Provider Directory (PD) Section
----------------------------------------------------
| 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 |
| ADDRESS INFORMATION FOR PROVIDERS. THIS LOOP |
| CYCLES ON PROVIDERS THAT MEET THE FOLLOWING |
| CONDITIONS: |
| - CREATED THIS ROUND |
| OR |
| - CREATED IN ROUND 1 AND WAS ASSOCIATED WITH AN |
| IC EVENT (I.E., DID NOT COMPLETE LOOP_01) |
| 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’ |
-----------------------------------------------------
PD01A
=====
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
NO ..................................... 2
REF ................................... -7
DK .................................... -8
-----------------------------------------------------
| 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), ‘-7’ (REFUSED) OR ‘-8’ |
| (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 |
----------------------------------------------------
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_02 |
----------------------------------------------------
BOX_02
======
----------------------------------------------------
| GO TO BOX_03 |
----------------------------------------------------
PD01
====
OMITTED.
PD02
====
OMITTED.
BOX_03
======
----------------------------------------------------
| IF LOOPING ON PROVIDER ASSOCIATED ONLY WITH AN MV |
| EVENT AND RU IS NOT SELECTED FOR 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
====
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 TO CONTINUE.
PD04
====
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}.
[Enter State Code] ............
PRESS F1 FOR LIST OF STATE ABBREVIATIONS.
----------------------------------------------------
| ALLOW CODE “FC” (FOREIGN COUNTRY). |
----------------------------------------------------
----------------------------------------------------
| 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’. |
----------------------------------------------------
----------------------------------------------------
| 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 |
----------------------------------------------------
PD05
====
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 ......... 1 {BOX_05}
CHANGE NAME BEFORE SEARCH ................... 2
SEARCH ON CORE STREET NAME ............... 3 {PD10}
SEARCH ON TELEPHONE NUMBER .................. 4 {PD11}
CHANGE STATE FOR SEARCH ..................... 5
DO NOT SEARCH - GO DIRECTLY TO
PROVIDER INFORMATION FORM ................ 6 {PD18}
[Code One]
----------------------------------------------------
| 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’. |
----------------------------------------------------
----------------------------------------------------
| 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 |
----------------------------------------------------
----------------------------------------------------
| EDIT: CODES ‘1’ (SEARCH ON PROVIDER NAME SHOWN |
| ABOVE), ‘2’ (CHANGE NAME BEFORE SEARCH), ‘3’ |
| (SEARCH ON CORE STREET NAME), AND ‘4’ (SEARCH ON |
| TELEPHONE 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 ENTRY. IF STATE IS ‘FC’, CODES 1-4 ARE |
| UNAVAILABLE. VERIFY AND RE-ENTER.’ |
----------------------------------------------------
PD06
====
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.
[Enter State Code] .....................
PRESS F1 FOR LIST OF STATE ABBREVIATIONS.
----------------------------------------------------
| DISALLOW CODE “FC” (FOREIGN COUNTRY). |
----------------------------------------------------
----------------------------------------------------
| EDIT: IF CODE “FC” (FOREIGN COUNTRY) IS ENTERED, |
| DISPLAY THE FOLLOWING MESSAGE: ‘INVALID RESPONSE.|
| PLEASE RE-ENTER.’ |
----------------------------------------------------
----------------------------------------------------
| 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’. |
----------------------------------------------------
PD07
====
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 .... 1 {BOX_05}
CHANGE NAME BEFORE SEARCH .............. 2
SEARCH ON CORE STREET NAME ............. 3 {PD10}
SEARCH ON TELEPHONE NUMBER ............. 4 {PD11}
DO NOT SEARCH - GO DIRECTLY TO
PROVIDER INFORMATION FORM ............ 5 {PD18}
[Code One]
----------------------------------------------------
| 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’. |
----------------------------------------------------
----------------------------------------------------
| 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 |
----------------------------------------------------
PD08
====
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).
PRESS ENTER TO PASS THROUGH FIELDS WHERE NO CORRECTION IS
REQUIRED.
{Display FIRST NAME} {Display LAST NAME}
[Enter First Name] [Enter Last Name]
----------------------------------------------------
| 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’. |
----------------------------------------------------
----------------------------------------------------
| GO TO BOX_05 |
----------------------------------------------------
PD09
====
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}
[Enter Facility Name]
----------------------------------------------------
| 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’. |
----------------------------------------------------
----------------------------------------------------
| GO TO BOX_05 |
----------------------------------------------------
PD10
====
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)
[Enter Core Street Name] ...............
PRESS F1 FOR DEFINITION OF CORE STREET NAME.
----------------------------------------------------
| 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’. |
----------------------------------------------------
----------------------------------------------------
| GO TO BOX_05 |
----------------------------------------------------
PD11
====
PROVIDER NAME: {NAME OF MEDICAL CARE PROVIDER FROM PV}
STREET ADDRESS: {STREET ADDRESS FROM PV}
STATE: {STATE ABBREVIATION}
ENTER COMPLETE TELEPHONE NUMBER:
[Enter Area Code-3, Exchange-3,
Local Number-4] ......................
----------------------------------------------------
| 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’. |
----------------------------------------------------
----------------------------------------------------
| 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.’ |
----------------------------------------------------
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 |
----------------------------------------------------
PD12
====
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 TO CONTINUE.
----------------------------------------------------
| 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’. |
----------------------------------------------------
PD13
====
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.
