STANDARD DATA DICTIONARY #350.9 -- IB SITE PARAMETERS FILE 3/24/25 PAGE 1
STORED IN ^IBE(350.9, (1 ENTRY) SITE: WWW.BMIRWIN.COM UCI: VISTA,VISTA (VERSION 2.0)
DATA NAME GLOBAL DATA
ELEMENT TITLE LOCATION TYPE
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This file contains the data necessary to run the IB package, and to manage the IB background filer. The menu IB SITE MANAGER MENU
provides options that allow display and editing of data in this file, in addition to options to manage the IB background filer, for
the site manager.
The Billing Site Parameters are also found in this file. The option to edit these parameters is on the Billing Supervisor menu.
This file should always be edited by use of the provided options.
Per VHA Directive 10-93-142, this file definition should not be modified.
DD ACCESS: @
RD ACCESS: @
WR ACCESS: @
DEL ACCESS: @
LAYGO ACCESS: @
AUDIT ACCESS: @
IDENTIFIED BY: FACILITY NAME (#.02)[R]
CROSS
REFERENCED BY: NAME(B)
LAST MODIFIED: AUG 22,2024@15:15:17
350.9,.01 NAME 0;1 NUMBER (Required)
INPUT TRANSFORM: K:+X'=X!(X>1)!(X<1)!(X?.E1"."1N.N) X I $D(X) S DINUM=X
HELP-PROMPT: Type a Number between 1 and 1, 0 Decimal Digits
DESCRIPTION: You may only have one site parameter entry. Its internal number must be 1 and its name must be the
same.
DELETE TEST: 1,0)= I 1 W !,"Deleting site parameters not allowed!"
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
CROSS-REFERENCE: 350.9^B
1)= S ^IBE(350.9,"B",$E(X,1,30),DA)=""
2)= K ^IBE(350.9,"B",$E(X,1,30),DA)
350.9,.02 FACILITY NAME 0;2 POINTER TO INSTITUTION FILE (#4) (Required)
INPUT TRANSFORM: S DIC("S")="I $S('$D(^(99)):0,+^(99)<1:0,1:1)" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X
LAST EDITED: FEB 21, 1991
DESCRIPTION: This is the name of your facility from the institution file. There must be a station number
associated with this entry. This value will be used by IFCAP in determining the bill number.
SCREEN: S DIC("S")="I $S('$D(^(99)):0,+^(99)<1:0,1:1)"
EXPLANATION: Institution must have a facility number defined
350.9,.03 FILE IN BACKGROUND 0;3 SET
'1' FOR YES;
'0' FOR NO;
LAST EDITED: FEB 25, 1991
DESCRIPTION: Set this field to 'YES' to cause the IB Background Filer to run as a background job. If it is set
to 'NO' or left blank, filing will occur as applications pass data to Integrated Billing. Sites
may wish to experiment with running the filer in the foreground (answer 'NO') or filing in the
background. For Pharmacy Co-Pay, it is expected that some sites will experience significant delays
in Outpatient Pharmacy label printing if filing is not done in the background.
350.9,.04 FILER STARTED 0;4 DATE
INPUT TRANSFORM: S %DT="ESTXR" D ^%DT S X=Y K:Y<1 X
LAST EDITED: FEB 25, 1991
DESCRIPTION: This is the internal fileman date/time that the IBE filer was last started. This field should be
blank if the FILER STOPPED field contains data.
If this field contains a date/time and the field FILE IN BACKGROUND is answered 'YES' then it is
assumed that an IBE Filer is running. Use the option 'Start the Integrated Billing Background
Filer' to start a new filer if needed. This field is updated by the IBE Filer and should not be
edited with FileMan.
350.9,.05 FILER STOPPED 0;5 DATE
INPUT TRANSFORM: S %DT="ESTXR" D ^%DT S X=Y K:Y<1 X
LAST EDITED: FEB 25, 1991
DESCRIPTION: This is the internal fileman date/time that the IBE filer was last stopped. This field should be
blank if the FILER STARTED field contains data.
This field is updated by the IBE Filer. It should not be edited with FileMan.
350.9,.06 FILER LAST RAN 0;6 DATE
INPUT TRANSFORM: S %DT="ESTXR" D ^%DT S X=Y K:Y<1 X
LAST EDITED: FEB 25, 1991
DESCRIPTION: This is the date/time that the IBE Filer last passed data to the Accounts Receivable module of
IFCAP.
This field is updated by the IBE Filer and should not be edited with FileMan.
350.9,.07 FILER UCI,VOL 0;7 FREE TEXT
INPUT TRANSFORM: K:$L(X)>30!($L(X)<3) X
LAST EDITED: FEB 25, 1991
HELP-PROMPT: Answer must be 3-30 characters in length.
DESCRIPTION: This is the UCI and Volume set that you want the IBE Filer to run on. Vax sites should leave this
blank. It is recommended that the filer run on the volume set that contains either the IB globals
or the PRC globals.
350.9,.08 FILER HANG TIME 0;8 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>15)!(X<1)!(X?.E1"."1N.N) X
LAST EDITED: FEB 27, 1991
HELP-PROMPT: Type a Number between 1 and 15, 0 Decimal Digits
DESCRIPTION: This is the number of seconds that the filer will remain idle after finishing all transactions and
before checking for more transactions to file. The filer will shut itself down after 2000 hangs
with no activity detected. The default value for this field is 2 if left blank.
350.9,.09 COPAY BACKGROUND ERROR GROUP 0;9 POINTER TO MAIL GROUP FILE (#3.8)
LAST EDITED: FEB 20, 1992
DESCRIPTION: This is the mail group that will receive mail bulletins from the IBE filer when an unsuccessful
attempt to file is detected. Remember to add users to it.
350.9,.1 FILER QUEUED 0;10 SET
'1' FOR YES;
'0' FOR NO;
LAST EDITED: FEB 28, 1991
DESCRIPTION: This field will be set to 'YES' when a file job is queued and set back to 'NO' when the queued job
is started. It will be used to prevent queueing two or more jobs before the first job starts.
350.9,.11 MEANS TEST BILLING MAIL GROUP 0;11 POINTER TO MAIL GROUP FILE (#3.8)
LAST EDITED: JUN 25, 2001
DESCRIPTION: Members of this mail group will receive bulletins when Means Test billing processing errors have
been encountered, and when movements and Means Tests have been edited or deleted for veterans that
require Means Test charges.
350.9,.12 PER DIEM START DATE 0;12 DATE
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:3991231X) X
LAST EDITED: FEB 05, 1992
HELP-PROMPT: This is the date this hospital began the $5 and $10 Per Diem Billing. Enter a date no earlier than
11/5/90.
DESCRIPTION: This is the date that this facility counseled category C patients that they would have to pay the
new Per Diem charges and began the Per Diem billing.
This field represents the earliest date for which the Hospital ($10) or Nursing Home ($5) Per Diem
charge may be billed to a Category C patient. This billing is mandated by Public Law 101-508,
which was implemented on November 5, 1990.
Please note that the Per Diem billing will not occur if this field is null.
350.9,.13 COPAY EXEMPTION MAIL GROUP 0;13 POINTER TO MAIL GROUP FILE (#3.8)
LAST EDITED: JAN 15, 1993
HELP-PROMPT: Type a Number between 1 and 99, 0 Decimal Digits
DESCRIPTION:
This mail group will be sent the copay exemption bulletins and error messages.
350.9,.14 USE ALERTS 0;14 SET
'1' FOR YES;
'0' FOR NO;
LAST EDITED: FEB 04, 1993
DESCRIPTION: If a facility has installed Version 7 or higher of Kernel, then the site may decide whether to use
Alerts or Bulletins for internal messages in Integrated Billing. Initially this functionality will
only be available for the Medication Copayment Exemption functionality. If this is a desirable
feature it may be expanded in the future.
If this field is unanswered, the default is No and IB will use bulletins.
TECHNICAL DESCR: The node ^DD(200,0,"VR") is checked for version number. If the value of this node is less than 7
then the user will not be able to turn this feature on.
SCREEN: S DIC("S")="I 'Y!(+$G(^DD(200,0,""VR""))'<7)"
EXPLANATION: Version 7 of Kernel must be installed inorder to turn this feature on.
350.9,.15 SUPPRESS MT INS BULLETIN 0;15 SET
'1' FOR YES;
'0' FOR NO;
LAST EDITED: AUG 05, 1993
DESCRIPTION: This parameter is used to control the bulletin that is posted when any Means Test charge which
might be covered by the patient's health insurance is billed. If the site wishes to suppress this
bulletin, then this parameter should be answered 'Yes'.
350.9,.16 LAST LTC COMPLETION DATE 0;16 DATE
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:X<1 X
LAST EDITED: APR 23, 2002
HELP-PROMPT: Enter the date the last time LTC calculation was completed.
DESCRIPTION:
This is the last time the LTC background job was completed.
350.9,.17 DATE/TIME SYSTEM LAST UPDATED 0;17 DATE
INPUT TRANSFORM: S %DT="ESTX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: FEB 08, 2024
HELP-PROMPT: This field is set by the system and should not be directly edited.
DESCRIPTION: This field is set by the system and should not be directly edited. The IB MT NIGHT COMP nightly
process is supposed to run every night to run the batch billing processes. This parameter is set
upon completion of that process. If the process does not run to completion, certain events that
must occur may have not been run to completion.
350.9,1.01 NAME OF CLAIM FORM SIGNER 1;1 FREE TEXT
INPUT TRANSFORM: K:$L(X)>20!($L(X)<2) X
LAST EDITED: JAN 19, 1994
HELP-PROMPT: Enter the name of the person responsible for signing third party bills as it should appear on the
bills. Answer must be 2-20 characters in length
DESCRIPTION: This is the name of the signer of third party bills and will be printed on the claim form in the
signature block.
350.9,1.02 TITLE OF CLAIM FORM SIGNER 1;2 FREE TEXT
INPUT TRANSFORM: K:$L(X)>20!($L(X)<2) X
LAST EDITED: JAN 19, 1994
HELP-PROMPT: Enter the title of the person responsible for signing this bill as it should appear on the bill.
Answer must be 2-20 characters in length.
DESCRIPTION:
This is the title of the person signing the claim form as it will appear on the bill.
350.9,1.03 *CAN REVIEWER AUTHORIZE? 1;3 SET
'1' FOR YES;
'0' FOR NO;
LAST EDITED: APR 29, 1992
HELP-PROMPT: Enter 1 or 'YES' if the person who reviews a billing record is also able to authorize that record.
DESCRIPTION: Creating a third party bill is a 4 part process. The bill is Entered, Reviewed, Authorized, and
Printed. The bill is considered complete and passed to Accounts Receivable immediately after it
has been Authorized. This parameter is used to determine if the same person who Reviewed the bill
can Authorize the bill. If the paramater CAN INITIATOR REVIEW? and this parameter, CAN REVIEWER
AUTHORIZE?, are both answered "YES" then the same individual can perform all 4 parts of the billing
process. If either parameter is answered 'NO' then more than one person must be involved in each
bill.
TECHNICAL DESCR:
This field should be deleted in the next release of IB after v2.0.
350.9,1.04 *REMARKS ON EACH EDI CLAIM 1;4 FREE TEXT
INPUT TRANSFORM: K:$L(X)>39!($L(X)<2) X
LAST EDITED: DEC 03, 2007
HELP-PROMPT: Enter any facility specific remarks to appear in the CCOM segment of the electronic transmission.
Answer must be 2-39 characters in length.
DESCRIPTION: This remark will appear in the CCOM segment of the electronic transmission.
November 2007: This field is being removed from the IB site parameter screen with IB patch 377.
The CCOM segment is no longer being sent.
350.9,1.05 FEDERAL TAX NUMBER 1;5 FREE TEXT (Required)
INPUT TRANSFORM: K:$L(X)>10!($L(X)<10)!'(X?2N1"-"7N) X
LAST EDITED: DEC 15, 2006
HELP-PROMPT: Enter the federal tax number for your facility in NN-NNNNNNN format. Answer must be 10 characters
in length.
DESCRIPTION: This is your facility federal tax number. If unknown, this may be obtained from your Fiscal
Service.
TECHNICAL DESCR:
This is not editable from the billing screens. Printed in Form Locator 5 of the UB-04.
350.9,1.06 BLUE CROSS/SHIELD PROVIDER # 1;6 FREE TEXT (Required)
INPUT TRANSFORM: K:$L(X)>13!($L(X)<3) X
LAST EDITED: FEB 04, 1992
HELP-PROMPT: Enter the 3-13 character BC/BS Provider Number which will be the default for all billing episodes
at this facility. Answer must be 3-13 characters in length.
DESCRIPTION:
This is the BC/BS Provider Number which Blue Cross has assigned your facility.
350.9,1.07 BILL CANCELLATION MAILGROUP 1;7 POINTER TO MAIL GROUP FILE (#3.8)
LAST EDITED: JAN 19, 1994
HELP-PROMPT: Enter the mail group you want notified whenever a third party bill is cancelled. If none is
entered no mailman notification will be made.
DESCRIPTION: This is the mail group that will recieve automatic notification every time a third party bill is
cancelled. This must be answered for the automatic notification to occur.
350.9,1.08 BILLING SUPERVISOR NAME 1;8 POINTER TO NEW PERSON FILE (#200) (Required)
LAST EDITED: FEB 04, 1992
HELP-PROMPT: Enter the Person who is the billing supervisor.
DESCRIPTION:
This is the pointer to the PERSON file for the Billing Supervisor.
350.9,1.09 BILL DISAPPROVED MAILGROUP 1;9 POINTER TO MAIL GROUP FILE (#3.8)
LAST EDITED: JAN 19, 1994
HELP-PROMPT: When a third party bill is disapproved the supervisor and initiator of the bill will be notified.
If you want additional people notified create a mailgroup and specify it here.
DESCRIPTION: When a third party bill is disapproved the supervisor and initiator of the bill will be notified.
If you want additional people to be notified that a bill has been disapproved then you must create
a mail group and add the member and then specify the group here. The members of this mail group
will then recieve the disapproval bulletin.
350.9,1.11 *CAN INITIATOR REVIEW 1;11 SET
'1' FOR YES;
'0' FOR NO;
LAST EDITED: APR 29, 1992
HELP-PROMPT: Enter 1 or 'YES' if the person who created/edited a billing record is also able to review that
record.
DESCRIPTION: Creating a third party bill is a 4 part process. The bill is Entered, Reviewed, Authorized, and
Printed. The bill is considered complete and passed to Accounts Receivable immediately after it
has been Authorized. This parameter is used to determine if the same person who Reviewed the bill
can Authorize the bill. If the paramater CAN REVIEWER AUTHORIZE? and this parameter, CAN INITIATOR
REVIEW?, are both answered "YES" then the same individual can perform all 4 parts of the billing
process. If either parameter is answered "NO" then more than one person must be involved in each
bill.
TECHNICAL DESCR:
This field should be deleted in the next release of IB after v2.0.
350.9,1.14 MAS SERVICE POINTER 1;14 POINTER TO SERVICE/SECTION FILE (#49) (Required)
HELP-PROMPT: Enter the Service/Section which is your facilities MAS Service.
DESCRIPTION: Accounts Receivable requires that every bill be associated with a SERVICE/SECTION. This is the
Service that will be identified with bills sent to Accounts Receivable from the Integrated Billing
Module.
350.9,1.15 CAN CLERK ENTER NON-PTF CODES? 1;15 SET
'1' FOR YES;
'0' FOR NO;
HELP-PROMPT: Enter '1' or 'YES' if diagnosis and procedure codes not found in the PTF record may be entered by
the billing clerk into a billing record. This affects inpatient bills only.
DESCRIPTION: Answering 'YES' to this parameter will also allow billing clerks to enter CPT and HCPS codes into
the billing record as well as ICD diagnosis and Procedure codes that are not in the corresponding
PTF record. This parameter only affects inpatient bills.
350.9,1.16 ASK HINQ IN MCCR 1;16 SET
'1' FOR YES;
'0' FOR NO;
HELP-PROMPT: Enter '1' or 'YES' if you want the person entering a new bill to be able to request a HINQ inquiry
for bills on patients with unverified eligibility.
DESCRIPTION: When creating a new bill on a Veteran with unverified eligibility the user may be asked if they
would like to put a HINQ request in the HINQ SUSPENSE file if this parameter is answered 'YES'.
350.9,1.17 USE OP CPT SCREEN? 1;17 SET
'1' FOR YES;
'0' FOR NO;
HELP-PROMPT: Enter '1' or 'YES' if you want the person entering an outpatient bill to easily transfer CPT
procedures from scheduling into the bill.
