MEPS-HC-Advance Letters & Screener Questionnaires

Other Medical Expenses (OM) Section
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BOX_01A
IF ROUND 3, CONTINUE WITH BOX_01B
OTHERWISE, GO TO BOX_01

BOX_01B
IF OM ITEM TYPE IS GLASSES/CONTACT LENSES, CONTINUE WITH OM01A
OTHERWISE, GO TO BOX_01

OM01A

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Variable Name
EVNT.NOGLSLYR

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Label
NUMBER OF TIMES GLASSES OBTAINED LAST YR

Size
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{PERSON'S FIRST MIDDLE AND LAST NAME} {STR-DT}
Of the times (PERSON) obtained glasses or contact lenses since (START
DATE), how many were during 2007?
NUMBER OF TIMES: _______

{OM01B}

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Refused
Don't Know

RF
DK

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{OM01B}
{OM01B}

Other Medical Expenses (OM) Section
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OM01B

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Variable Name
EVNT.NOGLSCYR

Comment Enabled

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Label
NUMBER OF TIMES GLASSES OBTAINED THIS YR

Size
2

{PERSON'S FIRST MIDDLE AND LAST NAME} {STR-DT}
Of the times (PERSON) obtained glasses or contact lenses since (START
DATE), how many were during 2008?
NUMBER OF TIMES: _______
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Refused
Don't Know

RF
DK

ROUTING INSTRUCTION:
IF THE CHARGE/PAYMENT (CP) SECTION HAS NOT BEEN ASKED FOR THE
EVENT BEING ASKED ABOUT, GO TO THE CP SECTION.
OTHERWISE, GO TO EVENT DRIVER (ED) SECTION.

BOX_01
IF THE OM ITEM TYPE IS INSULIN OR OTHER DIABETIC EQUIPMENT OR SUPPLIES, GO
TO OM02
OTHERWISE, CONTINUE WITH OM01

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Other Medical Expenses (OM) Section
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OM01

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{PERSON'S FIRST MIDDLE AND LAST NAME}
NOTE:
NO UTILIZATION SECTION IS REQUIRED FOR {GLASSES OR CONTACT
LENSES/AMBULANCE SERVICES/ORTHOPEDIC ITEMS/HEARING
DEVICES/PROSTHESES/BATHROOM AIDS/MEDICAL
EQUIPMENT/DISPOSABLE SUPPLIES/ALTERATIONS OR
MODIFICATIONS/{TEXT FROM OTHER SPECIFY}}.

PRESS ENTER OR SELECT NEXT PAGE TO CONTINUE.
DISPLAY INSTRUCTIONS:
DISPLAY ‘GLASSES OR CONTACT LENSES’ IF EVENT TYPE IS OM AND
ITEM TYPE IS CODED ‘1’ (GLASSES OR CONTACT LENSES.) DISPLAY
‘AMBULANCE SERVICES’ IF EVENT TYPE IS OM AND ITEM TYPE IS
CODED ‘4’ (AMBULANCE SERVICES). DISPLAY ‘ORTHOPEDIC ITEMS’ IF
EVENT TYPE IS OM AND ITEM TYPE IS CODED ‘5’ (ORTHOPEDIC
ITEMS). DISPLAY ‘HEARING DEVICES’ IF EVENT TYPE IS OM AND ITEM
TYPE IS CODED ‘6’ (HEARING DEVICES). DISPLAY ‘PROSTHESES’ IF
EVENT TYPE IS OM AND ITEM TYPE IS CODED ‘7’ (PROSTHESES).
DISPLAY ‘BATHROOM AIDS’ IF EVENT TYPE IS OM AND ITEM TYPE IS
CODED ‘8’ (BATHROOM AIDS). DISPLAY ‘MEDICAL EQUIPMENT’ IF
EVENT TYPE IS OM AND ITEM TYPE IS CODED ‘9’ (MEDICAL
EQUIPMENT). DISPLAY ‘DISPOSABLE SUPPLIES’ IF EVENT TYPE IS OM
AND ITEM TYPE IS CODED ‘10’ (DISPOSABLE SUPPLIES). DISPLAY
‘ALTERATIONS OR MODIFICATIONS’ IF EVENT TYPE IS OM AND ITEM
TYPE IS CODED ‘11’ (ALTERATIONS/MODIFICATIONS). FOR ‘TEXT FROM
OTHER SPECIFY’, DISPLAY THE TEXT ENTERED IN THE OTHER SPECIFY
FIELD FOR OM EVENTS WHEN OM ITEM TYPE IS CODED ‘91’ (OTHER).
ROUTING INSTRUCTION:
IF THE CHARGE PAYMENT (CP) SECTION HAS NOT BEEN ASKED FOR THE
EVENT BEING ASKED ABOUT, GO TO THE CHARGE PAYMENT (CP) SECTION.
OTHERWISE, GO TO THE EVENT DRIVER (ED) SECTION.

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Other Medical Expenses (OM) Section
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OM02

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{PERSON'S FIRST MIDDLE AND LAST NAME}
NOTE:
{INSULIN/OTHER DIABETIC EQUIPMENT OR SUPPLIES} WILL BE
PROCESSED LIKE A PRESCRIBED MEDICINE.
AT THIS TIME, NO UTILIZATION OR CHARGE/PAYMENT SECTION WILL
BE ASKED.
PRESCRIBED MEDICINE QUESTIONS AND CHARGE/PAYMENT DATA
WILL BE COLLECTED LATER.

PRESS ENTER OR SELECT NEXT PAGE TO CONTINUE.
DISPLAY INSTRUCTIONS:
DISPLAY ‘INSULIN’ IF OM ITEM TYPE BEING ASKED ABOUT IS
INSULIN.
DISPLAY ‘OTHER DIABETIC EQUIPMENT OR SUPPLIES’ IF OM TYPE
BEING ASKED ABOUT IS OTHER DIABETIC EQUIPMENT OR SUPPLIES.
PROGRAMMER NOTES:
FLAG THE OM CHARGE/PAYMENT (CP) SECTION AS ‘PROCESSED’.
INSULIN AND OTHER DIABETIC EQUIPMENT AND SUPPLIES WILL BE
PROCESSED THROUGH THE CHARGE PAYMENT (CP) SECTION AS
PRESCRIBED MEDICINES.
ROUTING INSTRUCTION:
Routing Instructions: Go to Box_02

BOX_02
GO TO THE EVENT DRIVER (ED) SECTION.

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