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Sub-Field: 365.121

Package: Integrated Billing

PAYER(#365.12)-->365.121

Sub-Field: 365.121


Information

Parent File Name Number Package
PAYER(#365.12) APPLICATION 365.121 Integrated Billing

Details

Field # Name Loc Type Details
.01 APPLICATION 0;1 POINTER TO PAYER APPLICATION FILE (#365.13) PAYER APPLICATION(#365.13)

  • LAST EDITED:  MAY 17, 2002
  • DESCRIPTION:  
    This field identifies the specific application which may have an interface.
  • CROSS-REFERENCE:  365.121^B
    1)= S ^IBE(365.12,DA(1),1,"B",$E(X,1,30),DA)=""
    2)= K ^IBE(365.12,DA(1),1,"B",$E(X,1,30),DA)
    Standard "B" cross-reference
.02 NATIONALLY ENABLED 0;2 SET
  • '0' FOR Not Enabled;
  • '1' FOR Enabled;

  • LAST EDITED:  SEP 24, 2020
  • HELP-PROMPT:  Enter 1 for Enabled or 0 for Not Enabled.
  • DESCRIPTION:  
    This field identifies whether a particular payer is set up and accepting data from the Eligibility Communicator for this application.
.03 LOCALLY ENABLED 0;3 SET
  • '0' FOR Not Enabled;
  • '1' FOR Enabled;

  • LAST EDITED:  OCT 07, 2020
  • HELP-PROMPT:  Answer must be '0' for NOT ENABLED or '1' for ENABLED.
  • DESCRIPTION:  
    This field identifies whether the local VA facility is allowing for electronic interface for this payer and application.
  • AUDIT:  YES, ALWAYS
.04 USER EDITED LOCAL 0;4 POINTER TO NEW PERSON FILE (#200) NEW PERSON(#200)

  • LAST EDITED:  OCT 28, 2019
  • DESCRIPTION:  
    This is the user who last edited the local active switch.
.05 DATE/TIME LOCAL EDITED 0;5 DATE

  • INPUT TRANSFORM:  S %DT="ESTXR" D ^%DT S X=Y K:X<1 X
  • LAST EDITED:  OCT 28, 2019
  • HELP-PROMPT:  (No range limit on date)
  • DESCRIPTION:  
    This field indicates the date and time the local switch was last edited.
.06 DATE/TIME NATIONAL EDITED 0;6 DATE

  • INPUT TRANSFORM:  S %DT="ESTXR" D ^%DT S X=Y K:X<1 X
  • LAST EDITED:  JAN 23, 2003
  • DESCRIPTION:  
    This field indicates the date and time that this payer application was last updated via EC.
.07 *AUTO-ACCEPT 0;7 SET
  • '1' FOR YES;
  • '0' FOR NO;

  • LAST EDITED:  AUG 19, 2020
  • DESCRIPTION:  This field indicates whether the site will automatically accept the incoming application information and file it into VISTA rather than storing the information in a temporary file for manual intervention.
    For insurance identification and verification, this data will be stored in the Insurance Buffer file.
    This field is scheduled for deletion with patch IB*2.0*668. The data was moved to (#365.121,4.01).
.08 *IDENT REQUIRES SUBSCRIBER ID 0;8 SET
  • '0' FOR NO;
  • '1' FOR YES;

  • LAST EDITED:  AUG 19, 2020
  • HELP-PROMPT:  Enter YES if the Payer requires the Subscriber ID for identification transactions, Enter NO otherwise.
  • DESCRIPTION:  This flag is set by the Eligibility Communicator (EC). It should not be modified via FileMan. The flag indicates whether or not a payer requires a Subscriber ID for identification transactions.
    This field is scheduled for deletion with patch IB*2.0*668. The data was moved to (#365.121,4.02) and renamed to better align with the meaning of the field.
.09 *USE SSN FOR SUBSCRIBER ID 0;9 SET
  • '0' FOR NO;
  • '1' FOR YES;

  • LAST EDITED:  AUG 19, 2020
  • HELP-PROMPT:  Enter 1 for Yes, if the Payer uses the patient's SSN as the Subscriber ID. Enter 0 for No, otherwise.
  • DESCRIPTION:  This flag is set by the Eligibility Communicator (EC). It should not be modified via FileMan. The flag indicates whether or not a payer recognizes a patient's SSN as a valid Subscriber ID.
    This field is scheduled for deletion with patch IB*2.0*668.
.1 *TRANSMIT SSN 0;10 SET
  • '0' FOR NO;
  • '1' FOR YES;

