applicable) | | Address: | | City: | | State: Zip: | | Telephone: | | Date: Signature & Title of Company Official| | Note:List Terms/Discounts if Applicable | ---------------------------------------------------------------------- FL 10-90 ADP Enter RETURN to continue or '^' to exit: Would you like to see more letters? No// Do you wish to create a correspondence letter? No//  View Entitlement Information Function descriptionYou can view the patients entitlement information by typing (3) at the Enter 10-2319 screen to VIEW... prompt. StepsTo view entitlement information, follow these steps: StepAction1Select the Entitlement Information screen by typing 3.2The patient name, social security number, date of birth, and claim number displays as well as any entitlements. This includes a clothing allowance if applicable, automobile information, and items returned. Entitlement ScreenSelect one of the following: 1 PATIENT DEMOGRAPHICS 2 CLINIC ENROLLMENTS/CORRESPONDENCE 3 ENTITLEMENT INFORMATION 4 APPLIANCE TRANSACTIONS 5 AUTO ADAPTIVE INFORMATION 6 CRITICAL COMMENTS 7 ADD/EDIT DISABILITY CODE 8 HOME OXYGEN ITEMS Enter 10-2319 screen to VIEW (1-8),'^' to EXIT, or 'return' to continue : 3 ENTITLEMENT INFORMATION PROSPATIENT,ONE SSN: 000-00-0001 DOB: JAN 1,1930 CLAIM# PSC Issue Card: Appliance Ht 68 Wt 192 Eyes BR Hair GY Serial Number JAN 31, 2000 TEST ITEM Clothing Allowance: Date: 04-01-01 ELIGIBLE STATIC Date of Exam: JUL 11, 2000 Examiner: PROSPROVIDER,EIGHT Desc: Date: 03-15-02 NOT-ELIGIBLE NON-STATIC Date of Exam: MAR 10, 2002 Examiner: PROSPROVIDER,NINE Desc: Date: 05-08-02 ELIGIBLE STATIC Date of Exam: MAY 08, 2002 Examiner: PROSPROVIDER,SEVEN Desc: TESTING Items Returned: Date Item Serial Status Enter RETURN to continue or '^' to exit:  View Appliance Transactions Function descriptionYou can view appliance transactions for the patient by typing 4 at the Enter 10-2319 screen to VIEW... prompt.  StepsTo view entitlement information, follow these steps: StepAction1Select the Appliance Transactions screen by typing 4.2If you want to view the complete entry for a transaction, type the number of the transaction at the Enter 1-n to show full entry... prompt. Appliance Transactions ScreenSelect one of the following: 1 PATIENT DEMOGRAPHICS 2 CLINIC ENROLLMENTS/CORRESPONDENCE 3 ENTITLEMENT INFORMATION 4 APPLIANCE TRANSACTIONS 5 AUTO ADAPTIVE INFORMATION 6 CRITICAL COMMENTS 7 ADD/EDIT DISABILITY CODE 8 HOME OXYGEN ITEMS Enter 10-2319 screen to VIEW (1-8),'^' to EXIT, or 'return' to continue : 4 APPLIANCE TRANSACTIONS PROSPATIENT,TWO SSN: 000-00-0002 DOB: FEB 28,1949 CLAIM# Date Qty Item Type Vendor Sta Serial Delivery Date Tot Cost 1. 02/16/00 1 TEST ITEM I VENDOR,TWO 499 9.00 2. 02/16/00 2 TEST ITEM I VENDOR,TWO 499 5.00 3. 02/16/00 1 EYEGLASSES I VENDOR,TWO 499 0.00 4. 05/07/03 1 WHEELCHAIR I VENDOR,THREE 05/07/03 300.00 +=Turned-In *=Historical Data I=Initial X=Repair S=Spare R=Replacement Enter 1-19 to show full entry, '^' to exit or `return` to continue. 4  Continued on next page styleref "Map Title"View Appliance Transactions, Continued ContinuedBelow is the complete entry for the transaction selected previously.  Appliance/ Repair Line Item DetailPROSTHETICS,PATIENTONE SSN: 000-12-3456 DOB: 01-01-1000 APPLIANCE/REPAIR LINE ITEM DETAIL <4-1> TYPE OF FORM: INITIATOR: DATE: OCT 01, 2013 DELIVER TO: TYPE TRANS: INITIAL ISSUE QTY: SOURCE: COMMERCIAL VENDOR: DELIVERY DATE: TOTAL COST: OBL: REMARKS: DISABILITY SERVED: NSC/OP ITEM DESCRIPTION: COOKIE APPLIANCE: COOKIE CONTRACT #: EXCLUDED/WAIVER: PSAS HCPCS: A4364 ADHESIVE ICD10 Code: A00.0 CHOLERA DUE TO VIBRIO CHOLERAE 01, BIOVAR CHOLERAE CPT MODIFIER: DESCRIPTION: EXTENDED DESCRIPTION: Enter RETURN to continue or '^' to exit: Screen outputBelow is the continued screen output from the Appliance Transaction information. View Auto Adaptive Information Function descriptionYou can view the patients auto adaptive information by typing 5 at the Enter 10-2319 screen to VIEW... prompt.  Auto Adaptive ScreenSelect one of the following: 1 PATIENT DEMOGRAPHICS 2 CLINIC ENROLLMENTS/CORRESPONDENCE 3 ENTITLEMENT INFORMATION 4 APPLIANCE TRANSACTIONS 5 AUTO ADAPTIVE INFORMATION 6 CRITICAL COMMENTS 7 ADD/EDIT DISABILITY CODE 8 HOME OXYGEN ITEMS Enter 10-2319 screen to VIEW (1-8),'^' to EXIT, or 'return' to continue : 5 AUTO ADAPTIVE INFORMATION NAME: PTROSPATIENT,TWO SSN: 000000002 CLAIM NO. VEHICLE ID# YEAR PURCHASE DATE MAKE MODEL PAGE 1 PROCESS DATE ITEM QTY COST AMIS TYPE '*' Denotes Inactive Vehicle of Record --------------------------------------------------------------------- VAN-123 199 MAR 13, 2000 FORD VAN 4502: MAR 13, 2000 MAR 13, 2000 AIR-CONDITIONING 1 $500.00 ADAP EQP INITIAL MAR 13, 2000 CB RADIO 1 $100.00 VAN MOD INITIAL Total/Date: $600.00 Enter RETURN to continue or '^' to exit: View Critical Comments Function descriptionYou can view, add, or edit any critical comments for the patient by typing 6 at the Enter 10-2319 screen to VIEW... prompt.  StepsTo add or edit critical comments, follow these steps: StepAction1Select the Critical Comments option by typing 6.2At the Would you like to Add/Edit Patient Critical Comments? No// prompt, type Y for Yes, and press .3At the Edit? No// prompt, type Y for Yes, and press .4The word processing text editor displays for you to type your note.5Press the Num Lock key and the E key together to exit and save the information. Critical Comments ScreenSelect one of the following: 1 PATIENT DEMOGRAPHICS 2 CLINIC ENROLLMENTS/CORRESPONDENCE 3 ENTITLEMENT INFORMATION 4 APPLIANCE TRANSACTIONS 5 AUTO ADAPTIVE INFORMATION 6 CRITICAL COMMENTS 7 ADD/EDIT DISABILITY CODE 8 HOME OXYGEN ITEMS Enter 10-2319 screen to VIEW (1-8),'^' to EXIT, or 'return' to continue : 6 CRITICAL COMMENTS PATIENT:PROSPATIENT,ONE CRITICAL COMMENTS No Patient Critical Comments Recorded for this patient! Would you like to Add/Edit Patient Critical Comments? No// Y (Yes) CRITICAL COMMENTS: No existing text Edit? NO// YES ==[ WRAP ]==[ INSERT ]======< CRITICAL COMMENTS >=====[ H=Help]= Editing Critical Comments. <======T======T======T======T======T======T======T======T======T>==== PATIENT: PROSPATIENT,ONE CRITICAL COMMENTS Editing Critical Comments. Would you like to Add/Edit Patient Critical Comments? No// (No) *Comments on file Add/Edit Disability Codes Function descriptionYou can add to or edit the patients disability codes by typing 7 at the Enter 10-2319 screen to VIEW... prompt. StepsTo add or edit a Disability Code, follow these steps: StepAction1Select the Add/Edit Disability Code option by typing 7.2At the Would you like to Add/Edit a Disability Code to the Patients 2319? Yes// prompt, press 3At the Select Prosthetic Disability Code prompt, type a Disability Code, and press (You can also type two question marks to view a list and select one.) Add/Edit Disability Code ScreenSelect one of the following: 1 PATIENT DEMOGRAPHICS 2 CLINIC ENROLLMENTS/CORRESPONDENCE 3 ENTITLEMENT INFORMATION 4 APPLIANCE TRANSACTIONS 5 AUTO ADAPTIVE INFORMATION 6 CRITICAL COMMENTS 7 ADD/EDIT DISABILITY CODE 8 HOME OXYGEN ITEMS Enter 10-2319 screen to VIEW (1-8),'^' to EXIT, or 'return' to continue : 7 ADD/EDIT DISABILITY CODE Would you like to ADD/EDIT a Disability Code to the Patient's 2319? YES// Select PROSTHETIC DISABILITY CODE: ?? Choose from: AMP/LAE SC SC VIETNAM COS/B NSC EMPLOYEE You may enter a new PROSTHETIC DISABILITY CODE, if you wish This is a pointer to the Prosthetic Disability Code file (662). Choose from: 1 AMP/LAE 2 AMP/LAK 3 AMP/LBE Select PROSTHETIC DISABILITY CODE: 1 AMP/LAE ...OK? Yes// (Yes) SC SC VIETNAM Select one of the following: E EDIT DISABILITY CODE A ADD DUPLICATE DISABILITY CODE Enter response: EDIT// A ADD DUPLICATE DISABILITY CODE PROSTHETIC DISABILITY CODE: AMP/LAE//  Continued on next page styleref "Map Title"Add/Edit Disability Codes, Continued Add a CodeTo continue to add a Disability Code, see the sample screen below. At the Would you like to Mark a Disability Code as Deleted? NO// prompt, press to accept the default setting. StepsTo add or edit a Disability Code, follow these steps: StepAction1Select the Add/Edit Disability Code option by typing 7. Add/Edit Disability Code Screen (continued)SERVICE/NON-SERVICE: ?? Enter `1` for Service Connected or `2` for Non-Service Connected. Choose from: 1 SERVICE CONNECTED 2 NON-SERVICE CONNECTED SERVICE/NON-SERVICE: 2 NON-SERVICE CONNECTED ELIGIBILITY CATEGORY: ?? This field stores the Eligibility Category for the Patient. Choose from: 1 SC VIETNAM 2 ALL OTHER SERVICE-CONNECTED 3 NSC A&A 4 OTHERS ELIGIBLE 5 V.I.S.T. 6 VOC REHAB 7 PHC 8 INPATIENT 9 EMPLOYEE 10 PRIMA FACIA ELIGIBILITY CATEGORY: 1 SC VIETNAM Select PROSTHETIC DISABILITY CODE: PROSPATIENT,ONE HAS THE FOLLOWING DISABILITY CODES: COS/B NSC EMPLOYEE AMP/LAE SC SC VIETNAM AMP/LAE NSC SC VIETNAM Would you like to Mark a Disability Code as Deleted? NO// *Comments on file Continued on next page styleref "Map Title"Add/Edit Disability Codes, Continued To Edit a CodeYou can edit and delete a Disability Code using this screen. To edit a disability code, type E for Edit Disability Code at the Enter Response prompt. Press at the additional prompts to accept the default settings. You delete a Disability Code for a patient by entering YES at the Would you like to Mark a Disability Code as Deleted? No// prompt. Add/Edit Disability Code Screen Select one of the following: E EDIT DISABILITY CODE A ADD DUPLICATE DISABILITY CODE Enter response: EDIT// DISABILITY CODE PROSTHETIC DISABILITY CODE: AO/AUTO// SERVICE/NON-SERVICE: SERVICE CONNECTED// ELIGIBILITY CATEGORY: SC VIETNAM// Select PROSTHETIC DISABILITY CODE: PROSPATIENT,ONE HAS THE FOLLOWING DISABILITY CODES: COS/B NSC EMPLOYEE AMP/LAE SC SC VIETNAM AMP/LAE NSC SC VIETNAM ORTH/PLS SC INPATIENT ORTH/DLF SC SC VIETNAM AO/AUTO SC SC VIETNAM Would you like to Mark a Disability Code as Deleted? NO// *Comments on file View Home Oxygen Items Function descriptionYou can view the patients home oxygen information by typing 8 at the Enter 10-2319.... prompt. Sample outputSelect one of the following: 1 PATIENT DEMOGRAPHICS 2 CLINIC ENROLLMENTS/CORRESPONDENCE 3 ENTITLEMENT INFORMATION 4 APPLIANCE TRANSACTIONS 5 AUTO ADAPTIVE INFORMATION 6 CRITICAL COMMENTS 7 ADD/EDIT DISABILITY CODE 8 HOME OXYGEN ITEMS Enter 10-2319 screen to VIEW (1-8),'^' to EXIT, or 'return' to continue: 8 HOME OXYGEN ITEMS PROSPATIENT,THREE 000-00-0003 Current Prescription (#5) Active Date: OCT 16,2003 Expiration Date: OCT 15,2004 CONCENTRATOR 02 @ 28% VIA COOL AEROSOL TRACH MASK, BUNN COMPRESSOR, M TANK 10 E TANKS, 4 TRACH MASKS, 6 1000 ML PREFILLED AND 4 500 ML AEROSOL BTLS PER MO. NEBULIZER .5 CC ALBUTEROL & 2.5 CC IPRATROPRIUM, 2 #6 SHILEY TRACH TUBES CUFFED, UNFENESTRATED EVERY 6 MONTHS WITH NON- DISPOSABLE INNER CANNULAS Enter RETURN to continue or '^' to exit: PROSPATIENT,THREE SSN: 000-00-0003 DOB: OCT 12,1954 CLAIM# 391580866 Date Qty Item Type Vendor Sta Serial Delivery Date Tot Cost 1. 