| FileMan FileNo | FileMan Filename | Package |
|---|---|---|
| 162.7 | FEE BASIS UNAUTHORIZED CLAIMS | Fee Basis |
| Package | Total | FileMan Files |
|---|---|---|
| Fee Basis | 6 | FEE BASIS UNAUTHORIZED CLAIMS DISPOSITIONS(#162.91)[10] FEE BASIS UNAUTHORIZED CLAIMS STATUS(#162.92)[24, #162.701(.03)] FEE BASIS UNAUTHORIZED DISAPPROVAL REASONS(#162.94)[#162.715(.01)] FEE BASIS UNAUTHORIZED CLAIMS(#162.7)[20] FEE BASIS PROGRAM(#161.8)[.5] FEE BASIS VENDOR(#161.2)[1, 23] |
| Kernel | 2 | INSTITUTION(#4)[6] NEW PERSON(#200)[23, 27, #162.701(.02), #162.792(1), #162.793(4)] |
| DRG Grouper | 1 | ICD DIAGNOSIS(#80)[5.1] |
| Registration | 1 | PATIENT(#2)[2, 23] |
| Field # | Name | Loc | Type | Details |
|---|---|---|---|---|
| .01 | DATE CLAIM RECEIVED | 0;1 | DATE | ************************REQUIRED FIELD************************
|
| .5 | FEE PROGRAM | 0;2 | POINTER TO FEE BASIS PROGRAM FILE (#161.8) | ************************REQUIRED FIELD************************ FEE BASIS PROGRAM(#161.8)
|
| 1 | VENDOR | 0;3 | POINTER TO FEE BASIS VENDOR FILE (#161.2) | ************************REQUIRED FIELD************************ FEE BASIS VENDOR(#161.2)
|
| 2 | VETERAN | 0;4 | POINTER TO PATIENT FILE (#2) | ************************REQUIRED FIELD************************ PATIENT(#2)
|
| 3 | TREATMENT FROM DATE | 0;5 | DATE | ************************REQUIRED FIELD************************
|
| 4 | TREATMENT TO DATE | 0;6 | DATE | ************************REQUIRED FIELD************************
|
| 5 | DIAGNOSIS | DX;1 | FREE TEXT |
|
| 5.1 | ICD DIAGNOSIS | DX;2 | POINTER TO ICD DIAGNOSIS FILE (#80) | ICD DIAGNOSIS(#80)
|
| 6 | PRIMARY SERVICE FACILITY | 0;7 | POINTER TO INSTITUTION FILE (#4) | INSTITUTION(#4)
|
| 7 | DATE VALID CLAIM RECEIVED | 0;8 | DATE |
|
| 8 | AMOUNT CLAIMED | 0;9 | NUMBER |
|
| 9 | PATIENT TYPE CODE | 0;10 | SET | ************************REQUIRED FIELD************************
|
| 10 | DISPOSITION | 0;11 | POINTER TO FEE BASIS UNAUTHORIZED CLAIMS DISPOSITIONS FILE (#162.91) | FEE BASIS UNAUTHORIZED CLAIMS DISPOSITIONS(#162.91)
|
| 10.5 | DISPOSITION REMARKS | 4;0 | WORD-PROCESSING #162.702 |
|
| 10.6 | APPEAL DISPOSITION REMARKS | A1;0 | WORD-PROCESSING #162.703 |
|
| 10.7 | COVA DISPOSITION REMARKS | A2;0 | WORD-PROCESSING #162.704 |
|
| 11 | DATE OF DISPOSITION | 0;12 | DATE |
|
| 12 | AUTHORIZED FROM DATE | 0;13 | DATE |
