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Global: ^DGCR(399.3

Package: Integrated Billing

Global: ^DGCR(399.3

Information

FileMan FileNo	FileMan Filename	Package
399.3	RATE TYPE	Integrated Billing

Description

This file contains all of the Rate Types which may be used in MCCR Billing. Per VHA Directive 10-93-142, this file definition should not be modified.

Directly Accessed By Routines, Total: 115

Package	Total	Routines
Integrated Billing	110	IB CLK PROD IB20P154 IB20P460 IB20P501 IB20P503 IB20P541 IB20P569 IB20P578 IB20P610 IB20P632 IB20P684 IB20P691 IB20P750 IB20P754 IB20P774 IB20P781 IB3PSOU IB488PRE IBCA1 IBCB IBCBB IBCBB1 IBCBB11 IBCD5 IBCEF21 IBCEF4 IBCEST IBCF IBCF10 IBCF32 IBCONS1 IBCOPV IBNCPDPU IBORT1 IBOSTUS1 IBPUDEL ^IBE(399.6 IBCNSBL2 IBCRLS IBCU IBCU64 IBJD IBJDB21 IBNCPDP6 IBOMBL IBOMTP1 IBRSUTL IBTUBOA IBY137PO IBY623PO IBYPSA1 ^DGCR(399 IBYBPRE INPUT VARIABLE ^DGCR(399.3 IB20P383 IB20P424 IB20P510 IB20P538 IB20P554 IB20P558 IB20P618 IB20P645 IB20P666 IB20P722 IB20P725 IB20PT7 IBACUS2 IBCA IBCBB7 IBCD2 IBCEF2 IBCEMSR6 IBCEMSRI IBCEU3 IBCF11 IBCF12 IBCF31 IBCF34 IBCNQ IBCNQ1 IBCNSMR IBCRBE IBCRLT IBCRTN IBCSC3 IBCU1 IBCU3 IBCU41 IBCU61 IBEFUNC IBFBWL3 IBJTCA1 IBJTLA1 IBJTLB1 IBNCPDP1 IBOA31 IBOAMS IBOBL IBOCPDS IBOLK1 IBORT IBTOECT IBXS3 IBXSC3 IBXX19 IBY473PO IBY547PR IBY568PO IBYPPC1
Accounts Receivable	5	PRCABJ2 PRCAUDT1 RCDPEARL RCXVDC3 RCXVUTIL

Accessed By FileMan Db Calls, Total: 22

Package	Total	Routines
Integrated Billing	18	IB20P154 IB20P554 IB20P618 IB20PT7 IB488PRE IBCA IBCEMSRI IBCMENU IBCREE IBCROR IBJPS7 IBOAMS IBOTR IBTUBO IBY137PO IBY547PR IBY568PO IBYBPT
Accounts Receivable	2	PRCAUDT1 RCDPENR2
E Claims Management Engine	2	BPSPRRX2 BPSPRRX3

Pointed To By FileMan Files, Total: 8

Package	Total	FileMan Files
Integrated Billing	5	BILL/CLAIMS(#399)[.07] IB NCPDP EVENT LOG(#366.14)[#366.141(7.04)] IB NCPDP PRESCRIPTION(#366.15)[.03] IB SITE PARAMETERS(#350.9)[#350.928(.01)] RATE SCHEDULE(#363)[.02]
E Claims Management Engine	3	BPS REQUESTS(#9002313.77)[1.08] BPS TRANSACTION(#9002313.59)[#9002313.59902(902.29)] BPS LOG OF TRANSACTIONS(#9002313.57)[#9002313.57902(902.29)]

Pointer To FileMan Files, Total: 2

Package	Total	FileMan Files
Accounts Receivable	2	ACCOUNTS RECEIVABLE CATEGORY(#430.2)[.06] AR DEBT LIST(#430.6)[.11]

