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Global: ^IBA(355.32

Package: Integrated Billing

Global: ^IBA(355.32


Information

FileMan FileNo FileMan Filename Package
355.32 PLAN COVERAGE LIMITATIONS Integrated Billing

Description

Directly Accessed By Routines, Total: 19

Package Total Routines
Integrated Billing 19 IBBFAPI    IBCMDT2    IBCNBCD2    IBCNRP    IBCNRP5    IBCNRPM1    IBCNRPMT    IBCNRPS2
IBCNRRP2    IBCNSC41    IBCNSJ    IBCNSJ51    IBCNSJ52    IBCNSU3    IBCNSUR2    IBCONS1
IBOHLD2    IBOHLS1    IBRBUL    

Accessed By FileMan Db Calls, Total: 4

Package Total Routines
Integrated Billing 4 IBCMDT2    IBCNBCD2    IBCNSJ    IBCNSJ51    

Pointer To FileMan Files, Total: 3

Package Total FileMan Files
Integrated Billing 2 GROUP INSURANCE PLAN(#355.3)[.01]    PLAN LIMITATION CATEGORY(#355.31)[.02]    
Kernel 1 NEW PERSON(#200)[1.021.04]    

Fields, Total: 9

Field # Name Loc Type Details
.01 PLAN 0;1 POINTER TO GROUP INSURANCE PLAN FILE (#355.3)
************************REQUIRED FIELD************************
GROUP INSURANCE PLAN(#355.3)

  • LAST EDITED:  AUG 16, 1995
  • HELP-PROMPT:  Enter the plan that this limitation applies to.
  • DESCRIPTION:  
    The plan that this limitation will apply to.
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
  • CROSS-REFERENCE:  355.32^B
    1)= S ^IBA(355.32,"B",$E(X,1,30),DA)=""
    2)= K ^IBA(355.32,"B",$E(X,1,30),DA)
  • CROSS-REFERENCE:  355.32^APCD^MUMPS
    1)= I $P($G(^IBA(355.32,DA,0)),U,2)'="",$P(^(0),U,3)'="" S ^IBA(355.32,"APCD",$E(X,1,30),$P(^IBA(355.32,DA,0),U,2),-$P(^IBA(355.32,DA,0),U,3),DA)=""
    2)= I $P($G(^IBA(355.32,DA,0)),U,2)'="",$P(^(0),U,3)'="" K ^IBA(355.32,DA,"APCD",$E(X,1,30),$P(^IBA(355.32,DA,0),U,2),-$P(^IBA(355.32,DA,0),U,3),DA)
    3)= DO NOT DELETE
    Multiple xref on plan, coverage, and -effective date
  • CROSS-REFERENCE:  ^^TRIGGER^355.32^1.01
    1)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(0)=X S Y(1)=$S($D(^IBA(355.32,D0,1)):^(1),1:"") S X=$P(Y(1),U,1)="" I X S X=DIV S Y(1)=$S($D(^IBA(355.32,D0,1)):^(1),1:"") S X=$P(Y(1),U,1),X=X S DIU=X K Y X ^DD(355.32,.01,1,3,1.1) X
    ^DD(355.32,.01,1,3,1.4)
    1.1)= S X=DIV N %I,%H,% D NOW^%DTC S X=%
    1.4)= S DIH=$S($D(^IBA(355.32,DIV(0),1)):^(1),1:""),DIV=X S $P(^(1),U,1)=DIV,DIH=355.32,DIG=1.01 D ^DICR:$O(^DD(DIH,DIG,1,0))>0
    2)= Q
    CREATE CONDITION)= #1.01=""
    CREATE VALUE)= NOW
    DELETE VALUE)= NO EFFECT
    FIELD)= #1.01
    Triggers the date/time entered when creating a new entry.
  • CROSS-REFERENCE:  ^^TRIGGER^355.32^1.02
    1)= X ^DD(355.32,.01,1,4,1.3) I X S X=DIV S Y(1)=$S($D(^IBA(355.32,D0,1)):^(1),1:"") S X=$P(Y(1),U,2),X=X S DIU=X K Y S X=DIV S X=DUZ X ^DD(355.32,.01,1,4,1.4)
    1.3)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(0)=X S Y(1)=$S($D(^IBA(355.32,D0,1)):^(1),1:"") S X=$S('$D(^VA(200,+$P(Y(1),U,2),0)):"",1:$P(^(0),U,1))=""
    1.4)= S DIH=$S($D(^IBA(355.32,DIV(0),1)):^(1),1:""),DIV=X S $P(^(1),U,2)=DIV,DIH=355.32,DIG=1.02 D ^DICR:$O(^DD(DIH,DIG,1,0))>0
    2)= Q
    CREATE CONDITION)= #1.02=""
    CREATE VALUE)= S X=DUZ
    DELETE VALUE)= NO EFFECT
    FIELD)= #1.02
    Triggers the user who created this entry.
.02 COVERAGE CATEGORY 0;2 POINTER TO PLAN LIMITATION CATEGORY FILE (#355.31)
************************REQUIRED FIELD************************
PLAN LIMITATION CATEGORY(#355.31)

