Home   Package List   Routine Alphabetical List   Global Alphabetical List   FileMan Files List   FileMan Sub-Files List   Package Component Lists   Package-Namespace Mapping  
Info |  Desc |  Directly Accessed By Routines |  Accessed By FileMan Db Calls |  Pointer To FileMan Files |  Fields |  ICR |  Found Entries |  External References |  Global Variables Directly Accessed |  Naked Globals |  Local Variables  | All
Print Page as PDF
Global: ^IBE(350.9

Package: Integrated Billing

Global: ^IBE(350.9


Information

FileMan FileNo FileMan Filename Package
350.9 IB SITE PARAMETERS Integrated Billing

Description

Directly Accessed By Routines, Total: 274

Package Total Routines
Integrated Billing 267 *POPULAR PAYERS    BATCH EXTRACTS    BILLING PROVIDER FAC TYPES    HCSR INSCO APPT LIST    HCSR WARD LIST    IB SCREEN3    IB20P129    IB20P150
IB20PT1    IB20PT3    IBACUS2    IBAECM3    IBAERR1    IBAERR3    IBAFIL    IBAMTC
IBARXEC1    IBATEI1    IBATER    IBAUTL2    IBAUTL7    IBCAPP1    IBCB    IBCBB0
IBCBULL    IBCCC    IBCDE    IBCE837B    IBCE837P    IBCE837S    IBCEF75    IBCEF79
IBCEMU3    IBCF22    IBCFP    IBCIPOST    IBCIUT1    IBCNERP7    IBCNEUT1    IBCNHHLO
IBCNSBL    IBCNSBL1    IBCNSCD    IBCOIVM2    IBCSC5C    IBCU    IBCU7    IBECUS2
IBECUSM    IBEF    IBFBWL3    IBJPS1    IBJPS2    IBNCPDP3    IBNCPDP4    IBNCPDP5
IBNCPNB    IBTOAT1    IBTRH1A    IBTRH2A    IBTRKR3    IBTRP    IBXPAR    IBY137PO
IBY155PO    IBY283PO    IBY316PS    IBY349PO    IBY438PO    ^IBA(364.7    IB20P132    IB20PT6
IB20PT61    IB20PT62    IBACUS    IBAECM1    IBARX    IBARXEC    IBBSHDWN    IBCB1
IBCB11    IBCE837    IBCECOB2    IBCECSA1    IBCEF21    IBCEF77    IBCEMQC    IBCEMSR6
IBCEMSRI    IBCEMU2    IBCEXTR    IBCF2P    IBCIUT5    IBCNEDE    IBCNEDE1    IBCNEDE5
IBCNEDE7    IBCNEDST    IBCNEHLT    IBCNESI1    IBCNFCON    IBCNSCD1    IBCNSMR6    IBCNSMR7
IBCNSMRE    IBCRBC1    IBCU63    IBECUS1    IBEFUTL    ^IBE(399.6    CLAIMSMANAGER PORTS    EXTRACT FILES
IB20P157    IB20P384    IBAERR    IBARXEC3    IBATEP    IBATFILE    IBCC    IBCD
IBCD2    IBCEMRAA    IBCERP6    IBCNBLL    IBCNEDE2    IBCNEDEP    IBCNEHL1    IBCNES
IBCNQ    IBCNRE5    IBCNSM3    IBNCPDPI    IBRFN3    IBTRH7    ^DGCR(399    IBCNHUT2
IBCNSC    IBCORC2    IBNCPDP1    IBXS3    IBY547PO    IBYRPOST    INS. CO's WITHHOLDING SUPPLIMENTAL PAYMENTS    PRIMARY PAYER ID TYPES COM
^IBA(364.5    IBCNHHLI    ^IBE(350.9    CMN CPT CODES    HCSR CLINIC LIST    HCSR INSCO ADM LIST    IB20P203    IB20P297
IB20P383    IB20P457    IB20PT5    IBAECU    IBAERR2    IBARXEB    IBARXEC2    IBARXEU4
IBATEI    IBATEO    IBAUTL    IBAUTL5    IBCA    IBCBB1    IBCD4    IBCE837A
IBCEF1    IBCEF4    IBCEF74A    IBCEMPRG    IBCEP3    IBCEP7A    IBCEP8A    IBCEQ1A
IBCEQBS    IBCF1    IBCF2TP    IBCF3    IBCIUT4    IBCIUT6    IBCNEHLM    IBCNERTQ
IBCNRU1    IBCNSBL2    IBCNSM31    IBCNSMR    IBCNSMRA    IBCNSP1    IBCNSP11    IBCNSP2
IBCONSC    IBCRED    IBCSC10    IBCSC10H    IBCSC3    IBCSC4C    IBCSCE    IBCSCH1
IBCU1    IBCU82    IBCU9    IBECK    IBECUS    IBEPAR    IBESTAT    IBFBNP1
IBJDE1    IBJPB    IBJPC    IBJPC1    IBJPC2    IBJPC3    IBJPI    IBJPI5
IBJPS3    IBJPS4    IBJPS5    IBJPS6    IBJPS7    IBJPS8    IBJTA1    IBNCPDP2
IBOHRL    IBOMHC    IBRBUL    IBRUTL    IBTOAT    IBTRH5    IBTRHDE    IBTRKR
IBTRKR1    IBTRKR2    IBTRKR4    IBTRKR5    IBTUBO    IBTUBUL    IBXPAR1    IBXPAR2
IBXSC3    IBXX19    IBY232PO    IBY288PO    IBY320PR    IBY348PO    IBY400PO    IBY403PR
IBY416PO    IBY461PO    IBY497PO    IBY5PT    IBY608PO    IBY623PO    IBY668PR    IBY687PO
IBY743PO    IBY759PO    IBY8POST    IBYP520    INCLUDE CLINIC FOR PAYERS    INCLUDE WARD FOR PAYERS    NON-MCCF RATE TYPES FOR PTP    PAY-TO PROVIDERS
PRIMARY PAYER ID TYPES MED    PRINTED CLAIMS RC EXCLUSIONS    TRICARE PAY-TO PROVIDERS    
Kernel 3 XUSNPIX1    XUSNPIX2    XUSNPIXU    
Accounts Receivable 2 PRCAMAS    RCDPENRU    

Accessed By FileMan Db Calls, Total: 105

Package Total Routines
Integrated Billing 102 IB20P202    IB20P203    IB20P297    IB20P383    IB20P656    IB20PT1    IB20PT5    IBAECN1
IBAECU5    IBAMTC    IBAMTS3    IBARXEPS    IBBSHDWN    IBCAPR    IBCAPR1    IBCAPU
IBCB1    IBCD    IBCDE    IBCE    IBCE837    IBCE837A    IBCE837K    IBCE837S
IBCE837T    IBCEM03    IBCEMU3    IBCESRV    IBCEXTRP    IBCNEDE    IBCNEDE2    IBCNEDE7
IBCNEDST    IBCNEHL1    IBCNEHL7    IBCNEHLM    IBCNEHLT    IBCNEHLU    IBCNEPM    IBCNEQU
IBCNERP7    IBCNERTQ    IBCNETST    IBCNEUT3    IBCNEUT5    IBCNEUT7    IBCNFCON    IBCNFRD
IBCNHUT2    IBCNINS    IBCNIUF    IBCNIUH1    IBCNIUHL    IBCNIUK    IBCNOR2    IBCNRDV
IBCNRE5    IBCNSMRE    IBCSCH1    IBCU    IBECEA3    IBECEAMH    IBECUS    IBEF
IBEFCOP    IBEFUTL    IBEPAR1    IBJPB    IBJPC    IBJPI    IBJPI2    IBJPS
IBJPS2    IBJPS3    IBJPS5    IBJPS7    IBJPS8    IBMHRPT    IBMHVM    IBRFIHL1
IBRFIWLA    IBTRP    IBXPAR    IBXPAR1    IBXPAR2    IBY137PO    IBY316PS    IBY400PO
IBY416PO    IBY438PO    IBY461PO    IBY497PO    IBY549PO    IBY592PO    IBY668PR    IBY687PO
IBY702PO    IBY721PO    IBY763PO    IBY784PO    IBY8POST    IBYOPOST    
Registration 2 DGREG    DGROAPI    
Accounts Receivable 1 RCHRFSUT    

Pointer To FileMan Files, Total: 22

Package Total FileMan Files
Integrated Billing 8 REVENUE CODE(#399.2)[1.18, 1.28, #350.9399(.01)]
RATE TYPE(#399.3)[#350.928(.01)]    INSURANCE COMPANY(#36)[4.02, 4.06, #350.965(.01), #350.966(.01), #350.999(.01)]    IB ALTERNATE PRIMARY ID TYPE(#355.98)[#350.981(.01), #350.982(.01)]    TRANSFER PRICING PATIENT(#351.6)[10.01]    CHARGE SET(#363.1)[9.12]    X12 271 SERVICE TYPE(#365.013)[60.01, 60.02, 60.03, 60.04, 60.05, 60.06, 60.07, 60.08, 60.09, 60.1, 60.11, 61.01, 61.02, 61.03, 61.04, 61.05, 61.06, 61.07, 61.08, 61.09]    PAYER(#365.12)[51.25, 51.3, 51.31, #350.9003(.01), #350.9631(.01), #350.9641(.01)]    
Kernel 6 DEVICE(#3.5)[8.14, 8.15, 8.16, 8.19]    INSTITUTION(#4)[.02, 10.01, #350.9004(.01), #350.929(.01)]    FACILITY TYPE(#4.1)[#350.9005(.01)]    SERVICE/SECTION(#49)[1.14]    STATE(#5)[2.04, #350.9004(1.04), #350.929(1.04)]
NEW PERSON(#200)[1.08, 51.16, 51.24]
Registration 3 MEDICAL CENTER DIVISION(#40.8)[1.25]    WARD LOCATION(#42)[#350.964(.01)]    PATIENT(#2)[4.02]    
CPT HCPCS Codes 1 CPT(#81)[1.3, #350.916(.01)]    
DRG Grouper 1 ICD DIAGNOSIS(#80)[1.29, 7.05]    
Health Summary 1 HEALTH SUMMARY TYPE(#142)[2.08, 2.09]    
MailMan 1 MAIL GROUP(#3.8)[.09, .11, .13, 1.07, 1.09, 4.04, 6.25, 50.03, 50.04, 51.04]    
Scheduling 1 HOSPITAL LOCATION(#44)[#350.963(.01)]    

Fields, Total: 274

Field # Name Loc Type Details
.01 NAME 0;1 NUMBER
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  K:+X'=X!(X>1)!(X<1)!(X?.E1"."1N.N) X I $D(X) S DINUM=X
  • HELP-PROMPT:  Type a Number between 1 and 1, 0 Decimal Digits
  • DESCRIPTION:  
    You may only have one site parameter entry. Its internal number must be 1 and its name must be the same.
  • DELETE TEST:  1,0)= I 1 W !,"Deleting site parameters not allowed!"
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
  • CROSS-REFERENCE:  350.9^B
    1)= S ^IBE(350.9,"B",$E(X,1,30),DA)=""
    2)= K ^IBE(350.9,"B",$E(X,1,30),DA)
.02 FACILITY NAME 0;2 POINTER TO INSTITUTION FILE (#4)
************************REQUIRED FIELD************************
INSTITUTION(#4)

  • INPUT TRANSFORM:  S DIC("S")="I $S('$D(^(99)):0,+^(99)<1:0,1:1)" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X
  • LAST EDITED:  FEB 21, 1991
  • DESCRIPTION:  
    This is the name of your facility from the institution file. There must be a station number associated with this entry. This value will be used by IFCAP in determining the bill number.
  • SCREEN:  S DIC("S")="I $S('$D(^(99)):0,+^(99)<1:0,1:1)"
  • EXPLANATION:  Institution must have a facility number defined
.03 FILE IN BACKGROUND 0;3 SET
  • '1' FOR YES;
  • '0' FOR NO;

  • LAST EDITED:  FEB 25, 1991
  • DESCRIPTION:  Set this field to 'YES' to cause the IB Background Filer to run as a background job. If it is set to 'NO' or left blank, filing will occur as applications pass data to Integrated Billing. Sites may wish to experiment
    with running the filer in the foreground (answer 'NO') or filing in the background. For Pharmacy Co-Pay, it is expected that some sites will experience significant delays in Outpatient Pharmacy label printing if filing is
    not done in the background.
.04 FILER STARTED 0;4 DATE

  • INPUT TRANSFORM:  S %DT="ESTXR" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  FEB 25, 1991
  • DESCRIPTION:  This is the internal fileman date/time that the IBE filer was last started. This field should be blank if the FILER STOPPED field contains data.
    If this field contains a date/time and the field FILE IN BACKGROUND is answered 'YES' then it is assumed that an IBE Filer is running. Use the option 'Start the Integrated Billing Background Filer' to start a new filer if
    needed. This field is updated by the IBE Filer and should not be edited with FileMan.
.05 FILER STOPPED 0;5 DATE

  • INPUT TRANSFORM:  S %DT="ESTXR" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  FEB 25, 1991
  • DESCRIPTION:  This is the internal fileman date/time that the IBE filer was last stopped. This field should be blank if the FILER STARTED field contains data.
    This field is updated by the IBE Filer. It should not be edited with FileMan.
.06 FILER LAST RAN 0;6 DATE

  • INPUT TRANSFORM:  S %DT="ESTXR" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  FEB 25, 1991
  • DESCRIPTION:  This is the date/time that the IBE Filer last passed data to the Accounts Receivable module of IFCAP.
    This field is updated by the IBE Filer and should not be edited with FileMan.
.07 FILER UCI,VOL 0;7 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>30!($L(X)<3) X
  • LAST EDITED:  FEB 25, 1991
  • HELP-PROMPT:  Answer must be 3-30 characters in length.
  • DESCRIPTION:  
    This is the UCI and Volume set that you want the IBE Filer to run on. Vax sites should leave this blank. It is recommended that the filer run on the volume set that contains either the IB globals or the PRC globals.
.08 FILER HANG TIME 0;8 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>15)!(X<1)!(X?.E1"."1N.N) X
  • LAST EDITED:  FEB 27, 1991
  • HELP-PROMPT:  Type a Number between 1 and 15, 0 Decimal Digits
  • DESCRIPTION:  This is the number of seconds that the filer will remain idle after finishing all transactions and before checking for more transactions to file. The filer will shut itself down after 2000 hangs with no activity detected.
    The default value for this field is 2 if left blank.
.09 COPAY BACKGROUND ERROR GROUP 0;9 POINTER TO MAIL GROUP FILE (#3.8) MAIL GROUP(#3.8)

  • LAST EDITED:  FEB 20, 1992
  • DESCRIPTION:  
    This is the mail group that will receive mail bulletins from the IBE filer when an unsuccessful attempt to file is detected. Remember to add users to it.
.1 FILER QUEUED 0;10 SET
  • '1' FOR YES;
  • '0' FOR NO;

  • LAST EDITED:  FEB 28, 1991
  • DESCRIPTION:  
    This field will be set to 'YES' when a file job is queued and set back to 'NO' when the queued job is started. It will be used to prevent queueing two or more jobs before the first job starts.
.11 MEANS TEST BILLING MAIL GROUP 0;11 POINTER TO MAIL GROUP FILE (#3.8) MAIL GROUP(#3.8)

  • LAST EDITED:  JUN 25, 2001
  • DESCRIPTION:  Members of this mail group will receive bulletins when Means Test billing processing errors have been encountered, and when movements and Means Tests have been edited or deleted for veterans that require Means Test
    charges.
.12 PER DIEM START DATE 0;12 DATE

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:3991231X) X
  • LAST EDITED:  FEB 05, 1992
  • HELP-PROMPT:  This is the date this hospital began the $5 and $10 Per Diem Billing. Enter a date no earlier than 11/5/90.
  • DESCRIPTION:  This is the date that this facility counseled category C patients that they would have to pay the new Per Diem charges and began the Per Diem billing.
    This field represents the earliest date for which the Hospital ($10) or Nursing Home ($5) Per Diem charge may be billed to a Category C patient. This billing is mandated by Public Law 101-508, which was implemented on
    November 5, 1990.
    Please note that the Per Diem billing will not occur if this field is null.
.13 COPAY EXEMPTION MAIL GROUP 0;13 POINTER TO MAIL GROUP FILE (#3.8) MAIL GROUP(#3.8)

  • LAST EDITED:  JAN 15, 1993
  • HELP-PROMPT:  Type a Number between 1 and 99, 0 Decimal Digits
  • DESCRIPTION:  
    This mail group will be sent the copay exemption bulletins and error messages.
.14 USE ALERTS 0;14 SET
  • '1' FOR YES;
  • '0' FOR NO;

  • LAST EDITED:  FEB 04, 1993
  • DESCRIPTION:  If a facility has installed Version 7 or higher of Kernel, then the site may decide whether to use Alerts or Bulletins for internal messages in Integrated Billing. Initially this functionality will only be available for
    the Medication Copayment Exemption functionality. If this is a desirable feature it may be expanded in the future.
    If this field is unanswered, the default is No and IB will use bulletins.
  • TECHNICAL DESCR:  
    The node ^DD(200,0,"VR") is checked for version number. If the value of this node is less than 7 then the user will not be able to turn this feature on.
  • SCREEN:  S DIC("S")="I 'Y!(+$G(^DD(200,0,""VR""))'<7)"
  • EXPLANATION:  Version 7 of Kernel must be installed inorder to turn this feature on.
.15 SUPPRESS MT INS BULLETIN 0;15 SET
  • '1' FOR YES;
  • '0' FOR NO;

  • LAST EDITED:  AUG 05, 1993
  • DESCRIPTION:  This parameter is used to control the bulletin that is posted when any Means Test charge which might be covered by the patient's health insurance is billed. If the site wishes to suppress this bulletin, then this
    parameter should be answered 'Yes'.
.16 LAST LTC COMPLETION DATE 0;16 DATE

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:X<1 X
  • LAST EDITED:  APR 23, 2002
  • HELP-PROMPT:  Enter the date the last time LTC calculation was completed.
  • DESCRIPTION:  
    This is the last time the LTC background job was completed.
.17 DATE/TIME SYSTEM LAST UPDATED 0;17 DATE

  • INPUT TRANSFORM:  S %DT="ESTX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  FEB 08, 2024
  • HELP-PROMPT:  This field is set by the system and should not be directly edited.
  • DESCRIPTION:  This field is set by the system and should not be directly edited. The IB MT NIGHT COMP nightly process is supposed to run every night to run the batch billing processes. This parameter is set upon completion of that
    process. If the process does not run to completion, certain events that must occur may have not been run to completion.
1.01 NAME OF CLAIM FORM SIGNER 1;1 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>20!($L(X)<2) X
  • LAST EDITED:  JAN 19, 1994
  • HELP-PROMPT:  Enter the name of the person responsible for signing third party bills as it should appear on the bills. Answer must be 2-20 characters in length
  • DESCRIPTION:  
    This is the name of the signer of third party bills and will be printed on the claim form in the signature block.
1.02 TITLE OF CLAIM FORM SIGNER 1;2 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>20!($L(X)<2) X
  • LAST EDITED:  JAN 19, 1994
  • HELP-PROMPT:  Enter the title of the person responsible for signing this bill as it should appear on the bill. Answer must be 2-20 characters in length.
  • DESCRIPTION:  
    This is the title of the person signing the claim form as it will appear on the bill.
1.03 *CAN REVIEWER AUTHORIZE? 1;3 SET
  • '1' FOR YES;
  • '0' FOR NO;