|
| 13 | AUTHORIZED TO DATE | 0;14 | DATE |
|
| 14 | AMOUNT APPROVED | 0;15 | NUMBER |
|
| 15 | REASON FOR DISAPPROVAL | D;0 | POINTER Multiple #162.715 | 162.715
|
| 16 | *DISPOSITON DESCRIPTION | 1;0 | WORD-PROCESSING #162.716 |
|
| 17 | *REASON FOR PENDING | 2;0 | WORD-PROCESSING #162.717 |
|
| 19 | PRINT LETTER? | 0;16 | SET |
|
| 19.5 | DATE LETTER SENT | 0;19 | DATE |
|
| 19.6 | DATE REQ INFO SENT | 6;1 | DATE |
|
| 20 | MASTER CLAIM | 0;20 | POINTER TO FEE BASIS UNAUTHORIZED CLAIMS FILE (#162.7) | ************************REQUIRED FIELD************************ FEE BASIS UNAUTHORIZED CLAIMS(#162.7)
|
| 21 | REOPEN CLAIM DATE | 0;21 | DATE |
|
| 22 | DATE OF ORIGINAL DISPOSITION | 0;22 | DATE |
|
| 23 | CLAIM SUBMITTED BY | 0;23 | VARIABLE POINTER | ************************REQUIRED FIELD************************ PATIENT(#2) FEE BASIS VENDOR(#161.2) NEW PERSON(#200)
|
| 24 | STATUS | 0;24 | POINTER TO FEE BASIS UNAUTHORIZED CLAIMS STATUS FILE (#162.92) | ************************REQUIRED FIELD************************ FEE BASIS UNAUTHORIZED CLAIMS STATUS(#162.92)
|
| 25 | DATE OF CURRENT STATUS | 0;25 | DATE | ************************REQUIRED FIELD************************
|
| 26 | EXPIRATION DATE OF CLAIM | 0;26 | DATE |
|
| 26.5 | EXTENSIONS | 3;0 | DATE Multiple #162.701 | 162.701 |
| 27 | ENTERED/LAST EDITED BY | 0;17 | POINTER TO NEW PERSON FILE (#200) | NEW PERSON(#200)
|
| 28 | DATE ENTERED/LAST EDITED | 0;18 | DATE |
|
| 29 | DISCHARGE TYPE | COMPUTED |
|
|
| 30 | AUTHORIZATION | 0;27 | NUMBER |
|
| 31 | 38 U.S.C. 1725 | 0;28 | SET |
|
| 32 | FPPS CLAIM ID | 5;1 | FREE TEXT |
|
| 50 | NOTICE OF DISAGREEMENT RECV'D | A;1 | DATE |
|
| 51 | STATEMENT OF THE CASE ISSUED | A;2 | DATE |
|
| 52 | DATE SUBSTANTIVE APPEAL RECV'D | A;3 | DATE |
|
| 53 | DATE APPEAL DISPOSITIONED | A;4 | DATE |
|
| 54 | DATE APPEALED TO COVA | A;5 | DATE |
|
| 55 | DATE COVA APPEAL DISPOSITIONED | A;6 | DATE |
|
| 292 | USER AUDIT | LOG1;0 | DATE Multiple #162.792 | 162.792
|
| 293 | DATA AUDIT | LOG2;0 | DATE Multiple #162.793 | 162.793
|
| Name | Field # of Occurrence |
|---|---|
| ^%DT | .01+1, 3+1, 4+1, 7+1, 11+1, 12+1, 13+1, 19.5+1, 19.6+1, 21+1 , 22+1, 25+1, 26+1, 28+1, 50+1, 51+1, 52+1, 53+1, 54+1, 55+1 |
| ^DIC | .5+1, 10+1, 20+1, 24+1 |
| Y^DIQ | ID1+1, ID2+1, ID24+1 |
| $$DATX^FBAAUTL | IDWRITE+1, 12(HELP ), 13(HELP ) |