DESCRIPTION: CPT codes for outpatient visits are currently stored as Ambulatory Procedures in the Scheduling
Visits file. The user editing a bill will be displayed all CPT codes stored in the Scheduling
Visits file for the date range of the bill if the parameter is set to 'YES'. This display screen
will prompt the user if they would like to easily import any or all of the CPT codes into the bill.
This will include both Ambulatory Procedures and the Billable Ambulatory Surgical Codes.
350.9,1.18 *DEFAULT AMB SURG REV CODE 1;18 POINTER TO REVENUE CODE FILE (#399.2)
INPUT TRANSFORM: S DIC("S")="I $P(^(0),U,3)" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X
LAST EDITED: SEP 25, 1996
HELP-PROMPT: Enter the Revenue Code that you will usually want for Ambulatory Surgery.
DESCRIPTION: When billing Billable Ambulatory Surgical Codes (BASC), this will be the default revenue code
stored in the bill. If this is not appropriate for any particular insurance company then the field
AMBULATORY SURG. REV. CODE in the Insurance Company file may be entered and it will be used for
that particular insurance company entry.
Field is no longer used, it has been replaced by functionality provided by the Charge Master in
IB*2*52.
350.9,1.19 TRANSFER PROCEDURES TO SCHED? 1;19 SET
'1' FOR YES;
'0' FOR NO;
LAST EDITED: FEB 05, 1992
HELP-PROMPT: Enter '1' or 'YES' if you would like the person entering a bill to be able to automatically store
the CPT procedures in a bill in the Scheduling Visits file.
DESCRIPTION: CPT procedures may be stored as Ambulatory Procedures in the Scheduling Visits file (using the
Add/Edit Stop Code option) and they may be stored in the billing record as procedures to print on a
bill. There is now a two way sharing of information between these two files. If this parameter is
answered 'YES' then as CPT procedures are entered in a bill that are also Ambulatory Procedures,
then the user will be prompted as to whether they should be transfered to the Scheduling Visits
file also. The reverse of this is the parameter USE OP CPT SCREEN? which allows importing of
Ambulatory Procedures into a bill.
Only CPT procedures that are either Billable Ambulatory Surgical Codes or either Nationally or
Locally active Ambulatory Procedures may be transfered.
350.9,1.2 HOLD MT BILLS W/INS 1;20 SET
'1' FOR YES;
'0' FOR NO;
LAST EDITED: MAR 02, 1992
HELP-PROMPT: Enter 'Yes' if automated Means Test Charges should be held until claim disposition from an
insurance Company. If 'Yes' and a patient has insurance then the bills will automatically be
placed on hold.
DESCRIPTION: If this parameter is answered 'YES' then the automated Category C bills will automatically be
placed on hold if the Patient has active Insurance. The bills will need to be released to Accounts
Receivable after claim disposition from the Insurance Company.
350.9,1.21 MEDICARE PROVIDER NUMBER 1;21 FREE TEXT
INPUT TRANSFORM: K:$L(X)>8!($L(X)<1) X
LAST EDITED: MAR 06, 1992
HELP-PROMPT: Enter the number Medicare provided your facility. Answer must be 1-8 characters in length.
DESCRIPTION: This is the 1-8 character number provided by Medicare to the facility.
350.9,1.22 MULTIPLE FORM TYPES 1;22 SET
'1' FOR YES;
'0' FOR NO;
LAST EDITED: APR 28, 2017
HELP-PROMPT: Enter 'Y'es if your facility uses the CMS-1500 & J430D as well as the UB claim form.
DESCRIPTION: Set this field to 'YES' if the facility uses more than one health insurance form type. Therefore,
if your site uses the UB form and the CMS-1500 & J430D forms, this should be answered 'YES'. If
your site is only using the UB form, then answer 'NO'. If this is set to 'NO' or left blank then
only the UB type claim forms will be allowed.
350.9,1.23 CAN INITIATOR AUTHORIZE? 1;23 SET
'1' FOR YES;
'0' FOR NO;
LAST EDITED: APR 28, 1992
DESCRIPTION: Beginning with IB Version 1.5, the Review step in creating a bill has been eliminated. If this
parameter is answered YES and the initiator holds the IB AUTHORIZE key then the initiator of the
bill will be allowed to Authorize the Bill. If this is answered no then another user who holds the
IB AUTHORIZE key will have to authorize the bill.
350.9,1.24 BASC START DATE 1;24 DATE
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: MAY 06, 1992
DESCRIPTION: This is the date that facilities can begin billing Ambulatory Surgical Code Rates. The earliest
date is the date that IB Version 1.5 was installed at the site or the date the regulation allowing
BASC billing was approved. This date will be stored automatically in the file.
If this field is null then BASC rates will not automatically calculate.
350.9,1.25 DEFAULT DIVISION 1;25 POINTER TO MEDICAL CENTER DIVISION FILE (#40.8)
LAST EDITED: FEB 05, 1999
HELP-PROMPT: Enter the division that should be used as a bill's default division.
DESCRIPTION: This field will be used as the default division for all bills and will be automatically added to
each bill as it is created.
350.9,1.27 CMS-1500 ADDRESS COLUMN 1;27 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>80)!(X<1)!(X?.E1"."1.N) X
LAST EDITED: SEP 27, 2006
HELP-PROMPT: Type a number between 1 and 80, 0 Decimal Digits. Used only for the 1500 claim form.
DESCRIPTION: This is the column that the mailing address will begin printing on row 1 of the CMS-1500 claim
form.
TECHNICAL DESCR: With this parameter the site can specify where the address prints, depending on the type of
envelope they use. The first 5 rows are the only blank space on the form available for the mailing
address.
350.9,1.28 *DEFAULT RX REFILL REV CODE 1;28 POINTER TO REVENUE CODE FILE (#399.2)
INPUT TRANSFORM: S DIC("S")="I $P(^(0),U,3)" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X
LAST EDITED: SEP 25, 1996
HELP-PROMPT: Enter the revenue code that should be used for Rx Refills.
DESCRIPTION: If entered, this Revenue Code will be used for all prescription refill's on a bill when the revenue
codes and charges are automatically calculated. This default will be overridden by the
PRESCRIPTION REFILL REV. CODE for an insurance company, if one exists.
Field is no longer used, it has been replaced by functionality provided by the Charge Master in
IB*2*52.
SCREEN: S DIC("S")="I $P(^(0),U,3)"
EXPLANATION: Only Activated Revenue Codes can be selected!
350.9,1.29 DEFAULT RX REFILL DX 1;29 POINTER TO ICD DIAGNOSIS FILE (#80)
INPUT TRANSFORM: S DIC("S")="I $$ICD9ACT^IBACSV(+Y)" D ^DIC K DIC S DIC=$G(DIE),X=+Y K:Y<0 X
LAST EDITED: MAY 01, 2003
HELP-PROMPT: Enter a Diagnosis that should be added to every RX Refill bill.
DESCRIPTION:
If entered, this diagnosis will be automatically added to every bill that has prescription refills.
TECHNICAL DESCR:
Should probably be a genaric code like V68.1 ISSUE REPEAT PRESCRIPT.
SCREEN: S DIC("S")="I $$ICD9ACT^IBACSV(+Y)"
EXPLANATION: Only active diagnosis codes may be selected.
350.9,1.3 DEFAULT RX REFILL CPT 1;30 POINTER TO CPT FILE (#81)
INPUT TRANSFORM: S DIC("S")="I $$CPTACT^IBACSV(+Y)" D ^DIC K DIC S DIC=$G(DIE),X=+Y K:Y<0 X
LAST EDITED: MAY 01, 2003
HELP-PROMPT: Enter a CPT procedure code that should be printed on every bill that has RX Refills.
DESCRIPTION: If entered, this procedure will automatically be added to every bill that has a prescription
refill.
TECHNICAL DESCR:
Should probably be a genaric code like 99070 SPECIAL SUPPLIES.
SCREEN: S DIC("S")="I $$CPTACT^IBACSV(+Y)"
EXPLANATION: Only active CPT codes may be entered.
350.9,1.31 UB-04 ADDRESS COLUMN 1;31 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>30)!(X<1)!(X?.E1"."1.N) X
LAST EDITED: NOV 27, 2006
HELP-PROMPT: Type a number between 1 and 30, 0 Decimal Digits
DESCRIPTION: This is the column on which the Mailing Address should begin printing on the UB-04. The purpose of
this field is to help in placing the mailing address in the area required so that it is visible
through the envelope window. Please note that the UB-04 Mailing Address block (FL 38) has a
maximum width of 42 characters. The number entered here will cause the address to be moved to the
right and therefore the allowable width of the mailing address will be reduced.
350.9,1.32 CMS-1500 PRINT LEGACY ID 1;32 SET
'Y' FOR YES;
'N' FOR NO;
'C' FOR CONDITIONAL;
LAST EDITED: OCT 19, 2006
DESCRIPTION: This parameter determines whether legacy (example: IDs furnished by an Insurance Company) Provider
IDs will appear on locally printed CMS-1500 claims.
YES - Legacy IDs will always be printed. NO - Legacy IDs will never be printed.
CONDITIONAL - Legacy IDs will be printed only when
no NPIs are available.
350.9,1.33 UB-04 PRINT LEGACY ID 1;33 SET
'Y' FOR YES;
'N' FOR NO;
'C' FOR CONDITIONAL;
LAST EDITED: NOV 27, 2006
DESCRIPTION: This parameter determines whether legacy (example: IDs furnished by an Insurance Company) Provider
IDs will appear on locally printed UB claims.
YES - Legacy IDs will always be printed. NO - Legacy IDs will never be printed.
CONDITIONAL - Legacy IDs will be printed only when
no NPIs are available.
350.9,2.01 *AGENT CASHIER MAIL SYMBOL 2;1 FREE TEXT
INPUT TRANSFORM: K:$L(X)>25!($L(X)<1) X
LAST EDITED: NOV 10, 2008
HELP-PROMPT: Enter the mail routing symbol for the agent cashier. Answer must be 1-25 characters in length.
DESCRIPTION: This is the facility mail routing symbol for the Agent Cashier. This may begin with 04 (for Fiscal
Service) at most facilities.
This field is inactive with IB patch 400. The information in the PAY-TO PROVIDERS subfile
(#350.9004) has replaced this field.
350.9,2.02 *AGENT CASHIER STREET ADDRESS 2;2 FREE TEXT
INPUT TRANSFORM: K:$L(X)>25!($L(X)<3) X
LAST EDITED: NOV 10, 2008
HELP-PROMPT: Enter the street address for the Agent Cashier. Aswer must be 3-25 characters in length.
DESCRIPTION: This is the street address that checks should be mailed to. This will appear on the on all claim
forms as the billing address.
This field is inactive with IB patch 400. The information in the PAY-TO PROVIDERS subfile
(#350.9004) has replaced this field.
350.9,2.03 *AGENT CASHIER CITY 2;3 FREE TEXT
INPUT TRANSFORM: K:$L(X)>15!($L(X)<1) X
LAST EDITED: NOV 10, 2008
HELP-PROMPT: Enter the City for the Agent Cashier. Answer must be 1-15 characters in length.
DESCRIPTION: This is the City for the Agent Cashier. This will be part of the address that Checks are mailed to
and will appear on the claim forms.
This field is inactive with IB patch 400. The information in the PAY-TO PROVIDERS subfile
(#350.9004) has replaced this field.
350.9,2.04 *AGENT CASHIER STATE 2;4 POINTER TO STATE FILE (#5)
LAST EDITED: NOV 10, 2008
HELP-PROMPT: Enter the state for the Agent Cashier.
DESCRIPTION: This is the state for the Agent Cashier. This will be the State part of the address that checks
are mailed to as it appears on the claim forms.
This field is inactive with IB patch 400. The information in the PAY-TO PROVIDERS subfile
(#350.9004) has replaced this field.
350.9,2.05 *AGENT CASHIER ZIP CODE 2;5 FREE TEXT
INPUT TRANSFORM: S:$E(X,6)="-" X=$TR(X,"-") K:$L(X)>9!($L(X)<5)!'(X?5N!(X?9N)) X
LAST EDITED: NOV 10, 2008
HELP-PROMPT: Answer must be 5-9 characters in length.
DESCRIPTION: Enter the zip code for the Agent Cashier. This will be the zip code that checks should be mailed
to and appears on the claims forms.
This field is inactive with IB patch 400. The information in the PAY-TO PROVIDERS subfile
(#350.9004) has replaced this field.
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
350.9,2.06 *AGENT CASHIER PHONE NUMBER 2;6 FREE TEXT
INPUT TRANSFORM: K:$L(X)>25!($L(X)<4) X
LAST EDITED: NOV 10, 2008
HELP-PROMPT: Answer must be 4-25 characters in length.
DESCRIPTION: This is the phone number for the agent cashier.
This field is inactive with IB patch 400. The information in the PAY-TO PROVIDERS subfile
(#350.9004) has replaced this field.
350.9,2.07 CANCELLATION REMARK FOR FISCAL 2;7 FREE TEXT
INPUT TRANSFORM: K:$L(X)>75!($L(X)<3)!'(X?1A.E) X
LAST EDITED: FEB 04, 1992
HELP-PROMPT: Enter the remark (reason for cancellation) which will be sent to Fiscal Service every time a bill
is cancelled in MAS. Answer must be 3-75 characters in length.
DESCRIPTION: This is the remark which will be sent to Fiscal every time a bill is cancelled in MAS. This remark
will explain to Fiscal why the IFCAP billing record is being amended or cancelled. The generic
remark, "BILL CANCELLED IN MAS" will be transmitted to Fiscal Service if no remark is entered in
this field. The site may enter any remark which is meaningful to MAS and Fiscal.
350.9,2.08 INPT HEALTH SUMMARY 2;8 POINTER TO HEALTH SUMMARY TYPE FILE (#142)
LAST EDITED: MAY 11, 1995
HELP-PROMPT: Enter the Health Summary to print for inpatient admissions in Joint Billing Inquiry.
DESCRIPTION: This Health Summary will be displayed when the Health Summary action is chosen for an Inpatient
bill in the Joint Billing Inquire option.
350.9,2.09 OUTPT HEALTH SUMMARY 2;9 POINTER TO HEALTH SUMMARY TYPE FILE (#142)
LAST EDITED: MAY 11, 1995
HELP-PROMPT: Enter the Health Summary to print for outpatients in Joint Billing Inquiry.
DESCRIPTION: This Health Summary will be displayed when the Health Summary action is chosen for an Outpatient
bill in the Joint Billing Inquiry option.
350.9,2.1 *FACILITY NAME FOR BILLING 2;10 FREE TEXT (Required)
INPUT TRANSFORM: K:$L(X)>18!($L(X)<1)!'($TR(X," ")?.A) X
LAST EDITED: NOV 10, 2008
HELP-PROMPT: Enter your Facility Name for Billing. Answer must be 1-18 alpha characters in length.
DESCRIPTION: This is the Facility Name for Billing that will print on the first line of the UB-04 form locator 2
and in box 33 of the CMS-1500.
This field is inactive with IB patch 400. The information in the PAY-TO PROVIDERS subfile
(#350.9004) has replaced this field.
350.9,2.11 SITE CONTACT PHONE NUMBER 2;11 FREE TEXT
INPUT TRANSFORM: K:$L(X)>25!($L(X)<10) X
LAST EDITED: JUN 01, 1999
HELP-PROMPT: Must be a phone number, including area code
DESCRIPTION: This is the phone number associated with the site contact position that EDI inquiries will be
directed to when a payer needs to get in touch with the facility.
350.9,3.01 *CONVERSION LAST BILL DATE 3;1 DATE
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: JAN 27, 1994
DESCRIPTION: This field will only be used for the Means Test conversion which is part of the Integrated Billing
v1.5 post init. The field will be deleted with the next version of Integrated Billing.
This field is updated during the IB v1.5 post init. The value of this field designates the last
day through which Means Test charges will be created during the conversion.
Please note that this field has been starred for deletion in IB v2.0. This field will be deleted
in the version of IB which follows v2.0.
350.9,3.02 *CONVERSION BREAK DATE 3;2 DATE
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: JAN 27, 1994
DESCRIPTION: This field will only be used for the Means Test conversion which is part of the Integrated Billing
v1.5 post init. The field will be deleted with the next version of Integrated Billing.
This field is updated during the IB v1.5 post init. The value of this field is used by the
conversion when creating Hospital/NHCU per diem charges. If a patient owes the per diem on this
date, and has accumulated other charges prior to this date, a charge is filed for all previous
charges up through the date. The intent of "splitting" charges in this manner is to allow
facilities to select a "final" date through which Means Test billing will have been completed
manually so that charges created by the conversion may easily be passed to the Accounts Receivable
package (and thus billed to the patient).
