| GENERAL DESCRIPTION |
Update: IB*2*497 increased the length of the SUBSCRIBER
ID field, NAME OF INSURED field, GROUP NAME field, and GROUP NUMBER field to
support the EDI New Standards and Operating Rules for VHA providers. This
required length increase made it necessary to move the location of these 4
fields to new Data Dictionary nodes. To support this implementation, all
subscribers to this ICR will need to make the necessary changes in their
applications to reference the new fields and remove the references to the old
fields. When all subscribers have implemented the use of the new fields, the
old fields will be deleted with IB*2*518 patch. New fields are noted in the
field list detail of this ICR.
DSIV requests access to file 355.33 INSURANCE BUFFER to do the following for
its Insurance Capture Buffer (ICB) application to add/edit entries.
^IBA(355.33,D0,0)
.01 DATE ENTERED 0;1 FileMan read/write
.01 DATE ENTERED 0;1 Laygo new entry into file
.02 ENTERED BY 0;2 FileMan read/write
.03 SOURCE OF INFORMATION 0;3 FileMan read/write
.04 STATUS 0;4 FileMan read
.05 DATE PROCESSED 0;5 FileMan r,Direct Global r
.06 PROCESSED BY 0;6 FileMan read
.07 NEW COMPANY 0;7 FileMan read/write
.08 NEW GROUP/PLAN 0;8 FileMan read/write
.09 NEW POLICY 0;9 FileMan read/write
.1 DATE VERIFIED 0;10 FileMan read/write
.11 VERIFIED BY 0;11 FileMan read/write
.12 IIV STATUS 0;12 FileMan read/write
.13 OVERRIDE FRESHNESS FLAG 0;13 FileMan read
.14 REMOTE LOCATION 0;14 FileMan read
.15 IIV PROCESSED DATE 0;15 FileMan read
^IBA(355.33,D0,20)
20.01 INSURANCE COMPANY NAME 20;1 FileMan read/write
20.02 PHONE NUMBER 20;2 FileMan read/write
20.03 BILLING PHONE NUMBER 20;3 FileMan read/write
20.04 PRECERTIFICATION PHONE NUMBER 20;4 FileMan read/write
20.05 REIMBURSE? 20;5 FileMan read/write
^IBA(355.33,D0,21)
21.01 STREET ADDRESS [LINE 1] 21;1 FileMan read/write
21.02 STREET ADDRESS [LINE 2] 21;2 FileMan read/write
21.03 STREET ADDRESS [LINE 3] 21;3 FileMan read/write
21.04 CITY 21;4 FileMan read/write
21.05 STATE 21;5 FileMan read/write
21.06 ZIP CODE 21;6 FileMan read/write
^IBA(355.33,D0,40)
40.01 IS THIS A GROUP POLICY? 40;1 FileMan read/write
40.02 *GROUP NAME 40;2 FileMan read/write
Note: IB*2*497 - replaced by field 90.01
40.03 *GROUP NUMBER 40;3 FileMan read/write
Note: IB*2*497 - replaced by field 90.02
40.04 UTILITZATION REVIEW REQUIRED 40;4 FileMan read/write
40.05 PRECERTIFICATION REQUIRED 40;5 FileMan read/write
40.06 AMBULATORY CARE CERTIFICATION 40;6 FileMan read/write
40.07 EXCLUDE PREEXISTING CONDITION 40;7 FileMan read/write
40.08 BENEFITS ASSIGNABLE 40;8 FileMan read/write
40.09 TYPE OF PLAN 40;9 FileMan read/write
40.1 BANKING IDENTIFICATION NUMBER 40;10 FileMan read/write
40.11 PROCESSOR CONTROL NUMBER (PCN) 40;11 FileMan read/write
^IBA(355.33,D0,60)
60.01 PATIENT NAME 60;1 FileMan read/write
60.02 EFFECTIVE DATE 60;2 FileMan read/write
60.03 EXPIRATION DATE 60;3 FileMan read/write
60.04 *SUBSCRIBER ID 60;4 FileMan read/write
Note: IB*2*497 - replaced by field 90.03
60.05 WHOSE INSURANCE 60;5 FileMan read/write
60.06 PT. RELATIONSHIP TO INSURED 60;6 FileMan read/write
60.07 *NAME OF INSURED 60;7 FileMan read/write
Note: IB*2*497 - replaced by field 91.01
60.08 INSURED'S DOB 60;8 FileMan read/write
60.09 INSURED'S SSN 60;9 FileMan read/write
60.1 PRIMARY CARE PROVIDER 60;10 FileMan read/write
60.11 PRIMARY PROVIDER PHONE 60;11 FileMan read/write
60.12 COORDINATION OF BENEFITS 60;12 FileMan read/write
60.13 INSURED'S SEX 60;13 FileMan read/write
60.14 PT. RELATIONSHIP - HIPAA 60;14 FileMan read/write
^IBA(355.33,D0,61)
61.01 ESGHP? 61;1 FileMan read/write
61.02 SPONSORING EMPLOYER NAME 61;2 FileMan read/write
61.03 EMPLOYMENT STATUS 61;3 FileMan read/write
61.04 RETIREMENT DATE 61;4 FileMan read/write
61.05 SEND BILL TO EMPLOYER 61;5 FileMan read/write
61.06 EMPLOYER CLAIMS STREET LINE 1 61;6 FileMan read/write
61.07 EMPLOYER CLAIMS STREET LINE 2 61;7 FileMan read/write
61.08 EMPLOYER CLAIMS STREET LINE 3 61;8 FileMan read/write
61.09 EMPLOYER CLAIMS CITY 61;9 FileMan read/write
61.1 EMPLOYER CLAIMS STATE 61;10 FileMan read/write
61.11 EMPLOYER CLAIMS ZIP CODE 61;11 FileMan read/write
61.12 EMPLOYER CLAIMS PHONE NUMBER 61;12 FileMan read/write
^IBA(355.33,D0,62)
62.01 PATIENT ID 62;1 FileMan read/write
^IBA(355.33,D0,90)
90.01 GROUP NAME 90;1 FileMan read/write
90.02 GROUP NUMBER 90;2 FileMan read/write
90.03 SUBSCRIBER ID 90;3 FileMan read/write
^IBA(355.33,D0,91)
91.01 NAME OF INSURED 91;1 FileMan read/write
"C" cross reference (Patient) Direct Global read
"AEST" cross reference (Status) Direct Global read by
Date Entered "E" entries
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