PA/DVS Response Details
PA/DVS Response DetailsThe PA/DVS Response Details page contains the information that was received from NY Medicaid. The information transmitted in the Request will be returned and displayed along with a textual response message from NY Medicaid.
The information presented is divided into sections. Any or all of these sections may be blank depending upon the level of information supplied by NY Medicaid.
Client Information - Includes the client ID, patient account #, name, gender and date of birth to assist in ensuring confirmation was requested for the proper individual.
Transaction Type: Displays the Transaction Type that was selected for the PA or DVS Initial request.
Response - NY Medicaid's response to the request for PA/DVS. Responses indicating approval will be displayed in Black; while denial and error responses will be displayed in Red.
Action Code: This is explains the actions taken by the reviewer.
Issue Date: This will display the date the PA/DVS is issued.
Reviewer ID Number: The PA/DVS number assigned will display here.
Effective Date: This is the date the PA/DVS is effective.
Expiration Date: This is the date the PA/DVS is expired.
Prescribing Provider: If a prescribing provider was entered on the request, it will be displayed here.
If an ordering provider was entered on the request, it will be displayed here.
If fields were entered under Event Information in the request, they will display here on the response.
Facility Type: This will display the code identifying the type of facility where services were performed. Either Professional/Dental or (UB) Institutional.
Service Type: This will display the service type selected on the request.
Release of Information: This will display the option chosen for release of information.
Accident Date: If an accident date was given in the request, it will display here.
Service Date From/To: The service date(s) entered on the request will display here.
Onset Date: If an onset date was given on the request, it will display here.
Admission Date: If an admission date was given on the request, it will display here.
Discharge Date: If a discharge date was given on the request, it will display here.
Related Causes Information
If fields were entered under Related Causes Information in the request, they will display here on the response.
Related Causes: If any related causes was entered on the request, it will display here.
Accident Location: If an accident location was given in the request, it will display here.
Diagnosis
ICD-9/ICD-10 (not labeled): The applicable diagnosis code type—ICD-9 or ICD-10—displays above the Primary and Secondary diagnosis codes.
Primary: The primary diagnosis given on the request will display here.
Secondary: If a secondary diagnosis was given on the request, it will display here.
If fields were entered under Pattern of Delivery in the request, they will display here on the response.
Unit Count: The number of units entered on the request.
Frequency: The frequency entered on the request.
Duration: The duration entered on the request.
Calendar Pattern: The calendar pattern entered on the request.
Unit Qualifier: The unit qualifier pattern entered on the request.
Freq. Type: The frequency type entered on the request.
Duration Type: The duration type entered on the request.
Time Pattern: The time pattern entered on the request.
If fields were entered under Home Oxygen Therapy in the request, they will display here on the response.
Oxygen Equipment type: The equipment type on the request.
Equipment Reason: The equipment reason on the request.
Oxygen Delivery System: The oxygen delivery system on the request.
Oxygen Flow Rate: The oxygen flow rate on the request.
Portable Oxygen System Flow Rate: The portable oxygen flow rate on the request.
Test Type Results: The test type results on the request.
Test Condition: The test condition on the request.
Test Findings: The test findings on the request.
Daily Oxygen Use count: The daily oxygen count on the request.
Oxygen Use Period Hour Count: The oxygen use period count on the request.
Respiratory Therapist Order: The respiratory therapist order on the request.
If fields were entered under Home Health Care in the request, they will display here on the response.
Prognosis: The prognosis entered on the request.
Physician Order Date: The physician order date entered on the request.
Start Date: The start date entered on the request.
Last Visit Date: The last visit date entered on the request.
Physician Contact Date: The physician contact date entered on the request.
Certification Period From/To: The certification period entered on the request.
Admission Period From/To: The admission period entered on the request.
Discharge Facility Type: The discharge facility type entered on the request.
Related Surgery Date: The related surgery date entered on the request.
Related Surgical Procedure: The related surgical procedure entered on the request.
Comments: Any additional comments that were entered on the request.
Once you have reviewed the information displayed on the page, you have two options. You may click the Close button which will set the status of the response to "Viewed" or you may click Worked to mark the response as such, indicating that follow-up has been completed. Both buttons will close the details page and return you to the DVS Activity Worklist.