Please note that this field has been starred for deletion in IB v2.0. This field will be deleted
in the version of IB which follows v2.0.
350.9,3.03 COPAY EXEMPTION CONV. STARTED 3;3 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>9999999)!(X<1)!(X?.E1"."1N.N) X
LAST EDITED: JAN 14, 1993
HELP-PROMPT: Type a Number between 1 and 9999999, 0 Decimal Digits
DESCRIPTION: This is the number of times the Medication Copayment Exemption Conversion has been started. It is
used to tell if the conversion has been restarted.
TECHNICAL DESCR: The Medication Copayment Exemption Conversion can be stopped by editing this field to a number
different that its current value. This is NOT a recommended procedure but should only be used in
exception cases. It will cause an orderly shut down on the completion of a single patient. After
the conversion shuts down, the value of this field should be returned to its original value.
If a second conversion is started this field will be updated causing the first conversion to stop.
At that point it is possible that a patient may be double processed, possible causing the double
decreasing of charges in AR for that patient.
350.9,3.04 COPAY EXEMPTION LAST DFN 3;4 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>999999999)!(X<1)!(X?.E1"."1N.N) X
LAST EDITED: NOV 24, 1992
HELP-PROMPT: Type a Number between 1 and 999999999, 0 Decimal Digits
DESCRIPTION: This is the internal entry number of the last patient completely converted by the Medication
Copayment Exemption Conversion. The Conversion processes patients in order of internal entry
number. If the conversion stops for any reason it will start with the next internal number after
this one.
WRITE AUTHORITY: ^
350.9,3.05 TOTAL PATIENTS CONVERTED 3;5 NUMBER
COPAY EXEMPTION TOTAL PATIENT CONVERTED
INPUT TRANSFORM: K:+X'=X!(X>999999999)!(X<1)!(X?.E1"."1N.N) X
LAST EDITED: JAN 07, 1993
HELP-PROMPT: Type a Number between 1 and 999999999, 0 Decimal Digits
DESCRIPTION: This is the total number of patients in the IB file that were set up with an exemption status
during the conversion.
WRITE AUTHORITY: ^
350.9,3.06 TOTAL PATIENTS EXEMPT 3;6 NUMBER
COPAY EXEMPTION TOTAL PATIENTS CONVERTED EXEMPT
INPUT TRANSFORM: K:+X'=X!(X>999999999)!(X<1)!(X?.E1"."1N.N) X
LAST EDITED: JAN 07, 1993
HELP-PROMPT: Type a Number between 1 and 999999999, 0 Decimal Digits
DESCRIPTION:
This is the number of patients that were converted to an exempt status.
WRITE AUTHORITY: ^
350.9,3.07 TOTAL PATIENT NON-EXEMPT 3;7 NUMBER
COPAY EXEMPTION TOTAL PATIENTS CONVERTED NON-EXEMPT
INPUT TRANSFORM: K:+X'=X!(X>999999999)!(X<1)!(X?.E1"."1N.N) X
LAST EDITED: JAN 07, 1993
HELP-PROMPT: Type a Number between 1 and 999999999, 0 Decimal Digits
DESCRIPTION:
This is the number of patients converted to a non-exempt status.
WRITE AUTHORITY: ^
350.9,3.08 COUNT OF EXEMPT BILLS 3;8 NUMBER
COPAY EXEMPTION TOTAL COUNT OF CANCELED RX CHARGES
INPUT TRANSFORM: K:+X'=X!(X>999999999)!(X<1)!(X?.E1"."1N.N) X
LAST EDITED: JAN 14, 1993
HELP-PROMPT: Type a Number between 1 and 999999999, 0 Decimal Digits
DESCRIPTION: This is the number of Medication Copayment IB Actions that were issued to patients who's status is
exempt from the start of the exemption legislation to the running of the conversion.
WRITE AUTHORITY: ^
350.9,3.09 AMOUNT OF CHARGES CHECKED 3;9 NUMBER
COPAY EXEMPTION CONVERSION TOTAL CHARGES CHECKED
INPUT TRANSFORM: K:+X'=X!(X>999999999)!(X<1)!(X?.E1"."1N.N) X
LAST EDITED: JAN 07, 1993
HELP-PROMPT: Type a Number between 1 and 999999999, 0 Decimal Digits
DESCRIPTION: This is the total dollar amount of charges checked during the Medication Copayment Exemption
Conversion issued to patients from the start date of the exemption legislation to the running of
the conversion.
WRITE AUTHORITY: ^
350.9,3.1 TOTAL EXEMPT DOLLAR AMOUNT 3;10 NUMBER
COPAY EXEMPTION CONVERSION TOTAL EXEMPTED CHARGES
INPUT TRANSFORM: K:+X'=X!(X>999999999)!(X<1)!(X?.E1"."1N.N) X
LAST EDITED: JAN 14, 1993
HELP-PROMPT: Type a Number between 1 and 999999999, 0 Decimal Digits
DESCRIPTION: This is the total dollar amount of charges checked during the Medication Copayment Exemption
Conversion issued to Exempt patients from the start date of the exemption legislation to the
running of the conversion.
WRITE AUTHORITY: ^
350.9,3.11 AMOUNT OF NON-EXEMPT CHARGES 3;11 NUMBER
COPAY EXEMPTION CONVERSION TOTAL NON-EXEMPT CHARGES
INPUT TRANSFORM: K:+X'=X!(X>999999999)!(X<1)!(X?.E1"."1N.N) X
LAST EDITED: JAN 07, 1993
HELP-PROMPT: Type a Number between 1 and 999999999, 0 Decimal Digits
DESCRIPTION: This is the total dollar amount of charges checked during the Medication Copayment Exemption
Conversion issued to Non-Exempt patients from the start date of the exemption legislation to the
running of the conversion.
WRITE AUTHORITY: ^
350.9,3.12 AMOUNT OF CANCELED CHARGES 3;12 NUMBER
COPAY EXEMPTION CONVERSION TOTAL AMOUNT OF CANCELED CHARGES
INPUT TRANSFORM: K:+X'=X!(X>999999999)!(X<1)!(X?.E1"."1N.N) X
LAST EDITED: JAN 07, 1993
HELP-PROMPT: Type a Number between 1 and 999999999, 0 Decimal Digits
DESCRIPTION: This is the total dollar amount of charges actually canceled during the Medication Copayment
Exemption Conversion issued to Exempt patients from the start date of the exemption legislation to
the running of the conversion.
WRITE AUTHORITY: ^
350.9,3.13 COPAY EXEMPTION START DATE 3;13 DATE (Required)
INPUT TRANSFORM: S %DT="ESTXR" D ^%DT S X=Y K:Y<1 X
LAST EDITED: JAN 13, 1993
DESCRIPTION: This is the date/time that the Medication Copayment Exemption Conversion started. It should not be
edited.
WRITE AUTHORITY: ^
350.9,3.14 COPAY EXEMPTION STOP DATE 3;14 DATE (Required)
INPUT TRANSFORM: S %DT="ESTXR" D ^%DT S X=Y K:Y<1 X
LAST EDITED: JAN 13, 1993
DESCRIPTION: This is the date/time that the conversion completed. This field should not be edited. It will be
stored by the conversion routine when it is finished.
TECHNICAL DESCR: If for some reason, it is necessary to restart the conversion after this field has been populated
you may delete the data in this field. Sites should check with their supporting ISC prior to doing
this. The field, LAST DFN UPDATED (3.04) in this file may also need to be edited.
Normally it is not recommended that the conversion be re-run after it has run once. Re-running the
conversion will not cause updating of patients with current exemptions, nor will it cause
re-cancellation of charges cancelled previously.
WRITE AUTHORITY: ^
UNEDITABLE
350.9,3.15 NON-EXEMPT PATIENTS CONVERTED 3;15 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>999999999)!(X<0)!(X?.E1"."1N.N) X
LAST EDITED: JAN 14, 1993
HELP-PROMPT: Type a Number between 0 and 999999999, 0 Decimal Digits
DESCRIPTION: This is the count of patients in the IB Action file that had an exemption status of Non-exempt set
up during the conversion.
WRITE AUTHORITY: ^
350.9,3.16 TOTAL BILLS DURING CONVERSION 3;16 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>999999999)!(X<0)!(X?.E1"."1N.N) X
LAST EDITED: JAN 14, 1993
HELP-PROMPT: Type a Number between 0 and 999999999, 0 Decimal Digits
DESCRIPTION: This is the total number of IB ACTION entries issued from the effective date of the Income
Exemption Legislation until the running of the conversion that were issued to either exempt or
non-exempt patients.
WRITE AUTHORITY: ^
350.9,3.17 COUNT OF BILLS CANCELED 3;17 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>999999999)!(X<0)!(X?.E1"."1N.N) X
LAST EDITED: JAN 14, 1993
HELP-PROMPT: Type a Number between 0 and 999999999, 0 Decimal Digits
DESCRIPTION: This is the count of bills actually sent to be canceled in the IB ACTION file during the
conversion.
WRITE AUTHORITY: ^
350.9,3.18 INSURANCE CONVERSION COMPLETE 3;18 DATE (Required)
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: NOV 08, 1993
DESCRIPTION: This is the date the insurance conversion completes. It is not editable. The data should not be
deleted.
The v2.0 insurance conversion will automatically set this field to the date it completes.
UNEDITABLE
350.9,3.19 BILL/CLAIMS CONV. COMPLETE 3;19 DATE (Required)
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: NOV 08, 1993
DESCRIPTION: This is the date that the v2 post-init conversion of the bill/claims file completed. It will
automatically be updated by the conversion routine when it completes.
UNEDITABLE
350.9,3.2 CURRENT INPATIENTS LOADED 3;20 DATE (Required)
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: NOV 08, 1993
DESCRIPTION: This is the date that the current inpatients were loaded into claims tracking as part of the IB v2
post init. This date will automatically be entered upon completion.
UNEDITABLE
350.9,4.01 INSURANCE EXTENDED HELP 4;1 SET
'0' FOR OFF;
'1' FOR ON;
LAST EDITED: AUG 13, 1993
DESCRIPTION: Should the extended help display be always on in the Insurance Management options. Answer 'ON' if
you always want it to display automatically or answer 'OFF' if you do not want to see it.
It is recommended that the extended help be turned on initially after v2 is installed. As users
become more familiar with the new functionality the parameter can be turned off.
350.9,4.02 PATIENT OR INSURANCE COMPANY 4;2 VARIABLE POINTER
FILE ORDER PREFIX LAYGO MESSAGE
2 1 2 n Patient
36 10 36 n Insurance company
LAST EDITED: MAR 03, 1993
DESCRIPTION:
Enter the patient or insurance company you wish to access.
TECHNICAL DESCR: This field does not contain data. It is used as a file definition by the reader to do a variable
pointer look up that is not tied to any data base element.
350.9,4.03 HEALTH INSURANCE POLICY 4;3 FREE TEXT
INPUT TRANSFORM: K:$L(X)>20!($L(X)<1) X
LAST EDITED: AUG 29, 1993
HELP-PROMPT: Answer must be 1-20 characters in length.
DESCRIPTION:
Enter the name of the patient's health insurance policy.
TECHNICAL DESCR: This field does not contain data. It is used by the reader to provide a definition to do a lookup
that is not tied to a particular data base element.
350.9,4.04 NEW INSURANCE MAIL GROUP 4;4 POINTER TO MAIL GROUP FILE (#3.8)
LAST EDITED: AUG 29, 1993
DESCRIPTION: Enter the mail group that should receive a bulletin every time an insurance policy is added for a
patient that has potential billings associated with it.
350.9,4.05 CENTRAL COLLECTION MAIL GROUP 4;5 FREE TEXT
INPUT TRANSFORM: K:$L(X)>45!($L(X)<3) X
LAST EDITED: SEP 03, 1993
HELP-PROMPT: Answer must be 3-45 characters in length.
DESCRIPTION: The MCCR Program Office has recently requested that the results from the report Rank Insurance
Carriers By Amount Billed be transmitted centrally for nation-wide compilation. This field
contains the mail group on Forum to which these reports will be sent.
The field is being exported with the value G.MCCR DATA@DOMAIN.EXT. It is anticipated that future
reports may be sent to this group for compilation. If it becomes necessary to change the mail
group name or domain, this field may be edited using Fileman. Do not edit this field without
receiving instructions from your supporting ISC.
350.9,4.06 INSURANCE COMPANY 4;6 POINTER TO INSURANCE COMPANY FILE (#36)
INPUT TRANSFORM: S DIC("S")="I '$P(^(0),U,5)" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X
LAST EDITED: JAN 19, 1994
SCREEN: S DIC("S")="I '$P(^(0),U,5)"
EXPLANATION: Only Active Companies may be selected!
350.9,4.07 IVM CENTER MAIL GROUP 4;7 FREE TEXT
INPUT TRANSFORM: K:$L(X)>45!($L(X)<3) X
LAST EDITED: MAY 05, 1994
HELP-PROMPT: Answer must be 3-45 characters in length.
DESCRIPTION: The IVM Center has recently requested that the results from the report IB Billing Activity be
transmitted to the IVM Center for nation-wide compilation. This field contains the mail group to
which these reports will be sent. The field is being exported with the value G.IVM
REPORTS@IVM.DOMAIN.EXT.
350.9,4.08 INS. CO. DELETION TASK 4;8 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>999999999999)!(X<1)!(X?.E1"."1N.N) X
LAST EDITED: AUG 04, 1995
HELP-PROMPT: Type a Number between 1 and 999999999999, 0 Decimal Digits
DESCRIPTION: This field contains the task number of a job that is scheduled to run which performs all clean-up
tasks when an Insurance Company is deleted. After the tasked job runs to completion, the value of
this field will be deleted.
TECHNICAL DESCR: This field is used to control background processing when an Insurance Company is deleted. When a
company is 'deleted' using the Delete Company action within the Insurance Company editor, a
background task needs to be queued to perform final clean-up tasks. This job searches several
files and is queued to run during non-business hours. However, if subsequent companies are also
deleted before the queued job runs, it would not be desirable to queue another job.
The task number for the background job for the first deleted company is stored in this field. The
value is then used when subsequent companies are deleted, to determine if another job should be
queued or not. When a company is deleted, if this field contains a task number, and that task
number is queued to run, then a second task will not be queued. The queued job will delete the
value from this field at job completion.
350.9,5.01 ADMISSION SHEET HEADER LINE 1 5;1 FREE TEXT
INPUT TRANSFORM: K:$L(X)>50!($L(X)<3) X
LAST EDITED: AUG 26, 1993
HELP-PROMPT: Answer must be 3-50 characters in length.
DESCRIPTION: Enter the text that your facility would like to have printed as the first line of the header on the
admission sheet. This is generally the name of your medical center.
350.9,5.02 ADMISSION SHEET HEADER LINE 2 5;2 FREE TEXT
INPUT TRANSFORM: K:$L(X)>50!($L(X)<3) X
LAST EDITED: AUG 26, 1993
HELP-PROMPT: Answer must be 3-50 characters in length.
DESCRIPTION: Enter the text that your facility would like to have printed as the second line of the header on
the admission sheet. This is generally the street address of your medical center.
350.9,5.03 ADMISSION SHEET HEADER LINE 3 5;3 FREE TEXT
INPUT TRANSFORM: K:$L(X)>50!($L(X)<3) X
LAST EDITED: AUG 26, 1993
HELP-PROMPT: Answer must be 3-50 characters in length.
DESCRIPTION: Enter the text that your facility would like to have printed as the third line of the header on the
admission sheet. This is generally the city, state and zip code of your medical center.
350.9,6.01 CLAIMS TRACKING START DATE 6;1 DATE
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: AUG 04, 1993
DESCRIPTION: If you choose to run the claims tracking module and populate the files with past episodes of care,
this is the date that the routine will use to start.
This is the main parameter that contro what past care can be entered into claims tracking. At no
time does the software automatically add entires older than this date. The one exception is that
this parameter does not affect the entries that may be added to claims tracking using the add
tracking entry action on the main claims tracking screen.
350.9,6.02 INPATIENT CLAIMS TRACKING 6;2 SET
'0' FOR OFF;
'1' FOR INSURED AND UR ONLY;
'2' FOR ALL PATIENTS;
LAST EDITED: AUG 04, 1993
DESCRIPTION: This field determines what inpatients will automatically be added to the claims tracking module.
If this parameter is set to "OFF" then no new patients will be added. If this is set to "INSURED
AND UR ONLY" then only the insured patients and random sample patients will be added. If this is
set to "ALL PATIENTS" then a record of all admissions will be created.
