FIELD ENTRY INFORMATION TYPE Use this field for Coordination - or “Benefits Credential” Coordination Non-Credential. If the Bilingual “Benefits – Supplement has been approved and authorized for the case SERVICE DESCRIPTION DROP select the Benefits Coordination - “Bilingual Credential” (UOS SERVICES) DOWN or Benefits Coordination Non-Credential.” “Bilingual – option. This field will load the associated rates, individual and/or group, as applicable. Field is calculated based on information entered into the SERVICE AREA MODIFIER report form. Providers may not edit this field. Field is calculated based on information entered in the INVOICE TOTAL report form. Providers may not edit this field. SPECIFIC BENEFITS Individual has recently started work and needs assistance in CONCERN(S) THAT VR STAFF reporting their income to Social Security. VR Staff wants Planner OR VR CONTRACTOR WANTS to work with the Individual to teach them how to report income THE PROVIDER TO WORK WITH and then also coach them while the Individual does it themselves THE INDIVIDUAL TO RESOLVE. to make sure they know the process. FIELD ENTRY INFORMATION TYPE SPECIFIC BENEFITS Enter what you specially want the Provider to accomplish as part of the service. Consult the VR Fee Schedule to CONCERN(S) THAT VR determine specifically what types of activities are allowed STAFF OR VR as part of the service. CONTRACTOR WANTS TEXT THE PROVIDER TO WORK WITH THE INDIVIDUAL TO RESOLVE. CONTACTS & SUMMARY OF START END SAM SUMMARY OF STEPS TAKEN STAFF DATE UNITS TIME TIME Level ISSUE(S)/CONCERN(S) TO RESOLVE INITIALS ISSUE(S)/CONCERN(S) 0 0 FIELD ENTRY INFORMATION TYPE Enter the date that the service took place. DATE FIELD DATE MM/DD/YY (REQUIRED FIELD) Enter the time that the actual service started, not the TIME FIELD scheduled start time. START TIME AM/PM (REQUIRED FIELD) Enter the time that the actual service ended, not the TIME FIELD END TIME scheduled end time. AM/PM (REQUIRED FIELD)
FIELD ENTRY TYPE INFORMATION SERVICE DESCRIPTION (UOS SERVICES) DROP DOWN Use this field for “Benefits Coordination - Credential” or “Benefits Coordination – Non-Credential. If the Bilingual Supplement has been approved and authorized for the case select the “Bilingual Benefits Coordination - Credential” or “Bilingual Benefits Coordination – Non-Credential.” option. This field will load the associated rates, individual and/or group, as applicable. SERVICE AREA MODIFIER Field is calculated based on information entered into the report form. Providers may not edit this field. INVOICE TOTAL Field is calculated based on information entered in the report form. Providers may not edit this field. SPECIFIC BENEFITS CONCERN(S) THAT VR STAFF OR VR CONTRACTOR WANTS THE PROVIDER TO WORK WITH THE INDIVIDUAL TO RESOLVE. Individual has recently started work and needs assistance in reporting their income to Social Security. VR Staff wants Planner to work with the Individual to teach them how to report income and then also coach them while the Individual does it themselves to make sure they know the process. FIELD ENTRY TYPE INFORMATION SPECIFIC BENEFITS CONCERN(S) THAT VR STAFF OR VR CONTRACTOR WANTS THE PROVIDER TO WORK WITH THE INDIVIDUAL TO RESOLVE. TEXT Enter what you specially want the Provider to accomplish as part of the service. Consult the VR Fee Schedule to determine specifically what types of activities are allowed as part of the service. DATE START TIME END TIME UNITS SAM Level SUMMARY OF ISSUE(S)/CONCERN(S) CONTACTS & SUMMARY OF STEPS TAKEN TO RESOLVE ISSUE(S)/CONCERN(S) STAFF INITIALS 0 0 FIELD ENTRY TYPE INFORMATION DATE DATE FIELD MM/DD/YY Enter the date that the service took place. (REQUIRED FIELD) START TIME TIME FIELD AM/PM Enter the time that the actual service started, not the scheduled start time. (REQUIRED FIELD) END TIME TIME FIELD AM/PM Enter the time that the actual service ended, not the scheduled end time. (REQUIRED FIELD)
VR%20Provider%20Manual%20-%20Effective%20010118.docx