IB ACCESS TO FB #161 ICR (6384)

Name

Value

NUMBER

6384

IA #

6384

FILE NUMBER

161

GLOBAL ROOT

FBAAA

DATE CREATED

2016/03/03

CUSTODIAL PACKAGE

FEE BASIS

USAGE

Private

TYPE

File

DBIC APPROVAL STATUS

APPROVED

NAME

IB ACCESS TO FB #161

GENERAL DESCRIPTION

Integrated Billing (IB) accesses the Fee Basis Payment
File (#161) in order to submit claims to third party payers for reimbursement
of Fee Basis payments. This is read only access.

GLOBAL REFERENCE

FIELD NUMBER

GLOBAL DESCRIPTION

FBAAA(D0,1,D1,0)

FIELD NUMBER	ACCESS	FIELD NAME	LOCATION
.01	Read w/Fileman	FROM DATE	0;1
.02	Read w/Fileman	TO DATE	0;2
.03	Read w/Fileman	FEE PROGRAM	0;3
.04	Read w/Fileman	VENDOR	0;4
101	Read w/Fileman	PRIMARY SERVICE AREA	0;5
.07	Read w/Fileman	PURPOSE OF VISIT CODE	0;7
.08	Read w/Fileman	DX LINE 1	0;8
.055	Read w/Fileman	ASSOCIATED 7078/583	0;9
.095	Read w/Fileman	TREATMENT TYPE CODE	0;13
.06	Read w/Fileman	DISCHARGE TYPE	0;15
.065	Read w/Fileman	PATIENT TYPE CODE	0;18
.096	Read w/Fileman	ACCIDENT RELATED (Y/N)	0;19
.097	Read w/Fileman	POTENTIAL COST RECOVERY CASE	0;20
104	Read w/Fileman	REFERRING PROVIDER	0;21
105	Read w/Fileman	CONTRACT	0;22

FBAAA(D0,1,D1,2,0)

FIELD NUMBER	ACCESS	FIELD NAME	LOCATION
.021	Read w/Fileman	AUTHORIZATION REMARKS	2;0

Used to identify limitations or detail specifics
regarding the authorization. The information contained here is displayed
during the enter payment option and also on patient inquiry option.

FBAAA(D0,1,D1,3)

FIELD NUMBER	ACCESS	FIELD NAME	LOCATION
.085	Read w/Fileman	DX LINE 2	3;1
.086	Read w/Fileman	DX LINE 3	3;2

FBAAA(D0,1,D1,C)

FIELD NUMBER	ACCESS	FIELD NAME	LOCATION
.087	Read w/Fileman	ICD DIAGNOSIS	C;2

STATUS

Active

KEYWORDS

161
FBAA
FEE BASIS CONTRACT FILE

DURATION

Till Otherwise Agreed

FBAAA

SUBSCRIBING PACKAGE

INTEGRATED BILLING

DATE ACTIVATED

2016/05/09