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Global: ^DGBT(392

Package: Beneficiary Travel

Global: ^DGBT(392


Information

FileMan FileNo FileMan Filename Package
392 BENEFICIARY TRAVEL CLAIM Beneficiary Travel

Description

Directly Accessed By Routines, Total: 38

Package Total Routines
Beneficiary Travel 30 DGBT1    DGBT1P28    DGBT2    DGBTCD    DGBTCDSP    DGBTCE    DGBTCE1    DGBTCR
DGBTDLT    DGBTDLT1    DGBTE    DGBTE1    DGBTE1A    DGBTEE    DGBTEE1    DGBTEE2
DGBTEND    DGBTOA2    DGBTOA6    DGBTR    DGBTR121    DGBTR122    DGBTR123    DGBTR124
DGBTR125    DGBTR17    DGBTRDVW    DGBTSP    DGBTSP1    DGBTUTL    
Income Verification Match 2 IVMCUC    IVMUFNC4    
Kernel 2 ARRAY SUBSCRIPTS    COMPUTABLE FILE REFERENCES    
Registration 2 DGYMBT    VAFHLZBT    

Accessed By FileMan Db Calls, Total: 24

Package Total Routines
Beneficiary Travel 24 DGBTCD    DGBTCDSP    DGBTCE    DGBTCE1    DGBTCR    DGBTDLT    DGBTDLT1    DGBTE
DGBTE1    DGBTE1A    DGBTEE    DGBTEE1    DGBTEND    DGBTR    DGBTR121    DGBTR122
DGBTR123    DGBTR124    DGBTR125    DGBTR17    DGBTRDVW    DGBTSP    DGBTSP1    DGBTUTL1

Pointer To FileMan Files, Total: 13

Package Total FileMan Files
Beneficiary Travel 7 BENEFICIARY TRAVEL CERTIFICATION(#392.2)[5]    BENEFICIARY TRAVEL ACCOUNT(#392.3)[6]    LOCAL VENDOR(#392.31)[14]    BT CLAIM ELIGIBILITY CODE(#392.41)[43.1]    BT SPECIAL MODE OF TRANSPORTATION(#392.42)[57]    BT COMMON CARRIER MODE OF TRANSPORTATION(#392.43)[44]    BENEFICIARY TRAVEL DENIAL REASONS(#392.8)[45.4]    
Registration 3 MEDICAL CENTER DIVISION(#40.8)[11]    ELIGIBILITY CODE(#8)[3]    PATIENT(#2)[2]    
Kernel 2 STATE(#5)[24.1, 28.1, 76, 82]    NEW PERSON(#200)[12, 41, 84]
IFCAP 1 VENDOR(#440)[7, 71]    

Fields, Total: 81

Field # Name Loc Type Details
.01 Claim DATE/TIME 0;1 DATE
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  S %DT="ESTXR" D ^%DT S X=Y K:Y<1 X I $D(X) S DINUM=X
  • LAST EDITED:  JUN 29, 2012
  • HELP-PROMPT:  Enter the Beneficiary Travel CLAIM date/time in the usual fileman format.
  • DESCRIPTION:  
    Enter the date/time of the Bene Travel Claim.
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
  • CROSS-REFERENCE:  392^B
    1)= S ^DGBT(392,"B",$E(X,1,30),DA)=""
    2)= K ^DGBT(392,"B",$E(X,1,30),DA)
  • RECORD INDEXES:  AF (#1101)
2 NAME 0;2 POINTER TO PATIENT FILE (#2)
************************REQUIRED FIELD************************
PATIENT(#2)

  • LAST EDITED:  JUN 29, 2012
  • DESCRIPTION:  
    Enter the patient that is related to this Bene Travel Claim.
    UNEDITABLE
  • CROSS-REFERENCE:  392^C
    1)= S ^DGBT(392,"C",$E(X,1,30),DA)=""
    2)= K ^DGBT(392,"C",$E(X,1,30),DA)
  • CROSS-REFERENCE:  392^AI^MUMPS
    1)= S ^DGBT(392,"AI",$E(X,1,30),9999999.99999-DA)=DA
    2)= K ^DGBT(392,"AI",$E(X,1,30),9999999.99999-DA)
  • RECORD INDEXES:  AF (#1101)
3 ELIGIBILITY 0;3 POINTER TO ELIGIBILITY CODE FILE (#8) ELIGIBILITY CODE(#8)

  • LAST EDITED:  JAN 08, 1989
  • HELP-PROMPT:  Enter the primary eligibility or other entitled eligibilities
  • DESCRIPTION:  
    This field contains the eligibililty of the patient for this Bene Travel Claim.
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
  • CROSS-REFERENCE:  392^AE
    1)= S ^DGBT(392,"AE",$E(X,1,30),DA)=""
    2)= K ^DGBT(392,"AE",$E(X,1,30),DA)
4 SC PERCENTAGE 0;4 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>100)!(X<0)!(X?.E1"."1N.N) X
  • HELP-PROMPT:  Type a Number between 0 and 100, 0 Decimal Digits
  • DESCRIPTION:  
    Enter the SC percentage of this patient related to this Bene Travel Claim.
5 CERTIFICATION DATE 0;5 POINTER TO BENEFICIARY TRAVEL CERTIFICATION FILE (#392.2) BENEFICIARY TRAVEL CERTIFICATION(#392.2)