If a patient is not insured then each record will be so annotated automatically on creation and no
follow-up will be required. The advantage of tracking all patients is that you can determine the
percentage of billable cases and make necessary adjustments if the patients are later found to have
insurance. The disadvantage is that additional capacity is used.
350.9,6.03 OUTPATIENT CLAIMS TRACKING 6;3 SET
'0' FOR OFF;
'1' FOR INSURED ONLY;
'2' FOR ALL PATIENTS;
LAST EDITED: AUG 04, 1993
DESCRIPTION: This field determines if outpatient visit dates will automatically be entered into the claims
tracking module. If this is answered "OFF" then no entries will be entered. If this is answered
"INSURED ONLY" then only outpatient visits for insured patients will be added. If this parameter
is set to ALL PATIENTS then the outpatient visits for all patients will be added to claims
tracking.
Initially we recommend this parameter be set to INSURED ONLY.
350.9,6.04 PRESCRIPTION CLAIMS TRACKING 6;4 SET
'0' FOR OFF;
'1' FOR INSURED ONLY;
'2' FOR ALL PATIENTS;
LAST EDITED: AUG 04, 1993
DESCRIPTION: This field determines if prescriptions will automatically be entered into the claims tracking
module. If this is answered "OFF" then no prescriptions or refills will be entered. If this is
answered "INSURED ONLY", then only prescriptions and refills will be added if the patient is
insured. If all is choose then an entry for all prescriptions will be entered.
If a prescription or refill does not appear to be billable, that is it may be for SC care, or there
is a visit date associated with that prescription or refill, this will be so noted in the reason
not billable.
350.9,6.05 PROSTHETICS CLAIMS TRACKING 6;5 SET
'0' FOR OFF;
'1' FOR INSURED ONLY;
'2' FOR ALL PATIENTS;
LAST EDITED: AUG 04, 1993
DESCRIPTION: This field will be used to determine if prosthetics should be tracked in the claims tracking
module. If this parameter is set to OFF, then no prosthetic entries will be added to claims
tracking. If this is set to INSURED ONLY then only parameter entries for insured patients will be
added to claims tracking. If this is set to ALL PATIENTS then an entry will be created for all
patients prosthetic items.
350.9,6.06 USE ADMISSION SHEETS 6;6 SET
'0' FOR NO;
'1' FOR YES;
LAST EDITED: AUG 04, 1993
DESCRIPTION: Enter whether your facility is using Admission Sheets as part of the MCCR/UR functionality. If
this parameter is answered "YES" then users will be asked for the device to print admissions sheets
to. The default device will be from the BILL FORM TYPE file.
350.9,6.07 RANDOM SAMPLE DATE 6;7 DATE
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: AUG 04, 1993
DESCRIPTION: This is the date that random sampling was last re-generated. The IB background job will
re-generate a new date, new random numbers, and zero the counters every Sunday night.
350.9,6.08 MEDICINE SAMPLE SIZE 6;8 NUMBER (Required)
INPUT TRANSFORM: K:+X'=X!(X>99)!(X<0)!(X?.E1"."1N.N) X
LAST EDITED: JAN 13, 1994
HELP-PROMPT: Type a Number between 0 and 99, 0 Decimal Digits
DESCRIPTION: This is the number of required Utilization Reviews that you wish to have done each week for
Medicine admissions. The minimum recommended by the QA office is one per week.
350.9,6.09 MEDICINE WEEKLY ADMISSIONS 6;9 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>99)!(X<5)!(X?.E1"."1N.N) X
LAST EDITED: AUG 04, 1993
HELP-PROMPT: Type a Number between 5 and 99, 0 Decimal Digits
DESCRIPTION: This is the minimum number of admissions for Medicine that your Medical Center generally averages.
This is used along with the Medicine sample size to compute a random number.
350.9,6.1 MEDICINE RANDOM NUMBER 6;10 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>99)!(X<1)!(X?.E1"."1N.N) X
LAST EDITED: AUG 04, 1993
HELP-PROMPT: Type a Number between 1 and 99, 0 Decimal Digits
DESCRIPTION: This is an internally computed random number. It is re-computed each week. When the count of the
Medicine admissions reaches a multiple of this number it is considered the random selection. The
total number of random selections for UR will not exceed the Medicine sample size.
350.9,6.11 MEDICINE ENTRIES MET 6;11 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>99)!(X<1)!(X?.E1"."1N.N) X
LAST EDITED: AUG 04, 1993
HELP-PROMPT: Type a Number between 1 and 99, 0 Decimal Digits
DESCRIPTION:
This is the number of random selections generated this week.
350.9,6.12 MEDICINE ADMISSION COUNTER 6;12 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>99)!(X<1)!(X?.E1"."1N.N) X
LAST EDITED: AUG 04, 1993
HELP-PROMPT: Type a Number between 1 and 99, 0 Decimal Digits
DESCRIPTION: This is the number of admissions for this service counted by the claims tracking module so far this
week.
350.9,6.13 SURGERY SAMPLE SIZE 6;13 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>99)!(X<0)!(X?.E1"."1N.N) X
LAST EDITED: JAN 13, 1994
HELP-PROMPT: Type a Number between 0 and 99, 0 Decimal Digits
DESCRIPTION: This is the number of required Utilization Reviews that you wish to have done each week for Surgery
admissions. The minimum recommended by the QA office is one per week.
350.9,6.14 SURGERY WEEKLY ADMISSIONS 6;14 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>99)!(X<5)!(X?.E1"."1N.N) X
LAST EDITED: SEP 01, 1993
HELP-PROMPT: Type a Number between 5 and 99, 0 Decimal Digits
DESCRIPTION: This is the minimum number of admissions for Surgery that your Medical Center generally averages.
This is used along with the Surgery sample size to compute a random number.
350.9,6.15 SURGERY RANDOM NUMBER 6;15 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>99)!(X<1)!(X?.E1"."1N.N) X
LAST EDITED: AUG 04, 1993
HELP-PROMPT: Type a Number between 1 and 99, 0 Decimal Digits
DESCRIPTION: This is an internally computed random number. It is re-computed each week. When the count of the
Surgery admissions reaches a multiple of this number it is considered the random selection. The
total number of random selections for UR will not exceed the Surgery sample size.
350.9,6.16 SURGERY ENTRIES MET 6;16 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>99)!(X<1)!(X?.E1"."1N.N) X
LAST EDITED: AUG 04, 1993
HELP-PROMPT: Type a Number between 1 and 99, 0 Decimal Digits
DESCRIPTION:
This is the number of random selections generated this week.
350.9,6.17 SURGERY ADMISSION COUNTER 6;17 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>99)!(X<1)!(X?.E1"."1N.N) X
LAST EDITED: AUG 04, 1993
HELP-PROMPT: Type a Number between 1 and 99, 0 Decimal Digits
DESCRIPTION: This is the number of admissions for this service counted by the claims tracking module so far this
week.
350.9,6.18 PSYCH SAMPLE SIZE 6;18 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>99)!(X<0)!(X?.E1"."1N.N) X
LAST EDITED: JAN 13, 1994
HELP-PROMPT: Type a Number between 0 and 99, 0 Decimal Digits
DESCRIPTION: This is the number of required Utilization Reviews that you wish to have done each week for
Psychiatry admissions. The minimum recommended by the QA office is one per week.
350.9,6.19 PSYCH WEEKLY ADMISSIONS 6;19 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>99)!(X<5)!(X?.E1"."1N.N) X
LAST EDITED: SEP 01, 1993
HELP-PROMPT: Type a Number between 5 and 99, 0 Decimal Digits
DESCRIPTION: This is the minimum number of admissions for Psychiatry that your Medical Center generally
averages. This is used along with the Psychiatry sample size to compute a random number.
350.9,6.2 PSYCH RANDOM NUMBER 6;20 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>99)!(X<1)!(X?.E1"."1N.N) X
LAST EDITED: AUG 04, 1993
HELP-PROMPT: Type a Number between 1 and 99, 0 Decimal Digits
DESCRIPTION: This is an internally computed random number. It is re-computed each week. When the count of the
Psychiatry admissions reaches a multiple of this number it is considered the random selection. The
total number of random selections for UR will not exceed the Psychiatry sample size.
350.9,6.21 PSYCH ENTRIES MET 6;21 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>99)!(X<1)!(X?.E1"."1N.N) X
LAST EDITED: AUG 04, 1993
HELP-PROMPT: Type a Number between 1 and 99, 0 Decimal Digits
DESCRIPTION:
This is the number of random selections generated this week.
350.9,6.22 PSYCH ADMISSION COUNTER 6;22 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>99)!(X<1)!(X?.E1"."1N.N) X
LAST EDITED: AUG 04, 1993
HELP-PROMPT: Type a Number between 1 and 99, 0 Decimal Digits
DESCRIPTION: This is the number of admissions for this service counted by the claims tracking module so far this
week.
350.9,6.23 REPORTS ADD TO CLAIMS TRACKING 6;23 SET
'0' FOR NO;
'1' FOR YES;
LAST EDITED: OCT 26, 1993
HELP-PROMPT: Should the Patients with Insurance Reports add entries to claims tracking.
DESCRIPTION: This field determines whether or not you wish to allow the Veterans with Insurance reports to add
entries to Claims tracking. If you answer 'YES' then admisssions and outpatient visits found as
billable but not found in claims tracking will be added to claims tracking for billing information
purposes only. No review will be set up. This is to allow flagging of these visits as unbillable
so that they can be removed from these reports. Answering 'YES' does not guarantee that the entry
will be added. The related parameters about whether Claims Tracking is turned on and the Claims
Tracking Start Date will override this parameter.
TECHNICAL DESCR:
350.9,6.24 AUTO PRINT UNBILLED LIST 6;24 SET
'0' FOR NO;
'1' FOR YES;
LAST EDITED: SEP 29, 1994
HELP-PROMPT: Answer 'Yes' if you want a detailed patient listing or 'No' if you only want the mail message
containing the totals.
DESCRIPTION: Enter 'Yes' if you would like a detailed patient listing of unbilled cases automatically printed
each month, when the option Auto-Generate Unbilled Amounts Report runs on the first of each month.
If you answer 'Yes' you must enter the printer in the DEFAULT PRINTER (BILLING) field of the BILL
FORM TYPE File (353).
If you answer 'NO' the option will not generate a detailed listing of cases. You will only receive
the mailman message with the totals.
A detailed listing may be reprinted using the option Re-Generate Unbilled Amounts Report (IBT
RE-GEN UNBILLED REPORT).
350.9,6.25 UNBILLED MAIL GROUP 6;25 POINTER TO MAIL GROUP FILE (#3.8)
LAST EDITED: SEP 29, 1994
HELP-PROMPT: Enter the name of the mail group that should receive the Unbilled Amounts mail message.
DESCRIPTION: Enter the name of the mail group that will receive the monthly mail message that contains the data
for the unbilled amounts report. Generally this will include the Chief of Accounting and others
who are responsible for inputting the code sheets to Austin.
350.9,7.01 AUTO BILLER FREQUENCY 7;1 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>9999)!(X<0)!(X?.E1"."1N.N) X
LAST EDITED: OCT 21, 1993
HELP-PROMPT: Type a Number between 0 and 9999, 0 Decimal Digits
DESCRIPTION: Enter the number of days between each execution of the automated biller. For example, if the auto
biller should run only once a week, enter 7. If the auto biller should run every night, enter 1.
This will not effect the date range of the bills themselves, but will only effect the date they are
created.
If this is left blank or zero then the auto biller will never run.
350.9,7.02 LAST AUTO BILLER DATE 7;2 DATE
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: OCT 21, 1993
HELP-PROMPT: This is the last date on which the auto biller ran.
DESCRIPTION:
This is generally set by the system.
350.9,7.03 INPATIENT STATUS (AB) 7;3 SET
'1' FOR Closed;
'2' FOR Released;
'3' FOR Transmitted;
LAST EDITED: JAN 25, 1994
HELP-PROMPT: Enter the Status that an Inpatients PTF record should have before the automated biller attempts to
create a bill for that inpatient stay.
DESCRIPTION: This is the status that a PTF record must be in before the automated biller will attempt to create
an inpatient bill.
The auto biller will use the Frequency, Billing Cycle and Days Delay parameters to decide when to
try to create an inpatient bill. However, the auto biller can not set up a bill until the PTF
record is Closed. Of the two dates, the date calculated from the site parameters or the date that
the PTF record meets the Status entered here, the bill will be created on the later date.
TECHNICAL DESCR: This set of codes should exactly mirror the PTF Status (45,6) set of codes, except for Open.
Some sites want to wait until the PTF is closed before a bill is created because they know it will
be coded at that time. Others do not want to bill until the PTF record has been transmitted and
they know that it is complete.
After this had been added it was decided that an auto bill should not be created for inpatients
until after the PTF record has been closed. So, the option of creating an auto bill when the PTF
record was still open was removed.
350.9,7.04 NUMBER OF DAYS PT CHARGES HELD 7;4 NUMBER (Required)
INPUT TRANSFORM: K:+X'=X!(X>90)!(X<90)!(X?.E1"."1N.N) X
LAST EDITED: OCT 11, 2001
HELP-PROMPT: VA Policy determines number of days charges are held before auto-release.
DESCRIPTION: Patient charges with a status of ON HOLD will be automatically released to the Accounts Receivable
package after this number of days has passed. The MCCR Program Office has determined that charges
will be released after this number days if no payment has been received from the patient's
insurance carrier for the episode of care.
350.9,7.05 DEFAULT RX REFILL DX ICD-10 7;5 POINTER TO ICD DIAGNOSIS FILE (#80)
INPUT TRANSFORM: S DIC("S")="I $$ICD9ACT^IBACSV(+Y)" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X
LAST EDITED: NOV 25, 2013
HELP-PROMPT: Enter a Diagnosis that should be added to every RX Refill bill.
DESCRIPTION: If entered, this diagnosis will be automatically added to every bill that has prescription refills.
ICD-10 Diagnosis only. Should be a generic ICD-10 code such as Z76.0 - Encounter for issue of
repeat prescription.
TECHNICAL DESCR:
Replaces #350.9, 1.29 DEFAULT RX REFILL DX after ICD-10 is active.
SCREEN: S DIC("S")="I $$ICD9ACT^IBACSV(+Y)"
EXPLANATION: Only active diagnosis codes may be selected.
350.9,8.01 LIVE TRANSMIT 837 QUEUE 8;1 FREE TEXT
INPUT TRANSFORM: K:$L(X)>40!($L(X)<3) X
LAST EDITED: JUN 02, 1997
HELP-PROMPT: Answer with the name (3-40 characters) of the 837 transmit live queue.
DESCRIPTION: This is the name of the transmission queue that will be used to send live 837 transactions to
Austin.
350.9,8.02 DAYS TO WAIT TO PURGE MSGS 8;2 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>999)!(X<1)!(X?.E1"."1N.N) X
LAST EDITED: MAR 05, 2001
HELP-PROMPT: Type a Number between 1 and 999, 0 Decimal Digits
DESCRIPTION: This is the # of days after an electronic status message has been marked as having been reviewed
that the purge message option can delete it from the BILL STATUS MESSAGE file (#361).
350.9,8.03 AUTO TRANSMIT BILL FREQUENCY 8;3 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>9999)!(X<0)!(X?.E1"."1N.N) X
LAST EDITED: JAN 02, 1996
HELP-PROMPT: Type a Number between 0 and 9999, 0 Decimal Digits
DESCRIPTION: This is the desired number of days between each execution of the automated bill transmitter where
all bills in the BILL TRANSMIT file that are in a status of READY FOR EXTRACT will be extracted and
sent to the queue for electronic processing. For example, if the automated bill transmitter should
run only once a week, this number would be 7. If the automated bill transmitter should run every
night, then the number should be 1. If this is left blank or zero then the automated bill
transmitter background job will never run.
350.9,8.04 MAX # BILLS IN A BATCH 8;4 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>50)!(X<1)!(X?.E1"."1N.N) X
LAST EDITED: APR 29, 1999
HELP-PROMPT: Type a Number between 1 and 50, 0 Decimal Digits
DESCRIPTION: The maximum number of bills to be allowed to be batched together for transmission purposes. This
should be kept to a manageable level as when one bill in a batch is rejected, the entire batch is
returned to the site unprocessed. However, one bill per batch is very inefficient for transmission
purposes.
350.9,8.05 LAST 837 AUTO-TRANSMIT DATE 8;5 DATE
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: MAR 13, 1996
HELP-PROMPT: Enter the last date that the auto-transmit of bills ran at this facility.
DESCRIPTION:
This is the last date that the auto-transmit of bills ran at this facility.
