GLOBAL MAP DATA DICTIONARY #355.5 -- INSURANCE CLAIMS YEAR TO DATE FILE 3/24/25 PAGE 1 STORED IN ^IBA(355.5, *** NO DATA STORED YET *** SITE: WWW.BMIRWIN.COM UCI: VISTA,VISTA (VERSION 2.0) ----------------------------------------------------------------------------------------------------------------------------------- This file will contain the claim to date information about a patient's health insurance claims to a specific carrier for a specific year. This will allow estimate of receivables based on whether claims exceed deductibles or other maximum benefits. Per VHA Directive 10-93-142, this file definition should not be modified. CROSS REFERENCED BY: PATIENT(APPY), POLICY(APPY1), BENEFIT YEAR BEGINNING ON(APPY2), PATIENT POLICY POINTER(APPY3), POLICY(B), PATIENT(C) ^IBA(355.5,D0,0)= (#.01) POLICY [1P:355.3] ^ (#.02) PATIENT [2P:2] ^ (#.03) BENEFIT YEAR BEGINNING ON [3D] ^ (#.04) DEDUCTIBLE ==>MET? [4S] ^ (#.05) AMOUNT OF DEDUCTIBLE MET [5N] ^ (#.06) DEDUCTIBLE (INPT) MET? [6S] ^ (#.07) AMOUNT OF ==>DEDUCTIBLE (INP) MET [7N] ^ (#.08) DEDUCTIBLE (OPT) MET? [8S] ^ (#.09) AMOUNT OF DEDUCTIBLE (OPT) MET [9N] ^ ==>(#.1) AMT LIFETIME MAX USED (OPT) [10N] ^ (#.11) MH DEDUCTIBLE (INP) MET? [11S] ^ (#.12) AMOUNT OF MH (INP) DED ==>MET [12N] ^ (#.13) MH DEDUCTIBLE (OPT) MET? [13S] ^ (#.14) AMOUNT OF MH (OPT) DED MET [14N] ^ (#.15) ==>PRE-EXISTING CONDITIONS [15F] ^ (#.16) COORDINATION OF BENEFITS DATA [16F] ^ (#.17) PATIENT POLICY POINTER ==>[17N] ^ (#.18) AMT. MH LIFET. MAX USED (INPT) [18N] ^ (#.19) AMT LIFETIME MAX USED (INPT) [19N] ^ (#.2) AMT MH ==>LIFET MAX USED (OPT) [20N] ^ ^IBA(355.5,D0,1)= (#1.01) DATE ENTERED [1D] ^ (#1.02) ENTERED BY [2P:200] ^ (#1.03) DATE LAST VERIFIED [3D] ^ (#1.04) VERIFIED BY ==>[4P:200] ^ (#1.05) DATE LAST EDITED [5D] ^ (#1.06) EDITED BY [6P:200] ^ (#1.07) PERSON CONTACTED [7F] ^ (#1.08) ==>COMMENT - CLAIMS FILED [8F] ^ (#1.09) CONTACT'S PHONE NUMBER [9F] ^ INPUT TEMPLATE(S): ^DIE(567)= IBCN BU ADD COM ^DIE(571)= IBCN BU ED AL ^DIE(568)= IBCN BU INPT ^DIE(569)= IBCN BU OPT ^DIE(570)= IBCN BU POL PRINT TEMPLATE(S): SORT TEMPLATE(S): FORM(S)/BLOCK(S):