Print Page as PDF
LIGHTHOUSE INSURANCE COMPANY ICR ICR (7303)

LIGHTHOUSE INSURANCE COMPANY ICR    ICR (7303)

Name Value
NUMBER 7303
IA # 7303
FILE NUMBER 36
GLOBAL ROOT DIC(36,
DATE CREATED 2021/10/15
CUSTODIAL PACKAGE INTEGRATED BILLING
USAGE Private
TYPE File
NAME LIGHTHOUSE INSURANCE COMPANY ICR
GENERAL DESCRIPTION 
Lighthouse requires access to the INSURANCE COMPANY
file #36 to support the AMCMS/WellHive Insurance Capture initiative.
GLOBAL REFERENCE
GLOBAL REFERENCE FIELD NUMBER GLOBAL DESCRIPTION
DIC(36,D0,0)
FIELD NUMBER ACCESS FIELD NAME LOCATION
.01 Both R/W w/Fileman NAME 0;1
.05 Read w/Fileman INACTIVE 0;5
.06 Both R/W w/Fileman ALLOW MULTIPLE BEDSECTIONS 0;6
.07 Both R/W w/Fileman DIFFERENT REVENUE CODES TO USE 0;7
.08 Both R/W w/Fileman ONE OPT. VISIT ON BILL ONLY 0;8
.12 Both R/W w/Fileman FILING TIME FRAME 0;12
.13 Both R/W w/Fileman TYPE OF COVERAGE .12;9
.15 Both R/W w/Fileman PRESCRIPTION REFILL REV.CODE 0;15
.17 Both R/W w/Fileman PROFESSIONAL PROVIDER NUMBER 0;17
.18 Both R/W w/Fileman STANDARD FTF 0;18
.19 Both R/W w/Fileman STANDARD FTF VALUE 0;19
1 Direct Global R/W & w/Fileman REIMBURSE 0;2
2 Both R/W w/Fileman REIMBURSE 0;2
.09 Both R/W w/Fileman AMBULATORY SURG. REV. CODE 0;9
.1 Both R/W w/Fileman ATTENDING PHYSICIAN ID. 0;10
DIC(36,D0,.11)
FIELD NUMBER ACCESS FIELD NAME LOCATION
.111 Direct Global R/W & w/Fileman STREET ADDRESS [LINE 1] .11;1
.112 Both R/W w/Fileman STREET ADDRESS [LINE 2] .11;2
.113 Both R/W w/Fileman STREET ADDRESS [LINE 3] .11;3
.114 Direct Global R/W & w/Fileman CITY .11;4
.115 Both R/W w/Fileman STATE .11;5
.116 Both R/W w/Fileman ZIP CODE .11;6
.117 Both R/W w/Fileman BILLING COMPANY NAME .11;7
.119 Both R/W w/Fileman FAX NUMBER .11;9
DIC(36,D0,.12)
FIELD NUMBER ACCESS FIELD NAME LOCATION
.121 Both R/W w/Fileman CLAIMS (INPT) STREET ADDRESS 1 .12;1
.122 Both R/W w/Fileman CLAIMS (INPT) STREET ADDRESS 2 .12;2
.123 Both R/W w/Fileman CLAIMS (INPT) STREET ADDRESS 3 .12;3
.124 Both R/W w/Fileman CLAIMS (INPT) PROCESS CITY .12;4
.125 Both R/W w/Fileman CLAIMS (INPT) PROCESS STATE .12;5
.126 Both R/W w/Fileman CLAIMS (INPT) PROCESS ZIP .12;6
.127 Both R/W w/Fileman CLAIMS (INPT) COMPANY NAME .12;7
.128 Both R/W w/Fileman ANOTHER CO. PROCESS IP CLAIMS .12;8
.129 Both R/W w/Fileman CLAIMS (INPT) FAX .12;9
DIC(36,D0,.13)
FIELD NUMBER ACCESS FIELD NAME LOCATION
.131 Direct Global R/W & w/Fileman PHONE NUMBER .13;1
.132 Direct Global R/W & w/Fileman BILLING PHONE NUMBER .13;2
.1311 Both R/W w/Fileman CLAIMS (RX) PHONE NUMBER .13;11
.133 Direct Global R/W & w/Fileman PRECERTIFICATION PHONE NUMBER .13;3
.134 Both R/W w/Fileman VERIFICATION PHONE NUMBER .13;4
.135 Both R/W w/Fileman CLAIMS (INPT) PHONE NUMBER .13;5
.136 Both R/W w/Fileman CLAIMS (OPT) PHONE NUMBER .13;6
.137 Both R/W w/Fileman APPEALS PHONE NUMBER .13;7
.138 Both R/W w/Fileman INQUIRY PHONE NUMBER .13;8
