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pdfProvider Directory (PD) Section
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NOTE: THERE ARE THREE BASIC TYPES OF PROVIDERS:
1. PERSON-TYPE-PROVIDERS
2. PERSON-IN-FACILITY-PROVIDERS
3. FACILITY PROVIDERS
THE PROVIDER DIRECTORY (PD) SECTION DEALS ONLY WITH THE FIRST AND THIRD
TYPES. THE SECOND TYPE (PERSON-IN-FACILITY-PROVIDERS) SHOULD BE
TREATED AS A FACILITY FOR THE PURPOSES OF THE PD SECTION. THAT IS, THE
PERSON'S NAME IS NOT DISPLAYED OR SEARCHED ON, BUT RATHER THE FACILITY
WITH WHICH S/HE IS ASSOCIATED WILL BE DISPLAYED AND SEARCHED ON.
THEREFORE, IF THERE IS MORE THAN ONE PERSON-IN-FACILITY-PROVIDER
ASSOCIATED WITH THE SAME FACILITY, THE PROVIDER LOOP WILL BE CYCLED ON
ONCE FOR THAT FACILITY.
LOOP_01
FOR EACH ELEMENT IN RU-MEDICAL-PROVIDERS-ROSTER, ASK PD01A - END_LP01
LOOP DEFINITION: LOOP_01 COLLECTS VA AFFILIATION AND ADDRESS INFORMATION
FOR PROVIDERS. THIS LOOP CYCLES ON PROVIDERS THAT MEET THE FOLLOWING
CONDITIONS:
- CREATED THIS ROUND
AND
- ASSOCIATED WITH AN HS, ER, OP OR IC EVENT OR
- ASSOCIATED WITH AN MV EVENT OR
- ASSOCIATED WITH A HH EVENT AND FLAGGED AS ‘AGENCY’
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Provider Directory (PD) Section
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PD01A
Help Enabled
Variable Name
PROV.VAFAC
Comment Enabled
Jump Back Enabled
Label
IS PROV A FACILITY OF THE VETERAN'S ADMN
Size
2
PROVIDER: {NAME OF MEDICAL CARE PROVIDER}
IF PERSON PROVIDER, READ:
Is the clinic or place where (PROVIDER) was seen a facility of the Veteran's
Administration?
IF FACILITY PROVIDER, READ:
Is (PROVIDER) a facility of the Veteran's Administration?
YES
1
{BOX_01A}
NO
2
{BOX_01A}
----------------------------------------------------------------------------------------------------------------------------------
Refused
Don't Know
RF
DK
{BOX_01A}
{BOX_01A}
DISPLAY INSTRUCTIONS:
DISPLAY NAME OF PROVIDER BEING LOOPED ON FOR ‘NAME OF MEDICAL
CARE PROVIDER.’
BOX_01A
IF PROVIDER IS:
- ASSOCIATED WITH AN HS, ER, OP, OR IC EVENT
OR
- ASSOCIATED WITH AN MV EVENT AND MV03 IS CODED '1' (YES - TALKED TO A
MEDICAL DOCTOR) OR MV03 IS CODED '2' (NO), 'RF' (REFUSED) OR 'DK' (DON'T
KNOW) AND MV06 IS CODED '1' (YES - MEDICAL DOCTORS WORK AT LOCATION)
OR
- ASSOCIATED WITH A HH EVENT AND FLAGGED AS 'AGENCY'
CONTINUE WITH BOX_01
OTHERWISE, GO TO END_LP01
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Provider Directory (PD) Section
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BOX_01
IF PROVIDER IS:
- ASSOCIATED WITH A HH EVENT AND FLAGGED AS 'AGENCY',
OR
- ASSOCIATED WITH AN IC EVENT,
GO TO BOX_04
OTHERWISE, CONTINUE WITH BOX_03
BOX_03
IF LOOPING ON PROVIDER ASSOCIATED ONLY WITH AN MV EVENT AND RU IS NOT
SELECTED FOR THE MEDICAL PROVIDER COMPONENT (MPC), GO TO END_LP01
OTHERWISE, CONTINUE WITH BOX_04
BOX_04
IF FIRST TIME THROUGH LOOP_01, CONTINUE WITH PD03
OTHERWISE, GO TO PD04
PD03
Help Enabled
Comment Enabled
Jump Back Enabled
Now I would like to make sure I have complete information for the medical
providers you mentioned. I will use a directory to look up the names,
addresses, and telephone numbers of the sources of medical care you
mentioned.
PRESS ENTER OR SELECT NEXT PAGE TO CONTINUE.
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Provider Directory (PD) Section
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PD04
Help Enabled (STATE)
Variable Name
PROV.PDSTATE
Comment Enabled
Jump Back Enabled
Label
Size
2
PD15/18 PROVIDER STATE - PD
PROVIDER NAME: {NAME OF MEDICAL CARE PROVIDER FROM PV} STREET
ADDRESS: {STREET ADDRESS FROM PV}
ENTER PROVIDER'S STATE ABBREVIATION.
PRESS ENTER FOR {STATE ABBREVIATION FOR RESPONDENT}.
STATE CODE: _______________________
{LOOP_02}
USE HELP TO VIEW LIST OF STATE ABBREVIATIONS.
DISPLAY INSTRUCTIONS:
DISPLAY NAME OF PROVIDER AS RECORDED ON THE PROVIDER ROSTER
FROM SECTION PV FOR THE PROVIDER BEING LOOPED ON FOR ‘NAME OF
MEDICAL PROVIDER FROM PV’. IF PERSON-TYPE-PROVIDER, DISPLAY
PERSON NAME. IF FACILITY-PROVIDER, DISPLAY FACILITY NAME.
