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| # | Location | File | Last Modified |
|---|---|---|---|
| 1 | OSCIF_HEC_v1.4_Sprint23_build4_Apr_2017.zip\Scribe_Packages\SampleSeibelData.zip | CN_DATA.xlsx | Mon Apr 25 16:24:42 2016 UTC |
| 2 | OSCIF_HEC_v1.4_Sprint23_build4_Apr_2017.zip\Scribe_Packages\SampleSeibelData.zip | CN_DATA.xlsx | Thu May 4 23:00:52 2017 UTC |
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| 1 | SHEET: CN_ DATA | |
| 2 | CN_ID,CN_C REATED,CN_ LST_UPD,CN _CREATED_B Y,CN_LST_U PD_BY,CN_S R_ID,CN_TY PE,CN_NOTE ,CN_STATUS ,CN_SR_INF O, | |
| 3 | 1-1LU2R,7/ 28/12 1:13 ,7/28/12 1 :14,0-1,0- 1,1-109AL, General,te st,Done,NU LL, | |
| 4 | 1-1M3KP,7/ 30/12 18:0 4,7/30/12 18:04,1-5S R0,1-5SR0, 1-109AL,FP Dispute,I ssue: DI SPUTE | |
| 5 | Reason: | |
| 6 | Choose fro m list bel ow | |
| 7 | [x ] Phon e Call | |
| 8 | [ ] Patie nt Not See n Eligi bility | |
| 9 | [ ] Catas trophicall y Disabled (Catastr ophically Disabled R eview Date : ________ ___ ) | |
| 10 | [ ] Comba t Veteran (Combat V eteran Eli gibility E nd Date: ) Non-copa y | |
| 11 | [ ] C&P E xam | |
| 12 | [ ] Agent Orange | |
| 13 | [ ] Flu S hot Flu S hot | |
| 14 | Thank you for your a ttention t o this mat ter.,Done, NULL, | |
| 15 | 1-1MIVQ,8/ 1/12 16:36 ,8/1/12 16 :36,1-1RPZ ,1-1RPZ,1- 11E2N,PCC Damaged Me dication,I SSUE(S): Medication veteran r eceived in the mail was damage d and pati ent is req uesting a replacemen t. | |
| 16 | ||
| 17 | (Provide n ame of med ication an d RX #) | |
| 18 | ||
| 19 | Nature of Damage: | |
| 20 | ___ Crus hed Packag e | |
| 21 | ___ Open Bottle | |
| 22 | ___ Froz en product | |
| 23 | _x_ Extr eme Heat | |
| 24 | ___ Wet Package | |
| 25 | ___ Othe r: ______ __________ ________ | |
| 26 | ___ Unkno wn | |
| 27 | ||
| 28 | RECOMMENDA TION(S): If you are unable to replace t he damaged medicatio n, please contact Ve teran. | |
| 29 | ||
| 30 | Thank you! | |
| 31 | ||
| 32 | Priority 3-Medium,D one,NULL, | |
| 33 | 1-1P4B8,8/ 6/12 17:02 ,8/6/12 17 :02,1-HNFO ,1-HNFO,1- 10GYF,Gene ral,456,In Progress, NULL, | |
| 34 | 1-1RD7K,8/ 14/12 15:5 5,8/14/12 16:25,1-1R PZ,1-1RPZ, 1-11EA5,FP Dispute,I ssue: DI SPUTE | |
| 35 | Reason: C hoose from list belo w | |
| 36 | [ X ] Phon e Call | |
| 37 | ||
| 38 | [ ] Patie nt Not See n | |
| 39 | ||
| 40 | Eligibilit y | |
| 41 | [ ] Catas trophicall y Disabled (Catastro phically D isabled Re view Date: _________ __ ) | |
| 42 | [ ] Comba t Veteran (Combat Ve teran Elig ibility En d Date: __ _________) | |
| 43 | ||
| 44 | Non-copay | |
| 45 | [ ] C&P E xam | |
| 46 | [ ] Agent Orange | |
| 47 | [ ] Flu S hot Flu Sh ot | |
| 48 | ||
| 49 | (Paste SP info here) | |
| 50 | ||
| 51 | Thank you for your a ttention t o this mat ter.,Done, NULL, | |