  • LAST EDITED:  APR 29, 1992
  • HELP-PROMPT:  Enter 1 or 'YES' if the person who reviews a billing record is also able to authorize that record.
  • DESCRIPTION:  Creating a third party bill is a 4 part process. The bill is Entered, Reviewed, Authorized, and Printed. The bill is considered complete and passed to Accounts Receivable immediately after it has been Authorized. This
    parameter is used to determine if the same person who Reviewed the bill can Authorize the bill. If the paramater CAN INITIATOR REVIEW? and this parameter, CAN REVIEWER AUTHORIZE?, are both answered "YES" then the same
    individual can perform all 4 parts of the billing process. If either parameter is answered 'NO' then more than one person must be involved in each bill.
  • TECHNICAL DESCR:  
    This field should be deleted in the next release of IB after v2.0.
1.04 *REMARKS ON EACH EDI CLAIM 1;4 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>39!($L(X)<2) X
  • LAST EDITED:  DEC 03, 2007
  • HELP-PROMPT:  Enter any facility specific remarks to appear in the CCOM segment of the electronic transmission. Answer must be 2-39 characters in length.
  • DESCRIPTION:  This remark will appear in the CCOM segment of the electronic transmission.
    November 2007: This field is being removed from the IB site parameter screen with IB patch 377. The CCOM segment is no longer being sent.
1.05 FEDERAL TAX NUMBER 1;5 FREE TEXT
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  K:$L(X)>10!($L(X)<10)!'(X?2N1"-"7N) X
  • LAST EDITED:  DEC 15, 2006
  • HELP-PROMPT:  Enter the federal tax number for your facility in NN-NNNNNNN format. Answer must be 10 characters in length.
  • DESCRIPTION:  
    This is your facility federal tax number. If unknown, this may be obtained from your Fiscal Service.
  • TECHNICAL DESCR:  
    This is not editable from the billing screens. Printed in Form Locator 5 of the UB-04.
1.06 BLUE CROSS/SHIELD PROVIDER # 1;6 FREE TEXT
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  K:$L(X)>13!($L(X)<3) X
  • LAST EDITED:  FEB 04, 1992
  • HELP-PROMPT:  Enter the 3-13 character BC/BS Provider Number which will be the default for all billing episodes at this facility. Answer must be 3-13 characters in length.
  • DESCRIPTION:  
    This is the BC/BS Provider Number which Blue Cross has assigned your facility.
1.07 BILL CANCELLATION MAILGROUP 1;7 POINTER TO MAIL GROUP FILE (#3.8) MAIL GROUP(#3.8)

  • LAST EDITED:  JAN 19, 1994
  • HELP-PROMPT:  Enter the mail group you want notified whenever a third party bill is cancelled. If none is entered no mailman notification will be made.
  • DESCRIPTION:  
    This is the mail group that will recieve automatic notification every time a third party bill is cancelled. This must be answered for the automatic notification to occur.
1.08 BILLING SUPERVISOR NAME 1;8 POINTER TO NEW PERSON FILE (#200)
************************REQUIRED FIELD************************
NEW PERSON(#200)

  • LAST EDITED:  FEB 04, 1992
  • HELP-PROMPT:  Enter the Person who is the billing supervisor.
  • DESCRIPTION:  
    This is the pointer to the PERSON file for the Billing Supervisor.
1.09 BILL DISAPPROVED MAILGROUP 1;9 POINTER TO MAIL GROUP FILE (#3.8) MAIL GROUP(#3.8)

  • LAST EDITED:  JAN 19, 1994
  • HELP-PROMPT:  When a third party bill is disapproved the supervisor and initiator of the bill will be notified. If you want additional people notified create a mailgroup and specify it here.
  • DESCRIPTION:  When a third party bill is disapproved the supervisor and initiator of the bill will be notified. If you want additional people to be notified that a bill has been disapproved then you must create a mail group and add the
    member and then specify the group here. The members of this mail group will then recieve the disapproval bulletin.
1.11 *CAN INITIATOR REVIEW 1;11 SET
  • '1' FOR YES;
  • '0' FOR NO;

  • LAST EDITED:  APR 29, 1992
  • HELP-PROMPT:  Enter 1 or 'YES' if the person who created/edited a billing record is also able to review that record.
  • DESCRIPTION:  Creating a third party bill is a 4 part process. The bill is Entered, Reviewed, Authorized, and Printed. The bill is considered complete and passed to Accounts Receivable immediately after it has been Authorized. This
    parameter is used to determine if the same person who Reviewed the bill can Authorize the bill. If the paramater CAN REVIEWER AUTHORIZE? and this parameter, CAN INITIATOR REVIEW?, are both answered "YES" then the same
    individual can perform all 4 parts of the billing process. If either parameter is answered "NO" then more than one person must be involved in each bill.
  • TECHNICAL DESCR:  
    This field should be deleted in the next release of IB after v2.0.
1.14 MAS SERVICE POINTER 1;14 POINTER TO SERVICE/SECTION FILE (#49)
************************REQUIRED FIELD************************
SERVICE/SECTION(#49)

  • HELP-PROMPT:  Enter the Service/Section which is your facilities MAS Service.
  • DESCRIPTION:  
    Accounts Receivable requires that every bill be associated with a SERVICE/SECTION. This is the Service that will be identified with bills sent to Accounts Receivable from the Integrated Billing Module.
1.15 CAN CLERK ENTER NON-PTF CODES? 1;15 SET
  • '1' FOR YES;
  • '0' FOR NO;

  • HELP-PROMPT:  Enter '1' or 'YES' if diagnosis and procedure codes not found in the PTF record may be entered by the billing clerk into a billing record. This affects inpatient bills only.
  • DESCRIPTION:  Answering 'YES' to this parameter will also allow billing clerks to enter CPT and HCPS codes into the billing record as well as ICD diagnosis and Procedure codes that are not in the corresponding PTF record. This
    parameter only affects inpatient bills.
1.16 ASK HINQ IN MCCR 1;16 SET
  • '1' FOR YES;
  • '0' FOR NO;

  • HELP-PROMPT:  Enter '1' or 'YES' if you want the person entering a new bill to be able to request a HINQ inquiry for bills on patients with unverified eligibility.
  • DESCRIPTION:  
    When creating a new bill on a Veteran with unverified eligibility the user may be asked if they would like to put a HINQ request in the HINQ SUSPENSE file if this parameter is answered 'YES'.
1.17 USE OP CPT SCREEN? 1;17 SET
  • '1' FOR YES;
  • '0' FOR NO;

  • HELP-PROMPT:  Enter '1' or 'YES' if you want the person entering an outpatient bill to easily transfer CPT procedures from scheduling into the bill.
  • DESCRIPTION:  CPT codes for outpatient visits are currently stored as Ambulatory Procedures in the Scheduling Visits file. The user editing a bill will be displayed all CPT codes stored in the Scheduling Visits file for the date range
    of the bill if the parameter is set to 'YES'. This display screen will prompt the user if they would like to easily import any or all of the CPT codes into the bill. This will include both Ambulatory Procedures and the
    Billable Ambulatory Surgical Codes.
1.18 *DEFAULT AMB SURG REV CODE 1;18 POINTER TO REVENUE CODE FILE (#399.2) REVENUE CODE(#399.2)

  • INPUT TRANSFORM:  S DIC("S")="I $P(^(0),U,3)" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X
  • LAST EDITED:  SEP 25, 1996
  • HELP-PROMPT:  Enter the Revenue Code that you will usually want for Ambulatory Surgery.
  • DESCRIPTION:  When billing Billable Ambulatory Surgical Codes (BASC), this will be the default revenue code stored in the bill. If this is not appropriate for any particular insurance company then the field AMBULATORY SURG. REV. CODE
    in the Insurance Company file may be entered and it will be used for that particular insurance company entry.
    Field is no longer used, it has been replaced by functionality provided by the Charge Master in IB*2*52.
1.19 TRANSFER PROCEDURES TO SCHED? 1;19 SET
  • '1' FOR YES;
  • '0' FOR NO;

  • LAST EDITED:  FEB 05, 1992
  • HELP-PROMPT:  Enter '1' or 'YES' if you would like the person entering a bill to be able to automatically store the CPT procedures in a bill in the Scheduling Visits file.
  • DESCRIPTION:  CPT procedures may be stored as Ambulatory Procedures in the Scheduling Visits file (using the Add/Edit Stop Code option) and they may be stored in the billing record as procedures to print on a bill. There is now a two
    way sharing of information between these two files. If this parameter is answered 'YES' then as CPT procedures are entered in a bill that are also Ambulatory Procedures, then the user will be prompted as to whether they
    should be transfered to the Scheduling Visits file also. The reverse of this is the parameter USE OP CPT SCREEN? which allows importing of Ambulatory Procedures into a bill.
    Only CPT procedures that are either Billable Ambulatory Surgical Codes or either Nationally or Locally active Ambulatory Procedures may be transfered.
1.2 HOLD MT BILLS W/INS 1;20 SET
  • '1' FOR YES;
  • '0' FOR NO;

  • LAST EDITED:  MAR 02, 1992
  • HELP-PROMPT:  Enter 'Yes' if automated Means Test Charges should be held until claim disposition from an insurance Company. If 'Yes' and a patient has insurance then the bills will automatically be placed on hold.
  • DESCRIPTION:  If this parameter is answered 'YES' then the automated Category C bills will automatically be placed on hold if the Patient has active Insurance. The bills will need to be released to Accounts Receivable after claim
    disposition from the Insurance Company.
1.21 MEDICARE PROVIDER NUMBER 1;21 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>8!($L(X)<1) X
  • LAST EDITED:  MAR 06, 1992
  • HELP-PROMPT:  Enter the number Medicare provided your facility. Answer must be 1-8 characters in length.
  • DESCRIPTION:  This is the 1-8 character number provided by Medicare to the facility.
1.22 MULTIPLE FORM TYPES 1;22 SET
  • '1' FOR YES;
  • '0' FOR NO;

  • LAST EDITED:  APR 28, 2017
  • HELP-PROMPT:  Enter 'Y'es if your facility uses the CMS-1500 & J430D as well as the UB claim form.
  • DESCRIPTION:  Set this field to 'YES' if the facility uses more than one health insurance form type. Therefore, if your site uses the UB form and the CMS-1500 & J430D forms, this should be answered 'YES'. If your site is only using
    the UB form, then answer 'NO'. If this is set to 'NO' or left blank then only the UB type claim forms will be allowed.
1.23 CAN INITIATOR AUTHORIZE? 1;23 SET
  • '1' FOR YES;
  • '0' FOR NO;

  • LAST EDITED:  APR 28, 1992
  • DESCRIPTION:  Beginning with IB Version 1.5, the Review step in creating a bill has been eliminated. If this parameter is answered YES and the initiator holds the IB AUTHORIZE key then the initiator of the bill will be allowed to
    Authorize the Bill. If this is answered no then another user who holds the IB AUTHORIZE key will have to authorize the bill.
1.24 BASC START DATE 1;24 DATE

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  MAY 06, 1992
  • DESCRIPTION:  This is the date that facilities can begin billing Ambulatory Surgical Code Rates. The earliest date is the date that IB Version 1.5 was installed at the site or the date the regulation allowing BASC billing was approved.
    This date will be stored automatically in the file.
    If this field is null then BASC rates will not automatically calculate.
1.25 DEFAULT DIVISION 1;25 POINTER TO MEDICAL CENTER DIVISION FILE (#40.8) MEDICAL CENTER DIVISION(#40.8)

  • LAST EDITED:  FEB 05, 1999
  • HELP-PROMPT:  Enter the division that should be used as a bill's default division.
  • DESCRIPTION:  
    This field will be used as the default division for all bills and will be automatically added to each bill as it is created.
1.27 CMS-1500 ADDRESS COLUMN 1;27 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>80)!(X<1)!(X?.E1"."1.N) X
  • LAST EDITED:  SEP 27, 2006
  • HELP-PROMPT:  Type a number between 1 and 80, 0 Decimal Digits. Used only for the 1500 claim form.
  • DESCRIPTION:  
    This is the column that the mailing address will begin printing on row 1 of the CMS-1500 claim form.
  • TECHNICAL DESCR:  
    With this parameter the site can specify where the address prints, depending on the type of envelope they use. The first 5 rows are the only blank space on the form available for the mailing address.
1.28 *DEFAULT RX REFILL REV CODE 1;28 POINTER TO REVENUE CODE FILE (#399.2) REVENUE CODE(#399.2)

  • INPUT TRANSFORM:  S DIC("S")="I $P(^(0),U,3)" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X
  • LAST EDITED:  SEP 25, 1996
  • HELP-PROMPT:  Enter the revenue code that should be used for Rx Refills.
  • DESCRIPTION:  If entered, this Revenue Code will be used for all prescription refill's on a bill when the revenue codes and charges are automatically calculated. This default will be overridden by the PRESCRIPTION REFILL REV. CODE for
    an insurance company, if one exists.
    Field is no longer used, it has been replaced by functionality provided by the Charge Master in IB*2*52.
  • SCREEN:  S DIC("S")="I $P(^(0),U,3)"
  • EXPLANATION:  Only Activated Revenue Codes can be selected!
1.29 DEFAULT RX REFILL DX 1;29 POINTER TO ICD DIAGNOSIS FILE (#80) ICD DIAGNOSIS(#80)

  • INPUT TRANSFORM:  S DIC("S")="I $$ICD9ACT^IBACSV(+Y)" D ^DIC K DIC S DIC=$G(DIE),X=+Y K:Y<0 X
  • LAST EDITED:  MAY 01, 2003
  • HELP-PROMPT:  Enter a Diagnosis that should be added to every RX Refill bill.
  • DESCRIPTION:  
    If entered, this diagnosis will be automatically added to every bill that has prescription refills.
  • TECHNICAL DESCR:  
    Should probably be a genaric code like V68.1 ISSUE REPEAT PRESCRIPT.
  • SCREEN:  S DIC("S")="I $$ICD9ACT^IBACSV(+Y)"
  • EXPLANATION:  Only active diagnosis codes may be selected.
1.3 DEFAULT RX REFILL CPT 1;30 POINTER TO CPT FILE (#81) CPT(#81)

  • INPUT TRANSFORM:  S DIC("S")="I $$CPTACT^IBACSV(+Y)" D ^DIC K DIC S DIC=$G(DIE),X=+Y K:Y<0 X
  • LAST EDITED:  MAY 01, 2003
  • HELP-PROMPT:  Enter a CPT procedure code that should be printed on every bill that has RX Refills.
  • DESCRIPTION:  
    If entered, this procedure will automatically be added to every bill that has a prescription refill.
  • TECHNICAL DESCR:  
    Should probably be a genaric code like 99070 SPECIAL SUPPLIES.
  • SCREEN:  S DIC("S")="I $$CPTACT^IBACSV(+Y)"
  • EXPLANATION:  Only active CPT codes may be entered.
1.31 UB-04 ADDRESS COLUMN 1;31 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>30)!(X<1)!(X?.E1"."1.N) X
  • LAST EDITED:  NOV 27, 2006
  • HELP-PROMPT:  Type a number between 1 and 30, 0 Decimal Digits
  • DESCRIPTION:  This is the column on which the Mailing Address should begin printing on the UB-04. The purpose of this field is to help in placing the mailing address in the area required so that it is visible through the envelope
    window. Please note that the UB-04 Mailing Address block (FL 38) has a maximum width of 42 characters. The number entered here will cause the address to be moved to the right and therefore the allowable width of the
    mailing address will be reduced.
1.32 CMS-1500 PRINT LEGACY ID 1;32 SET
  • 'Y' FOR YES;
  • 'N' FOR NO;
  • 'C' FOR CONDITIONAL;

  • LAST EDITED:  OCT 19, 2006
  • DESCRIPTION:  This parameter determines whether legacy (example: IDs furnished by an Insurance Company) Provider IDs will appear on locally printed CMS-1500 claims.
    YES - Legacy IDs will always be printed. NO - Legacy IDs will never be printed. CONDITIONAL - Legacy IDs will be printed only when
    no NPIs are available.
1.33 UB-04 PRINT LEGACY ID 1;33 SET
  • 'Y' FOR YES;
  • 'N' FOR NO;
  • 'C' FOR CONDITIONAL;

  • LAST EDITED:  NOV 27, 2006
  • DESCRIPTION:  This parameter determines whether legacy (example: IDs furnished by an Insurance Company) Provider IDs will appear on locally printed UB claims.
    YES - Legacy IDs will always be printed. NO - Legacy IDs will never be printed. CONDITIONAL - Legacy IDs will be printed only when
    no NPIs are available.
2.01 *AGENT CASHIER MAIL SYMBOL 2;1 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>25!($L(X)<1) X
  • LAST EDITED:  NOV 10, 2008
  • HELP-PROMPT:  Enter the mail routing symbol for the agent cashier. Answer must be 1-25 characters in length.
  • DESCRIPTION:  This is the facility mail routing symbol for the Agent Cashier. This may begin with 04 (for Fiscal Service) at most facilities.
    This field is inactive with IB patch 400. The information in the PAY-TO PROVIDERS subfile (#350.9004) has replaced this field.
2.02 *AGENT CASHIER STREET ADDRESS 2;2 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>25!($L(X)<3) X
  • LAST EDITED:  NOV 10, 2008
  • HELP-PROMPT:  Enter the street address for the Agent Cashier. Aswer must be 3-25 characters in length.
  • DESCRIPTION:  This is the street address that checks should be mailed to. This will appear on the on all claim forms as the billing address.
    This field is inactive with IB patch 400. The information in the PAY-TO PROVIDERS subfile (#350.9004) has replaced this field.
2.03 *AGENT CASHIER CITY 2;3 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>15!($L(X)<1) X
  • LAST EDITED:  NOV 10, 2008
  • HELP-PROMPT:  Enter the City for the Agent Cashier. Answer must be 1-15 characters in length.
  • DESCRIPTION:  This is the City for the Agent Cashier. This will be part of the address that Checks are mailed to and will appear on the claim forms.
    This field is inactive with IB patch 400. The information in the PAY-TO PROVIDERS subfile (#350.9004) has replaced this field.
2.04 *AGENT CASHIER STATE 2;4 POINTER TO STATE FILE (#5) STATE(#5)

  • LAST EDITED:  NOV 10, 2008
  • HELP-PROMPT:  Enter the state for the Agent Cashier.
  • DESCRIPTION:  This is the state for the Agent Cashier. This will be the State part of the address that checks are mailed to as it appears on the claim forms.
    This field is inactive with IB patch 400. The information in the PAY-TO PROVIDERS subfile (#350.9004) has replaced this field.
2.05 *AGENT CASHIER ZIP CODE 2;5 FREE TEXT

