| FileMan FileNo | FileMan Filename | Package |
|---|---|---|
| 355.3 | GROUP INSURANCE PLAN | Integrated Billing |
| Package | Total | FileMan Files |
|---|---|---|
| Integrated Billing | 4 | INSURANCE COMPANY(#36)[.01] PLAN(#366.03)[6.01] TYPE OF PLAN(#355.1)[.09] INSURANCE FILING TIME FRAME(#355.13)[.16] |
| Kernel | 1 | NEW PERSON(#200)[1.02, 1.04, 1.06, 1.08] |
| Registration | 1 | PATIENT(#2)[.1] |
| Field # | Name | Loc | Type | Details |
|---|---|---|---|---|
| .01 | INSURANCE COMPANY | 0;1 | POINTER TO INSURANCE COMPANY FILE (#36) | ************************REQUIRED FIELD************************ INSURANCE COMPANY(#36)
|
| .02 | IS THIS A GROUP POLICY? | 0;2 | SET |
|
| .03 | *GROUP NAME | 0;3 | FREE TEXT |
|
| .04 | *GROUP NUMBER | 0;4 | FREE TEXT |
|
| .05 | IS UTILIZATION REVIEW REQUIRED | 0;5 | SET |
|
| .06 | IS PRE-CERTIFICATION REQUIRED? | 0;6 | SET |
|
| .07 | EXCLUDE PRE-EXISTING CONDITION | 0;7 | SET |
|
| .08 | BENEFITS ASSIGNABLE? | 0;8 | SET |
|
| .09 | TYPE OF PLAN | 0;9 | POINTER TO TYPE OF PLAN FILE (#355.1) | TYPE OF PLAN(#355.1)
|
| .1 | INDIVIDUAL POLICY PATIENT | 0;10 | POINTER TO PATIENT FILE (#2) | PATIENT(#2)
|
| .11 | INACTIVE | 0;11 | SET |
|
| .12 | AMBULATORY CARE CERTIFICATION | 0;12 | SET |
|
| .13 | PLAN FILING TIME FRAME | 0;13 | FREE TEXT |
|
| .14 | PLAN CATEGORY | 0;14 | SET |
|
| .15 | ELECTRONIC PLAN TYPE | 0;15 | SET |
|
| .16 | PLAN STANDARD FTF | 0;16 | POINTER TO INSURANCE FILING TIME FRAME FILE (#355.13) | INSURANCE FILING TIME FRAME(#355.13)
|
| .17 | PLAN STANDARD FTF VALUE | 0;17 | NUMBER |
|
| 1.01 | DATE ENTERED | 1;1 | DATE |
|
| 1.02 | ENTERED BY | 1;2 | POINTER TO NEW PERSON FILE (#200) | NEW PERSON(#200)
|
| 1.03 | DATE LAST VERIFIED | 1;3 | DATE |
|
| 1.04 | VERIFIED BY | 1;4 | POINTER TO NEW PERSON FILE (#200) | NEW PERSON(#200)
|
| 1.05 | DATE LAST EDITED | 1;5 | DATE |
|
| 1.06 | LAST EDITED BY | 1;6 | POINTER TO NEW PERSON FILE (#200) | NEW PERSON(#200)
|
| 1.07 | DATE LAST MATCHED | 1;7 | DATE |
|
| 1.08 | LAST MATCHED BY | 1;8 | POINTER TO NEW PERSON FILE (#200) | NEW PERSON(#200)
|
| 2.01 | GROUP NAME | 2;1 | FREE TEXT |
|
| 2.02 | GROUP NUMBER | 2;2 | FREE TEXT |
|
| 3.01 | DELETE REASON | 3;1 | FREE TEXT |
|