DISPLAY THE FIRST STREET ADDRESS AS RECORDED ON THE PROVIDER
ROSTER FROM SECTION PV FOR THE PROVIDER BEING LOOPED ON FOR
‘STREET ADDRESS FROM PV’.
DISPLAY TWO CHARACTER STATE ABBREVIATION ASSOCIATED WITH THIS
RU’S ADDRESS FOR ‘STATE ABBREVIATION FOR RESPONDENT’.
PROGRAMMER NOTES:
ALLOW CODE “FC” (FOREIGN COUNTRY).
NOTE: IF ENTER IS PRESSED WITHOUT ANY ENTRY, PD05 SHOULD BE
THE SAME AS STATE ABBREVIATION USED IN THE PD04 DISPLAY.
LOOP_02
FOR EACH SEARCH ATTEMPT, ASK PD05-END_LP02
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Provider Directory (PD) Section
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PD05
Help Enabled
Comment Enabled
Jump Back Enabled
PROVIDER NAME: {NAME OF MEDICAL CARE PROVIDER FROM PV} STREET
ADDRESS: {STREET ADDRESS FROM PV}
STATE: {STATE ABBREVIATION}
SELECT A SEARCH STRATEGY.
SEARCH ON PROVIDER NAME SHOWN
ABOVE
CHANGE NAME BEFORE SEARCH
1
{BOX_05}
SEARCH ON CORE STREET NAME
3
{PD10}
SEARCH ON TELEPHONE NUMBER
CHANGE STATE FOR SEARCH
4
5
{PD11}
{PD06}
DO NOT SEARCH - GO DIRECTLY TO
PROVIDER INFORMATION FORM
6
{PD18}
2
DISPLAY INSTRUCTIONS:
DISPLAY NAME OF PROVIDER AS RECORDED ON THE PROVIDER ROSTER
FROM SECTION PV FOR THE PROVIDER BEING LOOPED ON FOR ‘NAME OF
MEDICAL PROVIDER FROM PV’. IF PERSON-TYPE-PROVIDER, DISPLAY
PERSON NAME. IF FACILITY-PROVIDER, DISPLAY FACILITY NAME.
DISPLAY THE FIRST STREET ADDRESS AS RECORDED ON THE PROVIDER
ROSTER FROM SECTION PV FOR THE PROVIDER BEING LOOPED ON FOR
‘STREET ADDRESS FROM PV’.
DISPLAY TWO CHARACTER STATE ABBREVIATION ENTERED IN PD04 FOR
‘STATE ABBREVIATION’.
ROUTING INSTRUCTION:
IF CODED ‘2’ (CHANGE NAME BEFORE SEARCH) AND PROVIDER FLAGGED
AS ‘PERSON-TYPE-PROVIDER’, GO TO PD08
IF CODED ‘2’ (CHANGE NAME BEFORE SEARCH) AND PROVIDER FLAGGED
AS ‘FACILITY-PROVIDER’, GO TO PD09
Hard CHECK:
CODES ‘1’ (SEARCH ON PROVIDER NAME SHOWN ABOVE), ‘2’ (CHANGE NAME BEFORE
SEARCH), ‘3’ (SEARCH ON CORE STREET NAME), AND ‘4’ (SEARCH ON TELEPHONE
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Provider Directory (PD) Section
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NUMBER) ARE NOT ALLOWED WHEN THE PROVIDER’S STATE IS CODED ‘FC’ (FOREIGN
COUNTRY). IF STATE IS CODED ‘FC’ AND CODE ‘1’, ‘2’, ‘3’, OR ‘4’ IS ENTERED,
DISPLAY THE FOLLOWING MESSAGE: ‘INVALID RESPONSE. IF STATE IS ‘FC’, THIS
RESPONSE ID UNAVAILABLE. VERIFY AND RE-ENTER.’
PD06
Help Enabled (STATE)
Variable Name
PROV.PDSTATE
Comment Enabled
Jump Back Enabled
Label
Size
2
PD15/18 PROVIDER STATE - PD
PROVIDER NAME: {NAME OF MEDICAL CARE PROVIDER FROM PV}
STREET ADDRESS: {STREET ADDRESS FROM PV}
CURRENT STATE CODE: {STATE ABBREVIATION}
ENTER NEW STATE CODE FOR PROVIDER.
STATE CODE: _______________________
{PD07}
USE HELP TO VIEW LIST OF STATE ABBREVIATIONS.
DISPLAY INSTRUCTIONS:
DISPLAY NAME OF PROVIDER AS RECORDED ON THE PROVIDER ROSTER
FROM SECTION PV FOR THE PROVIDER BEING LOOPED ON FOR ‘NAME OF
MEDICAL PROVIDER FROM PV’. IF PERSON-TYPE-PROVIDER, DISPLAY
PERSON NAME. IF FACILITY-PROVIDER, DISPLAY FACILITY NAME.
DISPLAY THE FIRST STREET ADDRESS AS RECORDED ON THE PROVIDER
ROSTER FROM SECTION PV FOR THE PROVIDER BEING LOOPED ON FOR
‘STREET ADDRESS FROM PV’.
DISPLAY TWO CHARACTER STATE ABBREVIATION CURRENTLY BEING USED
(I.E., FROM PD06 OR IF PD06 NOT ASKED, FROM PD04) FOR ‘STATE
ABBREVIATION’.
PROGRAMMER NOTES:
DISALLOW CODE “FC” (FOREIGN COUNTRY).
Hard CHECK:
IF CODE “FC” (FOREIGN COUNTRY) IS ENTERED, DISPLAY THE FOLLOWING MESSAGE:
‘INVALID RESPONSE. PLEASE RE-ENTER.’
