Jason Jordan
496 lines
21 KiB
XML
496 lines
21 KiB
XML
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<text><![CDATA[Eligibility]]></text>
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<text><![CDATA[Utilization / Pre-Cert]]></text>
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<text><![CDATA[To confirm eligibility, verify benefits, or check claim:
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]]></text>
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<text><![CDATA[Britton Benefit Services, LLC]]></text>
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<text><![CDATA[Call:
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1.800.676.1182 (8am – 5pm)
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Online:
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www.bbstpa.com (24/7)
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This card does not guarantee
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eligibility or payment
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<font size="5" isBold="true"/>
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<text><![CDATA[RX PCN:]]></text>
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<text><![CDATA[021841]]></text>
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<textFieldExpression><![CDATA[$F{rx_group}]]></textFieldExpression>
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<text><![CDATA[Customer Service:]]></text>
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<textElement textAlignment="Center">
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<font fontName="SansSerif" size="6" isBold="true"/>
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</textElement>
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<text><![CDATA[Precertification]]></text>
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<printWhenExpression><![CDATA[!$F{network_provider}.equals("MedCost")]]></printWhenExpression>
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<textElement textAlignment="Center">
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<font fontName="SansSerif" size="6" isBold="true"/>
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<textFieldExpression><![CDATA["Call Britton Benefit Services, LLC"]]></textFieldExpression>
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<font fontName="SansSerif" size="6" isBold="true"/>
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||
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<property name="com.jaspersoft.studio.unit.y" value="px"/>
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<printWhenExpression><![CDATA[$F{network_provider}.equals("Cigna")]]></printWhenExpression>
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<imageExpression><![CDATA["./../../images/LOGO - AFHC.jpg"]]></imageExpression>
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<property name="com.jaspersoft.studio.unit.y" value="px"/>
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<property name="com.jaspersoft.studio.unit.width" value="px"/>
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||
<printWhenExpression><![CDATA[$F{network_provider}.equals("Cigna")]]></printWhenExpression>
|
||
</reportElement>
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||
<textElement>
|
||
<font size="5.5" isBold="true"/>
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||
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|
||
<text><![CDATA[Benefits are not insured by Cigna Healthcare or affiliates]]></text>
|
||
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||
<printWhenExpression><![CDATA[!$F{network_provider}.equals("MedCost")]]></printWhenExpression>
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||
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<textElement textAlignment="Center">
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||
<font fontName="SansSerif" size="6" isBold="true"/>
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||
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<textFieldExpression><![CDATA["1.800.676.1182 (8am-5pm)"]]></textFieldExpression>
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||
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<textField>
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||
<printWhenExpression><![CDATA[$F{network_provider}.equals("MedCost")]]></printWhenExpression>
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||
</reportElement>
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<textElement textAlignment="Center">
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||
<font fontName="SansSerif" size="6" isBold="true"/>
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||
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||
<textFieldExpression><![CDATA["1.800.722.2157"]]></textFieldExpression>
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||
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||
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<textFieldExpression><![CDATA[$F{claim_to_12}]]></textFieldExpression>
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<textFieldExpression><![CDATA[$F{provider_line_12}]]></textFieldExpression>
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||
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||
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|
||
<band splitType="Stretch"/>
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||
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||
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|
||
<band splitType="Stretch"/>
|
||
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|
||
<summary>
|
||
<band splitType="Stretch"/>
|
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||
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