350.9,8.06 HOURS TO TRANSMIT BILLS 8;6 FREE TEXT
INPUT TRANSFORM: K:$L(X)>19!($L(X)<4)!'(X?4N!(X?4N1";"4N)!(X?4N1";"4N1";"4N)!(X?4N1";"4N1";"4N1";"4N)) X I $D(X) N Z
F Z=1:1:4 Q:'$D(X)!($P(X,";",Z)="") K:$P(X,";",Z)>2400 X
LAST EDITED: APR 24, 2001
HELP-PROMPT: Enter 1-4 times of the day (military format, separated by ;) when EDI bill transmit should run
DESCRIPTION: This field contains the times of the day when EDI transmission of bills should occur. There is a
maximum of 4 times that may be entered and each time must be separated from the previous one by a
semi-colon. Times must be entered in 4 digit military format, without punctuation as indicated:
HHMM;HHMM;HHMM;HHMM. The IB nightly job will queue 1-4 jobs to automatically start EDI
transmission at these designated times for that day if the time is after the time the nightly job
is running. If the time is before the time the nightly job is running, the transmission is queued
for the following day. If no times are entered, EDI transmission will take place as part of the
nightly job.
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
350.9,8.07 ONLY 1 INS CO PER CLAIM BATCH 8;7 SET
'1' FOR YES;
'0' FOR NO;
LAST EDITED: NOV 23, 1998
HELP-PROMPT: Enter YES if only 1 insurance company should be included in a claim batch
DESCRIPTION: This field indicates whether or not the site wishes to limit bill claim batches to contain only a
single insurance company.
350.9,8.09 TEST TRANSMIT 837 QUEUE 8;9 FREE TEXT
INPUT TRANSFORM: K:$L(X)>40!($L(X)<3) X
LAST EDITED: JUN 02, 1997
HELP-PROMPT: Answer with the name (3-40 characters) of the 837 transmit test queue.
DESCRIPTION: This is the name of the transmission queue that will be used to send test 837 transactions to
Austin.
350.9,8.1 EDI/MRA ACTIVATED 8;10 SET
'0' FOR NOT EDI OR MRA;
'1' FOR EDI ONLY;
'2' FOR MRA ONLY;
'3' FOR BOTH EDI AND MRA;
LAST EDITED: DEC 04, 2003
HELP-PROMPT: Enter the status of EDI/MRA you want to exist at your site
DESCRIPTION:
This parameter controls whether EDI and/or requests for MRA are available functions for your site.
CROSS-REFERENCE: ^^TRIGGER^350.9^8.13
1)= X ^DD(350.9,8.1,1,1,1.3) I X S X=DIV S Y(1)=$S($D(^IBE(350.9,D0,8)):^(8),1:"") S X=$P(Y(1),U,13
),X=X S DIU=X K Y S X=DIV N %I,%H,% D NOW^%DTC S DIH=$G(^IBE(350.9,DIV(0),8)),DIV=X S $P(^(8),U,13)
=DIV,DIH=350.9,DIG=8.13 D ^DICR
1.3)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(0)=X S Y(1)=$S($D(^IBE(350.9,D0,8)):^(8),1:"") S X=$P(Y(1),
U,13)="",Y(2)=$G(X),Y(3)=$G(X) S X=Y(0),X=X S X=X>1,Y=X,X=Y(2),X=X&Y
2)= Q
CREATE CONDITION)= (DATE MRA FIRST ACTIVATED="")&(INTERNAL(EDI/MRA ACTIVATED)>1)
CREATE VALUE)= TODAY
DELETE VALUE)= NO EFFECT
FIELD)= `8.13
350.9,8.11 AUTOMATIC MRA EOB PROCESS? 8;11 SET
Enable Automatic MRA Processing?
'0' FOR NO;
'1' FOR YES;
LAST EDITED: AUG 28, 2003
HELP-PROMPT: Enter Yes or No
DESCRIPTION: This field controls whether or not incoming Medicare Remittance Advice (MRA) EOB's can be
automatically processed so that the secondary bill is automatically generated and automatically
authorized and sent to the secondary payer.
If this field is NO, then all incoming MRA EOB's will remain on the MRA management worklist and
manual processing of the MRA EOB's will be necessary.
350.9,8.12 ALLOW MRA EOB PROCESSING? 8;12 SET
Allow MRA Processing?
'0' FOR NO;
'1' FOR YES;
LAST EDITED: AUG 28, 2003
HELP-PROMPT: Enter Yes or No
DESCRIPTION: This field controls whether or not Medicare Remittance Advice (MRA) EOB's are allowed to be
processed so that a bill can become a secondary bill and be authorized to the secondary payer.
This field is checked by both the manual Process COB action from the MRA management worklist and
also by the automatic MRA process.
350.9,8.13 DATE MRA FIRST ACTIVATED 8;13 DATE
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:X<1 X
LAST EDITED: JUN 04, 2004
HELP-PROMPT: (No range limit on date)
DESCRIPTION:
This is the date Medicare Remittance Advice (MRA) was activated at site.
NOTES: TRIGGERED by the EDI/MRA ACTIVATED field of the IB SITE PARAMETERS File
350.9,8.14 CMS-1500 AUTO PRINTER 8;14 POINTER TO DEVICE FILE (#3.5)
CMS-1500 Auto Printer
LAST EDITED: OCT 12, 2010
HELP-PROMPT: Enter the name of the printer that will print automatically-processed secondary/tertiary CMS 1500
claims.
DESCRIPTION: This is the printer that will be used to automatically print CMS-1500s when an electronic
non-Medicare EOB is received and the subsequent insurance company requires printed claims.
350.9,8.15 UB-04 AUTO PRINTER 8;15 POINTER TO DEVICE FILE (#3.5)
UB-04 Auto Printer
LAST EDITED: OCT 12, 2010
HELP-PROMPT: Enter the name of the printer that will print automatically-processed secondary/tertiary UB04
claims.
DESCRIPTION: This is the printer that will be used to automatically print UB-04s when an electronic non-Medicare
EOB is received and the subsequent insurance company requires printed claims.
350.9,8.16 EOB AUTO PRINTER 8;16 POINTER TO DEVICE FILE (#3.5)
EOB Auto Printer
LAST EDITED: OCT 12, 2010
HELP-PROMPT: Enter the name of the printer that will print EOBs for automatically-processed secondary/tertiary
claims.
DESCRIPTION: This is the printer that will be used for automatically printing EOBs of automatically-processed
claims when the subsequent insurance company requires printed secondary or tertiary claims.
350.9,8.17 AUTOMATIC REG EOB PROCESS? 8;17 SET
Enable Auto Reg EOB Processing?
'0' FOR NO;
'1' FOR YES;
LAST EDITED: DEC 22, 2010
HELP-PROMPT: Should Regular EOBs be automatically processed?
DESCRIPTION: This field controls whether or not incoming Regular (Non-Medicare) EOBs can be automatically
processed so that the subsequent bill is automatically generated and automatically authorized and
sent to the next payer.
If this field is NO, then all incoming Regular (Non-Medicare) EOBs will remain on the COB
management worklist and manual processing of the EOBs will be necessary.
350.9,8.19 MRA AUTO PRINTER 8;19 POINTER TO DEVICE FILE (#3.5)
MRA Auto Printer
LAST EDITED: DEC 30, 2010
HELP-PROMPT: Enter the name of the printer that will print MRAs for automatically-processed secondary/tertiary
claims.
DESCRIPTION: This is the printer that will be used for automatically printing MRAs of automatically-processed
claims when the subsequent insurance company requires printed secondary or tertiary claims. MRAs
need to have a device set up for 132 character printing.
350.9,8.2 DENTAL ENABLED? 8;20 SET
Allow Dental Claim Processing?
'0' FOR NO;
'1' FOR YES;
LAST EDITED: JUL 17, 2017
HELP-PROMPT: Enter 'Yes' to enable the processing of Dental Claims. Otherwise, enter 'No'.
DESCRIPTION: This value determines if Dental Claims can be processed in VistA. Yes indicates that Dental claims
may be entered and processed by the Integrated Billing auto-biller. No indicates that no Dental
claims processing can occur in VistA.
350.9,8.21 837 FHIR ENABLED? 8;21 SET (audited)
Allow 837 FHIR Trans processing?
'0' FOR NO;
'1' FOR YES;
LAST EDITED: JUL 22, 2020
HELP-PROMPT: Enter 'Yes' to indicate using TAS Core platform and FHIR for all 837 transactions. Otherwise,
enter 'No'.
DESCRIPTION: This field indicates whether all EDI 837 Claim Transactions are to be submitted to FSC through the
TAS Core platform using FHIR. A 'Yes' value will indicate using FHIR and 'No' will indicate still
using MailMan format.
AUDIT: YES, ALWAYS
350.9,8.22 PCR LAST SEARCH DATE 8;22 DATE
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: NOV 21, 2022
HELP-PROMPT: Enter the date the PCR report data was last extracted.
DESCRIPTION:
This value is the last Date the PCR report used to extract claim data.
350.9,8.23 PAYERID SWITCH DISABLED? 8;23 SET (BOOLEAN Data Type)
LAST EDITED: DEC 16, 2022
HELP-PROMPT: Enter 1 to indicate that the Payer ID switch process is disabled in VistA. Otherwise, enter 0.
DESCRIPTION: This field indicates whether the Payer ID switch function is enabled within VistA and disabled at
FSC. A value of zero (0) indicates that VistA will perform the Payer ID switching, when
applicable. A value of one (1) will disable the VistA Payer ID switching process.
350.9,9.01 BILLING PORT 9;1 FREE TEXT
INPUT TRANSFORM: K:$L(X)>15!($L(X)<3) X
LAST EDITED: MAY 12, 2004
HELP-PROMPT: Answer must be 3-15 characters in length.
DESCRIPTION: This is the logical port which is opened to transmit pharmacy transactions to the TRICARE fiscal
intermediary. If there is no value in this field, the Pharmacy billing engine cannot be started.
350.9,9.02 AWP PORT 9;2 FREE TEXT
INPUT TRANSFORM: K:$L(X)>15!($L(X)<3) X
LAST EDITED: MAY 12, 2004
HELP-PROMPT: Answer must be 3-15 characters in length.
DESCRIPTION: This is the logical port which is opened to receive AWP updates from the TRICARE fiscal
intermediary. If this field has no value, the AWP update engine cannot be started.
350.9,9.03 TCP/IP ADDRESS 9;3 FREE TEXT
INPUT TRANSFORM: K:$L(X)>39!($L(X)<3) X
LAST EDITED: JUL 24, 2015
HELP-PROMPT: Answer must be 3-39 characters in length.
DESCRIPTION: This field holds the TCP/IP address needed to reach the Pharmacy billing commercial software
package. The billing interface cannot be started if there is no value on this field.
350.9,9.04 PRIMARY BILLING TASK 9;4 FREE TEXT
INPUT TRANSFORM: K:$L(X)>15!($L(X)<1) X
LAST EDITED: AUG 19, 1996
HELP-PROMPT: Answer must be 1-15 characters in length.
DESCRIPTION: This is the task number for the primary billing transaction engine which communicates with the
Pharmacy billing commercial software package. This field will be deleted during an orderly
shutdown or when an error occurs. If this field is deleted, the secondary billing job will become
the primary.
350.9,9.05 SECONDARY BILLING TASK 9;5 FREE TEXT
INPUT TRANSFORM: K:$L(X)>15!($L(X)<1) X
LAST EDITED: AUG 19, 1996
HELP-PROMPT: Answer must be 1-15 characters in length.
DESCRIPTION: This is the task number for the secondary billing transaction engine. This task is normally idled
and becomes activated if the primary task errors out.
350.9,9.06 PRIMARY AWP TASK 9;6 FREE TEXT
INPUT TRANSFORM: K:$L(X)>15!($L(X)<1) X
LAST EDITED: AUG 19, 1996
HELP-PROMPT: Answer must be 1-15 characters in length.
DESCRIPTION: This is the task number for the primary AWP update task. This task communicates with the Pharmacy
billing commercial software package to receive updates to the AWP (Average Wholesale Pricelist).
If this field becomes null, the secondary task will become the primary task.
350.9,9.07 SECONDARY AWP TASK 9;7 FREE TEXT
INPUT TRANSFORM: K:$L(X)>15!($L(X)<1) X
LAST EDITED: AUG 19, 1996
HELP-PROMPT: Answer must be 1-15 characters in length.
DESCRIPTION: This is the task number for the secondary AWP update task. This task is normally idled and becomes
activated if the primary task errors out.
350.9,9.08 DATE PRIMARY TASK STARTED 9;8 DATE
INPUT TRANSFORM: S %DT="ESTXR" D ^%DT S X=Y K:Y<1 X
LAST EDITED: AUG 19, 1996
DESCRIPTION:
This is the date/time in which the primary billing transaction engine began running.
350.9,9.09 DATE PRIMARY TASK LAST RAN 9;9 DATE
INPUT TRANSFORM: S %DT="ESTXR" D ^%DT S X=Y K:Y<1 X
LAST EDITED: AUG 19, 1996
DESCRIPTION: This date/time is the last time that the primary billing transaction engine passed a transaction to
the commercial software package.
350.9,9.1 SHUTDOWN BACKGROUND JOBS 9;10 SET
'0' FOR NO;
'1' FOR YES;
LAST EDITED: AUG 19, 1996
DESCRIPTION: This field will be used to control both the Billing transaction and AWP update tasks. If this
field is set to Yes, both of these sets of jobs will shutdown in an orderly fashion.
350.9,9.11 TASK UCI,VOL 9;11 FREE TEXT
INPUT TRANSFORM: K:$L(X)>12!($L(X)<3) X
LAST EDITED: AUG 19, 1996
HELP-PROMPT: Answer must be 3-12 characters in length.
DESCRIPTION: If this field has a value, this will be the volume and uci in which the engines will be tasked to
run.
350.9,9.12 AWP CHARGE SET 9;12 POINTER TO CHARGE SET FILE (#363.1)
INPUT TRANSFORM: S DIC("S")="I +$$CSBI^IBCRU3(Y)=3" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X
LAST EDITED: MAY 12, 2004
DESCRIPTION: The value of this field points to a Charge Set in file #363.1 which will be used to retrieve the
Average Wholesale Price (AWP) of a drug when the TRICARE Pharmacy Billing software interface is
running.
SCREEN: S DIC("S")="I +$$CSBI^IBCRU3(Y)=3"
EXPLANATION: This screen only allows Charge Sets which are based on NDC numbers.
350.9,9.13 PRESCRIBER ID 9;13 FREE TEXT
INPUT TRANSFORM: K:$L(X)>15!($L(X)<3) X
LAST EDITED: MAY 12, 2004
HELP-PROMPT: Answer must be 3-15 characters in length.
DESCRIPTION: The Prescriber ID is assigned by the TRICARE fiscal intermediary to a facility. The ID is used in
the TRICARE pharmacy billing transmission to identify the facility to the intermediary.
There must be a value in this field in order to start the TRICARE pharmacy billing interface task.
TECHNICAL DESCR:
350.9,9.14 DEA# OVERRIDE PRESC. ID 9;14 SET
'0' FOR NO;
'1' FOR YES;
LAST EDITED: NOV 21, 2000
HELP-PROMPT: Answering YES to this field will send the DEA# from the New Person file (if available) to the
fiscal intermediary as the provider reference in place of the Prescriber ID.
DESCRIPTION: Answering yes to this field, causes the DEA# from the NEW PERSON (#200) file to override the
Prescriber ID as the provider reference sent to the fiscal intermediary when billing Tricare RX.
If this field is answered as NO, left unanswered, or answered YES but the DEA# is not available for
the provider, then the Prescriber ID is sent as the provider reference.
TECHNICAL DESCR:
350.9,9.15 PHARM CALC COMPOUND CODE 9;15 SET
'0' FOR NO;
'1' FOR YES;
LAST EDITED: NOV 20, 2000
HELP-PROMPT: Answering YES to this field, will use the values calculated in the pharmacy package for compound
code to be sent to the fiscal intermediary (1 or 2) instead of a zero.
DESCRIPTION: Answering YES to this prompt will send the values calculated in the Pharmacy package, for compound
code, to the fiscal intermediary when billing Tricare RX. Pharmacy evaluates the drug to be either
a compound drug ( code=2 ) or a non compound drug ( code = 1 ). If this field is left blank or is
answered NO, a code of 0 will be sent.
TECHNICAL DESCR:
350.9,10.01 PATIENT OR FACILITY 10;1 VARIABLE POINTER
FILE ORDER PREFIX LAYGO MESSAGE
351.6 1 P n Patient
4 2 F n Facility
SCREEN ON FILE 4: S DIC("S")="I $$SCR^IBATUTL(Y)"
SCREEN EXPLANATION: Only valid Facilities
LAST EDITED: FEB 19, 1999
HELP-PROMPT: You can just type in a PATIENT or FACILITY name.