| 52 | 1-1RZ4I,8/ 16/12 18:3 6,8/16/12 18:37,1-11 KC6,1-11KC 6,1-11OM1, General,I do like th e new CRM! ,Done,NULL , | |
| 53 | 1-1RZCI,8/ 16/12 19:0 0,8/16/12 19:00,1-11 KC6,1-11KC 6,1-11OM1, Live Enrol lment,Subj ect: Live Enrollment | |
| 54 | Gender: | |
| 55 | Phone: | |
| 56 | Best time to Call: A M or PM | |
| 57 | Email Addr ess:,In Pr ogress,NUL L, | |
| 58 | 1-1RZMK,8/ 16/12 19:2 2,8/16/12 19:22,1-11 KC6,1-11KC 6,1-11OLV, General,NO NE,Done,NU LL, | |
| 59 | 1-1SB2J,8/ 22/12 15:0 5,8/22/12 15:13,1-1T 2X,1-1T2X, 1-10LO7,PC C Suspende d RX Needs Filled So oner,ISSUE (S): Vete ran’s medi cation is suspended until a fu ture date and patien t is reque sting a re fill soone r than the date list ed. | |
| 60 | ||
| 61 | (Provide n ame of med ication an d RX #) | |
| 62 | ||
| 63 | Veteran in dicates he is short on supply of medicat ion due to (please m ark one): | |
| 64 | ___ Rece ived Damag ed/Open | |
| 65 | ___ Quan tity Recei ved was In correct | |
| 66 | ___ Out of Town, l eaving on (insert da te)___ and returning on (inser t date) __ | |
| 67 | ___ Othe r (please list) ___ __________ __________ ___ | |
| 68 | ||
| 69 | ||
| 70 | RECOMMENDA TION(S): If you are unable to revise th e mailing date of th e medicati on, please contact V eteran. T hank you! | |
| 71 | ||
| 72 | Priority 3 - Medium, Done,NULL, | |
| 73 | 1-1SB2K,8/ 22/12 15:0 7,8/22/12 15:13,1-1T 2X,1-1T2X, 1-10LO7,PC C Emergenc y Fill Req uested,ISS UE(S): Ve teran is o ut of medi cation and is reques ting an em ergency fi ll. | |
| 74 | ||
| 75 | ||
| 76 | Name of me dication a nd RX # | |
| 77 | _____ Pl ease mark if View Al ert has al ready been sent to p rovider | |
| 78 | ||
| 79 | _____ Ple ase mark i f refill h as already been requ ested | |
| 80 | ||
| 81 | ||
| 82 | Veteran in dicates he is out of medicatio n due to ( please mar k one): | |
| 83 | ___ Recei ved Damage d/Open | |
| 84 | ___ Late Ordering R efill | |
| 85 | ___ Quant ity Receiv ed was Inc orrect | |
| 86 | ___ Out o f Town, le aving on _ _(insert d ate)__ and returning on _(inse rt date)_ | |
| 87 | ___ Track ing shows RX was del ivered, bu t patient states it was not re ceived | |
| 88 | ___ Other (please l ist) ____ __________ __________ __ | |
| 89 | ||
| 90 | ||
| 91 | RECOMMENDA TION(S): Please con tact Veter an within one busine ss day for possible refill of medication . Thank y ou! | |
| 92 | ||
| 93 | Priority 2 - High,Do ne,NULL, | |
| 94 | 1-1SB2L,8/ 22/12 15:0 7,8/22/12 15:07,1-1T 2X,1-1T2X, 1-10LO7,PC C Emergenc y Fill Req uested,ISS UE(S): Ve teran is o ut of medi cation and is reques ting an em ergency fi ll. | |
| 95 | ||
| 96 | ||
| 97 | Name of me dication a nd RX # | |
| 98 | _____ Pl ease mark if View Al ert has al ready been sent to p rovider | |
| 99 | ||
| 100 | _____ Ple ase mark i f refill h as already been requ ested | |