  • LAST EDITED:  AUG 19, 2020
  • HELP-PROMPT:  Enter YES if the patient's SSN should be transmitted for this payer application, Enter NO otherwise.
  • DESCRIPTION:  This flag is set by the Eligibility Communicator (EC). It should not be modified via FileMan. The flag indicates whether or not a payer accepts a patient's SSN for transactions.
    This field is scheduled for deletion with patch IB*2.0*668.
.11 *DEACTIVATED? 0;11 SET
  • '0' FOR NO;
  • '1' FOR YES;

  • LAST EDITED:  AUG 18, 2020
  • HELP-PROMPT:  Enter 1 to Deactivate or 0 to Activate
  • DESCRIPTION:  This field is the flag which determines if a payer and application is no longer active.
    This field will be applied by the EC. Users should not modify this field.
    This field is scheduled for deletion with patch IB*2.0*668. The data was moved to (#365.12,.07).
.12 *DATE/TIME DEACTIVATED 0;12 DATE

  • INPUT TRANSFORM:  S %DT="ESTX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  AUG 18, 2020
  • DESCRIPTION:  This is the date and time that the payer and application were deactivated.
    This field is scheduled for deletion with patch IB*2.0*668. The data was moved to (#365.12,.08).
.13 DATE/TIME CREATED 0;13 DATE

  • INPUT TRANSFORM:  S %DT="ESTXR" D ^%DT S X=Y K:X<1 X
  • LAST EDITED:  JAN 23, 2003
  • DESCRIPTION:  
    This is the date/time that this application was created. This field should not be edited through FileMan.
.14 *FUTURE SERVICE DAYS 0;14 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>9999)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  AUG 19, 2020
  • HELP-PROMPT:  Type a Number between 0 and 9999
  • DESCRIPTION:  A service date is acceptable to the payer if the service date is not greater than "T+" this value.
    This field is scheduled for deletion with patch IB*2.0*668. The data was moved to (#365.121,4.03).
.15 *PAST SERVICE DAYS 0;15 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>9999)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  AUG 19, 2020
  • HELP-PROMPT:  Type a Number between 0 and 9999
  • DESCRIPTION:  A service date is acceptable to the payer if the service date is not less than "T-" this value.
    This field is scheduled for deletion with patch IB*2.0*668. The data was moved to (#365.121,4.04).
2 NATIONALLY ENABLED LOG 2;0 DATE Multiple #365.1212 365.1212

  • LAST EDITED:  AUG 20, 2020
  • DESCRIPTION:  
    Log of changes to the NATIONALLY ENABLED flag.
  • TECHNICAL DESCR:  
    A new entry is added every time Payer Update HL7 message is received that contains a change to the current NATIONALLY ENABLED flag setting (field 365.121/.02).
3 AUTO-UPDATE LOG 3;0 DATE Multiple #365.1213 365.1213

  • LAST EDITED:  AUG 20, 2020
  • DESCRIPTION:  
    Log of changes to the AUTO-UPDATE flag.
  • TECHNICAL DESCR:  
    A new entry is added every time Payer Update HL7 message is received that contains a change to the current AUTO-UPDATE flag setting (field 365.121/.07).
4.01 AUTO-UPDATE 4;1 SET

  • LAST EDITED:  SEP 25, 2020
  • HELP-PROMPT:  Enter 1 to Auto Update or 0 to not Auto Update.
  • DESCRIPTION:  This field indicates whether the site will automatically accept the incoming application information and file it into VISTA rather than storing the information in a temporary file for manual intervention.
    For insurance identification and verification, this data will be stored in the Insurance Buffer file.
4.02 270 REQUIRES SUB ID 4;2 SET

  • LAST EDITED:  AUG 27, 2020
  • HELP-PROMPT:  Enter YES if the Payer requires the Subscriber ID for a X12 270 transaction, Enter NO otherwise.
  • DESCRIPTION:  
    This flag is set by the Eligibility Communicator (EC). It should not be modified via FileMan. The flag indicates whether or not a payer requires a Subscriber ID for a X12 270 transaction.
4.03 FUTURE SERVICE DAYS 4;3 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>9999)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  AUG 20, 2020
  • HELP-PROMPT:  Type a number between 0 and 9999, 0 decimal digits.
  • DESCRIPTION:  
    A service date is acceptable to the payer if the service date is not greater than "T+" this value.
4.04 PAST SERVICE DAYS 4;4 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>9999)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  AUG 20, 2020
  • HELP-PROMPT:  Type a number between 0 and 9999, 0 decimal digits.
  • DESCRIPTION:  
    A service date is acceptable to the payer if the service date is not less than "T-" this value.
5.01 RECEIVE IIU DATA 5;1 SET (BOOLEAN Data Type)

  • LAST EDITED:  JUL 07, 2022
  • DESCRIPTION:  
    This field identifies whether the local VA facility is allowing IIU data to be displayed to the user for processing.
  • EXECUTABLE HELP:  D HELP1^IBCNEPY
  • AUDIT:  YES, ALWAYS
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