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
| ROSTER. PROVIDER-MATCHES |
PD13_02. STREET ADDRESS |
| [Display Provider Name-40] |
[Display Street Address-20] |
| [Display Provider Name-40] |
[Display Street Address-20] |
| [Display Provider Name-40] |
[Display Street Address-20] |
{Display Provider Name}
{Display Provider Street Address}
{Display Provider City, State, Zip}
{Display Provider Telephone Number}
{Display Provider Specialty}
----------------------------------------------------
| 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). |
----------------------------------------------------
----------------------------------------------------
| IF NO PROVIDER SELECTED FROM ROSTER, GO TO PD17 |
----------------------------------------------------
----------------------------------------------------
| OTHERWISE, CONTINUE WITH PD14 |
----------------------------------------------------
PD14
====
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
ACCEPT PROVIDER BUT MAKE CHANGES ....... 2
WRONG PROVIDER, GO BACK TO PREVIOUS
SCREEN ............................... 3
----------------------------------------------------
| 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 (I.E., CHECKED) IN PD13 FOR |
| ‘DISPLAY PROVIDER...’. |
----------------------------------------------------
----------------------------------------------------
| IF CODED ‘1’ (ACCEPT PROVIDER AS SHOWN) OR ‘2’ |
| (ACCEPT PROVIDER BUT MAKE CHANGES), STORE THIS |
| PROVIDER DIRECTORY ID. |
----------------------------------------------------
----------------------------------------------------
| NOTE: 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 |
----------------------------------------------------
----------------------------------------------------
| IF CODED ‘1’ (ACCEPT PROVIDER AS SHOWN), |
| GO TO END_LP02 |
----------------------------------------------------
----------------------------------------------------
| IF CODED ‘2’ (ACCEPT PROVIDER BUT MAKE CHANGES), |
| CONTINUE WITH PD15 |
----------------------------------------------------
PD15
====
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.
PRESS ENTER TO PASS THROUGH FIELDS THAT REQUIRE NO CORRECTION.
{Display Prov Name from ProvDir}
NAME (PD15_01): [______________________________]
{Display Prov Street Address from ProvDir}
1ST_STR_ ADDRESS (PD15_02): [______________________________]
{Display Prov City from ProvDir}
CITY (PD15_03): [______________________________]
{Display Prov State from ProvDir}
STATE (PD15_04): [______________________________]
{Display Prov Zip Code from ProvDir}
ZIP CODE (PD15_05): [______________________________]
{Display Prov Telephone from ProvDir}
TELEPHONE (PD15_06): [______________________________]
----------------------------------------------------
| 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 (I.E., CHECKED) IN|
| PD13 FOR ‘DISPLAY PROV...’ EACH PIECE OF THE |
| INFORMATION SHOULD BE DISPLAYED ABOVE THE |
| APPROPRIATE LINE. |
----------------------------------------------------
----------------------------------------------------
| ENTRY FIELD SPECIFICATIONS: |
| |
| IF PERSON-TYPE-PROVIDER, DISPLAY FIRST NAME AND |
| LAST NAME FIELDS. |
| |
| IF FACILITY-PROVIDER, DISPLAY FACILITY NAME |
| FIELD. |
----------------------------------------------------
----------------------------------------------------
| FLAG THIS RECORD AS ‘UPDATED. NEEDS HOME OFFICE |
| REVIEW.’ . |
----------------------------------------------------
PD16
====
PROVIDER NAME: {NAME OF MEDICAL CARE PROVIDER}
STREET ADDRESS: {STREET ADDRESS}
DO YOU WANT TO MAKE ANY NOTES ABOUT THIS PROVIDER?
YES .................................... 1
NO ..................................... 2 {END_LP02}
----------------------------------------------------
| 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’. |
----------------------------------------------------
PD16OV
======
[ENTER TEXT].........................{END_LP02}
----------------------------------------------------
| ALLOW MULTIPLE LINES FOR ENTRY. |
----------------------------------------------------
PD17
====
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
[Code One]
----------------------------------------------------
| 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 ‘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). |
----------------------------------------------------
PD18
====
TO VERIFY INFO, PRESS ENTER. TO CORRECT OR ADD INFO, RE-TYPE
ENTIRE FIELD.
{Provider Name from PV}
{NAME (PD18_01): [______________________________]}
{1ST_STR_Provider Address from PV}
1ST_STR_ADDRESS (PD18_02): [______________________________]
{2ND_STR_Provider Address from PV}
2ND_STR_ADDRESS (PD18_03): [______________________________]
CITY (PD18_04): [______________________________]
STATE (PD18_05): [______________________________]
ZIP CODE (PD18_06): [______________________________]
TELEPHONE (PD18_07): [______________________________]
{SPECIALTY (PD18_08): [______________________________]}
PRESS F1 FOR LIST OF STATE ABBREVIATIONS.
----------------------------------------------------
| IF STREET ADDRESS LINES ARE CODED REFUSED OR DON’T|
| KNOW (-7 OR -8) 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 PD18_08, |
| ‘SPECIALTY’ FIELD, FOR COLLECTION. |
| |
| IF FACILITY-PROVIDER, DISPLAY ‘FACILITY NAME’ |
| FIELD. DO NOT DISPLAY ‘SPECIALTY’ FIELD. |
----------------------------------------------------
----------------------------------------------------
| 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. |
----------------------------------------------------
PD19
====
PROVIDER NAME: {NAME OF MEDICAL CARE PROVIDER}
STREET ADDRESS: {STREET ADDRESS}
DO YOU WANT TO MAKE ANY NOTES ABOUT THIS PROVIDER?
YES .................................... 1
NO ..................................... 2 {END_LP02}
----------------------------------------------------
| 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’. |
----------------------------------------------------
PD19OV
======
[ENTER TEXT]....................
----------------------------------------------------
| 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. |
----------------------------------------------------
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