DESCRIPTION: This field definition is used by the Patient or Preferred Facility selection when using the FileMan
Reader only.
No data needs to be set in this field.
350.9,10.02 TP INPATIENT ACTIVE 10;2 SET
'0' FOR NO;
'1' FOR YES;
LAST EDITED: APR 07, 2000
HELP-PROMPT: Choose to activitate this software for Inpatient.
DESCRIPTION: This flag will identify if the facility has Transfer Pricing turned on for Inpatient tracking. If
this field is blank, Transfer Pricing will be off for Inpatient tracking.
350.9,10.03 TP OUTPATIENT ACTIVE 10;3 SET
'0' FOR NO;
'1' FOR YES;
LAST EDITED: APR 07, 2000
HELP-PROMPT: Choose to activitate this software for Outpatient.
DESCRIPTION: This flag will identify if the facility has Transfer Pricing turned on for Outpatient tracking. If
this field is blank, Transfer Pricing will be off for Outpatient tracking.
350.9,10.04 TP PHARMACY ACTIVE 10;4 SET
'0' FOR NO;
'1' FOR YES;
LAST EDITED: APR 07, 2000
HELP-PROMPT: Choose to activitate this software for Pharmacy.
DESCRIPTION: This flag will identify if the facility has Transfer Pricing turned on for Prescription tracking.
If this field is blank, Transfer Pricing will be off for Prescription tracking.
350.9,10.05 TP PROSTHETICS ACTIVE 10;5 SET
'0' FOR NO;
'1' FOR YES;
LAST EDITED: APR 11, 2000
HELP-PROMPT: Choose to activitate this software for Prosthetics.
DESCRIPTION: This flag will identify if the facility has Transfer Pricing turned on for Prosthetics tracking. If
this field is blank, Transfer Pricing will be off for Prosthetics tracking.
350.9,11.01 HIPAA NCPDP ACTIVE FLAG 11;1 SET (audited)
'1' FOR Active;
'0' FOR Not Active;
LAST EDITED: APR 09, 2004
HELP-PROMPT: e-Pharmacy interface active? Enter 'A' for Active or 'N' for not active.
DESCRIPTION:
This field is used to activate the e-Pharmacy interface.
AUDIT: EDITED OR DELETED
350.9,11.03 DEFAULT PAY-TO PROVIDER 11;3 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>9999)!(X<1)!(X?.E1"."1.N) X
LAST EDITED: NOV 14, 2008
HELP-PROMPT: Type a number between 1 and 9999, 0 Decimal Digits.
DESCRIPTION: This field is the internal entry number to the 350.9004 pay-to provider sub-file. It should not be
edited by FileMan directly. It is set by the Pay-To provider maintenance application in the IB
Site Parameters edit option.
350.9,11.04 DEFAULT TRICARE PAY-TO PROV 11;4 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>9999)!(X<1)!(X?.E1"."1N.N) X
LAST EDITED: MAY 08, 2014
HELP-PROMPT: Type a number between 1 and 9999, 0 decimal digits.
DESCRIPTION: This field is the internal entry number to the 350.929 TRICARE pay-to provider sub-file. It should
not be edited by FileMan directly. It is set by the Pay-To provider maintenance application in the
IB Site Parameters edit option.
350.9,13.01 HMS DIRECTORY 13;1 FREE TEXT
INPUT TRANSFORM: K:$L(X)>30!($L(X)<5) X
LAST EDITED: OCT 04, 2011
HELP-PROMPT: Enter the name of the directory where Extract/Result files are stored.
DESCRIPTION:
Name of the directory where Extract/Result files are stored as needed by HMS Data Extractor.
350.9,13.02 EII ACTIVE 13;2 SET
Is eII Active?
'1' FOR YES;
'0' FOR NO;
LAST EDITED: OCT 04, 2011
HELP-PROMPT: Enable/activate eII Software?
DESCRIPTION:
This is a flag to indicate whether the eII software is enabled/active.
350.9,13.03 RESULT FILE NAME 13;3 FREE TEXT
INPUT TRANSFORM: K:$L(X)>30!($L(X)<5) X
LAST EDITED: OCT 04, 2011
HELP-PROMPT: Enter the name of the Result file as it is configured in HMS Data Extractor software.
DESCRIPTION:
Name of the Result file as it is configured in HMS Data Extractor software.
350.9,13.04 DAY OF MONTH RESULT FILE DUE 13;4 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>31)!(X<0)!(X?.E1"."1N.N) X
LAST EDITED: OCT 04, 2011
HELP-PROMPT: Enter the day of month, 0 to 31 when the Result file expected from HMS. A value of 0 means do not
check the due date.
DESCRIPTION: Day of the month when Result file is due be received from HMS through AITC. if "0" entered or
empty, due check would not be calculated. For a day , say 31 that does not exist for a given
month, eII software will assume last day of that month. This includes last day of February
whether it is a leap year or not.
350.9,13.05 DAYS BEFORE LATE MESSAGE SENT 13;5 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>30)!(X<0)!(X?.E1"."1N.N) X
LAST EDITED: NOV 23, 2011
HELP-PROMPT: Enter number of days after the Result File Due day, before the Result File arrival from HMS is
considered overdue.
DESCRIPTION: Number of days after the Result File Due day of the month, before the Result file arrival from HMS
is considered overdue. If the Result file is not received by this time a late message is sent to
IRM mail group.
350.9,13.06 MAX EXT FILE QUE CONFIRM TIME 13;6 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>99)!(X<0)!(X?.E1"."1N.N) X
LAST EDITED: JAN 10, 2012
HELP-PROMPT: Enter maximum number of hours (usually 24 hours) to wait for confirmation message(s) to be received
after an Extract file message is sent to AITC.
DESCRIPTION: Maximum number of hours (usually 24 hours) to wait for confirmation message(s) to be received after
an Extract file message is sent to AITC. When this time is exceeded, a no confirmation message is
sent to the IBCNF EII IRM mail group.
350.9,13.07 MAX NUM OF RECORDS PER MESSAGE 13;7 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>9999)!(X<0)!(X?.E1"."1N.N) X
LAST EDITED: JAN 10, 2012
HELP-PROMPT: Enter maximum number of records per message that can be sent to AITC DMI Queues, when the Extract
file message(s) are built.
DESCRIPTION: Extract file records are sent via one or more Mailman messages to ATIC DMI Queues. This field is
the maximum number (usually 100) of records per message.
350.9,13.08 EXTRACT FILES 13.08;0 SET Multiple #350.9006
DESCRIPTION:
This sub-file contains configuration information for each extracted file type.
350.9006,.01 EXTRACT FILE TYPE 0;1 SET (Multiply asked)
'NOINSUR' FOR NOINSUR;
'ENHNOIN' FOR ENHNOIN;
'NORXINS' FOR NORXINS;
'NONVERINS' FOR NONVERINS;
LAST EDITED: JAN 19, 2012
HELP-PROMPT: Enter the extract file type.
DESCRIPTION: Type of Extract file. Depending on your site requirements, you may want to define one or more of
the following Extract types:
NOINSUR - (HMS No Insurance Data Extract) Pulls patients with no insurance info on file.
ENHNOIN - (HMS Enhanced No Insurance Data Extract) Pulls patients with only Medicare insurance on
file and no commercial insurance.
NORXINS - (HMS No Prescription Insurance Extract) Pulls patients with active insurance that is
not "Prescription Only" and identifies Prescription Only insurance in the monthly insurance
matching process.
NONVERINS - (HMS Non-Verified Insurance Data Extract) Pulls patients treated within a
user-specified date range WITH insurance information and where the insurance information has NOT
been re-verified in the last six months (or other specified period). This file is also known as
the reverification file.
CROSS-REFERENCE: 350.9006^B
1)= S ^IBE(350.9,DA(1),13.08,"B",$E(X,1,30),DA)=""
2)= K ^IBE(350.9,DA(1),13.08,"B",$E(X,1,30),DA)
350.9006,.02 EXTRACT FILE ACTIVE 0;2 SET
'1' FOR YES;
'0' FOR NO;
LAST EDITED: DEC 08, 2011
HELP-PROMPT: Enable/activate extract file processing?
DESCRIPTION:
This is a flag to indicate whether the processing for this file type is enabled/active.
350.9006,.03 FILE NAME 0;3 FREE TEXT
INPUT TRANSFORM: K:$L(X)>30!($L(X)<3) X
LAST EDITED: DEC 08, 2011
HELP-PROMPT: Enter the name of the Extract file.
DESCRIPTION: Name of the extract file created by HMS Data Extract Utility associated with the extract file
type.
350.9006,.04 AITC DMI QUEUE EMAIL ADDRESS 0;4 FREE TEXT
INPUT TRANSFORM: K:$L(X)>30!($L(X)<3) X
LAST EDITED: JAN 10, 2012
HELP-PROMPT: Enter the Email address of the DMI Queue where the extract file message(s) associated with
extract file type will be sent.
DESCRIPTION: Email address of the DMI Queue where the extract file message(s) associated with this extract
file type will be sent.
350.9006,.05 DAY OF MONTH EXTRACT FILE DUE 0;5 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>31)!(X<0)!(X?.E1"."1N.N) X
LAST EDITED: OCT 04, 2011
HELP-PROMPT: Enter the day of month, 0 to 31 when the extract file associated with this extract file type is
expected from HMS. A value of 0 means do not check the due date.
DESCRIPTION: Day of month, 0 to 31 when the extract file associated with this extract file type is expected
from HMS data extractor software, installed at the local site. A value of 0 means do not check
the due date. For a day say 31 that does not exist for a given month, eII software will assume
last day of that month. This includes last day of February whether it is a leap year or not.
350.9006,.06 DAYS BEFORE LATE MESSAGE SENT 0;6 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>5)!(X<0)!(X?.E1"."1N.N) X
LAST EDITED: JAN 19, 2012
HELP-PROMPT: Type a number between 0 and 5, 0 decimal digits.
DESCRIPTION: Number of days after the Extract File Due day of the month, before the Extract file creation by
the HMS Data Extract is considered overdue. If the Extract File is not created by this time a
late message is sent to IBCNF EII IRM mail group.
350.9,15 PRINTED CLAIMS RC EXCLUSIONS 15;0 POINTER Multiple #350.9399 (Add New Entry without Asking)
DESCRIPTION: This field contains Revenue Codes that are used to exclude a claim from the Locally Printed Claims
Report.
TECHNICAL DESCR: This multi-field points to the Revenue Code file. It contains a list of the Revenue Codes that are
used to determine if a claim will be excluded from the Locally Printed Claims Report. If a claim
contains one of these Revenue Codes, the claim will not show on the Printed Claims Report.
350.9399,.01 REVENUE CODE 0;1 POINTER TO REVENUE CODE FILE (#399.2)
LAST EDITED: AUG 28, 2015
HELP-PROMPT: Enter a Rev Code to Exclude a Claim from the Printed Claims Report.
DESCRIPTION: This field contains Revenue Codes that are used to exclude a claim from the Locally Printed
Claims Report.
TECHNICAL DESCR: This multi-field points to the Revenue Code file. It contains a list of the Revenue Codes that
are used to determine if a claim will be excluded from the Locally Printed Claims Report. If a
claim contains one of these Revenue Codes, the claim will not show on the Printed Claims Report.
CROSS-REFERENCE: 350.9399^B
1)= S ^IBE(350.9,DA(1),15,"B",$E(X,1,30),DA)=""
2)= K ^IBE(350.9,DA(1),15,"B",$E(X,1,30),DA)
350.9,16 CMN CPT CODES 16;0 POINTER Multiple #350.916 (Add New Entry without Asking)
350.916,.01 CMN CPT CODES 0;1 POINTER TO CPT FILE (#81)
LAST EDITED: FEB 21, 2018
HELP-PROMPT: Enter a CPT code which should prompt biller for CMN.
CROSS-REFERENCE: 350.916^B
1)= S ^IBE(350.9,DA(1),16,"B",$E(X,1,30),DA)=""
2)= K ^IBE(350.9,DA(1),16,"B",$E(X,1,30),DA)
350.9,19 PAY-TO PROVIDERS 19;0 POINTER Multiple #350.9004
DESCRIPTION:
This multiple contains the list of Pay-To Providers for this VistA database.
INDEXED BY: FACILITY (AC)
350.9004,.01 FACILITY 0;1 POINTER TO INSTITUTION FILE (#4) (Multiply asked)
INPUT TRANSFORM: S DIC("S")="I $$SCRN4^IBJPS4(Y)" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X
LAST EDITED: JUL 09, 2014
HELP-PROMPT: Please choose the Pay-To Provider from the Institution file.
DESCRIPTION: Enter a Pay-to Provider. Usually, a Pay-to Provider is a medical center (Example VAMC, M&ROC,
etc.). If you enter only one Pay-to Provider, it will be the default Pay-to Provider for all
claims and you do not need to associate divisions with the default. Multiple Pay-to Providers
must be associated with the divisions to which they apply.
SCREEN: S DIC("S")="I $$SCRN4^IBJPS4(Y)"
EXPLANATION: Inactive, not national, and pharmacy entries are screened out.
CROSS-REFERENCE: 350.9004^B
1)= S ^IBE(350.9,DA(1),19,"B",$E(X,1,30),DA)=""
2)= K ^IBE(350.9,DA(1),19,"B",$E(X,1,30),DA)
FIELD INDEX: AC (#818) MUMPS IR ACTION
Short Descr: Name and address defaults
Description: The purpose of this x-ref is to default the name and address fields in this sub-file from data
found in the Institution file. The idea is that the user will select a VA Institution from file
4 to be one of the Pay-To providers in this sub-file. The name and address of the VA Institution
will be used as defaults for the name and address fields here in this sub-file. The default name
and address information may be overridden.
Set Logic: I $G(X1(1))'=$G(X2(1)) D DEF^IBJPS3(+$G(X2(1)),.DA,0)
Kill Logic: Q
X(1): FACILITY (350.9004,.01) (forwards)
350.9004,.02 NAME 0;2 FREE TEXT (Required)
Pay-to Provider Name
INPUT TRANSFORM: K:$L(X)>35!($L(X)<1) X
LAST EDITED: NOV 14, 2008
HELP-PROMPT: Answer must be 1-35 characters in length.
DESCRIPTION:
You may modify the Pay-to Provider Name for use on electronic or printed claims.
TECHNICAL DESCR:
This field is initially set by the "AC" x-ref of the .01 field.
350.9004,.03 FEDERAL TAX NUMBER 0;3 FREE TEXT
Pay-to Provider Federal Tax ID Number
INPUT TRANSFORM: K:$L(X)>10!($L(X)<10)!'(X?2N1"-"7N) X
LAST EDITED: NOV 14, 2008
HELP-PROMPT: Answer must be 10 characters in length.
DESCRIPTION: Enter the Federal Tax ID for the Pay-to Provider. Make sure you enter the Tax ID Number for the
Pay-to Provider which may be different from your site's Tax ID. Enter 10 digits in the format
NN-NNNNNNN.
TECHNICAL DESCR: This field is initially set by the "AC" x-ref of the .01 field if the .01 field is the same
institution as defined in the IB site parameters field 350.9,.02.
350.9004,.04 TELEPHONE NUMBER 0;4 FREE TEXT
Pay-to Provider Phone Number
INPUT TRANSFORM: K:$L(X)>30!($L(X)<1) X
LAST EDITED: NOV 14, 2008
HELP-PROMPT: Answer must be 1-30 characters in length.
DESCRIPTION: Enter the phone number to be used on electronic or printed claims. This is the number you would
want a payer to use to contact the site about a claim.
350.9004,.05 PARENT PAY-TO PROVIDER 0;5 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>9999)!(X<1)!(X?.E1"."1.N) X
LAST EDITED: NOV 14, 2008
HELP-PROMPT: Type a number between 1 and 9999, 0 Decimal Digits.
DESCRIPTION: This field determines if this entry in the sub-file is a Pay-to provider institution or if it is
a Division being linked to the parent Pay-to Provider institution - another sub-file entry.
If this field is defined, then it holds the IEN in this sub-file which is the parent Pay-to
Provider institution for this specific division.
If this field is nil, then this means that this sub-file entry is the parent Pay-to Provider
Institution.
This field should not be set via FileMan. The application in the IB site parameter edit option
will set this field appropriately based on user input.
350.9004,1.01 STREET ADDRESS 1 1;1 FREE TEXT
Pay-to Provider Address Line 1
INPUT TRANSFORM: K:$L(X)>55!($L(X)<1) X
MAXIMUM LENGTH: 55
LAST EDITED: APR 27, 2017
HELP-PROMPT: Answer must be 1-55 characters in length.