| 101 | ||
| 102 | ||
| 103 | Veteran in dicates he is out of medicatio n due to ( please mar k one): | |
| 104 | ___ Recei ved Damage d/Open | |
| 105 | ___ Late Ordering R efill | |
| 106 | ___ Quant ity Receiv ed was Inc orrect | |
| 107 | ___ Out o f Town, le aving on _ _(insert d ate)__ and returning on _(inse rt date)_ | |
| 108 | ___ Track ing shows RX was del ivered, bu t patient states it was not re ceived | |
| 109 | ___ Other (please l ist) ____ __________ __________ __ | |
| 110 | ||
| 111 | ||
| 112 | RECOMMENDA TION(S): Please con tact Veter an within one busine ss day for possible refill of medication . Thank y ou! | |
| 113 | ||
| 114 | Priority 2 - High,Do ne,NULL, | |
| 115 | 1-1SD4H,8/ 22/12 19:0 4,8/22/12 19:04,1-JO T4,1-JOT4, 1-11E52,FP Dispute,I ssue: DI SPUTE | |
| 116 | Reason: C hoose from list belo w | |
| 117 | [ ] Phone Call | |
| 118 | ||
| 119 | [ X ] Pati ent Not Se en | |
| 120 | ||
| 121 | Eligibilit y | |
| 122 | [ ] Catas trophicall y Disabled (Catastro phically D isabled Re view Date: _________ __ ) | |
| 123 | [ ] Comba t Veteran (Combat Ve teran Elig ibility En d Date: __ _________) | |
| 124 | ||
| 125 | Non-copay | |
| 126 | [ ] C&P E xam | |
| 127 | [ ] Agent Orange | |
| 128 | [ ] Flu S hot Flu Sh ot | |
| 129 | ||
| 130 | (Paste SP info here) | |
| 131 | ||
| 132 | Thank you for your a ttention t o this mat ter.,Done, NULL, | |
| 133 | 1-1SD94,8/ 24/12 16:1 7,8/24/12 16:17,1-ZS ZI,1-ZSZI, 1-10MD5,Te mplate,Att empt #: | |
| 134 | Phone #: | |
| 135 | Email: | |
| 136 | Person Spo ken With: | |
| 137 | Call Summa ry: | |
| 138 | VIC: | |
| 139 | HEC Contac t: | |
| 140 | 30 Day Fol low-Up: | |
| 141 | Best Conta ct Number: ,In Progre ss,NULL, | |
| 142 | 1-1XADJ,1/ 23/13 14:5 2,1/23/13 14:52,1-1T 3P,1-1T3P, 1-10HBF,Ge neral,aaa, In Progres s,NULL, | |
| 143 | 1-1YDZ8,5/ 2/13 16:57 ,5/2/13 16 :58,1-1Y6J F,1-1Y6JF, 1-10GZ0,Ge neral,note , sent bac k to facil ity, wrong area,Done ,NULL, | |
| 144 | 1-1YE0G,5/ 2/13 19:17 ,5/2/13 19 :19,1-1Y6L K,1-1Y6LK, 1-10HFO,FP CC Audit R X,Callback Number (o nly if Vet eran speci fies medic ation or i nsists upo n a return call): _ _ | |
| 145 | Caller’s N ame and Re lationship if not th e Veteran: _______ | |
| 146 | ||
| 147 | Issue: Ve t requests that medi cation cha rges be re viewed as indicated. | |
| 148 | ||
| 149 | [Bill numbers, n ames of me dications to review, and/or st art date o f audit MU ST be incl uded] | |
| 150 | ||
| 151 | _X Ser vice Conne cted | |
| 152 | Co py informa tion from VR Screen 11 | |
| 153 | ||
| 154 | ______ _Agent Ora nge/ Ioniz ing Radiat ion/ South west Asia | |
| 155 | Co py informa tion from VR Screen 6 | |
| 156 | ||
| 157 | ______ _Combat Ve teran | |
| 158 | Co py informa tion from VR Screen 7,Done,NUL L, | |