01/27/04 4 HUMIDIFIER X FIRST COMM 695 02/11/04 26.60 4111 2. 01/27/04 1 OXYGEN-REN X FIRST COMM 695 02/11/04 90.25 4111 3. 01/27/04 1 OX-COMPRES X FIRST COMM 695 02/11/04 42.75 4111 4. 12/17/03 12 NEBULIZER I FIRST COMM 695 12/22/03 14.76 4111 5. 12/17/03 1 OXYGEN-REN X FIRST COMM 695 12/22/03 90.25 4111 6. 12/17/03 8 OXYGEN-REF X FIRST COMM 695 12/22/03 72.24 4111 7. 12/17/03 1 OX-COMPRES X FIRST COMM 695 12/22/03 42.75 4111 8. 11/24/03 4 HUMIDIFIER X FIRST COMM 695 12/05/03 26.60 4111 9. 11/24/03 4 NEBULIZER I FIRST COMM 695 12/05/03 4.92 4111 10. 11/24/03 1 OXYGEN-REN X FIRST COMM 695 12/05/03 90.25 Transaction Inquiry (TI) View a Transaction Function descriptionYou can view a single purchasing transaction through the Transaction Inquiry (TI) option from the Display/Print Menu. (This option displays purchasing information for a specific transaction from the Prosthetics 1358 file (#664.)) StepsTo perform a transaction inquiry, follow these steps: StepAction1Type TI for the Transaction Inquiry option from the Display/Print Menu.2At the Select Patient Name or Transaction Number prompt, type a patient name or transaction number, and press .3Select the transaction you want to view from the list of transactions displayed. Transaction Inquiry Screen 23 Display/Print Patient 2319 TI Transaction Inquiry IP Print All Prosthetic Items BI Print Prosthetic Billings for MAS IH Item History SE Search for Recalled Item SI Site Parameter Inquiry VI Vendor Inquiry Select Display/Print Option: TI Transaction Inquiry Select Patient Name or Transaction Number: PROVIDER1,TWO PROSPATIENT,ONE 1-1-30 453890765 NO PILL HINES, IL 1 PATIENT,ONE 1-31-2000 PATIENT,ONEClosed REF: 0002 EYEGLASSES 2 PATIENT,ONE 1-31-2000 PATIENT,ONEClosed REF: 0003 TEST ITEM 3 PATIENT,ONE 1-31-2000 PATIENT,ONE REF: 0004 TEST ITEM 4 PATIENT,ONE 1-31-2000 PATIENT,ONE TEST ITEM 5 PATIENT,ONE 1-31-2000 PATIENT,ONE REF: 0003 PICKUP/DELIVERY Press to see more, '^' to exit this list, OR CHOOSE 1-5: 1  Continued on next page styleref "Map Title"View a Transaction, Continued Print a transactionYou can also print a transaction as well as view one. Steps (continued)To perform a transaction inquiry, follow these steps: StepAction4The Device prompt appears.5At the Device prompt, press twice to display information to your terminal screen. (You can also type SLAVE to send the information to your printer, and press .)6The transaction information displays for the requested patient. Transaction Inquiry Screen1-31-2000 PROSPATIENT,ONE Closed REF: 0002 EYEGLASSES DEVICE: TELNET Right Margin: 80// PROSTHETICS 1358 LIST SEP 27,2000 09:46 PAGE 1 --------------------------------------------------------------------- DATE: JAN 31, 2000 PATIENT: PROSPATIENT,ONE OBLIGATION NUMBER: 499-C45004 VENDOR: VENDOR PRODUCTION C.P.: 499-94-2-055-0047 REFERENCE: 499-C45004-0002 CLOSE OUT DATE: JAN 31, 2000@13:05:53 INITIATOR: PROVIDER,THREE EST. SHIPPING CHARGE: 1 SHIPPING ENTRY: JAN 31, 2000 STATION NAME: SUPPORT ISC ITEM: EYEGLASSES BRIEF DESCRIPTION: ITEM 1 UNIT COST: 1 QTY: 1 UNIT OF ISSUE: EA TYPE OF TRANSACTION: INITIAL ISSUE PATIENT CATEGORY: SC/OP SOURCE: COMMERCIAL APPLIANCE/REPAIR: JAN 31, 2000 PSAS HCPCS: A4500 CLOSE-OUT REMARKS: CLOSE FORM TYPE: 2421 CLOSED BY: PROVIDER,THREE DELIVER TO: VETERAN DATE REQUIRED: MAR 01, 2000 DELIVERY TIME: 30 Select Patient Name or Transaction Number: to exit the screen.  Print All Prosthetic Items (IP) Overview IntroductionThe Print All Prosthetic Items (IP) option prints all Prosthetic Item Master records along with their new and repair AMIS codes. This listing is useful for Purchasing Agents as a catalog of all current Prosthetic items available for issue, and for Prosthetics Supervisors to validate correctness of Prosthetics AMIS codes. Note: Lab AMIS codes are not printed with this version of Prosthetics. StepsTo print all Prosthetic items, follow these steps: StepAction1Type IP for the Print All Prosthetic Items option from the Display/Print Menu.2At the Device prompt, press . The following displays: Right Margin: 80//.3Press . Print All Prosthetic Items Screen 23 Display/Print Patient 2319 TI Transaction Inquiry IP Print All Prosthetic Items BI Print Prosthetic Billings for MAS IH Item History SE Search for Recalled Item SI Site Parameter Inquiry VI Vendor Inquiry Select Display/Print Option: IP Print All Prosthetic Items DEVICE: TELNET Right Margin: 80//  RecommendationIt is recommended that you run this option quarterly to verify the AMIS codes that have been assigned. This will assure that you will receive proper calculations in your AMIS Worksheets. View the Prosthetic Item Master List Prosthetic Item Master ListYou can view the Prosthetic Item Master List from the Print All Prosthetic Items (IP) option. Notice that the Item Master List below has three pages displayed with the Item Number, short description, and extended description. Print All Prosthetic Items Screen (continued)PROS ITEM MASTER LIST SEP 27,2000 09:47 PAGE 1 ITEM NUMBER SHORT DESCRIPTION DESCRIPTION ------------------------------------------------------------------------------ 3 **SYRINGE-SUBCUTANEOUS-3I 3 IN SUBCUTANEOUS SYRINGE (3) ANC: 05 A ARC: R01 ONC: 10 ORC: R15 A RNC: RRC: ANC: 01 A ARC: R15 ONC: ORC: RNC: RRC: ANC: 04 A ARC: R03 B ONC: 03 ORC: R15 A RNC: RRC: 59 EYEGLASSES EYEGLASSES ANC: 11 ARC: R06 ONC: 10 ORC: R15 A RNC: 04 RRC: R13 10000 EYEGLASSES EYEGLASSES ANC: 11 ARC: R06 ONC: ORC: RNC: RRC: PROS ITEM MASTER LIST SEP 27,2000 09:47 PAGE 2 ITEM NUMBER SHORT DESCRIPTION DESCRIPTION ------------------------------------------------------------------------------ ANC: 04 A ARC: ONC: ORC: RNC: RRC: 903 TEST ITEM TEST ANC: 05 D ARC: R15 ONC: ORC: R15 B RNC: RRC: 55 WHEELCHAIR-ADULT/HEMI/BLU STANDARD ADULT ROLLS 2000 HEMI WHEELCHAIR WITH ELEVATING LEG REST AND ANTI TIPPER, BLUE (55) ANC: R14 ARC: R15 ONC: 10 ORC: R15 A RNC: 10 RRC: R12 56 WHEELCHAIR-CLASSIC-18X16 PREMIER CLASSIC STANDARD WIDTH AND DEPTH, 18X16, SEAT HEIGHT (19 3/4) BACK HEIGHT STYLE 16 1/2IN, FIXED DETACHABLE DESK LENGTH ARMS, REAR WHEEL SIZE 24X11IN, BLACK MOLDED WITH SOLID SNAP ON TIRES, CHROME PLATED STEEL HANDRIMS, PUSH TO LOCK WHEEL LOCKS, 8X1 CASTERS, BLACK MOLDED PROS ITEM MASTER LIST SEP 27,2000 09:47 PAGE 3 ITEM NUMBER SHORT DESCRIPTION DESCRIPTION ------------------------------------------------------------------------------ WITH SOLID TIRES, REGAL BLUE LEATHERETTE UPHOLSTERY, CHROME FRAME FINISH (56) ANC: 17 A ARC: R15 ONC: 12 ORC: R15 D RNC: 09 RRC:  Print Prosthetic Billings for MAS (BI) Overview IntroductionThe Print Prosthetic Billings for MAS (BI) option prints all NSC (non-service connected) items issued to patients for billing purposes. MAS stands for Medical Administrative Services.  StepsTo view Prosthetic Billings for MAS, follow these steps: StepAction1Type BI for the Print Prosthetic Billings for MAS option from the Display/Print Menu.2At the Site prompt, enter the name of the site and press .3At the Start With Delivery Date prompt, enter the beginning date of the date range. (For instance if the report should cover one year from the current date, enter T-365 which stands for Today minus 365 days from today).4At the End With Delivery Date prompt, type a T for Today if you want to enter the end of the date range with the current date.5At the Device prompt, enter a printer or press . The following displays: Right Margin: 80//. Press again. Print Prosthetic Billings for MAS Screen 23 Display/Print Patient 2319 TI Transaction Inquiry IP Print All Prosthetic Items BI Print Prosthetic Billings for MAS IH Item History SE Search for Recalled Item SI Site Parameter Inquiry VI Vendor Inquiry Select Display/Print Option: BI Print Prosthetic Billings for MAS SITE: Hines Development System// 499 Start With Delivery Date: T-365 (SEP 28, 1999) End With Delivery Date: T (SEP 27, 2000) DEVICE: HOME// TELNET Right Margin: 80// ...EXCUSE ME, JUST A MOMENT PLEASE... ...PREPARING TO PRINT PROSTHETIC BILLING... Purchasing MenuEach transaction done through the Purchasing Menu requires the Prosthetic Purchasing Agent to enter the correct patient category for each item issued. Any item issued to a veteran who is NSC/OP and has insurance recorded in the MAS Patient file, will appear on this listing for billing purposes in MAS. View Prosthetic Billing Information Billing InformationBelow are the first two pages of the Prosthetic billing information for this sample. Print Prosthetic Billings for MAS Screen (continued)PATIENT NAME SSN SEP 28, 1999-SEP 27, 2000STA 499 PAGE 1 ------------------------------------------------------------------------------ TEST,A 5465 Insurance