| 6.01 | PLAN ID | 6;1 | POINTER TO PLAN FILE (#366.03) | PLAN(#366.03)
|
| 6.02 | BANKING IDENTIFICATION NUMBER | 6;2 | FREE TEXT |
|
| 6.03 | PROCESSOR CONTROL NUMBER (PCN) | 6;3 | FREE TEXT |
|
| 11 | COMMENTS | 11;0 | WORD-PROCESSING #355.311 |
|
| ICR LINK | Subscribing Package(s) | Fields Referenced | Description |
|---|---|---|---|
| ICR #952 | IS PRE-CERTIFICATION REQUIRED? (.06). Access: Write w/Fileman TYPE OF PLAN (.09). Access: Write w/Fileman |
||
| ICR #3823 | GROUP NAME (.03). Access: Direct Global Read & w/Fileman GROUP NUMBER (.04). Access: Direct Global Read & w/Fileman TYPE OF PLAN (.09). Access: Direct Global Read & w/Fileman |
||
| ICR #5293 | |||
| ICR #7304 | INSURANCE COMPANY (.01). Access: Both R/W w/Fileman IS THIS A GROUP POLICY (.02). Access: Both R/W w/Fileman IS UTILIZATION REVIEW REQUIRED (.05). Access: Both R/W w/Fileman IS PRE-CERTIFICATION REQUIRED? (.06). Access: Both R/W w/Fileman BENEFITS ASSIGNABLE? (.08). Access: Both R/W w/Fileman TYPE OF PLAN (.09). Access: Both R/W w/Fileman INDIVIDUAL POLICY PATIENT (.1). Access: Both R/W w/Fileman INACTIVE (.11). Access: Read w/Fileman AMBULATORY CARE CERTIFICATION (.12). Access: Both R/W w/Fileman PLAN FILING TIME FRAME (.13). Access: Both R/W w/Fileman PLAN CATEGORY (.14). Access: Both R/W w/Fileman ELECTRONIC PLAN TYPE (.15). Access: Both R/W w/Fileman PLAN STANDARD FTF (.16). Access: Both R/W w/Fileman PLAN STANDARD FTF VALUE (.17). Access: Both R/W w/Fileman DATE LAST VERIFIED (1.03). Access: Write w/Fileman VERIFIED BY (1.04). Access: Write w/Fileman DATE LAST EDITED (1.05). Access: Write w/Fileman LAST EDITED BY (1.06). Access: Write w/Fileman GROUP NAME (2.01). Access: Both R/W w/Fileman GROUP NUMBER (2.02). Access: Both R/W w/Fileman PLAN ID (6.01). Access: Both R/W w/Fileman BANKING IDENTIFICATION NUMBER (6.02). Access: Both R/W w/Fileman PROCESSOR CONTROL NUMBER (6.03). Access: Both R/W w/Fileman COMMENTS (.01). Access: Both R/W w/Fileman |
| Name | Field # of Occurrence |
|---|---|
| ^%DT | 1.01+1, 1.03+1, 1.05+1, 1.07+1 |
| NOW^%DTC | .01(XREF 2n1.1) |
| ^DIC | .09+1 |
| ^DICR | .01(XREF 2n1.4), .01(XREF 3n1.4), .03(XREF 4n1.4), .03(XREF 4n2.4), .04(XREF 5n1.4), .04(XREF 5n2.4), .09(XREF 1n1.4), .09(XREF 1n2.4), .16(XREF 1S), .16(XREF 1K) , 2.01(XREF 1n1.4), 2.01(XREF 1n2.4), 2.02(XREF 1n1.4), 2.02(XREF 1n2.4) |