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Provider Directory (PD) Section
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PD07
Help Enabled
Comment Enabled
Jump Back Enabled
PROVIDER NAME: {NAME OF MEDICAL CARE PROVIDER FROM PV}
STREET ADDRESS: {STREET ADDRESS FROM PV}
SELECT A SEARCH STRATEGY.
SEARCH ON PROVIDER NAME SHOWN
ABOVE
CHANGE NAME BEFORE SEARCH
1
{BOX_05}
SEARCH ON CORE STREET NAME
3
{PD10}
SEARCH ON TELEPHONE NUMBER
DO NOT SEARCH - GO DIRECTLY TO
PROVIDER INFORMATION FORM
4
5
{PD11}
{PD18}
2
DISPLAY INSTRUCTIONS:
DISPLAY NAME OF PROVIDER AS RECORDED ON THE PROVIDER ROSTER
FROM SECTION PV FOR THE PROVIDER BEING LOOPED ON FOR ‘NAME OF
MEDICAL PROVIDER FROM PV’. IF PERSON-TYPE-PROVIDER, DISPLAY
PERSON NAME. IF FACILITY-PROVIDER, DISPLAY FACILITY NAME.
DISPLAY THE FIRST STREET ADDRESS AS RECORDED ON THE PROVIDER
ROSTER FROM SECTION PV FOR THE PROVIDER BEING LOOPED ON FOR
‘STREET ADDRESS FROM PV’.
ROUTING INSTRUCTION:
IF CODED ‘2’ (CHANGE NAME BEFORE SEARCH) AND PROVIDER FLAGGED
AS ‘PERSON-TYPE-PROVIDER’, CONTINUE WITH PD08
IF CODED ‘2’ (CHANGE NAME BEFORE SEARCH) AND PROVIDER FLAGGED
AS ‘FACILITY-PROVIDER’, GO TO PD09
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Provider Directory (PD) Section
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PD08
Help Enabled
Comment Enabled
Variable Name
PROV.PDDRFNAM
PD15/18 PROVIDER FIRST NAME - PD
PROV.PDLORPNM
PD15/18 PROV LAST NAME/FACILITY NAME-PD
Jump Back Enabled
Label
Size
20
45
PROVIDER NAME: {NAME OF MEDICAL CARE PROVIDER FROM PV}
STREET ADDRESS: {STREET ADDRESS FROM PV}
CURRENT STATE CODE: {STATE ABBREVIATION}
ENTER CORRECTED NAME INFORMATION IN APPROPRIATE FIELD(S).
PASS THROUGH FIELDS WHERE NO CORRECTION IS REQUIRED.
{Display First Name}
{Display Last Name}
FIRST NAME:____________
LAST NAME:______________
DISPLAY INSTRUCTIONS:
DISPLAY NAME OF PROVIDER AS RECORDED ON THE PROVIDER ROSTER
FROM SECTION PV FOR THE PROVIDER BEING LOOPED ON FOR ‘NAME OF
MEDICAL PROVIDER FROM PV’.
DISPLAY THE FIRST STREET ADDRESS AS RECORDED ON THE PROVIDER
ROSTER FROM SECTION PV FOR THE PROVIDER BEING LOOPED ON FOR
‘STREET ADDRESS FROM PV’.
DISPLAY TWO CHARACTER STATE ABBREVIATION CURRENTLY BEING USED
(I.E., FROM PD06 OR IF PD06 NOT ASKED, FROM PD04) FOR ‘STATE
ABBREVIATION’.
DISPLAY NAME OF PROVIDER AS RECORDED ON THE PROVIDER ROSTER
FROM SECTION PV FOR THE PROVIDER BEING LOOPED ON FOR ‘DISPLAY
FIRST NAME’ AND ‘DISPLAY LAST NAME’.
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Provider Directory (PD) Section
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PD09
Help Enabled
Variable Name
PROV.PDLORPNM
Comment Enabled
Jump Back Enabled
Label
PD15/18 PROV LAST NAME/FACILITY NAME-PD
Size
45
PROVIDER NAME: {NAME OF MEDICAL CARE PROVIDER FROM PV}
STREET ADDRESS: {STREET ADDRESS FROM PV}
STATE: {STATE ABBREVIATION}
ENTER CORRECTED FACILITY, GROUP PRACTICE, OR HMO NAME.
DISPLAY FACILITY _______________________
NAME:
{BOX_05}
DISPLAY INSTRUCTIONS:
DISPLAY NAME OF PROVIDER AS RECORDED ON THE PROVIDER ROSTER
FROM SECTION PV FOR THE PROVIDER BEING LOOPED ON FOR ‘NAME OF
MEDICAL PROVIDER FROM PV’.
DISPLAY THE FIRST STREET ADDRESS AS RECORDED ON THE PROVIDER
ROSTER FROM SECTION PV FOR THE PROVIDER BEING LOOPED ON FOR
‘STREET ADDRESS FROM PV’.
DISPLAY TWO CHARACTER STATE ABBREVIATION CURRENTLY BEING USED
(I.E., FROM PD06 OR IF PD06 NOT ASKED, FROM PD04) FOR ‘STATE
ABBREVIATION’.
DISPLAY NAME OF PROVIDER AS RECORDED ON THE PROVIDER ROSTER
FROM SECTION PV FOR THE PROVIDER BEING LOOPED ON FOR ‘DISPLAY
FACILITY NAME’.
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Provider Directory (PD) Section
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PD10
Help Enabled (PD10Help)
Comment Enabled
Jump Back Enabled
Variable Name
PROV.PDSTRT1
Label
PD15/18 STREET ADDRESS 1 FOR PROV - PD
Size
30
PROV.PDSTRT2
PD15/18 STREET ADDRESS 2 FOR PROV - PD
30
PROVIDER NAME: {NAME OF MEDICAL CARE PROVIDER FROM PV}
STREET ADDRESS: {STREET ADDRESS FROM PV}
STATE: {STATE ABBREVIATION}
ENTER CORE STREET NAME.