DESCRIPTION: You may modify the Pay-to Provider Address for use on electronic or printed claims. You may
enter a P.O. Box.
TECHNICAL DESCR:
This field is initially set by the "AC" x-ref of the .01 field.
350.9004,1.02 STREET ADDRESS 2 1;2 FREE TEXT
Pay-to Provider Address Line 2
INPUT TRANSFORM: K:$L(X)>55!($L(X)<1) X
MAXIMUM LENGTH: 55
LAST EDITED: APR 27, 2017
HELP-PROMPT: Answer must be 1-55 characters in length.
DESCRIPTION:
Enter additional Address information if needed.
TECHNICAL DESCR:
This field is initially set by the "AC" x-ref of the .01 field.
350.9004,1.03 CITY 1;3 FREE TEXT
Pay-to Provider City
INPUT TRANSFORM: K:$L(X)>40!($L(X)<2) X
LAST EDITED: NOV 14, 2008
HELP-PROMPT: Answer must be 2-40 characters in length.
DESCRIPTION:
You may modify the Pay-to Provider Address for use on electronic or printed claims.
TECHNICAL DESCR:
This field is initially set by the "AC" x-ref of the .01 field.
350.9004,1.04 STATE 1;4 POINTER TO STATE FILE (#5)
Pay-to Provider State
LAST EDITED: NOV 14, 2008
HELP-PROMPT: Enter the Pay-To Provider state.
DESCRIPTION:
You may modify the Pay-to Provider Address for use on electronic or printed claims.
TECHNICAL DESCR:
This field is initially set by the "AC" x-ref of the .01 field.
350.9004,1.05 ZIP 1;5 FREE TEXT
Pay-to Provider Zip Code
INPUT TRANSFORM: K:$L(X)>15!($L(X)<3) X
LAST EDITED: NOV 14, 2008
HELP-PROMPT: Answer must be 3-15 characters in length.
DESCRIPTION:
You may modify the Pay-to Provider Address for use on electronic or printed claims.
TECHNICAL DESCR:
This field is initially set by the "AC" x-ref of the .01 field.
350.9,20 BILLING PROVIDER FAC TYPES 20;0 POINTER Multiple #350.9005
DESCRIPTION: This multiple field contains a list of the valid Billing Provider facility types and also whether
or not a facility type may also be a Pay-To Provider.
350.9005,.01 BILLING PROVIDER FAC TYPES 0;1 POINTER TO FACILITY TYPE FILE (#4.1) (Multiply asked)
INPUT TRANSFORM: S DIC("S")="I $P($G(^(0)),U,4)=""N""" D ^DIC K DIC S DIC=$G(DIE),X=+Y K:Y<0 X
LAST EDITED: NOV 12, 2008
HELP-PROMPT: Enter a Billing Provider Facility Type
DESCRIPTION: This field is a pointer to the Kernel Facility Type file (file# 4.1). It is a multiple so the
entries in this sub-file comprise the list of valid Billing Provider facility types. Only
national facility types may be selected for this list.
SCREEN: S DIC("S")="I $P($G(^(0)),U,4)=""N"""
EXPLANATION: Only national facility types may be selected.
CROSS-REFERENCE: 350.9005^B
1)= S ^IBE(350.9,DA(1),20,"B",$E(X,1,30),DA)=""
2)= K ^IBE(350.9,DA(1),20,"B",$E(X,1,30),DA)
350.9005,.02 PAY-TO PROVIDER TYPE? 0;2 SET
'1' FOR YES;
'0' FOR NO;
LAST EDITED: NOV 12, 2008
HELP-PROMPT: Enter YES if this facility type can be a Pay-to Provider.
DESCRIPTION: If this facility type may also be a possible Pay-to Provider, then enter YES for this field. The
Pay-to Provider is the organization to which payers send the payment.
350.9,28 NON-MCCF RATE TYPES FOR PTP 28;0 POINTER Multiple #350.928 (Add New Entry without Asking)
DESCRIPTION: This contains the Non-MCCF Rate Types that are related to the Non-MCCF Pay-To Providers. If a
claim has one of the rate types in this multiple field, the claim is considered to be a Non-MCCF
Claim.
350.928,.01 NON-MCCF RATE TYPES FOR PTP 0;1 POINTER TO RATE TYPE FILE (#399.3) (Multiply asked)
LAST EDITED: FEB 27, 2018
HELP-PROMPT: Enter Rate Types for which non-MCCF Pay to Provider should be used.
DESCRIPTION: Each multiple field should be a Non-MCCF Rate Type. It is used to determine if a claim is a
Non-MCCF Claim.
CROSS-REFERENCE: 350.928^B
1)= S ^IBE(350.9,DA(1),28,"B",$E(X,1,30),DA)=""
2)= K ^IBE(350.9,DA(1),28,"B",$E(X,1,30),DA)
350.9,29 TRICARE PAY-TO PROVIDERS 29;0 POINTER Multiple #350.929
DESCRIPTION:
This multiple contains the list of Non-MCCF-specific Pay-To Providers for this VistA database.
INDEXED BY: TC FACILITY (AC)
350.929,.01 TC FACILITY 0;1 POINTER TO INSTITUTION FILE (#4)
INPUT TRANSFORM: S DIC("S")="I $$SCRN4^IBJPS4(Y)" D ^DIC K DIC S DIC=$G(DIE),X=+Y K:Y<0 X
LAST EDITED: FEB 22, 2018
HELP-PROMPT: Please choose the Non-MCCF-specific Pay-To Provider from the Institution file.
DESCRIPTION: Enter a Non-MCCF-specific Pay-to Provider. Usually, a Pay-to Provider is a medical center (e.g.
VAMC, M&ROC, etc.). If you enter only one Non-MCCF-specific Pay-to Provider, it will be the
default Pay-to Provider for all Non-MCCF claims and you would not need to associate divisions
with the default. Multiple Non-MCCF- specific Pay-to Providers must be associated with the
divisions to which they apply.
SCREEN: S DIC("S")="I $$SCRN4^IBJPS4(Y)"
EXPLANATION: Inactive, not national, and pharmacy entries are screened out.
CROSS-REFERENCE: 350.929^B
1)= S ^IBE(350.9,DA(1),29,"B",$E(X,1,30),DA)=""
2)= K ^IBE(350.9,DA(1),29,"B",$E(X,1,30),DA)
FIELD INDEX: AC (#994) MUMPS IR ACTION
Short Descr: Name and address defaults
Description: The purpose of this x-ref is to default the name and address fields in this sub-file from data
found in the Institution file. The idea is that the user will select a VA Institution from file
4 to be one of the TRICARE-specific Pay-To Providers in this sub-file. The name and address of
the VA Institution will be used as defaults for the name and address fields here in this
sub-file. The default name and address information may be overridden.
Set Logic: I $G(X1(1))'=$G(X2(1)) D DEF^IBJPS3(+$G(X2(1)),.DA,1)
Kill Logic: Q
X(1): TC FACILITY (350.929,.01) (forwards)
350.929,.02 TC NAME 0;2 FREE TEXT (Required)
Non-MCCF Pay-to Provider Name
INPUT TRANSFORM: K:$L(X)>35!($L(X)<1) X
LAST EDITED: FEB 22, 2018
HELP-PROMPT: Answer must be 1-35 characters in length.
DESCRIPTION: You may modify the Non-MCCF-specific Pay-to Provider name for use on electronic or printed
claims.
TECHNICAL DESCR:
This field is initially set by the "AC" x-ref of the .01 field.
350.929,.03 TC FEDERAL TAX NUMBER 0;3 FREE TEXT
Non-MCCF Pay-to Provider Federal Tax ID Number
INPUT TRANSFORM: K:$L(X)>10!($L(X)<10)!'(X?2N1"-"7N) X
LAST EDITED: FEB 22, 2018
HELP-PROMPT: Answer must be 10 characters in the format NN-NNNNNNN.
DESCRIPTION: Enter the Federal Tax ID for the Non-MCCF-specific Pay-to Provider. Make sure you enter the Tax
ID Number for the Non-MCCF Pay-to Provider, which may be different from your site's Tax ID.
Enter 10 characters in the format NN-NNNNNNN.
TECHNICAL DESCR: This field is initially set by the "AC" x-ref of the .01 field if the .01 field is the same
institution as defined in the IB site parameters field 350.9, .02.
350.929,.04 TC TELEPHONE NUMBER 0;4 FREE TEXT
Non-MCCF Pay-to Provider Phone Number
INPUT TRANSFORM: K:$L(X)>30!($L(X)<1) X
LAST EDITED: FEB 22, 2018
HELP-PROMPT: Answer must be 1-30 characters in length.
DESCRIPTION: Enter the phone number to be used on electronic or printed claims. This is the number you would
want a payer to use to contact the site about a Non-MCCF claim.
350.929,.05 TC PARENT PAY-TO PROVIDER 0;5 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>9999)!(X<1)!(X?.E1"."1N.N) X
LAST EDITED: FEB 22, 2018
HELP-PROMPT: Type a number between 1 and 9999, 0 decimal digits.
DESCRIPTION: This field determines if this entry in the sub-file is a Non-MCCF Pay-to Provider institution or
if it is a Division being linked to the parent Non-MCCF Pay-to Provider institution, that is,
another sub-file entry.
If this field is defined, then it holds the IEN in this sub-file of the parent Non-MCCF Pay-to
Provider institution for this specific division.
If this field is nil, then this sub-file entry is the parent Non-MCCF Pay-to Provider
institution.
This field should not be set via FileMan. The application in the IB Site Paremeter edit option
will set this field appropriately based on user input.
350.929,1.01 TC STREET ADDRESS 1 1;1 FREE TEXT
Non-MCCF Pay-to Provider Address Line 1
INPUT TRANSFORM: K:$L(X)>55!($L(X)<1) X
LAST EDITED: FEB 22, 2018
HELP-PROMPT: Answer must be 1-55 characters in length.
DESCRIPTION: You may modify the Non-MCCF-specific Pay-To Provider Address for use on electronic or printed
claims. You may enter a P.O. Box.
TECHNICAL DESCR:
This field is initially set by the "AC" x-ref of the .01 field.
350.929,1.02 TC STREET ADDRESS 2 1;2 FREE TEXT
Non-MCCF Pay-to Provider Address Line 2
INPUT TRANSFORM: K:$L(X)>55!($L(X)<1) X
LAST EDITED: FEB 22, 2018
HELP-PROMPT: Answer must be 1-55 characters in length.
DESCRIPTION:
Enter additional address information, if needed.
TECHNICAL DESCR:
This field is initially set by the "AC" x-ref of the .01 field.
350.929,1.03 TC CITY 1;3 FREE TEXT
Non-MCCF Pay-to Provider City
INPUT TRANSFORM: K:$L(X)>40!($L(X)<2) X
LAST EDITED: FEB 22, 2018
HELP-PROMPT: Answer must be 2-40 characters in length.
DESCRIPTION:
You may modify the Non-MCCF Pay-to Provider address for use on electronic or printed claims.
TECHNICAL DESCR:
This field is initially set by the "AC" x-ref of the .01 field.
350.929,1.04 TC STATE 1;4 POINTER TO STATE FILE (#5)
Non-MCCF Pay-to Provider State
LAST EDITED: FEB 22, 2018
HELP-PROMPT: Answer with State Number, or Name, or Abbreviation.
DESCRIPTION:
You may modify the Non-MCCF Pay-to Provider address for use on electronic or printed claims.
TECHNICAL DESCR:
This field is initially set by the "AC" x-ref of the .01 field.
350.929,1.05 TC ZIP 1;5 FREE TEXT
Non-MCCF Pay-to Provider Zip Code
INPUT TRANSFORM: K:$L(X)>15!($L(X)<3) X
LAST EDITED: FEB 22, 2018
HELP-PROMPT: Answer must be 3-15 characters in length.
DESCRIPTION:
You may modify the Non-MCCF Pay-to Provider address for use on electronic or printed claims.
TECHNICAL DESCR:
This field is initially set by the "AC" x-ref of the .01 field.
350.9,50.01 RUNNING CLAIMSMANAGER? 50;1 SET
'1' FOR YES;
'0' FOR NO;
LAST EDITED: MAR 16, 2001
DESCRIPTION: This field will contain a 1 if the site is running the Ingenix ClaimsManager interface and software
and a 0 or "" if it is not.
350.9,50.02 CLAIMSMANAGER WORKING OK? 50;2 SET
'1' FOR YES;
'0' FOR NO;
LAST EDITED: MAR 16, 2001
DESCRIPTION: This field will normally contain a 1 (yes), but may be set to 0 (no) in order to halt the
processing of claims through ClaimsManager. This would normally be used to correct a communication
problem or any other problem that was preventing the claim from processing in ClaimsManager.
350.9,50.03 GENERAL ERROR MSG MAIL GROUP 50;3 POINTER TO MAIL GROUP FILE (#3.8)
LAST EDITED: JAN 05, 2001
DESCRIPTION: This field will point to the mail group that will receive the error messages to be received at the
user level. If more than one mail group is desired, they may be added as a REMOTE USER in the mail
group that is entered in this field.
350.9,50.04 COMM ERR MSG MAIL GROUP 50;4 POINTER TO MAIL GROUP FILE (#3.8)
LAST EDITED: JAN 05, 2001
DESCRIPTION: This field will point to the mail group that will receive messages that a Communication Error
exists. This would normally include the technical support personnel.
350.9,50.05 CLAIMSMANAGER TCP/IP 50;5 FREE TEXT
INPUT TRANSFORM: K:$L(X)>39!($L(X)<3) X
LAST EDITED: JUL 24, 2015
HELP-PROMPT: Answer must be 3-39 characters in length.
DESCRIPTION:
This is the tcp/ip address for the Ingenix ClaimsManager server.
350.9,50.06 CLAIMSMANAGER PORTS 50.06;0 Multiple #350.9001
LAST EDITED: MAR 16, 2001
DESCRIPTION:
This is the ports used by the Ingenix ClaimsManager.
350.9001,.01 CLAIMSMANAGER PORTS 0;1 FREE TEXT (Multiply asked)
INPUT TRANSFORM: K:$L(X)>20!($L(X)<1) X
LAST EDITED: AUG 31, 2001
HELP-PROMPT: Answer must be 1-20 characters in length.
DESCRIPTION:
This field will contain the ports used for accessing the Ingenix ClaimsManager server.
CROSS-REFERENCE: 350.9001^B
1)= S ^IBE(350.9,DA(1),50.06,"B",$E(X,1,30),DA)=""
2)= K ^IBE(350.9,DA(1),50.06,"B",$E(X,1,30),DA)
350.9,50.07 MAILMAN MESSAGE FLAG 50;7 SET
'P' FOR PRIORITY;
'N' FOR NORMAL;
LAST EDITED: AUG 31, 2001
HELP-PROMPT: Please choose the type of MailMan message to be used.
DESCRIPTION: This field is either 'P' for Priority MailMan messages or 'N' for Normal MailMan messages. This
only applies to the MailMan messages that are created and sent when one user is assigning a bill to
another user.
350.9,51.01 FRESHNESS DAYS 51;1 NUMBER (Required)
INPUT TRANSFORM: K:+X'=X!(X>180)!(X<7)!(X?.E1"."1N.N) X
LAST EDITED: JUN 05, 2002
HELP-PROMPT: Enter the number of days data remains "fresh". Type a Number between 7 and 180.
DESCRIPTION: This parameter determines how "fresh" the insurance verification This field is a parameter that is
used by two of the data extracts to determine whether a record should be extracted or not.
For both the Insurance Buffer extract and the Appointment extract, this represents how long to wait
before IIV can attempt to reverify the same insurance for that patient.
If the value is 10, this means that IIV can attempt to reverify insurance for a patient 11 days
after the most recently inquired date. A specific date is always asked of the payer when trying to
identify patients eligibility.
350.9,51.02 DAILY MAILMAN MSG 51;2 SET
'1' FOR YES;
'0' FOR NO;
LAST EDITED: AUG 18, 2009
HELP-PROMPT: Answer 'Yes' if the daily eIV Statistical Report should be sent via MailMan.
DESCRIPTION: This field determines whether the daily eIV Statistical Report should be sent via MailMan. This
report contains information about the electronic insurance verification process - both inquiries
and responses.
350.9,51.03 DAILY MSG TIME 51;3 FREE TEXT
INPUT TRANSFORM: K:(X'?4N)!('X)!(X>2400)!($E(X,3,4)'<60) X
LAST EDITED: AUG 18, 2009
HELP-PROMPT: This is the time of day to generate the daily eIV Statistical Report sent via MailMan. The time
must be in four digit military format.
