5.11.1: Service Agreement Informaton Glossary

FIELD NAME DESCRIPTION
FY Mandatory - Fiscal year of the service agreement
Indiv ID Mandatory - Social Security Number of the individual receiving service
Display - Individual's Name
Month Optional - For inquiry only:  enter specific month to be viewed
CK Mandatory - Action indicator for the line
User entry: 
A - Add
C - Change
 D - Delete
X - Bypass
* - Propagate
Serv Prov ID Mandatory - Taxpayer ID Number/Taxpayer ID suffix (if assigned)
Pgm Mandatory - Program Code/Program Suffix
I/G Mandatory - Service mode for program to indicate whether the service was billed at the individual or group rate
I - Individual
G - Group
Effective Date Mandatory - Date on which the service agreement becomes active.
Termination Date Optional - Date on which the service agreement becomes inactive.
Rate Mandatory - Program Rate
Maximum Monthly Units Mandatory - Total maximum monthly service units
Maximum Monthly Amount Display - Total maximum monthly amount that can be billed to DHS
xxx Total Amount Display - Total amount of the service agreements for the month (xxx = current system month or inquiry month depending upon ACTION).
xxx Amount Billed To Date Display - Total charge amount of the bills current in the system for the month (this includes the DPA DT amount).