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Global: ^IBMH(351.83

Package: Integrated Billing

Global: ^IBMH(351.83


Information

FileMan FileNo FileMan Filename Package
351.83 IB MH VISIT TRACKING Integrated Billing

Description

Accessed By FileMan Db Calls, Total: 6

Package Total Routines
Integrated Billing 6 IBECEAMH    IBMHPMPY1    IBMHPMPY2    IBMHPMPY3    IBMHSP1    IBMHVM    

Pointer To FileMan Files, Total: 3

Package Total FileMan Files
Integrated Billing 1 INTEGRATED BILLING ACTION(#350)[.08]    
Kernel 1 INSTITUTION(#4)[.02, 3.03]    
Registration 1 PATIENT(#2)[.01]    

Fields, Total: 12

Field # Name Loc Type Details
.01 PATIENT 0;1 POINTER TO PATIENT FILE (#2)
************************REQUIRED FIELD************************
PATIENT(#2)

  • LAST EDITED:  APR 06, 2023
  • HELP-PROMPT:  Enter the veteran who received Mental Health care.
  • DESCRIPTION:  
    This field identifies the veteran who has been seen for a Mental Health visit.
  • CROSS-REFERENCE:  351.83^B
    1)= S ^IBMH(351.83,"B",$E(X,1,30),DA)=""
    2)= K ^IBMH(351.83,"B",$E(X,1,30),DA)
.02 SITE 0;2 POINTER TO INSTITUTION FILE (#4)
************************REQUIRED FIELD************************
INSTITUTION(#4)

  • LAST EDITED:  MAY 26, 2023
  • HELP-PROMPT:  Enter the site where the bill was processed for the patient's visit.
  • DESCRIPTION:  
    This field stores the site where the bill was processed.
.03 VISIT DATE 0;3 DATE
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  APR 06, 2023
  • HELP-PROMPT:  Enter the date of the Mental Health Care visit.
  • DESCRIPTION:  
    This field contains the date when the patient received Mental Health Care.
  • CROSS-REFERENCE:  351.83^VD
    1)= S ^IBMH(351.83,"VD",$E(X,1,30),DA)=""
    2)= K ^IBMH(351.83,"VD",$E(X,1,30),DA)
    This index allows the system to find a visit in the Mental Health Care Visit Tracking Database by the Date of the visit.
.04 STATUS 0;4 SET
************************REQUIRED FIELD************************
  • '1' FOR FREE;
  • '2' FOR BILLED;
  • '3' FOR REMOVED;
  • '4' FOR VISIT ONLY;

  • LAST EDITED:  MAY 26, 2023
  • HELP-PROMPT:  FREE - Exempt under the CLELAND-DOLE ACT of 2022, BILLED if a copay was filed, REMOVED if the visit was entered in error, or VISIT ONLY if the visit has no copay linked to it.
  • DESCRIPTION:  This field contains the visit status of the Mental Health Care visit. The status can be:
    FREE if the veteran's visit is exempt, under the Cleland-Dole Act of 2022.
    BILLED if the Visit was charged a copay, regardless of the copay's billing status.
    REMOVED if the Visit was entered in error.
    VISIT ONLY if the visit needs to be tracked and there is no copay associated with the visit.
.05 BILL NUMBER 0;5 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>12!($L(X)<6) X
    MAXIMUM LENGTH: 12
  • LAST EDITED:  APR 06, 2023
  • HELP-PROMPT:  Answer must be 6-12 characters in length. Enter either ON HOLD or the full bill number associated with this visit from the Copay file.
  • DESCRIPTION:  
    This field contains the bill number under which a tracked Mental Health Care copay was billed. It must be in the form of -. or the words ON HOLD. It is not a mandatory field.
  • CROSS-REFERENCE:  351.83^C
    1)= S ^IBMH(351.83,"C",$E(X,1,30),DA)=""
    2)= K ^IBMH(351.83,"C",$E(X,1,30),DA)
    This free text field will contain one of 3 values:
    If the Visit's status is not BILLED
    - NULL (no Copay associated with the visit).
    If the Visit's status is BILLED
    - ON HOLD (A copay was charged but the Copay is waiting to see if
    3rd Party Insurance will occur).
    - xxx-Knnnnnn - the AR Bill Number (field #.11) from the Copay
    file (#350).
.06 REASON 0;6 SET
  • '1' FOR SC/SA;
  • '2' FOR CLELAND-DOLE ACT;
  • '3' FOR ENTERED IN ERROR;
  • '4' FOR DUPLICATE VISIT;
  • '5' FOR NO COPAY ADDED;
  • '6' FOR FRM OVERRIDE;

