Download:
pdf |
pdfPBP 2013 Data Entry System Screens
Section D- Plan Deductible (Combined) - Base 1 Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 1 of 64
PBP 2013 Data Entry System Screens
Section D- Plan Deductible (Combined) - Base 2 Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 2 of 64
PBP 2013 Data Entry System Screens
Section D- Plan Deductible (In-Network) - Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 3 of 64
PBP 2013 Data Entry System Screens
Section D- Plan Deductible (RPPO-Differential Deductibles) – Base 1 Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 4 of 64
PBP 2013 Data Entry System Screens
Section D- Plan Deductible (RPPO-Differential Deductibles) – Base 2 Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 5 of 64
PBP 2013 Data Entry System Screens
Section D- Plan Deductible (RPPO-Differential Deductibles) – Base 3 Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 6 of 64
PBP 2013 Data Entry System Screens
Section D- Plan Deductible (Out-Of-Network) – Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 7 of 64
PBP 2013 Data Entry System Screens
Section D- Plan Deductible (Non-Network) – Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 8 of 64
PBP 2013 Data Entry System Screens
Section D- Maximum Enrollee Cost Limit (Combined) – Base 1 Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 9 of 64
PBP 2013 Data Entry System Screens
Section D- Maximum Enrollee Cost Limit (Combined) – Base 2 Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 10 of 64
PBP 2013 Data Entry System Screens
Section D- Maximum Enrollee Cost Limit (In-Network) – Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 11 of 64
PBP 2013 Data Entry System Screens
Section D- Maximum Enrollee Cost Limit (Out-of-Network) – Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 12 of 64
PBP 2013 Data Entry System Screens
Section D- Maximum Enrollee Cost Limit (Non-Network) – Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 13 of 64
PBP 2013 Data Entry System Screens
Section D- Maximum Plan Benefit Coverage – Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 14 of 64
PBP 2013 Data Entry System Screens
Section D- Maximum Plan Benefit Coverage (Non-Network) – Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 15 of 64
PBP 2013 Data Entry System Screens
Section D- Plan Premium and Rebate Reduction – Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 16 of 64
PBP 2013 Data Entry System Screens
Section D- PFFS Billing – Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 17 of 64
PBP 2013 Data Entry System Screens
Section D- MSA Annual Deductible and Deposit – Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 18 of 64
PBP 2013 Data Entry System Screens
Section D- Notes – Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 19 of 64
PBP 2013 Data Entry System Screens
Section D- Optional Supplemental – Management Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 20 of 64
PBP 2013 Data Entry System Screens
Section D- Optional Supplemental – Label and Premium Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 21 of 64
PBP 2013 Data Entry System Screens
Section D- Optional Supplemental – Service Categories Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 22 of 64
PBP 2013 Data Entry System Screens
Section D- Optional Supplemental – OON Stepup Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 23 of 64
PBP 2013 Data Entry System Screens
Section D- Optional Supplemental – OON Optional Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 24 of 64
PBP 2013 Data Entry System Screens
Section D- Step Up #7B Chiropractic Services – Base 1 Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 25 of 64
PBP 2013 Data Entry System Screens
Section D- Step Up #7B Chiropractic Services – Base 2 Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 26 of 64
PBP 2013 Data Entry System Screens
Section D- Step Up #7B Chiropractic Services – Base 3 Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 27 of 64
PBP 2013 Data Entry System Screens
Section D- Step Up #7B Chiropractic Services – Base 4 Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 28 of 64
PBP 2013 Data Entry System Screens
Section D- Step Up #7F Podiatry Services – Base 1 Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 29 of 64
PBP 2013 Data Entry System Screens
Section D- Step Up #7F Podiatry Services – Base 2 Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 30 of 64
PBP 2013 Data Entry System Screens
Section D- Step Up #7F Podiatry Services – Base 3 Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 31 of 64
PBP 2013 Data Entry System Screens
Section D- Step Up #10B Transportation Services – Base 1 Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 32 of 64
PBP 2013 Data Entry System Screens
