IB ACCESS TO FB #162 ICR (6383)

Name

Value

NUMBER

6383

IA #

6383

FILE NUMBER

162

GLOBAL ROOT

FBAAC

DATE CREATED

2016/03/03

CUSTODIAL PACKAGE

FEE BASIS

USAGE

Private

TYPE

File

DBIC APPROVAL STATUS

APPROVED

NAME

IB ACCESS TO FB #162

GENERAL DESCRIPTION

Integrated Billing (IB) accesses the Fee Basis Payment
File (#162) in order to submit claims to third party payers for reimbursement
of Fee Basis payments. This is read only access.

GLOBAL REFERENCE

FIELD NUMBER

FBAAC(D0,1,D1,1,D2,1,0)

FIELD NUMBER	ACCESS	FIELD NAME	LOCATION
2	Read w/Fileman	SERVICE PROVIDED	0;1

FBAAC(D0,1,D1,1,D2,1,D3,0)

FIELD NUMBER	ACCESS	FIELD NAME	LOCATION
.01	Read w/Fileman	SERVICE PROVIDED	0;1
2	Read w/Fileman	AMOUNT PAID	0;3
23	Read w/Fileman	FEE PROGRAM	0;9
26	Read w/Fileman	PRIMARY SERVICE FACILITY	0;12
27	Read w/Fileman	ASSOCIATED 7078/583	0;13
12	Read w/Fileman	DATE PAID	0;14
14	Read w/Fileman	INVOICE NUMBER	0;16
16	Read w/Fileman	PURPOSE OF VISIT	0;18
28	Read w/Fileman	PRIMARY DIAGNOSIS	0;23

FBAAC(D0,1,D1,1,D2,1,D3,3)

FIELD NUMBER	ACCESS	FIELD NAME	LOCATION
15.5	Read w/Fileman	AUTHORIZATION POINTER	3;9

FBAAC(D0,1,D1,1,D2,1,D3,4)

FIELD NUMBER	ACCESS	FIELD NAME	LOCATION
63	Read w/Fileman	RENDERING PROV NAME	4;6
64	Read w/Fileman	RENDERING PROV NPI	4;7
65	Read w/Fileman	RENDERING PROV TAXONOMY CODE	4;8

FBAAC(D0,1,D1,1,D2,0)

FIELD NUMBER	ACCESS	FIELD NAME	LOCATION
.01	Read w/Fileman	INITIAL TREATMENT DATE	0;1

STATUS

Active

KEYWORDS

IB
FB
FBAAC
162
162.03
FEE BASIS PAYMENT

DURATION

Till Otherwise Agreed

FBAAC

SUBSCRIBING PACKAGE

INTEGRATED BILLING

DATE ACTIVATED

2016/05/18