  • INPUT TRANSFORM:  S:$E(X,6)="-" X=$TR(X,"-") K:$L(X)>9!($L(X)<5)!'(X?5N!(X?9N)) X
  • LAST EDITED:  NOV 10, 2008
  • HELP-PROMPT:  Answer must be 5-9 characters in length.
  • DESCRIPTION:  Enter the zip code for the Agent Cashier. This will be the zip code that checks should be mailed to and appears on the claims forms.
    This field is inactive with IB patch 400. The information in the PAY-TO PROVIDERS subfile (#350.9004) has replaced this field.
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
2.06 *AGENT CASHIER PHONE NUMBER 2;6 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>25!($L(X)<4) X
  • LAST EDITED:  NOV 10, 2008
  • HELP-PROMPT:  Answer must be 4-25 characters in length.
  • DESCRIPTION:  This is the phone number for the agent cashier.
    This field is inactive with IB patch 400. The information in the PAY-TO PROVIDERS subfile (#350.9004) has replaced this field.
2.07 CANCELLATION REMARK FOR FISCAL 2;7 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>75!($L(X)<3)!'(X?1A.E) X
  • LAST EDITED:  FEB 04, 1992
  • HELP-PROMPT:  Enter the remark (reason for cancellation) which will be sent to Fiscal Service every time a bill is cancelled in MAS. Answer must be 3-75 characters in length.
  • DESCRIPTION:  This is the remark which will be sent to Fiscal every time a bill is cancelled in MAS. This remark will explain to Fiscal why the IFCAP billing record is being amended or cancelled. The generic remark, "BILL CANCELLED IN
    MAS" will be transmitted to Fiscal Service if no remark is entered in this field. The site may enter any remark which is meaningful to MAS and Fiscal.
2.08 INPT HEALTH SUMMARY 2;8 POINTER TO HEALTH SUMMARY TYPE FILE (#142) HEALTH SUMMARY TYPE(#142)

  • LAST EDITED:  MAY 11, 1995
  • HELP-PROMPT:  Enter the Health Summary to print for inpatient admissions in Joint Billing Inquiry.
  • DESCRIPTION:  
    This Health Summary will be displayed when the Health Summary action is chosen for an Inpatient bill in the Joint Billing Inquire option.
2.09 OUTPT HEALTH SUMMARY 2;9 POINTER TO HEALTH SUMMARY TYPE FILE (#142) HEALTH SUMMARY TYPE(#142)

  • LAST EDITED:  MAY 11, 1995
  • HELP-PROMPT:  Enter the Health Summary to print for outpatients in Joint Billing Inquiry.
  • DESCRIPTION:  
    This Health Summary will be displayed when the Health Summary action is chosen for an Outpatient bill in the Joint Billing Inquiry option.
2.1 *FACILITY NAME FOR BILLING 2;10 FREE TEXT
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  K:$L(X)>18!($L(X)<1)!'($TR(X," ")?.A) X
  • LAST EDITED:  NOV 10, 2008
  • HELP-PROMPT:  Enter your Facility Name for Billing. Answer must be 1-18 alpha characters in length.
  • DESCRIPTION:  This is the Facility Name for Billing that will print on the first line of the UB-04 form locator 2 and in box 33 of the CMS-1500.
    This field is inactive with IB patch 400. The information in the PAY-TO PROVIDERS subfile (#350.9004) has replaced this field.
2.11 SITE CONTACT PHONE NUMBER 2;11 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>25!($L(X)<10) X
  • LAST EDITED:  JUN 01, 1999
  • HELP-PROMPT:  Must be a phone number, including area code
  • DESCRIPTION:  
    This is the phone number associated with the site contact position that EDI inquiries will be directed to when a payer needs to get in touch with the facility.
3.01 *CONVERSION LAST BILL DATE 3;1 DATE

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  JAN 27, 1994
  • DESCRIPTION:  This field will only be used for the Means Test conversion which is part of the Integrated Billing v1.5 post init. The field will be deleted with the next version of Integrated Billing.
    This field is updated during the IB v1.5 post init. The value of this field designates the last day through which Means Test charges will be created during the conversion.
    Please note that this field has been starred for deletion in IB v2.0. This field will be deleted in the version of IB which follows v2.0.
3.02 *CONVERSION BREAK DATE 3;2 DATE

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  JAN 27, 1994
  • DESCRIPTION:  This field will only be used for the Means Test conversion which is part of the Integrated Billing v1.5 post init. The field will be deleted with the next version of Integrated Billing.
    This field is updated during the IB v1.5 post init. The value of this field is used by the conversion when creating Hospital/NHCU per diem charges. If a patient owes the per diem on this date, and has accumulated other
    charges prior to this date, a charge is filed for all previous charges up through the date. The intent of "splitting" charges in this manner is to allow facilities to select a "final" date through which Means Test billing
    will have been completed manually so that charges created by the conversion may easily be passed to the Accounts Receivable package (and thus billed to the patient).
    Please note that this field has been starred for deletion in IB v2.0. This field will be deleted in the version of IB which follows v2.0.
3.03 COPAY EXEMPTION CONV. STARTED 3;3 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>9999999)!(X<1)!(X?.E1"."1N.N) X
  • LAST EDITED:  JAN 14, 1993
  • HELP-PROMPT:  Type a Number between 1 and 9999999, 0 Decimal Digits
  • DESCRIPTION:  
    This is the number of times the Medication Copayment Exemption Conversion has been started. It is used to tell if the conversion has been restarted.
  • TECHNICAL DESCR:  The Medication Copayment Exemption Conversion can be stopped by editing this field to a number different that its current value. This is NOT a recommended procedure but should only be used in exception cases. It will
    cause an orderly shut down on the completion of a single patient. After the conversion shuts down, the value of this field should be returned to its original value.
    If a second conversion is started this field will be updated causing the first conversion to stop. At that point it is possible that a patient may be double processed, possible causing the double decreasing of charges in
    AR for that patient.
3.04 COPAY EXEMPTION LAST DFN 3;4 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>999999999)!(X<1)!(X?.E1"."1N.N) X
  • LAST EDITED:  NOV 24, 1992
  • HELP-PROMPT:  Type a Number between 1 and 999999999, 0 Decimal Digits
  • DESCRIPTION:  This is the internal entry number of the last patient completely converted by the Medication Copayment Exemption Conversion. The Conversion processes patients in order of internal entry number. If the conversion stops
    for any reason it will start with the next internal number after this one.
    WRITE AUTHORITY: ^
3.05 TOTAL PATIENTS CONVERTED 3;5 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>999999999)!(X<1)!(X?.E1"."1N.N) X
  • LAST EDITED:  JAN 07, 1993
  • HELP-PROMPT:  Type a Number between 1 and 999999999, 0 Decimal Digits
  • DESCRIPTION:  
    This is the total number of patients in the IB file that were set up with an exemption status during the conversion.
    WRITE AUTHORITY: ^
3.06 TOTAL PATIENTS EXEMPT 3;6 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>999999999)!(X<1)!(X?.E1"."1N.N) X
  • LAST EDITED:  JAN 07, 1993
  • HELP-PROMPT:  Type a Number between 1 and 999999999, 0 Decimal Digits
  • DESCRIPTION:  
    This is the number of patients that were converted to an exempt status.
    WRITE AUTHORITY: ^
3.07 TOTAL PATIENT NON-EXEMPT 3;7 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>999999999)!(X<1)!(X?.E1"."1N.N) X
  • LAST EDITED:  JAN 07, 1993
  • HELP-PROMPT:  Type a Number between 1 and 999999999, 0 Decimal Digits
  • DESCRIPTION:  
    This is the number of patients converted to a non-exempt status.
    WRITE AUTHORITY: ^
3.08 COUNT OF EXEMPT BILLS 3;8 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>999999999)!(X<1)!(X?.E1"."1N.N) X
  • LAST EDITED:  JAN 14, 1993
  • HELP-PROMPT:  Type a Number between 1 and 999999999, 0 Decimal Digits
  • DESCRIPTION:  
    This is the number of Medication Copayment IB Actions that were issued to patients who's status is exempt from the start of the exemption legislation to the running of the conversion.
    WRITE AUTHORITY: ^
3.09 AMOUNT OF CHARGES CHECKED 3;9 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>999999999)!(X<1)!(X?.E1"."1N.N) X
  • LAST EDITED:  JAN 07, 1993
  • HELP-PROMPT:  Type a Number between 1 and 999999999, 0 Decimal Digits
  • DESCRIPTION:  
    This is the total dollar amount of charges checked during the Medication Copayment Exemption Conversion issued to patients from the start date of the exemption legislation to the running of the conversion.
    WRITE AUTHORITY: ^
3.1 TOTAL EXEMPT DOLLAR AMOUNT 3;10 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>999999999)!(X<1)!(X?.E1"."1N.N) X
  • LAST EDITED:  JAN 14, 1993
  • HELP-PROMPT:  Type a Number between 1 and 999999999, 0 Decimal Digits
  • DESCRIPTION:  
    This is the total dollar amount of charges checked during the Medication Copayment Exemption Conversion issued to Exempt patients from the start date of the exemption legislation to the running of the conversion.
    WRITE AUTHORITY: ^
3.11 AMOUNT OF NON-EXEMPT CHARGES 3;11 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>999999999)!(X<1)!(X?.E1"."1N.N) X
  • LAST EDITED:  JAN 07, 1993
  • HELP-PROMPT:  Type a Number between 1 and 999999999, 0 Decimal Digits
  • DESCRIPTION:  
    This is the total dollar amount of charges checked during the Medication Copayment Exemption Conversion issued to Non-Exempt patients from the start date of the exemption legislation to the running of the conversion.
    WRITE AUTHORITY: ^
3.12 AMOUNT OF CANCELED CHARGES 3;12 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>999999999)!(X<1)!(X?.E1"."1N.N) X
  • LAST EDITED:  JAN 07, 1993
  • HELP-PROMPT:  Type a Number between 1 and 999999999, 0 Decimal Digits
  • DESCRIPTION:  
    This is the total dollar amount of charges actually canceled during the Medication Copayment Exemption Conversion issued to Exempt patients from the start date of the exemption legislation to the running of the conversion.
    WRITE AUTHORITY: ^
3.13 COPAY EXEMPTION START DATE 3;13 DATE
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  S %DT="ESTXR" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  JAN 13, 1993
  • DESCRIPTION:  
    This is the date/time that the Medication Copayment Exemption Conversion started. It should not be edited.
    WRITE AUTHORITY: ^
3.14 COPAY EXEMPTION STOP DATE 3;14 DATE
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  S %DT="ESTXR" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  JAN 13, 1993
  • DESCRIPTION:  This is the date/time that the conversion completed. This field should not be edited. It will be stored by the conversion routine when it is finished.
  • TECHNICAL DESCR:  If for some reason, it is necessary to restart the conversion after this field has been populated you may delete the data in this field. Sites should check with their supporting ISC prior to doing this. The field, LAST
    DFN UPDATED (3.04) in this file may also need to be edited.
    Normally it is not recommended that the conversion be re-run after it has run once. Re-running the conversion will not cause updating of patients with current exemptions, nor will it cause re-cancellation of charges
    cancelled previously.
    WRITE AUTHORITY: ^
    UNEDITABLE
3.15 NON-EXEMPT PATIENTS CONVERTED 3;15 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>999999999)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  JAN 14, 1993
  • HELP-PROMPT:  Type a Number between 0 and 999999999, 0 Decimal Digits
  • DESCRIPTION:  
    This is the count of patients in the IB Action file that had an exemption status of Non-exempt set up during the conversion.
    WRITE AUTHORITY: ^
3.16 TOTAL BILLS DURING CONVERSION 3;16 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>999999999)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  JAN 14, 1993
  • HELP-PROMPT:  Type a Number between 0 and 999999999, 0 Decimal Digits
  • DESCRIPTION:  
    This is the total number of IB ACTION entries issued from the effective date of the Income Exemption Legislation until the running of the conversion that were issued to either exempt or non-exempt patients.
    WRITE AUTHORITY: ^
3.17 COUNT OF BILLS CANCELED 3;17 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>999999999)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  JAN 14, 1993
  • HELP-PROMPT:  Type a Number between 0 and 999999999, 0 Decimal Digits
  • DESCRIPTION:  
    This is the count of bills actually sent to be canceled in the IB ACTION file during the conversion.
    WRITE AUTHORITY: ^
3.18 INSURANCE CONVERSION COMPLETE 3;18 DATE
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  NOV 08, 1993
  • DESCRIPTION:  This is the date the insurance conversion completes. It is not editable. The data should not be deleted.
    The v2.0 insurance conversion will automatically set this field to the date it completes.
    UNEDITABLE
3.19 BILL/CLAIMS CONV. COMPLETE 3;19 DATE
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  NOV 08, 1993
  • DESCRIPTION:  
    This is the date that the v2 post-init conversion of the bill/claims file completed. It will automatically be updated by the conversion routine when it completes.
    UNEDITABLE
3.2 CURRENT INPATIENTS LOADED 3;20 DATE
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  NOV 08, 1993
  • DESCRIPTION:  
    This is the date that the current inpatients were loaded into claims tracking as part of the IB v2 post init. This date will automatically be entered upon completion.
    UNEDITABLE
4.01 INSURANCE EXTENDED HELP 4;1 SET
  • '0' FOR OFF;
  • '1' FOR ON;

  • LAST EDITED:  AUG 13, 1993
  • DESCRIPTION:  Should the extended help display be always on in the Insurance Management options. Answer 'ON' if you always want it to display automatically or answer 'OFF' if you do not want to see it.
    It is recommended that the extended help be turned on initially after v2 is installed. As users become more familiar with the new functionality the parameter can be turned off.
4.02 PATIENT OR INSURANCE COMPANY 4;2 VARIABLE POINTER PATIENT(#2)  INSURANCE COMPANY(#36)  

  • LAST EDITED:  MAR 03, 1993
  • DESCRIPTION:  
    Enter the patient or insurance company you wish to access.
  • TECHNICAL DESCR:  
    This field does not contain data. It is used as a file definition by the reader to do a variable pointer look up that is not tied to any data base element.
4.03 HEALTH INSURANCE POLICY 4;3 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>20!($L(X)<1) X
  • LAST EDITED:  AUG 29, 1993
  • HELP-PROMPT:  Answer must be 1-20 characters in length.
  • DESCRIPTION:  
    Enter the name of the patient's health insurance policy.
  • TECHNICAL DESCR:  
    This field does not contain data. It is used by the reader to provide a definition to do a lookup that is not tied to a particular data base element.
4.04 NEW INSURANCE MAIL GROUP 4;4 POINTER TO MAIL GROUP FILE (#3.8) MAIL GROUP(#3.8)

  • LAST EDITED:  AUG 29, 1993
  • DESCRIPTION:  
    Enter the mail group that should receive a bulletin every time an insurance policy is added for a patient that has potential billings associated with it.
4.05 CENTRAL COLLECTION MAIL GROUP 4;5 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>45!($L(X)<3) X
  • LAST EDITED:  SEP 03, 1993
  • HELP-PROMPT:  Answer must be 3-45 characters in length.
  • DESCRIPTION:  The MCCR Program Office has recently requested that the results from the report Rank Insurance Carriers By Amount Billed be transmitted centrally for nation-wide compilation. This field contains the mail group on Forum to
    which these reports will be sent.
    The field is being exported with the value G.MCCR DATA@DOMAIN.EXT. It is anticipated that future reports may be sent to this group for compilation. If it becomes necessary to change the mail group name or domain, this
    field may be edited using Fileman. Do not edit this field without receiving instructions from your supporting ISC.
4.06 INSURANCE COMPANY 4;6 POINTER TO INSURANCE COMPANY FILE (#36) INSURANCE COMPANY(#36)

  • INPUT TRANSFORM:  S DIC("S")="I '$P(^(0),U,5)" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X
  • LAST EDITED:  JAN 19, 1994
  • SCREEN:  S DIC("S")="I '$P(^(0),U,5)"
  • EXPLANATION:  Only Active Companies may be selected!
4.07 IVM CENTER MAIL GROUP 4;7 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>45!($L(X)<3) X
  • LAST EDITED:  MAY 05, 1994
  • HELP-PROMPT:  Answer must be 3-45 characters in length.
  • DESCRIPTION:  The IVM Center has recently requested that the results from the report IB Billing Activity be transmitted to the IVM Center for nation-wide compilation. This field contains the mail group to which these reports will be
    sent. The field is being exported with the value G.IVM REPORTS@IVM.DOMAIN.EXT.
4.08 INS. CO. DELETION TASK 4;8 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>999999999999)!(X<1)!(X?.E1"."1N.N) X
  • LAST EDITED:  AUG 04, 1995
  • HELP-PROMPT:  Type a Number between 1 and 999999999999, 0 Decimal Digits
  • DESCRIPTION:  This field contains the task number of a job that is scheduled to run which performs all clean-up tasks when an Insurance Company is deleted. After the tasked job runs to completion, the value of this field will be
    deleted.
  • TECHNICAL DESCR:  This field is used to control background processing when an Insurance Company is deleted. When a company is 'deleted' using the Delete Company action within the Insurance Company editor, a background task needs to be
    queued to perform final clean-up tasks. This job searches several files and is queued to run during non-business hours. However, if subsequent companies are also deleted before the queued job runs, it would not be
    desirable to queue another job.
    The task number for the background job for the first deleted company is stored in this field. The value is then used when subsequent companies are deleted, to determine if another job should be queued or not. When a
    company is deleted, if this field contains a task number, and that task number is queued to run, then a second task will not be queued. The queued job will delete the value from this field at job completion.
5.01 ADMISSION SHEET HEADER LINE 1 5;1 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>50!($L(X)<3) X
  • LAST EDITED:  AUG 26, 1993
  • HELP-PROMPT:  Answer must be 3-50 characters in length.
  • DESCRIPTION:  
    Enter the text that your facility would like to have printed as the first line of the header on the admission sheet. This is generally the name of your medical center.
5.02 ADMISSION SHEET HEADER LINE 2 5;2 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>50!($L(X)<3) X
  • LAST EDITED:  AUG 26, 1993
  • HELP-PROMPT:  Answer must be 3-50 characters in length.
  • DESCRIPTION:  
    Enter the text that your facility would like to have printed as the second line of the header on the admission sheet. This is generally the street address of your medical center.
5.03 ADMISSION SHEET HEADER LINE 3 5;3 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>50!($L(X)<3) X
  • LAST EDITED:  AUG 26, 1993
  • HELP-PROMPT:  Answer must be 3-50 characters in length.
  • DESCRIPTION:  
    Enter the text that your facility would like to have printed as the third line of the header on the admission sheet. This is generally the city, state and zip code of your medical center.
6.01 CLAIMS TRACKING START DATE 6;1 DATE

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  AUG 04, 1993
  • DESCRIPTION:  If you choose to run the claims tracking module and populate the files with past episodes of care, this is the date that the routine will use to start.
    This is the main parameter that contro what past care can be entered into claims tracking. At no time does the software automatically add entires older than this date. The one exception is that this parameter does not
    affect the entries that may be added to claims tracking using the add tracking entry action on the main claims tracking screen.
6.02 INPATIENT CLAIMS TRACKING 6;2 SET
  • '0' FOR OFF;
  • '1' FOR INSURED AND UR ONLY;
  • '2' FOR ALL PATIENTS;

  • LAST EDITED:  AUG 04, 1993
  • DESCRIPTION:  This field determines what inpatients will automatically be added to the claims tracking module. If this parameter is set to "OFF" then no new patients will be added. If this is set to "INSURED AND UR ONLY" then only the
    insured patients and random sample patients will be added. If this is set to "ALL PATIENTS" then a record of all admissions will be created.
    If a patient is not insured then each record will be so annotated automatically on creation and no follow-up will be required. The advantage of tracking all patients is that you can determine the percentage of billable
    cases and make necessary adjustments if the patients are later found to have insurance. The disadvantage is that additional capacity is used.
6.03 OUTPATIENT CLAIMS TRACKING 6;3 SET
  • '0' FOR OFF;
  • '1' FOR INSURED ONLY;
  • '2' FOR ALL PATIENTS;