Section D- Step Up #10B Transportation Services – Base 2 Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 33 of 64
PBP 2013 Data Entry System Screens
Section D- Step Up #10B Transportation Services – Base 3 Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 34 of 64
PBP 2013 Data Entry System Screens
Section D- Step Up #16A Preventive Dental – Base 1 Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 35 of 64
PBP 2013 Data Entry System Screens
Section D- Step Up #16A Preventive Dental – Base 2 Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 36 of 64
PBP 2013 Data Entry System Screens
Section D- Step Up #16A Preventive Dental – Base 3 Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 37 of 64
PBP 2013 Data Entry System Screens
Section D- Step Up #16A Preventive Dental – Base 4 Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 38 of 64
PBP 2013 Data Entry System Screens
Section D- Step Up #16A Preventive Dental – Base 5 Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 39 of 64
PBP 2013 Data Entry System Screens
Section D- Step Up #16B Comprehensive Dental – Base 1 Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 40 of 64
PBP 2013 Data Entry System Screens
Section D- Step Up #16B Comprehensive Dental – Base 2 Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 41 of 64
PBP 2013 Data Entry System Screens
Section D- Step Up #16B Comprehensive Dental – Base 3 Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 42 of 64
PBP 2013 Data Entry System Screens
Section D- Step Up #16B Comprehensive Dental – Base 4 Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 43 of 64
PBP 2013 Data Entry System Screens
Section D- Step Up #16B Comprehensive Dental – Base 5 Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 44 of 64
PBP 2013 Data Entry System Screens
Section D- Step Up #16B Comprehensive Dental – Base 6 Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 45 of 64
PBP 2013 Data Entry System Screens
Section D- Step Up #17A Eye Exams – Base 1 Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 46 of 64
PBP 2013 Data Entry System Screens
Section D- Step Up #17A Eye Exams – Base 2 Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 47 of 64
PBP 2013 Data Entry System Screens
Section D- Step Up #17A Eye Exams – Base 3 Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 48 of 64
PBP 2013 Data Entry System Screens
Section D- Step Up #17B Eye Wear – Base 1 Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 49 of 64
PBP 2013 Data Entry System Screens
Section D- Step Up #17B Eye Wear – Base 2 Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 50 of 64
PBP 2013 Data Entry System Screens
Section D- Step Up #17B Eye Wear – Base 3 Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 51 of 64
PBP 2013 Data Entry System Screens
Section D- Step Up #17B Eye Wear – Base 4 Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 52 of 64
PBP 2013 Data Entry System Screens
Section D- Step Up #17B Eye Wear – Base 5 Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 53 of 64
PBP 2013 Data Entry System Screens
Section D- Step Up #17B Eye Wear – Base 6 Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 54 of 64
PBP 2013 Data Entry System Screens
Section D- Step Up #18A Hearing Exams – Base 1 Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 55 of 64
PBP 2013 Data Entry System Screens
Section D- Step Up #18A Hearing Exams – Base 2 Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 56 of 64
PBP 2013 Data Entry System Screens
Section D- Step Up #18A Hearing Exams – Base 3 Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 57 of 64
PBP 2013 Data Entry System Screens
Section D- Step Up #18A Hearing Exams – Base 4 Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 58 of 64
PBP 2013 Data Entry System Screens
Section D- Step Up #18A Hearing Exams – Base 4 Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 59 of 64
PBP 2013 Data Entry System Screens
Section D- Step Up #18B Hearing Aids – Base 1 Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 60 of 64
PBP 2013 Data Entry System Screens
Section D- Step Up #18B Hearing Aids – Base 2 Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 61 of 64
PBP 2013 Data Entry System Screens
Section D- Step Up #18B Hearing Aids – Base 3 Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 62 of 64
PBP 2013 Data Entry System Screens
Section D- Step Up #18B Hearing Aids – Base 4 Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 63 of 64
PBP 2013 Data Entry System Screens
Section D- Step Up #18B Hearing Aids – Base 5 Screen
Fu Associates, Ltd.
CY 2013 PBP – Section D
12/9/2011
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
Page 64 of 64
| File Type | application/pdf |
| Author | meyer |
| File Modified | 2011-12-09 |
| File Created | 2011-12-09 |