COB Subscriber ID Group Holder Effective Expires =========================================================================== BLUE CROSS 9432 111 SELF 03/01/70 06/21/00 06/21/00 TEST ITEM QTY: 1 TOTAL COST: 1.00 PROSPATIENT,TWO 0002 Insurance COB Subscriber ID Group Holder Effective Expires =========================================================================== AETNA 72727272 1633 SELF 01/01/90 01/01/99 BLUE CROSS p 088888888 3333 SELF 01/01/93 12/13/99 12/20/99* EYEGLASSES QTY: 1 TOTAL COST: 50.00 PATIENT NAME SSN SEP 28, 1999-SEP 27, 2000STA 499 PAGE 2 ------------------------------------------------------------------------------ PROSPATIENT,TWO 0002 Insurance COB Subscriber ID Group Holder Effective Expires =========================================================================== AETNA 72727272 1633 SELF 01/01/90 01/01/99 BLUE CROSS p 088888888 3333 SELF 01/01/93 12/13/99 12/13/99 EYEGLASSES QTY: 1 TOTAL COST: 5.00 12/13/99 12/13/99 WHEELCHAIR-ADULT/HEMI/BLUE-STD QTY: 1 TOTAL COST: 5.00 Enter RETURN to continue or '^' to exit:  Continued on next page styleref "Map Title"View Prosthetic Billing Information, Continued Billing informationBelow are pages 3 and 4 of the Prosthetic billing information of this report. Print Prosthetic Billings for MAS Screen (continued) PATIENT NAME SSN SEP 28, 1999-SEP 27, 2000STA 499 PAGE 3 ------------------------------------------------------------------------------ PROSPATIENT,TWO 0002 Insurance COB Subscriber ID Group Holder Effective Expires =========================================================================== AETNA 72727272 1633 SELF 01/01/90 01/01/99 BLUE CROSS p 088888888 3333 SELF 01/01/93 12/13/99 12/13/99 EYEGLASSES QTY: 1 TOTAL COST: 50.00 12/13/99 12/13/99 EYEGLASSES QTY: 1 TOTAL COST: 50.00 12/13/99 12/13/99 EYEGLASSES QTY: 1 TOTAL COST: 50.00 12/13/99 12/13/99 EYEGLASSES QTY: 1 TOTAL COST: 50.00 12/13/99 12/13/99 EYEGLASSES QTY: 1 TOTAL COST: 5.00 12/13/99 12/13/99 WHEELCHAIR-ADULT/HEMI/BLUE-STD QTY: 1 TOTAL COST: 5.00 12/20/99 12/20/99 EYEGLASSES QTY: 1 TOTAL COST: 50.00 Enter RETURN to continue or '^' to exit: PATIENT NAME SSN SEP 28, 1999-SEP 27, 2000STA 499 PAGE 4 ------------------------------------------------------------------------------ PROSPATIENT,TWO 0002 Insurance COB Subscriber ID Group Holder Effective Expires =========================================================================== AETNA 72727272 1633 SELF 01/01/90 01/01/99 BLUE CROSS p 088888888 3333 SELF 01/01/93 12/20/99 12/20/99 EYEGLASSES QTY: 1 TOTAL COST: 5.00 12/20/99 12/20/99 WHEELCHAIR-ADULT/HEMI/BLUE-STD QTY: 1 TOTAL COST: 5.00 12/20/99 12/20/99 EYEGLASSES QTY: 1 TOTAL COST: 50.00 12/20/99 12/20/99 EYEGLASSES QTY: 1 TOTAL COST: 5.00 12/20/99 12/20/99 WHEELCHAIR-ADULT/HEMI/BLUE-ST QTY: 1 TOTAL COST: 5.00 01/07/00 01/07/00 EYEGLASSES QTY: 1 TOTAL COST: 5.00 01/07/00 01/07/00 EYEGLASSES QTY: 1 TOTAL COST: 5.00 Item History (IH) View Item History IntroductionThe Item History (IH) option from the Display/Print Menu prints the history of all purchases made for an item you select. It allows you to review the history of all items issued during any date range you may choose. You can view the request date, patient name, SSN, Vendor, Serial Number, quantity, total cost, and Initiator. There are four types of transactions including: 1) Initial Issue, 2) Replacement, 3) Repair, and 4) Spare. You can select multiple items to view at one time. This includes who received the item, cost of the item, quantity, purchased or issued, etc.  StepsTo view item history, follow these steps: StepAction1Type IH for the Item History option from the Display/Print Menu.2At the Site prompt, press to accept the default Site or type two question marks to display and list and select a different site.3Once you have selected a site, an OK? Yes// prompt displays. 4Press and another Select Item prompt displays. Item History Screen 23 Display/Print Patient 2319 TI Transaction Inquiry IP Print All Prosthetic Items BI Print Prosthetic Billings for MAS IH Item History SE Search for Recalled Item SI Site Parameter Inquiry VI Vendor Inquiry Select Display/Print Option: IH Item History SITE: Hines Development System2// ST. NUM. 578 Select ITEM 1: ?? Choose from: 3 **** THIS ITEM IS INACTIVE **** 7 9 **** THIS ITEM IS INACTIVE, USE ITEM NUMBER 11 **** 40 55 Select ITEM 1: 3 1 3 **** THIS ITEM IS INACTIVE **** 2 345-1234 55 CHOOSE 1-2: 2 55 ...OK? Yes// (Yes) Select ITEM 2: or enter another item. View Item History Within a Date Range Item Master filePlease note that the item number and the item name must correspond with what is contained in the Prosthetics Item Master file when you are requesting to view items in the Item History option. Steps (continued)To view item history, follow these steps: StepAction5At the Beginning Date: T-30// prompt, press to accept this default setting. You can also enter a different entry for a beginning date.6At the Ending Date: TODAY// prompt, press to accept this default setting. You can also enter a different entry for an ending date.7At the Device prompt, press . The following displays: Right Margin: 80//. Press again.8The Item History displays. Item History Screen (continued)Beginning Date: T-30// (AUG 29, 2000) Ending Date: TODAY// (SEP 28, 2000) DEVICE: HOME// TELNET Right Margin: 80// ...EXCUSE ME, LET ME THINK ABOUT THAT A MOMENT... ITEM HISTORY: WHEELCHAIR-ADULT/HEMI/BLUE-STD FOR ALL STA ST. NUM. 578P AGE 1 REQUEST DATE PATIENT NAME SSN VENDOR AUG 29, 2000-SEP 28, 2000 SEP 25, 2000@11:56 PATIENT,FOUR 2750 Vendor SERIAL NBR: QTY: 1 TOTAL COST: 23.00 INITIAL ISSUE INITIATOR: PROSPROVIDER,THREE TOTAL DOLLARS SPENT ON THIS ITEM: $ 23.00 TOTAL QUANTITY ISSUED: 1 Search for Recalled Item (SE) Overview IntroductionThe Search for Recalled Item (SE) option from the Display/Print Menu searches the RECORD OF PROS APPLIANCE/REPAIR file (#660) for a recalled item. Steps To search for a recalled item, follow these steps: StepAction1Type SE for the Search for Recalled Item (SE) option from the Display/Print Menu.2At the Site prompt, press to accept the default Site or type two question marks to display a list and select a different site.3At the Beginning Date prompt, enter a date for the beginning of the date range of the data you want to view, and press . (For instance, if you want a range of a year of data, enter T-365 for Today minus 365 days from the current date.)4At the Ending Date prompt, enter the end date of the date range of the data you want to view, and press . (For instance, you can enter T for Today for the current date.)5At the Select one of the following prompts, a list of options display including: 1) Search by Serial Number or Lot Number or 2) Search by Item. Type the option that you want and press .  Search for Recalled Item Screen 23 Display/Print Patient 2319 TI Transaction Inquiry IP Print All Prosthetic Items BI Print Prosthetic Billings for MAS IH Item History SE Search for Recalled Item SI Site Parameter Inquiry VI Vendor Inquiry Select Display/Print Option: SE Search for Recalled Item SITE: A 3456789012345678901234567890 LONG NAME// 499 Beginning Date: T-365 (SEP 28, 1999) Ending Date: T (SEP 27, 2000) Select one of the following: 1 Search by Serial Number or Lot Number 2 Search by Item Enter response:  Search by Serial Number or Lot Number Search patternsItems issued through the Prosthetics stock program can be traced to an individual patient if either the items lot or serial number was recorded at the time of the issue. To use the Search by Serial Number or Lot Number option, some unique pattern in either the lot or serial number must be known. For example, to find all issues to patients receiving an item with the Serial Number (or in the Lot Number) of 90-222-98, enter 90- at the Enter Serial Number or Lot Number: prompt. A search of the database will begin and the results may be sent to the screen or printer. Multiple results may display. For this example, entering 90-222 or 222 would have given the same results. Entering 222-90 would NOT have found these transactions since 222-90 is NOT a pattern in either transactions Serial Number or Lot Number. Note: You may also search by item name. Steps To search for a recalled item, follow these steps: StepAction1Enter 1 for the Search by Serial Number or Lot Number.2At the Enter Serial Number or Lot Number prompt, you can enter partial information to begin the search.3At the Device prompt, press . The following displays: Right Margin: 80//. Press again. Search by Serial Number or Lot Number Screen Select one of the following: 1 Search by Serial Number or Lot Number 2 Search by Item Enter response: 1 Search by Serial Number or Lot Number Enter Serial Number or Lot Number: 9 DEVICE: HOME// TELNET Right Margin: 80// ...HMMM, I'M WORKING AS FAST AS I CAN.. RECALLED ITEM REPORT JUN 20, 1997-OCT 02, 2000 STA ST. NUM. 578 PAGE 1 REQUEST DATE PATIENT NAME SSN ITEM VENDOR JUN 01, 2000 TEST,H 5612 TEST ITEM PROSVENDOR,THREE LOT NBR: SERIAL NBR: K0429 END OF REPORT Search by Item Number Report descriptionThe Recalled Item Report displays the request date, patient name, SSN, item and vendor. Steps To search for a recalled item, follow these steps: StepAction6At the Select ITEM prompt, type either an item number or two question marks to display a list and then select one.7At the Device: HOME// prompt, press twice to display the information to your terminal screen (or type SLAVE to print it). Search for Recalled Item Screen (continued)Select one of the following: 1 Search by Serial Number or Lot Number 2 Search by Item Enter response: 2 Search by Item Select ITEM: ?? Choose from: 3 **** THIS ITEM IS INACTIVE **** 7 9 **** THIS ITEM IS INACTIVE, USE ITEM NUMBER 11 **** 40 55 56 Select ITEM: 3 1 3 **** THIS ITEM IS INACTIVE **** 2 345-1234 55 