  • LAST EDITED:  AUG 04, 1993
  • DESCRIPTION:  This field determines if outpatient visit dates will automatically be entered into the claims tracking module. If this is answered "OFF" then no entries will be entered. If this is answered "INSURED ONLY" then only
    outpatient visits for insured patients will be added. If this parameter is set to ALL PATIENTS then the outpatient visits for all patients will be added to claims tracking.
    Initially we recommend this parameter be set to INSURED ONLY.
6.04 PRESCRIPTION CLAIMS TRACKING 6;4 SET
  • '0' FOR OFF;
  • '1' FOR INSURED ONLY;
  • '2' FOR ALL PATIENTS;

  • LAST EDITED:  AUG 04, 1993
  • DESCRIPTION:  This field determines if prescriptions will automatically be entered into the claims tracking module. If this is answered "OFF" then no prescriptions or refills will be entered. If this is answered "INSURED ONLY", then
    only prescriptions and refills will be added if the patient is insured. If all is choose then an entry for all prescriptions will be entered.
    If a prescription or refill does not appear to be billable, that is it may be for SC care, or there is a visit date associated with that prescription or refill, this will be so noted in the reason not billable.
6.05 PROSTHETICS CLAIMS TRACKING 6;5 SET
  • '0' FOR OFF;
  • '1' FOR INSURED ONLY;
  • '2' FOR ALL PATIENTS;

  • LAST EDITED:  AUG 04, 1993
  • DESCRIPTION:  This field will be used to determine if prosthetics should be tracked in the claims tracking module. If this parameter is set to OFF, then no prosthetic entries will be added to claims tracking. If this is set to INSURED
    ONLY then only parameter entries for insured patients will be added to claims tracking. If this is set to ALL PATIENTS then an entry will be created for all patients prosthetic items.
6.06 USE ADMISSION SHEETS 6;6 SET
  • '0' FOR NO;
  • '1' FOR YES;

  • LAST EDITED:  AUG 04, 1993
  • DESCRIPTION:  Enter whether your facility is using Admission Sheets as part of the MCCR/UR functionality. If this parameter is answered "YES" then users will be asked for the device to print admissions sheets to. The default device
    will be from the BILL FORM TYPE file.
6.07 RANDOM SAMPLE DATE 6;7 DATE

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  AUG 04, 1993
  • DESCRIPTION:  
    This is the date that random sampling was last re-generated. The IB background job will re-generate a new date, new random numbers, and zero the counters every Sunday night.
6.08 MEDICINE SAMPLE SIZE 6;8 NUMBER
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  K:+X'=X!(X>99)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  JAN 13, 1994
  • HELP-PROMPT:  Type a Number between 0 and 99, 0 Decimal Digits
  • DESCRIPTION:  
    This is the number of required Utilization Reviews that you wish to have done each week for Medicine admissions. The minimum recommended by the QA office is one per week.
6.09 MEDICINE WEEKLY ADMISSIONS 6;9 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>99)!(X<5)!(X?.E1"."1N.N) X
  • LAST EDITED:  AUG 04, 1993
  • HELP-PROMPT:  Type a Number between 5 and 99, 0 Decimal Digits
  • DESCRIPTION:  
    This is the minimum number of admissions for Medicine that your Medical Center generally averages. This is used along with the Medicine sample size to compute a random number.
6.1 MEDICINE RANDOM NUMBER 6;10 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>99)!(X<1)!(X?.E1"."1N.N) X
  • LAST EDITED:  AUG 04, 1993
  • HELP-PROMPT:  Type a Number between 1 and 99, 0 Decimal Digits
  • DESCRIPTION:  This is an internally computed random number. It is re-computed each week. When the count of the Medicine admissions reaches a multiple of this number it is considered the random selection. The total number of random
    selections for UR will not exceed the Medicine sample size.
6.11 MEDICINE ENTRIES MET 6;11 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>99)!(X<1)!(X?.E1"."1N.N) X
  • LAST EDITED:  AUG 04, 1993
  • HELP-PROMPT:  Type a Number between 1 and 99, 0 Decimal Digits
  • DESCRIPTION:  
    This is the number of random selections generated this week.
6.12 MEDICINE ADMISSION COUNTER 6;12 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>99)!(X<1)!(X?.E1"."1N.N) X
  • LAST EDITED:  AUG 04, 1993
  • HELP-PROMPT:  Type a Number between 1 and 99, 0 Decimal Digits
  • DESCRIPTION:  
    This is the number of admissions for this service counted by the claims tracking module so far this week.
6.13 SURGERY SAMPLE SIZE 6;13 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>99)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  JAN 13, 1994
  • HELP-PROMPT:  Type a Number between 0 and 99, 0 Decimal Digits
  • DESCRIPTION:  
    This is the number of required Utilization Reviews that you wish to have done each week for Surgery admissions. The minimum recommended by the QA office is one per week.
6.14 SURGERY WEEKLY ADMISSIONS 6;14 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>99)!(X<5)!(X?.E1"."1N.N) X
  • LAST EDITED:  SEP 01, 1993
  • HELP-PROMPT:  Type a Number between 5 and 99, 0 Decimal Digits
  • DESCRIPTION:  
    This is the minimum number of admissions for Surgery that your Medical Center generally averages. This is used along with the Surgery sample size to compute a random number.
6.15 SURGERY RANDOM NUMBER 6;15 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>99)!(X<1)!(X?.E1"."1N.N) X
  • LAST EDITED:  AUG 04, 1993
  • HELP-PROMPT:  Type a Number between 1 and 99, 0 Decimal Digits
  • DESCRIPTION:  This is an internally computed random number. It is re-computed each week. When the count of the Surgery admissions reaches a multiple of this number it is considered the random selection. The total number of random
    selections for UR will not exceed the Surgery sample size.
6.16 SURGERY ENTRIES MET 6;16 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>99)!(X<1)!(X?.E1"."1N.N) X
  • LAST EDITED:  AUG 04, 1993
  • HELP-PROMPT:  Type a Number between 1 and 99, 0 Decimal Digits
  • DESCRIPTION:  
    This is the number of random selections generated this week.
6.17 SURGERY ADMISSION COUNTER 6;17 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>99)!(X<1)!(X?.E1"."1N.N) X
  • LAST EDITED:  AUG 04, 1993
  • HELP-PROMPT:  Type a Number between 1 and 99, 0 Decimal Digits
  • DESCRIPTION:  
    This is the number of admissions for this service counted by the claims tracking module so far this week.
6.18 PSYCH SAMPLE SIZE 6;18 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>99)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  JAN 13, 1994
  • HELP-PROMPT:  Type a Number between 0 and 99, 0 Decimal Digits
  • DESCRIPTION:  
    This is the number of required Utilization Reviews that you wish to have done each week for Psychiatry admissions. The minimum recommended by the QA office is one per week.
6.19 PSYCH WEEKLY ADMISSIONS 6;19 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>99)!(X<5)!(X?.E1"."1N.N) X
  • LAST EDITED:  SEP 01, 1993
  • HELP-PROMPT:  Type a Number between 5 and 99, 0 Decimal Digits
  • DESCRIPTION:  
    This is the minimum number of admissions for Psychiatry that your Medical Center generally averages. This is used along with the Psychiatry sample size to compute a random number.
6.2 PSYCH RANDOM NUMBER 6;20 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>99)!(X<1)!(X?.E1"."1N.N) X
  • LAST EDITED:  AUG 04, 1993
  • HELP-PROMPT:  Type a Number between 1 and 99, 0 Decimal Digits
  • DESCRIPTION:  This is an internally computed random number. It is re-computed each week. When the count of the Psychiatry admissions reaches a multiple of this number it is considered the random selection. The total number of random
    selections for UR will not exceed the Psychiatry sample size.
6.21 PSYCH ENTRIES MET 6;21 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>99)!(X<1)!(X?.E1"."1N.N) X
  • LAST EDITED:  AUG 04, 1993
  • HELP-PROMPT:  Type a Number between 1 and 99, 0 Decimal Digits
  • DESCRIPTION:  
    This is the number of random selections generated this week.
6.22 PSYCH ADMISSION COUNTER 6;22 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>99)!(X<1)!(X?.E1"."1N.N) X
  • LAST EDITED:  AUG 04, 1993
  • HELP-PROMPT:  Type a Number between 1 and 99, 0 Decimal Digits
  • DESCRIPTION:  
    This is the number of admissions for this service counted by the claims tracking module so far this week.
6.23 REPORTS ADD TO CLAIMS TRACKING 6;23 SET
  • '0' FOR NO;
  • '1' FOR YES;

  • LAST EDITED:  OCT 26, 1993
  • HELP-PROMPT:  Should the Patients with Insurance Reports add entries to claims tracking.
  • DESCRIPTION:  This field determines whether or not you wish to allow the Veterans with Insurance reports to add entries to Claims tracking. If you answer 'YES' then admisssions and outpatient visits found as billable but not found in
    claims tracking will be added to claims tracking for billing information purposes only. No review will be set up. This is to allow flagging of these visits as unbillable so that they can be removed from these reports.
    Answering 'YES' does not guarantee that the entry will be added. The related parameters about whether Claims Tracking is turned on and the Claims Tracking Start Date will override this parameter.
  • TECHNICAL DESCR:  
6.24 AUTO PRINT UNBILLED LIST 6;24 SET
  • '0' FOR NO;
  • '1' FOR YES;

  • LAST EDITED:  SEP 29, 1994
  • HELP-PROMPT:  Answer 'Yes' if you want a detailed patient listing or 'No' if you only want the mail message containing the totals.
  • DESCRIPTION:  Enter 'Yes' if you would like a detailed patient listing of unbilled cases automatically printed each month, when the option Auto-Generate Unbilled Amounts Report runs on the first of each month. If you answer 'Yes' you
    must enter the printer in the DEFAULT PRINTER (BILLING) field of the BILL FORM TYPE File (353).
    If you answer 'NO' the option will not generate a detailed listing of cases. You will only receive the mailman message with the totals.
    A detailed listing may be reprinted using the option Re-Generate Unbilled Amounts Report (IBT RE-GEN UNBILLED REPORT).
6.25 UNBILLED MAIL GROUP 6;25 POINTER TO MAIL GROUP FILE (#3.8) MAIL GROUP(#3.8)

  • LAST EDITED:  SEP 29, 1994
  • HELP-PROMPT:  Enter the name of the mail group that should receive the Unbilled Amounts mail message.
  • DESCRIPTION:  Enter the name of the mail group that will receive the monthly mail message that contains the data for the unbilled amounts report. Generally this will include the Chief of Accounting and others who are responsible for
    inputting the code sheets to Austin.
7.01 AUTO BILLER FREQUENCY 7;1 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>9999)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  OCT 21, 1993
  • HELP-PROMPT:  Type a Number between 0 and 9999, 0 Decimal Digits
  • DESCRIPTION:  Enter the number of days between each execution of the automated biller. For example, if the auto biller should run only once a week, enter 7. If the auto biller should run every night, enter 1.
    This will not effect the date range of the bills themselves, but will only effect the date they are created.
    If this is left blank or zero then the auto biller will never run.
7.02 LAST AUTO BILLER DATE 7;2 DATE

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  OCT 21, 1993
  • HELP-PROMPT:  This is the last date on which the auto biller ran.
  • DESCRIPTION:  
    This is generally set by the system.
7.03 INPATIENT STATUS (AB) 7;3 SET
  • '1' FOR Closed;
  • '2' FOR Released;
  • '3' FOR Transmitted;

  • LAST EDITED:  JAN 25, 1994
  • HELP-PROMPT:  Enter the Status that an Inpatients PTF record should have before the automated biller attempts to create a bill for that inpatient stay.
  • DESCRIPTION:  This is the status that a PTF record must be in before the automated biller will attempt to create an inpatient bill.
    The auto biller will use the Frequency, Billing Cycle and Days Delay parameters to decide when to try to create an inpatient bill. However, the auto biller can not set up a bill until the PTF record is Closed. Of the two
    dates, the date calculated from the site parameters or the date that the PTF record meets the Status entered here, the bill will be created on the later date.
  • TECHNICAL DESCR:  This set of codes should exactly mirror the PTF Status (45,6) set of codes, except for Open.
    Some sites want to wait until the PTF is closed before a bill is created because they know it will be coded at that time. Others do not want to bill until the PTF record has been transmitted and they know that it is
    complete.
    After this had been added it was decided that an auto bill should not be created for inpatients until after the PTF record has been closed. So, the option of creating an auto bill when the PTF record was still open was
    removed.
7.04 NUMBER OF DAYS PT CHARGES HELD 7;4 NUMBER
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  K:+X'=X!(X>90)!(X<90)!(X?.E1"."1N.N) X
  • LAST EDITED:  OCT 11, 2001
  • HELP-PROMPT:  VA Policy determines number of days charges are held before auto-release.
  • DESCRIPTION:  Patient charges with a status of ON HOLD will be automatically released to the Accounts Receivable package after this number of days has passed. The MCCR Program Office has determined that charges will be released after
    this number days if no payment has been received from the patient's insurance carrier for the episode of care.
7.05 DEFAULT RX REFILL DX ICD-10 7;5 POINTER TO ICD DIAGNOSIS FILE (#80) ICD DIAGNOSIS(#80)

  • INPUT TRANSFORM:  S DIC("S")="I $$ICD9ACT^IBACSV(+Y)" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X
  • LAST EDITED:  NOV 25, 2013
  • HELP-PROMPT:  Enter a Diagnosis that should be added to every RX Refill bill.
  • DESCRIPTION:  
    If entered, this diagnosis will be automatically added to every bill that has prescription refills. ICD-10 Diagnosis only. Should be a generic ICD-10 code such as Z76.0 - Encounter for issue of repeat prescription.
  • TECHNICAL DESCR:  
    Replaces #350.9, 1.29 DEFAULT RX REFILL DX after ICD-10 is active.
  • SCREEN:  S DIC("S")="I $$ICD9ACT^IBACSV(+Y)"
  • EXPLANATION:  Only active diagnosis codes may be selected.
8.01 LIVE TRANSMIT 837 QUEUE 8;1 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>40!($L(X)<3) X
  • LAST EDITED:  JUN 02, 1997
  • HELP-PROMPT:  Answer with the name (3-40 characters) of the 837 transmit live queue.
  • DESCRIPTION:  
    This is the name of the transmission queue that will be used to send live 837 transactions to Austin.
8.02 DAYS TO WAIT TO PURGE MSGS 8;2 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>999)!(X<1)!(X?.E1"."1N.N) X
  • LAST EDITED:  MAR 05, 2001
  • HELP-PROMPT:  Type a Number between 1 and 999, 0 Decimal Digits
  • DESCRIPTION:  
    This is the # of days after an electronic status message has been marked as having been reviewed that the purge message option can delete it from the BILL STATUS MESSAGE file (#361).
8.03 AUTO TRANSMIT BILL FREQUENCY 8;3 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>9999)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  JAN 02, 1996
  • HELP-PROMPT:  Type a Number between 0 and 9999, 0 Decimal Digits
  • DESCRIPTION:  This is the desired number of days between each execution of the automated bill transmitter where all bills in the BILL TRANSMIT file that are in a status of READY FOR EXTRACT will be extracted and sent to the queue for
    electronic processing. For example, if the automated bill transmitter should run only once a week, this number would be 7. If the automated bill transmitter should run every night, then the number should be 1. If this
    is left blank or zero then the automated bill transmitter background job will never run.
8.04 MAX # BILLS IN A BATCH 8;4 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>50)!(X<1)!(X?.E1"."1N.N) X
  • LAST EDITED:  APR 29, 1999
  • HELP-PROMPT:  Type a Number between 1 and 50, 0 Decimal Digits
  • DESCRIPTION:  The maximum number of bills to be allowed to be batched together for transmission purposes. This should be kept to a manageable level as when one bill in a batch is rejected, the entire batch is returned to the site
    unprocessed. However, one bill per batch is very inefficient for transmission purposes.
8.05 LAST 837 AUTO-TRANSMIT DATE 8;5 DATE

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  MAR 13, 1996
  • HELP-PROMPT:  Enter the last date that the auto-transmit of bills ran at this facility.
  • DESCRIPTION:  
    This is the last date that the auto-transmit of bills ran at this facility.
8.06 HOURS TO TRANSMIT BILLS 8;6 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>19!($L(X)<4)!'(X?4N!(X?4N1";"4N)!(X?4N1";"4N1";"4N)!(X?4N1";"4N1";"4N1";"4N)) X I $D(X) N Z F Z=1:1:4 Q:'$D(X)!($P(X,";",Z)="") K:$P(X,";",Z)>2400 X
  • LAST EDITED:  APR 24, 2001
  • HELP-PROMPT:  Enter 1-4 times of the day (military format, separated by ;) when EDI bill transmit should run
  • DESCRIPTION:  This field contains the times of the day when EDI transmission of bills should occur. There is a maximum of 4 times that may be entered and each time must be separated from the previous one by a semi-colon. Times must be
    entered in 4 digit military format, without punctuation as indicated: HHMM;HHMM;HHMM;HHMM. The IB nightly job will queue 1-4 jobs to automatically start EDI transmission at these designated times for that day if the time
    is after the time the nightly job is running. If the time is before the time the nightly job is running, the transmission is queued for the following day. If no times are entered, EDI transmission will take place as part
    of the nightly job.
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
8.07 ONLY 1 INS CO PER CLAIM BATCH 8;7 SET
  • '1' FOR YES;
  • '0' FOR NO;

  • LAST EDITED:  NOV 23, 1998
  • HELP-PROMPT:  Enter YES if only 1 insurance company should be included in a claim batch
  • DESCRIPTION:  
    This field indicates whether or not the site wishes to limit bill claim batches to contain only a single insurance company.
8.09 TEST TRANSMIT 837 QUEUE 8;9 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>40!($L(X)<3) X
  • LAST EDITED:  JUN 02, 1997
  • HELP-PROMPT:  Answer with the name (3-40 characters) of the 837 transmit test queue.
  • DESCRIPTION:  
    This is the name of the transmission queue that will be used to send test 837 transactions to Austin.
8.1 EDI/MRA ACTIVATED 8;10 SET
  • '0' FOR NOT EDI OR MRA;
  • '1' FOR EDI ONLY;
  • '2' FOR MRA ONLY;
  • '3' FOR BOTH EDI AND MRA;

  • LAST EDITED:  DEC 04, 2003
  • HELP-PROMPT:  Enter the status of EDI/MRA you want to exist at your site
  • DESCRIPTION:  
    This parameter controls whether EDI and/or requests for MRA are available functions for your site.
  • CROSS-REFERENCE:  ^^TRIGGER^350.9^8.13
    1)= X ^DD(350.9,8.1,1,1,1.3) I X S X=DIV S Y(1)=$S($D(^IBE(350.9,D0,8)):^(8),1:"") S X=$P(Y(1),U,13),X=X S DIU=X K Y S X=DIV N %I,%H,% D NOW^%DTC S DIH=$G(^IBE(350.9,DIV(0),8)),DIV=X S $P(^(8),U,13)=DIV,DIH=350.9,DIG=8.13
    D ^DICR
    1.3)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(0)=X S Y(1)=$S($D(^IBE(350.9,D0,8)):^(8),1:"") S X=$P(Y(1),U,13)="",Y(2)=$G(X),Y(3)=$G(X) S X=Y(0),X=X S X=X>1,Y=X,X=Y(2),X=X&Y
    2)= Q
    CREATE CONDITION)= (DATE MRA FIRST ACTIVATED="")&(INTERNAL(EDI/MRA ACTIVATED)>1)
    CREATE VALUE)= TODAY
    DELETE VALUE)= NO EFFECT
    FIELD)= `8.13
8.11 AUTOMATIC MRA EOB PROCESS? 8;11 SET
  • '0' FOR NO;
  • '1' FOR YES;

