# | Name | Location | Type | Details | Index | Description |
---|---|---|---|---|---|---|
.01 | enrollment application date(+) | 0;1 | DATE-TIME | B | The date the enrollment application/registration was completed, i.e., the the signature date. Enrollment Application Date: Must be a date prior or equal to the veterans 'Date of Death' Must be a precise date, i.e. a day, month and year MUST be included Cannot be a date prior to the veterans 'Date of Birth' Cannot be a date in the future Cannot be a date prior to 10/1/1996 | |
.02 | patient(+) | 0;2 | POINTER | 2 | C | The patient associated with the enrollment. |
.03 | source of enrollment(+) | 0;3 | SET OF CODES | 1:VAMC 2:HEC 3:OTHER VAMC | How the enrollment was determined. | |
.04 | enrollment status(+) | 0;4 | POINTER | 27.15 | The status of an application for enrollment. | |
.05 | reason canceled/declined | 0;5 | SET OF CODES | 1:DISSATISFIED WITH CARE 2:GEOGRAPHIC ACCESS 3:OTHER INSURANCE 4:OTHER | When a patient self dis-enrolls or requests that his enrollment be ceased, s/he is asked to give a reason. | |
.06 | facility received | 0;6 | POINTER | 4 | This field should be used to document the VAMC that receives the application for enrollment. | |
.07 | enrollment priority | 0;7 | SET OF CODES | 1:GROUP 1 2:GROUP 2 3:GROUP 3 4:GROUP 4 5:GROUP 5 6:GROUP 6 7:GROUP 7 8:GROUP 8 | This field will contain the enrollment priority group determined for this enrollment. | |
.08 | effective date(+) | 0;8 | DATE-TIME | For any change that may affect a patient's enrollment, this field documents the effective date of the change. | ||
.09 | prior enrollment record | 0;9 | POINTER | 27.11 | This field is used to maintain the enrollment history for the patient. The enrollment history will be kept in the form of a linked list of enrollment records, with each record pointing to the enrollment record that came before it. | |
.1 | enrollment date | 0;10 | DATE-TIME | Beginning of the enrollment cycle. | ||
.11 | enrollment end date | 0;11 | DATE-TIME | The date specifying the end of the veteran's enrollment period. | ||
.12 | enrollment subgroup | 0;12 | SET OF CODES | 1:a 2:b 3:c 4:d 5:e 7:g | This field will contain the enrollment priority subgroup determined for this enrollment. | |
25 | canceled/declined remarks | R;1 | FREE TEXT | This field is used to enter an explanation for why the veteran is canceling or declining enrollment if the only code that fits is OTHER. | ||
50.01 | eligibility code | E;1 | POINTER | 8.1 | The eligibility code associated with the enrollment priority determination. | |
50.02 | service connected | E;2 | BOOLEAN | Y:YES N:NO | The service connection indicator associated with the enrollment priority determination. | |
50.03 | service connected percentage | E;3 | NUMERIC | The service connected percentage associated with the enrollment priority determination. | ||
50.04 | pow status indicated | E;4 | SET OF CODES | Y:YES N:NO U:UNKNOWN | The POW status associated with the enrollment priority determination. | |
50.05 | receiving a&a benefits | E;5 | SET OF CODES | Y:YES N:NO U:UNKNOWN | The RECEIVING A&A BENEFITS status associated with the enrollment priority determination. | |
50.06 | receiving housebound benefits | E;6 | SET OF CODES | Y:YES N:NO U:UNKNOWN | The RECEIVING HOUSEBOUND BENEFITS status that the enrollment priority determination is based on. | |
50.07 | receiving a va pension | E;7 | SET OF CODES | Y:YES N:NO U:UNKNOWN | The RECEIVING A VA PENSION status that the enrollment priority determination is based on. | |
50.08 | total annual va check amount | E;8 | NUMERIC | The TOTAL ANNUAL VA CHECK AMOUNT associated with the enrollment determination. | ||