(I.E., DO NOT ENTER STREET NUMBER OR DIRECTION)
CORE STREET _______________________
NAME:
{BOX_05}
HELP AVAILABLE FOR DEFINITION OF CORE STREET NAME.
DISPLAY INSTRUCTIONS:
DISPLAY NAME OF PROVIDER AS RECORDED ON THE PROVIDER ROSTER
FROM SECTION PV FOR THE PROVIDER BEING LOOPED ON FOR ‘NAME OF
MEDICAL PROVIDER FROM PV’. IF PERSON-TYPE-PROVIDER, DISPLAY
PERSON NAME. IF FACILITY-PROVIDER, DISPLAY FACILITY NAME.
DISPLAY THE FIRST STREET ADDRESS AS RECORDED ON THE PROVIDER
ROSTER FROM SECTION PV FOR THE PROVIDER BEING LOOPED ON FOR
‘STREET ADDRESS FROM PV’.
DISPLAY TWO CHARACTER STATE ABBREVIATION CURRENTLY BEING USED
(I.E., FROM PD06 OR IF PD06 NOT ASKED, FROM PD04) FOR ‘STATE
ABBREVIATION’.
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Provider Directory (PD) Section
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PD11
Help Enabled
Comment Enabled
Jump Back Enabled
Variable Name
PROV.PDAREA
Label
PD15/18 PROV PHONE NUMBER/AREA CODE - PD
Size
3
PROV.PDEXCH
PROV.PDLOCL
PD15/18 PROV PHONE NUMBER/EXCHANGE - PD
PD15/18 PROV PHONE NUMBER/LOCAL - PD
3
4
PROVIDER NAME: {NAME OF MEDICAL CARE PROVIDER FROM PV} STREET
ADDRESS: {STREET ADDRESS FROM PV}
STATE: {STATE ABBREVIATION}
ENTER COMPLETE TELEPHONE NUMBER:
AREA CODE: _______________________
EXCHANGE: _______________________
LOCAL NUMBER: _______________________
{BOX_05}
DISPLAY INSTRUCTIONS:
DISPLAY NAME OF PROVIDER AS RECORDED ON THE PROVIDER ROSTER
FROM SECTION PV FOR THE PROVIDER BEING LOOPED ON FOR ‘NAME OF
MEDICAL PROVIDER FROM PV’. IF PERSON-TYPE-PROVIDER, DISPLAY
PERSON NAME. IF FACILITY-PROVIDER, DISPLAY FACILITY NAME.
DISPLAY THE FIRST STREET ADDRESS AS RECORDED ON THE PROVIDER
ROSTER FROM SECTION PV FOR THE PROVIDER BEING LOOPED ON FOR
‘STREET ADDRESS FROM PV’.
DISPLAY TWO CHARACTER STATE ABBREVIATION CURRENTLY BEING USED
(I.E., FROM PD06 OR IF PD06 NOT ASKED, FROM PD04) FOR ‘STATE
ABBREVIATION’.
PROGRAMMER NOTES:
IF INTERVIEWER TRIES TO LEAVE SCREEN WITHOUT FILLING ALL ENTRY
FIELDS, DISPLAY THE FOLLOWING MESSAGE AT THE BOTTOM OF THE
SCREEN: ‘YOU MUST ENTER INFORMATION IN ALL FIELDS FOR THIS
SEARCH.’
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Provider Directory (PD) Section
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BOX_05
CAPI WILL AUTOMATICALLY CONDUCT THE APPROPRIATE SERIES OF SEARCHES FOR THE
SELECTED SEARCH CATEGORY AS FOLLOWS:
1) SEARCH ON PROVIDER NAME AS SHOWN ABOVE - PERSON-TYPE-PROVIDER FIRST AND LAST NAME; FIRST NAME INITIAL AND LAST NAME; LAST NAME ONLY;
FIRST THREE LETTERS OF LAST NAME ONLY
FACILITY-PROVIDER - FULL NAME; FIRST WORD OF FACILITY NAME;
FIRST THREE CHARACTERS OF FIRST WORD OF NAME.
2) SEARCH ON CORRECTED PROVIDER NAME - SAME AS #1
3) SEARCH ON CORE STREET NAME - FULL SPELLING OF CORE STREET NAME; FIRST
THREE LETTERS OF CORE STREET NAME
4) SEARCH ON TELEPHONE NUMBER - EXCHANGE AND LOCAL NUMBER; LOCAL ONLY;
EXCHANGE ONLY
IF NO MATCHES OR MORE THAN 75 MATCHES, GO TO PD17
OTHERWISE, CONTINUE WITH PD12
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Provider Directory (PD) Section
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PD12
Help Enabled
Comment Enabled
Jump Back Enabled
PROVIDER NAME: {NAME OF MEDICAL CARE PROVIDER FROM PV}
STREET ADDRESS: {STREET ADDRESS FROM PV}
STATE: {STATE}
SEARCH STRATEGY: {PROVIDER NAME SHOWN ABOVE/CORRECTED
{PERSON/FACILITY} NAME/CORE STREET NAME/TELEPHONE NUMBER}
NUMBER OF POTENTIAL MATCHES FOUND: {NUMBER OF MATCHES}
PRESS ENTER OR SELECT NEXT PAGE TO CONTINUE.
