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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

Accessed By FileMan Db Calls, Total: 8

Package Total Routines
Integrated Billing 8 IBCMDT2    IBCNBCD2    IBCNGP1    IBCNSC41    IBCNSJ    IBCNSJ51    IBY763PO    IBY771PO

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:  JAN 12, 2024
  • HELP-PROMPT:  Enter the name of the person who last edited the entry.
  • 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.
  • FIELD INDEX:  LAST (#1736) MUMPS LOOKUP & SORTING
    Short Descr: Multiple xref on PLAN, -DATE LAST EDITED, and LAST EDITED BY
    Description: Multiple xref on PLAN (#.01), -DATE LAST EDITIED (#1.03), and LAST EDITED BY (#1.04).
    Re-Indexing is not allowed due to possible corruption in the field. If a site has certain corrupted records this cross reference will not be rebuilt during a Re-Index. Cross reference was introduced with IB*2.0*763. If
    the cross reference needs to be rebuilt, use code to check that all field are NOT null then call the re-index function in FileMan for one entry. (Refer to NEWINDX^IBY771PO).
    Set Logic: S ^IBA(355.32,"LAST",X(3),-X(2),X,DA)=""
    Kill Logic: K ^IBA(355.32,"LAST",X(3),-X(2),X,DA)
    Whole Kill: K ^IBA(355.32,"LAST")
    X(1): LAST EDITED BY (355.32,1.04) (Subscr 1) (forwards)
    X(2): Computed Code: S X=$P($G(^IBA(355.32,DA,1)),U,3)
    X(3): Computed Code: S X=$P($G(^IBA(355.32,DA,0)),U)
    NO RE-INDEXING ALLOWED!
2 LIMITATION COMMENT 2;0 Multiple #355.321 355.321

ICR, Total: 2

ICR LINK Subscribing Package(s) Fields Referenced Description
ICR #5341
  • Insurance Capture Buffer
  • ICR #7305
  • Lighthouse
  • PLAN (.01).
    Access: Both R/W w/Fileman

    COVERAGE CATEGORY (.02).
    Access: Both R/W w/Fileman

    EFFECTIVE DATE (.03).
    Access: Both R/W w/Fileman

    COVERAGE STATUS (.04).
    Access: Both R/W w/Fileman

    COMMENTS (.01).
    Access: Both R/W w/Fileman

    DATE ENTERED (1.01).
    Access: Both R/W w/Fileman

    ENTERED BY (1.02).
    Access: Both R/W w/Fileman

    DATE LAST EDITED (1.03).
    Access: Both R/W w/Fileman

    LAST EDITED BY (1.04).
    Access: Both R/W w/Fileman

    LIMITATION COMMENT (Multiple-355.321)
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