Old Public Related Insurance (PR) SectionNovember 14, 2017 MEPS P21R5/P22R3/P23R1 NOTE: The MEPS instrument design changed beginning in Spring of 2018, affecting Panel 23 Round 1, Panel 22 Round 3, and Panel 21 Round 5, and affected the 2017 MEPS data files. The MEPS website releases the consolidated CAPI survey instruments each year for the Rounds 1 through 3 for the first year panel and Rounds 3 through 5 for the second year panel to accompany data releases. For the Full-Year 2017 PUFs, the Panel 22 Round 3 and Panel 21 Round 5 data were transformed to the degree possible to conform to the previous year (2016) design. For this reason, we are releasing 2016 CAPI survey instruments, updated to reflect 2017 dates, and users should note that not all changes to the instrument administered in the Spring of 2018 will be reflected in these documents.
THROUGHOUT THE SPECIFICATIONS FOR THIS CAPI SECTION, FOR SCREENS THAT SPECIFY THE REFERENCE PERIOD {END DATE} AS PART OF THE CONTEXT HEADER, CAPI DISPLAYS THE {END DATE} ONLY FOR ROUND 5. IN ANY OTHER ROUND, CAPI DOES NOT DISPLAY THE {END DATE} IN THE CONTEXT HEADER. FOR MOST PERSONS, THE END DATE FOR ROUND 5 WILL BE DECEMBER 31 OF THE SECOND YEAR OF THE PANEL. BOX_00
CONTEXT HEADER DISPLAY INSTRUCTIONS: DISPLAY {PERS.FULLNAME}, PRND.BEGREFMM, PRND.BEGREFDD, PRND.BEGREFYY, PRND.ENDREFMM, PRND.ENDREFDD, PRND.ENDREFYY. BOX_01
IF ONE OR MORE ESTABLISHMENT-PERSON-PAIRS MEET BOTH OF THE FOLLOWING CONDITIONS: - ESTABLISHMENT IS MEDICARE AND - PERSON WAS COVERED BY MEDICARE DURING THE PREVIOUS ROUND, CONTINUE WITH LOOP_01
OTHERWISE, GO TO BOX_02 LOOP_01
FOR EACH ELEMENT ON THE RU-ESTABLISHMENT-PERSON- PAIRS-ROSTER, ASK NAV_PR01 - END_LP01
LOOP DEFINITION: LOOP_01 COLLECTS INFORMATION ABOUT THE COVERAGE PROVIDED THROUGH MEDICARE. THIS LOOP CYCLES ON ESTABLISHMENT-PERSON-PAIRS THAT MEET BOTH OF THE FOLLOWING CONDITIONS: - ESTABLISHMENT IS MEDICARE AND - PERSON WAS COVERED BY MEDICARE AT ANY TIME DURING THE PREVIOUS ROUND
NAVIGATOR DETAILS: LOOP_01 USES NAV_PR01 TO TO CONTROL THE FLOW OF THE LOOP. NAV_PR01 {STR-DT}
ROSTER DETAILS: COL # 1 HEADER: RU MEMBER INSTRUCTIONS: DISPLAY RU MEMBER’S FIRST, MIDDLE, AND LAST NAMES (PERS.FULLNAME) COL # 2 HEADER: EMPTY INSTRUCTIONS: DISPLAY THE MOST CURRENT NAVIGATOR STATUS FOR EACH RU MEMBER EACH TIME THE NAVIGATOR IS PRESENTED
ROSTER DEFINITION: THIS ITEM DISPLAYS RU-ESTABLISHMENT-PERSON-PAIRS- ROSTER FOR SELECTION.
ROSTER BEHAVIOR: 1. SELECT ALLOWED. 2. MULTIPLE SELECT, ADD, DELETE, AND EDIT DISALLOWED.
ROSTER FILTER: DISPLAY ALL RU MEMBERS WHO MEET BOTH OF THE FOLLOWING CONDITIONS: - ESTABLISHMENT IS MEDICARE AND - PERSON WAS COVERED BY MEDICARE AT ANY TIME DURING THE PREVIOUS ROUND
CONTINUE WITH PR03 FOR SELECTED RU MEMBER. PR03 {PERSON’S FIRST MIDDLE AND LAST NAME} {STR-DT}
DISPLAY ‘{Are/Is} {you/{PERSON}} currently’ IF NOT ROUND 5. DISPLAY ‘As of {END DATE}, {were/ was} {you/{PERSON}}’ IF ROUND 5. PR04 {PERSON’S FIRST MIDDLE AND LAST NAME} {STR-DT}
DISPLAY ‘is’ IF NOT ROUND 5. DISPLAY ‘was’ IF ROUND 5. DISPLAY ‘as of {END DATE}’ IF ROUND 5. OTHERWISE, USE A NULL DISPLAY.
FLAG INSURER CODED ABOVE AS ‘CURRENT RD’S MEDICARE INSURER’ FOR THIS ESTABLISHMENT-PERSON- PAIR. PR05 {PERSON’S FIRST MIDDLE AND LAST NAME} {STR-DT}
DISPLAY ‘{Do/Does}’ IF NOT ROUND 5. DISPLAY ‘Did’ IF ROUND 5. DISPLAY ‘{NAME OF PLAN FROM PR04}’ IF A PLAN NAME WAS ENTERED AT PR04. DISPLAY {your/his/her} Medicare managed care plan’ IF PR04 IS CODED ‘-7’ (REF) OR ‘-8’ (DK). DISPLAY THE ACTUAL PLAN NAME ENTERED AT PR04 FOR ‘NAME OF PLAN FROM PR04’ IF A PLAN NAME WAS ENTERED. DISPLAY ‘as of {END DATE}’ IF ROUND 5. OTHERWISE, USE A NULL DISPLAY.
IF ROUND 3, CONTINUE WITH PR06
OTHERWISE, GO TO END_LP01 PR06 {PERSON’S FIRST MIDDLE AND LAST NAME} {STR-DT}
DISPLAY ‘the coverage with {NAME OF PLAN FROM PR04}’ IF A MEDICARE PLAN NAME WAS ENTERED AT PR04. DISPLAY ‘this Medicare managed care plan’ IF PR04 WAS CODED ‘-7’ (REF) OR ‘-8’ (DK). DISPLAY THE ACTUAL PLAN NAME ENTERED AT PR04 FOR ‘NAME OF PLAN FROM PR04’ IF A PLAN NAME WAS ENTERED. PR06A {PERSON’S FIRST MIDDLE AND LAST NAME} {STR-DT}
DISPLAY ‘{NAME OF PLAN FROM PR04}’ IF A MEDICARE PLAN NAME WAS ENTERED AT PR04. DISPLAY ‘Medicare managed care’ IF PR04 WAS CODED ‘-7’ (REF) OR ‘-8’ (DK). DISPLAY THE ACTUAL PLAN NAME ENTERED AT PR04 FOR ‘NAME OF PLAN FROM PR04’ IF A PLAN NAME WAS ENTERED. PR06AA {PERSON’S FIRST MIDDLE AND LAST NAME} {STR-DT}
DISPLAY ‘is {your/{PERSON}’s} Social Security deduction’ IF PR06AA IS CODED ‘1’ (DEDUCTED FROM SOCIAL SECURITY’. DISPLAY ‘{do/does} {you/ {PERSON}} pay in premiums’ IF PR06AA IS CODED ‘2’ (PAY DIRECTLY) OR ‘3’ (BOTH).
DISPLAY ‘{NAME OF PLAN FROM PR04}’ IF A MEDICARE PLAN NAME WAS ENTERED AT PR04. OTHERWISE (I.E., IF PR04 WAS CODED ‘-7’ (REF) OR ‘-8’ (DK)), USE A NULL DISPLAY. DISPLAY THE ACTUAL PLAN NAME ENTERED AT PR04 FOR ‘NAME OF PLAN FROM PR04’ IF A PLAN NAME WAS ENTERED. PR06AAOV1 Is that per year, per month, per week, or what? PR06AAOV2 SPECIFY: PR06AAA {PERSON’S FIRST MIDDLE AND LAST NAME} {STR-DT}
DISPLAY ‘PLAN NAME: {NAME OF PLAN FROM PR04}’ IF A MEDICARE PLAN NAME WAS ENTERED AT PR04. OTHERWISE (I.E., IF PR04 WAS CODED ‘-7’ (REF) OR ‘-8’ (DK)), USE A NULL DISPLAY. DISPLAY THE ACTUAL PLAN NAME ENTERED AT PR04 FOR ‘NAME OF PLAN FROM PR04’ IF A PLAN NAME WAS ENTERED. PR06B {PERSON’S FIRST MIDDLE AND LAST NAME} {STR-DT}
DISPLAY ‘{Are/Is}’ IF NOT ROUND 5. DISPLAY ‘{Were/Was}’ IF ROUND 5. DISPLAY ‘as of {END DATE}’ IF ROUND 5. OTHERWISE, USE A NULL DISPLAY.
IF CODED ‘1’ (YES) AND ROUND 3, CONTINUE WITH PR06C
OTHERWISE, GO TO END_LP01 PR06C {PERSON’S FIRST MIDDLE AND LAST NAME} {STR-DT} PR06D {PERSON’S FIRST MIDDLE AND LAST NAME} {STR-DT} PR06E {PERSON’S FIRST MIDDLE AND LAST NAME} {STR-DT}
DISPLAY ‘is {your/{PERSON}’s} Social Security deduction’ IF PR06D IS CODED ‘1’ (DEDUCTED FROM SOCIAL SECURITY’. DISPLAY ‘{do/does} {you/ {PERSON}} pay in premiums’ IF PR06D IS CODED ‘2’ (PAY DIRECTLY) OR ‘3’ (BOTH). PR06EOV1 Is that per year, per month, per week, or what? PR06EOV2 SPECIFY: PR06F {PERSON’S FIRST MIDDLE AND LAST NAME} {STR-DT} END_LP01
CYCLE ON NEXT PAIR ON RU-ESTABLISHMENT-PERSON- PAIRS-ROSTER THAT MEETS THE CONDITIONS STATED IN THE LOOP DEFINITION.