| AUD^FBUCAUD | IXAUDSL+1, IXAUDKL+1 |
| LTRDT^FBUCAUD | IXAILTSL+1, IXAILTKL+1 |
| $$DISCHTYP^FBUCDD | 29+1 |
| $$INPUT^FBUCDD | 4+1, 7+1, 10+1, 12+1, 13+1, 23+1, 24+1 |
| MSIX^FBUCDD | 1(XREF 4S), 1(XREF 4K), 2(XREF 4S), 2(XREF 4K), 20(XREF 4S), 20(XREF 4K), 20(XREF 5S), 20(XREF 5K), 20(XREF 6S), 20(XREF 6K) , 23(XREF 2S), 23(XREF 2K), 24(XREF 2S), 24(XREF 2K), 24(XREF 8S), 24(XREF 8K), 24(XREF 9S), 24(XREF 9K) |
| DEL^FBUCDD1 | .01DEL.01+1 |
| $$FBZ^FBUCUTL | IDWRITE+1, 1(XREF 3S), 1(XREF 3K), 2(XREF 3S), 2(XREF 3K), 23(XREF 1S), 23(XREF 1K), 24(XREF 3S), 24(XREF 3K), 24(XREF 4S) , 24(XREF 4K), 24(XREF 5S), 24(XREF 5K), 24(XREF 7S), 24(XREF 7K), 26(XREF 1S), 26(XREF 1K) |
| $$ORDER^FBUCUTL | 24(XREF 3S), 24(XREF 3K), 26(XREF 1S), 26(XREF 1K) |
| Name | Line Occurrences (* Changed, ! Killed) |
|---|---|
| ^DD(161.2 | ID1+1 |
| ^DD(162.92 | ID24+1 |
| ^DD(2 | ID2+1 |
| ^DPT - [#2] | ID2+1 |
| ^FB(162.92 - [#162.92] | ID24+1 |
| ^FB583 - [#162.7] | .5(XREF 1S), .5(XREF 1K), .5(XREF 2S), .5(XREF 2K), 1(XREF 2S), 1(XREF 2K), 2(XREF 2S), 2(XREF 2K), 3(XREF 1S), 3(XREF 1K) , 3(XREF 2S), 3(XREF 2K), 12(HELP ), 12(XREF 1S), 12(XREF 1K), 13(HELP ), 13(XREF 1S), 13(XREF 1K), 24(XREF 1S), 24(XREF 1K) , 25(XREF 1S), 25(XREF 1K) |
| ^FB583("AA" | .5(XREF 1S), .5(XREF 1K), 12(XREF 1S), 12(XREF 1K) |
| ^FB583("AC" | 10(XREF 1S), 10(XREF 1K) |
| ^FB583("AD" | .5(XREF 2S), .5(XREF 2K), 13(XREF 1S), 13(XREF 1K) |
| ^FB583("AES" | 24(XREF 3S), 24(XREF 3K), 26(XREF 1S), 26(XREF 1K) |
| ^FB583("AFC" | IXAFCSL+1*, IXAFCKL+1!, IXAFCKEIC+1! |
| ^FB583("AID" | .01(XREF 2S), .01(XREF 2K) |
| ^FB583("AL" | 19(XREF 1S), 19(XREF 1K) |
| ^FB583("ALP" | 19.5(XREF 1S), 19.5(XREF 1K) |
| ^FB583("AMC" | 20(XREF 3S), 20(XREF 3K) |
| ^FB583("AMP" | 20(XREF 2S), 20(XREF 2K) |
| ^FB583("AMS" | 20(XREF 1S), 20(XREF 1K) |
| ^FB583("AOS" | 23(XREF 1S), 23(XREF 1K), 24(XREF 7S), 24(XREF 7K) |
| ^FB583("APF" | 2(XREF 2S), 2(XREF 2K), 3(XREF 1S), 3(XREF 1K) |
| ^FB583("APS" | 2(XREF 3S), 2(XREF 3K), 24(XREF 4S), 24(XREF 4K) |
| ^FB583("AS" | 24(XREF 6S), 24(XREF 6K) |
| ^FB583("ASD" | 24(XREF 1S), 24(XREF 1K), 25(XREF 1S), 25(XREF 1K) |
| ^FB583("AVF" | 1(XREF 2S), 1(XREF 2K), 3(XREF 2S), 3(XREF 2K) |
| ^FB583("AVS" | 1(XREF 3S), 1(XREF 3K), 24(XREF 5S), 24(XREF 5K) |
| ^FB583("B" | .01(XREF 1S), .01(XREF 1K) |
