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Sub-Field: 350.9004

Package: Integrated Billing

IB SITE PARAMETERS(#350.9)-->350.9004

Sub-Field: 350.9004


Information

Parent File Name Number Package
IB SITE PARAMETERS(#350.9) PAY-TO PROVIDERS 350.9004 Integrated Billing

Details

Field # Name Loc Type Details
.01 FACILITY 0;1 POINTER TO INSTITUTION FILE (#4) INSTITUTION(#4)

  • INPUT TRANSFORM:  S DIC("S")="I $$SCRN4^IBJPS4(Y)" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X
  • LAST EDITED:  JUL 09, 2014
  • HELP-PROMPT:  Please choose the Pay-To Provider from the Institution file.
  • DESCRIPTION:  Enter a Pay-to Provider. Usually, a Pay-to Provider is a medical center (Example VAMC, M&ROC, etc.). If you enter only one Pay-to Provider, it will be the default Pay-to Provider for all claims and you do not need to
    associate divisions with the default. Multiple Pay-to Providers must be associated with the divisions to which they apply.
  • SCREEN:  S DIC("S")="I $$SCRN4^IBJPS4(Y)"
  • EXPLANATION:  Inactive, not national, and pharmacy entries are screened out.
  • CROSS-REFERENCE:  350.9004^B
    1)= S ^IBE(350.9,DA(1),19,"B",$E(X,1,30),DA)=""
    2)= K ^IBE(350.9,DA(1),19,"B",$E(X,1,30),DA)
  • FIELD INDEX:  AC (#818) MUMPS IR ACTION
    Short Descr: Name and address defaults
    Description: The purpose of this x-ref is to default the name and address fields in this sub-file from data found in the Institution file. The idea is that the user will select a VA Institution from file 4 to be one of the Pay-To
    providers in this sub-file. The name and address of the VA Institution will be used as defaults for the name and address fields here in this sub-file. The default name and address information may be overridden.
    Set Logic: I $G(X1(1))'=$G(X2(1)) D DEF^IBJPS3(+$G(X2(1)),.DA,0)
    Kill Logic: Q
    X(1): FACILITY (350.9004,.01) (forwards)
.02 NAME 0;2 FREE TEXT
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  K:$L(X)>35!($L(X)<1) X
  • LAST EDITED:  NOV 14, 2008
  • HELP-PROMPT:  Answer must be 1-35 characters in length.
  • DESCRIPTION:  
    You may modify the Pay-to Provider Name for use on electronic or printed claims.
  • TECHNICAL DESCR:  
    This field is initially set by the "AC" x-ref of the .01 field.
.03 FEDERAL TAX NUMBER 0;3 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>10!($L(X)<10)!'(X?2N1"-"7N) X
  • LAST EDITED:  NOV 14, 2008
  • HELP-PROMPT:  Answer must be 10 characters in length.
  • DESCRIPTION:  
    Enter the Federal Tax ID for the Pay-to Provider. Make sure you enter the Tax ID Number for the Pay-to Provider which may be different from your site's Tax ID. Enter 10 digits in the format NN-NNNNNNN.
  • TECHNICAL DESCR:  
    This field is initially set by the "AC" x-ref of the .01 field if the .01 field is the same institution as defined in the IB site parameters field 350.9,.02.
.04 TELEPHONE NUMBER 0;4 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>30!($L(X)<1) X
  • LAST EDITED:  NOV 14, 2008
  • HELP-PROMPT:  Answer must be 1-30 characters in length.
  • DESCRIPTION:  
    Enter the phone number to be used on electronic or printed claims. This is the number you would want a payer to use to contact the site about a claim.
.05 PARENT PAY-TO PROVIDER 0;5 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 determines if this entry in the sub-file is a Pay-to provider institution or if it is a Division being linked to the parent Pay-to Provider institution - another sub-file entry.
    If this field is defined, then it holds the IEN in this sub-file which is the parent Pay-to Provider institution for this specific division.
    If this field is nil, then this means that this sub-file entry is the parent Pay-to Provider Institution.
    This field should not be set via FileMan. The application in the IB site parameter edit option will set this field appropriately based on user input.
1.01 STREET ADDRESS 1 1;1 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>55!($L(X)<1) X
    MAXIMUM LENGTH: 55
  • LAST EDITED:  APR 27, 2017
  • HELP-PROMPT:  Answer must be 1-55 characters in length.
  • DESCRIPTION:  
    You may modify the Pay-to Provider Address for use on electronic or printed claims. You may enter a P.O. Box.
  • TECHNICAL DESCR:  
    This field is initially set by the "AC" x-ref of the .01 field.
1.02 STREET ADDRESS 2 1;2 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>55!($L(X)<1) X
    MAXIMUM LENGTH: 55
  • LAST EDITED:  APR 27, 2017
  • HELP-PROMPT:  Answer must be 1-55 characters in length.
  • DESCRIPTION:  
    Enter additional Address information if needed.
  • TECHNICAL DESCR:  
    This field is initially set by the "AC" x-ref of the .01 field.
1.03 CITY 1;3 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>40!($L(X)<2) X
  • LAST EDITED:  NOV 14, 2008
  • HELP-PROMPT:  Answer must be 2-40 characters in length.
  • DESCRIPTION:  
    You may modify the Pay-to Provider Address for use on electronic or printed claims.
  • TECHNICAL DESCR:  
    This field is initially set by the "AC" x-ref of the .01 field.
1.04 STATE 1;4 POINTER TO STATE FILE (#5) STATE(#5)

  • LAST EDITED:  NOV 14, 2008
  • HELP-PROMPT:  Enter the Pay-To Provider state.
  • DESCRIPTION:  
    You may modify the Pay-to Provider Address for use on electronic or printed claims.
  • TECHNICAL DESCR:  
    This field is initially set by the "AC" x-ref of the .01 field.
1.05 ZIP 1;5 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>15!($L(X)<3) X
  • LAST EDITED:  NOV 14, 2008
  • HELP-PROMPT:  Answer must be 3-15 characters in length.
  • DESCRIPTION:  
    You may modify the Pay-to Provider Address for use on electronic or printed claims.
  • TECHNICAL DESCR:  
    This field is initially set by the "AC" x-ref of the .01 field.
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