  • LAST EDITED:  AUG 08, 1995
  • HELP-PROMPT:  Enter the type of coverage that will be limited.
  • DESCRIPTION:  
    The type of coverage that the insurance company plan has reimbursement limits on.
  • CROSS-REFERENCE:  355.32^APCD1^MUMPS
    1)= I $P($G(^IBA(355.32,DA,0)),U)'="",$P(^(0),U,3)'="" S ^IBA(355.32,"APCD",$P(^IBA(355.32,DA,0),U),$E(X,1,30),-$P(^IBA(355.32,DA,0),U,3),DA)=""
    2)= I $P($G(^IBA(355.32,DA,0)),U)'="",$P(^(0),U,3)'="" K ^IBA(355.32,"APCD",$P(^IBA(355.32,DA,0),U),$E(X,1,30),-$P(^IBA(355.32,DA,0),U,3),DA)
    3)= DO NOT DELETE
    Multiple xref on plan, coverage, and -effective date
.03 EFFECTIVE DATE 0;3 DATE
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  JUL 27, 1995
  • HELP-PROMPT:  Enter the date that this limitation is effective.
  • DESCRIPTION:  
    The date on which the type of coverage for this limitation becomes limited for insurance billing purposes.
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
  • CROSS-REFERENCE:  355.32^APCD2^MUMPS
    1)= I $P($G(^IBA(355.32,DA,0)),U)'="",$P(^(0),U,2)'="" S ^IBA(355.32,"APCD",$P(^IBA(355.32,DA,0),U),$P(^IBA(355.32,DA,0),U,2),-$E(X,1,30),DA)=""
    2)= I $P($G(^IBA(355.32,DA,0)),U)'="",$P(^(0),U,2)'="" K ^IBA(355.32,"APCD",$P(^IBA(355.32,DA,0),U),$P(^IBA(355.32,DA,0),U,2),-$E(X,1,30),DA)
    3)= DO NOT DELETE
    Multiple xref on plan, coverage, and -effective date
.04 COVERAGE STATUS 0;4 SET
************************REQUIRED FIELD************************
  • '0' FOR NOT COVERED;
  • '1' FOR COVERED;
  • '2' FOR CONDITIONAL COVERAGE;

  • LAST EDITED:  AUG 29, 1995
  • HELP-PROMPT:  The status of this coverage for this plan as of the effective date.
  • DESCRIPTION:  
    This is the status of the coverage associated with this record on the effective date associated with this record.
1.01 DATE ENTERED 1;1 DATE

  • INPUT TRANSFORM:  S %DT="ETX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  AUG 16, 1995
  • DESCRIPTION:  
    This is the date this limitation was entered. It is triggered by the creation of this entry.
  • NOTES:  TRIGGERED by the PLAN field of the PLAN COVERAGE LIMITATIONS File
1.02 ENTERED BY 1;2 POINTER TO NEW PERSON FILE (#200) NEW PERSON(#200)

  • LAST EDITED:  AUG 16, 1995
  • DESCRIPTION:  
    This is the user who created this entry. It is automatically triggered by the creation of this entry.
  • NOTES:  TRIGGERED by the PLAN field of the PLAN COVERAGE LIMITATIONS File
1.03 DATE LAST EDITED 1;3 DATE

  • INPUT TRANSFORM:  S %DT="ETX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  AUG 16, 1995
  • DESCRIPTION:  
    This is the date this limitation was last edited. It is automatically updated any time the limitation is edited using one of the options provided.
1.04 LAST EDITED BY 1;4 POINTER TO NEW PERSON FILE (#200) NEW PERSON(#200)

  • LAST EDITED:  AUG 16, 1995
  • DESCRIPTION:  
    This is the user who last edited this limitation. It is automatically updated any time a person edits this limitation using one of the options provided.
2 LIMITATION COMMENT 2;0 Multiple #355.321 355.321

ICR, Total: 1

ICR LINK Subscribing Package(s) Fields Referenced Description
ICR #5341
  • Insurance Capture Buffer
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