  • INPUT TRANSFORM:  S DIC("S")="I $P(^(0),U,2)=$P(^DGBT(392,DA,0),U,2)" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X
  • LAST EDITED:  JAN 06, 1989
  • DESCRIPTION:  
    This field contains the Beneficiary Travel Certification date.
  • SCREEN:  S DIC("S")="I $P(^(0),U,2)=$P(^DGBT(392,DA,0),U,2)"
  • EXPLANATION:  Only allowed to select Certification Dates for this patient
6 ACCOUNT 0;6 POINTER TO BENEFICIARY TRAVEL ACCOUNT FILE (#392.3)
************************REQUIRED FIELD************************
BENEFICIARY TRAVEL ACCOUNT(#392.3)

  • INPUT TRANSFORM:  S DIC("S")="I $P(^(0),U,3)'>DA&('$P(^(0),U,4)!($P(^(0),U,4)'
  • LAST EDITED:  FEB 19, 1991
  • DESCRIPTION:  
    This field is a pointer to the Beneficiary Travel Account file and contains the account number assigned to an individual beneficiary travel claim.
  • SCREEN:  S DIC("S")="I $P(^(0),U,3)'>DA&('$P(^(0),U,4)!($P(^(0),U,4)'
  • EXPLANATION:  Enter the appropriate account at the time of the claim.
  • CROSS-REFERENCE:  392^AC
    1)= S ^DGBT(392,"AC",$E(X,1,30),DA)=""
    2)= K ^DGBT(392,"AC",$E(X,1,30),DA)
  • CROSS-REFERENCE:  392^ACTP^MUMPS
    1)= Q:'$D(^DGBT(392.3,X,0)) S:+$P(^(0),U,5) ^DGBT(392,"ACTP",+$P(^(0),U,5),DA)=""
    2)= Q:'$D(^DGBT(392.3,X,0)) K:+$P(^(0),U,5) ^DGBT(392,"ACTP",+$P(^(0),U,5),DA)
7 CARRIER 0;7 POINTER TO VENDOR FILE (#440)
************************REQUIRED FIELD************************
VENDOR(#440)

  • LAST EDITED:  JAN 29, 1989
  • DESCRIPTION:  
    This field points to the Vendor File and contains the Carrier providing services for this Bene Travel Claim.
  • CROSS-REFERENCE:  392^AS
    1)= S ^DGBT(392,"AS",$E(X,1,30),DA)=""
    2)= K ^DGBT(392,"AS",$E(X,1,30),DA)
8 MOST ECON. COST 0;8 NUMBER

  • INPUT TRANSFORM:  S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>10000)!(X<0) X
  • LAST EDITED:  DEC 14, 1988
  • HELP-PROMPT:  Type a Dollar Amount between 0 and 10000, 2 Decimal Digits
  • DESCRIPTION:  
    This field contains the most economical cost amount (whatever cost less) for this Bene Travel Claim.
9 DEDUCTIBLE AMOUNT 0;9 NUMBER

  • INPUT TRANSFORM:  S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>99)!(X<0) X
  • LAST EDITED:  SEP 24, 2012
  • HELP-PROMPT:  Type a Dollar Amount between 0 and 99, 2 Decimal Digits
  • DESCRIPTION:  
    This field contains the deductible amount applied to this Bene Travel Claim.
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
  • CROSS-REFERENCE:  392^AD^MUMPS
    1)= S ^DGBT(392,"AD",$P(^DGBT(392,DA,0),"^",2),$E(DA,2,5),DA)=X
    2)= K ^DGBT(392,"AD",$P(^DGBT(392,DA,0),"^",2),$E(DA,2,5),DA)
10 AMOUNT PAYABLE 0;10 NUMBER

  • INPUT TRANSFORM:  S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>10000)!(X<0) X
  • LAST EDITED:  JUL 03, 2012
  • HELP-PROMPT:  Type a dollar amount between 0 and 10000, 2 decimal digits.
  • DESCRIPTION:  
    This field contains the amount payable (cost minus any applied deductible) for this Bene Travel Claim.
11 DIVISION 0;11 POINTER TO MEDICAL CENTER DIVISION FILE (#40.8)
************************REQUIRED FIELD************************
MEDICAL CENTER DIVISION(#40.8)

  • LAST EDITED:  JAN 27, 1989
  • DESCRIPTION:  
    This field contains the medical center division related to this Bene Travel Claim.
12 WHO ENTERED INTO FILE 0;12 POINTER TO NEW PERSON FILE (#200) NEW PERSON(#200)

  • LAST EDITED:  OCT 17, 1990
  • DESCRIPTION:  
    The name of the user who first entered this patient into the Beneficiary Travel Claim file.
13 DATE ENTERED INTO THE FILE 0;13 DATE

  • INPUT TRANSFORM:  S %DT="ESTX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  MAY 08, 2012
  • DESCRIPTION:  
    The date this beneficiary travel claim was entered into this file.
  • CROSS-REFERENCE:  392^D
    1)= S ^DGBT(392,"D",$E(X,1,30),DA)=""
    2)= K ^DGBT(392,"D",$E(X,1,30),DA)
14 COREFLS CARRIER 0;14 POINTER TO LOCAL VENDOR FILE (#392.31) LOCAL VENDOR(#392.31)