IF NO MORE PAIRS MEET THE STATED CONDITIONS, END LOOP_01 AND CONTINUE WITH BOX_02 BOX_02
IF ANY RU MEMBER HAD MEDICAID/SCHIP AS A SOURCE OF INSURANCE AT ANY TIME DURING THE PREVIOUS ROUND, CONTINUE WITH PR07
OTHERWISE, GO TO BOX_05 PR07 {STR-DT}
DISPLAY ‘Medicaid’ IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME ‘Medicaid’ DISPLAY ‘STATE NAME FOR MEDICAID’ (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME ‘Medicaid’. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE TO DISPLAY, SEE ATTACHMENT 36.
DISPLAY ‘or STATE CHIP NAME’ UNDER ALL CONDITIONS, SUBSTITUTING THE REAL STATE NAME FOR PROGRAM. FOR THE SPECIFIC NAME TO USE BY STATE, SEE ATTACHMENT 36.
DISPLAY ‘since {START DATE}’ IF NOT ROUND 5. DISPLAY ‘between {START DATE} and {END DATE}’ IF ROUND 5.
IF CODED ‘1’ (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS ‘COVERED BY MEDICAID/SCHIP DURING CURRENT ROUND.’
IF CODED ‘3’ (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS ‘NOT COVERED BY MEDICAID/SCHIP DURING CURRENT ROUND.’
IF CODED ‘3’ (NO, NONE) AND IF ANY CURRENT RU MEMBERS NOT LISTED AT PR07, GO TO PR09
IF CODED ‘3’ (NO, NONE) AND IF ALL CURRENT RU MEMBERS ARE LISTED AT PR07, GO TO BOX_05
ROSTER DETAILS: TITLE: RU_ESTB_PERS_PAIRS_1 COL # 1 HEADER: NAME INSTRUCTIONS: DISPLAY RU MEMBER’S FIRST, MIDDLE, AND LAST NAMES (PERS.FULLNAME)
ROSTER DEFINITION: THIS ITEM DISPLAYS RU-ESTABLISHMENT-PERSON-PAIRS- ROSTER FOR DISPLAY OF RU-MEMBERS.
ROSTER BEHAVIOR: 1. DISPLAY ONLY. 2. SELECT, ADD, DELETE, AND EDIT DISALLOWED.
ROSTER FILTER: 1. DISPLAY ONLY THOSE RU MEMBERS WHO WERE COVERED BY MEDICAID/SCHIP AT ANY TIME DURING THE PREVIOUS ROUND. PR08 {STR-DT}
DISPLAY ‘Medicaid’ IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME ‘Medicaid’. DISPLAY ‘STATE NAME FOR MEDICAID’ (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME ‘Medicaid’. FOR THE SPECIFIC MEDICAID PROGRAM NAME BY STATE TO DISPLAY, SEE ATTACHMENT 36.
DISPLAY ‘or STATE CHIP NAME’ UNDER ALL CONDITIONS, SUBSTITUTING THE REAL STATE NAME FOR PROGRAM. FOR THE SPECIFIC NAME TO DISPLAY BY STATE, SEE ATTACHMENT 36.
DISPLAY ‘since {START DATE}’ IF NOT ROUND 5. DISPLAY ‘between {START DATE} and {END DATE}’ IF ROUND 5.
FLAG ALL PERSONS SELECTED AS ‘COVERED BY MEDICAID/ SCHIP DURING CURRENT ROUND.’ FLAG ALL PERSONS NOT SELECTED AS ‘NOT COVERED BY MEDICAID/SCHIP DURING CURRENT ROUND.’
GO TO BOX_03
ROSTER DETAILS: TITLE: RU_ESTB_PERS_PAIRS_1 COL # 1 HEADER: NAME INSTRUCTIONS: DISPLAY RU MEMBER’S FIRST, MIDDLE, AND LAST NAMES (PERS.FULLNAME)
ROSTER DEFINITION: THIS ITEM DISPLAYS RU-ESTABLISHMENT-PERSON-PAIRS- ROSTER FOR SELECTION OF RU-MEMBERS.
ROSTER BEHAVIOR: 1. MULTIPLE SELECT ALLOWED. 2. ADD, DELETE, AND EDIT DISALLOWED.
ROSTER FILTER: 1. DISPLAY ONLY THOSE RU MEMBERS WHO WERE COVERED BY MEDICAID/SCHIP AT ANY TIME DURING THE PREVIOUS ROUND. BOX_03
IF ALL CURRENT RU MEMBERS ARE ALREADY FLAGGED AS COVERED OR NOT COVERED BY MEDICAID/SCHIP DURING CURRENT ROUND (I.E., ALL CURRENT RU MEMBERS WERE LISTED AT PR07), GO TO LOOP_02
OTHERWISE, CONTINUE WITH PR09 PR09 {STR-DT}
DISPLAY ‘Medicaid’ IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME ‘Medicaid’. DISPLAY ‘STATE NAME FOR MEDICAID’ (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME ‘Medicaid’. FOR THE SPECIFIC MEDICAID PROGRAM NAME TO DISPLAY BY STATE, SEE ATTACHMENT 36.
DISPLAY ‘or STATE CHIP NAME’ UNDER ALL CONDITIONS, SUBSTITUTING THE REAL STATE NAME FOR PROGRAM. FOR THE SPECIFIC NAME TO DISPLAY BY STATE, SEE ATTACHMENT 36.
DISPLAY ‘since {START DATE}’ IF NOT ROUND 5. DISPLAY ‘between {START DATE} and {END DATE}’ IF ROUND 5.
IF CODED ‘2’ (NO), ‘-7’ (REFUSED), OR ‘8’ (DON’T KNOW) AND AT LEAST ONE RU MEMBER IS FLAGGED AS ‘COVERED BY MEDICAID/SCHIP DURING CURRENT ROUND,’ GO TO LOOP_02
IF CODED ‘2’ (NO), ‘-7’ (REFUSED), OR ‘-8’ (DON’T KNOW) AND NO RU MEMBERS ARE FLAGGED AS ‘COVERED BY MEDICAID/SCHIP DURING CURRENT ROUND,’ GO TO BOX_05 PR10 {STR-DT}
DISPLAY ‘Medicaid’ IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME ‘Medicaid’. DISPLAY ‘STATE NAME FOR MEDICAID’ (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME ‘Medicaid’. FOR THE SPECIFIC MEDICAID PROGRAM NAME TO DISPLAY BY STATE, SEE ATTACHMENT 36.
DISPLAY ‘or STATE CHIP NAME’ UNDER ALL CONDITIONS, SUBSTITUTING THE REAL STATE NAME FOR PROGRAM. FOR THE SPECIFIC NAME TO DISPLAY BY STATE, SEE ATTACHMENT 36.
DISPLAY ‘since {START DATE}’ IF NOT ROUND 5. DISPLAY ‘between {START DATE} and {END DATE}’ IF ROUND 5.
FLAG ALL PERSONS SELECTED AS ‘COVERED BY MEDICAID/ SCHIP’ DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS ‘NOT COVERED BY MEDICAID/SCHIP’ DURING CURRENT ROUND.
GO TO LOOP_02
ROSTER DETAILS:
Title: RU_MEMBERS_1 COL #1 HEADER: NAME INSTRUCTIONS: DISPLAY RU MEMBER’S FIRST, MIDDLE AND LAST NAMES (PERS.FULLNAME)
ROSTER DEFINITION: THIS ITEM DISPLAYS RU-MEMBERS-ROSTER FOR SELECTION OF RU-MEMBERS.
ROSTER BEHAVIOR: 1. MULTIPLE SELECT ALLOWED. 1. ADD, DELETE, AND EDIT DISALLOWED.
ROSTER FILTER: 1. RU MEMBERS NOT FLAGGED AS COVERED BY MEDICAID/ SCHIP AT ANY TIME DURING THE PREVIOUS ROUND. LOOP_02
FOR EACH ELEMENT ON THE RU-ESTABLISHMENT-PERSON- PAIRS-ROSTER, ASK NAV_PR02 - END_LP02
LOOP DEFINITION: LOOP_02 COLLECTS TIME PERIOD COVERAGE DETAIL FOR RU MEMBERS COVERED BY MEDICAID/SCHIP. THIS LOOP CYCLES ON ESTABLISHMENT-PERSON-PAIRS THAT MEET BOTH OF THE FOLLOWING CONDITIONS: - ESTABLISHMENT IS MEDICAID/SCHIP AND - PERSON IS COVERED BY MEDICAID/SCHIP DURING THE CURRENT ROUND
NAVIGATOR DETAILS: LOOP_02 USES NAV_PR02 TO TO CONTROL THE FLOW OF THE LOOP. NAV_PR02 MEDICAID/SCHIP {STR-DT}
ROSTER DETAILS: COL # 1 HEADER: RU MEMBER INSTRUCTIONS: DISPLAY RU MEMBER’S FIRST, MIDDLE, AND LAST NAMES (PERS.FULLNAME) COL # 2 HEADER: EMPTY INSTRUCTIONS: DISPLAY THE MOST CURRENT NAVIGATOR STATUS FOR EACH RU MEMBER EACH TIME THE NAVIGATOR IS PRESENTED
ROSTER DEFINITION: THIS ITEM DISPLAYS RU-ESTABLISHMENT-PERSON-PAIRS- ROSTER FOR SELECTION.
ROSTER BEHAVIOR: 1. SELECT ALLOWED. 2. MULTIPLE SELECT, ADD, DELETE, AND EDIT DISALLOWED.
ROSTER FILTER: DISPLAY ALL RU MEMBERS WHO MEET BOTH OF THE FOLLOWING CONDITIONS: - ESTABLISHMENT IS MEDICAID AND - PERSON IS COVERED BY MEDICAID/SCHIP DURING THE CURRENT ROUND
CONTINUE WITH BOX_04 FOR SELECTED RU MEMBER BOX_04
ASK THE TIME PERIOD COVERED DETAIL (HQ) SECTION FOR THIS PAIR. AT COMPLETION OF THE HQ SECTION, CONTINUE WITH END_LP02 END_LP02
CYCLE ON NEXT PAIR ON THE RU-ESTABLISHMENT- PERSON-PAIRS-ROSTER THAT MEETS THE CONDITIONS STATED IN THE LOOP DEFINITION.
