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IBCNHUT1 (HPID/OEID) ICR (6061)

IBCNHUT1 (HPID/OEID)    ICR (6061)

Name Value
NUMBER 6061
IA # 6061
DATE CREATED 2014/05/28
CUSTODIAL PACKAGE INTEGRATED BILLING
USAGE Private
TYPE Routine
DBIC APPROVAL STATUS APPROVED
ROUTINE IBCNHUT1
NAME IBCNHUT1 (HPID/OEID)
GENERAL DESCRIPTION
The purpose of the standardized HPID is to eliminate
the ambiguity that presently exists in electronic standard healthcare
transactions, and to streamline the numerous ways in which the term "health
plan" is interpreted based on the different ways that health plans operate.
This ambiguity undermines the value of electronic transactions by requiring
repeated manual intervention.

Both the IB and BPS (e-Claims Mgmt) namespaces will be displaying the HPID on
various reports and screens, and BPS will need to be able to access the IB
utility that was developed to find, validate and display the HPID for a
particular health plan.

The functions of IBCNHUT1 will return the HPID/OEID for an insurance company
and validate that the HPID/OEID is in the correct format (10 numeric
characters, 1st character is a 6 or 7 and the 10th character is the Luhn
check-digit).
STATUS Active
KEYWORDS
  • HPID
  • IBCNHUT1
DURATION Till Otherwise Agreed
ID IBCNHUT1
COMPONENT/ENTRY POINT
COMPONENT/ENTRY POINT COMPONENT DESCRIPTION VARIABLES
HPD
HPD(INS,V) ; this function returns the HPID/OEID for
an insurance company.  The user must pass INS = Insurance Company ien in file
36 (required).  Optional variable: V = 1 means run validation checks (not
required), which  will append an '*'  to the HPID if it does NOT pass
validation checks

Output: Null if no HPID/OEID found for this insurance company ien - or - Data
string contained in field #36.08 (HPID/OEID) of file 36 for ien, - and - if
V=1 and the data string fails validation, the data string with a '*' added to
the end.
VARIABLES TYPE VARIABLES DESCRIPTION
INS Input
Insurance Company internal entry number in file 36
(required).
V Input
Validation flag (optional).  If set to 1, validation
checks will be run on the HPID and a "*" will be appended to the end of the
HPID if it fails the validation  checks.  If not set or V'=1, only the HPID
for the insurance company will be  returned, no validation checks will be run.
To call:  W !,"HPID/OEID:  ",$$HPD^IBCNHUT1(INS,1) for validation - or - W
!,"HPID/OEID:  ",$$HPD^IBCNHUT1(INS) if no validation is to occur.
HOD
HOD(ID,INS,IBHD) ; function to determine if the data
is an HPID, an OEID, or an invalid ID ID = data string to validate (required)
INS = insurance co. ien (optional) IBHD = Insurance co HPID in file 36
(optional)

HPID/OEID is a 10 character string with the 1st digit being 7 for HPID & 6 for
OEID and the 10th digit being a LUHN Check digit. If the data passed in the ID
variable does not meet these requirements, this function returns a -1 for
invalid ID.  Otherwise it returns an H for HPID or an O for OEID.

If the optional INS or IBHD values are passed, an additional validation check
will be done, comparing the ID to what is currently on file for that insurance
company ien (INS) or the IBHD value. If they do not match, this function will
return a -1 for invalid ID.

returns data string:    H for HPID, O for OEID, -1 for Invalid ID
to call:  W $$HOD^IBCNHUT1(X,INS) - or - I $$HOD^IBCNHUT1(X,INS) it is not
a valid ID
VARIABLES TYPE VARIABLES DESCRIPTION
ID Input
HPID/OEID value to be validated (required).  Returns
an H if the ID is an HPID, an O if the ID is an OEID, and a string of
"-1^HPID/OEID^*" if the ID failed the validation checks.  To call:  I
$$HOD^IBCNHUT1(X) it is not a valid ID.
INS Input
The insurance ien in file 36 (not required).  If it
exists, an additional validation check will be performed.  The ID value will
be compared with the HPID/OEID value in field 8.01 for the insurance ien in
file 36.  If they do not match, a string of "-1^HPID/OEID^*" will be returned
indicating the ID did not pass validation checks.
IBHD Input
The value of the field #8.01 in file 36 for insurance
company ien INS, if already known (not required).  If it exists, an additional
validation check will be performed.  The ID value will be compared with the
IBHD value.  If they do not match, a string of "-1^HPID/OEID^*" will be
returned indicating the ID did not pass validation checks.
SUBSCRIBING PACKAGE
SUBSCRIBING PACKAGE SUBSCRIBING DETAILS
E CLAIMS MGMT ENGINE
E-claims needs to display the validated HPID from the
insurance company file on their COB screens and reports.  E-claims needs to
validate the HPID from the BPS response file on their ECME Claims Log and the
Response Inquiry Report.
DATE ACTIVATED 2014/06/19