| $$LENCHK^IBCNEUT1 | 2.01+1, 2.02+1 |
| $$COMP^IBCNSJ | .01(XREF 6S), .01(XREF 6K), .01(XREF 7S), .01(XREF 7K), .03(XREF 3S), .03(XREF 3K), .04(XREF 3S), .04(XREF 3K) |
| EVENT^IVMPLOG | .04(XREF 4S), .04(XREF 4K) |
| Name | Line Occurrences (* Changed, ! Killed) |
|---|---|
| ^DD( | .01(XREF 2n1.4), .01(XREF 3n1.4), .09(XREF 1n1.4), .09(XREF 1n2.4) |
| ^DD(355.1 | .09(XREF 1n69.2), .09(XREF 1n79.2) |
| ^DD(355.3 | .01(XREF 2S), .01(XREF 3S), .03(XREF 4S), .03(XREF 4K), .04(XREF 5S), .04(XREF 5K), .09(XREF 1S), .09(XREF 1n1.3), .09(XREF 1K), .09(XREF 1n2.3) , .09(XREF 1n69.3), .09(XREF 1n69.4), .09(XREF 1n79.3), .09(XREF 1n79.4), 2.01(XREF 1S), 2.01(XREF 1K), 2.02(XREF 1S), 2.02(XREF 1K) |
| ^IBA(355.3 - [#355.3] | .01(XREF 1S), .01(XREF 1K), .01(XREF 2S), .01(XREF 2n1.4), .01(XREF 3S), .01(XREF 3n1.3), .01(XREF 3n1.4), .01(XREF 4S), .01(XREF 4K), .01(XREF 5S) , .01(XREF 5K), .01(XREF 6S), .01(XREF 6K), .01(XREF 7S), .01(XREF 7K), .03(XREF 1S), .03(XREF 1K), .03(XREF 2S), .03(XREF 2K), .03(XREF 3S) , .03(XREF 3K), .03(XREF 4S), .03(XREF 4n1.3), .03(XREF 4n1.4), .03(XREF 4K), .03(XREF 4n2.4), .04(XREF 1S), .04(XREF 1K), .04(XREF 2S), .04(XREF 2K) , .04(XREF 3S), .04(XREF 3K), .04(XREF 4S), .04(XREF 4K), .04(XREF 5S), .04(XREF 5n1.3), .04(XREF 5n1.4), .04(XREF 5K), .04(XREF 5n2.4), .09(XREF 1S) , .09(XREF 1n1.4), .09(XREF 1K), .09(XREF 1n2.4), .09(XREF 1n69.2), .09(XREF 1n79.2), .16(XREF 1S), .16(XREF 1K), 2.01(XREF 1S), 2.01(XREF 1n1.3), 2.01(XREF 1n1.4) , 2.01(XREF 1K), 2.01(XREF 1n2.4), 2.02(XREF 1S), 2.02(XREF 1n1.3), 2.02(XREF 1n1.4), 2.02(XREF 1K), 2.02(XREF 1n2.4) |
| ^IBE(355.1 - [#355.1] | .09(XREF 1n69.2), .09(XREF 1n69.3), .09(XREF 1n79.2), .09(XREF 1n79.3) |
| ^VA(200 - [#200] | .01(XREF 3n1.3) |
| Name | Field # of Occurrence |
|---|---|
| ^(0 | ID.02+1, ID.03+1, ID.04+1, .01(XREF 3n1.3), .01(XREF 4S), .01(XREF 4K), .01(XREF 5S), .01(XREF 5K), .03(XREF 2S), .04(XREF 2S) , .09(XREF 1S), .09(XREF 1n1.4), .09(XREF 1K), .09(XREF 1n2.4), .09(XREF 1n69.2), .09(XREF 1n69.3), .09(XREF 1n79.2), .09(XREF 1n79.3), .16(XREF 1S), .16(XREF 1K) , 2.01(XREF 1S), 2.01(XREF 1n1.4), 2.01(XREF 1K), 2.01(XREF 1n2.4), 2.02(XREF 1S), 2.02(XREF 1n1.4), 2.02(XREF 1K), 2.02(XREF 1n2.4) |