  • OUTPUT TRANSFORM:  K DGBTPRV S DGBTPRV=$$PREV^DGBTCSL(.Y)
  • LAST EDITED:  DEC 11, 2002
  • HELP-PROMPT:  Enter a COREFLS Carrier for this claim.
  • DESCRIPTION:  
    This field contains the COREFLS Carrier for this Bene Travel Claim.
  • DELETE TEST:  1,0)= I 1 W !,*7,"DELETIONS ARE NOT ALLOWED"
  • CROSS-REFERENCE:  392^AFLS
    1)= S ^DGBT(392,"AFLS",$E(X,1,30),DA)=""
    2)= K ^DGBT(392,"AFLS",$E(X,1,30),DA)
21 PLACE OF DEPARTURE [LINE 1] D;1 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>35!($L(X)<3) X
  • LAST EDITED:  AUG 18, 2010
  • HELP-PROMPT:  Enter the first line of the place of departure address. Answer must be 3-35 characters in length.
  • DESCRIPTION:  
    This field contains the first line of the address for the place of departure for this Bene Travel Claim.
  • CROSS-REFERENCE:  ^^TRIGGER^392^22
    1)= Q
    2)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(1)=$S($D(^DGBT(392,D0,"D")):^("D"),1:"") S X=$P(Y(1),U,2),X=X S DIU=X K Y S X="" S DIH=$G(^DGBT(392,DIV(0),"D")),DIV=X S $P(^("D"),U,2)=DIV,DIH=392,DIG=22 D ^DICR
    CREATE VALUE)= NO EFFECT
    DELETE VALUE)= @
    FIELD)= PLACE OF DEPARTURE [LINE 2]
22 PLACE OF DEPARTURE [LINE 2] D;2 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>30!($L(X)<3) X
  • LAST EDITED:  AUG 04, 2010
  • HELP-PROMPT:  If the space provided in 'PLACE OF DEPARTURE [LINE 1] was not sufficient, enter the second line of the place of departure address. Answer must be 3-30 characters in length.
  • DESCRIPTION:  
    This field contains the second line of the address for the place of departure for this Bene Travel Claim.
  • NOTES:  TRIGGERED by the PLACE OF DEPARTURE [LINE 1] field of the BENEFICIARY TRAVEL CLAIM File
  • CROSS-REFERENCE:  ^^TRIGGER^392^23
    1)= Q
    2)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(1)=$S($D(^DGBT(392,D0,"D")):^("D"),1:"") S X=$P(Y(1),U,3),X=X S DIU=X K Y S X="" S DIH=$G(^DGBT(392,DIV(0),"D")),DIV=X S $P(^("D"),U,3)=DIV,DIH=392,DIG=23 D ^DICR
    CREATE VALUE)= NO EFFECT
    DELETE VALUE)= @
    FIELD)= PLACE OF DEPARTURE [LINE 3]
23 PLACE OF DEPARTURE [LINE 3] D;3 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>30!($L(X)<3) X
  • LAST EDITED:  DEC 15, 1988
  • HELP-PROMPT:  Answer must be 3-30 characters in length.
  • DESCRIPTION:  
    This field contains the third line of the address for the place of departure for this Bene Travel Claim.
  • NOTES:  TRIGGERED by the PLACE OF DEPARTURE [LINE 2] field of the BENEFICIARY TRAVEL CLAIM File
24 CITY OF DEPARTURE D;4 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>30!($L(X)<2)!'(X'?1P.E) X I $D(X) D UP^DGHELP
  • LAST EDITED:  FEB 27, 1989
  • HELP-PROMPT:  Answer must be 2-30 characters in length.
  • DESCRIPTION:  
    This field contains the name of the city in the address for the place of departure for this Bene Travel Claim.
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
24.1 STATE OF DEPARTURE D;5 POINTER TO STATE FILE (#5) STATE(#5)

  • LAST EDITED:  FEB 27, 1989
  • DESCRIPTION:  
    This field points to the State File and uses this for the state in the address for the place of departure for this Bene Travel Claim.
24.2 ZIP CODE/DEPARTURE D;6 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>20!($L(X)<5) X I $D(X) D ZIPIN^VAFADDR
  • OUTPUT TRANSFORM:  D ZIPOUT^VAFADDR
  • LAST EDITED:  AUG 14, 2012
  • HELP-PROMPT:  Answer with either 5 digit or 9 digit zip code.
  • DESCRIPTION:  
    This field contains the 5-digit zip code used in the address for the place of departure for this Bene Travel Claim.
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
25 DESTINATION [LINE 1] T;1 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>35!($L(X)<3) X
  • LAST EDITED:  AUG 04, 2010
  • HELP-PROMPT:  Answer must be 3-35 characters in length.
  • DESCRIPTION:  
    This field contains the first line of the address for place of destination for this Bene Travel Claim.
  • CROSS-REFERENCE:  ^^TRIGGER^392^26
    1)= Q
    2)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(1)=$S($D(^DGBT(392,D0,"T")):^("T"),1:"") S X=$P(Y(1),U,2),X=X S DIU=X K Y S X="" S DIH=$G(^DGBT(392,DIV(0),"T")),DIV=X S $P(^("T"),U,2)=DIV,DIH=392,DIG=26 D ^DICR
    CREATE VALUE)= NO EFFECT
    DELETE VALUE)= @
    FIELD)= DESTINATION [LINE 2]
26 DESTINATION [LINE 2] T;2 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>30!($L(X)<3) X
  • LAST EDITED:  AUG 04, 2010
  • HELP-PROMPT:  Answer must be 3-30 characters in length.
  • DESCRIPTION:  
    This field contains the second line of the address for the place of destination for this Bene Travel Claim.
  • NOTES:  TRIGGERED by the DESTINATION [LINE 1] field of the BENEFICIARY TRAVEL CLAIM File
  • CROSS-REFERENCE:  ^^TRIGGER^392^27
    1)= Q
    2)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(1)=$S($D(^DGBT(392,D0,"T")):^("T"),1:"") S X=$P(Y(1),U,3),X=X S DIU=X K Y S X="" S DIH=$G(^DGBT(392,DIV(0),"T")),DIV=X S $P(^("T"),U,3)=DIV,DIH=392,DIG=27 D ^DICR
    CREATE VALUE)= NO EFFECT
    DELETE VALUE)= @
    FIELD)= DESTINATION [LINE 3]
27 DESTINATION [LINE 3] T;3 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>30!($L(X)<3) X
  • LAST EDITED:  FEB 08, 1989
  • HELP-PROMPT:  Answer must be 3-30 characters in length.
  • DESCRIPTION:  
    This field contains the third line of the address for the place of destination for this Bene Travel Claim.
  • NOTES:  TRIGGERED by the DESTINATION [LINE 2] field of the BENEFICIARY TRAVEL CLAIM File
28 CITY OF DESTINATION T;4 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>30!($L(X)<2)!'(X'?1P.E) X I $D(X) D UP^DGHELP
  • LAST EDITED:  MAR 09, 1989
  • HELP-PROMPT:  Answer must be 2-30 characters in length.
  • DESCRIPTION:  
    This field contains the name of the city in the address for the place of destination for this Bene Travel Claim.
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
28.1 STATE OF DESTINATION T;5 POINTER TO STATE FILE (#5) STATE(#5)

