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IB BILLING DATA API ICR (4987)

IB BILLING DATA API    ICR (4987)

Name Value
NUMBER 4987
IA # 4987
DATE CREATED 2007/05/04
CUSTODIAL PACKAGE INTEGRATED BILLING
USAGE Private
TYPE Routine
DBIC APPROVAL STATUS APPROVED
ROUTINE IBRSUTL
NAME IB BILLING DATA API
GENERAL DESCRIPTION
This set of API's provide billing data related to
Outpatient Encounters and allows the update of an encounters billable status.
These are implemented to support the Automated Service Connected Designation
(ASCD) project.  This project may potentially update an encounters Service
Connected designation after the encounter's check-out.
STATUS Active
KEYWORDS
  • OUTPATIENT
  • ASCD
  • ENCOUNTER
DURATION Till Otherwise Agreed
ID IBRSUTL
COMPONENT/ENTRY POINT
COMPONENT/ENTRY POINT COMPONENT DESCRIPTION VARIABLES
RNBU(encounter,change)
Update an Outpatient Encounters Claims Tracking
Reason Not Billable.  When an encounters Service Connected designation is
changed after check-out this function may be used to update the encounters
Claims Tracking Reason Not Billable.

When the encounter is changed from NSC to SC the Claims Tracking record is
updated to non-billable only if it was identified as billable.  When the
encounter is changed from SC to NSC the Claims Tracking record is update to
billable only if it was identified as non-billable due to SC Treatment.
VARIABLES TYPE VARIABLES DESCRIPTION
encounter Input
IEN of Outpatient Encounter (#409.68)
change Input
1 - Encounter changed from NSC to SC              2 -
Encounter changed from SC to NSC
$$RNBU Output
Value returned by the function representing:      1 -
Claims Tracking record updated to non-billable If no Reason Not Billable then
SC TREATMENT added 2 - Claims Tracking record updated to billable      If
Reason Not Billable SC TREATMENT then deleted  0 - No change
CT(encounter)
Retrieve an Outpatient Encounters Claims Tracking
record.
VARIABLES TYPE VARIABLES DESCRIPTION
encounter Input
IEN of Outpatient Encounter (#409.68)
$$CT Output
Returns IEN of encounter in Claims Tracking (#356) or
returns null if no record found
FIRST(encounter)
Check if an Outpatient Encounter is billable for
First Party.  This function checks various elements related to the patient and
encounter.  Not all billable elements are checked, for example encounter
Classifications (SC/NSC) are not checked.
VARIABLES TYPE VARIABLES DESCRIPTION
encounter Input
IEN of Outpatient Encounter (#409.68)
$$FIRST Output
Returns encounter First Party billable status:    1 -
if encounter is billable to patient           0 ^ reason encounter not
billable
THIRD(encounter)
Check if an Outpatient Encounter is billable for
Third Party.  This function checks various elements related to the patient and
encounter.  Not all billable elements are checked, for example encounter
Classifications (SC/NSC) and patient insurance are not checked.
VARIABLES TYPE VARIABLES DESCRIPTION
encounter Input
IEN of Outpatient Encounter (#409.68)
$$THIRD Output
Returns encounter Third Party billable status:    1 -
if encounter is billable to insurance         0 ^ reason encounter not
billable
FPBILL(encounter)
Retrieve an Outpatient Encounters First Party bill
and charge.  The AR Bill number/transaction are only defined once charge is
passed to AR so a valid returned charge may only have a Total Charge defined.
VARIABLES TYPE VARIABLES DESCRIPTION
encounter Input
IEN of Outpatient Encounter (#409.68)
$$FPBILL Output
Returns encounters patient charge data if found: AR
BILL NUMBER (#350,.11) ^ AR TRANSACTION NUMBER (#350,.12) ^ TOTAL CHARGE
(#350,.07)             or returns null if no non-cancelled charge found
TPBILL(encounter)
Retrieve an Outpatient Encounters Third Party bills.
Encounters may have multiple Third Party bills.  This function returns a
string of all Third Party bills that have not been cancelled and have one of
the encounters procedures assigned.
VARIABLES TYPE VARIABLES DESCRIPTION
encounter Input
IEN of Outpatient Encounter (#409.68)
$$TPBILL Output
Returns encounters third party bill numbers:    BILL
NUMBER (#399,.01)^BILL NUMBER (#399,.01)^...  or returns null if no
non-cancelled bills found
TPCHG(encounter)
Calculate encounter's potential Third Party charges.
Based on encounters procedures and Reimbursable Insurance charges.
VARIABLES TYPE VARIABLES DESCRIPTION
encounter Input
IEN of Outpatient Encounter (#409.68)
$$TPCHG Output
Returns potential Third Party charges for the
procedures assigned to an encounter:            Total Institutional ^ Total
Professional charges or returns 0 if not billable or no charges found
SUBSCRIBING PACKAGE SCHEDULING
CREATOR HARPER,AMY R
DATE ACTIVATED 2007/09/19
DATE/TIME EDITED
DATE/TIME EDITED ACTION AT THE REQUEST OF WITH CONCURRENCE OF
2007/09/19 13:56 APPROVED HARPER,AMY FAIN,ZACH
Generated from AUG 12, 2020@ IA Listing Descriptions