PROGRAMMER NOTES:
DISPLAY NAME OF PROVIDER AS RECORDED ON THE PROVIDER ROSTER
FROM SECTION PV FOR THE PROVIDER BEING LOOPED ON FOR ‘NAME OF
MEDICAL PROVIDER FROM PV’. IF PERSON-TYPE-PROVIDER, DISPLAY
PERSON NAME. IF FACILITY-PROVIDER, DISPLAY FACILITY NAME.
DISPLAY THE FIRST STREET ADDRESS AS RECORDED ON THE PROVIDER
ROSTER FROM SECTION PV FOR THE PROVIDER BEING LOOPED ON FOR
‘STREET ADDRESS FROM PV’.
DISPLAY TWO CHARACTER STATE ABBREVIATION CURRENTLY BEING USED
(I.E., FROM PD06 OR IF PD06 NOT ASKED, FROM PD04) FOR ‘STATE
ABBREVIATION’.
SEARCH STRATEGY:
- DISPLAY ‘PROVIDER NAME SHOWN ABOVE’ IF PD05=1 OR IF PD07=1.
- DISPLAY ‘CORRECTED {PERSON/FACILITY} NAME’ IF PD05=2 OR
IF PD07=2.
- DISPLAY ‘PERSON’ IF PERSON-TYPE-PROVIDER AND PD08 WAS
ANSWERED.
- DISPLAY ‘FACILITY’ IF FACILITY-PROVIDER AND PD09 WAS
ANSWERED.
- DISPLAY ‘CORE STREET NAME’ IF PD05=3 OR IF PD07=3.
- DISPLAY ‘TELEPHONE NUMBER’ IF PD05=4 OR IF PD07=4.
DISPLAY THE NUMBER OF POTENTIAL MATCHES FOUND IN DIRECTORY FOR
‘NUMBER OF MATCHES’.
13
Provider Directory (PD) Section
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14
Provider Directory (PD) Section
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PD13
Help Enabled
Comment Enabled
Jump Back Enabled
PROVIDER NAME: {NAME OF MEDICAL CARE PROVIDER FROM PV}
STREET ADDRESS: {STREET ADDRESS FROM PV}
SELECT CORRECT PROVIDER. IF CORRECT PROVIDER NOT FOUND,
PRESS ESC TO LEAVE SCREEN.
|-------------------------------|-----------------------------|
| PROVIDER-MATCHES
| STREET ADDRESS
|
|-------------------------------|-----------------------------|
| [Display Provider Name]
| [Display Street Address]
|
|-------------------------------|-----------------------------|
| [Display Provider Name]
| [Display Street Address]
|
|-------------------------------|-----------------------------|
| [Display Provider Name]
| [Display Street Address]
|
|-------------------------------|-----------------------------|
| [Display Provider Name]
| [Display Street Address]
|
|-------------------------------|-----------------------------|
{Display
{Display
{Display
{Display
{Display
Provider
Provider
Provider
Provider
Provider
Name}
Street Address}
City, State, Zip}
Telephone Number}
Specialty}
DISPLAY INSTRUCTIONS:
DISPLAY NAME OF PROVIDER AS RECORDED ON THE PROVIDER ROSTER
FROM SECTION PV FOR THE PROVIDER BEING LOOPED ON FOR ‘NAME OF
MEDICAL PROVIDER FROM PV’. IF PERSON-TYPE-PROVIDER, DISPLAY
PERSON NAME. IF FACILITY-PROVIDER, DISPLAY FACILITY NAME.
DISPLAY STREET ADDRESS AS RECORDED ON THE PROVIDER ROSTER FROM
SECTION PV FOR THE PROVIDER BEING LOOPED ON FOR ‘STREET
ADDRESS FROM PV’.
DISPLAY FULL INFORMATION (I.E., NAME, ADDRESS, CITY, STATE,
ZIP, TELEPHONE, AND SPECIALTY) BELOW ROSTER FOR PROVIDER
CURSOR IS ON (I.E., HIGHLIGHTED).
15
Provider Directory (PD) Section
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ROUTING INSTRUCTION:
IF NO PROVIDER SELECTED FROM ROSTER, GO TO PD17
OTHERWISE, CONTINUE WITH PD14
Roster Details
Title:
PROVIDER DIRECTORY
Col #
Header
Instructions
1
PROVIDER_MATCHES Display Truncated Provider Name
PROV.DRFNAME (10),
PROV.LORPNAME (15)
2
STREET
Display Truncated Street Address
PROV.PVSTRT1,
PROV.PVSTRT2 (15)
Roster Definition:
This item displays entries from the provider directory for
selecting one medical provider’s locating information.
Roster Behavior:
1. Select allowed.
2. Multiple select disallowed.
3. Add, delete, and edit are not allowed.
Roster Filter:
Display providers returned by search strategy chosen at PD05
or PD07. (Providers are from the Provider Directory.)
16
Provider Directory (PD) Section
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PD14
Help Enabled
Variable Name
PROV.PDSELECT
Comment Enabled
Jump Back Enabled
Label
IS PROV SELECTED CORRECT/NEEDS CHANGES
Size
2
PROVIDER NAME: {NAME OF MEDICAL CARE PROVIDER FROM PV}
STREET ADDRESS: {STREET ADDRESS FROM PV}
YOU HAVE SELECTED:
{Display Provider Name}
{Display Provider Street Address}
{Display Provider City, State, Zip}
{Display Provider Telephone Number}
{Display Provider Specialty}
YOUR OPTIONS:
ACCEPT PROVIDER AS SHOWN
1
{END_LP02}
ACCEPT PROVIDER BUT MAKE
CHANGES
WRONG PROVIDER, GO BACK TO
PREVIOUS SCREEN
2
{PD15}
3
DISPLAY INSTRUCTIONS:
DISPLAY NAME OF PROVIDER AS RECORDED ON THE PROVIDER ROSTER
FROM SECTION PV FOR THE PROVIDER BEING LOOPED ON FOR ‘NAME OF
MEDICAL PROVIDER FROM PV’. IF PERSON-TYPE-PROVIDER, DISPLAY
PERSON NAME. IF FACILITY-PROVIDER, DISPLAY FACILITY NAME.