  • LAST EDITED:  FEB 27, 1989
  • DESCRIPTION:  
    This field points the the STATE file and contains the state used in the address for the place of destination for this Bene Travel Claim.
28.2 ZIP CODE/DESTINATION T;6 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>20!($L(X)<5) X I $D(X) D ZIPIN^VAFADDR
  • OUTPUT TRANSFORM:  D ZIPOUT^VAFADDR
  • LAST EDITED:  MAR 01, 1993
  • HELP-PROMPT:  Answer with either 5 digit or 9 digit zip code.
  • DESCRIPTION:  
    This field contains the 5-digit zip code used in the address for the place of destination for this Bene Travel Claim.
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
31 ONE WAY/ROUND TRIP M;1 SET
************************REQUIRED FIELD************************
  • '1' FOR ONE WAY;
  • '2' FOR ROUND TRIP;

  • LAST EDITED:  FEB 08, 1989
  • DESCRIPTION:  
    This field indicates one way or round trip for this Bene Travel Claim.
32 MILEAGE/ONE WAY M;2 NUMBER
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  K:+X'=X!(X>10000)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  JAN 29, 1989
  • HELP-PROMPT:  Type a Number between 0 and 10000, 0 Decimal Digits
  • DESCRIPTION:  
    This field contains the one way mileage for this Bene Travel Calim.
  • EXECUTABLE HELP:  S X="D MHELP^DGBTUTL" X X
33 TOTAL MILEAGE AMOUNT M;3 NUMBER

  • INPUT TRANSFORM:  S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>10000)!(X<0) X
  • LAST EDITED:  JAN 07, 1989
  • HELP-PROMPT:  Type a Dollar Amount between 0 and 10000, 2 Decimal Digits
  • DESCRIPTION:  
    This is a numeric field containing the total mileage entered for a specific beneficiary travel claim.
34 MEALS & LODGING M;4 NUMBER

  • INPUT TRANSFORM:  S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>10000)!(X<0) X
  • LAST EDITED:  JAN 07, 1989
  • HELP-PROMPT:  Type a Dollar Amount between 0 and 10000, 2 Decimal Digits
  • DESCRIPTION:  
    This field contains meals and lodging costs for this Bene Travel Claim.
35 FERRY, BRIDGES, ETC. M;5 NUMBER

  • INPUT TRANSFORM:  S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>10000)!(X<0) X
  • LAST EDITED:  JAN 07, 1989
  • HELP-PROMPT:  Type a Dollar Amount between 0 and 10000, 2 Decimal Digits
  • DESCRIPTION:  
    This field contains ferry, bridges, etc. costs for this Bene Travel Claim.
41 AUTHORIZING PERSON A;1 POINTER TO NEW PERSON FILE (#200) NEW PERSON(#200)

  • LAST EDITED:  JAN 27, 1993
  • DESCRIPTION:  
    This field points the person file to indicate who the authorizing person responsible for this Bene Travel Claim.
42 ATTENDANT/PAYEE A;2 FREE TEXT

  • INPUT TRANSFORM:  K:X[""""!($A(X)=45) X I $D(X) K:$L(X)>30!($L(X)<3)!(X?1P.E)!(X'?1U.ANP)!(X'[",") X I $D(X) D UP^DGHELP S Y=", " F I=0:0 Q:$F(X,Y)<1 S X=$E(X,1,($F(X,Y)-2))_$E(X,$F(X,Y),99)
  • LAST EDITED:  JUL 30, 1993
  • HELP-PROMPT:  Enter the name in 'Last,First Middle' format between 3-30 characters. With the exception of the comma, period, space, hyphen, dash and apostrophe punctuation characters should be avoided.
  • DESCRIPTION:  
    This field contains the 'Last, First Middle' name format of the attendent/payee of this Bene Travel Claim.
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
43 C&P REVIEW VISIT A;3 SET
  • '0' FOR NO;
  • '1' FOR YES;