IF NO MORE PAIRS MEET THE STATED CONDITIONS, END LOOP_02 AND CONTINUE WITH PR11 PR11 {STR-DT}
DISPLAY ‘Last time... {NAME OF PREV RD’S MEDICAID/SCHIP INSURER FOR RU}.’ IF THERE IS AN INSURER ASSOCIATED WITH MEDICAID/SCHIP IN THE PREVIOUS ROUND. FOR ‘NAME OF PREV RD’S MEDICAID/SCHIP INSURER FOR RU’, DISPLAY THE INSURER RECORDED FOR MEDICAID/ SCHIP DURING THE PREVIOUS ROUND. NOTE: THIS NAME WILL NO LONGER COME FROM THE PLAN FILL FILE. IT WILL BE THE NAME ENTERED AT EITHER HX44 OR PR15.
DISPLAY ‘Since {START DATE}’ IF NOT ROUND 5. DISPLAY ‘Between {START DATE} and {END DATE}’ IF ROUND 5.
DISPLAY ‘Medicaid’ IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME ‘Medicaid’. DISPLAY ‘STATE NAME FOR MEDICAID’ (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME ‘Medicaid’. FOR THE SPECIFIC MEDICAID PROGRAM NAME TO DISPLAY BY STATE, SEE ATTACHMENT 36.
DISPLAY ‘or STATE CHIP NAME’ UNDER ALL CONDITIONS, SUBSTITUTING THE REAL STATE NAME FOR PROGRAM. FOR THE SPECIFIC NAME TO DISPLAY BY STATE, SEE ATTACHMENT 36.
IF CODED ‘2’ (NO), ‘-7’ (REFUSED), OR ‘-8’ (DON’T KNOW), FLAG PREVIOUS ROUND’S INSURER AS ‘CURRENT RD’S MEDICAID/SCHIP INSURER’
ROSTER DETAILS: TITLE: RU_ESTB_PERS_PAIRS_1 COL # 1 HEADER: NAME INSTRUCTIONS: DISPLAY RU MEMBER’S FIRST, MIDDLE, AND LAST NAMES (PERS.FULLNAME)
ROSTER DEFINITION: THIS ITEM DISPLAYS RU-ESTABLISHMENT-PERSON-PAIRS- ROSTER FOR DISPLAY OF RU-MEMBERS.
ROSTER BEHAVIOR: 1. DISPLAY ONLY. 2. SELECT, ADD, DELETE, AND EDIT DISALLOWED.
ROSTER FILTER: 1. DISPLAY ONLY THOSE RU MEMBERS WHO ARE COVERED BY MEDICAID/SCHIP DURING THE CURRENT ROUND. PR13 {STR-DT}
DISPLAY ‘Medicaid’ IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME ‘Medicaid’. DISPLAY ‘STATE NAME FOR MEDICAID’ (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME ‘Medicaid’. FOR THE SPECIFIC MEDICAID PROGRAM NAME TO DISPLAY BY STATE, SEE ATTACHMENT 36.
DISPLAY ‘or STATE CHIP NAME’ UNDER ALL CONDITIONS, SUBSTITUTING THE REAL STATE NAME FOR PROGRAM. FOR THE SPECIFIC NAME TO DISPLAY BY STATE, SEE ATTACHMENT 36.
DISPLAY ‘(are/is)’ IF NOT ROUND 5. DISPLAY ‘(were/was)’ IF ROUND 5. DISPLAY ‘between {START DATE} and {END DATE}’ IF ROUND 5. OTHERWISE, USE A NULL DISPLAY.
ROSTER DETAILS: TITLE: RU_ESTB_PERS_PAIRS_1 COL # 1 HEADER: NAME INSTRUCTIONS: DISPLAY RU MEMBER’S FIRST, MIDDLE, AND LAST NAMES (PERS.FULLNAME)
ROSTER DEFINITION: THIS ITEM DISPLAYS RU-ESTABLISHMENT-PERSON-PAIRS- ROSTER FOR DISPLAY OF RU-MEMBERS.
ROSTER BEHAVIOR: 1. DISPLAY ONLY. 2. SELECT, ADD, DELETE, AND EDIT DISALLOWED.
ROSTER FILTER: 1. DISPLAY ONLY THOSE RU MEMBERS WHO ARE COVERED BY MEDICAID/SCHIP DURING THE CURRENT ROUND. PR14 {STR-DT}
DISPLAY ‘Medicaid’ IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME ‘Medicaid’. DISPLAY ‘STATE NAME FOR MEDICAID’ (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME ‘Medicaid’. FOR THE SPECIFIC MEDICAID PROGRAM NAME TO DISPLAY BY STATE, SEE ATTACHMENT 36.
DISPLAY ‘or STATE CHIP NAME’ UNDER ALL CONDITIONS, SUBSTITUTING THE REAL STATE NAME FOR PROGRAM. FOR THE SPECIFIC NAME TO DISPLAY BY STATE, SEE ATTACHMENT 36.
DISPLAY ‘Does’ IF NOT ROUND 5. DISPLAY ‘Between {START DATE} and {END DATE}, did’ IF ROUND 5.
IF CODED ‘3’ (NO, NONE REQUIRED), ‘-7’ (REFUSED), OR ‘-8’ (DON’T KNOW), THERE IS NO INSURER ASSOCIATED WITH THE CURRENT ROUND FOR MEDICAID/ SCHIP.
ROSTER DETAILS: TITLE: RU_ESTB_PERS_PAIRS_1 COL # 1 HEADER: NAME INSTRUCTIONS: DISPLAY RU MEMBER’S FIRST, MIDDLE, AND LAST NAMES (PERS.FULLNAME)
ROSTER DEFINITION: THIS ITEM DISPLAYS RU-ESTABLISHMENT-PERSON-PAIRS- ROSTER FOR DISPLAY OF RU-MEMBERS.
ROSTER BEHAVIOR: 1. DISPLAY ONLY. 2. SELECT, ADD, DELETE, AND EDIT DISALLOWED.
ROSTER FILTER: 1. DISPLAY ONLY THOSE RU MEMBERS WHO ARE COVERED BY MEDICAID/SCHIP DURING THE CURRENT ROUND. PR15 {STR-DT}
DISPLAY ‘Medicaid’ IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME ‘Medicaid’. DISPLAY ‘STATE NAME FOR MEDICAID’ (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME ‘Medicaid’. FOR THE SPECIFIC MEDICAID PROGRAM NAME TO DISPLAY BY STATE, SEE ATTACHMENT 36.
DISPLAY ‘or STATE CHIP NAME’ UNDER ALL CONDITIONS, SUBSTITUTING THE REAL STATE NAME FOR PROGRAM. FOR THE SPECIFIC NAME TO DISPLAY BY STATE, SEE ATTACHMENT 36.
DISPLAY ‘HMO’ IF PR13 IS CODED ‘1’ (YES, ALL ARE) OR ‘2’ (YES, SOME ARE). DISPLAY ‘health insurance’ IF PR14 IS CODED ‘1’ (YES, ALL REQUIRED) OR ‘2’ (YES, SOME REQUIRED).
FLAG INSURER CODED ABOVE AS ‘CURRENT ROUND’S MEDICAID/SCHIP INSURER’. BOX_04A
IF ROUND 2, ROUND 3 OR ROUND 4, CONTINUE WITH PR16
OTHERWISE, (I.E., IF ROUND 5), GO TO BOX_05 PR16 {STR-DT}
DISPLAY ‘{NAME OF PLAN FROM PR15}’ IF THERE IS A CURRENT ROUND INSURER ASSOCIATED WITH THE MEDICAID/SCHIP INSURANCE. OTHERWISE, DISPLAY ‘{Medicaid/{STATE NAME FOR MEDICAID}} or {STATE CHIP NAME}’ DISPLAY ‘{NAME OF PLAN FROM PR15}’ IF A PLAN NAME WAS ENTERED AT PR15. DISPLAY THE ACTUAL PLAN NAME THAT WAS ENTERED. DISPLAY ‘for anyone in the family’ IF MORE THAN ONE RU MEMBER SELECTED AS COVERED BY MEDICAID/ SCHIP INSURANCE. OTHERWISE, USE A NULL DISPLAY.
DISPLAY ‘Medicaid’ IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME ‘Medicaid’. DISPLAY ‘STATE NAME FOR MEDICAID’ (SUBSTITUTING THE STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME ‘Medicaid’. FOR THE SPECIFIC MEDICAID PROGRAM NAME TO DISPLAY BY STATE, SEE ATTACHMENT 36.
DISPLAY ‘or STATE CHIP NAME’ UNDER ALL CONDITIONS, SUBSTITUTING THE REAL STATE NAME FOR PROGRAM. FOR THE SPECIFIC NAME TO DISPLAY BY STATE, SEE ATTACHMENT 36.