50.09 | disability ret. from military | E;9 | SET OF CODES | 0:NO 1:YES, RECEIVING MILITARY RETIREMENT 2:YES, RECEIVING MILITARY RETIREMENT IN LIEU OF VA COMPENSATION 3:UNKNOWN | The status of DISABILITY RET. FROM MILITARY that is associated with the enrollment priority determination. | |
50.1 | medicaid | E;10 | BOOLEAN | 0:NO 1:YES | The Medicaid eligibility associated with the enrollment priority determination. | |
50.11 | exposed to agent orange | E;11 | SET OF CODES | Y:YES N:NO U:UNKNOWN | The EXPOSED TO AGENT ORANGE status associated with the enrollment priority determination. | |
50.12 | radiation exposure indicated | E;12 | SET OF CODES | Y:YES N:NO U:UNKNOWN | Enter 'Y' if the veteran was exposed to ionizing radiation 1) at a nuclear device testing site (e.g. the Pacific Islands, NM or NV) or 2) as a POW or while serving in Hiroshima and/or Nagasaki, Japan from August 6, 1945 through July 1, 1946, or 3) served at Department of Energy plants at Paducah, KY, Portsmouth, OH or the K25 area at Oak Ridge, TN for at least 250 days before February 1, 1992 or 4) served at Longshot, Milrow, or Cannikin underground nuclear tests at Amchitka Island, AK prior to January 1, 1974. Veterans exposed by method #3 or #4 are not eligible for copay exemption or enrollment in priority 6 based on their IR exposure. Enter 'N' if not exposed or 'U' if unknown. Once the record has been verified only HEC users may enter/edit this field. The RADIATION EXPOSURE INDICATED status associated with the enrollment priority determination. | |
50.13 | southwest asia conditions | E;13 | SET OF CODES | Y:YES N:NO U:UNKNOWN | The SOUTHWEST ASIA CONDITIONS status associated with the enrollment priority determination. | |
50.14 | means test status | E;14 | POINTER | 408.32 | The MEANS TEST STATUS associated with the enrollment priority determination. | |
50.15 | veteran catastrophically disabled | E;15 | BOOLEAN | Y:YES N:NO | This field was created to capture the Veteran's CATASTROPHIC DISABILITY status associated with the enrollment priority determination. | |
50.16 | purple heart indicated? | E;16 | BOOLEAN | Y:YES N:NO | This field corresponds to the CURRENT PH INDICATOR field .531 in the PATIENT file 2. It can be set by setting Purple Heart Indicated in the Registration screens, or by the Z11 Upload from HEC. Acceptable values are Y and N. | |
50.17 | unemployable | E;17 | BOOLEAN | Y:YES N:NO | Is this patient unemployable due to an SC condition as rated by VARO? | |
50.18 | combat veteran end date | E;18 | DATE-TIME | For veterans who have combat vet eligibility, this field represents the date when that eligibility ends. | ||
50.19 | proj 112/shad | E;19 | BOOLEAN | 1:YES 0:NO | ||
50.2 | discharged due to disability | E;20 | BOOLEAN | 1:YES 0:NO | Indicates whether or not discharge was due to a disability incurred in the Line of Duty. | |
50.22 | agent orange exposure location | E;22 | SET OF CODES | K:KOREAN DMZ V:VIETNAM O:OTHER | For this veteran applicant who was exposed to agent orange (EXPOSED TO AGENT ORANGE prompt must be answered YES) enter the location where the exposure occurred. | |
50.23 | medal of honor indicated? | E;23 | BOOLEAN | Y:YES N:NO | This field corresponds to the CURRENT MOH INDICATOR (#.541) field in the PATIENT (#2) file. It is set by the Medal of Honor Indicated in the Registration screens, or by the Z11 Upload from HEC. | |
75.01 | date/time entered(+) | U;1 | DATE-TIME | This field is used as part of the audit trail for the enrollment process. | ||
75.02 | entered by | U;2 | POINTER | 200 | For local enrollments, this field will point to the user who is enrolling the veteran. | |
76 | radiation exposure method | E;21 | SET OF CODES | 2:HIROSHIMA/NAGASAKI 3:ATMOSPHERIC NUCLEAR TESTING 4:H/N AND ATMOSPHERIC NUCLEAR TESTING 5:UNDERGROUND NUCLEAR TESTING 6:EXPOSURE AT NUCLEAR FACILITY 7:OTHER | The RADIATION EXPOSURE METHOD associated with the enrollment priority determination. |