Name	Value
NAME	IB2.0349
DATE DISTRIBUTED	2007-07-02 00:00:00
PACKAGE FILE LINK	INTEGRATED BILLING
REQUIRED BUILD	IB2.0348 ACTION: Don't install, leave global IB2.0343 ACTION: Don't install, leave global IB2.0358 ACTION: Don't install, leave global IB2.0327 ACTION: Don't install, leave global IB2.0323 ACTION: Don't install, leave global IB2.0294 ACTION: Don't install, leave global IB2.0230 ACTION: Don't install, leave global IB2.0122 ACTION: Don't install, leave global IB2.0356 ACTION: Don't install, leave global
TYPE	SINGLE PACKAGE
DESCRIPTION OF ENHANCEMENTS	UB-04 claim form.
TRACK PACKAGE NATIONALLY	YES
FILE	DD NUMBER: INSURANCE TYPE (sub-file) FIELD NUMBER: SUBSCRIBER'S EMPLOYER NAME UPDATE THE DATA DICTIONARY: YES SEND SECURITY CODE: YES SEND FULL OR PARTIAL DD: PARTIAL DATA COMES WITH FILE: NO MAY USER OVERRIDE DATA UPDATE: NO UPDATE THE DATA DICTIONARY: NO SEND SECURITY CODE: NO SEND FULL OR PARTIAL DD: FULL RESOLVE POINTERS: NO DATA COMES WITH FILE: YES SITE'S DATA: OVERWRITE MAY USER OVERRIDE DATA UPDATE: NO SCREEN TO SELECT DATA: I $F(".IB086.IB087.IB310.IB120.IB327.","."_$P($G(^IBE(350.8,+Y,0)),U,1)_".") DD NUMBER: IB SITE PARAMETERS (File-top level) FIELD NUMBER: REMARKS TO APPEAR ON EACH FORM FEDERAL TAX NUMBER UB-04 ADDRESS COLUMN UB-04 PRINT LEGACY ID FACILITY NAME FOR BILLING UPDATE THE DATA DICTIONARY: YES SEND SECURITY CODE: YES SEND FULL OR PARTIAL DD: PARTIAL DATA COMES WITH FILE: NO MAY USER OVERRIDE DATA UPDATE: NO DD NUMBER: BILL FORM TYPE (File-top level) FIELD NUMBER: FOLLOW-UP PRINTER (A/R) UPDATE THE DATA DICTIONARY: YES SEND SECURITY CODE: NO SEND FULL OR PARTIAL DD: PARTIAL DATA COMES WITH FILE: NO MAY USER OVERRIDE DATA UPDATE: NO DD NUMBER: IB BILLING PRACTITIONER ID (File-top level) FIELD NUMBER: FORM TYPE APPLIED TO UPDATE THE DATA DICTIONARY: YES SEND SECURITY CODE: YES SEND FULL OR PARTIAL DD: PARTIAL DATA COMES WITH FILE: NO MAY USER OVERRIDE DATA UPDATE: NO DD NUMBER: IB INSURANCE CO LEVEL BILLING PROV ID (File-top level) FIELD NUMBER: FORM TYPE APPLIED TO UPDATE THE DATA DICTIONARY: YES SEND SECURITY CODE: YES SEND FULL OR PARTIAL DD: PARTIAL DATA COMES WITH FILE: NO MAY USER OVERRIDE DATA UPDATE: NO DD NUMBER: FACILITY BILLING ID (File-top level) FIELD NUMBER: FORM TYPE APPLIED TO UPDATE THE DATA DICTIONARY: YES SEND SECURITY CODE: YES SEND FULL OR PARTIAL DD: PARTIAL DATA COMES WITH FILE: NO MAY USER OVERRIDE DATA UPDATE: NO DD NUMBER: IB INS CO PROVIDER ID CARE UNIT (File-top level) FIELD NUMBER: FORM TYPE APPLIED TO UPDATE THE DATA DICTIONARY: YES SEND SECURITY CODE: YES SEND FULL OR PARTIAL DD: PARTIAL DATA