Print Page as PDF
PATIENT INSURANCE ACCESS ICR (5304)

PATIENT INSURANCE ACCESS    ICR (5304)

Name Value
NUMBER 5304
IA # 5304
FILE NUMBER 2
GLOBAL ROOT DPT(
DATE CREATED 2008/11/24
CUSTODIAL PACKAGE INTEGRATED BILLING
USAGE Private
TYPE File
DBIC APPROVAL STATUS APPROVED
NAME PATIENT INSURANCE ACCESS
GENERAL DESCRIPTION
The DSIV package is requesting FileMan read access to
the Insurance Type data in file #2 PATIENT for the Insurance Capture Buffer
application in order to display insurance information to the user.

IB*2*497 increased the length of the SUBSCRIBER ID field and the NAME OF
INSURED 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 2 fields to new Data Dictionary nodes in the INSURANCE TYPE
sub-file. 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 a
IB*2*518. Old and new fields are noted in the field list detail of this ICR.

Update:  IB*2*528 increased the length of the COMMENT-PATIENT POLICY field
(2.312, 1.08) from 80 characters to 250 characters; and therefore it was
necessary to move this field to a new subscript in the INSURANCE TYPE sub-file
(2.312). All subscribers to this ICR will need to make the necessary changes
in their applications to reference the new field.  Old and new fields are
noted in the INSURANCE TYPE multiple details below.


^DPT(D0,.31)
.3192  COVERED BY HEALTH INSURANCE?  .31;11  Fileman read/write
insurance verification
INSURANCE TYPE MULTIPLE access:
^DPT(D0,.312,D1,0)
.01   INSURANCE TYPE                 0;1  Read w/FileMan
1    *SUBSCRIBER ID                 0;2  Read w/FileMan
Note: IB*2*497 - Replaced by field 7.02
2    *GROUP NUMBER                  0;3  Read w/FileMan
3    INSURANCE EXPIRATION DATE      0;4  Read w/FileMan
6    WHOSE INSURANCE                0;6  Read w/FileMan
8    EFFECTIVE DATE OF POLICY       0;8  Read w/FileMan
15   *GROUP NAME                    0;15 Read w/FileMan
16   PT. RELATIONSHIP TO INSURED    0;16 Read w/FileMan
17   *NAME OF INSURED               0;17 Read w/FileMan
Note: IB*2*497 - Replaced by field 7.01
.18   GROUP PLAN                     0;18 Read w/FileMan
.2    COORDINATION OF BENEFITS       0;20 Read w/FileMan
^DPT(D0,.312,D1,1)
1.01  DATE ENTERED                   1;1  Read w/FileMan
1.02  ENTERED BY                     1;2  Read w/FileMan
1.03  DATE LAST VERIFIED             1;3  Read w/FileMan
1.04  VERIFIED BY                    1;4  Read w/FileMan
1.05  DATE LAST EDITED               1;5  Read w/FileMan
1.06  LAST EDITED BY                 1;6  Read w/FileMan
1.08  *COMMENT - PATIENT POLICY      1;8  Read w/FileMan
Note:  IB*2*528 - 1.08 replaced by COMMENT-SUBSCRIBER POLICY multiple
1.09  SOURCE OF INFORMATION          1;9  Read w/FileMan
1.1   DATE OF SOURCE OF INFORMATION  1;10 Read w/FileMan
^DPT(D0,.312,D1,2)
2.01  SEND BILL TO EMPLOYER          2;1  Read w/FileMan
2.02  EMPLOYER CLAIMS STREET ADDRESS 2;2  Read w/FileMan
2.03  EMPLOY CLAIM ST ADDRESS LINE 2 2;3  Read w/FileMan
2.04  EMPLOY CLAIM ST ADDRESS LINE 3 2;4  Read w/FileMan
2.05  EMPLOYER CLAIMS CITY           2;5  Read w/FileMan
2.06  EMPLOYER CLAIMS STATE          2;6  Read w/FileMan
2.07  EMPLOYER CLAIMS ZIP CODE       2;7  Read w/FileMan
2.08  EMPLOYER CLAIMS PHONE          2;8  Read w/FileMan
2.015 SUBSCRIBER'S EMPLOYER NAME     2;9  Read w/FileMan
2.1   ESGHP                          2;10 Read w/FileMan
2.11  EMPLOYMENT STATUS              2;11 Read w/FileMan
2.12  RETIREMENT DATE                2;12 Read w/FileMan
^DPT(D0,.312,D1,3)
3.01  INSURED'S DOB                  3;1  Read w/FileMan
3.02  INSURED'S BRANCH               3;2  Read w/FileMan
3.03  INSURED'S RANK                 3;3  Read w/FileMan
3.04  POLICY NOT BILLABLE            3;4  Read w/FileMan
3.05  INSURED'S SSN                  3;5  Read w/FileMan
3.06  INSURED'S STREET 1             3;6  Read w/FileMan
3.07  INSURED'S STREET 2             3;7  Read w/FileMan
3.08  INSURED'S CITY                 3;8  Read w/FileMan
3.09  INSURED'S STATE                3;9  Read w/FileMan
3.1   INSURED'S ZIP                  3;10 Read w/FileMan
3.11  INSURED'S PHONE                3;11 Read w/FileMan
3.12  INSURED'S SEX                  3;12 Read w/FileMan
^DPT(D0,.312,D1,4)
4.01  PRIMARY CARE PROVIDER          4;1  Read w/FileMan
4.02  PRIMARY PROVIDER PHONE         4;2  Read w/FileMan
4.03  PT. RELATIONSHIP - HIPAA       4;3  Read w/FileMan
^DPT(D0,.312,D1,5)
5.01  PATIENT ID                     5;1  Read w/FileMan
5.02  SUBSCRIBER'S SEC QUALIFIER(1)  5;2  Read w/FileMan
5.03  SUBSCRIBER'S SEC ID(1)         5;3  Read w/FileMan
5.04  SUBSCRIBER'S SEC QUALIFIER(2)  5;4  Read w/FileMan
5.05  SUBSCRIBER'S SEC ID(2)         5;5  Read w/FileMan
5.06  SUBSCRIBER'S SEC QUALIFIER(3)  5;6  Read w/FileMan
5.07  SUBSCRIBER'S SEC ID(3)         5;7  Read w/FileMan
5.08  PATIENT'S SEC QUALIFIER(1)     5;8  Read w/FileMan
5.09  PATIENT'S SECONDARY ID(1)      5;9  Read w/FileMan
5.1   PATIENT'S SEC QUALIFIER(2)     5;10 Read w/FileMan
5.11  PATIENT'S SECONDARY ID(2)      5;11 Read w/FileMan
5.12  PATIENT'S SEC QUALIFIER(3)     5;12 Read w/FileMan
5.13  PATIENT'S SECONDARY ID(3)      5;13 Read w/FileMan
^DPT(D0,.312,D1,7)
7.01  NAME OF INSURED                7;1  Read w/FileMan
7.02  SUBSCRIBER ID                  7;2  Read w/FileMan
^DPT(D0,.312,D1,13,D2,0)
.01 COMMENT DATE                   0;1  Read w/FileMan
.02 LAST EDITED                    0;2  Read w/FileMan
^DPT(D0,.312,D1,13,D2,1)
.03 COMMENT                        1;1  Read w/FileMan





STATUS Active
DURATION Till Otherwise Agreed
ID DPT(
SUBSCRIBING PACKAGE INSURANCE CAPTURE BUFFER
DATE ACTIVATED 2017/07/24