| ^(1 | .01(XREF 2S), .01(XREF 2n1.4), .01(XREF 3S), .01(XREF 3n1.3), .01(XREF 3n1.4) |
| ^(2 | .03(XREF 4S), .03(XREF 4n1.4), .03(XREF 4K), .03(XREF 4n2.4), .04(XREF 5S), .04(XREF 5n1.4), .04(XREF 5K), .04(XREF 5n2.4) |
| >> | Not killed explicitly |
| * | Changed |
| ! | Killed |
| ~ | Newed |
| Name | Field # of Occurrence |
|---|---|
| % | .01(XREF 2n1.1) |
| >> %DT | 1.01+1*, 1.03+1*, 1.05+1*, 1.07+1* |
| %H | .01(XREF 2n1.1) |
| %I | .01(XREF 2n1.1) |
| >> D0 | .01(XREF 2S), .01(XREF 3S), .01(XREF 3n1.3), .03(XREF 4S), .03(XREF 4n1.3), .03(XREF 4K), .04(XREF 5S), .04(XREF 5n1.3), .04(XREF 5K), .09(XREF 1S) , .09(XREF 1n1.3), .09(XREF 1K), .09(XREF 1n2.3), .09(XREF 1n69.2), .09(XREF 1n69.3), .09(XREF 1n79.2), .09(XREF 1n79.3), .16(XREF 1S), .16(XREF 1K), 2.01(XREF 1S) , 2.01(XREF 1n1.3), 2.01(XREF 1K), 2.02(XREF 1S), 2.02(XREF 1n1.3), 2.02(XREF 1K) |
| >> DA | .01(XREF 1S), .01(XREF 1K), .01(XREF 2S), .01(XREF 3n1.3), .01(XREF 4S), .01(XREF 4K), .01(XREF 5S), .01(XREF 5K), .01(XREF 6S), .01(XREF 6K) , .01(XREF 7S), .01(XREF 7K), .03(XREF 1S), .03(XREF 1K), .03(XREF 2S), .03(XREF 2K), .03(XREF 3S), .03(XREF 3K), .03(XREF 4S), .03(XREF 4n1.3) , .03(XREF 4K), .04(XREF 1S), .04(XREF 1K), .04(XREF 2S), .04(XREF 2K), .04(XREF 3S), .04(XREF 3K), .04(XREF 4S), .04(XREF 4K), .04(XREF 5S) , .04(XREF 5n1.3), .04(XREF 5K), .09(XREF 1n1.3), .09(XREF 1n2.3), .16(XREF 1S), .16(XREF 1K), 2.01(XREF 1S), 2.01(XREF 1n1.3), 2.01(XREF 1K), 2.02(XREF 1S) , 2.02(XREF 1n1.3), 2.02(XREF 1K) |
| DIC | .09+1!* |
| DIC("S" | .09+1*, .09SCR+1*, .14SCR+1* |
| >> DIE | .09+1 |
| >> DIG | .01(XREF 2n1.4), .01(XREF 3n1.4), .03(XREF 4n1.4), .03(XREF 4n2.4), .04(XREF 5n1.4), .04(XREF 5n2.4), .09(XREF 1n1.4), .09(XREF 1n2.4), .16(XREF 1S), .16(XREF 1K) , 2.01(XREF 1n1.4), 2.01(XREF 1n2.4), 2.02(XREF 1n1.4), 2.02(XREF 1n2.4) |
| >> DIH | .01(XREF 2n1.4), .01(XREF 3n1.4), .03(XREF 4n1.4), .03(XREF 4n2.4), .04(XREF 5n1.4), .04(XREF 5n2.4), .09(XREF 1n1.4), .09(XREF 1n2.4), .16(XREF 1S), .16(XREF 1K) , 2.01(XREF 1n1.4), 2.01(XREF 1n2.4), 2.02(XREF 1n1.4), 2.02(XREF 1n2.4) |