| ^FB583("C" | 1(XREF 1S), 1(XREF 1K) |
| ^FB583("D" | 2(XREF 1S), 2(XREF 1K) |
| ^FBAAV - [#161.2] | ID1+1 |
| Name | Field # of Occurrence |
|---|---|
| ^(0 | ID1+1, ID2+1, ID24+1, .5(XREF 1S), .5(XREF 1K), .5(XREF 2S), .5(XREF 2K), 1(XREF 2S), 1(XREF 2K), 2(XREF 2S) , 2(XREF 2K), 3(XREF 1S), 3(XREF 1K), 3(XREF 2S), 3(XREF 2K), 12(XREF 1S), 12(XREF 1K), 13(XREF 1S), 13(XREF 1K), 24(XREF 1S) , 24(XREF 1K), 25(XREF 1S), 25(XREF 1K) |
| >> | Not killed explicitly |
| * | Changed |
| ! | Killed |
| ~ | Newed |
| Name | Field # of Occurrence |
|---|---|
| %DT | .01+1*!, 3+1*, 4+1*, 7+1*!, 11+1*!, 12+1*, 13+1*, 19.5+1*!, 19.6+1*, 21+1* , 22+1*!, 25+1*!, 26+1*, 28+1*!, 50+1*!, 51+1*!, 52+1*!, 53+1*!, 54+1*!, 55+1*! |
| %DT(0 | .01+1*, 3+1*!, 4+1*!, 7+1*, 11+1*, 12+1*!, 13+1*!, 19.5+1*, 22+1*, 25+1* , 28+1*, 50+1*, 51+1*, 52+1*, 53+1*, 54+1*, 55+1* |
| %I | ID1+1*!, ID2+1*!, ID24+1*! |
| >> C | ID1+1*, ID2+1*, ID24+1* |
| >> D0 | 29+1 |
| >> DA | IXAFCSL+1, IXAFCKL+1, .01DEL.01+1, .01(XREF 1S), .01(XREF 1K), .01(XREF 2S), .01(XREF 2K), .5(XREF 1S), .5(XREF 1K), .5(XREF 2S) , .5(XREF 2K), 1(XREF 1S), 1(XREF 1K), 1(XREF 2S), 1(XREF 2K), 1(XREF 3S), 1(XREF 3K), 1(XREF 4S), 1(XREF 4K), 2(XREF 1S) , 2(XREF 1K), 2(XREF 2S), 2(XREF 2K), 2(XREF 3S), 2(XREF 3K), 2(XREF 4S), 2(XREF 4K), 3(XREF 1S), 3(XREF 1K), 3(XREF 2S) , 3(XREF 2K), 4+1, 7+1, 10+1, 10(XREF 1S), 10(XREF 1K), 12+1, 12(HELP ), 12(XREF 1S), 12(XREF 1K) , 13+1, 13(HELP ), 13(XREF 1S), 13(XREF 1K), 19(XREF 1S), 19(XREF 1K), 19.5(XREF 1S), 19.5(XREF 1K), 20(XREF 1S), 20(XREF 1K) , 20(XREF 2S), 20(XREF 2K), 20(XREF 3S), 20(XREF 3K), 20(XREF 4S), 20(XREF 4K), 20(XREF 5S), 20(XREF 5K), 20(XREF 6S), 20(XREF 6K) , 23+1, 23(XREF 1S), 23(XREF 1K), 23(XREF 2S), 23(XREF 2K), 24+1, 24(XREF 1S), 24(XREF 1K), 24(XREF 2S), 24(XREF 2K) , 24(XREF 3S), 24(XREF 3K), 24(XREF 4S), 24(XREF 4K), 24(XREF 5S), 24(XREF 5K), 24(XREF 6S), 24(XREF 6K), 24(XREF 7S), 24(XREF 7K) , 24(XREF 8S), 24(XREF 8K), 24(XREF 9S), 24(XREF 9K), 25(XREF 1S), 25(XREF 1K), 26(XREF 1S), 26(XREF 1K) |
| DIC | ID1+1, ID2+1, ID24+1, .5+1!*, 10+1!*, 20+1!*, 24+1!* |
| DIC("S" | .5+1*, .5SCR+1*, 10+1*, 10SCR+1*, 20+1*, 20SCR+1*, 21SCR+1*, 24+1*, 24SCR+1* |
| >> DIE | .5+1, 10+1, 20+1, 24+1 |
| DT | .01+1, 3+1, 4+1, 7+1, 11+1, 12+1, 13+1, 19.5+1, 22+1, 25+1 , 28+1, 50+1, 51+1, 52+1, 53+1, 54+1, 55+1 |
