FileMan FileNo | FileMan Filename | Package |
---|---|---|
161 | FEE BASIS PATIENT | Fee Basis |
Package | Total | FileMan Files |
---|---|---|
Fee Basis | 4 | FEE BASIS CNH AUTHORIZATION RATE(#161.23)[.04] FEE BASIS PHARMACY INVOICE(#162.1)[#162.11(4)] FEE CNH ACTIVITY(#162.3)[1] FEE BASIS INVOICE(#162.5)[3] |
Field # | Name | Loc | Type | Details |
---|---|---|---|---|
.01 | NAME | 0;1 | POINTER TO PATIENT FILE (#2) | ************************REQUIRED FIELD************************ PATIENT(#2)
|
.5 | FEE ID CARD NUMBER | 4;1 | FREE TEXT |
|
.6 | FEE ID CARD ISSUE DATE | 4;2 | DATE |
|
.65 | FEE ID CARD EXPIRATION DATE | 4;4 | DATE |
|
.7 | REASON FOR CARD NUMBER CHANGE | 4;3 | FREE TEXT | ************************REQUIRED FIELD************************
|
1 | AUTHORIZATION | 1;0 | DATE Multiple #161.01 | 161.01
|
2 | REPORT OF CONTACT | 2;0 | DATE Multiple #161.02 | 161.02
|
11 | ARCH ELIGIBILITY | ARCHFEE;0 | DATE Multiple #161.011 | 161.011
|
ICR LINK | Subscribing Package(s) | Fields Referenced | Description |
---|---|---|---|
ICR #6384 | FROM DATE (.01). Access: Read w/Fileman TO DATE (.02). Access: Read w/Fileman FEE PROGRAM (.03). Access: Read w/Fileman VENDOR (.04). Access: Read w/Fileman PRIMARY SERVICE AREA (101). Access: Read w/Fileman PURPOSE OF VISIT CODE (.07). Access: Read w/Fileman DX LINE 1 (.08). Access: Read w/Fileman ASSOCIATED 7078/583 (.055). Access: Read w/Fileman TREATMENT TYPE CODE (.095). Access: Read w/Fileman DISCHARGE TYPE (.06). Access: Read w/Fileman PATIENT TYPE CODE (.065). Access: Read w/Fileman ACCIDENT RELATED (Y/N) (.096). Access: Read w/Fileman POTENTIAL COST RECOVERY CASE (.097). Access: Read w/Fileman REFERRING PROVIDER (104). Access: Read w/Fileman CONTRACT (105). Access: Read w/Fileman AUTHORIZATION REMARKS (.021). Access: Read w/Fileman DX LINE 2 (.085). Access: Read w/Fileman DX LINE 3 (.086). Access: Read w/Fileman ICD DIAGNOSIS (.087). Access: Read w/Fileman |
Used to identify limitations or detail specificsregarding the authorization. The information contained here is displayedduring the enter payment option and also on patient inquiry option. |