IF CODED ‘1’ (YES, EVERYONE COVERED PAYS) AT PR16 (HOME.PRMEDPRE), CODE PRND.MEDMNTHP FOR EACH PERSON IN THE ROSTER AT PR16A AS ‘1’ (PAYS FOR COVERAGE DURING THE CURRENT ROUND.) IF CODED ‘3’ (NO, NO ONE COVERED PAYS) AT PR16 (HOME.PRMEDPRE), CODE PRND.MEDMNTHP FOR EACH PERSON IN THE ROSTER AT PR16A AS ‘2’ (DOES NOT PAY FOR COVERAGE DURING THE CURRENT ROUND.) IF CODED -7 OR -8 OR -9 (WHETHER EVERYONE IS COVERED IS MISSING) AT PR16 (HOME.PRMEDPRE), CODE PRND.MEDMNTHP EQUAL TO THE MISSING VALUE IN HOME.PRMEDPRE FOR EACH PERSON IN THE PR16A ROSTER. LEAVE PRND.MEDGOVP BLANK (NO VALUE) FOR ANY RU MEMBER NOT ON THE ROSTER AT PR16A. THE PR16A ROSTER INCLUDES ALL PERSONS WITH MEDICAID/SCHIP COVERAGE (EPRS.MCAID = 1) IN THE CURRENT RU FOR THE CURRENT ROUND. PR16A {STR-DT}
CONTINUE WITH BOX_04B
ROSTER DETAILS: TITLE: RU_ESTB_PERS_PAIRS_1 COL # 1 HEADER: NAME INSTRUCTIONS: DISPLAY RU MEMBER’S FIRST, MIDDLE, AND LAST NAMES (PERS.FULLNAME)
ROSTER DEFINITION: THIS ITEM DISPLAYS RU-ESTABLISHMENT-PERSON-PAIRS- ROSTER FOR SELECTION OF RU-MEMBERS.
ROSTER BEHAVIOR: 1. MULTIPLE SELECT ALLOWED. 2. ADD, DELETE, AND EDIT DISALLOWED.
ROSTER FILTER: 1. DISPLAY ONLY THOSE RU MEMBERS WHO ARE COVERED BY MEDICAID/SCHIP DURING THE CURRENT ROUND.
THE PR16A ROSTER INCLUDES ALL PERSONS WITH MEDICAID/SCHIP COVERAGE (EPRS.MCAID = 1) IN THE CURRENT RU FOR THE CURRENT ROUND. CODE PRND.MEDMNTHP AS ‘1’ (PAYS FOR COVERAGE DURING THE CURRENT ROUND) FOR ALL PERSONS FROM THE PR16A ROSTER WHO ARE SELECTED. CODE PRND.MEDMNTHP AS ‘2’ (DOES NOT PAY FOR COVERAGE DURING THE CURRENT ROUND) FOR ALL PERSONS ON THE PR16A ROSTER WHO ARE NOT SELECTED. LEAVE PRND.MEDGOVP BLANK (NO VALUE) FOR ANY RU MEMBER NOT ON THE ROSTER AT PR16A. BOX_04B
IF ROUND 3, CONTINUE WITH PR17
OTHERWISE, GO TO PR17A PR17 {STR-DT}
DISPLAY ‘the {NAME OF PLAN FROM PR15}’ IF THERE IS A CURRENT ROUND INSURER ASSOCIATED WITH THE MEDICAID/SCHIP INSURANCE. OTHERWISE, DISPLAY ‘that’. DISPLAY ‘(NAME OF PLAN FROM PR15)’ IF A PLAN NAME WAS ENTERED AT PR15. DISPLAY THE ACTUAL PLAN NAME THAT WAS ENTERED. PR17OV1 Is that per year, per month, per week, or what? PR17OV2 SPECIFY: PR17A {STR-DT}
DISPLAY ‘PLAN NAME: ...’ IF THERE IS A CURRENT ROUND INSURER ASSOCIATED WITH THE MEDICAID/SCHIP INSURANCE. OTHERWISE, USE A NULL DISPLAY. DISPLAY ‘{NAME OF PLAN FROM PR15}’ IF A PLAN NAME WAS ENTERED AT PR15. DISPLAY THE ACTUAL PLAN NAME THAT WAS ENTERED. BOX_05
IF ANY RU MEMBER HAD TRICARE/CHAMPVA AS A SOURCE OF INSURANCE DURING PREVIOUS ROUND, CONTINUE WITH PR19
OTHERWISE, GO TO BOX_08 PR19 {STR-DT}
DISPLAY ‘since {START DATE}’ IF ROUND IS NOT 5. DISPLAY ‘between {START DATE} and {END DATE}’ IF ROUND IS 5.
IF CODED ‘3’ (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS ‘NOT COVERED BY TRICARE/CHAMPVA DURING CURRENT ROUND.’
IF CODED ‘3’ (NO, NONE) AND IF ANY CURRENT RU MEMBERS NOT LISTED IN PR19, GO TO PR21
IF CODED ‘3’ (NO, NONE), AND IF ALL CURRENT RU MEMBERS ARE LISTED IN PR19, GO TO BOX_08
ROSTER DETAILS: TITLE: RU_ESTB_PERS_PAIRS_1 COL # 1 HEADER: NAME INSTRUCTIONS: DISPLAY RU MEMBER’S FIRST, MIDDLE, AND LAST NAMES (PERS.FULLNAME)
ROSTER DEFINITION: THIS ITEM DISPLAYS RU-ESTABLISHMENT-PERSON-PAIRS- ROSTER FOR DISPLAY OF RU-MEMBERS.
ROSTER BEHAVIOR: 1. DISPLAY ONLY. 2. SELECT, ADD, DELETE, AND EDIT DISALLOWED.
ROSTER FILTER: DISPLAY ONLY THOSE RU MEMBERS WHO WERE COVERED BY TRICARE/CHAMPVA AT ANY TIME DURING THE PREVIOUS ROUND. PR19A {STR-DT}
IF PR19 IS CODED ‘1’ (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS ‘COVERED BY TRICARE/CHAMPVA DURING CURRENT ROUND.’ THEN GO TO BOX_06
IF PR19 IS CODED ‘2’ (NO, ONLY SOME), CONTINUE WITH PR20 PR20 {STR-DT}
DISPLAY ‘since {START DATE}’ IF NOT ROUND 5. DISPLAY ‘between {START DATE} and {END DATE}’ IF ROUND 5.
FLAG ALL PERSONS SELECTED AS ‘COVERED BY TRICARE/ CHAMPVA’ DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS ‘NOT COVERED BY TRICARE/CHAMPVA ‘ DURING CURRENT ROUND.
GO TO BOX_06
ROSTER DETAILS: TITLE: RU_ESTB_PERS_PAIRS_1 COL # 1 HEADER: NAME INSTRUCTIONS: DISPLAY RU MEMBER’S FIRST, MIDDLE, AND LAST NAMES (PERS.FULLNAME)
ROSTER DEFINITION: THIS ITEM DISPLAYS RU-ESTABLISHMENT-PERSON-PAIRS- ROSTER FOR SELECTION OF RU-MEMBERS.
ROSTER BEHAVIOR: 1. MULTIPLE SELECT ALLOWED. 2. ADD, DELETE, AND EDIT DISALLOWED.
ROSTER FILTER: DISPLAY ONLY THOSE RU MEMBERS WHO WERE COVERED BY TRICARE/CHAMPVA AT ANY TIME DURING THE PREVIOUS ROUND. BOX_06
IF ALL CURRENT RU MEMBERS ALREADY FLAGGED AS COVERED OR NOT COVERED BY TRICARE/CHAMPVA DURING CURRENT ROUND (I.E., ALL CURRENT RU MEMBERS WERE LISTED IN PR19), GO TO LOOP_03
OTHERWISE, CONTINUE WITH PR21 PR21 {STR-DT}
DISPLAY ‘since {START DATE}’ IF NOT ROUND 5. DISPLAY ‘between {START DATE} and {END DATE}’ IF ROUND 5.
IF CODED ‘2’ (NO), ‘-7’ (REFUSED) OR ‘8’ (DON’T KNOW) AND AT LEAST ONE RU MEMBER FLAGGED AS COVERED BY TRICARE/CHAMPVA DURING CURRENT ROUND, GO TO LOOP_03
IF CODED ‘2’ (NO), ‘-7’ (REFUSED) OR ‘8’ (DON’T KNOW) AND NO RU MEMBERS FLAGGED AS COVERED BY TRICARE/CHAMPVA DURING CURRENT ROUND, GO TO BOX_08 PR21A {STR-DT} PR22 {STR-DT}
DISPLAY ‘since {START DATE}’ IF ROUND IS NOT 5. DISPLAY ‘between {START DATE} and {END DATE}’ IF ROUND IS 5.
FLAG ALL PERSONS SELECTED AS ‘COVERED BY TRICARE/ CHAMPVA’ DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS ‘NOT COVERED BY TRICARE/CHAMPVA’ DURING CURRENT ROUND.
GO TO LOOP_03
ROSTER DETAILS: Title: RU_MEMBERS_1 COL #1 HEADER: NAME INSTRUCTIONS: DISPLAY RU MEMBER’S FIRST, MIDDLE AND LAST NAMES (PERS.FULLNAME)
ROSTER DEFINITION: THIS ITEM DISPLAYS RU-MEMBERS-ROSTER FOR SELECTION OF RU-MEMBERS.
ROSTER BEHAVIOR: 1. MULTIPLE SELECT ALLOWED. 1. ADD, DELETE, AND EDIT DISALLOWED.
ROSTER FILTER: DISPLAY ONLY THOSE RU MEMBERS WHO WERE NOT FLAGGED AS COVERED BY TRICARE/CHAMPVA AT ANY TIME DURING THE PREVIOUS ROUND. LOOP_03
FOR EACH ELEMENT ON THE RU-ESTABLISHMENT-PERSON- PAIRS-ROSTER, ASK NAV_PR03 - END_LP03
LOOP DEFINITION: LOOP_03 COLLECTS TIME PERIOD COVERAGE DETAIL FOR RU MEMBERS COVERED BY TRICARE/ CHAMPVA. THIS LOOP CYCLES ON ESTABLISHMENT-PERSON- PAIRS THAT MEET BOTH OF THE FOLLOWING CONDITIONS: - ESTABLISHMENT IS TRICARE/CHAMPVA AND - PERSON IS COVERED BY TRICARE/CHAMPVA DURING THE CURRENT ROUND
NAVIGATOR DETAILS: LOOP_03 USES NAV_PR03 TO TO CONTROL THE FLOW OF THE LOOP. NAV_PR03 TRICARE OR CHAMPVA {STR-DT}
ROSTER DETAILS: COL # 1 HEADER: RU MEMBER INSTRUCTIONS: DISPLAY RU MEMBER’S FIRST, MIDDLE, AND LAST NAMES (PERS.FULLNAME) COL # 2 HEADER: EMPTY INSTRUCTIONS: DISPLAY THE MOST CURRENT NAVIGATOR STATUS FOR EACH RU MEMBER EACH TIME THE NAVIGATOR IS PRESENTED
ROSTER DEFINITION: THIS ITEM DISPLAYS RU-ESTABLISHMENT-PERSON-PAIRS- ROSTER FOR SELECTION.