Fields, Total: 12

Field #	Name	Loc	Type	Details
.001	NUMBER		NUMBER	INPUT TRANSFORM: `K:+X'=X!(X>999)!(X<1)!(X?.E1"."1N.N) X` HELP-PROMPT: `Enter the internal file number of this entry.` DESCRIPTION: `This is the internal file number of this entry.`
.01	NAME	0;1	FREE TEXT	**********************REQUIRED FIELD********************** INPUT TRANSFORM: `K:$L(X)>30!($L(X)<1)!'(X'?1P.E) X` HELP-PROMPT: `Enter the 1-30 character name/description of this rate type.` DESCRIPTION: `This is the name/description of this rate type.` DELETE TEST: `.01,0)= I 1 W !,"Deletion of Rate Types not allowed. Use the Inactive field."` CROSS-REFERENCE: `399.3^B` `1)= S ^DGCR(399.3,"B",$E(X,1,30),DA)=""` `2)= K ^DGCR(399.3,"B",$E(X,1,30),DA)`
.02	BILL NAME	0;2	FREE TEXT	**********************REQUIRED FIELD********************** INPUT TRANSFORM: `K:$L(X)>30!($L(X)<1)!'(X'?1P.E) X` HELP-PROMPT: `Enter the 1-30 character text which you want to appear on the UB form each time a bill of this rate type is printed.` DESCRIPTION: `This is the text which will appear on the UB claim form each time a bill of this rate type is printed.`
.03	INACTIVE	0;3	SET	'0' FOR NO; '1' FOR YES; LAST EDITED: `APR 05, 1989` HELP-PROMPT: `Enter the code which indicates whether or not you would like to inactivate this rate type.` DESCRIPTION: `This indicates whether or not this code has been inactivated.`
.04	ABBREVIATION	0;4	FREE TEXT	**********************REQUIRED FIELD********************** INPUT TRANSFORM: `K:$L(X)>8!($L(X)<2)!'(X?1A.ANP) X` HELP-PROMPT: `Enter the 2-8 character abbreviation of the name of this rate type which will appear on all of the billing outputs.` DESCRIPTION: `This defines the abbreviation of the name of this rate type which will appear on all of the billing outputs.`
.05	IS THIS A THIRD PARTY BILL?	0;5	SET	**********************REQUIRED FIELD********************** '0' FOR NO; '1' FOR YES; HELP-PROMPT: `Enter '1' or 'Yes' if this is a third party bill or '0' or 'No' if a bill of this rate type is not a third party bill.` DESCRIPTION: `This allows the user to determine whether or not a bill of this rate type is a third party bill.`
.06	ACCOUNTS RECEIVABLE CATEGORY	0;6	POINTER TO ACCOUNTS RECEIVABLE CATEGORY FILE (#430.2)	**********************REQUIRED FIELD********************** ACCOUNTS RECEIVABLE CATEGORY(#430.2) INPUT TRANSFORM: `S DIC("S")="I $P(^(0),U,7)>9" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X` LAST EDITED: `DEC 17, 1993` HELP-PROMPT: `Select the 'Accounts Receivable Category' which corresponds to this rate type.` DESCRIPTION: `This points to the corresponding Accounts Receivable category.` SCREEN: `S DIC("S")="I $P(^(0),U,7)>9"` EXPLANATION: `Only Accounts Receivable categories may be selected` CROSS-REFERENCE: `^^TRIGGER^399.3^.07` `1)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(1)=$S($D(^DGCR(399.3,D0,0)):^(0),1:"") S X=$P(Y(1),U,7),X=X S DIU=X K Y S X=DIV D ARCAT^IBCU X ^DD(399.3,.06,1,1,1.4)` `1.4)= S DIH=$S($D(^DGCR(399.3,DIV(0),0)):^(0),1:""),DIV=X S $P(^(0),U,7)=DIV,DIH=399.3,DIG=.07 D ^DICR:$O(^DD(DIH,DIG,1,0))>0` `2)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(1)=$S($D(^DGCR(399.3,D0,0)):^(0),1:"") S X=$P(Y(1),U,7),X=X S DIU=X K Y S X="" X ^DD(399.3,.06,1,1,2.4)` `2.4)= S DIH=$S($D(^DGCR(399.3,DIV(0),0)):^(0),1:""),DIV=X S $P(^(0),U,7)=DIV,DIH=399.3,DIG=.07 D ^DICR:$O(^DD(DIH,DIG,1,0))>0` `CREATE VALUE)= D ARCAT^IBCU` `DELETE VALUE)= S X=""` `FIELD)= #.07` `This triggers the correct value for WHO's RESPONSIBLE for any AR Category that is entered.`