CHOOSE 1-2: 1 3 **** THIS ITEM IS INACTIVE **** ...OK? Yes// (Yes) DEVICE: HOME// TELNET Right Margin: 80// RECALLED ITEM REPORT SEP 28, 1999-SEP 27, 2000 STA 499 PAGE 1 REQUEST DATE PATIENT NAME SSN ITEM VENDOR MAY 19, 2000 PATIENT,TWO 8888 **SYRINGE-SUBCUTA PROSVENDOR,THREE LOT NBR: SERIAL NBR: MAY 22, 2000 PATIENT,TWO 8888 **SYRINGE-SUBCUTA PROSVENDOR,FIVE LOT NBR: SERIAL NBR: MAY 23, 2000 PATIENT,TWO 8888 **SYRINGE-SUBCUTA PROSVENDOR,FIVE LOT NBR: SERIAL NBR: END OF REPORT  Continued on next page styleref "Map Title"Search by Item Number, Continued ExampleThe following is an example of the usefulness of the Search for Recalled Item option: A vendor calls the Prosthetic office to look for a patients name and/or purchase order number but all they have is the item that was purchased and the date of the purchase. By using this option, you can locate the patients name and the item at the prompt that asks for the beginning and ending date. You would then access the patients 2319 which is located under the Display/Print option. Select the Appliance Transactions option. Select the date given to you by the vendor and enter the number that matches the date. The number will show full entry, and you will be able to locate the purchase order number. Site Parameter Inquiry (SI) Overview IntroductionThe Site Parameter Inquiry (SI) option from the Display/Print Menu should be used to review your local site information. Steps To inquire on a site parameter, follow these steps: StepAction1Type ST for the Search for Recalled Item (ST) option from the Display/Print Menu.2At the Site prompt, type two question marks to display a list and select a site.3At the Device: HOME// prompt, press twice to display the information to your terminal screen (or type SLAVE to print it). Site Parameter Inquiry Screen 23 Display/Print Patient 2319 TI Transaction Inquiry IP Print All Prosthetic Items BI Print Prosthetic Billings for MAS IH Item History SE Search for Recalled Item SI Site Parameter Inquiry VI Vendor Inquiry Select Display/Print Option: SI Site Parameter Inquiry Select PROSTHETICS SITE PARAMETERS SITE NAME: ?? Choose from: Hines Development System Hines Development System2 CORKWELL VAMC HINESTEST SAN ANTONIO VAMC ZZOJ VAMC VAMC Select PROSTHETICS SITE PARAMETERS SITE NAME: H 1 Hines System Development 2 Hines System Development2 CHOOSE 1-2: 1 Hines System Development DEVICE: 1 P-SLAVE-CERA10 173C Vendor Inquiry (VI) Overview IntroductionThe Vendor Inquiry (VI) option from the Display/Print Menu provides a display of all information contained in IFCAPs Vendor file. Enter the vendors name and the information is displayed. You can type two question marks to display a list of vendors to select one. Display/Print Menu Screen 23 Display/Print Patient 2319 TI Transaction Inquiry IP Print All Prosthetic Items BI Print Prosthetic Billings for MAS IH Item History SE Search for Recalled Item SI Site Parameter Inquiry VI Vendor Inquiry Select Display/Print Option: VI Vendor Inquiry Select VENDOR NAME: ?? Choose from: 1 PROSVENDOR,FOUR NO: 1 ORD ADD:M AND M AVENUE FMS: HACKETTSTOWN, NJ 07840 CODE: FAX:555 555-1212 ****THIS VENDOR IS INACTIVE, NO REPLACEMENT VENDOR ***** PLEASE CHOOSE ANOTHER VENDOR 2 PROSVENDOR,FIVE PH:555 555-5555 NO: 2 ORD ADD:1ST AVE NO 22ND FMS: HINES, IL 60141 CODE: FAX: 3 PROSVENDOR,THREE PH:555-555-5555 NO: 3 ORD ADD:CORPORATE ORDER ENTRY FMS: ANY PARK, IL 60064 CODE: FAX: 4 PROSVENDOR,SIX EDI PH:555 555-5555 NO: 4 ORD ADD:7701 SOUTH ST FMS:TEST TEST CHICAGO, IL 60620 CODE: FAX: 5 PROSVENDOR,SEVEN PH:555 555-5555 NO: 5 ORD ADD:7501 S PULASKI FMS: CHICAGO, IL 60652 CODE:FED000000 FAX: ^ Select VENDOR NAME: PROSVENDOR,SIX PROSVENDOR,SIX EDIPH:555 555-5555NO: 4 ORD ADD:7701 SOUTH ST FMS:TEST TEST CHICAGO, IL 60620 CODE: FAX: ...OK? Yes// (Yes)  Vendor Inquiry Screen Output Vendor ReportThe Vendor report displays for the vendor selected. You can press at the Device prompt, to display the information to your terminal or type SLAVE to send it to your printer for a hard copy. Vendor Inquiry ScreenDEVICE: TELNET Right Margin: 80// VENDOR LIST OCT 3,2000 15:13 PAGE 1 ------------------------------------------------------------------------------ NUMBER: 4 NAME: PROSVENDOR,SIX ORDERING ADDRESS1: 7701 SOUTH CLAREMONT ORDERING CITY: CHICAGO ORDERING STATE: ILLINOIS ORDERING ZIP CODE: 60620 PROCUREMENT CONTACT PERSON: PROVIDER,TEN VENDOR PHONE NUMBER: (555) 555-5555 BILLING ADDRESS1: BILLING ADDRESS 1 BILLING ADDRESS2: BILLING ADDRESS 2 BILLING CITY: CHICAGO BILLING STATE: ILLINOIS BILLING ZIP CODE: 60620 BILLING PHONE NUMBER: 555-5555 TYPE OF OWNERSHIP (FY88): V VIETNAM VETERAN - OWNED SOCIOECONOMIC GROUP (FPDS): Q VIETNAM VET-OWNED SM SOCIOECONOMIC GROUP (FPDS): S VETERAN-OWNED SM BUSINESS BUSINESS TYPE (FPDS): SMALL LABOR SURPLUS AREA?: YES BUSINESS TYPE (FPDS-88): SMALL IS A SF129 ON FILE?: YES DATE OF SF129: OCT 23, 1992 GUARANTEED DELIVERY VENDOR?: NO SPECIAL FACTORS: FAX#555-2509/FOB D EDI VENDOR?: YES VENDOR ID NUMBER: 77778 Section 3: Purchasing Menu (PU) Overview IntroductionCreating the Prosthetics purchase order is an involved process and includes the following: It combines patient information, vendor, item, obligation, and cost information on a single purchasing document. It is integrated with six other VISTA applications including: PSAS, IFCAP, Consult Tracking, CPRS, Patient Care Encounters, DSS and Billing. They are integrated by exchange of data between applications. It is also different because of the structure of the National Prosthetics Patient Database (NPPD) and the NPPD requirements. Creating the PSAS purchasing document using IFCAP interface is a seamless process. PSAS data (patient name, SSN, address, and phone number) are automatically printed on PSAS obligation document. BackgroundPSAS has developed a customized Purchasing Menu in the prosthetics software package in VISTA, which calls into IFCAP, in order to alleviate the need to switch to and from various packages in VISTA or various screens. This reduced processing time of procuring devices/appliances and services for direct patient care. The National Prosthetic Patient Database (NPPD) requires various fields, which are patient specific, in order to ensure we are adhering to eligibility criteria, and maintaining prescription, diagnosis, ordering, vendor, item, and accounting data is captured on the patients record. The need for one point of entry and seamless entry/order processing has proven effective in reducing delays and fast effective processing of orders. PSAS is held to a five-day time limit in processing an order (again since it is for direct patient care), and VISN Directors performance standards state such. Prosthetics SystemThe Purchasing Menu (PU) is accessed from the Prosthetic Officials Menu. Continued on next page  STYLEREF "Map Title" Overview, Continued VA FormsPurchasing interfaces with IFCAP into the IFCAP 1358 module. Forms printed include the following: VAF 10-2421, Prosthetics Authorization and Invoice Form Letter 10-55, Authority to Exceed Amount on Service Card. For tracking transactions associated with purchasing, Prosthetics will accommodate: VAF 10-2520, Prosthetic Service Card Invoice VAF 10-2914, Prescription and Authorization for Eyeglasses - Computer entry of eyeglass prescriptions has been automated. No-Form, Pickup/Delivery Charges Request for Estimate (FL 10-55) Patient Notification Letter. Listed below are all of the menus and sub-menus that you will use for purchasing purposes. If the system does not allow you to access an option, contact your Fiscal Service and inform them that you need access to fund control points. Purchasing Menu (PU)Select Prosthetic Official's Menu Option: PU Purchasing EN Enter New Request ... SI Stock Issues ... RP Reprints ... RE Record 2237 Purchase to 2319 ED Edit/Delete 2237 from 10-2319 CA Cancel a Transaction CO Close Out CPC Cancel Purchase Card Transaction CPO Reconcile/Close Out Purchase Card Transaction ED2 Edit 2319 ED2C Edit 2319 (Vendor,QTY,Cost) EDPC Edit Purchase Card Transaction HI Add Historical Data HID Delete Historical Data Entry LI List Open 1358 Prosthetic Transactions LII List Open 1358 Transactions By Initiator LPC List Open Purchase Card Transactions LPCI List Open Purchase Card Transactions By Initiator LPS Purchase Card Summary Sheet Select Purchasing Option: In this manualThe following topics are covered under the Purchasing Menu: TopicSee PageList Open 1358 Prosthetic Transactions (LI)61Close Out (CO)63Enter a New Request (EN)64 Continued on next page  STYLEREF "Map Title" Overview, Continued Stock IssuesThere is a separate Stock Issues User Manual that was developed with Patch RMPR*3*61 the Inventory/Bar Coding enhancement. Therefore this menu and the menu options will not be explained in this basic manual. Purchase CardsThere is also a Purchase Cards User Manual that is available from the Vista Document Library for you to download and therefore will not be explained in this basic manual. The Purchase Cards User Manual also documents the following Purchasing options: Purchase Card Form (PC) from the Enter New Request (EN) Menu CPC - Cancel Purchase Card Transaction CPO - Reconcile/Close Out Purchase Card Transaction LPC - List Open Purchase Card Transactions LPCI - List Open Purchase Card Transactions By Initiator LPS - Purchase Card Summary Sheet Reprint a Purchase Card Form (PCR) from the Reprints (RP) Menu List Open 1358 Prosthetic Transactions (LI) IntroductionThe List Open 1358 Prosthetic Transactions (LI) option produces a report that will print the open 1358 transactions in the Prosthetics Package, sorted by initiator. However, it will not include manual transactions that were created in the IFCAP 1358 module. Once the transaction has been closed out, it will