ROSTER BEHAVIOR: 1. SELECT ALLOWED. 2. MULTIPLE SELECT, ADD, DELETE, AND EDIT DISALLOWED.
ROSTER FILTER: DISPLAY ALL RU MEMBERS WHO MEET BOTH OF THE FOLLOWING CONDITIONS: - ESTABLISHMENT IS TRICARE/CHAMPVA AND - PERSON IS COVERED BY TRICARE/CHAMPVA DURING THE CURRENT ROUND
CONTINUE WITH BOX_07 FOR SELECTED RU MEMBER. BOX_07
ASK THE TIME PERIOD COVERED DETAIL (HQ) SECTION FOR THIS PAIR. AT COMPLETION OF THE HQ SECTION, CONTINUE WITH END_LP03 END_LP03
CYCLE ON NEXT PAIR ON THE RU-ESTABLISHMENT- PERSON-PAIRS-ROSTER THAT MEETS THE CONDITIONS STATED IN THE LOOP DEFINITION.
IF NO MORE PAIRS MEET THE STATED CONDITIONS, END LOOP_03 AND CONTINUE WITH BOX_08 BOX_08
IF ANY RU MEMBER HAD GOVT-HOSPITAL/PHYSICIAN AS A SOURCE OF INSURANCE AT ANY TIME DURING PREVIOUS ROUND, CONTINUE WITH PR23
OTHERWISE, GO TO BOX_11 PR23 {STR-DT}
DISPLAY ‘since {START DATE}’ IF NOT ROUND 5. DISPLAY ‘between {START DATE} and {END DATE}’ IF ROUND 5.
IF CODED ‘3’ (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS ‘NOT COVERED BY GOVT-HOSPITAL/ PHYSICIAN’ DURING CURRENT ROUND.
IF CODED ‘1’ (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS ‘COVERED BY GOVT-HOSPITAL/ PHYSICIAN’ DURING CURRENT ROUND.
IF CODED ‘3’ (NO, NONE) AND IF ANY CURRENT RU MEMBERS NOT LISTED AT PR23, GO TO PR25
IF CODED ‘3’ (NO, NONE) AND IF ALL CURRENT RU MEMBERS ARE LISTED AT PR23, GO TO BOX_11
ROSTER DETAILS: TITLE: RU_ESTB_PERS_PAIRS_1 COL # 1 HEADER: NAME INSTRUCTIONS: DISPLAY RU MEMBER’S FIRST, MIDDLE, AND LAST NAMES (PERS.FULLNAME)
ROSTER DEFINITION: THIS ITEM DISPLAYS RU-ESTABLISHMENT-PERSON-PAIRS- ROSTER FOR DISPLAY OF RU-MEMBERS.
ROSTER BEHAVIOR: 1. DISPLAY ONLY. 2. SELECT, ADD, DELETE, AND EDIT DISALLOWED.
ROSTER FILTER: DISPLAY ONLY THOSE RU MEMBERS WHO WERE FLAGGED AS COVERED BY GOVT-HOSPITAL/PHYSICIAN AT ANY TIME DURING THE PREVIOUS ROUND. PR24 {STR-DT}
DISPLAY ‘since {START DATE}’ IF NOT ROUND 5. DISPLAY ‘between {START DATE} and {END DATE}’ IF ROUND 5.
FLAG ALL PERSONS SELECTED AS ‘COVERED BY GOVT-HOSPITAL/PHYSICIAN’ DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS ‘NOT COVERED BY GOVT-HOSPITAL/PHYSICIAN’ DURING CURRENT ROUND.
GO TO BOX_09
ROSTER DETAILS: TITLE: RU_ESTB_PERS_PAIRS_1 COL # 1 HEADER: NAME INSTRUCTIONS: DISPLAY RU MEMBER’S FIRST, MIDDLE, AND LAST NAMES (PERS.FULLNAME)
ROSTER DEFINITION: THIS ITEM DISPLAYS RU-ESTABLISHMENT-PERSON-PAIRS- ROSTER FOR SELECTION OF RU-MEMBERS.
ROSTER BEHAVIOR: 1. MULTIPLE SELECT ALLOWED. 2. ADD, DELETE, AND EDIT DISALLOWED.
ROSTER FILTER: DISPLAY ONLY THOSE RU MEMBERS WHO WERE COVERED BY GOVT-HOSPITAL/PHYSICIAN AT ANY TIME DURING THE PREVIOUS ROUND. BOX_09
IF ALL CURRENT RU MEMBERS ALREADY FLAGGED AS COVERED OR NOT COVERED BY THE GOVT-HOSPITAL/ PHYSICIAN DURING CURRENT ROUND (I.E., ALL CURRENT RU MEMBERS WERE LISTED IN PR23), GO TO LOOP_04
OTHERWISE, CONTINUE WITH PR25 PR25 {STR-DT}
DISPLAY ‘since {START DATE}’ IF NOT ROUND 5. DISPLAY ‘between {START DATE} and {END DATE}’ IF ROUND 5.
IF CODED ‘2’ (NO), ‘-7’ (REFUSED) OR ‘-8’ (DON’T KNOW) AND AT LEAST ONE RU MEMBER FLAGGED AS ‘COVERED BY GOVT-HOSPITAL/PHYSICIAN’ DURING CURRENT ROUND, GO TO LOOP_04
IF CODED ‘2’ (NO), ‘-7’ (REFUSED) OR ‘-8’ (DON’T KNOW) AND NO RU MEMBERS FLAGGED AS ‘COVERED BY GOVT-HOSPITAL/PHYSICIAN’ DURING CURRENT ROUND, GO TO BOX_11 PR26 {STR-DT}
DISPLAY ‘since {START DATE}’ IF NOT ROUND 5. DISPLAY ‘between {START DATE} and {END DATE}’ IF ROUND 5.
FLAG ALL PERSONS SELECTED AS ‘COVERED BY GOVT- HOSPITAL/PHYSICIAN’ DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS ‘NOT COVERED BY GOVT-HOSPITAL/PHYSICIAN’ DURING CURRENT ROUND.
GO TO LOOP_04
ROSTER DETAILS:
Title: RU_MEMBERS_1 COL #1 HEADER: NAME INSTRUCTIONS: DISPLAY RU MEMBER’S FIRST, MIDDLE AND LAST NAMES (PERS.FULLNAME)
ROSTER DEFINITION: THIS ITEM DISPLAYS RU-MEMBERS-ROSTER FOR SELECTION OF RU-MEMBERS.
ROSTER BEHAVIOR: 1. MULTIPLE SELECT ALLOWED. 1. ADD, DELETE, AND EDIT DISALLOWED.
ROSTER FILTER: DISPLAY ONLY THOSE RU MEMBERS WHO WERE NOT FLAGGED AS COVERED BY GOVT-HOSPITAL/PHYSICIAN AT ANY TIME DURING THE PREVIOUS ROUND. LOOP_04
FOR EACH ELEMENT ON THE RU-ESTABLISHMENT-PERSON- PAIRS-ROSTER, ASK NAV_PR04 - END_LP04
LOOP DEFINITION: LOOP_04 COLLECTS TIME PERIOD COVERAGE DETAIL FOR RU MEMBERS COVERED BY GOVT- HOSPITAL/PHYSICIAN. THIS LOOP CYCLES ON ESTABLISHMENT-PERSON-PAIRS THAT MEET BOTH OF THE FOLLOWING CONDITIONS: - ESTABLISHMENT IS GOVT-HOSPITAL/PHYSICIAN AND - PERSON IS FLAGGED AS COVERED BY GOVT-HOSPITAL/ PHYSICIAN DURING THE CURRENT ROUND
NAVIGATOR DETAILS: LOOP_04 USES NAV_PR04 TO TO CONTROL THE FLOW OF THE LOOP. NAV_PR04 {NAME OF PREV RD’S GOVT-HOSPITAL/PHYSICIAN INSURER FOR
RU}
FOR ‘NAME OF PREV RD’S GOVT-HOSPITAL/PHYSICIAN INSURER FOR RU’, DISPLAY THE INSURER RECORDED FOR GOVT-HOSPITAL/PHYSICIAN AT ANY TIME DURING THE PREVIOUS ROUND.
ROSTER DETAILS: COL # 1 HEADER: RU MEMBER INSTRUCTIONS: DISPLAY RU MEMBER’S FIRST, MIDDLE, AND LAST NAMES (PERS.FULLNAME) COL # 2 HEADER: EMPTY INSTRUCTIONS: DISPLAY THE MOST CURRENT NAVIGATOR STATUS FOR EACH RU MEMBER EACH TIME THE NAVIGATOR IS PRESENTED
ROSTER DEFINITION: THIS ITEM DISPLAYS RU-ESTABLISHMENT-PERSON-PAIRS- ROSTER FOR SELECTION.
ROSTER BEHAVIOR: 1. SELECT ALLOWED. 2. MULTIPLE SELECT, ADD, DELETE, AND EDIT DISALLOWED.
ROSTER FILTER: DISPLAY ALL RU MEMBERS WHO MEET BOTH OF THE FOLLOWING CONDITIONS: - ESTABLISHMENT IS GOVT-HOSPITAL/PHYSICIAN AND - PERSON IS FLAGGED AS COVERED BY GOVT-HOSPITAL/ PHYSICIAN DURING THE CURRENT ROUND
CONTINUE WITH BOX_10 FOR SELECTED RU MEMBER. BOX_10
ASK THE TIME PERIOD COVERED DETAIL (HQ) SECTION FOR THIS PAIR. AT COMPLETION OF THE HQ SECTION, CONTINUE WITH END_LP04 END_LP04
CYCLE ON NEXT PAIR ON THE RU-ESTABLISHMENT-PERSON PAIRS-ROSTER THAT MEETS THE CONDITIONS STATED IN THE LOOP DEFINITION.