| >> DIU | .01(XREF 2S), .01(XREF 3S), .03(XREF 4S), .03(XREF 4K), .04(XREF 5S), .04(XREF 5K), .09(XREF 1S), .09(XREF 1K), .16(XREF 1S), .16(XREF 1K) , 2.01(XREF 1S), 2.01(XREF 1K), 2.02(XREF 1S), 2.02(XREF 1K) |
| DIV | .01(XREF 2S), .01(XREF 2n1.1), .01(XREF 2n1.4), .01(XREF 3S), .01(XREF 3n1.3), .01(XREF 3n1.4), .03(XREF 4S), .03(XREF 4n1.3), .03(XREF 4n1.4), .03(XREF 4K) , .03(XREF 4n2.4), .04(XREF 5S), .04(XREF 5n1.3), .04(XREF 5n1.4), .04(XREF 5K), .04(XREF 5n2.4), .09(XREF 1S), .09(XREF 1n1.3), .09(XREF 1n1.4), .09(XREF 1K) , .09(XREF 1n2.3), .09(XREF 1n2.4), .16(XREF 1S), .16(XREF 1K), 2.01(XREF 1S), 2.01(XREF 1n1.3), 2.01(XREF 1n1.4), 2.01(XREF 1K), 2.01(XREF 1n2.4), 2.02(XREF 1S) , 2.02(XREF 1n1.3), 2.02(XREF 1n1.4), 2.02(XREF 1K), 2.02(XREF 1n2.4) |
| DIV(0 | .01(XREF 2S), .01(XREF 2n1.4), .01(XREF 3n1.3), .01(XREF 3n1.4), .03(XREF 4n1.3), .03(XREF 4n1.4), .03(XREF 4K), .03(XREF 4n2.4), .04(XREF 5n1.3), .04(XREF 5n1.4) , .04(XREF 5K), .04(XREF 5n2.4), .09(XREF 1n1.3), .09(XREF 1n1.4), .09(XREF 1n2.3), .09(XREF 1n2.4), .16(XREF 1S), .16(XREF 1K), 2.01(XREF 1n1.3), 2.01(XREF 1n1.4) , 2.01(XREF 1K), 2.01(XREF 1n2.4), 2.02(XREF 1n1.3), 2.02(XREF 1n1.4), 2.02(XREF 1K), 2.02(XREF 1n2.4) |
| DUZ | .01(XREF 3S) |
| >> I(0 | .09(XREF 1n1.3), .09(XREF 1n2.3), .09(XREF 1n69.2), .09(XREF 1n79.2) |
| U | ID.02+1, ID.03+1, ID.04+1, .01(XREF 2S), .01(XREF 2n1.4), .01(XREF 3S), .01(XREF 3n1.3), .01(XREF 3n1.4), .01(XREF 4S), .01(XREF 4K) , .01(XREF 5S), .01(XREF 5K), .03(XREF 4S), .03(XREF 4n1.3), .03(XREF 4n1.4), .03(XREF 4K), .03(XREF 4n2.4), .04(XREF 4S), .04(XREF 4K), .04(XREF 5S) , .04(XREF 5n1.3), .04(XREF 5n1.4), .04(XREF 5K), .04(XREF 5n2.4), .09(XREF 1S), .09(XREF 1n1.4), .09(XREF 1K), .09(XREF 1n2.4), .09(XREF 1n69.2), .09(XREF 1n69.3) , .09(XREF 1n69.4), .09(XREF 1n79.2), .09(XREF 1n79.3), .09(XREF 1n79.4), .16(XREF 1S), .16(XREF 1K), 2.01(XREF 1S), 2.01(XREF 1n1.3), 2.01(XREF 1n1.4), 2.01(XREF 1K) , 2.01(XREF 1n2.4), 2.02(XREF 1S), 2.02(XREF 1n1.3), 2.02(XREF 1n1.4), 2.02(XREF 1K), 2.02(XREF 1n2.4) |