.139 Both R/W w/Fileman PRECERT COMPANY NAME .13;9
DIC(36,D0,.14)
FIELD NUMBER ACCESS FIELD NAME LOCATION
.141 Both R/W w/Fileman APPEALS ADDRESS ST. [LINE 1] .14;1
.142 Both R/W w/Fileman APPEALS ADDRESS ST. [LINE 2] .14;2
.143 Both R/W w/Fileman APPEALS ADDRESS ST. [LINE 3] .14;3
.144 Both R/W w/Fileman APPEALS ADDRESS CITY .14;4
.145 Both R/W w/Fileman APPEALS ADDRESS STATE .14;5
.146 Both R/W w/Fileman APPEALS ADDRESS ZIP .14;6
.147 Both R/W w/Fileman APPEALS COMPANY NAME .14;7
.148 Both R/W w/Fileman ANOTHER CO. PROCESS APPEALS .14;8
.149 Both R/W w/Fileman APPEALS FAX .14;9
DIC(36,D0,.15)
FIELD NUMBER ACCESS FIELD NAME LOCATION
.151 Both R/W w/Fileman INQUIRY ADDRESS ST. [LINE 1] .15;1
.152 Both R/W w/Fileman INQUIRY ADDRESS ST. [LINE 2] .15;2
.153 Both R/W w/Fileman INQUIRY ADDRESS ST. [LINE 3] .15;3
.154 Both R/W w/Fileman INQUIRY ADDRESS CITY .15;4
.155 Both R/W w/Fileman INQUIRY ADDRESS STATE .15;5
.156 Both R/W w/Fileman INQUIRY ADDRESS ZIP CODE .15;6
.157 Both R/W w/Fileman INQUIRY COMPANY NAME .15;7
.158 Both R/W w/Fileman ANOTHER CO. PROCESS INQUIRIES .15;8
.159 Both R/W w/Fileman INQUIRY FAX .15;9
DIC(36,D0,.16)
FIELD NUMBER ACCESS FIELD NAME LOCATION
.161 Both R/W w/Fileman CLAIMS (OPT) STREET ADDRESS 1 .16;1
.162 Both R/W w/Fileman CLAIMS (OPT) STREET ADDRESS 2 .16;2
.163 Both R/W w/Fileman CLAIMS (OPT) STREET ADDRESS 3 .16;3
.164 Both R/W w/Fileman CLAIMS (OPT) PROCESS CITY .16;4
.165 Both R/W w/Fileman CLAIMS (OPT) PROCESS STATE .16;5
.166 Both R/W w/Fileman CLAIMS (OPT) PROCESS ZIP .16;6
.167 Both R/W w/Fileman CLAIMS (OPT) COMPANY NAME .16;7
.168 Both R/W w/Fileman ANOTHER CO. PROCESS OP CLAIMS .16;8
.169 Both R/W w/Fileman CLAIMS (OPT) FAX .16;9
DIC(36,D0,.17)
FIELD NUMBER ACCESS FIELD NAME LOCATION
.178 Both R/W w/Fileman ANOTHER CO. PROCESS PRECERTS .17;8
DIC(36,D0,.18)
FIELD NUMBER ACCESS FIELD NAME LOCATION
.181 Both R/W w/Fileman CLAIMS (RX) STREET ADDRESS 1 .18;1
.182 Both R/W w/Fileman CLAIMS (RX) STREET ADDRESS 2 .18;2
.183 Both R/W w/Fileman CLAIMS (RX) STREET ADDRESS 3 .18;3
.184 Both R/W w/Fileman CLAIMS (RX) CITY .18;4
.185 Both R/W w/Fileman CLAIMS (RX) STATE .18;5
.186 Both R/W w/Fileman CLAIMS (RX) ZIP .18;6
.187 Both R/W w/Fileman CLAIMS (RX) COMPANY NAME .18;7
.188 Both R/W w/Fileman ANOTHER CO. PROCESS RX CLAIMS .18;8
.189 Both R/W w/Fileman CLAIMS (RX) FAX .18;9
DIC(36,D0,.19)
FIELD NUMBER ACCESS FIELD NAME LOCATION
.191 Both R/W w/Fileman CLAIMS (DENTAL) STREET ADDR 1 .19;1
.1911 Both R/W w/Fileman CLAIMS (DENTAL) PHONE NUMBER .19;11
.192 Both R/W w/Fileman CLAIMS (DENTAL) STREET ADDR 2 .19;2
.194 Both R/W w/Fileman CLAIMS (DENTAL) PROCESS CITY .19;4
.195 Both R/W w/Fileman CLAIMS (DENTAL) PROCESS STATE .19;5
.196 Both R/W w/Fileman CLAIMS (DENTAL) PROCESS ZIP .19;6
.197 Both R/W w/Fileman CLAIMS (DENTAL) COMPANY NAME .19;7
.198 Both R/W w/Fileman ANOTHER CO. PROC DENT CLAIMS .19;8