not appear on this report. Purchasing (PU) Menu EN Enter New Request ... SI Stock Issues ... RP Reprints ... RE Record 2237 Purchase to 2319 ED Edit/Delete 2237 from 10-2319 CA Cancel a Transaction CO Close Out CPC Cancel Purchase Card Transaction CPO Reconcile/Close Out Purchase Card Transaction ED2 Edit 2319 ED2C Edit 2319 (Vendor,QTY,Cost) EDPC Edit Purchase Card Transaction HI Add Historical Data HID Delete Historical Data Entry LI List Open 1358 Prosthetic Transactions LII List Open 1358 Transactions By Initiator LPC List Open Purchase Card Transactions LPCI List Open Purchase Card Transactions By Initiator LPS Purchase Card Summary Sheet Select Purchasing Option: LI List Open 1358 Prosthetic Transactions This report lists open purchasing transactions created in the Prosthetic Package. It will not include manual transactions done in the IFCAP 1358 module. SITE: Hines Development System// 499 Starting Date: T-300 (JAN 31, 2001) Ending Date: T (NOV 27, 2001) DEVICE: HOME// TELNET Right Margin: 80// Hmmm, Im working as fast as I can  SiteMultiple division sites are available Date promptsThe date prompts determine the range of dates for which the report will be produced. Continued on next page  STYLEREF "Map Title" List Open 1358 Prosthetic Transactions (LI), Continued OutputHeres the output: Screen outputFROM: JAN 31, 2001-NOV 27, 2001 OPEN 1358 TRANSACTIONS STA 499 PAGE 1 PATIENT NAME SSN OBLIGATION REQUEST DATE VENDOR ITEM ITEM COST PATIENT,FIVE 0005 A20012-0132 FEB 02, 2001 VENDOR,EIGHT TEST ITEM 0.01 PATIENT,FOUR 0004 A20012-0133 FEB 05, 2001 VENDOR,THREE TEST ITEM 0.01 PATIENT,FIVE 0005 A20012-0134 FEB 06, 2001 VENDOR,THREE TEST ITEM 0.01 PATIENT,FIVE 0005 A20012-0135 FEB 06, 2001 VENDOR,THREE EYEGLASSES 0.01 PATIENT,FOUR 0004 A20012-0140 MAY 22, 2001 VENDOR,NINE *SHIPPING 1.00 OXYGEN DEV 1.00 PATIENT,FOUR 0004 A20012-0141 JUL 10, 2001 VENDOR,TEN OXYGEN DEV 1.00 PATIENT,FOUR 0004 A20012-0142 JUL 16, 2001 VENDOR,THREE *DELIVERY 1.00 PATIENT,F0UR 0004 A20012-0143 JUL 19, 2001 VENDOR,THRE TEST ITEM 2.00 PATIENT,FOUR 0004 A20012-0144 JUL 19, 2001 VENDOR,TEN DELIVERY  Close Out (CO) Menu descriptionThe Close Out (CO) option is used to close out transactions when invoices are received from the vendor. This will update the actual VAF 1358 account balance. Screen sample EN Enter New Request ... SI Stock Issues ... RP Reprints ... RE Record 2237 Purchase to 2319 ED Edit/Delete 2237 from 10-2319 CA Cancel a Transaction CO Close Out CPC Cancel Purchase Card Transaction CPO Reconcile/Close Out Purchase Card Transaction ED2 Edit 2319 ED2C Edit 2319 (Vendor,QTY,Cost) EDPC Edit Purchase Card Transaction HI Add Historical Data HID Delete Historical Data Entry LI List Open 1358 Prosthetic Transactions LII List Open 1358 Transactions By Initiator LPC List Open Purchase Card Transactions LPCI List Open Purchase Card Transactions By Initiator LPS Purchase Card Summary Sheet Select Purchasing Option: CO Close Out SITE: Hines Development System// 499 Select OBLIGATION NUMBER: 499-A20012 07-01-97 1358 Obligated - 1358 FCP: 910 $ 2000.00 1358 Balance is $ 2911.23 Select PATIENT: 8-16-2001 PROSPATIENT,FOUR REF: 0167 SHOE COMPONENTS PROSPATIENT,FOUR 000-00-0004 499-A20012 ------------------------------------------------------------------------------ ITEM: 913 SHOE COMPONENTS AMIS: 20 PSAS HCPCS CODE: L3455 SHOE HEEL NEW LEATHER STANDA CPT MODIFIER: LT,RT REMARKS: TESTING DESCRIPTION: TESTING SERIAL NUMBER: UNIT COST: 20 UNIT OF ISSUE: EA QTY: 1 ITEM COST: 20.00 TYPE: INITIAL CATEGORY: SC/OP SPECIAL CATEGORY: SUB TOTAL: $ 20.00 % DISCOUNT: 5 $ 1.00 SHIPPING CHARGE: $ 2.00 TOTAL COST: $ 21.00 Ready to Close-Out Transaction? No// Y (Yes) CLOSE-OUT REMARKS: TESTING Updated 1 10-2319 record for this Veteran Closed out Transaction Enter New Request (EN) Overview Menu descriptionIn order to use the Enter New Request (EN) option or to enter a new transaction, you must choose one of the menu options (purchasing forms) below. All of the options listed under this menu are similar in several ways. Each form type will, upon posting, update the patients electronic 10-2319, and record the transaction to the 1358 obligation that you choose. Once posted, these requests may only be closed out or cancelled. After you begin input into the computer, these forms must be completed to the point of posting to the 1358 obligation and patient's 10-2319 record. If the form is not completed, exiting the program during input of one of these forms will cause the transaction to be deleted. (This is unlike IFCAP where a transaction may be started and later edited.) Note: Prosthetics purchasing forms are not saved in the computer for editing at a later time. Enter New Request Menu (EN) EN Enter New Request ... SI Stock Issues ... RP Reprints ... RE Record 2237 Purchase to 2319 ED Edit/Delete 2237 from 10-2319 CA Cancel a Transaction CO Close Out CPC Cancel Purchase Card Transaction CPO Reconcile/Close Out Purchase Card Transaction ED2 Edit 2319 ED2C Edit 2319 (Vendor,QTY,Cost) EDPC Edit Purchase Card Transaction HI Add Historical Data HID Delete Historical Data Entry LI List Open 1358 Prosthetic Transactions LII List Open 1358 Transactions By Initiator LPC List Open Purchase Card Transactions LPCI List Open Purchase Card Transactions By Initiator LPS Purchase Card Summary Sheet Select Purchasing Option: EN Enter New Request 24 2421 Form 25 2520 Transaction without printing 10-55 10 10-55 PSC Form 29 2914 Eyeglass Record NF Create a No-Form Daily Record PD Pickup and Delivery Charges PC Purchase Card Form SS Purchase Card Site Parameter TopicSee Page2421 Form (24)652520 Transaction without printing 10-557510-55 PSC Form (10)772914 Eyeglass Record (29)80 Continued on next page Enter a 2421 Form (24) IntroductionWith the 2421 Form (24) option, the user will create a 2421 Form for a selected patient. This form will update the patients electronic 10-2319, and record the transaction to the 1358 obligation that you choose. Once posted, this request may only be closed out or cancelled.  When do you use this option?You must use the 2421 Form (24) option when a vendor does NOT accept the government purchase card. (This is another form of a Prosthetics Purchase Order using a 1358.) What is the process?After you access the 2421 Form (24) option, this form must be completed to the point of posting to the 1358 obligation and patient's 10-2319 record. If it is not completed, exiting the program during input will cause the transaction to be deleted. You will be prompted to enter the site, substation, obligation number, patient, and disability code(s) if none exists. If the patient already has disability codes, they will display. You may view any of the 10-2319 patient screens (patient demographics, clinic enrollments/correspondence, entitlement information, appliance transactions, auto adaptive information, critical comments, add/edit disability code). Continued on next page styleref "Map Title"Enter a 2421 Form (24), Continued Obligation NumberThis is the 1358 Number. This prompt will display: This will Create a 10-2421 Do you wish to Continue? Yes//. By pressing , you accept the default answer of YES and are asked to select the Prosthetics 1358 patient. The Obligation Number is also considered all of the following: Procurement & Accounting Transactions Purchase Order Number, or method of processing, or Depot Voucher No., or Supply Status, or Supply Status Order, or FCP or vendor, or Purchase Card holder, or Requisition No.(Supply), or Issue Voucher No.(Supply), or Issue Voucher No.(Fiscal), or Inventory/Distribution Point, or ISMS Order No. StepsTo enter a 2421 Form (24), follow these steps: StepAction1Select the Form Type (i.e., 2421 Form (24)).2Enter the Site (if a multi-site facility).3Enter the 1358 Obligation Number. 2421 Form screenSITE: Hines Development System// 499 Select OBLIGATION NUMBER: ?? Choose from: 499-A20003 11-24-95 1358 Cancelled Order FCP: 910 $ 0.00 499-A20010 01-04-00 1358 Order Not Completely Prepared FCP: 910 $ 0.00 499-A20012 07-01-97 1358 Obligated - 1358 FCP: 910 $ 2000.00 Select OBLIGATION NUMBER: 499-a20012 07-01-97 1358 Obligated - 1358 FCP: 910 $ 2000.00 1358 Balance is $ 2984.97 This will Create a 10-2421 Do you wish to Continue? Yes// Y (Yes) Continued on next page  STYLEREF "Map Title" Enter a 2421 Form (24), Continued Prosthetic patientThe patient selected must be in both the MAS patient file and the Prosthetic Patient file. If the patient is not in the Prosthetic Patient file, but is in the MAS Patient file, you may enter the patient into the Prosthetic Patient file at this time. The current Disability codes will be displayed for the selected patient. If there is no Prosthetic Disability Code entered for the patient, you must do so prior to continuing. StepsTo continue to enter a 2421 Form (24), follow these steps: StepAction4Enter the Prosthetic Patient. The Disability Codes will display.5Enter the Date or press to accept the default setting.6Select a Vendor. Screen SampleSelect PROSTHETIC PATIENT: PATIENT,FOUR PATIENT,FOUR 12-27-50 000654321 YES SC VETERAN Enrollment Priority: GROUP 2 Category: IN PROCESS End Date: ...OK? Yes// (Yes) SUPPORT ISC Current Disability Codes are: AMP/LS INPATIENT S/C BLD/TRE EMPLOYEE NSC Enter 10-2319 screen to VIEW (1-8),'^' to EXIT, or 'return' to continue: DATE REQUIRED: T+30// (AUG 18, 2001) VENDOR:?? Enter the Vendor the item is being purchased from. VENDOR: VENDOR,THREE VENDOR,THREE PH:555 555-5555 NO: 3 ORD ADD:CORPORATE ORDER ENTRY FMS: PARK, IL 60064 CODE: FAX: ...OK? Yes// (Yes) Date RequiredPress at the Date Required prompt to accept the default response, which is todays date plus 30 days. If another date is necessary (i.e., item is needed in one week), enter that date.  