  • LAST EDITED:  OCT 19, 2012
  • HELP-PROMPT:  Answer whether this claim is a C&P review visit and should be paid at the C&P review visit mileage rate as indicated in the BT parameters.
  • DESCRIPTION:  
    This field indicates whether this is a C&P review visit and should be paid at the C&P review visit mileage rate as indicated in the BT parameters for this Bene Travel Claim.
43.1 BT CLAIM ELIGIBILITY CODE 1;2 POINTER TO BT CLAIM ELIGIBILITY CODE FILE (#392.41) BT CLAIM ELIGIBILITY CODE(#392.41)

  • LAST EDITED:  AUG 02, 2012
  • HELP-PROMPT:  Select the eligibility code.
  • DESCRIPTION:  
    This is the reason patient is eligible for BT.
43.2 BT CLAIM ELIGIBILITY ADDITION 1;1 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>80!($L(X)<1) X
  • LAST EDITED:  AUG 06, 2012
  • HELP-PROMPT:  Answer must be 1-80 characters in length.
  • DESCRIPTION:  
    This is additional information or explanation if 'Other Eligibility Reason' was entered in the BT CLAIM ELIGIBILITY CODE (#43.1) field.
43.4 SC APPOINTMENT A;12 SET
  • '0' FOR NO;
  • '1' FOR YES;

  • LAST EDITED:  OCT 19, 2012
  • HELP-PROMPT:  Enter a 'Yes' or 'No'.
  • DESCRIPTION:  
    This field contains 1(Yes) or 0(No) on whether or not the patients appointment was a SC appointment.
43.5 QUALIFIED APPOINTMENT A;11 SET
  • '0' FOR NO;
  • '1' FOR YES;

  • LAST EDITED:  OCT 19, 2012
  • HELP-PROMPT:  Enter 'Yes' if a Qualified Appointment, 'No' if not a Qualified Appointment.
  • DESCRIPTION:  
    The field will contain the a 1(yes) or 0(no) on whether or not the patients appointment was a qualified appointment for BT reimburstment.
44 MODE OF TRANSPORTATION A;4 POINTER TO BT COMMON CARRIER MODE OF TRANSPORTATION FILE (#392.43)
************************REQUIRED FIELD************************
BT COMMON CARRIER MODE OF TRANSPORTATION(#392.43)

  • LAST EDITED:  SEP 28, 2012
  • HELP-PROMPT:  Enter the mode of transportation used for this Beneficiary Travel Claim.
  • DESCRIPTION:  
    This field indicates the mode of transportation used for this Beneficiary Travel Claim.
  • CROSS-REFERENCE:  ^^TRIGGER^392^52
    1)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(0)=X S X=$P($G(^DGBT(392.43,+Y(0),0)),U)'["BUS" I X S X=DIV S Y(1)=$S($D(^DGBT(392,D0,"B")):^("B"),1:"") S X=$P(Y(1),U,1),X=X S DIU=X K Y S X="" X ^DD(392,44,1,2,1.4)
    1.4)= S DIH=$G(^DGBT(392,DIV(0),"B")),DIV=X S $P(^("B"),U,1)=DIV,DIH=392,DIG=52 D ^DICR
    2)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(1)=$S($D(^DGBT(392,D0,"B")):^("B"),1:"") S X=$P(Y(1),U,1),X=X S DIU=X K Y S X="" S DIH=$G(^DGBT(392,DIV(0),"B")),DIV=X S $P(^("B"),U,1)=DIV,DIH=392,DIG=52 D ^DICR
    CREATE CONDITION)= MODE OF TRANSPORTATION'["BUS"
    CREATE VALUE)= @
    DELETE VALUE)= @
    FIELD)= BUS PASS OR TICKET
    If mode of transportation is changed to something other than bus then the BUS PASS OR TICKET field is automatically deleted as it's no longer relevant to this claim.
45 DENIAL LETTER ISSUED A;6 SET
  • '0' FOR NO;
  • '1' FOR YES;

  • LAST EDITED:  AUG 08, 2012
  • HELP-PROMPT:  Was a BT denial letter issued?
  • DESCRIPTION:  
    Field indicates whether or not a BT claim denial letter was issued.
45.1 DENIAL LETTER ISSUED DATE A;7 DATE

  • INPUT TRANSFORM:  S %DT="ESTX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  JUL 03, 2012
  • HELP-PROMPT:  Please enter date and time
  • DESCRIPTION:  
    Date and time the BT claim was denied and letter was issued.
45.2 CLAIM DENIED A;8 SET
  • '0' FOR NO;
  • '1' FOR YES;

  • LAST EDITED:  OCT 21, 2012
  • HELP-PROMPT:  Is the claim denied?
  • DESCRIPTION:  
    This field will inform whether a claim has been approved or denied.
  • CROSS-REFERENCE:  392^ADENIED^MUMPS
    1)= I X S DFN=$P(^DGBT(392,DA,0),"^",2) S ^DGBT(392,"ADENIED",DFN,DA)=""
    2)= I $D(DA) S DFN=$P(^DGBT(392,DA,0),"^",2) K ^DGBT(392,"ADENIED",DFN,DA)
    WHOLE FILE CROSS REFERENCE ON FIELD 45.2, CLAIM DENIED.
45.3 DATE CLAIM DENIED A;9 DATE

  • INPUT TRANSFORM:  S %DT="ESTX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  AUG 07, 2012
  • HELP-PROMPT:  Enter Date the Claim was Denied.
  • DESCRIPTION:  
    This field contains the date the claim was denied.
45.4 CLAIM DENIED REASON A;10 POINTER TO BENEFICIARY TRAVEL DENIAL REASONS FILE (#392.8) BENEFICIARY TRAVEL DENIAL REASONS(#392.8)