| FBZ | IDWRITE+1*!, 1(XREF 3S), 1(XREF 3K), 2(XREF 3S), 2(XREF 3K), 23(XREF 1S), 23(XREF 1K), 24(XREF 3S), 24(XREF 3K), 24(XREF 4S) , 24(XREF 4K), 24(XREF 5S), 24(XREF 5K), 24(XREF 7S), 24(XREF 7K), 26(XREF 1S), 26(XREF 1K) |
| FBZZ | 4+1*!, 7+1*!, 10+1*!, 12+1*!, 13+1*!, 23+1~*!, 24+1*! |
| U | ID1+1, ID2+1, ID24+1, IDWRITE+1, .5(XREF 1S), .5(XREF 1K), .5(XREF 2S), .5(XREF 2K), 1(XREF 2S), 1(XREF 2K) , 1(XREF 3S), 1(XREF 3K), 2(XREF 2S), 2(XREF 2K), 2(XREF 3S), 2(XREF 3K), 3(XREF 1S), 3(XREF 1K), 3(XREF 2S), 3(XREF 2K) , 12(HELP ), 12(XREF 1S), 12(XREF 1K), 13(HELP ), 13(XREF 1S), 13(XREF 1K), 23(XREF 1S), 23(XREF 1K), 24(XREF 1S), 24(XREF 1K) , 24(XREF 3S), 24(XREF 3K), 24(XREF 4S), 24(XREF 4K), 24(XREF 5S), 24(XREF 5K), 24(XREF 7S), 24(XREF 7K), 25(XREF 1S), 25(XREF 1K) , 26(XREF 1S), 26(XREF 1K) |
| X | IXAFCSL+1, IXAFCKL+1, IXAILTSCC+1*, IXAILTKCC+1*, .01+1*!, .01(XREF 1S), .01(XREF 1K), .01(XREF 2S), .01(XREF 2K), .5+1*! , .5(XREF 1S), .5(XREF 1K), .5(XREF 2S), .5(XREF 2K), 1(XREF 1S), 1(XREF 1K), 1(XREF 2S), 1(XREF 2K), 1(XREF 3S), 1(XREF 3K) , 1(XREF 4S), 1(XREF 4K), 2(XREF 1S), 2(XREF 1K), 2(XREF 2S), 2(XREF 2K), 2(XREF 3S), 2(XREF 3K), 2(XREF 4S), 2(XREF 4K) , 3+1*!, 3(XREF 1S), 3(XREF 1K), 3(XREF 2S), 3(XREF 2K), 4+1*!, 5+1!, 7+1*!, 8+1*!, 10+1*! , 10(XREF 1S), 10(XREF 1K), 11+1*!, 12+1*!, 12(XREF 1S), 12(XREF 1K), 13+1*!, 13(XREF 1S), 13(XREF 1K), 14+1*! , 19(XREF 1S), 19(XREF 1K), 19.5+1*!, 19.5(XREF 1S), 19.5(XREF 1K), 19.6+1*!, 20+1*!, 20(XREF 1S), 20(XREF 1K), 20(XREF 2S) , 20(XREF 2K), 20(XREF 3S), 20(XREF 3K), 20(XREF 4S), 20(XREF 4K), 20(XREF 5S), 20(XREF 5K), 20(XREF 6S), 20(XREF 6K), 21+1*! , 22+1*!, 23+1!, 23(XREF 1S), 23(XREF 1K), 23(XREF 2S), 23(XREF 2K), 24+1*!, 24(XREF 1S), 24(XREF 1K), 24(XREF 2S) , 24(XREF 2K), 24(XREF 3S), 24(XREF 3K), 24(XREF 4S), 24(XREF 4K), 24(XREF 5S), 24(XREF 5K), 24(XREF 6S), 24(XREF 6K), 24(XREF 7S) , 24(XREF 7K), 24(XREF 8S), 24(XREF 8K), 24(XREF 9S), 24(XREF 9K), 25+1*!, 25(XREF 1S), 25(XREF 1K), 26+1*!, 26(XREF 1S) , 26(XREF 1K), 28+1*!, 29+1*, 30+1!, 32+1!, 50+1*!, 51+1*!, 52+1*!, 53+1*!, 54+1*! , 55+1*! |
| >> X1(1 | IXAILTSCC+1, IXAILTKCC+1 |
| >> X2(1 | IXAILTSCC+1, IXAILTKCC+1 |
| >> Y | ID1+1*, ID2+1*, ID24+1*, IDWRITE+1, .01+1, .5+1, 3+1, 4+1, 7+1, 10+1 , 11+1, 12+1, 13+1, 19.5+1, 19.6+1, 20+1, 21+1, 22+1, 23+1, 24+1 , 25+1, 26+1, 28+1, 50+1, 51+1, 52+1, 53+1, 54+1, 55+1 |