VendorSelect the Vendor for the item you are purchasing. If the computer does not recognize the vendor you select, you must first enter the vendor into the IFCAP file. You may enter an ^ to exit the program at this time if you need to enter data into either of these files.  Continued on next page styleref "Map Title"Enter a 2421 Form (24), Continued Contract/BOA NumberIf the item you are purchasing is on contract with the vendor, enter the Contract Number at the prompt.  Type of TransactionEnter a question mark (?) to view the choices for the Type of Transaction prompt. They are the following: I Initial Issue R Replace S Spare X Repair StepsTo continue to enter a 2421 Form (24), follow these steps: StepAction7Select a Contract/BOA Number.8Select a Type of Transaction.  2421 Form Screen (continued)Select CONTRACT/BOA NUMBER: ?? Choose from: V797P-5640M -- EXP. DATE: 12-31-95 MOL$100000 CONTRACT V797P-5894M 02-09-00 EXP. DATE: 05-04-01 MIN$1000/MOL$15000 CONTRACT Select CONTRACT/BOA NUMBER: v797p-5640M -- EXP. DATE: 12-31-95 MOL $100000 CONTRACT TYPE OF TRANSACTION: I INITIAL ISSUE Continued on next page  STYLEREF "Map Title" Enter a 2421 Form (24), Continued Patient CategoryThe Patient Category includes the following: SC/OP (Service connected/Outpatient) SC/IP (Service connected/Inpatient) NSC/IP (Non-service connected/Inpatient) NSC/OP (Non-service connected/Outpatient) Note: If you select the NSC/OP option, a prompt for Special Category appears requiring you to select from one of four options (i.e., Special Legislation, AA, etc.) ItemThis is the item entered into the Prosthetic Item master list. You can search for an item using the question mark processing feature. PSAS HCPCSEnter the appropriate HCPCS (Health Care Financing Administration Common Procedure Coding System) code. Try the HCPCS, E1399 if unknown. This field should have the HCPCS code for the Item you are selecting. HCPCS is a uniform method to report professional services, procedures and supplies for healthcare providers and medical suppliers. Steps (continued)To continue to enter a 2421 Form (24), follow these steps: StepAction9Enter the Patient Category. (If the veteran is NSC/OP, then select a Special Category.)10Select the Item to be Issued or Repaired.11Select the PSAS HCPCS and if necessary a CPT Modifier. 2421 Form screen (continued)PATIENT CATEGORY: ?? Enter a code from the list. Select one of the following: 1 SC/OP 2 SC/IP 3 NSC/IP NSC/OP PATIENT CATEGORY: NSC/IP Select ITEM: 913 SHOE COMPONENTS ...OK? Yes// (Yes) PSAS HCPCS: L3455 SHOE HEEL NEW LEATHER STANDA Enter a CPT MODIFIER for HCPCS L3455: (LT/RT/B): Both Left and Right  Continued on next page  STYLEREF "Map Title" Enter a 2421 Form (24), Continued Brief/Extended Description of ItemYou can type a brief description of the item for that specific vendor. This description will print on the 10-2421 form for use by the vendor to determine what item is to be provided to the veteran. At the Extended Description, you can further describe the item for the vendor in a text editor at the Edit? prompt. Steps (continued)To continue to enter a 2421 Form (24), follow these steps: StepAction12Enter a brief and an extended description of the item (for the vendor).13Enter the Quantity to be Purchased.14Enter Unit Cost.15Enter Unit of Issue.16Enter Remarks (2310 and 1358).17Establish a Shipping Charge (optional). 2421 Form screen (continued)BRIEF DESCRIPTION OF ITEM (for Vendor): SHOE HEEL EXTENDED DESCRIPTION: No existing text Edit? NO// QTY: 1 UNIT COST: 2500 UNIT OF ISSUE: ea EACH REMARKS (2319 and 1358): ---------------------------------- EST. SHIPPING CHARGE:  PromptDescriptionQuantityEnter the number of the item you want to order total amount of units issued for this item.Unit CostEnter the cost of one item to be purchased.Unit of IssueThis field uses data from the IFCAP system (i.e., ea for Each).RemarksAny Remarks you would like printed on the 1358 Obligation form and the 10-2319 should be entered here.Est. Shipping ChargeThe estimated shipping charge when the transaction is created. This field only holds the estimate, not the actual charge. Continued on next page  STYLEREF "Map Title" Enter a 2421 Form (24), Continued Percent DiscountContains the percent discount for the purchase. Estimated Cost and Actual Cost are calculated with the percent Discount. Deliver ToYou have four selections of delivery locations to choose one. Steps (continued)To continue to enter a 2421 Form (24), follow these steps: StepAction18Enter a Percent Discount (if applicable).19Select one of the following to Deliver To: Veteran VAMC Warehouse Prosthetics Other20Answer Yes or No at the following prompt: Are you ready to POST to IFCAP and 10-2319 NOW? No//  2421 Form screen (continued)PERCENT DISCOUNT: DELIVER TO: ?? Enter a code from the list. Select one of the following: 1 VETERAN 2 VAMC WAREHOUSE 3 PROSTHETICS OTHER DELIVER TO: PROSTHETICS Are you ready to POST to IFCAP and 10-2319 NOW? No// NO (No) Are you ready to Post?The prompt, Are you ready to Post to IFCAP and the 2319 now?//No displays. The default answer for posting will always be NO. Accept the default answer by pressing the key, so you may verify that the information entered on the request is correct. The data entered displays for your review. If information is not correct, you have the option to edit the transaction as shown in the example on the next page. Continued on next page styleref "Map Title"Enter a 2421 Form (24), Continued Display EntryThe data entered displays below for your review if you accepted the default of NO at the Are you ready to Post to IFCAP and 10-2319 NOW? prompt. 2421 Form screen (continued) PROSPATIENT,FOUR 000-00-0004 499-A20012 ----------------------------------------------------------------------------- ITEM: 903 TEST ITEM AMIS: 05 D PSAS HCPCS CODE: VENDOR,FOUR HEART PACEMAKER, PERMANENT CPT MODIFIER: GX DELIVER TO: PROSTHETICS DESCRIPTION: Heart Pacemaker, Permanent SERIAL NUMBER: UNIT COST: 2500 UNIT OF ISSUE: EA QTY: 1 ITEM COST: 2500.00 TYPE: INITIAL CATEGORY: NSC/IP SPECIAL CATEGORY: SUB TOTAL: $2500.00 % DISCOUNT: SHIPPING CHARGE: $ 0.00 TOTAL COST: $2500.00 Enter Item to Edit: 903 TEST ITEM ...OK? Yes// (Yes) Continued on next page  STYLEREF "Map Title" Enter a 2421 Form (24), Continued Edit the formYou can now edit the prompts if you need to change anything on the order. Press to view each prompt and accept the default entry shown. Steps (continued)To continue to enter a 2421 Form (24), follow these steps: StepAction21Press for each prompt that you do not want to edit.22None of the fields have been edited in the example below because the information is correct. When you are asked again Are you Ready to POST to IFCAP and 10-2319 NOW? NO// you can answer YES.23A YES response at the Would you like to print the Privacy Act Statement? will print an additional page to the 10-2319.24At the prompt, Would you like to print a Patient Notification letter? A YES response will print the Patient Notification letter on the purchasing printer defined in the Site Parameter File. You may also print the Patient Notification letter from the Reprint 2421 Form (24) option from the Reprints (RP) Menu. 2421 Form screen (continued)TYPE OF TRANSACTION: INITIAL ISSUE// PATIENT CATEGORY: NSC/IP// ITEM: TEST ITEM// PSAS HCPCS: SI501// BRIEF DESCRIPTION: Heart Pacemaker, Permanent Replace EXTENDED DESCRIPTION: No existing text Edit? NO// QTY: 1// UNIT COST: 2500// 2 ** Total for Previous Item(s) is $2500 ** Total With This Amount is $2 UNIT OF ISSUE: EA// REMARKS: EST. SHIPPING CHARGE: PERCENT DISCOUNT: DATE REQUIRED: AUG 18,2001// DELIVER TO: PROSTHETICS// Enter Item to Edit: Are you ready to POST to IFCAP and 10-2319 NOW? No// Y (Yes) Would you like to print the Privacy Act Statement? Yes// Y (Yes) Would you like to print a Patient Notification letter? No// (No) Posting Now ... 1358 Transaction has been assigned Number: 499-A20012-0143 Updated 10-2319 DEVICE: HOME// TELNET Right Margin: 80//  Continued on next page  STYLEREF "Map Title" Enter a 2421 Form (24), Continued Final OutputBelow is the output of the data from the 2421 Form (24) option. Then the Suspense Processing (SU) screen displays and allows you to perform an action on a Suspense item and link it to the item(s) you just ordered through the Stock Issues (SI) Menu. 2421 Form (24) Screen Final OutputOMB Number 2900-0188 Estimated Burden: 4 minutes ***ORIGINAL COPY AND COMMERCIAL INVOICE MUST BE SUBMITTED*** TO THE VAMC PROSTHETIC ACTIVITY LISTED BELOW ______________________________________________________________________________ Department of Veterans Affairs|Prosthetics Authorization for Items or Services ------------------------------------------------------------------------------ 1. Name and Address of Vendor 2. Name and Address of VA Facility PROSVENDOR,THREE Hines Development System (499/121) CORPORATE ORDER ENTRY TEST 2 PO BOX 1140 HINES, IL 60142 ANY PARK,IL 60064 (800) 255-5162 222 ------------------------------------------------------------------------------ 3. Veterans Name (Last, First, MI) 4. Date of Authorization PROSPATIENT,FOUR JUL 19, 2001 ------------------------------------------------------------------------------ 5. Veterans Address 6. Date Required 100 HOLLYWOOD AUG 18, 2001 HOLLYWOOD,CALIFORNIA -------------------------------------- 9. Authority For Issuance CFR 17.115 CHARGE MEDICAL APPROPRIATION ------------------------------------------------------------------------------ 7. Claim Number 000654322P 8. SSN 000-00-0004 ------------------------------------------------------------------------------ 10. Statistical Data 11. FOB Point 12. Discount 13. Delivery Time NSC/IP DEST % 30 Days ------------------------------------------------ 14. Delivery To: PROSTHETICS ------------------------------------------------------------------------------ 15. DESCRIPTION OF ITEMS OR SERVICES AUTHORIZED ------------------------------------------------------------------------------ ITEM NUMBER DESCRIPTION/NOMENCLATURE QUANTITY UNIT UNIT AMOUNT ORDERED PRICE ------------------------------------------------------------------------------ #1. Heart Pacemaker, Permanent 1 EA 2.00 2.00 ------------------------------------------------------------------------------ 16. Contract Number: Subtotal: 2.00 ACCT.