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Sub-Field: 9002313.772

Package: E Claims Management Engine

BPS REQUESTS(#9002313.77)-->9002313.772

Sub-Field: 9002313.772


Information

Parent File Name Number Package
BPS REQUESTS(#9002313.77) INSURER DATA 9002313.772 E Claims Management Engine

Details

Field # Name Loc Type Details
.01 COB INDICATOR 0;1 SET
  • '1' FOR PRIMARY;
  • '2' FOR SECONDARY;
  • '3' FOR TERTIARY;

  • LAST EDITED:  JUN 24, 2008
  • HELP-PROMPT:  Is the payer a primary, secondary or tertiary insurer?
  • DESCRIPTION:  
    Coordination Of Benefits (COB) indicator for the payer.
  • CROSS-REFERENCE:  9002313.772^B
    1)= S ^BPS(9002313.77,DA(1),5,"B",$E(X,1,30),DA)=""
    2)= K ^BPS(9002313.77,DA(1),5,"B",$E(X,1,30),DA)
.02 USED FOR THE REQUEST 0;2 SET
  • '0' FOR NO;
  • '1' FOR YES;

  • LAST EDITED:  JUN 24, 2008
  • HELP-PROMPT:  Should this payer be used for billing in this request?
  • DESCRIPTION:  The INSURER DATA multiple can store up to three entries with details for primary, secondary and tertiary insurers. This field marks the active payer entry, which points to the payer data to be used to process this
    request.
  • CROSS-REFERENCE:  9002313.772^C
    1)= S ^BPS(9002313.77,DA(1),5,"C",$E(X,1,30),DA)=""
    2)= K ^BPS(9002313.77,DA(1),5,"C",$E(X,1,30),DA)
    To find an active COB indicator.
.03 INSURER DATA 0;3 POINTER TO BPS INSURER DATA FILE (#9002313.78) BPS INSURER DATA(#9002313.78)

  • LAST EDITED:  JUN 20, 2008
  • HELP-PROMPT:  Select insurer for the request
  • DESCRIPTION:  
    Contains IB determination data for the payer (insurer).
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