.199 Both R/W w/Fileman CLAIMS (DENTAL) FAX .19;9
DIC(36,D0,3)
FIELD NUMBER ACCESS FIELD NAME LOCATION
3.01 Both R/W w/Fileman TRANSMIT ELECTRONICALLY 3;1
3.02 Both R/W w/Fileman EDI ID NUMBER - PROF 3;2
3.03 Both R/W w/Fileman BIN NUMBER 3;3
3.04 Both R/W w/Fileman EDI ID NUMBER - INST 3;4
3.05 Both R/W w/Fileman LAST EXTRACT DATE FOR TEST 3;5
3.06 Both R/W w/Fileman MAX NUMBER TEST BILLS PER DAY 3;6
3.07 Both R/W w/Fileman NUMBER TEST BILLS FOR LAST DT 3;7
3.09 Both R/W w/Fileman ELECTRONIC INSURANCE TYPE 3;9
3.1 Both R/W w/Fileman PAYER 3;10
3.13 Both R/W w/Fileman INS COMPANY LINK TYPE 3;13
3.14 Both R/W w/Fileman INS COMPANY LINK PARENT 3;14
3.15 Both R/W w/Fileman EDI ID NUMBER - DENTAL 3;15
DIC(36,D0,4)
FIELD NUMBER ACCESS FIELD NAME LOCATION
4.01 Both R/W w/Fileman PERF PROV SECOND ID TYPE 1500 4;1
4.02 Both R/W w/Fileman PERF PROV SECOND ID TYPE UB 4;2
4.03 Both R/W w/Fileman SECONDARY ID REQUIREMENTS 4;3
4.04 Both R/W w/Fileman REF PROV SEC ID DEF CMS-1500 4;4
4.05 Both R/W w/Fileman REF PROV SEC ID REQ ON CLAIMS 4;5
4.06 Both R/W w/Fileman ATT/REND ID BILL SEC ID PROF 4;6
4.08 Both R/W w/Fileman ATT/REND ID BILL SEC ID INST 4;8
4.09 Both R/W w/Fileman PERF PROV CARE UNIT PROMPT 4;9
DIC(36,D0,6)
FIELD NUMBER ACCESS FIELD NAME LOCATION
6.01 Both R/W w/Fileman EDI INST SECONDARY ID QUAL(1) 6;1
6.02 Both R/W w/Fileman EDI INST SECONDARY ID(1) 6;2
6.03 Both R/W w/Fileman EDI INST SECONDARY ID QUAL(2) 6;3
6.04 Both R/W w/Fileman EDI INST SECONDARY ID(2) 6;4
6.05 Both R/W w/Fileman EDI PROF SECONDARY ID QUAL(1) 6;5
6.06 Both R/W w/Fileman EDI PROF SECONDARY ID(1) 6;6
6.07 Both R/W w/Fileman EDI PROF SECONDARY ID QUAL(2) 6;7
6.08 Both R/W w/Fileman EDI PROF SECONDARY ID(2) 6;8
6.09 Both R/W w/Fileman PRINT SEC/TERT AUTO CLAIMS 6;9
6.1 Both R/W w/Fileman PRINT SEC MED CLAIMS W/O MRA 6;10
DIC(36,D0,7)
FIELD NUMBER ACCESS FIELD NAME LOCATION
7.01 Both R/W w/Fileman EDI - UMO (278) ID 7;1
DIC(36,D0,8)
FIELD NUMBER ACCESS FIELD NAME LOCATION
8.01 Both R/W w/Fileman HPID/OEID 8;1
8.02 Both R/W w/Fileman CHP/SHP 8;2
8.03 Both R/W w/Fileman PARENT CHP (HPID) 8;3
8.04 Both R/W w/Fileman NIF ID 8;4
DIC(36,D0,10,D1,0)
FIELD NUMBER ACCESS FIELD NAME LOCATION
.01 Both R/W w/Fileman SYNONYM 0;1 
SYNONYM (Multiple-36.03)
DIC(36,D0,13,D1,0)
FIELD NUMBER ACCESS FIELD NAME LOCATION
.01 Both R/W w/Fileman PLAN TYPES NO BILL PRV SEC ID 0;1 
PLAN TYPES NO BILL PRV SEC ID (Multiple-36.013)
DIC(36,D0,17,D1,0)
FIELD NUMBER ACCESS FIELD NAME LOCATION
.01 Both R/W w/Fileman 277EDI ID NUMBER 0;1
.02 Both R/W w/Fileman 277DATE EDI ID NUMBER 0;2
.03 Both R/W w/Fileman 277EDI TYPE 0;3
.04 Both R/W w/Fileman 277EDI ID NUMBER ON FILE 0;4 
277EDI ID NUMBER (Multiple-36.017)
DIC(36,D0,AJK1UB)
FIELD NUMBER ACCESS FIELD NAME LOCATION
580950.01 Both R/W w/Fileman COLLECTIONS DOLLAR LIMIT AJK1UB;1
STATUS Withdrawn
DURATION Till Otherwise Agreed
ID DIC(36,
SUBSCRIBING PACKAGE LIGHTHOUSE