IBCEF79 ;ALB/ESG - Billing Provider functions ;13-Aug-2008
Source file <IBCEF79.m>
| Name | Comments | DBIA/ICR reference |
|---|---|---|
| B(IBIFN,COB) | ; Determine Billing Provider and Service Facility information
; This function returns a string in the following format: ; [1] billing provider Institution file pointer (IEN to file 4) or "0" ; if the billing provider cannot be determined ; [2] billing provider name (.01 field in file 4) or Error reason why ; the billing provider cannot be determined - used when piece [1]=0 ; [3] 0 if the service facility is a VA institution in file 4 ; 1 if the service facility is a non-VA facility in file 355.93 ; "" if the service facility is blank - when there is no service facility ; [4] service facility IEN - either an IEN to file 4 or to file 355.93 ; or "" if the service facility is blank |
|
| B1 | ;
; check the parent |
|
| BX | ;
|
|
| CHK(IEN) | ; Perform final billing provider checks on passed in Institution
; file pointer - File 4 ien ; Function returns final pieces 1 and 2 of $$B function as described above |
|
| CHKX | ;
|
|
| BPCHKN(IEN) | ; Is this a national Institution?
|
|
| BPCHKNX | ;
|
|
| BPCHKA(IEN) | ; Is this an active Institution?
|
|
| BPCHKAX | ;
|
|
| BPFACTYP(IEN) | ; Is the facility type of this Institution a valid Billing Provider facility type?
|
|
| BPFACTPX | ;
|
|
| BPPAR(IEN) | ; Who is the parent for this Institution?
; Function returns the IEN to file 4 of the parent institution as defined in File 4 |
|
| BPPARX | ;
|
|
| TAX(IBIFN) | ; Update default billing provider and service facility taxonomy codes
; and billing provider secondary IDs and Qualifiers. ; This is called via new style xrefs to update the default value of these fields |
|
| TAXQ | ;
|
|
| INSFLGS(IBIFN,COB) | ; get insurance company flags for a given claim
; returns string of flags in the following format: ; switchback flag ^ send service facility flag ^ institution file address flag ^ error ; switchback flag: field 36/4.11 or 36/4.12, depending on form type. "-1" if error has occurred. ; send service facility flag: field 36/4.07, empty if error has occurred or switchback flag is not set. ; institution file address flag: field 36/4.13, empty if error has occurred or switchback flag is not set. ; ; MRD;IB*2.0*516 - The four flag fields described above (File #36, ; Field #'s 4.07, 4.11, 4.12, 4.13) are all being marked for ; deletion. All references to those fields are being removed ; as part of this patch. |
|
| GETBP(IBIFN,COB,INST,SUB,IBXSAVE) | ; Get billing provider data for claim output
; Used to extract billing provider name, address, and phone# for PRV segment and for CMS-1500, Box 33 ; IBIFN - claim ien required ; COB - payer sequence (optional, defaults to current payer seq) ; INST - billing provider VA file 4 ien required ; SUB - subscript to use in IBXSAVE local array required ; IBXSAVE - pass by reference ; Returns IBXSAVE(SUB,"NAME") ; IBXSAVE(SUB,"ADDR1") ; IBXSAVE(SUB,"ADDR2") ; IBXSAVE(SUB,"CITY") ; IBXSAVE(SUB,"ST") ; IBXSAVE(SUB,"ZIP") ; IBXSAVE(SUB,"PHONE") |
|
| GETBPX | ;
|
|
| SENDSF(IBIFN,COB) | ; Send service facility information for the EDI claim?
; Function value returns 1 (send service facility information) or 0 (don't send it) ; The only time this function returns 0 is when the pre-patch 400 switchback flag is set, and ; care was provided at the main division (VAMC) in the database, and the 36,4.07 ins. co. flag is set to NO. ; This function is used in the EDI claim (segments SUB, SUB2, NPI-16, and NPI-17). ; IBIFN required ; COB optional, defaults to current payer sequence |
|
| SENDSFX | ;
|
|
| SLPROV(IBXIEN,TYPE) | ; return array of service line provider data
; IBXIEN - ien in file 399 ; TYPE: O1 = operating physician, O2 = other operating physician, RE = rendering provider, ; P = purchase service provider, S = supervising provider, RF = referring provider |
| FileNo | Call Tags |
|---|---|
| ^VA(200 - [#200] | GET1^DIQ |
| ^IBA(355.93 - [#355.93] | GET1^DIQ |
| ^DIC(4 - [#4] | GET1^DIQ |
