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LIGHTHOUSE INSURANCE VERIFICATION PROCESSOR ICR ICR (7318)

LIGHTHOUSE INSURANCE VERIFICATION PROCESSOR ICR    ICR (7318)

Name Value
NUMBER 7318
IA # 7318
FILE NUMBER 355.33
GLOBAL ROOT IBA(355.33,
DATE CREATED 2021/12/23
CUSTODIAL PACKAGE INTEGRATED BILLING
USAGE Private
TYPE File
NAME LIGHTHOUSE INSURANCE VERIFICATION PROCESSOR ICR
GENERAL DESCRIPTION 
Lighthouse requires access to the INSURANCE
VERIFICATION PROCESSOR file #355.33 to support the AMCMS/WellHive Insurance
Capture initiative.
GLOBAL REFERENCE
GLOBAL REFERENCE FIELD NUMBER
IBA(355.33,D0,0)
FIELD NUMBER ACCESS FIELD NAME LOCATION
.01 LAYGO DATE ENTERED 0;1
.02 Both R/W w/Fileman ENTERED BY 0;2
.03 Both R/W w/Fileman SOURCE OF INFORMATION 0;3
.04 Both R/W w/Fileman STATUS 0;4
.13 Both R/W w/Fileman OVERRIDE FRESHNESS 0;13
.18 Both R/W w/Fileman SERVICE DATE 0;18
20.01 Both R/W w/Fileman INSURANCE COMPANY NAME 20;1
20.02 Both R/W w/Fileman PHONE NUMBER 20;2
20.03 Both R/W w/Fileman BILLING PHONE NUMBER 20;3
20.04 Both R/W w/Fileman PRECERTIFICATION PHONE NUMBER 20;4
20.05 Both R/W w/Fileman REIMBURSE? 20;5
21.01 Both R/W w/Fileman STREET ADDRESS [LINE 1] 21;1
21.02 Both R/W w/Fileman STREET ADDRESS [LINE 2] 21;2
21.03 Both R/W w/Fileman STREET ADDRESS [LINE 3] 21;3
21.04 Both R/W w/Fileman CITY 21;4
21.05 Both R/W w/Fileman STATE 21;5
21.06 Both R/W w/Fileman ZIP CODE 21;6
40.01 Both R/W w/Fileman IS THIS A GROUP POLICY? 40;1
40.04 Both R/W w/Fileman UTILIZATION REVIEW REQUIRED 40;4
40.05 Both R/W w/Fileman PRECERTIFICATION REQUIRED 40;5
40.06 Both R/W w/Fileman AMBULATORY CARE CERTIFICATION 40;6
40.09 Both R/W w/Fileman TYPE OF PLAN 40;9
40.1 Both R/W w/Fileman BANKING IDENTIFICATION NUMBER 40;10
40.11 Both R/W w/Fileman PROCESSOR CONTROL NUMBER 40;11
60.01 Both R/W w/Fileman PATIENT NAME 60;1
60.02 Both R/W w/Fileman EFFECTIVE DATE 60;2
60.03 Both R/W w/Fileman EXPIRATION DATE 60;3
60.05 Both R/W w/Fileman WHOSE INSURANCE 60;5
60.08 Both R/W w/Fileman INSURED'S DOB 60;8
60.09 Both R/W w/Fileman INSURED'S SSN 60;8
60.1 Both R/W w/Fileman PRIMARY CARE PROVIDER 60;10
60.11 Both R/W w/Fileman PRIMARY PROVIDER PHONE 60;11
60.12 Both R/W w/Fileman COORDINATION OF BENEFITS 60;12
60.13 Both R/W w/Fileman INSURED'S SEX 60;13
60.14 Both R/W w/Fileman PT. RELATIONSHIP - HIPAA 60;14
60.15 Both R/W w/Fileman PHARMACY RELATIONSHIP CODE 60;15
60.16 Both R/W w/Fileman PHARMACY PERSON CODE 60;16
62.01 Both R/W w/Fileman PATIENT ID 62;1
62.02 Both R/W w/Fileman SUBSCRIBER ADDRESS LINE 1 62;2
62.03 Both R/W w/Fileman SUBSCRIBER ADDRESS LINE 2 62;3
62.04 Both R/W w/Fileman SUBSCRIBER ADDRESS CITY 62;4
62.05 Both R/W w/Fileman SUBSCRIBER ACCESS STATE 62;5
62.06 Both R/W w/Fileman SUBSCRIBER ADDRESS ZIP 62;6
62.08 Both R/W w/Fileman SUBSCRIBER ADDRESS SUBDIVISION 62;8
62.09 Both R/W w/Fileman SUBSCRIBER PHONE 62;9
80.01 Both R/W w/Fileman INQ SERVICE TYPE CODE 1 80;1
90.01 Both R/W w/Fileman GROUP NAME 90;1
90.02 Both R/W w/Fileman GROUP NUMBER 90;2
90.03 Both R/W w/Fileman SUBSCRIBER ID 90;3
91.01 Both R/W w/Fileman NAME OF INSURED 91;1
40.07 Both R/W w/Fileman EXCLUDE PREEXISTING CONDITION 40;7
40.08 Both R/W w/Fileman BENEFITS ASSIGNABLE 40;8
62.07 Both R/W w/Fileman SUBSCRIBER ADDRESS COUNTRY 62;7
STATUS Withdrawn
ID IBA(355.33,
SUBSCRIBING PACKAGE LIGHTHOUSE