DISPLAY THE FIRST STREET ADDRESS AS RECORDED ON THE PROVIDER
ROSTER FROM SECTION PV FOR THE PROVIDER BEING LOOPED ON FOR
‘STREET ADDRESS FROM PV’.
DISPLAY FULL INFORMATION (I.E., NAME, ADDRESS, CITY, STATE,
ZIP, TELEPHONE, AND SPECIALTY) FOR PROVIDER SELECTED IN PD13
FOR ‘DISPLAY PROVIDER...’.
17
Provider Directory (PD) Section
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PROGRAMMER NOTES:
IF CODED ‘1’ (ACCEPT PROVIDER AS SHOWN) OR ‘2’ (ACCEPT
PROVIDER BUT MAKE CHANGES), STORE THIS PROVIDER DIRECTORY ID.
INFORMATION OBTAINED FROM THE PROVIDER DIRECTORY SEARCH IS NOT
USED TO REPLACE DATA REPORTED BY THE RESPONDENT DURING THE
INTERVIEW OR INCORPORATED INTO PROVIDER ROSTER DISPLAYS.
IF CODED ‘3’ (WRONG PROVIDER, GO BACK TO PREVIOUS SCREEN),
CAPI AUTOMATICALLY RETURNS TO PD13
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Provider Directory (PD) Section
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PD15
Help Enabled
Comment Enabled
Jump Back Enabled
Variable Name
PROV.PDTITLE
PD15/18 PROV TITLE - PD UPDT
Label
Size
3
PROV.PDDRFNAM
PROV.PDLORPNM
PD15/18 PROVIDER FIRST NAME - PD
PD15/18 PROV LAST NAME/FACILITY NAME-PD
20
45
PROV.PDSTRT1
PROV.PDCITY
PD15/18 STREET ADDRESS 1 FOR PROV - PD
PD15/18 PROVIDER CITY - PD
30
20
PROV.PDSTATE
PD15/18 PROVIDER STATE - PD
2
PROV.PDZIP
PROV.PDAREA
PD15/18 PROVIDER ZIP - PD
PD15/18 PROV PHONE NUMBER/AREA CODE - PD
5
3
PROV.PDEXCH
PD15/18 PROV PHONE NUMBER/EXCHANGE - PD
3
PROV.PDLOCL
PROV.PDDIRID
PD15/18 PROV PHONE NUMBER/LOCAL - PD
PD15/18 DIRECTORY ID # FOR PROV - PD
4
8
PROV.PVFLAG
PD - FLAG FOR HOME OFFICE REVIEW
2
PROVIDER NAME: {NAME OF MEDICAL CARE PROVIDER FROM PV}
STREET ADDRESS: {STREET ADDRESS FROM PV}
ENTER CORRECTIONS, AS APPROPRIATE.
RE-TYPE ENTIRE FIELD TO MAKE CORRECTION.
PASS THROUGH FIELDS THAT REQUIRE NO CORRECTION.
NAME: _______________________
1ST STR ADDRESS: _______________________
CITY: _______________________
STATE: _______________________
ZIP CODE: _______________________
TELEPHONE: _______________________
19
{PD16}
Provider Directory (PD) Section
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DISPLAY INSTRUCTIONS:
DISPLAY NAME OF PROVIDER AS RECORDED ON THE PROVIDER ROSTER
FROM SECTION PV FOR THE PROVIDER BEING LOOPED ON FOR ‘NAME OF
MEDICAL PROVIDER FROM PV’. IF PERSON-TYPE-PROVIDER, DISPLAY
PERSON NAME. IF FACILITY-PROVIDER, DISPLAY FACILITY NAME.
DISPLAY THE FIRST STREET ADDRESS AS RECORDED ON THE PROVIDER
ROSTER FROM SECTION PV FOR THE PROVIDER BEING LOOPED ON FOR
‘STREET ADDRESS FROM PV’.
DISPLAY NAME, ADDRESS, CITY, STATE, ZIP, AND TELEPHONE FOR
PROVIDER SELECTED IN PD13 FOR ‘DISPLAY PROV...’ EACH PIECE OF
THE INFORMATION SHOULD BE DISPLAYED ABOVE THE APPROPRIATE LINE.
ENTRY FIELD SPECIFICATIONS:
- FOR NAME, IF PERSON-TYPE-PROVIDER, DISPLAY FIRST NAME AND
LAST NAME FIELDS FROM PROVIDER DIRECTORY
- FOR NAME, FOR ADDRESS AND TELEPHONE FIELDS, DISPLAY
INFORMATION FOR THIS PROVIDER FROM THE PROVIDER
DIRECTORY. IF FACILITY-PROVIDER, DISPLAY FACILITY NAME
FIELD PROVIDER DIRECTORY
PROGRAMMER NOTES:
FLAG THIS RECORD AS ‘UPDATED. NEEDS HOME OFFICE REVIEW.’
20
Provider Directory (PD) Section
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PD16
Help Enabled
Variable Name
PROV.ANYNOTES
Comment Enabled
Jump Back Enabled
Label
PD16/19 ANY NOTES/COMMENTS ABOUT PROV
Size
2
PROVIDER NAME: {NAME OF MEDICAL CARE PROVIDER}
STREET ADDRESS: {STREET ADDRESS}
DO YOU WANT TO MAKE ANY NOTES ABOUT THIS PROVIDER?
