Forms must be keyed in all CAPITAL
LETTERS.
“Key what you see” means to literally key what you see. You are trying to replicate the form as it was submitted; you cannot fix errors.
H26_Patient_Account_No
H26_Patient_Account_No
|
Key what you see.
|
H27_Accept
Assignment
H27_Accept Assignment
|
Only allowed values:
Y N |
Y=Yes N=No
|
H28_Total_Charge
|
Punctuation and spaces are
optional. Do not include dollar signs ($). All charge figures must be at
least three digits.
If part of a multipage form and
CONTINUED appears in the total field, do not key the word CONTINUED. Instead,
leave the field blank.
|
As it appears on form:
|
Acceptable entries:
|
||
$107.60
|
107.60
|
107 60
|
10760
|
0
|
0.00
|
0 00
|
000
|
1,795.65
|
1,795.65
|
1795 65
|
179565
|
68--
|
68.00
|
68 00
|
6800
|
68 -
|
68.00
|
68 00
|
6800
|
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