Sub-Field: 367.12

Parent File	Name	Number	Package
HPID/OEID TRANSMISSION QUEUE(#367.1)	IDENTIFIERS	367.12	Integrated Billing

Details

Field # Name Loc Type Details

Field #	Name	Loc	Type	Details
.01	INSURANCE COMPANY ID TYPE	0;1	POINTER TO INSURANCE COMPANY ID TYPE FILE (#367.11)	INSURANCE COMPANY ID TYPE(#367.11) LAST EDITED: `MAR 24, 2014` HELP-PROMPT: `Enter the type of INSURANCE COMPANY ID sent in the inquiry to the NIF.` DESCRIPTION: `This is the type of Insurance Company ID sent to the NIF. The data can be an EDI number, a VA National ID, a NIF ID or an HPID/OEID.` CROSS-REFERENCE: `367.12^B` `1)= S ^IBCNH(367.1,DA(1),1,"B",$E(X,1,30),DA)=""` `2)= K ^IBCNH(367.1,DA(1),1,"B",$E(X,1,30),DA)`
.02	ID	0;2	FREE TEXT	INPUT TRANSFORM: `K:$L(X)>30!($L(X)<1) X` LAST EDITED: `MAR 24, 2014` HELP-PROMPT: `Answer must be 1-30 characters in length.` DESCRIPTION: `This is the actual data sent to the NIF from the insurance company entry in the INSURANCE COMPANY file.` TECHNICAL DESCR: `Here are the possible data fields that could be sent from file #36: (#3.02) EDI ID NUMBER - PROF, (#3.04) EDI ID NUMBER - INST (#6.02) EDI INST SECONDARY ID(1), (#6.04) EDI INST SECONDARY ID(2), (#6.06) EDI PROF` `SECONDARY ID(1), (#6.08) EDI PROF SECONDARY ID(2), (#8.01) HPID/OEID, (#8.04) NIF ID, (#3.1) VA NATIONAL ID.`
.03	SECONDARY ID QUALIFIER	0;3	SET	'2U' FOR PAYER ID #; 'FY' FOR CLAIM OFFICE #; 'NF' FOR NAIC CODE; 'TJ' FOR FED TAXPAYER #; LAST EDITED: `MAR 13, 2014` HELP-PROMPT: `If the ID is a Secondary Payer ID, enter the qualifier.` DESCRIPTION: `If the ID type is a SECONDARY ID, you must enter a qualifier to indicate` `the type of secondary payer ID that it is. You can not use the same` `qualifier multiple times for the same secondary ID type.`

.01

INSURANCE COMPANY ID TYPE

0;1

POINTER TO INSURANCE COMPANY ID TYPE FILE (#367.11)

INSURANCE COMPANY ID TYPE(#367.11)

LAST EDITED: MAR 24, 2014
HELP-PROMPT: Enter the type of INSURANCE COMPANY ID sent in the inquiry to the NIF.
DESCRIPTION:
This is the type of Insurance Company ID sent to the NIF. The data can be an EDI number, a VA National ID, a NIF ID or an HPID/OEID.
CROSS-REFERENCE: 367.12^B
1)= S ^IBCNH(367.1,DA(1),1,"B",$E(X,1,30),DA)=""
2)= K ^IBCNH(367.1,DA(1),1,"B",$E(X,1,30),DA)

.02

0;2

FREE TEXT

INPUT TRANSFORM: K:$L(X)>30!($L(X)<1) X
LAST EDITED: MAR 24, 2014
HELP-PROMPT: Answer must be 1-30 characters in length.
DESCRIPTION:
This is the actual data sent to the NIF from the insurance company entry in the INSURANCE COMPANY file.
TECHNICAL DESCR: Here are the possible data fields that could be sent from file #36: (#3.02) EDI ID NUMBER - PROF, (#3.04) EDI ID NUMBER - INST (#6.02) EDI INST SECONDARY ID(1), (#6.04) EDI INST SECONDARY ID(2), (#6.06) EDI PROF
SECONDARY ID(1), (#6.08) EDI PROF SECONDARY ID(2), (#8.01) HPID/OEID, (#8.04) NIF ID, (#3.1) VA NATIONAL ID.

.03

SECONDARY ID QUALIFIER

0;3

SET

'2U' FOR PAYER ID #;
'FY' FOR CLAIM OFFICE #;
'NF' FOR NAIC CODE;
'TJ' FOR FED TAXPAYER #;

LAST EDITED: MAR 13, 2014
HELP-PROMPT: If the ID is a Secondary Payer ID, enter the qualifier.
DESCRIPTION: If the ID type is a SECONDARY ID, you must enter a qualifier to indicate
the type of secondary payer ID that it is. You can not use the same
qualifier multiple times for the same secondary ID type.

Customize PDF page

Package: Integrated Billing

HPID/OEID TRANSMISSION QUEUE(#367.1)-->367.12

Sub-Field: 367.12

Information

Details