  • LAST EDITED:  AUG 28, 2003
  • HELP-PROMPT:  Enter Yes or No
  • DESCRIPTION:  This field controls whether or not incoming Medicare Remittance Advice (MRA) EOB's can be automatically processed so that the secondary bill is automatically generated and automatically authorized and sent to the secondary
    payer.
    If this field is NO, then all incoming MRA EOB's will remain on the MRA management worklist and manual processing of the MRA EOB's will be necessary.
8.12 ALLOW MRA EOB PROCESSING? 8;12 SET
  • '0' FOR NO;
  • '1' FOR YES;

  • LAST EDITED:  AUG 28, 2003
  • HELP-PROMPT:  Enter Yes or No
  • DESCRIPTION:  This field controls whether or not Medicare Remittance Advice (MRA) EOB's are allowed to be processed so that a bill can become a secondary bill and be authorized to the secondary payer.
    This field is checked by both the manual Process COB action from the MRA management worklist and also by the automatic MRA process.
8.13 DATE MRA FIRST ACTIVATED 8;13 DATE

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:X<1 X
  • LAST EDITED:  JUN 04, 2004
  • HELP-PROMPT:  (No range limit on date)
  • DESCRIPTION:  
    This is the date Medicare Remittance Advice (MRA) was activated at site.
  • NOTES:  TRIGGERED by the EDI/MRA ACTIVATED field of the IB SITE PARAMETERS File
8.14 CMS-1500 AUTO PRINTER 8;14 POINTER TO DEVICE FILE (#3.5) DEVICE(#3.5)

  • LAST EDITED:  OCT 12, 2010
  • HELP-PROMPT:  Enter the name of the printer that will print automatically-processed secondary/tertiary CMS 1500 claims.
  • DESCRIPTION:  
    This is the printer that will be used to automatically print CMS-1500s when an electronic non-Medicare EOB is received and the subsequent insurance company requires printed claims.
8.15 UB-04 AUTO PRINTER 8;15 POINTER TO DEVICE FILE (#3.5) DEVICE(#3.5)

  • LAST EDITED:  OCT 12, 2010
  • HELP-PROMPT:  Enter the name of the printer that will print automatically-processed secondary/tertiary UB04 claims.
  • DESCRIPTION:  
    This is the printer that will be used to automatically print UB-04s when an electronic non-Medicare EOB is received and the subsequent insurance company requires printed claims.
8.16 EOB AUTO PRINTER 8;16 POINTER TO DEVICE FILE (#3.5) DEVICE(#3.5)

  • LAST EDITED:  OCT 12, 2010
  • HELP-PROMPT:  Enter the name of the printer that will print EOBs for automatically-processed secondary/tertiary claims.
  • DESCRIPTION:  
    This is the printer that will be used for automatically printing EOBs of automatically-processed claims when the subsequent insurance company requires printed secondary or tertiary claims.
8.17 AUTOMATIC REG EOB PROCESS? 8;17 SET
  • '0' FOR NO;
  • '1' FOR YES;

  • LAST EDITED:  DEC 22, 2010
  • HELP-PROMPT:  Should Regular EOBs be automatically processed?
  • DESCRIPTION:  This field controls whether or not incoming Regular (Non-Medicare) EOBs can be automatically processed so that the subsequent bill is automatically generated and automatically authorized and sent to the next payer.
    If this field is NO, then all incoming Regular (Non-Medicare) EOBs will remain on the COB management worklist and manual processing of the EOBs will be necessary.
8.19 MRA AUTO PRINTER 8;19 POINTER TO DEVICE FILE (#3.5) DEVICE(#3.5)

  • LAST EDITED:  DEC 30, 2010
  • HELP-PROMPT:  Enter the name of the printer that will print MRAs for automatically-processed secondary/tertiary claims.
  • DESCRIPTION:  This is the printer that will be used for automatically printing MRAs of automatically-processed claims when the subsequent insurance company requires printed secondary or tertiary claims. MRAs need to have a device set
    up for 132 character printing.
8.2 DENTAL ENABLED? 8;20 SET
  • '0' FOR NO;
  • '1' FOR YES;

  • LAST EDITED:  JUL 17, 2017
  • HELP-PROMPT:  Enter 'Yes' to enable the processing of Dental Claims. Otherwise, enter 'No'.
  • DESCRIPTION:  This value determines if Dental Claims can be processed in VistA. Yes indicates that Dental claims may be entered and processed by the Integrated Billing auto-biller. No indicates that no Dental claims processing can
    occur in VistA.
8.21 837 FHIR ENABLED? 8;21 SET
  • '0' FOR NO;
  • '1' FOR YES;

  • LAST EDITED:  JUL 22, 2020
  • HELP-PROMPT:  Enter 'Yes' to indicate using TAS Core platform and FHIR for all 837 transactions. Otherwise, enter 'No'.
  • DESCRIPTION:  
    This field indicates whether all EDI 837 Claim Transactions are to be submitted to FSC through the TAS Core platform using FHIR. A 'Yes' value will indicate using FHIR and 'No' will indicate still using MailMan format.
  • AUDIT:  YES, ALWAYS
8.22 PCR LAST SEARCH DATE 8;22 DATE

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  NOV 21, 2022
  • HELP-PROMPT:  Enter the date the PCR report data was last extracted.
  • DESCRIPTION:  
    This value is the last Date the PCR report used to extract claim data.
8.23 PAYERID SWITCH DISABLED? 8;23 SET (BOOLEAN Data Type)
  • will disable the VistA Payer ID switching process.

  • LAST EDITED:  DEC 16, 2022
  • HELP-PROMPT:  Enter 1 to indicate that the Payer ID switch process is disabled in VistA. Otherwise, enter 0.
  • DESCRIPTION:  This field indicates whether the Payer ID switch function is enabled within VistA and disabled at FSC. A value of zero (0) indicates that VistA will perform the Payer ID switching, when applicable. A value of one (1)
    will disable the VistA Payer ID switching process.
9.01 BILLING PORT 9;1 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>15!($L(X)<3) X
  • LAST EDITED:  MAY 12, 2004
  • HELP-PROMPT:  Answer must be 3-15 characters in length.
  • DESCRIPTION:  
    This is the logical port which is opened to transmit pharmacy transactions to the TRICARE fiscal intermediary. If there is no value in this field, the Pharmacy billing engine cannot be started.
9.02 AWP PORT 9;2 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>15!($L(X)<3) X
  • LAST EDITED:  MAY 12, 2004
  • HELP-PROMPT:  Answer must be 3-15 characters in length.
  • DESCRIPTION:  
    This is the logical port which is opened to receive AWP updates from the TRICARE fiscal intermediary. If this field has no value, the AWP update engine cannot be started.
9.03 TCP/IP ADDRESS 9;3 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>39!($L(X)<3) X
  • LAST EDITED:  JUL 24, 2015
  • HELP-PROMPT:  Answer must be 3-39 characters in length.
  • DESCRIPTION:  
    This field holds the TCP/IP address needed to reach the Pharmacy billing commercial software package. The billing interface cannot be started if there is no value on this field.
9.04 PRIMARY BILLING TASK 9;4 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>15!($L(X)<1) X
  • LAST EDITED:  AUG 19, 1996
  • HELP-PROMPT:  Answer must be 1-15 characters in length.
  • DESCRIPTION:  This is the task number for the primary billing transaction engine which communicates with the Pharmacy billing commercial software package. This field will be deleted during an orderly shutdown or when an error occurs.
    If this field is deleted, the secondary billing job will become the primary.
9.05 SECONDARY BILLING TASK 9;5 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>15!($L(X)<1) X
  • LAST EDITED:  AUG 19, 1996
  • HELP-PROMPT:  Answer must be 1-15 characters in length.
  • DESCRIPTION:  
    This is the task number for the secondary billing transaction engine. This task is normally idled and becomes activated if the primary task errors out.
9.06 PRIMARY AWP TASK 9;6 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>15!($L(X)<1) X
  • LAST EDITED:  AUG 19, 1996
  • HELP-PROMPT:  Answer must be 1-15 characters in length.
  • DESCRIPTION:  This is the task number for the primary AWP update task. This task communicates with the Pharmacy billing commercial software package to receive updates to the AWP (Average Wholesale Pricelist). If this field becomes
    null, the secondary task will become the primary task.
9.07 SECONDARY AWP TASK 9;7 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>15!($L(X)<1) X
  • LAST EDITED:  AUG 19, 1996
  • HELP-PROMPT:  Answer must be 1-15 characters in length.
  • DESCRIPTION:  
    This is the task number for the secondary AWP update task. This task is normally idled and becomes activated if the primary task errors out.
9.08 DATE PRIMARY TASK STARTED 9;8 DATE

  • INPUT TRANSFORM:  S %DT="ESTXR" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  AUG 19, 1996
  • DESCRIPTION:  
    This is the date/time in which the primary billing transaction engine began running.
9.09 DATE PRIMARY TASK LAST RAN 9;9 DATE

  • INPUT TRANSFORM:  S %DT="ESTXR" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  AUG 19, 1996
  • DESCRIPTION:  
    This date/time is the last time that the primary billing transaction engine passed a transaction to the commercial software package.
9.1 SHUTDOWN BACKGROUND JOBS 9;10 SET
  • '0' FOR NO;
  • '1' FOR YES;

  • LAST EDITED:  AUG 19, 1996
  • DESCRIPTION:  
    This field will be used to control both the Billing transaction and AWP update tasks. If this field is set to Yes, both of these sets of jobs will shutdown in an orderly fashion.
9.11 TASK UCI,VOL 9;11 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>12!($L(X)<3) X
  • LAST EDITED:  AUG 19, 1996
  • HELP-PROMPT:  Answer must be 3-12 characters in length.
  • DESCRIPTION:  
    If this field has a value, this will be the volume and uci in which the engines will be tasked to run.
9.12 AWP CHARGE SET 9;12 POINTER TO CHARGE SET FILE (#363.1) CHARGE SET(#363.1)

  • INPUT TRANSFORM:  S DIC("S")="I +$$CSBI^IBCRU3(Y)=3" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X
  • LAST EDITED:  MAY 12, 2004
  • DESCRIPTION:  
    The value of this field points to a Charge Set in file #363.1 which will be used to retrieve the Average Wholesale Price (AWP) of a drug when the TRICARE Pharmacy Billing software interface is running.
  • SCREEN:  S DIC("S")="I +$$CSBI^IBCRU3(Y)=3"
  • EXPLANATION:  This screen only allows Charge Sets which are based on NDC numbers.
9.13 PRESCRIBER ID 9;13 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>15!($L(X)<3) X
  • LAST EDITED:  MAY 12, 2004
  • HELP-PROMPT:  Answer must be 3-15 characters in length.
  • DESCRIPTION:  The Prescriber ID is assigned by the TRICARE fiscal intermediary to a facility. The ID is used in the TRICARE pharmacy billing transmission to identify the facility to the intermediary.
    There must be a value in this field in order to start the TRICARE pharmacy billing interface task.
  • TECHNICAL DESCR:  
9.14 DEA# OVERRIDE PRESC. ID 9;14 SET
  • '0' FOR NO;
  • '1' FOR YES;

  • LAST EDITED:  NOV 21, 2000
  • HELP-PROMPT:  Answering YES to this field will send the DEA# from the New Person file (if available) to the fiscal intermediary as the provider reference in place of the Prescriber ID.
  • DESCRIPTION:  Answering yes to this field, causes the DEA# from the NEW PERSON (#200) file to override the Prescriber ID as the provider reference sent to the fiscal intermediary when billing Tricare RX. If this field is answered as
    NO, left unanswered, or answered YES but the DEA# is not available for the provider, then the Prescriber ID is sent as the provider reference.
  • TECHNICAL DESCR:  
9.15 PHARM CALC COMPOUND CODE 9;15 SET
  • '0' FOR NO;
  • '1' FOR YES;

  • LAST EDITED:  NOV 20, 2000
  • HELP-PROMPT:  Answering YES to this field, will use the values calculated in the pharmacy package for compound code to be sent to the fiscal intermediary (1 or 2) instead of a zero.
  • DESCRIPTION:  Answering YES to this prompt will send the values calculated in the Pharmacy package, for compound code, to the fiscal intermediary when billing Tricare RX. Pharmacy evaluates the drug to be either a compound drug (
    code=2 ) or a non compound drug ( code = 1 ). If this field is left blank or is answered NO, a code of 0 will be sent.
  • TECHNICAL DESCR:  
10.01 PATIENT OR FACILITY 10;1 VARIABLE POINTER TRANSFER PRICING PATIENT(#351.6)  INSTITUTION(#4)  

  • EXPLANATION:  Only valid Facilities
  • LAST EDITED:  FEB 19, 1999
  • HELP-PROMPT:  You can just type in a PATIENT or FACILITY name.
  • DESCRIPTION:  This field definition is used by the Patient or Preferred Facility selection when using the FileMan Reader only.
    No data needs to be set in this field.
10.02 TP INPATIENT ACTIVE 10;2 SET
  • '0' FOR NO;
  • '1' FOR YES;

  • LAST EDITED:  APR 07, 2000
  • HELP-PROMPT:  Choose to activitate this software for Inpatient.
  • DESCRIPTION:  
    This flag will identify if the facility has Transfer Pricing turned on for Inpatient tracking. If this field is blank, Transfer Pricing will be off for Inpatient tracking.
10.03 TP OUTPATIENT ACTIVE 10;3 SET
  • '0' FOR NO;
  • '1' FOR YES;

  • LAST EDITED:  APR 07, 2000
  • HELP-PROMPT:  Choose to activitate this software for Outpatient.
  • DESCRIPTION:  
    This flag will identify if the facility has Transfer Pricing turned on for Outpatient tracking. If this field is blank, Transfer Pricing will be off for Outpatient tracking.
10.04 TP PHARMACY ACTIVE 10;4 SET
  • '0' FOR NO;
  • '1' FOR YES;

  • LAST EDITED:  APR 07, 2000
  • HELP-PROMPT:  Choose to activitate this software for Pharmacy.
  • DESCRIPTION:  
    This flag will identify if the facility has Transfer Pricing turned on for Prescription tracking. If this field is blank, Transfer Pricing will be off for Prescription tracking.
10.05 TP PROSTHETICS ACTIVE 10;5 SET
  • '0' FOR NO;
  • '1' FOR YES;

  • LAST EDITED:  APR 11, 2000
  • HELP-PROMPT:  Choose to activitate this software for Prosthetics.
  • DESCRIPTION:  
    This flag will identify if the facility has Transfer Pricing turned on for Prosthetics tracking. If this field is blank, Transfer Pricing will be off for Prosthetics tracking.
11.01 HIPAA NCPDP ACTIVE FLAG 11;1 SET
  • '1' FOR Active;
  • '0' FOR Not Active;

  • LAST EDITED:  APR 09, 2004
  • HELP-PROMPT:  e-Pharmacy interface active? Enter 'A' for Active or 'N' for not active.
  • DESCRIPTION:  
    This field is used to activate the e-Pharmacy interface.
  • AUDIT:  EDITED OR DELETED
11.03 DEFAULT PAY-TO PROVIDER 11;3 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>9999)!(X<1)!(X?.E1"."1.N) X
  • LAST EDITED:  NOV 14, 2008
  • HELP-PROMPT:  Type a number between 1 and 9999, 0 Decimal Digits.
  • DESCRIPTION:  This field is the internal entry number to the 350.9004 pay-to provider sub-file. It should not be edited by FileMan directly. It is set by the Pay-To provider maintenance application in the IB Site Parameters edit
    option.
11.04 DEFAULT TRICARE PAY-TO PROV 11;4 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>9999)!(X<1)!(X?.E1"."1N.N) X
  • LAST EDITED:  MAY 08, 2014
  • HELP-PROMPT:  Type a number between 1 and 9999, 0 decimal digits.
  • DESCRIPTION:  This field is the internal entry number to the 350.929 TRICARE pay-to provider sub-file. It should not be edited by FileMan directly. It is set by the Pay-To provider maintenance application in the IB Site Parameters edit
    option.
13.01 HMS DIRECTORY 13;1 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>30!($L(X)<5) X
  • LAST EDITED:  OCT 04, 2011
  • HELP-PROMPT:  Enter the name of the directory where Extract/Result files are stored.
  • DESCRIPTION:  
    Name of the directory where Extract/Result files are stored as needed by HMS Data Extractor.
13.02 EII ACTIVE 13;2 SET
  • '1' FOR YES;
  • '0' FOR NO;

  • LAST EDITED:  OCT 04, 2011
  • HELP-PROMPT:  Enable/activate eII Software?
  • DESCRIPTION:  
    This is a flag to indicate whether the eII software is enabled/active.
13.03 RESULT FILE NAME 13;3 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>30!($L(X)<5) X
  • LAST EDITED:  OCT 04, 2011
  • HELP-PROMPT:  Enter the name of the Result file as it is configured in HMS Data Extractor software.
  • DESCRIPTION:  
    Name of the Result file as it is configured in HMS Data Extractor software.
13.04 DAY OF MONTH RESULT FILE DUE 13;4 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>31)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  OCT 04, 2011
  • HELP-PROMPT:  Enter the day of month, 0 to 31 when the Result file expected from HMS. A value of 0 means do not check the due date.
  • DESCRIPTION:  Day of the month when Result file is due be received from HMS through AITC. if "0" entered or empty, due check would not be calculated. For a day , say 31 that does not exist for a given month, eII software will assume
    last day of that month. This includes last day of February whether it is a leap year or not.
13.05 DAYS BEFORE LATE MESSAGE SENT 13;5 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>30)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  NOV 23, 2011
  • HELP-PROMPT:  Enter number of days after the Result File Due day, before the Result File arrival from HMS is considered overdue.
  • DESCRIPTION:  
    Number of days after the Result File Due day of the month, before the Result file arrival from HMS is considered overdue. If the Result file is not received by this time a late message is sent to IRM mail group.
13.06 MAX EXT FILE QUE CONFIRM TIME 13;6 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>99)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  JAN 10, 2012
  • HELP-PROMPT:  Enter maximum number of hours (usually 24 hours) to wait for confirmation message(s) to be received after an Extract file message is sent to AITC.
  • DESCRIPTION:  Maximum number of hours (usually 24 hours) to wait for confirmation message(s) to be received after an Extract file message is sent to AITC. When this time is exceeded, a no confirmation message is sent to the IBCNF EII
    IRM mail group.
13.07 MAX NUM OF RECORDS PER MESSAGE 13;7 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>9999)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  JAN 10, 2012
  • HELP-PROMPT:  Enter maximum number of records per message that can be sent to AITC DMI Queues, when the Extract file message(s) are built.
  • DESCRIPTION:  
    Extract file records are sent via one or more Mailman messages to ATIC DMI Queues. This field is the maximum number (usually 100) of records per message.
13.08 EXTRACT FILES 13.08;0 SET Multiple #350.9006 350.9006