  • LAST EDITED:  AUG 08, 2012
  • HELP-PROMPT:  Enter reason claim was denied.
  • DESCRIPTION:  
    Reason claim was denied.
51 REMARKS R;1 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>79!($L(X)<1)!(X[";") X
  • LAST EDITED:  AUG 06, 2012
  • HELP-PROMPT:  Answer must be 1-79 characters in length and not containing a "".
  • DESCRIPTION:  
    This field contains remarks related to this Beneficiary Travel Claim.
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
52 BUS PASS OR TICKET B;1 SET
  • 'P' FOR PASS;
  • 'T' FOR TICKET;

  • LAST EDITED:  AUG 08, 2012
  • HELP-PROMPT:  Choose whether the patient has a monthly bus pass or a single use ticket.
  • DESCRIPTION:  
    This field stores the type of ticket that the veteran used when riding the bus. The type of ticket determines how the veteran is reimbursed.
  • NOTES:  TRIGGERED by the MODE OF TRANSPORTATION field of the BENEFICIARY TRAVEL CLAIM File
  • CROSS-REFERENCE:  ^^TRIGGER^392^53
    1)= X ^DD(392,52,1,2,1.3) I X S X=DIV S Y(1)=$S($D(^DGBT(392,D0,"B")):^("B"),1:"") S X=$P(Y(1),U,2),X=X S DIU=X K Y S X="" S DIH=$G(^DGBT(392,DIV(0),"B")),DIV=X S $P(^("B"),U,2)=DIV,DIH=392,DIG=53 D ^DICR
    1.3)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(0)=X S Y(1)=$C(59)_$P($G(^DD(392,52,0)),U,3) S X=$P($P(Y(1),$C(59)_Y(0)_":",2),$C(59))'="PASS"
    2)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(1)=$S($D(^DGBT(392,D0,"B")):^("B"),1:"") S X=$P(Y(1),U,2),X=X S DIU=X K Y S X="" S DIH=$G(^DGBT(392,DIV(0),"B")),DIV=X S $P(^("B"),U,2)=DIV,DIH=392,DIG=53 D ^DICR
    CREATE CONDITION)= BUS PASS OR TICKET'="PASS"
    CREATE VALUE)= @
    DELETE VALUE)= @
    FIELD)= BUS PASS EXPIRATION DATE
    If the BUS PASS OR TICKET (#52) field doesn't contain "pass" as a value then the BUS PASS EXPIRATION DATE (#53) field is deleted as it's no longer relevant.
53 BUS PASS EXPIRATION DATE B;2 DATE

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:Y<1!($P($G(^DGBT(392,DA,"B")),U)'="P") X I $D(X),X<$P(DA,".",1) K X
  • LAST EDITED:  AUG 10, 2012
  • HELP-PROMPT:  Enter the expiration date for the patient's bus pass.
  • DESCRIPTION:  
    This field holds the expiration date of the bus pass and can only be filled in if the BUS PASS OR TICKET (#52) field is set to pass. The bus pass expiration date can't before the claim date.
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
    TRIGGERED by the BUS PASS OR TICKET field of the BENEFICIARY TRAVEL CLAIM File
54 COMMON CARRIER DATE REIMBURSED C;1 DATE
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  JAN 16, 2012
  • HELP-PROMPT:  Enter date reimbursement was given for use of common carrier. No future dates allowed.
  • DESCRIPTION:  
    This field holds the date of reimbursement for use of common carrier transportation.
55 COMMON CARRIER FEE C;2 NUMBER
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>1000000)!(X<0) X
  • LAST EDITED:  AUG 10, 2012
  • HELP-PROMPT:  Type a dollar amount between 0 and 1000000, 2 decimal digits.
  • DESCRIPTION:  
    This is the amount charged for use of the common carrier transportation.
55.1 COMMON CARRIER REQUIRED C;3 SET
************************REQUIRED FIELD************************
  • '1' FOR YES;
  • '0' FOR NO;

  • LAST EDITED:  AUG 10, 2012
  • HELP-PROMPT:  Is Common Carrier required?
  • DESCRIPTION:  
    Field is used to indicate whether or not the use of a common carrier was best or only way to travel to a VA medical center.
56 TYPE OF CLAIM 0;15 SET
************************REQUIRED FIELD************************
  • 'M' FOR MILEAGE;
  • 'S' FOR SPECIAL MODE;

  • LAST EDITED:  AUG 07, 2012
  • HELP-PROMPT:  Choose claim type.
  • DESCRIPTION:  
    This field indicates what type of claim this is.
57 SPECIAL MODE OF TRANSPORTATION SP;1 POINTER TO BT SPECIAL MODE OF TRANSPORTATION FILE (#392.42)
************************REQUIRED FIELD************************
BT SPECIAL MODE OF TRANSPORTATION(#392.42)

  • LAST EDITED:  FEB 24, 2012
  • HELP-PROMPT:  Select the method of the Special Mode of Transportation.
  • DESCRIPTION:  
    This is the type of Special Mode of Transportation.
58 INVOICE NUMBER SP;2 FREE TEXT
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  K:$L(X)>30!($L(X)<1) X
  • LAST EDITED:  FEB 24, 2012
  • HELP-PROMPT:  Answer must be 1-30 characters in length.
  • DESCRIPTION:  
    The field contains the invoice number from the vendor who provided the special mode of transportation for the patient.
59 DATE INVOICE RECEIVED SP;3 DATE