YES
NO
1
2
{PD16OV}
{END_LP02}
DISPLAY INSTRUCTIONS:
DISPLAY NAME OF PROVIDER AS RECORDED ON THE PROVIDER ROSTER
FROM SECTION PV OR AS UPDATED ON THE PREVIOUS SCREEN (PD15)
FOR THE PROVIDER BEING LOOPED ON FOR ‘NAME OF MEDICAL CARE
PROVIDER’. IF PERSON-TYPE-PROVIDER, DISPLAY PERSON NAME. IF
FACILITY-PROVIDER, DISPLAY FACILITY NAME.
DISPLAY THE FIRST STREET ADDRESS AS RECORDED ON THE PROVIDER
ROSTER FROM SECTION PV OR AS UPDATED ON THE PREVIOUS SCREEN
(PD15) FOR THE PROVIDER BEING LOOPED ON FOR ‘STREET ADDRESS’.
21
Provider Directory (PD) Section
Beta
PD16OV
Help Enabled
Comment Enabled
Jump Back Enabled
Variable Name
PROV.NOTE1
Label
PD16/19 ANYNOTES/COMMNTS LINE1 ABOUT PRV
Size
30
PROV.NOTE2
PROV.NOTE3
PD16/19 ANYNOTES/COMMNTS LINE2 ABOUT PRV
PD16/19 ANYNOTES/COMMNTS LINE3 ABOUT PRV
30
30
TEXT: _______________________
PROGRAMMER NOTES:
ALLOW MULTIPLE LINES FOR ENTRY.
22
{END_LP02}
Provider Directory (PD) Section
Beta
PD17
Help Enabled
Comment Enabled
Jump Back Enabled
PROVIDER NAME: {NAME OF MEDICAL CARE PROVIDER FROM PV}
STREET ADDRESS: {STREET ADDRESS FROM PV}
STATE: {STATE}
SEARCH STRATEGY: {PROVIDER NAME SHOWN ABOVE/CORRECTED
{PERSON/FACILITY} NAME/CORE STREET NAME/TELEPHONE NUMBER}
{NO MATCHES/MORE THAN 75 MATCHES/YOU DID NOT SELECT ANY
MATCHES WHICH} WERE LOCATED IN THE DIRECTORY DURING THE
LAST SEARCH. DO YOU WANT TO SEARCH AGAIN?
YES, SEARCH AGAIN
1
{END_LP02}
NO, GO TO PROVIDER FORM
2
{PD18}
23
Provider Directory (PD) Section
Beta
DISPLAY INSTRUCTIONS:
DISPLAY NAME OF PROVIDER AS RECORDED ON THE PROVIDER ROSTER
FROM SECTION PV FOR THE PROVIDER BEING LOOPED ON FOR ‘NAME OF
MEDICAL PROVIDER FROM PV’. IF PERSON-TYPE PROVIDER, DISPLAY
PERSON NAME. IF FACILITY-PROVIDER, DISPLAY FACILITY NAME.
DISPLAY THE FIRST STREET ADDRESS AS RECORDED ON THE PROVIDER
ROSTER FROM SECTION PV FOR THE PROVIDER BEING LOOPED ON FOR
‘STREET ADDRESS FROM PV’.
DISPLAY TWO CHARACTER STATE ABBREVIATION CURRENTLY BEING USED
(I.E., FROM PD06 OR IF PD06 NOT ASKED, FROM PD04) FOR ‘STATE
ABBREVIATION’.
SEARCH STRATEGY:
- DISPLAY ‘PROVIDER NAME SHOWN ABOVE’ IF PD05=1 OR IF PD07=1.
- DISPLAY ‘CORRECTED {PERSON/FACILITY} NAME’ IF PD05=2 OR IF
PD07=2.
- DISPLAY ‘PERSON’ IF PERSON-TYPE-PROVIDERAND PD08 WAS
ANSWERED.
- DISPLAY ‘FACILITY’ IF FACILITY-PROVIDER AND PD09 WAS
ANSWERED.
- DISPLAY ‘CORE STREET NAME’ IF PD05=3 OR IF PD07=3.
- DISPLAY ‘TELEPHONE NUMBER’ IF PD05=4 OR IF PD07=4.
DISPLAY ‘NO MATCHES’ IF NO POTENTIAL MATCHES WERE FOUND IN THE
DIRECTORY.
DISPLAY ‘MORE THAN 75 MATCHES’ IF MORE THAN 75 POTENTIAL
MATCHES WERE FOUND IN THE DIRECTORY.
DISPLAY ‘YOU DID NOT SELECT ANY MATCHES WHICH’ IF POTENTIAL
MATCHES WERE FOUND IN THE DIRECTORY BUT THE INTERVIEWER DID
NOT SELECT ANY (I.E., USED ESC AT PD13 AND NO PROVIDER HAD
BEEN CHECKED).
24
Provider Directory (PD) Section
Beta
PD18
Help Enabled (STATE)
Comment Enabled
Jump Back Enabled
Variable Name
PROV.PDTITLE
PD15/18 PROV TITLE - PD UPDT
Label
Size
3
PROV.PDDRFNAM
PROV.PDLORPNM
PD15/18 PROVIDER FIRST NAME - PD
PD15/18 PROV LAST NAME/FACILITY NAME-PD
20
45
PROV.PDSTRT1
PROV.PDSTRT2
PD15/18 STREET ADDRESS 1 FOR PROV - PD
PD15/18 STREET ADDRESS 2 FOR PROV - PD
30
30
PROV.PDCITY
PD15/18 PROVIDER CITY - PD
20
PROV.PDSTATE
PROV.PDZIP
PD15/18 PROVIDER STATE - PD
PD15/18 PROVIDER ZIP - PD
2
5
PROV.PDAREA
PD15/18 PROV PHONE NUMBER/AREA CODE - PD
3
PROV.PDEXCH
PROV.PDLOCL
PD15/18 PROV PHONE NUMBER/EXCHANGE - PD
PD15/18 PROV PHONE NUMBER/LOCAL - PD
3
4
PROV.PDTYPE
PROV.PDSPEC
PD15/18 PROV TYPE - PD
PD15/18 PROV SPECIALTY/FAC TYPE - PD
2
30
PROV.PVFLAG
PD - FLAG FOR HOME OFFICE REVIEW
2
PROV.PDDIRID
PD15/18 DIRECTORY ID # FOR PROV - PD
8
TO VERIFY INFO, PRESS ENTER. START NEW LINE TO CORRECT OR
ADD INFO, RE-TYPE ENTIRE FIELD.