IF NO MORE PAIRS MEET THE STATED CONDITIONS, END LOOP_04 AND CONTINUE WITH PR27 PR27 {STR-DT}
DISPLAY ‘Last time .... {NAME OF PREV RD’S GOVT- HOSPITAL/PHYSICIAN INSURER FOR RU}.’ IF THERE IS AN INSURER ASSOCIATED WITH GOVT-HOSPITAL/ PHYSICIAN IN THE PREVIOUS ROUND. NOTE: THIS NAME WILL NO LONGER COME FROM THE PLAN FILL FILE. IT WILL BE ENTERED AT EITHER HX44 OR PR31. FOR ‘NAME OF PREV RD’S GOVT-HOSPITAL/PHYSICIAN INSURER FOR RU’, DISPLAY THE INSURER RECORDED FOR GOVT-HOSPITAL/PHYSICIAN AT ANY TIME DURING THE PREVIOUS ROUND.
DISPLAY ‘Since {START DATE}’ IF NOT ROUND 5. DISPLAY ‘Between {START DATE} and {END DATE}’ IF ROUND 5.
IF CODED ‘2’ (NO), ‘-7’ (REFUSED), OR ‘-8’ (DON’T KNOW), FLAG PREVIOUS ROUND’S INSURER AS CURRENT ROUND’S INSURER FOR GOVT-HOSPITAL/PHYSICIAN.
ROSTER DETAILS: TITLE: RU_ESTB_PERS_PAIRS_1 COL # 1 HEADER: NAME INSTRUCTIONS: DISPLAY RU MEMBER’S FIRST, MIDDLE, AND LAST NAMES (PERS.FULLNAME)
ROSTER DEFINITION: THIS ITEM DISPLAYS RU-ESTABLISHMENT-PERSON-PAIRS- ROSTER FOR DISPLAY OF RU-MEMBERS.
ROSTER BEHAVIOR: 1. DISPLAY ONLY. 2. SELECT, ADD, DELETE, AND EDIT DISALLOWED.
ROSTER FILTER: DISPLAY ONLY THOSE RU MEMBERS WHO ARE FLAGGED AS COVERED BY GOVT-HOSPITAL/PHYSICIAN DURING THE CURRENT ROUND. PR29 {STR-DT}
DISPLAY ‘between {START DATE} and {END DATE}’ IF ROUND 5. OTHERWISE, USE A NULL DISPLAY. DISPLAY ‘(are/is)’ IF NOT ROUND 5. DISPLAY ‘(were/was)’ IF ROUND 5.
ROSTER DETAILS: TITLE: RU_ESTB_PERS_PAIRS_1 COL # 1 HEADER: NAME INSTRUCTIONS: DISPLAY RU MEMBER’S FIRST, MIDDLE, AND LAST NAMES (PERS.FULLNAME)
ROSTER DEFINITION: THIS ITEM DISPLAYS RU-ESTABLISHMENT-PERSON-PAIRS- ROSTER FOR DISPLAY OF RU-MEMBERS.
ROSTER BEHAVIOR: 1. DISPLAY ONLY. 2. SELECT, ADD, DELETE, AND EDIT DISALLOWED.
ROSTER FILTER: DISPLAY ONLY THOSE RU MEMBERS WHO ARE COVERED BY GOVT-HOSPITAL/PHYSICIAN DURING THE CURRENT ROUND. PR30 {STR-DT}
DISPLAY ‘Does’ IF NOT ROUND 5. DISPLAY ‘Between {START DATE} and {END DATE}, did’ IF ROUND 5.
IF CODED ‘3’ (NO, NONE REQUIRED), ‘-7’ (REFUSED), OR ‘-8’ (DON’T KNOW), THERE IS NO INSURER ASSOCIATED WITH THE CURRENT ROUND FOR GOVT-HOSPITAL/PHYSICIAN.
ROSTER DETAILS: TITLE: RU_ESTB_PERS_PAIRS_1 COL # 1 HEADER: NAME INSTRUCTIONS: DISPLAY RU MEMBER’S FIRST, MIDDLE, AND LAST NAMES (PERS.FULLNAME)
ROSTER DEFINITION: THIS ITEM DISPLAYS RU-ESTABLISHMENT-PERSON-PAIRS- ROSTER FOR DISPLAY OF RU-MEMBERS.
ROSTER BEHAVIOR: 1. DISPLAY ONLY. 2. SELECT, ADD, DELETE, AND EDIT DISALLOWED.
ROSTER FILTER: DISPLAY ONLY THOSE RU MEMBERS WHO ARE COVERED BY GOVT-HOSPITAL/PHYSICIAN DURING THE CURRENT ROUND. PR31 {STR-DT}
DISPLAY ‘HMO’ IF PR29 IS CODED ‘1’ (YES, ALL ARE) OR ‘2’ (YES, SOME ARE). DISPLAY ‘health insurance’ IF PR30 CODED ‘1’ (YES, ALL REQUIRED) OR ‘2’ (YES, SOME REQUIRED).
FLAG INSURER CODED ABOVE AS ‘CURRENT ROUND’S INSURER FOR GOVT-HOSPITAL/PHYSICIAN.’ BOX_10A
IF ROUND 2, ROUND 3 OR ROUND 4, CONTINUE WITH PR32
OTHERWISE, (I.E., IF ROUND 5), GO TO BOX_11 PR32 {STR-DT}
DISPLAY ‘{NAME OF PLAN FROM PR31}’ IF THERE IS A CURRENT ROUND INSURER ASSOCIATED WITH THE GOVT-HOSPITAL/PHYSICIAN INSURANCE. OTHERWISE, DISPLAY ‘the program sponsored ...’. DISPLAY ‘{NAME OF PLAN FROM PR31}’ IF A PLAN NAME WAS ENTERED AT PR31. DISPLAY THE ACTUAL PLAN NAME THAT WAS ENTERED. DISPLAY ‘for anyone in the family’ IF MORE THAN ONE RU MEMBER SELECTED AS COVERED BY GOVT- HOSPITAL/PHYSICIAN INSURANCE. OTHERWISE, USE A NULL DISPLAY.
IF CODED ‘1’ (YES, EVERYONE COVERED PAYS) AT PR32 (HOME.PRMEDPRE), CODE PRND.GOVMNTHP FOR EACH PERSON IN THE ROSTER AT PR32A AS ‘1’ (PAYS FOR COVERAGE DURING THE CURRENT ROUND.). IF CODED ‘3’ (NO, NO ONE COVERED PAYS) AT PR32 (HOME.PRMEDPRE), CODE PRND.GOVMNTHP FOR EACH PERSON IN THE ROSTER AT PR32A AS ‘2’ (DOES NOT PAY FOR COVERAGE DURING THE CURRENT ROUND.) IF CODED -7 OR -8 OR -9 (WHETHER EVERYONE IS COVERED IS MISSING) AT PR32 (HOME.PRMEDPRE), CODE PRND.GOVMNTHP EQUAL TO THE MISSING VALUE IN HOME.PRMEDPRE FOR EACH PERSON IN THE PR32A ROSTER. LEAVE PRND.MEDGOVP BLANK (NO VALUE) FOR ANY RU MEMBER NOT ON THE ROSTER AT PR32A. THE PR32A ROSTER INCLUDES ALL PERSONS WITH GOVT-HOSPITAL/PHYSICIAN PROGRAM COVERAGE (EPRS.GOVTPROG = 1) IN THE CURRENT RU FOR THE CURRENT ROUND. PR32A {STR-DT}
CONTINUE WITH BOX_10B
ROSTER DETAILS: TITLE: RU_ESTB_PERS_PAIRS_1 COL # 1 HEADER: NAME INSTRUCTIONS: DISPLAY RU MEMBER’S FIRST, MIDDLE, AND LAST NAMES (PERS.FULLNAME)
ROSTER DEFINITION: THIS ITEM DISPLAYS RU-ESTABLISHMENT-PERSON-PAIRS- ROSTER FOR SELECTION OF RU-MEMBERS.
ROSTER BEHAVIOR: 1. MULTIPLE SELECT ALLOWED. 2. ADD, DELETE, AND EDIT DISALLOWED.
ROSTER FILTER: DISPLAY ONLY THOSE RU MEMBERS WHO ARE COVERED BY GOVT-HOSPITAL/PHYSICIAN DURING THE CURRENT ROUND.