| 159 | 1-1YEM7,5/ 6/13 16:37 ,5/6/13 16 :37,1-1RS9 ,1-1RS9,1- 10HJJ,Gene ral,test,D one,NULL, | |
| 160 | 1-1YG9V,5/ 9/13 18:04 ,5/9/13 18 :04,1-1RS9 ,1-1RS9,1- 10HJJ,Gene ral,test,D one,NULL, | |
| 161 | 1-1YGA5,5/ 14/13 16:0 5,5/14/13 16:05,1-1R S9,1-1RS9, 1-10GZ0,Ge neral,revi ew and fou nd...,Done ,NULL, | |
| 162 | 1-1YJ2G,5/ 23/13 18:0 8,5/23/13 18:08,1-11 KCD,1-11KC D,1-10HF8, General,CC CCCCCCCCCC CCCCCC,Don e,NULL, | |
| 163 | 1-1YKSE,6/ 6/13 13:46 ,6/6/13 13 :46,1-1RR9 ,1-1RR9,1- 10HF8,Gene ral,______ __________ __________ __________ _________ | |
| 164 | From: | |
| 165 | Sent: Thur sday, June 06, 2013 8:45 AM | |
| 166 | To: | |
| 167 | Subject: H RC Notific ation; Pat ient Care Complaint SR#:1-1702 196 | |
| 168 | ||
| 169 | ||
| 170 | Hello, | |
| 171 | The follow ing Caller spoke to one of our Contact R epresentat ives regar ding the c omplaint b elow. | |
| 172 | Please rev iew and pr oceed acco rdingly. | |
| 173 | Thank you for your a ssistance in this ma tter. | |
| 174 | CCCCCCCCCC CCCCCCCC,D one,NULL, | |
| 175 | 1-1YXKY,8/ 29/13 12:0 2,1/14/14 15:32,1-1R S9,1-1RS9, 1-10K4J,Ge neral,test ,Done,NULL , | |
| 176 | 1-1YXKZ,8/ 29/13 12:0 3,4/9/14 2 1:16,1-1RS 9,1-1RS9,1 -10K8J,Gen eral,Vet. wants ins. billed fo r dos 9-6- 80,In Prog ress,NULL, | |
| 177 | 1-1YZDL,9/ 11/13 15:2 8,9/11/13 15:28,1-1U CQR,1-1UCQ R,1-10HF8, General,We dont have enough se rvers.,In Progress,N ULL, | |
| 178 | 1-1ZEGD,10 /8/13 15:5 7,10/8/13 15:57,1-1Y WMO,1-1YWM O,1-10K4L, General,XX XXXX,Done, NULL, | |
| 179 | 1-1ZUQJ,1/ 14/14 14:4 6,1/14/14 14:46,1-1R S9,1-1RS9, 1-11EVU,Ge neral,Test ,In Progre ss,NULL, | |
| 180 | 1-1ZUQK,1/ 14/14 14:4 7,1/14/14 14:47,1-1R S9,1-1RS9, 1-11EVU,Ge neral,Noth er Test,Do ne,NULL, | |
| 181 | 1-1ZUQL,1/ 14/14 14:4 9,1/14/14 14:49,1-1R S9,1-1RS9, 1-10LSL,Ge neral,Test ,Done,NULL , | |
| 182 | 1-1ZUQM,1/ 14/14 14:5 1,1/14/14 14:51,1-1R S9,1-1RS9, 1-10PDO,Ge neral,Test - 123 Tes t,In Progr ess,NULL, | |
| 183 | 1-1ZUQN,1/ 14/14 14:5 1,1/14/14 14:51,1-1R S9,1-1RS9, 1-10PDO,Ge neral,Test 4-5-6,Don e,NULL, | |
| 184 | 1-1ZUQO,1/ 14/14 14:5 3,1/14/14 14:53,1-1R S9,1-1RS9, 1-10LXB,Ge neral,Test - Trainin g,Done,NUL L, | |
| 185 | 1-1ZV77,1/ 14/14 15:2 4,1/14/14 15:24,1-1R S9,1-1RS9, 1-10LSL,Ge neral,This was refer red to us incor. We don't rev iew for SC ...,Done,N ULL, | |
| 186 | 1-1ZV78,1/ 14/14 15:3 2,1/14/14 15:32,1-1R S9,1-1RS9, 1-10K4J,Ge neral,k,Do ne,NULL, | |
| 187 | 1-2AMKH,3/ 21/14 19:2 5,3/21/14 19:25,1-1T 3P,1-1T3P, 1-10HJ7,Ge neral,Note s,Done,NUL L, | |
| 188 | 1-2EVGQ,3/ 26/14 20:3 3,3/26/14 20:33,1-1T 3P,1-1T3P, 1-10HJT,Ge neral,Vete ran state s/c back t o 1-1-2012 ee 3-26-1 4,In Progr ess,NULL, | |