  • DESCRIPTION:  
    This sub-file contains configuration information for each extracted file type.
15 PRINTED CLAIMS RC EXCLUSIONS 15;0 POINTER Multiple #350.9399 350.9399

  • DESCRIPTION:  
    This field contains Revenue Codes that are used to exclude a claim from the Locally Printed Claims Report.
  • TECHNICAL DESCR:  This multi-field points to the Revenue Code file. It contains a list of the Revenue Codes that are used to determine if a claim will be excluded from the Locally Printed Claims Report. If a claim contains one of these
    Revenue Codes, the claim will not show on the Printed Claims Report.
16 CMN CPT CODES 16;0 POINTER Multiple #350.916 350.916
19 PAY-TO PROVIDERS 19;0 POINTER Multiple #350.9004 350.9004

  • DESCRIPTION:  
    This multiple contains the list of Pay-To Providers for this VistA database.
  • INDEXED BY:  FACILITY (AC)
20 BILLING PROVIDER FAC TYPES 20;0 POINTER Multiple #350.9005 350.9005

  • DESCRIPTION:  
    This multiple field contains a list of the valid Billing Provider facility types and also whether or not a facility type may also be a Pay-To Provider.
28 NON-MCCF RATE TYPES FOR PTP 28;0 POINTER Multiple #350.928 350.928

  • DESCRIPTION:  
    This contains the Non-MCCF Rate Types that are related to the Non-MCCF Pay-To Providers. If a claim has one of the rate types in this multiple field, the claim is considered to be a Non-MCCF Claim.
29 TRICARE PAY-TO PROVIDERS 29;0 POINTER Multiple #350.929 350.929

  • DESCRIPTION:  
    This multiple contains the list of Non-MCCF-specific Pay-To Providers for this VistA database.
  • INDEXED BY:  TC FACILITY (AC)
50.01 RUNNING CLAIMSMANAGER? 50;1 SET
  • '1' FOR YES;
  • '0' FOR NO;

  • LAST EDITED:  MAR 16, 2001
  • DESCRIPTION:  
    This field will contain a 1 if the site is running the Ingenix ClaimsManager interface and software and a 0 or "" if it is not.
50.02 CLAIMSMANAGER WORKING OK? 50;2 SET
  • '1' FOR YES;
  • '0' FOR NO;

  • LAST EDITED:  MAR 16, 2001
  • DESCRIPTION:  This field will normally contain a 1 (yes), but may be set to 0 (no) in order to halt the processing of claims through ClaimsManager. This would normally be used to correct a communication problem or any other problem
    that was preventing the claim from processing in ClaimsManager.
50.03 GENERAL ERROR MSG MAIL GROUP 50;3 POINTER TO MAIL GROUP FILE (#3.8) MAIL GROUP(#3.8)

  • LAST EDITED:  JAN 05, 2001
  • DESCRIPTION:  This field will point to the mail group that will receive the error messages to be received at the user level. If more than one mail group is desired, they may be added as a REMOTE USER in the mail group that is entered
    in this field.
50.04 COMM ERR MSG MAIL GROUP 50;4 POINTER TO MAIL GROUP FILE (#3.8) MAIL GROUP(#3.8)

  • LAST EDITED:  JAN 05, 2001
  • DESCRIPTION:  
    This field will point to the mail group that will receive messages that a Communication Error exists. This would normally include the technical support personnel.
50.05 CLAIMSMANAGER TCP/IP 50;5 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>39!($L(X)<3) X
  • LAST EDITED:  JUL 24, 2015
  • HELP-PROMPT:  Answer must be 3-39 characters in length.
  • DESCRIPTION:  
    This is the tcp/ip address for the Ingenix ClaimsManager server.
50.06 CLAIMSMANAGER PORTS 50.06;0 Multiple #350.9001 350.9001

  • LAST EDITED:  MAR 16, 2001
  • DESCRIPTION:  
    This is the ports used by the Ingenix ClaimsManager.
50.07 MAILMAN MESSAGE FLAG 50;7 SET
  • 'P' FOR PRIORITY;
  • 'N' FOR NORMAL;

  • LAST EDITED:  AUG 31, 2001
  • HELP-PROMPT:  Please choose the type of MailMan message to be used.
  • DESCRIPTION:  
    This field is either 'P' for Priority MailMan messages or 'N' for Normal MailMan messages. This only applies to the MailMan messages that are created and sent when one user is assigning a bill to another user.
51.01 FRESHNESS DAYS 51;1 NUMBER
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  K:+X'=X!(X>180)!(X<7)!(X?.E1"."1N.N) X
  • LAST EDITED:  JUN 05, 2002
  • HELP-PROMPT:  Enter the number of days data remains "fresh". Type a Number between 7 and 180.
  • DESCRIPTION:  This parameter determines how "fresh" the insurance verification This field is a parameter that is used by two of the data extracts to determine whether a record should be extracted or not.
    For both the Insurance Buffer extract and the Appointment extract, this represents how long to wait before IIV can attempt to reverify the same insurance for that patient.
    If the value is 10, this means that IIV can attempt to reverify insurance for a patient 11 days after the most recently inquired date. A specific date is always asked of the payer when trying to identify patients
    eligibility.
51.02 DAILY MAILMAN MSG 51;2 SET
  • '1' FOR YES;
  • '0' FOR NO;

  • LAST EDITED:  AUG 18, 2009
  • HELP-PROMPT:  Answer 'Yes' if the daily eIV Statistical Report should be sent via MailMan.
  • DESCRIPTION:  
    This field determines whether the daily eIV Statistical Report should be sent via MailMan. This report contains information about the electronic insurance verification process - both inquiries and responses.
51.03 DAILY MSG TIME 51;3 FREE TEXT

  • INPUT TRANSFORM:  K:(X'?4N)!('X)!(X>2400)!($E(X,3,4)'<60) X
  • LAST EDITED:  AUG 18, 2009
  • HELP-PROMPT:  This is the time of day to generate the daily eIV Statistical Report sent via MailMan. The time must be in four digit military format.
  • DESCRIPTION:  Enter the time in four digit military format.
    Examples: 0100 = 1 AM 1300 = 1 PM
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
51.04 MESSAGES MAILGROUP 51;4 POINTER TO MAIL GROUP FILE (#3.8)
************************REQUIRED FIELD************************
MAIL GROUP(#3.8)

  • LAST EDITED:  AUG 18, 2009
  • HELP-PROMPT:  Select the mail group to whom eIV messages are sent.
  • DESCRIPTION:  
    This field identifies the mail group to whom the daily eIV Statistical Report and eIV error messages will be sent via MailMan.
51.05 TIMEOUT DAYS 51;5 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>7)!(X<1)!(X?.E1"."1N.N) X
  • LAST EDITED:  AUG 19, 2002
  • HELP-PROMPT:  Enter the number of days that will define a communication timeout. Enter a number between 1 and 7.
  • DESCRIPTION:  
    This field defines how many days without an insurance response is considered to be a communication timeout.
51.06 NUMBER RETRIES 51;6 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>5)!(X<0)!(X?.E1"."1.N) X
  • LAST EDITED:  AUG 18, 2009
  • HELP-PROMPT:  Enter the number of times to retry an eIV transmission. Enter a number between 0 and 5.
  • DESCRIPTION:  This field specifies how many retries to attempt when a communication timeout occurs before it is considered a communication failure.
    An entry of zero indicates that when a communication timeout occurs, no retries shall be attempted and the inquiry will be considered a communication failure.
51.07 TIMEOUT MAILMAN MSG 51;7 SET
  • '1' FOR YES;
  • '0' FOR NO;

  • LAST EDITED:  AUG 19, 2002
  • HELP-PROMPT:  Enter 'Yes' if a MailMan message should be generated for each communication timeout.
  • DESCRIPTION:  
    This field allows the site to send a MailMan message for each communication timeout.
51.08 INQUIRE INACTIVE INSURANCE 51;8 SET
  • '1' FOR YES;
  • '0' FOR NO;

  • LAST EDITED:  APR 08, 2003
  • HELP-PROMPT:  Enter 'Yes' if a patient's inactive insurance shall be queried if no active insurance is found.
  • DESCRIPTION:  
    This field helps guide both the No Insurance data extract and Appointment data extract to attempt to request information for a patient's inactive insurance if no active insurance is found.
51.09 *INQUIRE POPULAR PAYERS 51;9 SET
  • '1' FOR YES;
  • '0' FOR NO;

  • LAST EDITED:  AUG 04, 2022
  • HELP-PROMPT:  Enter 'Yes' if the most popular payers are to be queried if no active insurance is found for a patient.
  • DESCRIPTION:  This field guides both the No Insurance data extract and the Appointment data extract to attempt to request information for a patient, who has no previous insurance and/or no active insurance in VISTA, based upon the list
    of Most Popular Payers. ***Deleted - IB*2.0*737
51.1 *NO. POPULAR PAYERS 51;10 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>10)!(X<1)!(X?.E1"."1N.N) X
  • LAST EDITED:  AUG 04, 2022
  • HELP-PROMPT:  Enter the number of popular payers to query. Enter a number between 1 and 10.
  • DESCRIPTION:  
    This field is the number of the most popular payers that should be queried if the Inquire Popular Payers parameter is set to 'Yes'. *** Deleted - IB*2.0*737
51.11 *POPULAR INSUR CO. FROM DATE 51;11 DATE

  • INPUT TRANSFORM:  S %DT="E" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  AUG 04, 2022
  • HELP-PROMPT:  Enter the date from which popular insurance companies will be selected.
  • DESCRIPTION:  
    This field is the date that the calculation of the Most Popular Insurance Companies starts with when searching through the Bill/Claims File (#399). *** OBSOLETE - 12/15/2003 *** *** Deleted - IB*2.0*737
51.12 *POPULAR INSUR CO. THRU DATE 51;12 DATE

  • INPUT TRANSFORM:  S %DT="E" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  AUG 04, 2022
  • HELP-PROMPT:  Enter the date through which popular insurance companies will be selected
  • DESCRIPTION:  
    This field is the date that the calculation of the Most Popular Insurance Companies ends with when searching through the Bill/Claims File (#399). *** OBSOLETE - 12/15/2003 *** ***Deleted - IB*2.0*737
51.13 HL7 RESPONSE PROCESSING 51;13 SET
************************REQUIRED FIELD************************
  • 'B' FOR Batch;
  • 'I' FOR Immediate;

  • LAST EDITED:  AUG 18, 2009
  • HELP-PROMPT:  Enter 'I'mmediate for eIV responses to be forwarded to VistA immediately or 'B'atch to hold and batch the responses.
  • DESCRIPTION:  This field allows the site to tell the Eligibility Communicator how eIV responses should be returned to the site. Batch means that EC will hold all messages and return them between the HL7 Start Time and HL7 Stop Time.
    Immediate means that EC will return a response as soon as it is received from the payer.
51.14 HL7 START TIME 51;14 FREE TEXT
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  K:(X'?4N)!('X)!(X>2400)!($E(X,3,4)'<60) X
  • LAST EDITED:  AUG 18, 2009
  • HELP-PROMPT:  Enter the time when EC will start relaying eIV responses back to the site. The time must be in four digit military format.
  • DESCRIPTION:  Enter the time in military format. This time represents when the site has told the Eligibility Communicator to begin sending eIV responses to the site. This field only applies when the HL7 Response Processing is set to
    'B'atch processing. It is recommended that this be a time during low CPU processing.
    Examples: 0100 = 1 AM 1300 = 1 PM
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
51.15 HL7 MAXIMUM NUMBER 51;15 NUMBER
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  K:+X'=X!(X>99999)!(X<1)!(X?.E1"."1.N) X
  • LAST EDITED:  AUG 18, 2009
  • HELP-PROMPT:  Type a number between 1 and 99999, 0 Decimal Digits
  • DESCRIPTION:  
    This field allows a site to restrict the daily number of HL7 messages created and sent during the HL7 process for eIV. This feature can be used to manage the amount of eIV HL7 traffic flowing through the HL7 package.
  • TECHNICAL DESCR:  
    Patch IB*2*416 removed the ability for sites to limit the HL7 traffic and the maximum number of messages was set at 99999. This field is not being removed in case this functionality is needed in the future.
51.16 *CONTACT PERSON 51;16 POINTER TO NEW PERSON FILE (#200)
************************REQUIRED FIELD************************
NEW PERSON(#200)

  • LAST EDITED:  NOV 17, 2015
  • HELP-PROMPT:  This is the person that the Financial Services Center shall contact if there are communication problems.
  • DESCRIPTION:  This field identifies the person that the Financial Services Center or the Eligibility Communicator shall contact if there are any problems that need to be addressed; e.g. communication problems.
    This information will be sent nightly to FSC/EC to keep it up to date.
  • TECHNICAL DESCR:  
    This field will be removed. It was marked for deletion in patch IB*2.0*549
51.17 BATCH EXTRACTS 51.17;0 SET Multiple #350.9002 350.9002

  • DESCRIPTION:  This field identifies each of the three data extracts that eIV uses to find insurance data via verification inquiries.
    Buffer, appointment, and EICD.
51.18 *POPULAR PAYERS 51.18;0 POINTER Multiple #350.9003 350.9003

  • LAST EDITED:  AUG 04, 2022
51.19 HL7 STOP TIME 51;19 FREE TEXT
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  K:(X'?4N)!('X)!(X>2400)!($E(X,3,4)'<60) X
  • LAST EDITED:  AUG 18, 2009
  • HELP-PROMPT:  Enter the time when EC will stop relaying eIV responses back to the site. The time must be in four digit military format.
  • DESCRIPTION:  Enter the time in military format. This time represents when the site has told the Eligibility Communicator to stop sending eIV responses to the site. This field only applies when the HL7 Response Processing is set to
    'Batch' processing.
    Examples: 0100 = 1 AM 1300 = 1 PM
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
51.2 FAILURE MAILMAN MSG 51;20 SET
  • '1' FOR YES;
  • '0' FOR NO;

  • LAST EDITED:  AUG 18, 2009
  • HELP-PROMPT:  Enter 'Yes' if a MailMan message should be generated when eIV is unable to electronically confirm the patient's insurance information due to a communications problem.
  • DESCRIPTION:  
    This field allows the site to send a MailMan message for each communication failure. A communication failure is defined as having exhausted all retries.
51.21 *MOST POPULAR LAST SAVE DATE 51;21 DATE

  • INPUT TRANSFORM:  S %DT="EST" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  AUG 04, 2022
  • HELP-PROMPT:  The date/time when the Most Popular Payer list was last saved.
  • DESCRIPTION:  
    This is the date/time on which the Most Popular Payer list was last saved. This field is not available for edit by users. ***Deleted - IB*2.0*737
  • CROSS-REFERENCE:  ^^TRIGGER^350.9^51.24
    1)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(1)=$S($D(^IBE(350.9,D0,51)):^(51),1:"") S X=$P(Y(1),U,24),X=X S DIU=X K Y S X=DIV S X=DUZ S DIH=$G(^IBE(350.9,DIV(0),51)),DIV=X S $P(^(51),U,24)=DIV,DIH=350.9,DIG=51.24 D ^DICR
    2)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(1)=$S($D(^IBE(350.9,D0,51)):^(51),1:"") S X=$P(Y(1),U,24),X=X S DIU=X K Y S X=DIV S X=DUZ S DIH=$G(^IBE(350.9,DIV(0),51)),DIV=X S $P(^(51),U,24)=DIV,DIH=350.9,DIG=51.24 D ^DICR
    CREATE VALUE)= S X=DUZ
    DELETE VALUE)= S X=DUZ
    FIELD)= #51.24
51.22 REGISTRATION COMPLETE 51;22 SET
  • '1' FOR YES;
  • '0' FOR NO;

  • LAST EDITED:  APR 28, 2010
  • HELP-PROMPT:  Enter Yes or No.
  • DESCRIPTION:  
    This field indicates whether application acknowledgement has been received and processed from the Eligibility Communicator. If the registration message failed at the EC, no further processing of eIV messages will occur.
51.23 INQUIRE SECONDARY INSURANCES 51;23 SET
  • '1' FOR YES;
  • '0' FOR NO;

  • LAST EDITED:  APR 15, 2003
  • HELP-PROMPT:  Answer 'YES' to indicate that outgoing electronic insurance verification requests should return all additional/secondary insurance information identified for the patient.
  • DESCRIPTION:  This field contains an indicator that controls whether outgoing electronic verification requests should return any additional or secondary insurance information that is found for a patient when an eligibility request is
    made for a specific insurance company.
51.24 *MOST POPULAR LAST SAVED BY 51;24 POINTER TO NEW PERSON FILE (#200)
************************REQUIRED FIELD************************
NEW PERSON(#200)

  • LAST EDITED:  AUG 15, 2022
  • HELP-PROMPT:  This is the user who saved the current 'Most Popular Payer' list.
  • DESCRIPTION:  
    This is the user who last edited and saved the Most Popular Payer list. If the field MOST POPULAR LAST SAVE DATE is deleted, this field will be the user who deleted the date. *** Deleted - IB*2.0*737 ***
  • NOTES:  TRIGGERED by the *MOST POPULAR LAST SAVE DATE field of the IB SITE PARAMETERS File
51.25 MEDICARE PAYER 51;25 POINTER TO PAYER FILE (#365.12) PAYER(#365.12)

  • LAST EDITED:  OCT 22, 2009
  • HELP-PROMPT:  Select the Medicare entry from the Payer file.
  • DESCRIPTION:  
    This field holds the Medicare WNR payer entry. It is used to identify the Medicare payer for the insurance buffer lists and any other applications that need to know which payer is the Medicare WNR payer.
  • TECHNICAL DESCR:  This field is set during the post-install for IB*2*416. It should not have to be changed unless the Medicare WNR payer entry itself gets changed. This field is only available for editing via FileMan. Edit with extreme
    care.
51.26 RETRY FLAG 51;26 SET
  • 'Y' FOR YES;
  • 'N' FOR NO;

  • LAST EDITED:  SEP 12, 2013
  • HELP-PROMPT:  Should an eIV Inquiry retransmit if no response is received?
  • DESCRIPTION:  
    A 'Y'es value indicates that an eIV Inquiry will retransmit if no response is received within the number of TIMEOUT DAYS (51.05) field.
51.27 270 MASTER SWITCH REALTIME 51;27 SET
  • 'Y' FOR YES;
  • 'N' FOR NO;

  • LAST EDITED:  OCT 07, 2015
  • HELP-PROMPT:  Enter 'YES' if real time 270 transactions can be created and transmitted to the Eligibility Communicator (EC).
  • DESCRIPTION:  
    A 'Y'es values indicates that real time 270 transactions can be created and transmitted. A 'N'o value indicates that real time transactions cannot be created and transmitted.
51.28 270 MASTER SWITCH NIGHTLY 51;28 SET
  • 'Y' FOR YES;
  • 'N' FOR NO;

  • LAST EDITED:  OCT 07, 2015
  • HELP-PROMPT:  Enter 'YES' if nightly extract 270 transactions can be created and transmitted to the Eligibility Communicator (EC).
  • DESCRIPTION:  
    A "Y'es value indicates that nightly extract 270 transactions can be created and transmitted. A 'N'o value indicates that nightly 270 transactions cannot be created and transmitted.
51.29 DAILY NIF STATUS CHECK TIME 51;29 FREE TEXT