COMES WITH FILE: NO MAY USER OVERRIDE DATA UPDATE: NO DD NUMBER: INSURANCE COMPANY (File-top level) FIELD NUMBER: HOSPITAL PROVIDER NUMBER FORM TYPE PERF PROV SECOND ID TYPE UB SECONDARY ID REQUIREMENTS UPDATE THE DATA DICTIONARY: YES SEND SECURITY CODE: YES SEND FULL OR PARTIAL DD: PARTIAL DATA COMES WITH FILE: NO MAY USER OVERRIDE DATA UPDATE: NO DD NUMBER: EDI TRANSMISSION BATCH (File-top level) FIELD NUMBER: BILL TYPE UPDATE THE DATA DICTIONARY: YES SEND SECURITY CODE: YES SEND FULL OR PARTIAL DD: PARTIAL DATA COMES WITH FILE: NO MAY USER OVERRIDE DATA UPDATE: NO DD NUMBER: IB EDI TRANSMISSION RULE (File-top level) FIELD NUMBER: FORM TYPE TYPE OF RULE BILL TYPE RESTRICTIONS (sub-file) FIELD NUMBER: BILL TYPE UPDATE THE DATA DICTIONARY: YES SEND SECURITY CODE: YES SEND FULL OR PARTIAL DD: PARTIAL DATA COMES WITH FILE: NO MAY USER OVERRIDE DATA UPDATE: NO UPDATE THE DATA DICTIONARY: NO SEND SECURITY CODE: NO SEND FULL OR PARTIAL DD: FULL RESOLVE POINTERS: YES DATA COMES WITH FILE: YES SITE'S DATA: OVERWRITE MAY USER OVERRIDE DATA UPDATE: NO SCREEN TO SELECT DATA: I $$INCLUDE^IBY349PR(5,Y) UPDATE THE DATA DICTIONARY: NO SEND SECURITY CODE: NO SEND FULL OR PARTIAL DD: FULL RESOLVE POINTERS: YES DATA COMES WITH FILE: YES SITE'S DATA: OVERWRITE MAY USER OVERRIDE DATA UPDATE: NO SCREEN TO SELECT DATA: I $$INCLUDE^IBY349PR(6,Y) UPDATE THE DATA DICTIONARY: NO SEND SECURITY CODE: NO SEND FULL OR PARTIAL DD: FULL RESOLVE POINTERS: YES DATA COMES WITH FILE: YES SITE'S DATA: OVERWRITE MAY USER OVERRIDE DATA UPDATE: NO SCREEN TO SELECT DATA: I $$INCLUDE^IBY349PR(7,Y) DD NUMBER: BILL/CLAIMS (File-top level) FIELD NUMBER: LOCATION OF CARE BILL CLASSIFICATION TIMEFRAME OF BILL UB-04 LOCATION OF CARE UB-04 BILL CLASSIFICATION UB-04 TIMEFRAME OF BILL PATIENT SHORT MAILING ADDRESS PRIMARY PROVIDER # SECONDARY PROVIDER # TERTIARY PROVIDER # TREATMENT AUTHORIZATION CODE UB82 FORM LOCATOR 2 FORM LOCATOR 9 FORM LOCATOR 27 FORM LOCATOR 45 BILL COMMENT FORM LOCATOR 92 ADMITTING DIAGNOSIS COVERED DAYS NON-COVERED DAYS CO-INSURANCE DAYS SECONDARY AUTHORIZATION CODE TERTIARY AUTHORIZATION CODE PRINT FACILITY DATA IN BOX 32 BILL REMARKS UB92 FORM LOCATOR 2 FORM LOCATOR 11 FORM LOCATOR 31 FORM LOCATOR 64A FORM LOCATOR 64B FORM LOCATOR 64C FORM LOCATOR 56 FORM LOCATOR 57 FORM LOCATOR 78 PROCEDURES (sub-file) FIELD NUMBER: ASSOCIATED DIAGNOSIS (1) ASSOCIATED DIAGNOSIS (2) ASSOCIATED DIAGNOSIS (3) ASSOCIATED DIAGNOSIS (4) PRINT ORDER TYPE OF SERVICE REVENUE CODE (sub-file) FIELD NUMBER: *UB92 FORM LOCATOR 49 UPDATE THE DATA DICTIONARY: YES SEND SECURITY CODE: YES SEND FULL OR