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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

Accessed By FileMan Db Calls, Total: 21

Package Total Routines
Integrated Billing 17 IB20P154    IB20P554    IB20P618    IB20PT7    IB488PRE    IBCA    IBCEMSRI    IBCMENU
IBCREE    IBCROR    IBJPS7    IBOAMS    IBTUBO    IBY137PO    IBY547PR    IBY568PO
IBYBPT    
Accounts Receivable 2 PRCAUDT1    RCDPENR4    
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
    Info |  Desc |  Accessed By FileMan Db Calls |  Pointed To By FileMan Files |  Pointer To FileMan Files |  Fields |  ICR |  Found Entries  | All