ROSTER FILTER: THE PR32A ROSTER INCLUDES ALL PERSONS WITH GOVT-HOSPITAL/PHYSICIAN PROGRAM COVERAGE (EPRS.GOVTPROG = 1) IN THE CURRENT RU FOR THE CURRENT ROUND. CODE PRND.GOVMNTHP AS ‘1’ (PAYS FOR COVERAGE DURING THE CURRENT ROUND) FOR ALL PERSONS FROM THE PR32A ROSTER WHO ARE SELECTED. CODE PRND.GOVMNTHP AS ‘2’ (DOES NOT PAY FOR COVERAGE DURING THE CURRENT ROUND) FOR ALL PERSONS ON THE PR32A ROSTER WHO ARE NOT SELECTED. LEAVE PRND.MEDGOVP BLANK (NO VALUE) FOR ANY RU MEMBER NOT ON THE ROSTER AT PR32A. BOX_10B
IF ROUND 3, CONTINUE WITH PR33
OTHERWISE, GO TO PR33A PR33 {STR-DT}
DISPLAY ‘the {NAME OF PLAN FROM PR31}’ IF THERE IS A CURRENT ROUND INSURER ASSOCIATED WITH THE GOVT-HOSPITAL/PHYSICIAN INSURANCE. OTHERWISE, DISPLAY ‘that’. DISPLAY ‘{NAME OF PLAN FROM PR31}’ IF A PLAN NAME WAS ENTERED AT PR31. DISPLAY THE ACTUAL PLAN NAME THAT WAS ENTERED. PR33OV1 Is that per year, per month, per week, or what? PR33OV2 SPECIFY: PR33A {STR-DT}
DISPLAY ‘PLAN NAME: ...’ IF THERE IS A CURRENT ROUND INSURER ASSOCIATED WITH THE GOVT-HOSPITAL/ PHYSICIAN INSURANCE. OTHERWISE, USE A NULL DISPLAY. DISPLAY THE ACTUAL PLAN NAME ENTERED AT PR31 FOR ‘{NAME OF PLAN FROM PR31}’ IF A PLAN NAME WAS ENTERED. BOX_10C
IF ROUND 3 AND IF HX15A WAS CODED ‘1’ (YES, PLAN IS EXCHANGE) THE ROUND THE GOV’T-HOSPITAL/PHYSICIAN INSURANCE WAS CREATED AND PR32 IS CODED ‘1’ (YES, EVERYONE COVERED PAYS) OR ‘2’ (YES, SOME COVERED PAY), CONTINUE WITH PR34
OTHERWISE, GO TO BOX_11 PR34 {STR-DT}
DISPLAY ‘the {NAME OF PLAN FROM PR31} plan’ IF THERE IS A CURRENT ROUND INSURER ASSOCIATED WITH THE GOVT-HOSPITAL/PHYSICIAN INSURANCE. OTHERWISE, DISPLAY ‘this plan’. DISPLAY THE ACTUAL PLAN NAME ENTERED AT PR31 FOR ‘{NAME OF PLAN FROM PR31}’ IF A PLAN NAME WAS ENTERED. BOX_11
IF ANY RU MEMBER HAD OTHER PUBLIC (GROUP 1 OR 2) AS A SOURCE OF INSURANCE AT ANY TIME DURING PREVIOUS ROUND, CONTINUE WITH BOX_12
OTHERWISE, GO TO BOX_18 BOX_12
IF ANY CURRENT RU MEMBER HAD ANY GROUP 1 OTHER PUBLIC INSURANCE AT ANY TIME DURING PREVIOUS ROUND, CONTINUE WITH PR35
OTHERWISE, GO TO BOX_15
NOTE: FOR BOTH GROUP 1 AND GROUP 2 PUBLIC PROGRAMS, WE ASSUME THE PROGRAM IS THE SAME FROM THE PREVIOUS ROUND. ALTHOUGH WE SHOW THE SHOW CARD AND ASK IF THE FAMILY STILL HAD COVERAGE FROM ANY OF THOSE PROGRAMS, WE DO NOT ASK WHICH ONES. IF WE WERE TO ASK WHICH ONES, WE WOULD NEED TO ADD SEVERAL QUESTIONS, LIKE THE OTHER PUBLIC SERIES IN HX. PR35 {STR-DT}
DISPLAY THE LIST OF UP TO FOUR ACTUAL NAMES OF STATE PROGRAMS (AS LISTED IN ATTACHMENT 36) FOR ‘STATE NAME FOR PROGRAM #N’.
DISPLAY ‘since {START DATE}’ IF NOT ROUND 5. DISPLAY ‘between {START DATE} and {END DATE}’ IF ROUND 5.
IF PR35 IS CODED ‘1’ (YES, ALL), MARK ALL RU MEMBERS LISTED HERE AS COVERED BY GROUP 1 OTHER PUBLIC INSURANCE DURING CURRENT ROUND.
IF PR35 IS CODED ‘3’ (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS ‘NOT COVERED BY GROUP 1 OTHER PUBLIC INSURANCE’ DURING CURRENT ROUND.
IF CODED ‘3’ (NO, NONE) AND IF ANY CURRENT RU MEMBERS NOT LISTED AT PR35, GO TO PR37
IF CODED ‘3’ (NO, NONE), AND IF ALL CURRENT RU MEMBERS ARE LISTED AT PR35, GO TO BOX_15
ROSTER DETAILS: TITLE: RU_ESTB_PERS_PAIRS_1 COL # 1 HEADER: NAME INSTRUCTIONS: DISPLAY RU MEMBER’S FIRST, MIDDLE, AND LAST NAMES (PERS.FULLNAME)
ROSTER DEFINITION: THIS ITEM DISPLAYS RU-ESTABLISHMENT-PERSON-PAIRS- ROSTER FOR DISPLAY OF RU-MEMBERS.
ROSTER BEHAVIOR: 1. DISPLAY ONLY. 2. SELECT, ADD, DELETE, AND EDIT DISALLOWED.
ROSTER FILTER: DISPLAY ONLY THOSE RU MEMBERS WHO WERE COVERED BY GROUP 1 OTHER PUBLIC INSURANCE AT ANY TIME DURING THE PREVIOUS ROUND. PR36 {STR-DT}
DISPLAY ‘since {START DATE}’ IF NOT ROUND 5. DISPLAY ‘between {START DATE} and {END DATE}’ IF ROUND 5.
FLAG ALL PERSONS SELECTED AS ‘COVERED BY GROUP 1 OTHER PUBLIC INSURANCE’ DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS ‘NOT COVERED BY GROUP 1 OTHER PUBLIC INSURANCE’ DURING CURRENT ROUND.
GO TO BOX_13
ROSTER DETAILS: TITLE: RU_ESTB_PERS_PAIRS_1 COL # 1 HEADER: NAME INSTRUCTIONS: DISPLAY RU MEMBER’S FIRST, MIDDLE, AND LAST NAMES (PERS.FULLNAME)
ROSTER DEFINITION: THIS ITEM DISPLAYS RU-ESTABLISHMENT-PERSON-PAIRS- ROSTER FOR SELECTION OF RU-MEMBERS.
ROSTER BEHAVIOR: 1. MULTIPLE SELECT ALLOWED. 2. ADD, DELETE, AND EDIT DISALLOWED.
ROSTER FILTER: DISPLAY ONLY THOSE RU MEMBERS WHO WERE COVERED BY GROUP 1 OTHER PUBLIC INSURANCE AT ANY TIME DURING THE PREVIOUS ROUND. BOX_13
IF ALL CURRENT RU MEMBERS ALREADY FLAGGED AS COVERED OR NOT COVERED BY GROUP 1 OTHER PUBLIC INSURANCE DURING CURRENT ROUND (I.E., ALL CURRENT RU MEMBERS WERE LISTED IN PR35), GO TO LOOP_05
OTHERWISE, CONTINUE WITH PR37 PR37 {STR-DT}
DISPLAY THE LIST OF UP TO FOUR ACTUAL NAMES OF STATE PROGRAMS (AS LISTED IN HX16) FOR ‘STATE NAME FOR PROGRAM #N’.
DISPLAY ‘since {START DATE}’ IF NOT ROUND 5. DISPLAY ‘between {START DATE} and {END DATE}’ IF ROUND 5.
IF CODED ‘2’ (NO), ‘-7’ (REFUSED) OR ‘-8’ (DON’T KNOW) AND AT LEAST ONE RU MEMBER FLAGGED AS COVERED BY GROUP 1 OTHER PUBLIC INSURANCE DURING CURRENT ROUND, GO TO LOOP_05
IF CODED ‘2’ (NO), ‘-7’ (REFUSED) OR ‘-8’ (DON’T KNOW) AND NO RU MEMBERS FLAGGED AS COVERED BY GROUP 1 OTHER PUBLIC INSURANCE DURING CURRENT ROUND, GO TO BOX_15 PR38 {STR-DT}
DISPLAY ‘since {START DATE}’ IF NOT ROUND 5. DISPLAY ‘between {START DATE} and {END DATE}’ IF ROUND 5.
FLAG ALL PERSONS SELECTED AS ‘COVERED BY GROUP 1 OTHER PUBLIC INSURANCE’ DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS ‘NOT COVERED BY GROUP 1 OTHER PUBLIC INSURANCE DURING CURRENT ROUND.’
GO TO LOOP_05
ROSTER DETAILS:
Title: RU_MEMBERS_1 COL #1 HEADER: NAME INSTRUCTIONS: DISPLAY RU MEMBER’S FIRST, MIDDLE AND LAST NAMES (PERS.FULLNAME)
ROSTER DEFINITION: THIS ITEM DISPLAYS RU-MEMBERS-ROSTER FOR SELECTION OF RU-MEMBERS.
ROSTER BEHAVIOR: 1. MULTIPLE SELECT ALLOWED. 1. ADD, DELETE, AND EDIT DISALLOWED.
ROSTER FILTER: DISPLAY ONLY THOSE RU MEMBERS WHO WERE NOT FLAGGED AS COVERED BY GROUP 1 OTHER PUBLIC INSURANCE AT ANY TIME DURING THE PREVIOUS ROUND. LOOP_05
FOR EACH ELEMENT ON THE RU-ESTABLISHMENT-PERSON- PAIRS-ROSTER, ASK NAV_PR05 - END_LP05
LOOP DEFINITION: LOOP_05 COLLECTS TIME PERIOD COVERAGE DETAIL FOR RU MEMBERS COVERED BY GROUP 1 OTHER PUBLIC INSURANCE. THIS LOOP CYCLES ON ESTABLISHMENT-PERSON-PAIRS THAT MEET BOTH OF THE FOLLOWING CONDITIONS: - ESTABLISHMENT IS GROUP 1 OTHER PUBLIC INSURANCE AND - PERSON IS COVERED BY GROUP 1 OTHER PUBLIC INSURANCE DURING THE CURRENT ROUND
NAVIGATOR DETAILS: LOOP_05 USES NAV_PR05 TO TO CONTROL THE FLOW OF THE LOOP. NAV_PR05 STATE SPECIFIC PROGRAM {STR-DT}
ROSTER DETAILS: COL # 1 HEADER: RU MEMBER INSTRUCTIONS: DISPLAY RU MEMBER’S FIRST, MIDDLE, AND LAST NAMES (PERS.FULLNAME) COL # 2 HEADER: EMPTY INSTRUCTIONS: DISPLAY THE MOST CURRENT NAVIGATOR STATUS FOR EACH RU MEMBER EACH TIME THE NAVIGATOR IS PRESENTED
ROSTER DEFINITION: THIS ITEM DISPLAYS RU-ESTABLISHMENT-PERSON-PAIRS- ROSTER FOR SELECTION.