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  AUG 06, 2012
  • HELP-PROMPT:  Enter the date the invoice was received by the VA from the patient or vendor for the special mode transportation.
  • DESCRIPTION:  
    This is the date the invoice was received by the VA from either the patient or the vendor for the special mode transportation.
60 TOTAL INVOICE AMOUNT SP;4 NUMBER
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>999999)!(X<1) X
  • LAST EDITED:  SEP 05, 2017
  • HELP-PROMPT:  Type a dollar amount between 1 and 999999, 2 decimal digits.
  • DESCRIPTION:  
    This is the total of all charges by a vendor for the transportation of the patient by special mode. This includes all cost and special add-on fees.
61 BASE RATE FEE SP;5 NUMBER
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>100000)!(X<0)!(X?.E1"."3.N) X
  • LAST EDITED:  AUG 11, 2012
  • HELP-PROMPT:  Type a dollar amount between 0 and 100,000, 2 decimal digits.
  • DESCRIPTION:  
    This is the base rate fee if any, charged by the vendor for transporting the patient by special mode.
62 MILEAGE FEE SP;6 NUMBER
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>500000)!(X<0) X
  • LAST EDITED:  SEP 05, 2017
  • HELP-PROMPT:  Type a dollar amount between 0 and 500000, 2 decimal digits.
  • DESCRIPTION:  
    This is the per mile amount charged by the vendor for transporting the patient by special mode.
63 NO SHOW/NO LOAD FEE SP;7 NUMBER

  • INPUT TRANSFORM:  S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>1000)!(X<0)!(X?.E1"."3.N) X
  • LAST EDITED:  SEP 05, 2017
  • HELP-PROMPT:  Type a dollar amount between 0 and 1,000, 2 decimal digits.
  • DESCRIPTION:  
    Vendor's charge for a no-show patient.
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
64 WAIT TIME FEE SP;8 NUMBER

  • INPUT TRANSFORM:  S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>1000)!(X<0)!(X?.E1"."3.N) X
  • LAST EDITED:  AUG 11, 2012
  • HELP-PROMPT:  Type a dollar amount between 0 and 1,000, 2 decimal digits.
  • DESCRIPTION:  
    This is the fee charged by the vendor to wait for the patient.
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
65 EXTRA CREW FEE SP;9 NUMBER

  • INPUT TRANSFORM:  S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>10000)!(X<0)!(X?.E1"."3.N) X
  • LAST EDITED:  AUG 11, 2012
  • HELP-PROMPT:  Type a dollar amount between 0 and 10,000, 2 decimal digits.
  • DESCRIPTION:  
    This is the fee charged by the vendor when extra crew is provided by the vendor to transport the patient by special mode.
66 SPECIAL EQUIPMENT FEE SP;10 NUMBER

  • INPUT TRANSFORM:  S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>5000)!(X<0)!(X?.E1"."3.N) X
  • LAST EDITED:  AUG 11, 2012
  • HELP-PROMPT:  Type a dollar amount between 0 and 5,000, 2 decimal digits.
  • DESCRIPTION:  
    This is the fee charged by the vendor to provide special equipment during the special mode transportation.
67 SPECIAL MODE RT/ONE-WAY SP;11 SET
************************REQUIRED FIELD************************
  • 'R' FOR ROUND TRIP;
  • 'O' FOR ONE WAY;

  • LAST EDITED:  FEB 24, 2012
  • HELP-PROMPT:  Choose trip type.
  • DESCRIPTION:  
    This field indicates whether the special mode transportation was round trip or one way.
68 SPECIAL MODE TOTAL MILES SP;12 NUMBER
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  K:+X'=X!(X>10000)!(X<1)!(X?.E1"."1N.N) X
  • LAST EDITED:  JUN 24, 2015
  • HELP-PROMPT:  Type a number between 1 and 10000, 0 decimal digits.
  • DESCRIPTION:  
    This is the total mileage for the special mode transportation trip.
69 OTHER SM TRANSPORTATION SP;25 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>45!($L(X)<3) X
  • LAST EDITED:  AUG 10, 2012
  • HELP-PROMPT:  Answer must be 3-45 characters in length.
  • DESCRIPTION:  
    Other types of special mode transportation used when 'OTHER' is selected from the SPECIAL MODE OF TRANSPORTATION (#57) field.
70 PRE-AUTHORIZED SP;13 SET
************************REQUIRED FIELD************************
  • '1' FOR YES;
  • '0' FOR NO;

  • LAST EDITED:  AUG 10, 2012
  • HELP-PROMPT:  Was trip pre-authorized for Special Mode transportation?
  • DESCRIPTION:  
    This field indicates whether the transportation for the Special Mode trip was pre-authorized.
71 SPECIAL MODE VENDOR SP;14 POINTER TO VENDOR FILE (#440)
************************REQUIRED FIELD************************
VENDOR(#440)