#: 17000000 Discount $ 0.00 Shipping: 0.00 Total $ 2.00 ------------------------------------------------------------------------------ 17. Signature and Title of 18. DATE 19. Signature and Title of 20. Date Requesting Official Contracting/Accountable Officer PROSPROVIDER1,ONE PROSPROVIDER,FOUR ------------------------------------------------------------------------------ Order and Receipt Action ------------------------------------------------------------------------------ 21. Order Number 22. Date of Order 23. Date Item Received 24. Date Delivered 499-A20012-0143 JUL 19, 2001 ------------------------------------------------------------------------------ 25. The articles or services listed herein have been received, or rendered ordered in the quantity and quality specified originally or as shown by authenticated changes, except as noted. Signature of Veteran or VA Official Enter a 2520 Transaction without Printing 10-55 (25) DescriptionFrom the Purchasing (PU) Menu and the Enter New Request (EN) Menu, you can access the 2520 Transaction without Printing (25) option. This is used for VAF 10-2520 PSC transactions that are under $300.00 and do not have an FL 10-55. It will then post to the VAF 1358 and patient's VAF 10-2319 record. Screen sample 24 2421 Form 25 2520 Transaction without printing 10-55 10 10-55 PSC Form 29 2914 Eyeglass Record NF Create a No-Form Daily Record PD Pickup and Delivery Charges PC Purchase Card Form SS Purchase Card Site Parameter Select Enter New Request Option: 25 2520 Transaction without printing 10-55 SITE: Hines Development System// 499 Select OBLIGATION NUMBER: 499-A20012 07-01-97 1358 Obligated - 1358 FCP: 910 $ 2000.00 1358 Balance is $ 2570.23 This will Create ALL OTHER Do you wish to Continue? Yes// (Yes) Select PROSTHETIC PATIENT: PATIENT,FOUR SUPPORT ISC 12-27-50 00012275 0P YES SC VETERAN Current Disability Codes are: AMP/LS INPATIENT S/C BLD/TRE EMPLOYEE NSC Enter 10-2319 screen to VIEW (1-8),'^' to EXIT, or 'return' to continue: Enter 'W' for WHEELCHAIR, 'O' for BRACE, 'B' for BLIND AIDS, 'A' for ART. LIMBS Select PSC ITEM CATEGORY: ?? CHOOSE FROM: W WHEELCHAIR O BRACE B BLIND AID A ARTIFICIAL LIMB Enter 'W' for WHEELCHAIR, 'O' for BRACE, 'B' for BLIND AIDS, 'A' for ART. LIMBS Select PSC ITEM CATEGORY: W You will not be able to exceed an item repair cost of more than $100.00. Add/Edit/View Patient PSC? No// Y (Yes) Select PSC ISSUE CARD: ?? 1 MAY 22, 2000 TEST 345-678 You may enter a new PSC ISSUE CARD, if you wish This is the date the PSC card was issued. Select PSC ISSUE CARD: 1 5-22-2000 TEST 345-678 PSC ISSUE CARD DATE: MAY 22,2000//  Continued on next page  STYLEREF "Map Title" Enter a 2520 Transaction without Printing 10-55 (25), Continued Screen sample (continued)ITEM: EYEGLASSES// ?? This is the PSC item issued to the patient. Choose from: 3 **SYRINGE-SUBCUTANEOUS-3IN **** THIS ITEM IS INACTIVE **** 55 WHEELCHAIR-ADULT/HEMI/BLUE-STD FOR ALL PATIENTS 56 WHEELCHAIR-CLASSIC-18X16 59 EYEGLASSES 99 OXYGEN CONCENTRATOR 100 OXYGEN DEVICE 903 TEST ITEM 912 WHEELCHAIR GLOVES 913 SHOE COMPONENTS 921 WHEELCHAIR - ELECTRIC 922 WHEELCHAIR - MANUAL 925 SHOES 10000 EYEGLASSES ITEM: EYEGLASSES// DETAILED DESCRIPTION: TEST// SERIAL NUMBER: 345-678// Select PSC ISSUE CARD: ?? 1 MAY 22, 2000 TEST 345-678 You may enter a new PSC ISSUE CARD, if you wish This is the date the PSC card was issued. Select PSC ISSUE CARD: 1 5-22-2000 TEST 345-678 PSC ISSUE CARD DATE: MAY 22,2000// ITEM: EYEGLASSES// DETAILED DESCRIPTION: TEST// SERIAL NUMBER: 345-678// Select PSC ISSUE CARD: 1 5-22-2000 TEST 345-678 PSC ISSUE CARD DATE: MAY 22,2000// ITEM: EYEGLASSES// DETAILED DESCRIPTION: TEST//  10-55 PSC Form (10) DescriptionFrom the Purchasing (PU) Menu and the Enter New Request (EN) Menu, you can access the 10-55 PSC Form (10). This will create a new FL 10-55 form and post purchasing data to patient's VAF 10-2319 record and update the Service's VAF 1358 obligation. Sample 10-55 PSC Form (10) 24 2421 Form 25 2520 Transaction without printing 10-55 10 10-55 PSC Form 29 2914 Eyeglass Record NF Create a No-Form Daily Record PD Pickup and Delivery Charges PC Purchase Card Form SS Purchase Card Site Parameter Select Enter New Request Option: 10 10-55 PSC Form SITE: Hines Development System// Select STATION NUMBER: 499 SUPPORT ISC Select OBLIGATION NUMBER: ?? Choose from: 499-A20003 11-24-95 1358 Cancelled Order FCP: 910 $ 0.00 499-A20010 01-04-00 1358 Order Not Completely Prepared FCP: 910 $ 0.00 499-A20012 07-01-97 1358 Obligated - 1358 FCP: 910 $ 2000.00 Select OBLIGATION NUMBER: 499-A20012 07-01-97 1358 Obligated - 1358 FCP: 910 $ 2000.00 1358 Balance is $ 259.79 This will Create a PSC 10-55 Do you wish to Continue? Yes// (Yes) Select PROSTHETIC PATIENT: PROSPATIENT,ONE PROSPATIENT,ONE 1-1-30 453890765 NO PILL Enrollment Priority: Category: IN PROCESS End Date: *** Patient Requires a Means Test *** Primary Means Test Required from FEB 13,2002 ...OK? Yes// (Yes) HINES, IL Continued on next page  STYLEREF "Map Title" 10-55 PSC Form (10), Continued Screen (continued)*Comments on file Current Disability Codes are: COS/B EMPLOYEE NSC AMP/LAE SC VIETNAM S/C AMP/LAE SC VIETNAM NSC Deleted... ORTH/PLS INPATIENT S/C *More Disability Codes on File, See Screen 1 Enter 10-2319 screen to VIEW (1-8),'^' to EXIT, or 'return' to continue: Add/Edit/View Patient PSC? No// y (Yes) Select PSC ISSUE CARD: NAME SERIAL NUMBER 1. TEST ITEM SELECT NUMBER: 1 VENDOR: PROSVENDOR,THREE PH:555 555-5555 NO: 3 ORD ADD:CORPORATE ORDER ENTRY FMS: ANY PARK, IL 60064 CODE: FAX: ...OK? Yes// (Yes) TYPE OF TRANSACTION: I INITIAL ISSUE PATIENT CATEGORY: 4 NSC/OP SPECIAL CATEGORY: 4 ELIGIBILITY REFORM PSAS HCPCS: A4254 BATTERY FOR GLUCOSE MONITOR DESCRIPTION OF ITEM (For Vendor): Battery EXTENDED DESCRIPTION: No existing text Edit? NO// QTY: 1// UNIT COST: 20 UNIT OF ISSUE: JB// JOB REMARKS (2319 and 1358): battery EST. SHIPPING CHARGE: 2 Are you ready to POST to IFCAP and 10-2319 NOW? No// y (Yes) Would you like to print the Privacy Act Statement? Yes// n (No) Posting Now ... 1358 Transaction has been assigned Number: 499-A20012-0226 Updated 10-2319 DEVICE: HOME// TELNET Right Margin: 80//  Continued on next page  STYLEREF "Map Title" 10-55 PSC Form (10), Continued Letter on fileBelow is the letter on file for the 10-55 PSC Form (10). Sample Letter DEPARTMENT OF VETERANS AFFAIRS Hines Development System TEST 2 HINES, IL 60142 PROSVENDOR,THREE In Reply Refer to: -121 CORPORATE ORDER ENTRY PROSPATIENT,ONE ANY PARK, IL 60064 000-00-0001 499-A20012-0226 PROSVENDOR,THREE With reference to your request of 02/18/04, authority is granted to repair the appliance described below for the above-named veteran. .......................................................................... DESCRIPTION OF APPLIANCE OR REPAIR Unit Total Item Name Serial Number Qty Price Cost .......................................................................... 903 TEST ITEM 1 $20.00 Battery Shipping Charge: $2.00 The total cost, not including mailing cost, will not exceed $20.00 When repairs are completed, please attach the original of this letter to the original copy of your invoice covering repair charges. Your invoice, in original and one copy should then be forwarded to this office for payment. Please retain the duplicate copy of this letter for your files. Sincerely, PROVIDER,FOUR, Chief CHIEF Initiator: PROSPROVIDER1,ONE REF: 578 ADP FORM 10-55 2914 Eyeglass Record (29) DescriptionFrom the Purchasing (PU) Menu and the Enter New Request (EN) Menu, you can access the 2914 Eyeglass Record (29). This will create a VAF 10-2914 eyeglass record and post to the patient's VAF 10-2319 and VAF 1358 obligation. Enter New Request Menu 24 2421 Form 25 2520 Transaction without printing 10-55 10 10-55 PSC Form 29 2914 Eyeglass Record NF Create a No-Form Daily Record PD Pickup and Delivery Charges PC Purchase Card Form SS Purchase Card Site Parameter Select Enter New Request Option: 29 2914 Eyeglass Record 2914 Eyeglass Record Screen sampleSITE: Hines Development System// Select STATION NUMBER: 499 Select OBLIGATION NUMBER: 499-A20012 07-01-97 1358 Obligated - 1358 FCP: 910 $ 2000.00 1358 Balance is $ 237.79 This will Create an EYEGLASS 10-2914 Do you wish to Continue? Yes// (Yes) Select PROSTHETIC PATIENT: PROSPATIENT,ONE HINES, IL 1-1-30 000890765 NO PILL *Comments on file Current Disability Codes are: COS/B EMPLOYEE NSC AMP/LAE SC VIETNAM S/C AMP/LAE SC VIETNAM NSC Deleted... ORTH/PLS INPATIENT S/C *More Disability Codes on File, See Screen 1 Enter 10-2319 screen to VIEW (1-8),'^' to EXIT, or 'return' to continue:  Continued on next page  STYLEREF "Map Title" 2914 Eyeglass Record (29), Continued Screen sample (continued) Enter a screen number (1-8) OR '^' TO EXIT. Select one of the following: 1 PATIENT DEMOGRAPHICS 2 CLINIC ENROLLMENTS/CORRESPONDENCE 3 ENTITLEMENT INFORMATION 4 APPLIANCE TRANSACTIONS 5 AUTO ADAPTIVE INFORMATION 6 CRITICAL COMMENTS 7 ADD/EDIT DISABILITY CODE 8 HOME OXYGEN ITEMS Enter 10-2319 screen to VIEW (1-8),'^' to EXIT, or 'return' to continue: VENDOR: PROSVENDOR,THREE PH:555 555-5555 NO: 3 ORD ADD:CORPORATE ORDER ENTRY FMS: ANY PARK, IL 60064 CODE: FAX: ...OK? Yes// (Yes) ITEM (for AMIS): ?? Choose from: 59 EYEGLASSES 10000 EYEGLASSES ITEM (for AMIS): 59 EYEGLASSES ...OK? Yes// (Yes) TYPE OF TRANSACTION: I INITIAL ISSUE PATIENT CATEGORY: NSC OP PSAS HCPCS: A4254 Eyeglass BRIEF DESCRIPTION: Eyeglass for a stigmatism QTY: 1// UNIT COST: 29.99 UNIT OF ISSUE: ea EACH REMARKS (2319 and 1358): Ordered eyeglasses EST. SHIPPING CHARGE: 3.50 Are you ready to POST to IFCAP and 10-2319 NOW? No// y (Yes) Posting Now ... 