PARTIAL DD: PARTIAL DATA COMES WITH FILE: NO MAY USER OVERRIDE DATA UPDATE: NO DD NUMBER: MCCR UTILITY (File-top level) FIELD NUMBER: OCC RELATED TO UPDATE THE DATA DICTIONARY: YES SEND SECURITY CODE: YES SEND FULL OR PARTIAL DD: PARTIAL DATA COMES WITH FILE: NO MAY USER OVERRIDE DATA UPDATE: NO UPDATE THE DATA DICTIONARY: YES SEND SECURITY CODE: NO SEND FULL OR PARTIAL DD: FULL DATA COMES WITH FILE: NO
SEQ#	334
BUILD COMPONENTS	ENTRIES: IB SCREEN8H FILE #399 FILE: BILL/CLAIMS ACTION: SEND TO SITE IB SCREEN82 FILE #399 FILE: BILL/CLAIMS ACTION: SEND TO SITE IBEDIT INS CO1 FILE #36 FILE: File: 1, IEN: 36 ACTION: SEND TO SITE IB SCREEN6 FILE #399 FILE: BILL/CLAIMS ACTION: SEND TO SITE IB SCREEN7 FILE #399 FILE: BILL/CLAIMS ACTION: SEND TO SITE IB SCREEN1 FILE #399 FILE: BILL/CLAIMS ACTION: SEND TO SITE IB SCREEN8 FILE #399 FILE: BILL/CLAIMS ACTION: SEND TO SITE IB SCREEN4 FILE #399 FILE: BILL/CLAIMS ACTION: SEND TO SITE ENTRIES: IBCEF1 ACTION: SEND TO SITE CHECKSUM: B53245090 IBCEF11 ACTION: SEND TO SITE CHECKSUM: B48127699 IBCEU5 ACTION: SEND TO SITE CHECKSUM: B87835412 IBCEQ1 ACTION: SEND TO SITE CHECKSUM: B30648682 IBCEQ1A ACTION: SEND TO SITE CHECKSUM: B62926268 IBCERP6 ACTION: SEND TO SITE CHECKSUM: B24261779 IBCEU ACTION: SEND TO SITE CHECKSUM: B57127468 IBCEU0 ACTION: SEND TO SITE CHECKSUM: B62153346 IBCEU2 ACTION: SEND TO SITE CHECKSUM: B56928626 IBCEXTRP ACTION: SEND TO SITE CHECKSUM: B22039999 IBCF ACTION: SEND TO SITE CHECKSUM: B24102162 IBCEF3 ACTION: SEND TO SITE CHECKSUM: B46268284 IBCFP1 ACTION: SEND TO SITE CHECKSUM: B34736940 IBCNSC01 ACTION: SEND TO SITE CHECKSUM: B48419928 IBCNSC1 ACTION: SEND TO SITE CHECKSUM: B65094362 IBCSC4 ACTION: SEND TO SITE CHECKSUM: B22332423 IBCU4 ACTION: SEND TO SITE CHECKSUM: B17693963 IBJTBA ACTION: SEND TO SITE CHECKSUM: B47553598 IBJTBA1 ACTION: SEND TO SITE CHECKSUM: B26877071 IBJTBC ACTION: SEND TO SITE CHECKSUM: B13013403 IBCF33 ACTION: SEND TO SITE CHECKSUM: B31973795 IBCSC8H ACTION: SEND TO SITE CHECKSUM: B33583237 IBCBB1 ACTION: SEND TO SITE CHECKSUM: B70135753 IBCBB21 ACTION: SEND TO SITE CHECKSUM: B10829240 IBCBB3 ACTION: SEND TO SITE CHECKSUM: B37225304 IBCEOB1 ACTION: SEND TO SITE CHECKSUM: B69169596 IBCEMRAA ACTION: SEND TO SITE CHECKSUM: B61798719 IBCBB8 ACTION: SEND TO SITE CHECKSUM: B4642279 IBCE837 ACTION: SEND TO SITE CHECKSUM: B82438812 IBCECOB4 ACTION: SEND TO SITE CHECKSUM: B34090702 IBCSCE ACTION: SEND TO SITE CHECKSUM: B14217145 IBCECOB5 ACTION: SEND TO SITE CHECKSUM: B13398553 IBCECSA5 ACTION: SEND TO SITE CHECKSUM: B62746487 IBCEF2 ACTION: SEND TO SITE CHECKSUM: B53903581 IBCEF22 