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InfoFileMan FileNo | FileMan Filename | Package |
---|---|---|
356.1 | HOSPITAL REVIEW | Integrated Billing |
Package | Total | Routines |
---|---|---|
Integrated Billing | 5 | IBTRE1 IBTRV1 IBTRV31 IBTRVD1 IBTUTL2 |
Utilization Management Rollup | 1 | IBQLPOST |
Package | Total | FileMan Files |
---|---|---|
Integrated Billing | 2 | HOSPITAL REVIEW(#356.1)[.24] INSURANCE REVIEW(#356.2)[.03] |
Field # | Name | Loc | Type | Details |
---|---|---|---|---|
.01 | REVIEW DATE | 0;1 | DATE | ************************REQUIRED FIELD************************
|
.02 | TRACKING ID | 0;2 | POINTER TO CLAIMS TRACKING FILE (#356) | CLAIMS TRACKING(#356)
|
.03 | DAY FOR REVIEW | 0;3 | NUMBER |
|
.04 | SEVERITY OF ILLNESS | 0;4 | POINTER TO CLAIMS TRACKING SI/IS CATEGORIES FILE (#356.3) | CLAIMS TRACKING SI/IS CATEGORIES(#356.3)
|
.05 | INTENSITY OF SERVICE | 0;5 | POINTER TO CLAIMS TRACKING SI/IS CATEGORIES FILE (#356.3) | CLAIMS TRACKING SI/IS CATEGORIES(#356.3)
|
.06 | CRITERIA MET IN 24 HOURS | 0;6 | SET |
|
.07 | SPECIALTY FOR REVIEW | 0;7 | POINTER TO FACILITY TREATING SPECIALTY FILE (#45.7) | FACILITY TREATING SPECIALTY(#45.7)
|
.08 | SPECIALIZED UNIT SI | 0;8 | POINTER TO CLAIMS TRACKING SI/IS CATEGORIES FILE (#356.3) | CLAIMS TRACKING SI/IS CATEGORIES(#356.3)
|
.09 | SPECIALIZED UNIT IS | 0;9 | POINTER TO CLAIMS TRACKING SI/IS CATEGORIES FILE (#356.3) | CLAIMS TRACKING SI/IS CATEGORIES(#356.3)
|
.1 | PROVIDER INTERVIEWED? | 0;10 | SET |
|
.11 | ADMISSION DECISION INFLUENCED | 0;11 | SET |
|
.12 | D/C SCREENS MET | 0;12 | POINTER TO CLAIMS TRACKING SI/IS CATEGORIES FILE (#356.3) | CLAIMS TRACKING SI/IS CATEGORIES(#356.3)
|
.13 | SPECIAL CARE D/C SCREENS MET | 0;13 | POINTER TO CLAIMS TRACKING SI/IS CATEGORIES FILE (#356.3) | CLAIMS TRACKING SI/IS CATEGORIES(#356.3)
|
.14 | SI/IS APPLY ALL DAYS | 0;14 | SET |
|
.19 | ACTIVE | 0;19 | SET |
|
.2 | NEXT REVIEW DATE | 0;20 | DATE |
|
.21 | REVIEW STATUS | 0;21 | SET |
|
.22 | TYPE OF REVIEW | 0;22 | POINTER TO CLAIMS TRACKING REVIEW TYPE FILE (#356.11) | ************************REQUIRED FIELD************************ CLAIMS TRACKING REVIEW TYPE(#356.11)
|
.23 | REVIEW METHODOLOGY | 0;23 | SET |
|
.24 | REVIEW COPIED FROM | 0;24 | POINTER TO HOSPITAL REVIEW FILE (#356.1) | HOSPITAL REVIEW(#356.1)
|
1.01 | DATE ENTERED | 1;1 | DATE |
|
1.02 | ENTERED BY | 1;2 | POINTER TO NEW PERSON FILE (#200) | NEW PERSON(#200)
|
1.03 | LAST EDIT ON | 1;3 | DATE |
|
1.04 | LAST EDITED BY | 1;4 | POINTER TO NEW PERSON FILE (#200) | NEW PERSON(#200)
|
1.05 | DATE COMPLETED | 1;5 | DATE |
|
1.06 | COMPLETED BY | 1;6 | POINTER TO NEW PERSON FILE (#200) | NEW PERSON(#200)
|
1.13 | ADD NEXT REVIEW | 1;13 | SET |
|
1.14 | NEXT REVIEW EXACTLY THE SAME | 1;14 | SET |
|
1.15 | ADDITIONAL REVIEWS REQUIRED | 1;15 | SET |
|
1.17 | ACUTE CARE DISCHARGE DATE | 1;17 | DATE |
|
11 | UTILIZATION REVIEW COMMENTS | 11;0 | WORD-PROCESSING #356.111 |
|
12 | REASON FOR NON-ACUTE ADMISSION | 12;0 | POINTER Multiple #356.112 | 356.112
|
13 | REASON FOR NON-ACUTE DAYS | 13;0 | POINTER Multiple #356.113 | 356.113
|
21 | PATIENT | COMPUTED |
|
ICR LINK | Subscribing Package(s) | Fields Referenced | Description |
---|---|---|---|
ICR #1351 | DAY OF REVIEW (.03). Access: Direct Global Read & w/Fileman SEVERITY OF ILLNESS (.04). Access: Direct Global Read & w/Fileman INTENSITY OF SERVICE (.05). Access: Direct Global Read & w/Fileman CRITERIA MET IN 24 HOURS? (.06). Access: Direct Global Read & w/Fileman SPECIALTY FOR REVIEWS (.07). Access: Direct Global Read & w/Fileman SPECIALIZED UNIT SI (.08). Access: Direct Global Read & w/Fileman SPECIALIZED UNIT IS (.09). Access: Direct Global Read & w/Fileman PROVIDER INTERVIEWED? (.1). Access: Direct Global Read & w/Fileman ADMISSION DECISION INFLUENCED (.11). Access: Direct Global Read & w/Fileman D/C SCREEN MET (.12). Access: Direct Global Read & w/Fileman ACTIVE (.19). Access: Direct Global Read & w/Fileman REVIEW STATUS (.21). Access: Direct Global Read & w/Fileman REASONS FOR NON-ACUTE ADMISSION (356.112,.01). Access: Direct Global Read & w/Fileman REASONS FOR NON-ACUTE DAYS (356.113,.01). Access: Direct Global Read & w/Fileman |
The 'C' x-ref is used to retrieve information on thedays of review, given it's parent Claims Tracking number. | |
ICR #5314 |