1358 Transaction has been assigned Number: 499-A20012-0227 Updated 10-2319 Appendix A Online Help Question Mark HelpYou can view online descriptive help for menus, options, and prompts. You can enter one, two, or three question marks to get extended online help in Prosthetics. ? (Single question mark)Entering a single question mark at a prompt provides you with a single line of standard help.  ?? (Double question mark)Two question marks entered at a prompt provide you with a list of choices appropriate to the prompt where you entered the question marks. SITE: Hines Development System// ?? Choose from: ATLANTA VAMC 508 CORKWELL VAMC 500 HINESTEST 998 Hines Development System 499 SAN ANTONIO VAMC 671 ZZOJ VAMC VAMC 991 SITE: Hines Development System// Menu OptionsYou can enter three question marks to view Menu option descriptions. ??? (Triple question mark)Entering three question marks provides you with a brief description and a synonym: 24 2421 Form 25 2520 Transaction without printing 10-55 10 10-55 PSC Form 29 2914 Eyeglass Record NF Create a No-Form Daily Record PD Pickup and Delivery Charges PC Purchase Card Form SS Purchase Card Site Parameter Select Enter New Request Option: ??? '10-55 PSC Form' Option name: RMPR 10-55 Synonym: 10 This will create a new FL 10-55 form and post purchasing data to patient's VAF 10-2319 record and update the Service's VAF 1358 obligation. '2421 Form' Option name: RMPR 2421 Synonym: 24 This option will create a new VAF 10-2421 form, post to the patient's VAF 10-2319, and update the VAF 1358 obligation. '2520 Transaction without printing 10-55' Option name: RMPR 2520 Synonym: 25 For VAF 10-2520 PSC transactions that are under $300.00 and do not have and FL 10-55. It will then post to the VAF 1358 and patient's VAF 10-2319 record. Appendix B - Glossary Ad HocAn Ad-hoc has a specific purpose. Example: MS Access ad hoc query done to obtain specific data. AMISAutomated Management Information System. AuthorizationAn estimated payment that will be applied to the 1358. Control PointThe division of monies to a specified service, activity, or purpose from an appropriation. This is a financial element, existing only in IFCAP, that corresponds to the ACCS number in FMS. Cost CenterSubsections of Fund Control Points. Cost centers allow fiscal staff to create total expense reports for a section or service, and requestors to assign requests to that section or service. DCTDocument Confirmation Transactions DefaultA normal or suggested response to a prompt that is provided by the system. Detailed Inventory IDA description of the item and/or where it can be found within a location. DSSDecision Support System FMSFinancial Management System (FMS), which has replaced CALM as the primary accounting system for administration appropriations. FMS has a comprehensive database that provides for flexible on-line and/or batch processing, ad-hoc reporting, interactive query capability and extensive security. FMS is concerned with budget execution, general ledger, funds control, accounts receivable, accounts payable and cost accounting. Continued on next page FPDSFederal Procurement Data System. Fund Control PointCALM accounting element that is not used by FMS. Funds DistributionA group of fiscal options that allow the budget analyst to distribute funds to control points and track budget distribution reports information. GIPGeneric Inventory package. Grouper CounterThe grouper counter is used to associate multiple entries in file 660, Record of Appliance/Repair, to a single patient. A post-init routine initially sets the counter for you at 99999999, then counts backwards. Do not edit this number. HCPCSHealthcare Financing Administration Common Procedure Coding System. A code that represents an item or service. IFCAPIntegrated Funds Distribution, Control Point Activity, Accounting and Procurement. Item FileA listing of items specified by A&MM as being purchased repetitively. This file maintains a full description of the item, related stock numbers, vendors, contract numbers, and a procurement history. Item HistoryProcurement information stored in the ITEM file. A history is kept by fund control point at the time of request. Item Master NumberA computer-generated number used to identify an item in the ITEM file. LocationA specific area that contains prosthetic stock. MCCRMedical Care Cost Recovery Continued on next page No-Form Daily RecordThe no-form type of purchasing transaction is used to record purchases from local Durable Medical Equipment (DME) contracts. Not all VAMCs use this type of contract. Items such as hospital beds, bath transfer equipment, etc. are examples of types of equipment purchased from a DME on this form. NPPDNational Prosthetics Patient Database ObligationThe commitment of funds. The process that Fiscal Service completes to set aside monies to cover the cost of a purchase order. Obligation NumberThe C prefix number that Fiscal Service assigns to the 1358. Patient CategoryThe patients service connection and patient status: SC/OP SC/IP NSC/IP NSC/OP Pickup and Delivery Charges FormPickup and delivery charges must be included in AMIS information. This computer form records pickup and delivery charges when a local vendor is required by contract to pickup/deliver prosthetic items at a veterans home. PSAS ItemProsthetic Sensory Aids Service (PSAS) item that can be issued to a patient. There may be multiple PSAS items associated with one HCPCS: Sling, arm extra large Sling, arm medium Sling, arm small PSCProsthetic Service Card Purchase OrderA government document authorizing the purchase of goods or services within the terms indicated. Continued on next page Purchasing AgentsA&MM employees legally empowered to purchase goods and services from commercial vendors. Reference NumberAlso known as the transaction number. The computer-generated number that identifies a request. It is comprised of the station number, fiscal year, quarter, control point, four-digit sequence number. Re-order LevelA level at which time a stock item should be re-ordered. A mailman message will appear daily indicating the re-order level has been reached. Short DescriptionThe nomenclature that identifies the item in the ITEM MASTER file. It is restricted to three-to-sixty characters and consists of what the item is, what kind of item, and the size of the item (e.g., glove-surgical medium). Site ParametersInformation such as station number, cashier address, billing address, etc., that is unique to your station. SourceThe distribution for the stock, either VA or Commercial. TransactionAny action that affects a bill or an account. All transactions are numbered sequentially and may be examined individually. Transaction NumberThe number of the transaction that funded a control point. It consists of the station, fiscal year, quarter, control point sequence number. Type of TransactionA first-time issue, a repair of a previous issue, a spare, or a replacement of a stock item: Initial = I Repair = X Spare = S Replace = R Unit of IssueHow the item is issued, e.g., box, each, bottle, etc. Continued on next page VAThe Department of Veterans Affairs, formerly called the Veterans Administration. VA Form 4-1358This VA form is used to record estimated obligations or changes in estimated obligations. VA Form 10-2319Each time a patient receives medical equipment, supplier or services from Prosthetics Service, the item purchased is recorded on this form (Record of Appliance/Repair). This is an overall list of all appliances/repairs purchased for a veteran. VA Form 10-2421This is the main purchasing authorization and invoice form for items or services issued by Prosthetics Service. VA Form 10-2520This form is used to authorize repairs for prosthetic items/appliances prior to the item being sent to a vendor for repair. VA Form 10-2527Appointment roster and action sheet for clinics.  VA Form 10-2914Eyeglasses are authorized for purchase on this form. VA Form 10-55This repair authorization form letter is used by Prosthetics Service to authorize repairs of prosthetic items/appliances sent directly to the vendor by the veteran, without prior Prosthetic Service approval on VA Form 10-2520. VA Form 10-7306d (AMIS)This form tracks cumulative active prosthetics disability codes for AMIS calculations. VA Form 2237This form is used to request goods and services by a service/section, through A&MM. VA Form 2421PCThis form keeps track of purchases that are used with a purchase card. Form 1358 is no longer available when a purchase card is used. Continued on next page VendorThe company from which the item is purchased. Vendor FileAn IFCAP file (440) of vendors that the facility conducts business. This file contains ordering and billing addresses, contract information, FPDS information, and telephone numbers. VISTAVeterans Health Information Systems and Technology Architecture, formerly Decentralized Hospital Computer Program of the Veterans Health Administration (VHA), Department of Veterans Affairs (VA). VISTA software, developed by the VA, is used to support clinical and administrative functions at VA Medical Centers nationwide. It is written in M and, via the Kernel, runs on all major M implementations regardless of vendor. VISTA is composed of packages that undergo a verification process to ensure conformity with name spacing and other VISTA standards and conventions.     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