  • INPUT TRANSFORM:  K:(X'?4N)!(X>2400)!($E(X,3,4)'<60) X
  • LAST EDITED:  NOV 13, 2015
  • HELP-PROMPT:  Enter the time in four digit military format.
  • DESCRIPTION:  
    This is the time of day to check to see if the 'IB NIF TCP' HL7 Logical Link is enabled. If problems are encountered a message will be sent via MailMan to the VHAeInsuranceRapidResponse@domain.ext mailgroup.
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
51.3 MBI PAYER 51;30 POINTER TO PAYER FILE (#365.12) PAYER(#365.12)

  • LAST EDITED:  OCT 06, 2017
  • HELP-PROMPT:  Select the CMS MBI entry from the Payer file.
  • DESCRIPTION:  This field holds a pointer to the CMS MBI payer entry. It is the National payer utilized when requesting a MBI lookup for a Veteran. It is also used when displaying the MBI payer name in the insurance buffer list and
    other applications that need to display the MBI payer name.
  • TECHNICAL DESCR:  This field is set via a table update from FSC. It was introduced with IB*2.0*.601.It should not have to be changed unless the MBI payer entry itself gets changed. This field is only available for editing via FileMan.
    Edit with extreme care.
51.31 EICD PAYER 51;31 POINTER TO PAYER FILE (#365.12) PAYER(#365.12)

  • LAST EDITED:  MAY 23, 2018
  • HELP-PROMPT:  Select the EICD entry from the Payer file.
  • DESCRIPTION:  
    This field identifies the National payer utilized when performing an Electronic Insurance Coverage Discovery (EICD) inquiry for a Veteran.
  • TECHNICAL DESCR:  This field is a pointer to the EICD payer table (#365.12). It is set via a table update from FSC. It was introduced with IB*2.0*621 and should not have to change unless the EICD payer gets changed. It is only editable
    via FileMan. Edit with extreme care.
51.32 MEDICARE FRESHNESS DAYS 51;32 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>545)!(X<181)!(X?.E1"."1N.N) X
  • LAST EDITED:  OCT 07, 2019
  • HELP-PROMPT:  Enter the number of days (181-545) data remains "fresh" for Medicare policies.
  • DESCRIPTION:  
    This parameter determines how "fresh" the insurance verification is for Medicare policies. This field is a parameter that is used by the Appointment data extract to determine whether a record should be extracted or not.
  • TECHNICAL DESCR:  For the Appointment data extract, this represents how long to wait before IIV can attempt to reverify the same insurance for that patient.
    If the value is 370, this means that IIV can attempt to reverify insurance for a patient 371 days after the most recent inquired date.
51.33 MANILA EIV IIU ENABLED 51;33 SET
  • 'Y' FOR YES;
  • 'N' FOR NO;

  • LAST EDITED:  DEC 10, 2020
  • HELP-PROMPT:  Enter 'YES' if eIV/IIU is Enabled at the VAMC Site (#358) 'Manila'.
  • DESCRIPTION:  
    A "Y"es means the eIV/IIU software is Enabled for the VAMC site (#358) "Manila"; a "N"o means the eIV/IIU software is Disabled for the VAMC site (#358) "Manila".
  • TECHNICAL DESCR:  
    This is used in VistA to prevent Manila (Site #358) from creating and sending eIV messages to FSC and the sharing of verified policies to other VAMCs via IIU.
51.34 EIV NO GRP NUM A/U 51;34 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>180)!(X<7)!(X?.E1"."1.N) X
  • LAST EDITED:  JUL 20, 2021
  • HELP-PROMPT:  Enter the number of days (7-180) before an expired policy is not considered for eIV auto update purposes.
  • DESCRIPTION:  Select a value which represents how long ago a policy expiration date must be older than to evaluate eIV responses without a group number for auto-update consideration. This only applies when a patient file contains a
    single active policy and one or more expired policies for the same insurance company. Value must be a number between 7-180 days.
  • TECHNICAL DESCR:  
    This field controls how long a policy must be expired before it is not considered in the policy count for the payer in auto updating.
52.01 PURGE DAYS 277 RFAI 52;1 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>3000)!(X<365)!(X?.E1"."1N.N) X
  • LAST EDITED:  OCT 21, 2015
  • HELP-PROMPT:  Type a number between 365 and 3000, 0 decimal digits.
  • DESCRIPTION:  
    Enter the number of days (between 365 and 3000) to retain 277 RFAI transactions in VistA. A null entry (the default) indicates the transactions will be stored forever.
52.02 WORKLIST PURGE DAYS 277 RFAI 52;2 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>45)!(X<1)!(X?.E1"."1N.N) X
  • LAST EDITED:  OCT 21, 2015
  • HELP-PROMPT:  Type a number between 1 and 45, 0 decimal digits.
  • DESCRIPTION:  
    Enter the number of days (between 1 and 45) that a 277 RFAI transaction will remain on the RFAI Worklist unless specifically removed by a user. The default is 20 days.
53.01 IIU MASTER SWITCH 53;1 SET
  • 'Y' FOR YES;
  • 'N' FOR NO;

  • LAST EDITED:  DEC 10, 2020
  • HELP-PROMPT:  Enter 'Y'es to Enable IIU processing, allowing verified policies to be shared to other VAMCs. Enter 'N'o to Disable this functionality.
  • DESCRIPTION:  
    A 'Y'es means the IIU processing is Enabled, allowing verified policies to be shared to other VAMCs. A 'N'o means the IIU processing is Disabled.
  • TECHNICAL DESCR:  
    This field is used in VistA to allow/prevent the sharing of verified policies to other VAMCs via the IIU process. This field is controlled by FSC.
53.02 IIU ENABLED 53;2 SET (BOOLEAN Data Type)
  • the buffer.

  • LAST EDITED:  FEB 18, 2021
  • HELP-PROMPT:  Enter '0' for NO, '1' for YES.
  • DESCRIPTION:  If this field is set to '1' (YES), the receiving VAMC will evaluate the possibility of storing the active verified policy in the buffer. If this field is set to '0' (NO), the receiving VAMC will NOT store the policy in
    the buffer.
  • TECHNICAL DESCR:  
    This is user controlled.
53.03 IIU RECENT VISIT DAYS 53;3 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>500)!(X<1)!(X?.E1"."1.N) X
  • LAST EDITED:  DEC 10, 2020
  • HELP-PROMPT:  Type a whole number between 1 and 500.
  • DESCRIPTION:  
    A patient must have recently visited the receiving VAMC within this number of days, for the possibility of storing the active verified policy in the buffer.
  • TECHNICAL DESCR:  
    This field is controlled by FSC.
53.04 IIU MIN DAYS BEFORE SHARING 53;4 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>500)!(X<1)!(X?.E1"."1.N) X
  • LAST EDITED:  DEC 10, 2020
  • HELP-PROMPT:  Type a whole number between 1 and 500.
  • DESCRIPTION:  
    Minimum number of days allowed since the last time the policy information was sent/shared to another VAMC via IIU.
  • TECHNICAL DESCR:  
    This field is controlled by FSC.
53.05 IIU PURGE SENT RECORDS 53;5 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>365)!(X<3)!(X?.E1"."1.N) X
  • LAST EDITED:  DEC 10, 2020
  • HELP-PROMPT:  Type a whole number between 3 and 365.
  • DESCRIPTION:  
    Number of days to retain previously sent policies that are stored in the Interfacility Insurance Update file (#365.19) before purging.
53.06 IIU PURGE CANDIDATE RECORDS 53;6 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>14)!(X<3)!(X?.E1"."1.N) X
  • LAST EDITED:  DEC 10, 2020
  • HELP-PROMPT:  Type a whole number between 3 and 14.
  • DESCRIPTION:  
    Number of days to retain candidate records in the Interfacility Insurance Update file (#365.19) that are still waiting to be sent to other VAMCs before purging.
53.07 IIU PURGE RECEIVED RECORDS 53;7 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>60)!(X<15)!(X?.E1"."1.N) X
  • LAST EDITED:  DEC 10, 2020
  • HELP-PROMPT:  Type a whole number between 15 and 60.
  • DESCRIPTION:  
    Number of days to retain previously received Interfacility Insurance Update file (#365.19) before purging.
54.01 INSURANCE IMPORT ENABLED 54;1 SET (BOOLEAN Data Type)
************************REQUIRED FIELD************************
  • If this field is set to '1' (YES), the insurance policies will be imported related to the background execution of remote query. If this field is set to '0' (NO), the insurance policies will NOT be imported in the buffer.

  • LAST EDITED:  JUL 18, 2023
  • HELP-PROMPT:  Enter '1' (YES) to enable importing of insurance policies or '0' (NO) to disable importing of insurance policies.
  • DESCRIPTION:  
    If this field is set to '1' (YES), the insurance policies will be imported related to the background execution of remote query. If this field is set to '0' (NO), the insurance policies will NOT be imported in the buffer.
54.02 Daily Buffer Rpt Mail Group 54;2 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>80!($L(X)<8)!'($$UP^XLFSTR(X)?.E1"@DOMAIN.EXT") X
    MAXIMUM LENGTH: 80
  • LAST EDITED:  SEP 08, 2023
  • HELP-PROMPT:  Enter a @DOMAIN.EXT Outlook email address that will receive the Daily Buffer Report (Summary Version). Answer must be 8-80 characters in length.
  • DESCRIPTION:  
    This field MUST contain a @DOMAIN.EXT Outlook email address that will receive the Daily Buffer Report (Summary Version).
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
60.01 DEFAULT SERVICE TYPE CODE 1 60;1 POINTER TO X12 271 SERVICE TYPE FILE (#365.013)
************************REQUIRED FIELD************************
X12 271 SERVICE TYPE(#365.013)

  • LAST EDITED:  AUG 09, 2010
  • HELP-PROMPT:  Enter a default service type code.
  • DESCRIPTION:  
    First Default Service Type Code sent with eIV Eligibility Inquiry.
60.02 DEFAULT SERVICE TYPE CODE 2 60;2 POINTER TO X12 271 SERVICE TYPE FILE (#365.013) X12 271 SERVICE TYPE(#365.013)

  • LAST EDITED:  MAR 06, 2013
  • HELP-PROMPT:  Enter a default service type code.
  • DESCRIPTION:  
    Second Default Service Type Code sent with eIV Eligibility Inquiry.
60.03 DEFAULT SERVICE TYPE CODE 3 60;3 POINTER TO X12 271 SERVICE TYPE FILE (#365.013) X12 271 SERVICE TYPE(#365.013)

  • LAST EDITED:  MAR 06, 2013
  • HELP-PROMPT:  Enter a default service type code.
  • DESCRIPTION:  
    Third Default Service Type Code sent with eIV Eligibility Inquiry.
60.04 DEFAULT SERVICE TYPE CODE 4 60;4 POINTER TO X12 271 SERVICE TYPE FILE (#365.013) X12 271 SERVICE TYPE(#365.013)

  • LAST EDITED:  MAR 06, 2013
  • HELP-PROMPT:  Enter a default service type code.
  • DESCRIPTION:  
    Fourth Default Service Type Code sent with eIV Eligibility Inquiry.
60.05 DEFAULT SERVICE TYPE CODE 5 60;5 POINTER TO X12 271 SERVICE TYPE FILE (#365.013) X12 271 SERVICE TYPE(#365.013)

  • LAST EDITED:  MAR 06, 2013
  • HELP-PROMPT:  Enter a default service type code.
  • DESCRIPTION:  
    Fifth Default Service Type Code sent with eIV Eligibility Inquiry.
60.06 DEFAULT SERVICE TYPE CODE 6 60;6 POINTER TO X12 271 SERVICE TYPE FILE (#365.013) X12 271 SERVICE TYPE(#365.013)

  • LAST EDITED:  MAR 06, 2013
  • HELP-PROMPT:  Enter a default service type code.
  • DESCRIPTION:  
    Sixth Default Service Type Code sent with eIV Eligibility Inquiry.
60.07 DEFAULT SERVICE TYPE CODE 7 60;7 POINTER TO X12 271 SERVICE TYPE FILE (#365.013) X12 271 SERVICE TYPE(#365.013)

  • LAST EDITED:  MAR 06, 2013
  • HELP-PROMPT:  Enter a default service type code.
  • DESCRIPTION:  
    Seventh Default Service Type Code sent with eIV Eligibility Inquiry.
60.08 DEFAULT SERVICE TYPE CODE 8 60;8 POINTER TO X12 271 SERVICE TYPE FILE (#365.013) X12 271 SERVICE TYPE(#365.013)

  • LAST EDITED:  MAR 06, 2013
  • HELP-PROMPT:  Enter a default service type code.
  • DESCRIPTION:  
    Eighth Default Service Type Code sent with eIV Eligibility Inquiry.
60.09 DEFAULT SERVICE TYPE CODE 9 60;9 POINTER TO X12 271 SERVICE TYPE FILE (#365.013) X12 271 SERVICE TYPE(#365.013)

  • LAST EDITED:  MAR 06, 2013
  • HELP-PROMPT:  Enter a default service type code.
  • DESCRIPTION:  
    Ninth Default Service Type Code sent with eIV Eligibility Inquiry.
60.1 DEFAULT SERVICE TYPE CODE 10 60;10 POINTER TO X12 271 SERVICE TYPE FILE (#365.013) X12 271 SERVICE TYPE(#365.013)

  • LAST EDITED:  MAR 06, 2013
  • HELP-PROMPT:  Enter a default service type code.
  • DESCRIPTION:  
    Tenth Default Service Type Code sent with eIV Eligibility Inquiry.
60.11 DEFAULT SERVICE TYPE CODE 11 60;11 POINTER TO X12 271 SERVICE TYPE FILE (#365.013) X12 271 SERVICE TYPE(#365.013)

  • LAST EDITED:  MAR 06, 2013
  • HELP-PROMPT:  Enter a default service type code.
  • DESCRIPTION:  
    Eleventh Default Service Type Code sent with eIV Eligibility Inquiry.
61.01 SITE SELECTED SERVICE CODE 1 61;1 POINTER TO X12 271 SERVICE TYPE FILE (#365.013) X12 271 SERVICE TYPE(#365.013)

  • LAST EDITED:  AUG 09, 2010
  • HELP-PROMPT:  Enter a site selected service type code.
  • DESCRIPTION:  
    First Site Selected Service Type Code to send with eIV Eligibility Inquiry.
61.02 SITE SELECTED SERVICE CODE 2 61;2 POINTER TO X12 271 SERVICE TYPE FILE (#365.013) X12 271 SERVICE TYPE(#365.013)

  • LAST EDITED:  AUG 09, 2010
  • HELP-PROMPT:  Enter a site selected service type code.
  • DESCRIPTION:  
    Second Site Selected Service Type Code to send with eIV Eligibility Inquiry.
61.03 SITE SELECTED SERIVCE CODE 3 61;3 POINTER TO X12 271 SERVICE TYPE FILE (#365.013) X12 271 SERVICE TYPE(#365.013)

  • LAST EDITED:  AUG 09, 2010
  • HELP-PROMPT:  Enter a site selected service type code.
  • DESCRIPTION:  
    Third Site Selected Service Type Code to send with eIV Eligibility Inquiry.
61.04 SITE SELECTED SERVICE CODE 4 61;4 POINTER TO X12 271 SERVICE TYPE FILE (#365.013) X12 271 SERVICE TYPE(#365.013)

  • LAST EDITED:  AUG 09, 2010
  • HELP-PROMPT:  Enter a site selected service type code.
  • DESCRIPTION:  
    Fourth Site Selected Service Type Code to send with eIV Eligibility Inquiry.
61.05 SITE SELECTED SERVICE CODE 5 61;5 POINTER TO X12 271 SERVICE TYPE FILE (#365.013) X12 271 SERVICE TYPE(#365.013)

  • LAST EDITED:  AUG 09, 2010
  • HELP-PROMPT:  Enter a site selected service type code.
  • DESCRIPTION:  
    Fifth Site Selected Service Type Code to send with eIV Eligibility Inquiry.
61.06 SITE SELECTED SERVICE CODE 6 61;6 POINTER TO X12 271 SERVICE TYPE FILE (#365.013) X12 271 SERVICE TYPE(#365.013)

  • LAST EDITED:  AUG 09, 2010
  • HELP-PROMPT:  Enter a site selected service type code.
  • DESCRIPTION:  
    Sixth Site Selected Service Type Code to send with eIV Eligibility Inquiry.
61.07 SITE SELECTED SERVICE CODE 7 61;7 POINTER TO X12 271 SERVICE TYPE FILE (#365.013) X12 271 SERVICE TYPE(#365.013)

  • LAST EDITED:  AUG 09, 2010
  • HELP-PROMPT:  Enter a site selected service type code.
  • DESCRIPTION:  
    Seventh Site Selected Service Type Code to send with eIV Eligibility Inquiry.
61.08 SITE SELECTED SERVICE CODE 8 61;8 POINTER TO X12 271 SERVICE TYPE FILE (#365.013) X12 271 SERVICE TYPE(#365.013)

  • LAST EDITED:  AUG 09, 2010
  • HELP-PROMPT:  Enter a site selected service type code.
  • DESCRIPTION:  
    Eighth Site Selected Service Type Code to send with eIV Eligibility Inquiry.
61.09 SITE SELECTED SERVICE CODE 9 61;9 POINTER TO X12 271 SERVICE TYPE FILE (#365.013) X12 271 SERVICE TYPE(#365.013)

  • LAST EDITED:  AUG 09, 2010
  • HELP-PROMPT:  Enter a site selected service type code.
  • DESCRIPTION:  
    Ninth Site Selected Service Type Code to send with eIV Eligibility Inquiry.
62.01 LIMIT LENGTH OF EIV FIELDS? 62;1 SET
  • '0' FOR NO;
  • '1' FOR YES;