| 189 | 1-2I9DT,4/ 9/14 21:16 ,4/9/14 21 :16,1-1RS9 ,1-1RS9,1- 10K8J,Gene ral,Review ed TPJI... insurance billed DOS 9-6-1980. Ins. pai d 5.63...a pplied to copay Bill # K654452 . Called veteran an d explaine d. No fur ther actio n required .,Done,NUL L, | |
| 190 | 1-2I9DU,4/ 9/14 21:20 ,4/9/14 21 :20,1-1RS9 ,1-1RS9,1- 10K8J,Gene ral,added. ..veteran follow con versation. ,Done,NULL , | |
| 191 | 1-2I9DV,4/ 9/14 21:22 ,4/9/14 21 :22,1-1RS9 ,1-1RS9,1- 11EVU,Gene ral,Vetera n wants in surance bi lled for e verything dating bac k to 1986. ,In Progre ss,NULL, | |
| 192 | 1-2I9DW,4/ 9/14 21:22 ,4/9/14 21 :22,1-1RS9 ,1-1RS9,1- 11EVU,Gene ral,Please specifiy dates or t imeframe m ore specif ic than 19 86.,Done,N ULL, | |
| 193 | 1-2YP32,8/ 13/14 19:0 6,8/13/14 19:06,1-JO TI,1-JOTI, 1-11E2N,Ge neral,ISSU E(S): Med ication ve teran rece ived in th e mail was damaged a nd patient is reques ting a rep lacement. | |
| 194 | ||
| 195 | (Provide n ame of med ication an d RX #) | |
| 196 | ||
| 197 | Nature of Damage: | |
| 198 | ___ Crus hed Packag e | |
| 199 | ___ Open Bottle | |
| 200 | ___ Froz en product | |
| 201 | _x_ Extr eme Heat | |
| 202 | ___ Wet Package | |
| 203 | ___ Othe r: ______ __________ ________ | |
| 204 | ___ Unkno wn | |
| 205 | ||
| 206 | RECOMMENDA TION(S): If you are unable to replace t he damaged medicatio n, please contact Ve teran. | |
| 207 | ||
| 208 | Thank you! | |
| 209 | ||
| 210 | Priority 3-Medium,I n Progress ,NULL, | |
| 211 | 1-33059,8/ 22/14 14:0 3,8/22/14 14:03,1-JO TI,1-JOTI, 1-10JZJ,Ge neral,Augu st 22, 201 4 | |
| 212 | SR# | |
| 213 | Facility: | |
| 214 | Name: | |
| 215 | ID#: | |
| 216 | DOB: | |
| 217 | Phone: | |
| 218 | ||
| 219 | ISSUE(S): Veteran i s out of m edication and is req uesting an emergency fill. | |
| 220 | ||
| 221 | _____ Nu mber of da ys left of medicatio n stated b y Veteran | |
| 222 | ||
| 223 | ||
| 224 | Name of me dication a nd RX # | |
| 225 | ||
| 226 | _____ Pl ease mark if View Al ert has al ready been sent to p rovider | |
| 227 | ||
| 228 | _____ Ple ase mark i f refill h as already been requ ested | |
| 229 | ||
| 230 | ||
| 231 | Veteran in dicates he is out of medicatio n due to ( please mar k one): | |
| 232 | ___ Recei ved Damage d/Open | |
| 233 | ___ Late Ordering R efill | |
| 234 | ___ Quant ity Receiv ed was Inc orrect | |
| 235 | ___ Out o f Town, le aving on _ _(insert d ate)__ and returning on _(inse rt date)_ | |
| 236 | ___ Track ing shows RX was del ivered, bu t patient states it was not re ceived | |
| 237 | ___ Medic ation has been lost or stolen | |
| 238 | ___ Other (please l ist) ____ __________ __________ __ | |
| 239 | ||
| 240 | ||
| 241 | RECOMMENDA TION(S): Please con tact Veter an within one busine ss day for possible refill of medication . Thank y ou! | |
| 242 | ||
| 243 | Priority 2 - High,Do ne,NULL, |
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