ROSTER BEHAVIOR: 1. SELECT ALLOWED. 2. MULTIPLE SELECT, ADD, DELETE, AND EDIT DISALLOWED.
ROSTER FILTER: DISPLAY ALL RU MEMBERS WHO MEET BOTH OF THE FOLLOWING CONDITIONS: - ESTABLISHMENT IS GROUP 1 OTHER PUBLIC INSURANCE AND - PERSON IS COVERED BY GROUP 1 OTHER PUBLIC INSURANCE DURING THE CURRENT ROUND
CONTINUE WITH BOX_14 FOR SELECTED RU MEMBER. BOX_14
ASK THE TIME PERIOD COVERED DETAIL (HQ) SECTION FOR THIS PAIR. AT COMPLETION OF THE HQ SECTION, CONTINUE WITH END_LP05 END_LP05
CYCLE ON NEXT PAIR ON THE RU-ESTABLISHMENT- PERSON-PAIRS-ROSTER THAT MEETS THE CONDITIONS STATED IN THE LOOP DEFINITION.
IF NO MORE PAIRS MEET THE STATED CONDITIONS, END LOOP_05 AND CONTINUE WITH BOX_15 BOX_15
IF ANY CURRENT RU MEMBER HAD ANY ELIGIBLE GROUP 2 OTHER PUBLIC INSURANCE AT ANY TIME DURING THE PREVIOUS ROUND, CONTINUE WITH PR39
OTHERWISE, GO TO BOX_18 PR39 {STR-DT}
DISPLAY ‘since {START DATE}’ IF NOT ROUND 5. DISPLAY ‘between {START DATE} and {END DATE}’ IF ROUND 5.
IF CODED ‘1’ (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS ‘COVERED BY GROUP 2 OTHER PUBLIC INSURANCE’ DURING CURRENT ROUND.
IF CODED ‘3’ (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS ‘NOT COVERED BY GROUP 2 OTHER PUBLIC INSURANCE’ DURING CURRENT ROUND.
IF CODED ‘3’ (NO, NONE) AND IF ANY CURRENT RU MEMBERS NOT LISTED AT PR39, GO TO PR41
IF CODED ‘3’ (NO, NONE), AND IF ALL CURRENT RU MEMBERS ARE LISTED AT PR39, GO TO BOX_18
ROSTER DETAILS: TITLE: RU_ESTB_PERS_PAIRS_1 COL # 1 HEADER: NAME INSTRUCTIONS: DISPLAY RU MEMBER’S FIRST, MIDDLE, AND LAST NAMES (PERS.FULLNAME)
ROSTER DEFINITION: THIS ITEM DISPLAYS RU-ESTABLISHMENT-PERSON-PAIRS- ROSTER FOR DISPLAY OF RU-MEMBERS.
ROSTER BEHAVIOR: 1. DISPLAY ONLY. 2. SELECT, ADD, DELETE, AND EDIT DISALLOWED.
ROSTER FILTER: DISPLAY ONLY THOSE RU MEMBERS WHO WERE COVERED BY GROUP 2 OTHER PUBLIC INSURANCE AT ANY TIME DURING THE PREVIOUS ROUND. PR40 {STR-DT}
DISPLAY ‘since {START DATE}’ IF NOT ROUND 5. DISPLAY ‘between {START DATE} and {END DATE}’ IF ROUND 5.
FLAG ALL PERSONS SELECTED AS ‘COVERED BY GROUP 2 OTHER PUBLIC INSURANCE’ DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS ‘NOT COVERED BY GROUP 2 OTHER PUBLIC INSURANCE’ DURING CURRENT ROUND.
GO TO BOX_16
ROSTER DETAILS: TITLE: RU_ESTB_PERS_PAIRS_1 COL # 1 HEADER: NAME INSTRUCTIONS: DISPLAY RU MEMBER’S FIRST, MIDDLE, AND LAST NAMES (PERS.FULLNAME)
ROSTER DEFINITION: THIS ITEM DISPLAYS RU-ESTABLISHMENT-PERSON-PAIRS- ROSTER FOR SELECTION OF RU-MEMBERS.
ROSTER BEHAVIOR: 1. MULTIPLE SELECT ALLOWED. 2. ADD, DELETE, AND EDIT DISALLOWED.
ROSTER FILTER: DISPLAY ONLY THOSE RU MEMBERS WHO WERE COVERED BY GROUP 2 OTHER PUBLIC INSURANCE AT ANY TIME DURING THE PREVIOUS ROUND. BOX_16
IF ALL CURRENT RU MEMBERS ALREADY FLAGGED AS COVERED OR NOT COVERED BY GROUP 2 OTHER PUBLIC INSURANCE DURING CURRENT ROUND (I.E., ALL CURRENT RU MEMBERS WERE LISTED AT PR39), GO TO LOOP_06
OTHERWISE, CONTINUE WITH PR41 PR41 {STR-DT}
DISPLAY ‘since {START DATE}’ IF NOT ROUND 5. DISPLAY ‘between {START DATE} and {END DATE}’ IF ROUND 5.
IF CODED ‘2’ (NO), ‘-7’ (REFUSED) OR ‘-8’ (DON’T KNOW) AND AT LEAST ONE RU MEMBER FLAGGED AS COVERED BY GROUP 2 OTHER PUBLIC INSURANCE DURING CURRENT ROUND, GO TO LOOP_06
IF CODED ‘2’ (NO), ‘-7’ (REFUSED) OR ‘-8’ (DON’T KNOW) AND NO RU MEMBERS FLAGGED AS COVERED BY GROUP 2 OTHER PUBLIC INSURANCE DURING CURRENT ROUND, GO TO BOX_18 PR42 {STR-DT}
DISPLAY ‘since {START DATE}’ IF NOT ROUND 5. DISPLAY ‘between {START DATE} and {END DATE}’ IF ROUND 5.
FLAG ALL PERSONS SELECTED AS ‘COVERED BY GROUP 2 OTHER PUBLIC INSURANCE’ DURING CURRENT ROUND. FLAG ALL PERSONS NOT SELECTED AS ‘NOT COVERED BY GROUP 2 OTHER PUBLIC INSURANCE DURING CURRENT ROUND.’
GO TO LOOP_06
ROSTER DETAILS:
Title: RU_MEMBERS_1 COL #1 HEADER: NAME INSTRUCTIONS: DISPLAY RU MEMBER’S FIRST, MIDDLE AND LAST NAMES (PERS.FULLNAME)
ROSTER DEFINITION: THIS ITEM DISPLAYS RU-MEMBERS-ROSTER FOR SELECTION OF RU-MEMBERS.
ROSTER BEHAVIOR: 1. MULTIPLE SELECT ALLOWED. 1. ADD, DELETE, AND EDIT DISALLOWED.
ROSTER FILTER: DISPLAY ONLY THOSE RU MEMBERS WHO WERE NOT FLAGGED AS COVERED BY GROUP 2 OTHER PUBLIC INSURANCE AT ANY TIME DURING THE PREVIOUS ROUND. LOOP_06
FOR EACH ELEMENT ON THE RU-ESTABLISHMENT-PERSON- PAIRS-ROSTER, ASK NAV_PR06 - END_LP06
LOOP DEFINITION: LOOP_06 COLLECTS TIME PERIOD COVERAGE DETAIL FOR RU MEMBERS COVERED BY GROUP 2 OTHER PUBLIC INSURANCE. THIS LOOP CYCLES ON ESTABLISHMENT-PERSON-PAIRS THAT MEET BOTH OF THE FOLLOWING CONDITIONS: - ESTABLISHMENT IS GROUP 2 OTHER PUBLIC INSURANCE AND - PERSON IS COVERED BY GROUP 2 OTHER PUBLIC INSURANCE DURING THE CURRENT ROUND
NAVIGATOR DETAILS: LOOP_06 USES NAV_PR06 TO TO CONTROL THE FLOW OF THE LOOP. NAV_PR06 STATE: TANF/SSI/WIC/IHS/PHC/VA {STR-DT}
ROSTER DETAILS: COL # 1 HEADER: RU MEMBER INSTRUCTIONS: DISPLAY RU MEMBER’S FIRST, MIDDLE, AND LAST NAMES (PERS.FULLNAME) COL # 2 HEADER: EMPTY INSTRUCTIONS: DISPLAY THE MOST CURRENT NAVIGATOR STATUS FOR EACH RU MEMBER EACH TIME THE NAVIGATOR IS PRESENTED
ROSTER DEFINITION: THIS ITEM DISPLAYS RU-ESTABLISHMENT-PERSON-PAIRS- ROSTER FOR SELECTION.
ROSTER BEHAVIOR: 1. SELECT ALLOWED. 2. MULTIPLE SELECT, ADD, DELETE, AND EDIT DISALLOWED.
ROSTER FILTER: DISPLAY ALL RU MEMBERS WHO MEET BOTH OF THE FOLLOWING CONDITIONS: - ESTABLISHMENT IS GROUP 2 OTHER PUBLIC INSURANCE AND - PERSON IS COVERED BY GROUP 2 OTHER PUBLIC INSURANCE DURING THE CURRENT ROUND
CONTINUE WITH BOX_17 FOR SELECTED RU MEMBER. BOX_17
ASK THE TIME PERIOD COVERED DETAIL (HQ) SECTION FOR THIS PAIR. AT COMPLETION OF THE HQ SECTION, CONTINUE WITH END_LP06 END_LP06
CYCLE ON NEXT PAIR ON THE RU-ESTABLISHMENT-PERSON- PAIRS ROSTER THAT MEETS THE CONDITIONS STATED IN THE LOOP DEFINITION.
IF NO MORE PAIRS MEET THE STATED CONDITIONS, END LOOP_06 AND CONTINUE WITH BOX_18 BOX_18
RETURN TO THE HEALTH INSURANCE (HX) SECTION. |