  • LAST EDITED:  OCT 26, 2023
  • HELP-PROMPT:  Enter 1 for SC/SA, 2 for Cleland - Dole Act, 3 for Entered in Error, 4 for Duplicate Visit, 5 for No Copay Added, 6 for FRM Override, or if no extra comment is needed.
  • DESCRIPTION:  This field contains an extra comment to help describe why a veteran's visit was considered FREE, REMOVED, or VISIT ONLY. If used, the options to select from are Special Authority, Cleland-Dole Act, or FRM Override (for
    FREE), Entered in Error or Duplicate Visit (for REMOVED), or No Copay Added (for VISIT ONLY).
.07 UNIQUE ID 0;7 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>30!($L(X)<5)!'(X?3.5AN1"_"1AN.AN) X
    MAXIMUM LENGTH: 30
  • LAST EDITED:  APR 06, 2023
  • HELP-PROMPT:  Enter a unique identifier between 5 and 30 characters in the format 3-5 characters, underscore, 1-24 characters.
  • DESCRIPTION:  This field is used to determine the originating source of the record. It consists of the site number, an underscore, and the Internal Entry Number of the record at the originating site. Only the originating site can
    update the record.
  • CROSS-REFERENCE:  351.83^AUID
    1)= S ^IBMH(351.83,"AUID",$E(X,1,30),DA)=""
    2)= K ^IBMH(351.83,"AUID",$E(X,1,30),DA)
    This cross reference is used to lookup records by their unique identifier which consists of originating site, an underscore, and the IEN to this file at their originating site.
.08 INTEGRATED BILLING ACTION 0;8 POINTER TO INTEGRATED BILLING ACTION FILE (#350) INTEGRATED BILLING ACTION(#350)

  • LAST EDITED:  MAY 22, 2023
  • HELP-PROMPT:  Please select Integrated Billing Action to associate with this entry.
  • DESCRIPTION:  
    This field contains pointer to the entry in file 350 that is associated with this entry.
  • CROSS-REFERENCE:  351.83^D
    1)= S ^IBMH(351.83,"D",$E(X,1,30),DA)=""
    2)= K ^IBMH(351.83,"D",$E(X,1,30),DA)
    This index connects the entry in the Mental Health Visit Tracking File with the corresponding copay in the Integrated Billing Action file (#350).
1.01 UPDATED 1;1 SET
  • '0' FOR EXISTING;
  • '1' FOR NEW OR UPDATED;

  • LAST EDITED:  APR 06, 2023
  • HELP-PROMPT:  Enter 1 whenever this record is added or updated.
  • DESCRIPTION:  This flag is used to determine if a record should be pushed out to other sites. It is set to 1 when the record is added or updated and set to 0 after the updates are propagated to other sites a veteran has been treated
    at.
  • CROSS-REFERENCE:  351.83^AC
    1)= S ^IBMH(351.83,"AC",$E(X,1,30),DA)=""
    2)= K ^IBMH(351.83,"AC",$E(X,1,30),DA)
    This cross reference is used to find records updated since the last push out to other treating facilities.
3.01 EXCEPTIONS? 3;1 SET (BOOLEAN Data Type)
  • This flag is used to determine if a record was unsuccessfully pushed to other sites. Should be used in conjunction with EXCEPTION REASON Field (3.02). Set to 0 or NULL if transmission was finally successful.

  • LAST EDITED:  APR 06, 2023
  • HELP-PROMPT:  Enter 1 whenever this record did not successfully transmit due to a Data File issue.
  • DESCRIPTION:  
    This flag is used to determine if a record was unsuccessfully pushed to other sites. Should be used in conjunction with EXCEPTION REASON Field (3.02). Set to 0 or NULL if transmission was finally successful.
  • CROSS-REFERENCE:  351.83^AT
    1)= S ^IBMH(351.83,"AT",$E(X,1,30),DA)=""
    2)= K ^IBMH(351.83,"AT",$E(X,1,30),DA)
    This cross reference is used to find records that did not transfer when the last Mental Health Visit data push occurred.
3.02 EXCEPTION REASON 3;2 SET
  • 'N' FOR NO FREE VISITS;

  • LAST EDITED:  APR 06, 2023
  • HELP-PROMPT:  Enter N if there were no free visits available at the remote site.
  • DESCRIPTION:  This field is used to explain why a record did not transmit successfully. Used only if:
    A) There were no Free visits remaining at the receiving facility.
3.03 EXCEPTION SITE 3;3 POINTER TO INSTITUTION FILE (#4) INSTITUTION(#4)

  • LAST EDITED:  APR 06, 2023
  • HELP-PROMPT:  Enter the VAMC which did not receive the Visit Information.
  • DESCRIPTION:  
    This field is used to identify with VAMC did not successfully update their Visit Tracking file because of the Exceptions noted in field 3.02 (Exception Reason).
  • CROSS-REFERENCE:  351.83^ARS
    1)= S ^IBMH(351.83,"ARS",$E(X,1,30),DA)=""
    2)= K ^IBMH(351.83,"ARS",$E(X,1,30),DA)
    This cross reference is used to find the sites that had visit records that did not transfer when the last Cleland-Dole Care Visit data push occurred.
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