ACTION: SEND TO SITE CHECKSUM: B52106321 IBCEF31 ACTION: SEND TO SITE CHECKSUM: B7985183 IBCEF4 ACTION: SEND TO SITE CHECKSUM: B29271038 IBCEFG1 ACTION: SEND TO SITE CHECKSUM: B26630861 IBCEM03 ACTION: SEND TO SITE CHECKSUM: B45643062 IBCEMSR ACTION: SEND TO SITE CHECKSUM: B49071063 IBCEMSR1 ACTION: SEND TO SITE CHECKSUM: B59770244 IBCSC82 ACTION: SEND TO SITE CHECKSUM: B20854750 IBCEMU2 ACTION: SEND TO SITE CHECKSUM: B35260966 IBCEOB00 ACTION: SEND TO SITE CHECKSUM: B60829108 IBCEP ACTION: SEND TO SITE CHECKSUM: B21937532 IBCEP0 ACTION: SEND TO SITE CHECKSUM: B68376329 IBCEP2 ACTION: SEND TO SITE CHECKSUM: B43750443 IBCEP2A ACTION: SEND TO SITE CHECKSUM: B43323915 IBCEP3 ACTION: SEND TO SITE CHECKSUM: B36442740 IBCEP4 ACTION: SEND TO SITE CHECKSUM: B23664048 IBCEP4A ACTION: SEND TO SITE CHECKSUM: B49631156 IBCEP5 ACTION: SEND TO SITE CHECKSUM: B48846448 IBCSCH ACTION: SEND TO SITE CHECKSUM: B74472704 IBCEP5B ACTION: SEND TO SITE CHECKSUM: B41204243 IBCEP5C ACTION: SEND TO SITE CHECKSUM: B44199946 IBCEP5D ACTION: SEND TO SITE CHECKSUM: B62438221 IBCEP7 ACTION: SEND TO SITE CHECKSUM: B49016405 IBCEP7C ACTION: SEND TO SITE CHECKSUM: B59638074 IBCEP9 ACTION: SEND TO SITE CHECKSUM: B73704936 IBCEPB ACTION: SEND TO SITE CHECKSUM: B7676163 IBCEPTC ACTION: SEND TO SITE CHECKSUM: B73846372 IBCEPTC2 ACTION: SEND TO SITE CHECKSUM: B48277704 IBCEPTR ACTION: SEND TO SITE CHECKSUM: B102679616 IBJPS ACTION: SEND TO SITE CHECKSUM: B5288376 IBCEF73 ACTION: SEND TO SITE CHECKSUM: B54498448 IBCEF7 ACTION: SEND TO SITE CHECKSUM: B49975711 IBCEF71 ACTION: SEND TO SITE CHECKSUM: B63782219 IBCEF72 ACTION: SEND TO SITE CHECKSUM: B53742177 IBCEF76 ACTION: SEND TO SITE CHECKSUM: B34168446 IBCSC1 ACTION: SEND TO SITE CHECKSUM: B6857570 IBCCC2 ACTION: SEND TO SITE CHECKSUM: B66228987 IBCBB2 ACTION: SEND TO SITE CHECKSUM: B42055097 IBCBB9 ACTION: SEND TO SITE CHECKSUM: B10249958 IBJPS2 ACTION: SEND TO SITE CHECKSUM: B48618964 IBCEF74A ACTION: SEND TO SITE CHECKSUM: B19511866 IBCEMCA3 ACTION: SEND TO SITE CHECKSUM: B52111950 IBCEMRAB ACTION: SEND TO SITE CHECKSUM: B52118593 IBCEP7B ACTION: SEND TO SITE CHECKSUM: B7401780 IBCEP8A ACTION: SEND TO SITE CHECKSUM: B25658990 IBCEU1 ACTION: SEND TO SITE CHECKSUM: B41905172 IBCU63 ACTION: SEND TO SITE CHECKSUM: B16132764 IBCU71 ACTION: SEND TO SITE CHECKSUM: B21952006 IBCVA1 ACTION: SEND TO SITE CHECKSUM: B20900613 IBCEF77 ACTION: SEND TO SITE CHECKSUM: B24927059
POST-INSTALL ROUTINE	IBY349PO
DELETE POST-INIT ROUTINE	Yes
PRE-INSTALL ROUTINE	IBY349PR
DELETE PRE-INIT ROUTINE	Yes

IB*2.0*349 (7266) BUILD (9.6)

IB2.0349 (7266) BUILD (9.6)