  • LAST EDITED:  FEB 24, 2012
  • HELP-PROMPT:  Enter the Special Mode Transportation Vendor.
  • DESCRIPTION:  
    This is the vendor who supplied the special mode transportation for the patient.
72 SPECIAL MODE OTHER REMARKS SP;26 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>50!($L(X)<3) X
  • LAST EDITED:  FEB 02, 2012
  • HELP-PROMPT:  Answer must be 3-50 characters in length.
  • DESCRIPTION:  
    This field is any additional information about the special mode of transportation claim.
73 SP MODE DEPARTURE ADDRESS1 SPAD;1 FREE TEXT
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  K:$L(X)>30!($L(X)<1) X
  • LAST EDITED:  AUG 14, 2012
  • HELP-PROMPT:  Answer must be 1-30 characters in length.
  • DESCRIPTION:  
    Line one of the address the patient departed from for this claim. It defaults to line one of the patient's home address.
74 SP MODE DEPARTURE ADDRESS2 SPAD;2 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>30!($L(X)<1) X
  • LAST EDITED:  AUG 06, 2012
  • HELP-PROMPT:  Answer must be 1-30 characters in length.
  • DESCRIPTION:  
    This is the second line of the departure address of the patient. It defaults to the patient's 2nd line of their home address.
75 SP MODE DEPARTURE CITY SPAD;3 FREE TEXT
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  K:$L(X)>30!($L(X)<1) X
  • LAST EDITED:  AUG 06, 2012
  • HELP-PROMPT:  Answer must be 1-30 characters in length.
  • DESCRIPTION:  
    This is the city the patient departed from for this claim. It defaults to the patient's home address city.
76 SP MODE DEPARTURE STATE SPAD;4 POINTER TO STATE FILE (#5)
************************REQUIRED FIELD************************
STATE(#5)

  • LAST EDITED:  DEC 28, 2011
  • HELP-PROMPT:  Select the departure state.
  • DESCRIPTION:  
    This is the state from which the patient departed for the claim. It defaults to the state from the patient's home address.
77 SP MODE DEPARTURE ZIP CODE SPAD;5 FREE TEXT
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  K:$L(X)>20!($L(X)<5) X I $D(X) D ZIPIN^VAFADDR
  • OUTPUT TRANSFORM:  D ZIPOUT^VAFADDR
  • LAST EDITED:  AUG 14, 2012
  • HELP-PROMPT:  Answer with either 5 digit or 9 digit zip code.
  • DESCRIPTION:  
    This is the patient's departure ZIP code for this claim. It defaults to the ZIP code from the patient's home address.
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
78 SP MODE DESTINATION 1 SPAD;6 FREE TEXT
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  K:$L(X)>30!($L(X)<1) X
  • LAST EDITED:  FEB 18, 2012
  • HELP-PROMPT:  Answer must be 1-30 characters in length.
  • DESCRIPTION:  
    This is line one of the destination address. It defaults to the site's address.
79 SP MODE DESTINATION 2 SPAD;7 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>30!($L(X)<1) X
  • LAST EDITED:  AUG 10, 2012
  • HELP-PROMPT:  Answer must be 1-30 characters in length.
  • DESCRIPTION:  
    This is line 2 of the destination address. It defaults to the site's address line 2.
80 SP MODE DESTINATION 3 SPAD;8 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>30!($L(X)<1) X
  • LAST EDITED:  AUG 06, 2012
  • HELP-PROMPT:  Answer must be 1-30 characters in length.
  • DESCRIPTION:  
    This is the third line of the site's address. It defaults to the site's address line 3.
81 SP MODE DESTINATION CITY SPAD;9 FREE TEXT
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  K:$L(X)>25!($L(X)<3) X
  • LAST EDITED:  DEC 28, 2011
  • HELP-PROMPT:  Answer must be 3-25 characters in length.
  • DESCRIPTION:  
    This is the city the site is located in. It defaults to the site's city.
82 SP MODE DESTINATION STATE SPAD;10 POINTER TO STATE FILE (#5)
************************REQUIRED FIELD************************
STATE(#5)

  • LAST EDITED:  DEC 28, 2011
  • HELP-PROMPT:  Select the state of destination.
  • DESCRIPTION:  
    This is the destination state of the site. It defaults to the site's state.
83 SP MODE DESTINATION ZIP CODE SPAD;11 FREE TEXT
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  K:$L(X)>20!($L(X)<5) X I $D(X) D ZIPIN^VAFADDR
  • OUTPUT TRANSFORM:  D ZIPOUT^VAFADDR
  • LAST EDITED:  AUG 14, 2012
  • HELP-PROMPT:  Answer with either 5 digit or 9 digit zip code.
  • DESCRIPTION:  
    This is the destination ZIP code of the site. It defaults to the site's ZIP code.
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
84 PRE-AUTHORIZED BY SP;16 POINTER TO NEW PERSON FILE (#200) NEW PERSON(#200)

  • LAST EDITED:  AUG 06, 2012
  • HELP-PROMPT:  Enter User who PRE-AUTHORIZED the Claim.
  • DESCRIPTION:  
    This is User who PRE-AUTHORIZED the Claim. By default it's user who entered the claim.
85 SPECIAL MODE CLAIM AUTHORIZED SP;15 SET
  • '1' FOR YES;
  • '0' FOR NO;

  • LAST EDITED:  AUG 10, 2012
  • HELP-PROMPT:  Enter 'YES' if Special Mode Claim is Authorized, enter 'NO' if Special Mode Claim is Denied.
  • DESCRIPTION:  
    This field indicates whether Special Mode transportation is authorized or denied.
86 DATE/TIME AUTHORIZED SP;17 DATE

  • INPUT TRANSFORM:  S %DT="ETX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  AUG 06, 2012
  • HELP-PROMPT:  Enter Date/Time the trip was authorized.
  • DESCRIPTION:  
    This is the date/time the travel was authorized if not a pre-authorized trip.

ICR, Total: 1

ICR LINK Subscribing Package(s) Fields Referenced Description
ICR #2272
  • Scheduling
    		•  AMOUNT PAYABLE (10).
    Access: Direct Global Read & w/Fileman

    ONE WAY/ROUND TRIP (31).
    Access: Direct Global Read & w/Fileman

    TOTAL MILEAGE AMOUNT (33).
    Access: Direct Global Read & w/Fileman

    		 "C" xref.
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