| X | .01(XREF 1S), .01(XREF 1K), .01(XREF 2S), .01(XREF 2n1.1), .01(XREF 2n1.4), .01(XREF 3S), .01(XREF 3n1.3), .01(XREF 3n1.4), .01(XREF 4S), .01(XREF 4K) , .01(XREF 5S), .01(XREF 5K), .01(XREF 6S), .01(XREF 6K), .01(XREF 7S), .01(XREF 7K), .03+1!, .03(XREF 1S), .03(XREF 1K), .03(XREF 2S) , .03(XREF 2K), .03(XREF 3S), .03(XREF 3K), .03(XREF 4S), .03(XREF 4n1.3), .03(XREF 4n1.4), .03(XREF 4K), .03(XREF 4n2.4), .04+1!, .04(XREF 1S) , .04(XREF 1K), .04(XREF 2S), .04(XREF 2K), .04(XREF 3S), .04(XREF 3K), .04(XREF 5S), .04(XREF 5n1.3), .04(XREF 5n1.4), .04(XREF 5K), .04(XREF 5n2.4) , .09+1*!, .09(XREF 1S), .09(XREF 1n1.3), .09(XREF 1n1.4), .09(XREF 1K), .09(XREF 1n2.3), .09(XREF 1n2.4), .09(XREF 1n69.3), .09(XREF 1n69.4), .09(XREF 1n79.3) , .09(XREF 1n79.4), .13+1!, .16(XREF 1S), .16(XREF 1K), .17+1!, 1.01+1*!, 1.03+1*!, 1.05+1*!, 1.07+1*!, 2.01+1! , 2.01(XREF 1S), 2.01(XREF 1n1.3), 2.01(XREF 1n1.4), 2.01(XREF 1K), 2.01(XREF 1n2.4), 2.02+1!, 2.02(XREF 1S), 2.02(XREF 1n1.3), 2.02(XREF 1n1.4), 2.02(XREF 1K) , 2.02(XREF 1n2.4), 3.01+1!, 6.02+1!, 6.03+1! |
| Y | .01(XREF 2S), .01(XREF 3S), .01(XREF 6S), .01(XREF 6K), .01(XREF 7S), .01(XREF 7K), .03(XREF 3S), .03(XREF 3K), .03(XREF 4S), .03(XREF 4K) , .04(XREF 3S), .04(XREF 3K), .04(XREF 5S), .04(XREF 5K), .09+1, .09(XREF 1S), .09(XREF 1n1.3), .09(XREF 1K), .09(XREF 1n2.3), .09(XREF 1n69.4) , .09(XREF 1n79.4), .16(XREF 1S), .16(XREF 1K), 1.01+1, 1.03+1, 1.05+1, 1.07+1, 2.01(XREF 1S), 2.01(XREF 1K), 2.02(XREF 1S) , 2.02(XREF 1K) |
| Y(0 | .01(XREF 2S), .01(XREF 3n1.3), .03(XREF 4n1.3), .03(XREF 4K), .04(XREF 5n1.3), .04(XREF 5K), .09(XREF 1n1.3), .09(XREF 1n2.3), .09(XREF 1n69.2), 2.01(XREF 1n1.3) , 2.01(XREF 1K), 2.02(XREF 1n1.3), 2.02(XREF 1K) |
| Y(1 | .01(XREF 2S), .01(XREF 3S), .01(XREF 3n1.3), .03(XREF 4S), .03(XREF 4K), .04(XREF 5S), .04(XREF 5K), .09(XREF 1S), .09(XREF 1K), .09(XREF 1n79.2) , .09(XREF 1n79.4), .16(XREF 1S), .16(XREF 1K), 2.01(XREF 1S), 2.01(XREF 1K), 2.02(XREF 1S), 2.02(XREF 1K) |
| Y(101 | .09(XREF 1n69.3), .09(XREF 1n79.3) |
| Y(102 | .09(XREF 1n69.2), .09(XREF 1n69.3), .09(XREF 1n79.2), .09(XREF 1n79.3) |
| Y(103 | .09(XREF 1n1.3), .09(XREF 1n2.3), .09(XREF 1n69.3), .09(XREF 1n79.3) |
| Y(104 | .09(XREF 1n69.4), .09(XREF 1n79.4) |
| Y(105 | .09(XREF 1n1.3), .09(XREF 1n2.3), .09(XREF 1n69.4), .09(XREF 1n79.4) |
| Y(106 | .09(XREF 1n1.3), .09(XREF 1n2.3), .09(XREF 1n69.4), .09(XREF 1n79.4) |
| Y(107 | .09(XREF 1n1.3), .09(XREF 1n2.3), .09(XREF 1n69.4), .09(XREF 1n79.4) |
| Y(2 | .09(XREF 1n69.2), .09(XREF 1n69.4) |