  • LAST EDITED:  MAY 12, 2013
  • HELP-PROMPT:  Set to YES, if length of values in eIV fields should be limited.
  • DESCRIPTION:  
    If set to YES, eIV field values will be limited to pre-patch IB*2.0*497 lengths via corresponding input transforms.
62.02 CPAC ADM FUTURE DAYS 62;2 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>999)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  SEP 24, 2014
  • HELP-PROMPT:  Type the number of days into the future (between 0 and 999) to search for CPAC Admissions.
  • DESCRIPTION:  
    The number of days into the future the CPAC Scheduled Admissions search should use when attempting to create HCSR Transmission entries for future CPAC Admissions.
62.03 CPAC APPT PAST DAYS 62;3 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>999)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  SEP 24, 2014
  • HELP-PROMPT:  Type the number of days into the past (between 0 and 999) to search for CPAC Appointments.
  • DESCRIPTION:  
    The number of days into the past the CPAC Scheduled Appointments search should use when attempting to create HCSR Transmission entries for past CPAC Appointments.
62.04 CPAC ADM PAST DAYS 62;4 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>999)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  SEP 24, 2014
  • HELP-PROMPT:  Type the number of days into the past (between 0 and 999) to search for CPAC Admissions.
  • DESCRIPTION:  
    The number of days into the past the CPAC Scheduled Admissions search should use when attempting to create HCSR Transmission entries for past CPAC Admissions.
62.05 TRICARE APPT FUTURE DAYS 62;5 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>999)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  SEP 24, 2014
  • HELP-PROMPT:  Type the number of days into the future (between 0 and 999) to search for TRICARE/CHAMPVA Appointments.
  • DESCRIPTION:  
    The number of days into the future the TRICARE/CHAMPVA Scheduled Appointments search should use when attempting to create HCSR Transmission entries for future TRICARE/CHAMPVA Appointments.
62.06 TRICARE ADM FUTURE DAYS 62;6 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>999)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  SEP 24, 2014
  • HELP-PROMPT:  Type the number of days into the future (between 0 and 999) to search for TRICARE/CHAMPVA Admissions.
  • DESCRIPTION:  
    The number of days into the future the TRICARE/CHAMPVA Scheduled Admissions search should use when trying to create HCSR Transmission entries for future TRICARE/CHAMPVA Admissions.
62.07 TRICARE APPT PAST DAYS 62;7 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>999)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  SEP 24, 2014
  • HELP-PROMPT:  Type the number of days into the past (between 0 and 999) to search for TRICARE/CHAMPVA Appointments.
  • DESCRIPTION:  
    The number of days into the past the TRICARE/CHAMPVA Scheduled Appointments search should use when trying to create HCSR Transmission entries for past TRICARE/CHAMPVA Appointments.
62.08 TRICARE ADM PAST DAYS 62;8 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>999)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  SEP 24, 2014
  • HELP-PROMPT:  Type the number of days into the past (between 0 and 999) to search for TRICARE/CHAMPVA Admissions.
  • DESCRIPTION:  
    The number of days into the past the TRICARE/CHAMPVA Scheduled Appointments search should use when trying to create HCSR Transmission entries for past TRICARE/CHAMPVA Admissions.
62.09 PURGE DAYS 62;9 NUMBER
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  K:+X'=X!(X>3000)!(X<365)!(X?.E1"."1.N) X
  • LAST EDITED:  SEP 24, 2014
  • HELP-PROMPT:  Type the number of days to retain HCSR Transmission entries (between 365 and 3000) before removing them from the file.
  • DESCRIPTION:  
    The number of days to retain events in the HCSR Worklist (file 356.22) before removing them from the file.
62.1 INQUIRY TRIGGER APPT 62;10 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>14)!(X<0)!(X?.E1"."1.N) X
  • LAST EDITED:  DEC 08, 2014
  • HELP-PROMPT:  Type the number of days to wait (between 0 and 14) before triggering a 278 inquiry for HCSR Transmission entries created from appointments..
  • DESCRIPTION:  The number of days after the creation of an HCSR Worklist entry from an appointment to wait before automatically triggering a 278 Inquiry. Note, if the triggered inquiry does not generate a response, another inquiry will
    automatically be triggered again at a future date using this parameter. Inquiries will continue to be triggered until a response is received or the entry is purged from the worklist.
62.11 INQUIRY TRIGGER ADM 62;11 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>14)!(X<0)!(X?.E1"."1.N) X
  • LAST EDITED:  DEC 08, 2014
  • HELP-PROMPT:  Type the number of days to wait (between 0 and 14) before triggering a 278 Inquiry for HCSR Transmission entries created from admissions.
  • DESCRIPTION:  The number of days after the creation of an HCSR Worklist entry from an admission to wait before automatically triggering a 278 Inquiry. Note, if the triggered inquiry does not generate a response, another inquiry will
    automatically be triggered again at a future date using this parameter. Inquiries will continue to be triggered until a response is received or the entry is purged from the worklist.
62.12 HSCR RESPONSE PURGE DAYS 62;12 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>45)!(X<1)!(X?.E1"."1.N) X
  • LAST EDITED:  SEP 25, 2014
  • HELP-PROMPT:  Type the number of days (between 1 and 45) to display an entry with a completed response on the HCSR Response View before removing it.
  • DESCRIPTION:  
    This is the number of days an HCSR Transmission entry with a completed response status will be displayed on the HCSR Response Worklist.
62.13 CPAC APPT FUTURE DAYS 62;13 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>999)!(X<0)!(X?.E1"."1.N) X
  • LAST EDITED:  FEB 10, 2015
  • HELP-PROMPT:  Type a number between 0 and 999, 0 decimal digits.
  • DESCRIPTION:  
    The number of days into the future the CPAC Scheduled Appointments search should use when attempting to create HCSR Transmission entries for future CPAC Appointments.
63 HCSR CLINIC LIST 63;0 POINTER Multiple #350.963 350.963

  • DESCRIPTION:  Contains all of the clinics to be included in the search when trying to create HCSR Transmission entries for past and future appointments. Entries will not be created for appointments if the appointment's clinic is not in
    this list.
64 HCSR WARD LIST 64;0 POINTER Multiple #350.964 350.964

  • DESCRIPTION:  Contains all of the wards to be included in the search when trying to create HCSR Transmission entries for past and future admissions. Entries will not be created for admissions if the admission's ward is not included in
    this list.
65 HCSR INSCO APPT LIST 65;0 POINTER Multiple #350.965 350.965

  • DESCRIPTION:  Contains all of the insurance companies to be excluded from the search when trying to create HCSR Transmission entries for past and future appointments. Entries will not be created if the insurance company of the patient
    is included in this list.
66 HCSR INSCO ADM LIST 66;0 POINTER Multiple #350.966 350.966

  • DESCRIPTION:  Contains all of the insurance companies to be excluded from the search when trying to create HCSR Transmission entries for past and future admissions. Entries will not be created if the insurance company of the patient is
    included in this list.
70.01 HPID/OEID ACTIVE? 70;1 SET
  • '0' FOR Not Active;
  • '1' FOR Active;

  • LAST EDITED:  APR 24, 2014
  • HELP-PROMPT:  Enter 'Active' if your NIF link is active.
  • DESCRIPTION:  
    This parameter indicates whether or not the National Insurance File (NIF) is ready to communicate with your VISTA site.
70.02 SHRPE ACTIVATION DATE 70;2 DATE

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:3171101>X X
  • LAST EDITED:  JAN 30, 2018
  • HELP-PROMPT:  Type a date not earlier than NOV 01, 2017.
  • DESCRIPTION:  This is the date that legislation was passed to allow SHPRE visit copayment and prescription prorated amounts will be allowed (if supply is under 30 days). A check is done using this piece to determine if the above
    functions are allowed.
  • TECHNICAL DESCR:  As per the SHRPE project, we will be checking for a patient's active National flag for High Risk for Suicide, and this date is set at the date of service, the patient will have Visit copayments waived and prescriptions
    less than 30 days will be prorated. This date is necessary (it will be defined in IB*2.0*614 as NULL), the field will be set to Uneditable to prevent accidental revision.
71.01 COVID-19 RELIEF END DATE 71;1 DATE

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  MAR 25, 2021
  • HELP-PROMPT:  Please enter the end date for Covid-19 relief.
  • DESCRIPTION:  
    This parameter contains the end date for COVID-19 relief.
71.02 COMPACT EFFECTIVE DATE 71;2 DATE

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  NOV 01, 2021
  • HELP-PROMPT:  Please enter the start date of COMPACT ACT Benefit.
  • DESCRIPTION:  
    This parameter contains the start date of COMPACT ACT Benefit.
71.03 CLELAND-DOLE EFFECTIVE DATE 71;3 DATE

  • INPUT TRANSFORM:  S %DT="E" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  APR 10, 2023
  • HELP-PROMPT:  Enter the start date for CLELAND-DOLE Mental Health Benefits.
  • DESCRIPTION:  
    This parameter contains the start date for CLELAND-DOLE Mental Health Benefits.
71.04 CLELAND-DOLE END DATE 71;4 DATE

  • INPUT TRANSFORM:  S %DT="E" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  APR 10, 2023
  • HELP-PROMPT:  Enter the end date for the CLELAND-DOLE Health Benefits
  • DESCRIPTION:  
    This parameter contains the end date for CLELAND-DOLE Mental Health Benefits.
81 PRIMARY PAYER ID TYPES MED 81;0 POINTER Multiple #350.981 350.981

  • DESCRIPTION:  This ID Type designates the type of claims which are processed by a different Administration Contractor than normal claims. It determines which Alternate Institutional or Professional Payer Primary ID will be transmitted
    for Medicare Plans.
82 PRIMARY PAYER ID TYPES COM 82;0 POINTER Multiple #350.982 350.982

  • DESCRIPTION:  This ID Type designates the type of claims which are processed by a different Administration Contractor than normal claims. It determines which Alternate Institutional or Professional Payer Primary ID will be transmitted
    for Commercial Plans.
99 INS. CO's WITHHOLDING SUPPLIMENTAL PAYMENTS 99;0 POINTER Multiple #350.999 350.999

  • DESCRIPTION:  This sub-file contains pointers to the INSURANCE COMPANY (#36) file. The sub-file is populated from the option Edit List of Ins. Co. Witholding Payments [IB MRA EDIT INS CO LIST] or the Queue MRA Extract [IB MRA
    EXTRACT].
    The insurance companies listed in this sub-file represent the companies for which means test bills will be extracted.

Found Entries, Total: 1

Entry: 1    

ICR, Total: 5

ICR LINK Subscribing Package(s) Fields Referenced Description
ICR #3827
  • Accounts Receivable
    		•  MEDICARE PROVIDER NUMBER (1.21).
    Access: Direct Global Read & w/Fileman
    ICR #4049
  • Accounts Receivable
    		•  AGENT CASHIER PHONE NUMBER (2.06).
    Access: Direct Global Read & w/Fileman
    ICR #4964
  • Kernel
    		•  FACILITY NAME (.02).
    Access: Direct Global Read & w/Fileman

    FEDERAL TAX NUMBER (1.05).
    Access: Direct Global Read & w/Fileman

    PAY-TO PROVIDER NAME (19;.02).
    Access: Direct Global Read & w/Fileman

    Street Address 1. (19;1.01).
    Access: Direct Global Read & w/Fileman

    Street Address 2 (19;1.02).
    Access: Direct Global Read & w/Fileman

    City (19;1.03).
    Access: Direct Global Read & w/Fileman

    State (19;1.04).
    Access: Direct Global Read & w/Fileman

    Default Pay-To Provider (11.03).
    Access: Direct Global Read & w/Fileman

    Pay-To Provider Zip Code (19;1.05).
    Access: Direct Global Read & w/Fileman

    		 The IBE(350.9 global contains the data necessary to runthe IB package and to manage the IB background filer.
    ICR #6143
  • Insurance Capture Buffer
    		•  LIMIT FIELD LENGTH OF EIV FIELDS? (62.01).
    Access: Read w/Fileman
    ICR #7228
  • Accounts Receivable
    		•  SHRPE ACTIVATION DATE (70.02).
    Access: Read w/Fileman

    External References

    Name Field # of Occurrence
    ^%DT .04+1, .05+1, .06+1, .12+1, .16+1, .17+1, 1.24+1, 3.01+1, 3.02+1, 3.13+1
    , 3.14+1, 3.18+1, 3.19+1, 3.2+1, 6.01+1, 6.07+1, 7.02+1, 8.05+1, 8.13+1, 8.22+1
    , 9.08+1, 9.09+1, 51.11+1, 51.12+1, 51.21+1, 70.02+1, 71.01+1, 71.02+1, 71.03+1, 71.04+1
    NOW^%DTC 8.1(XREF 1S)
    ^DIC .02+1, 1.18+1, 1.28+1, 1.29+1, 1.3+1, 4.06+1, 7.05+1, 9.12+1
    ^DICR 8.1(XREF 1S), 51.21(XREF 1S), 51.21(XREF 1K)
    Y^DIQ ID.02+1
    $$UP^XLFSTR 54.02+1

    Global Variables Directly Accessed

    Name Line Occurrences  (* Changed,  ! Killed)
    ^DD(350.9 8.1(XREF 1S)
    ^DD(4 ID.02+1
    ^DIC(4 - [#4] ID.02+1
    ^IBE(350.9 - [#350.9] .01(XREF 1S), .01(XREF 1K), 8.1(XREF 1S), 8.1(XREF 1n1.3), 51.21(XREF 1S), 51.21(XREF 1K)

    Naked Globals

    Name Field # of Occurrence
    ^(0 ID.02+1
    ^(51 51.21(XREF 1S), 51.21(XREF 1K)
    ^(8 8.1(XREF 1S), 8.1(XREF 1n1.3)

    Local Variables

    Legend:

    >> Not killed explicitly
    * Changed
    ! Killed
    ~ Newed

    Name Field # of Occurrence
    % 8.1(XREF 1S)
    >> %DT .04+1*, .05+1*, .06+1*, .12+1*, .16+1*, .17+1*, 1.24+1*, 3.01+1*, 3.02+1*, 3.13+1*
    , 3.14+1*, 3.18+1*, 3.19+1*, 3.2+1*, 6.01+1*, 6.07+1*, 7.02+1*, 8.05+1*, 8.13+1*, 8.22+1*
    , 9.08+1*, 9.09+1*, 51.11+1*, 51.12+1*, 51.21+1*, 70.02+1*, 71.01+1*, 71.02+1*, 71.03+1*, 71.04+1*
    %H 8.1(XREF 1S)
    %I ID.02+1*!, 8.1(XREF 1S)
    >> C ID.02+1*
    >> D0 8.1(XREF 1S), 8.1(XREF 1n1.3), 51.21(XREF 1S), 51.21(XREF 1K)
    >> DA .01(XREF 1S), .01(XREF 1K), 8.1(XREF 1n1.3), 51.21(XREF 1S), 51.21(XREF 1K)
    DIC ID.02+1, .02+1!*, 1.18+1!*, 1.28+1!*, 1.29+1!*, 1.3+1!*, 4.06+1!*, 7.05+1!*, 9.12+1!*
    DIC("S" .02+1*, .02SCR+1*, .14SCR+1*, 1.18+1*, 1.28+1*, 1.28SCR+1*, 1.29+1*, 1.29SCR+1*, 1.3+1*, 1.3SCR+1*
    , 4.06+1*, 4.06SCR+1*, 7.05+1*, 7.05SCR+1*, 9.12+1*, 9.12SCR+1*, 10.01VPSCR2+1*
    >> DIE .02+1, 1.18+1, 1.28+1, 1.29+1, 1.3+1, 4.06+1, 7.05+1, 9.12+1
    >> DIG 8.1(XREF 1S), 51.21(XREF 1S), 51.21(XREF 1K)
    >> DIH 8.1(XREF 1S), 51.21(XREF 1S), 51.21(XREF 1K)
    >> DINUM .01+1*
    >> DIU 8.1(XREF 1S), 51.21(XREF 1S), 51.21(XREF 1K)
    DIV 8.1(XREF 1S), 8.1(XREF 1n1.3), 51.21(XREF 1S), 51.21(XREF 1K)
    DIV(0 8.1(XREF 1S), 8.1(XREF 1n1.3), 51.21(XREF 1S), 51.21(XREF 1K)
    DUZ 51.21(XREF 1S), 51.21(XREF 1K)
    U ID.02+1, 8.1(XREF 1S), 8.1(XREF 1n1.3), 51.21(XREF 1S), 51.21(XREF 1K)
    X .01+1!, .01(XREF 1S), .01(XREF 1K), .02+1*!, .04+1*!, .05+1*!, .06+1*!, .07+1!, .08+1!, .12+1*!
    , .16+1*!, .17+1*!, 1.01+1!, 1.02+1!, 1.04+1!, 1.05+1!, 1.06+1!, 1.18+1*!, 1.21+1!, 1.24+1*!
    , 1.27+1!, 1.28+1*!, 1.29+1*!, 1.3+1*!, 1.31+1!, 2.01+1!, 2.02+1!, 2.03+1!, 2.05+1*!, 2.06+1!
    , 2.07+1!, 2.1+1!, 2.11+1!, 3.01+1*!, 3.02+1*!, 3.03+1!, 3.04+1!, 3.05+1!, 3.06+1!, 3.07+1!
    , 3.08+1!, 3.09+1!, 3.1+1!, 3.11+1!, 3.12+1!, 3.13+1*!, 3.14+1*!, 3.15+1!, 3.16+1!, 3.17+1!
    , 3.18+1*!, 3.19+1*!, 3.2+1*!, 4.03+1!, 4.05+1!, 4.06+1*!, 4.07+1!, 4.08+1!, 5.01+1!, 5.02+1!
    , 5.03+1!, 6.01+1*!, 6.07+1*!, 6.08+1!, 6.09+1!, 6.1+1!, 6.11+1!, 6.12+1!, 6.13+1!, 6.14+1!
    , 6.15+1!, 6.16+1!, 6.17+1!, 6.18+1!, 6.19+1!, 6.2+1!, 6.21+1!, 6.22+1!, 7.01+1!, 7.02+1*!
    , 7.04+1!, 7.05+1*!, 8.01+1!, 8.02+1!, 8.03+1!, 8.04+1!, 8.05+1*!, 8.06+1!, 8.09+1!, 8.1(XREF 1S)
    , 8.1(XREF 1n1.3), 8.13+1*!, 8.22+1*!, 9.01+1!, 9.02+1!, 9.03+1!, 9.04+1!, 9.05+1!, 9.06+1!, 9.07+1!
    , 9.08+1*!, 9.09+1*!, 9.11+1!, 9.12+1*!, 9.13+1!, 11.03+1!, 11.04+1!, 13.01+1!, 13.03+1!, 13.04+1!
    , 13.05+1!, 13.06+1!, 13.07+1!, 50.05+1!, 51.01+1!, 51.03+1!, 51.05+1!, 51.06+1!, 51.1+1!, 51.11+1*!
    , 51.12+1*!, 51.14+1!, 51.15+1!, 51.19+1!, 51.21+1*!, 51.21(XREF 1S), 51.21(XREF 1K), 51.29+1!, 51.32+1!, 51.34+1!
    , 52.01+1!, 52.02+1!, 53.03+1!, 53.04+1!, 53.05+1!, 53.06+1!, 53.07+1!, 54.02+1!, 62.02+1!, 62.03+1!
    , 62.04+1!, 62.05+1!, 62.06+1!, 62.07+1!, 62.08+1!, 62.09+1!, 62.1+1!, 62.11+1!, 62.12+1!, 62.13+1!
    , 70.02+1*!, 71.01+1*!, 71.02+1*!, 71.03+1*!, 71.04+1*!
    Y ID.02+1*, .02+1, .04+1, .05+1, .06+1, .12+1, .16+1, .17+1, 1.18+1, 1.24+1
    , 1.28+1, 1.29+1, 1.3+1, 3.01+1, 3.02+1, 3.13+1, 3.14+1, 3.18+1, 3.19+1, 3.2+1
    , 4.06+1, 6.01+1, 6.07+1, 7.02+1, 7.05+1, 8.05+1, 8.1(XREF 1S), 8.1(XREF 1n1.3), 8.13+1, 8.22+1
    , 9.08+1, 9.09+1, 9.12+1, 51.11+1, 51.12+1, 51.21+1, 51.21(XREF 1S), 51.21(XREF 1K), 70.02+1, 71.01+1
    , 71.02+1, 71.03+1, 71.04+1
    Y(0 8.1(XREF 1n1.3)
    Y(1 8.1(XREF 1S), 8.1(XREF 1n1.3), 51.21(XREF 1S), 51.21(XREF 1K)
    Y(2 8.1(XREF 1n1.3)
    Y(3 8.1(XREF 1n1.3)
    Z 8.06+1~*
    Info |  Desc |  Directly Accessed By Routines |  Accessed By FileMan Db Calls |  Pointer To FileMan Files |  Fields |  ICR |  Found Entries |  External References |  Global Variables Directly Accessed |  Naked Globals |  Local Variables  | All