.07	WHO'S RESPONSIBLE	0;7	SET	'p' FOR PATIENT; 'i' FOR INSURER; 'o' FOR OTHER (INSTITUTION); LAST EDITED: `FEB 14, 1990` HELP-PROMPT: `Enter the Expected debtor for this rate type.` DESCRIPTION: `This field is triggered when an Accounts Receivable Category is entered. It is used to provide consistency between packages so the the debtor for the bill is from the correct file. Debtors can be from the Patient file,` `the Insurance Company file, or the Institution file.` `UNEDITABLE` NOTES: `TRIGGERED by the ACCOUNTS RECEIVABLE CATEGORY field of the RATE TYPE File`
.08	REIMBURSABLE INSURANCE?	0;8	SET	'1' FOR YES; '0' FOR NO; LAST EDITED: `APR 06, 1992` HELP-PROMPT: `Answer '1' or 'YES' if you want the Medicare statement to print on all UB bills of this Rate Type.` DESCRIPTION: `This field should be answered 'YES' if this is a Reimbursable Insurance rate type, all other rate types should be answered 'NO'. This field will be used to determine if a bill is reimbursable Insurance.` `Primarily, this field will be used by the bill print option to determine if the 7 line statement that begins "For your information..." should be printed on the UB claim form. (Only applies to the UB form types.)`
.09	NSC STATEMENT ON UB BILLS	0;9	SET	'1' FOR YES; '0' FOR NO; LAST EDITED: `JAN 20, 1994` HELP-PROMPT: `Enter '1' or 'YES' if you want the statement "The undersigned certifies that treatment rendered is not for a service connected disablility." to print on UB bills of this rate type.` DESCRIPTION: `The statement "The undersigned certifies that treatment rendered is not for a service connected disablity." will be printed on UB claim forms of this Rate Type if this field is answered 'YES'.` `This field should be answered 'YES' for all rate types where the bill can only be for NSC care.`
.1	ELECTRONIC TRANSMIT	0;10	SET	'0' FOR NOT ALLOWED; '1' FOR ALLOWED; LAST EDITED: `MAR 02, 1999` HELP-PROMPT: `Enter the type of electronic transmission (or none) for bills of this rate type.` DESCRIPTION: `The type of transmission allowed, if any, for bills of this rate type.`
.11	BILL RESULTING FROM	0;11	POINTER TO AR DEBT LIST FILE (#430.6)	AR DEBT LIST(#430.6) INPUT TRANSFORM: `S DIC("S")="N Z0 S Z0=$P($G(^DGCR(399.3,DA,0)),U,6) Q:+Z0'>0 S Z0=$P(^PRCA(430.2,Z0,0),U,6) I ($P(^PRCA(430.6,Y,0),U,4)[Z0)!($P(^(0),U,4)[""X"")" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X` LAST EDITED: `DEC 17, 2002` HELP-PROMPT: `Enter the default that will be used for the BILL RESULTING FROM field when auto-audit is invoked` DESCRIPTION: `This is the default value for the BILL RESULTING FROM (#4.5) field in the ACCOUNTS RECEIVABLE file (#430) that will be used during auto-audit for all bills with this rate type.` SCREEN: `S DIC("S")="N Z0 S Z0=$P($G(^DGCR(399.3,DA,0)),U,6) Q:+Z0'>0 S Z0=$P(^PRCA(430.2,Z0,0),U,6) I ($P(^PRCA(430.6,Y,0),U,4)[Z0)!($P(^(0),U,4)[""X"")"` EXPLANATION: `Type for the entry must be compatible with Rate Type/AR Category's Type`