USE HELP TO VIEW LIST OF STATE ABBREVIATIONS.
NAME:
1ST STREET ADDRESS:
{PD19}
2ND STREET ADDRESS:
CITY:
STATE:
ZIP CODE:
PHONE:
SPECIALTY:
25
Provider Directory (PD) Section
Beta
DISPLAY INSTRUCTIONS:
IF STREET ADDRESS LINES ARE CODED REFUSED OR DON’T KNOW (RF OR
DK) IN PROVIDER ROSTER (PV) SECTION, DISPLAY BLANK LINES FOR
THESE FIELDS.
DISPLAY THE NAME AND ADDRESS AS RECORDED ON THE PROVIDER
ROSTER FROM SECTION PV FOR THE PROVIDER BEING LOOPED ON FOR
‘PROVIDER NAME FROM PV’. IF PERSON-TYPE-PROVIDER, DISPLAY
PERSON NAME. IF FACILITY-PROVIDER, DISPLAY FACILITY NAME.
EACH PIECE OF THE INFORMATION SHOULD BE DISPLAYED ABOVE THE
APPROPRIATE LINE.
ENTRY FIELD SPECIFICATIONS:
-
IF PERSON-TYPE-PROVIDER, DISPLAY ‘FIRST’ AND ‘LAST NAME’
FIELDS. ALSO DISPLAY ‘SPECIALTY’ FIELD FOR COLLECTION.
-
IF FACILITY-PROVIDER, DISPLAY ‘FACILITY NAME’ FIELD.
NOT DISPLAY ‘SPECIALTY’ FIELD.
DO
PROGRAMMER NOTES:
FLAG THIS RECORD AS ‘NEW NAME/ADDRESS INFORMATION. NEEDS HOME
OFFICE REVIEW.’
REFUSED AND DON’T KNOW ALLOWED IN ALL FIELDS, EXCEPT THE
‘NAME’ FIELD.
26
Provider Directory (PD) Section
Beta
PD19
Help Enabled
Variable Name
PROV.ANYNOTES
Comment Enabled
Jump Back Enabled
Label
PD16/19 ANY NOTES/COMMENTS ABOUT PROV
Size
2
PROVIDER NAME: {NAME OF MEDICAL CARE PROVIDER}
STREET ADDRESS: {STREET ADDRESS}
DO YOU WANT TO MAKE ANY NOTES ABOUT THIS PROVIDER?
YES
NO
1
2
{PD19OV}
{END_LP02}
DISPLAY INSTRUCTIONS:
DISPLAY NAME OF PROVIDER AS RECORDED ON THE PROVIDER ROSTER
FROM SECTION PV OR AS UPDATED ON THE PREVIOUS SCREEN (PD18)
FOR THE PROVIDER BEING LOOPED ON FOR ‘NAME OF MEDICAL CARE
PROVIDER’. IF PERSON-TYPE PROVIDER, DISPLAY PERSON NAME. IF
FACILITY-PROVIDER, DISPLAY FACILITY NAME.
DISPLAY THE FIRST STREET ADDRESS AS RECORDED ON THE PROVIDER
ROSTER FROM SECTION PV OR AS UPDATED ON THE PREVIOUS SCREEN
(PD18) FOR THE PROVIDER BEING LOOPED ON FOR ‘STREET ADDRESS’.
27
Provider Directory (PD) Section
Beta
PD19OV
Help Enabled
Comment Enabled
Jump Back Enabled
Variable Name
PROV.NOTE1
Label
PD16/19 ANYNOTES/COMMNTS LINE1 ABOUT PRV
Size
30
PROV.NOTE2
PROV.NOTE3
PD16/19 ANYNOTES/COMMNTS LINE2 ABOUT PRV
PD16/19 ANYNOTES/COMMNTS LINE3 ABOUT PRV
30
30
TEXT: _______________________
{END_LP02}
PROGRAMMER NOTES:
ALLOW MULTIPLE LINES FOR ENTRY.
END_LP02
IF PD17 IS CODED ‘1’ (YES), CYCLE FOR NEXT SEARCH.
IF NO MORE SEARCHES TO BE MADE, THAT IS, IF PD17 IS CODED ‘2’ (NO) OR PD14
IS CODED ‘1’ (ACCEPT PROVIDER AS SHOWN), CONTINUE WITH END_LP01
END_LP01
CYCLE ON NEXT PROVIDER THAT MEETS THE CONDITIONS STATED IN THE LOOP
DEFINITION.
IF NO OTHER PROVIDER MEETS THE STATED CONDITIONS, END LOOP_01 AND CONTINUE
WITH BOX_06
BOX_06
GO TO NEXT QUESTIONNAIRE SECTION.
28
| File Type | application/pdf |
| File Title | C:\Documents and Settings\POLACHEK_L\Local Settings\Temporary Internet Files\OLK8\PD (Beta).snp |
| Author | polachek_l |
| File Modified | 2006-02-20 |
| File Created | 2006-02-20 |