Found Entries, Total: 39

NAME: CRIME VICTIM	NAME: DENTAL	NAME: HUMANITARIAN	NAME: INTERAGENCY	NAME: MEANS TEST	NAME: MEDICARE ESRD	NAME: NO FAULT INS.	NAME: REIMBURSABLE INS.
NAME: SHARING AGREEMENT	NAME: TORT FEASOR	NAME: WORKERS' COMP.	NAME: CHAMPVA REIMB. INS.	NAME: CHAMPVA	NAME: TRICARE REIMB. INS.	NAME: TRICARE	NAME: INELIGIBLE
NAME: FEE REIMB INS	NAME: HUMANITARIAN REIMB. INS.	NAME: INELIGIBLE REIMB. INS.	NAME: DENTAL REIMB. INS.	NAME: CC WORKERS' COMP	NAME: CC NO-FAULT AUTO	NAME: CC TORT FEASOR	NAME: CHOICE WORKERS' COMP
NAME: CHOICE NO-FAULT AUTO	NAME: CHOICE TORT FEASOR	NAME: CCN WORKERS' COMP	NAME: CCN NO-FAULT AUTO	NAME: CCN TORT FEASOR	NAME: CHOICE REIMB INS	NAME: CC REIMB INS	NAME: CCN REIMB INS
NAME: CC MTF REIMB INS	NAME: DOD DISABILITY EVALUATION	NAME: DOD SPINAL CORD INJURY	NAME: DOD TRAUMATIC BRAIN INJURY	NAME: DOD BLIND REHABILITATION	NAME: TRICARE DENTAL	NAME: TRICARE PHARMACY

ICR, Total: 2

ICR LINK	Subscribing Package(s)	Fields Referenced	Description
ICR #3822	Accounts Receivable E Claims Management Engine	NAME (.01). Access: Direct Global Read & w/Fileman
ICR #4118	Accounts Receivable	BILL RESULTING FROM (.11). Access: Write w/Fileman

External References

Name	Field # of Occurrence
^DIC	.06+1, .11+1
^DICR	.06(XREF 1n1.4), .06(XREF 1n2.4)
ARCAT^IBCU	.06(XREF 1S)

Global Variables Directly Accessed

Name	Line Occurrences (* Changed, ! Killed)
^DD(	.06(XREF 1n1.4), .06(XREF 1n2.4)
^DD(399.3	.06(XREF 1S), .06(XREF 1K)
^DGCR(399.3 - [#399.3]	.01(XREF 1S), .01(XREF 1K), .06(XREF 1S), .06(XREF 1n1.4), .06(XREF 1K), .06(XREF 1n2.4)

Naked Globals

Name	Field # of Occurrence
^(0	.06(XREF 1S), .06(XREF 1n1.4), .06(XREF 1K), .06(XREF 1n2.4)

Local Variables

Legend:

>>	Not killed explicitly
*	Changed
!	Killed
~	Newed

Name	Field # of Occurrence
>> D0	.06(XREF 1S), .06(XREF 1K)
>> DA	.01(XREF 1S), .01(XREF 1K), .06(XREF 1S), .06(XREF 1K)
DIC	ID.07+1, .06+1!, .11+1!
DIC("S"	.06+1, .06SCR+1, .11+1, .11SCR+1
>> DIE	.06+1, .11+1
>> DIG	.06(XREF 1n1.4), .06(XREF 1n2.4)
>> DIH	.06(XREF 1n1.4), .06(XREF 1n2.4)
>> DIU	.06(XREF 1S), .06(XREF 1K)
DIV	.06(XREF 1S), .06(XREF 1n1.4), .06(XREF 1K), .06(XREF 1n2.4)
DIV(0	.06(XREF 1S), .06(XREF 1n1.4), .06(XREF 1K), .06(XREF 1n2.4)
U	.06(XREF 1S), .06(XREF 1n1.4), .06(XREF 1K), .06(XREF 1n2.4)
X	.001+1!, .01+1!, .01(XREF 1S), .01(XREF 1K), .02+1!, .04+1!, .06+1!, .06(XREF 1S), .06(XREF 1n1.4), .06(XREF 1K) , .06(XREF 1n2.4), .11+1!
Y	.06+1, .06(XREF 1S), .06(XREF 1K), .11+1
Y(1	.06(XREF 1S), .06(XREF 1K)

Info | Desc | Directly Accessed By Routines | Accessed By FileMan Db Calls | Pointed To By FileMan Files | Pointer To FileMan Files | Fields | ICR | Found Entries | External References | Global Variables Directly Accessed | Naked Globals | Local Variables | All