DESCRIPTION: Enter the time in four digit military format.
Examples: 0100 = 1 AM 1300 = 1 PM
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
350.9,51.04 MESSAGES MAILGROUP 51;4 POINTER TO MAIL GROUP FILE (#3.8) (Required)
LAST EDITED: AUG 18, 2009
HELP-PROMPT: Select the mail group to whom eIV messages are sent.
DESCRIPTION: This field identifies the mail group to whom the daily eIV Statistical Report and eIV error
messages will be sent via MailMan.
350.9,51.05 TIMEOUT DAYS 51;5 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>7)!(X<1)!(X?.E1"."1N.N) X
LAST EDITED: AUG 19, 2002
HELP-PROMPT: Enter the number of days that will define a communication timeout. Enter a number between 1 and 7.
DESCRIPTION: This field defines how many days without an insurance response is considered to be a communication
timeout.
350.9,51.06 NUMBER RETRIES 51;6 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>5)!(X<0)!(X?.E1"."1.N) X
LAST EDITED: AUG 18, 2009
HELP-PROMPT: Enter the number of times to retry an eIV transmission. Enter a number between 0 and 5.
DESCRIPTION: This field specifies how many retries to attempt when a communication timeout occurs before it is
considered a communication failure.
An entry of zero indicates that when a communication timeout occurs, no retries shall be attempted
and the inquiry will be considered a communication failure.
350.9,51.07 TIMEOUT MAILMAN MSG 51;7 SET
'1' FOR YES;
'0' FOR NO;
LAST EDITED: AUG 19, 2002
HELP-PROMPT: Enter 'Yes' if a MailMan message should be generated for each communication timeout.
DESCRIPTION:
This field allows the site to send a MailMan message for each communication timeout.
350.9,51.08 INQUIRE INACTIVE INSURANCE 51;8 SET
'1' FOR YES;
'0' FOR NO;
LAST EDITED: APR 08, 2003
HELP-PROMPT: Enter 'Yes' if a patient's inactive insurance shall be queried if no active insurance is found.
DESCRIPTION: This field helps guide both the No Insurance data extract and Appointment data extract to attempt
to request information for a patient's inactive insurance if no active insurance is found.
350.9,51.09 *INQUIRE POPULAR PAYERS 51;9 SET
'1' FOR YES;
'0' FOR NO;
LAST EDITED: AUG 04, 2022
HELP-PROMPT: Enter 'Yes' if the most popular payers are to be queried if no active insurance is found for a
patient.
DESCRIPTION: This field guides both the No Insurance data extract and the Appointment data extract to attempt to
request information for a patient, who has no previous insurance and/or no active insurance in
VISTA, based upon the list of Most Popular Payers. ***Deleted - IB*2.0*737
350.9,51.1 *NO. POPULAR PAYERS 51;10 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>10)!(X<1)!(X?.E1"."1N.N) X
LAST EDITED: AUG 04, 2022
HELP-PROMPT: Enter the number of popular payers to query. Enter a number between 1 and 10.
DESCRIPTION: This field is the number of the most popular payers that should be queried if the Inquire Popular
Payers parameter is set to 'Yes'. *** Deleted - IB*2.0*737
350.9,51.11 *POPULAR INSUR CO. FROM DATE 51;11 DATE
INPUT TRANSFORM: S %DT="E" D ^%DT S X=Y K:Y<1 X
LAST EDITED: AUG 04, 2022
HELP-PROMPT: Enter the date from which popular insurance companies will be selected.
DESCRIPTION: This field is the date that the calculation of the Most Popular Insurance Companies starts with
when searching through the Bill/Claims File (#399). *** OBSOLETE - 12/15/2003 *** *** Deleted -
IB*2.0*737
350.9,51.12 *POPULAR INSUR CO. THRU DATE 51;12 DATE
INPUT TRANSFORM: S %DT="E" D ^%DT S X=Y K:Y<1 X
LAST EDITED: AUG 04, 2022
HELP-PROMPT: Enter the date through which popular insurance companies will be selected
DESCRIPTION: This field is the date that the calculation of the Most Popular Insurance Companies ends with when
searching through the Bill/Claims File (#399). *** OBSOLETE - 12/15/2003 *** ***Deleted -
IB*2.0*737
350.9,51.13 HL7 RESPONSE PROCESSING 51;13 SET (Required)
'B' FOR Batch;
'I' FOR Immediate;
LAST EDITED: AUG 18, 2009
HELP-PROMPT: Enter 'I'mmediate for eIV responses to be forwarded to VistA immediately or 'B'atch to hold and
batch the responses.
DESCRIPTION: This field allows the site to tell the Eligibility Communicator how eIV responses should be
returned to the site. Batch means that EC will hold all messages and return them between the HL7
Start Time and HL7 Stop Time. Immediate means that EC will return a response as soon as it is
received from the payer.
350.9,51.14 HL7 START TIME 51;14 FREE TEXT (Required)
INPUT TRANSFORM: K:(X'?4N)!('X)!(X>2400)!($E(X,3,4)'<60) X
LAST EDITED: AUG 18, 2009
HELP-PROMPT: Enter the time when EC will start relaying eIV responses back to the site. The time must be in
four digit military format.
DESCRIPTION: Enter the time in military format. This time represents when the site has told the Eligibility
Communicator to begin sending eIV responses to the site. This field only applies when the HL7
Response Processing is set to 'B'atch processing. It is recommended that this be a time during low
CPU processing.
Examples: 0100 = 1 AM 1300 = 1 PM
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
350.9,51.15 HL7 MAXIMUM NUMBER 51;15 NUMBER (Required)
INPUT TRANSFORM: K:+X'=X!(X>99999)!(X<1)!(X?.E1"."1.N) X
LAST EDITED: AUG 18, 2009
HELP-PROMPT: Type a number between 1 and 99999, 0 Decimal Digits
DESCRIPTION: This field allows a site to restrict the daily number of HL7 messages created and sent during the
HL7 process for eIV. This feature can be used to manage the amount of eIV HL7 traffic flowing
through the HL7 package.
TECHNICAL DESCR: Patch IB*2*416 removed the ability for sites to limit the HL7 traffic and the maximum number of
messages was set at 99999. This field is not being removed in case this functionality is needed in
the future.
350.9,51.16 *CONTACT PERSON 51;16 POINTER TO NEW PERSON FILE (#200) (Required)
LAST EDITED: NOV 17, 2015
HELP-PROMPT: This is the person that the Financial Services Center shall contact if there are communication
problems.
DESCRIPTION: This field identifies the person that the Financial Services Center or the Eligibility Communicator
shall contact if there are any problems that need to be addressed; e.g. communication problems.
This information will be sent nightly to FSC/EC to keep it up to date.
TECHNICAL DESCR:
This field will be removed. It was marked for deletion in patch IB*2.0*549
350.9,51.17 BATCH EXTRACTS 51.17;0 SET Multiple #350.9002
DESCRIPTION: This field identifies each of the three data extracts that eIV uses to find insurance data via
verification inquiries.
Buffer, appointment, and EICD.
350.9002,.01 BATCH EXTRACTS 0;1 SET (Required) (Multiply asked)
'1' FOR Buffer;
'2' FOR Appt;
'4' FOR EICD;
LAST EDITED: JUL 20, 2022
HELP-PROMPT: Enter a code from the list.
DESCRIPTION: This field identifies each of the three data extracts that eIV uses to find data to request
insurance verification.
Buffer, appointment, and EICD.
CROSS-REFERENCE: 350.9002^B
1)= S ^IBE(350.9,DA(1),51.17,"B",$E(X,1,30),DA)=""
2)= K ^IBE(350.9,DA(1),51.17,"B",$E(X,1,30),DA)
Standard "B" cross-reference
350.9002,.02 ACTIVE? 0;2 SET (Required)
'0' FOR Not Active;
'1' FOR Active;
LAST EDITED: AUG 18, 2009
HELP-PROMPT: Enter 'Active' if the extract is active and should run daily.
DESCRIPTION: This parameter indicates whether or not this extract should be performed during the daily eIV
extract process.
350.9002,.03 SELECTION CRITERIA #1 0;3 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>180)!(X<1)!(X?.E1"."1N.N) X
LAST EDITED: MAR 21, 2024
HELP-PROMPT: Type a number between 1 and 180, 0 decimal digits. This control is for the eIV appointment
extract and is not to be modified by a VistA user.
DESCRIPTION: This field is a parameter that is used by the appointment data extract to determine whether a
record should be extracted or not.
For the Appointments extract (#2), this indicates how far in the future a patient can be
scheduled for an appointment and be eligible for extract. If the value is 10, then a patient
will be eligible for extract if their appointment is within 10 days of the extract date.
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
350.9002,.04 *SELECTION CRITERIA #2 0;4 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>180)!(X<7)!(X?.E1"."1N.N) X
LAST EDITED: JUL 20, 2022
HELP-PROMPT: Type a number between 7 and 180, 0 decimal digits.
DESCRIPTION: This field is a parameter that is used by the Non-Verified Insurance extract to determine whether
a record should be extracted or not.
For the Non-Verified Insurance extract, this is similar to the FRESHNESS DAYS parameter in that
this represents how long to wait before eIV can attempt to re-verify the same insurance for that
patient.
If the value is 10, this means that eIV can attempt to re-verify insurance for a patient 11 days
after the most recently inquired date. A specific date is always asked of the payer when trying
to determine patient's eligibility.
Deleted with IB*2.0*737
350.9002,.05 MAXIMUM EXTRACT NUMBER 0;5 NUMBER (Required)
INPUT TRANSFORM: K:+X'=X!(X>99999)!(X<1)!(X?.E1"."1.N) X
LAST EDITED: MAR 21, 2024
HELP-PROMPT: Type a number between 1 and 99999, 0 decimal digits. This control is for the eIV batch extracts
and is not to be modified by a VistA user.
DESCRIPTION: This field allows a site to restrict the daily number of records extracted and placed in the eIV
Transmission Queue.
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
350.9002,.06 SUPPRESS BUFFER CREATION 0;6 SET
'0' FOR No;
'1' FOR Yes;
LAST EDITED: AUG 18, 2009
HELP-PROMPT: Enter 'Yes' if Insurance Buffer entries should not be created when the insurance inquiry could
not be transmitted. Enter 'No', otherwise.
DESCRIPTION: This flag will suppress the creation of Insurance Buffer entries when attempting to create
insurance inquiries during the eIV process. If the insurance inquiry cannot be transmitted
because the insurance company does not resolve to a valid and eligible payer, this flag will not
allow an Insurance Buffer entry to be created and flagged to be corrected manually before being
sent out. This is intended to reduce the number of Insurance Buffer entries to be resolved
manually which did not originate in the Buffer originally.
Please note that this flag only applies to the Appointment extract.
350.9002,.07 START DAYS 0;7 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>31)!(X<7)!(X?.E1"."1.N) X
LAST EDITED: JUN 25, 2018
HELP-PROMPT: Type a number between 7 and 31, 0 decimal digits.
DESCRIPTION: This parameter is the number of days added to today to form the extract's start date used to
determine whether a record should be extracted or not.
To date, this parameter is only used by the EICD extract (#4), formerly "No Insurance".
For EICD, this indicates how far in the future a Patient can be scheduled for an appointment and
be eligible for extract. If the value is 21, then a patient will be eligible for extract if their
appointment is no earlier than 21 days from the extract date (current date).
350.9002,.08 DAYS AFTER START 0;8 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>20)!(X<0)!(X?.E1"."1.N) X
LAST EDITED: MAY 22, 2018
HELP-PROMPT: Type a number between 0 and 20, 0 decimal digits.
DESCRIPTION: This parameter is added to the start date, calculated using "START DAYS", to form the extract's
end date used to determine whether a record should be extracted or not.
To date, this parameter is only used by the EICD extract (#4), formerly "No Insurance".
For EICD, this indicates how far in the future a patient from the start date, calculated using
"START DAYS", that a scheduled appointment must be within in order to be eligible for extract.
If the value is 9, then a patient will be eligible for extract if their appointment is no earlier
than start date and is no further than start date + 9.
350.9002,.09 FREQUENCY 0;9 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>365)!(X<90)!(X?.E1"."1.N) X
LAST EDITED: MAY 22, 2018
HELP-PROMPT: Type a number between 90 and 365, 0 decimal digits.
DESCRIPTION: This parameter is similar to the FRESHNESS DAYS parameter in that it represents how long the
extract must wait before an attempt to re-verify the insurance for the patient.
To date, this parameter is only used by the EICD extract (#4), formerly "No Insurance".
For EICD, If the value is 365, this means that eIV can attempt to re-verify the lack of insurance
for a patient 366 days after the last time an EICD inquiry was run.
350.9,51.18 *POPULAR PAYERS 51.18;0 POINTER Multiple #350.9003
LAST EDITED: AUG 04, 2022
350.9003,.01 *POPULAR PAYER 0;1 POINTER TO PAYER FILE (#365.12) (Multiply asked)
LAST EDITED: AUG 04, 2022
HELP-PROMPT: Select a Payer
DESCRIPTION:
This field identifies the most popular payers based upon user selection. ***Deleted - IB*2.0*737
CROSS-REFERENCE: 350.9003^B
1)= S ^IBE(350.9,DA(1),51.18,"B",$E(X,1,30),DA)=""
2)= K ^IBE(350.9,DA(1),51.18,"B",$E(X,1,30),DA)
Standard "B" cross-reference
350.9,51.19 HL7 STOP TIME 51;19 FREE TEXT (Required)
INPUT TRANSFORM: K:(X'?4N)!('X)!(X>2400)!($E(X,3,4)'<60) X
LAST EDITED: AUG 18, 2009
HELP-PROMPT: Enter the time when EC will stop relaying eIV responses back to the site. The time must be in four
digit military format.
DESCRIPTION: Enter the time in military format. This time represents when the site has told the Eligibility
Communicator to stop sending eIV responses to the site. This field only applies when the HL7
Response Processing is set to 'Batch' processing.
Examples: 0100 = 1 AM 1300 = 1 PM
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
350.9,51.2 FAILURE MAILMAN MSG 51;20 SET
'1' FOR YES;
'0' FOR NO;
LAST EDITED: AUG 18, 2009
HELP-PROMPT: Enter 'Yes' if a MailMan message should be generated when eIV is unable to electronically confirm
the patient's insurance information due to a communications problem.
DESCRIPTION: This field allows the site to send a MailMan message for each communication failure. A
communication failure is defined as having exhausted all retries.
350.9,51.21 *MOST POPULAR LAST SAVE DATE 51;21 DATE
INPUT TRANSFORM: S %DT="EST" D ^%DT S X=Y K:Y<1 X
LAST EDITED: AUG 04, 2022
HELP-PROMPT: The date/time when the Most Popular Payer list was last saved.
DESCRIPTION: This is the date/time on which the Most Popular Payer list was last saved. This field is not
available for edit by users. ***Deleted - IB*2.0*737
CROSS-REFERENCE: ^^TRIGGER^350.9^51.24
1)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(1)=$S($D(^IBE(350.9,D0,51)):^(51),1:"") S X=$P(Y(1),U,24),X=X
S DIU=X K Y S X=DIV S X=DUZ S DIH=$G(^IBE(350.9,DIV(0),51)),DIV=X S $P(^(51),U,24)=DIV,DIH=350.9,D
IG=51.24 D ^DICR
2)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(1)=$S($D(^IBE(350.9,D0,51)):^(51),1:"") S X=$P(Y(1),U,24),X=X
S DIU=X K Y S X=DIV S X=DUZ S DIH=$G(^IBE(350.9,DIV(0),51)),DIV=X S $P(^(51),U,24)=DIV,DIH=350.9,D
IG=51.24 D ^DICR
CREATE VALUE)= S X=DUZ
DELETE VALUE)= S X=DUZ
FIELD)= #51.24
350.9,51.22 REGISTRATION COMPLETE 51;22 SET
'1' FOR YES;
'0' FOR NO;
LAST EDITED: APR 28, 2010
HELP-PROMPT: Enter Yes or No.
DESCRIPTION: This field indicates whether application acknowledgement has been received and processed from the
Eligibility Communicator. If the registration message failed at the EC, no further processing of
eIV messages will occur.
350.9,51.23 INQUIRE SECONDARY INSURANCES 51;23 SET
'1' FOR YES;
'0' FOR NO;
LAST EDITED: APR 15, 2003
HELP-PROMPT: Answer 'YES' to indicate that outgoing electronic insurance verification requests should return all
additional/secondary insurance information identified for the patient.
DESCRIPTION: This field contains an indicator that controls whether outgoing electronic verification requests
should return any additional or secondary insurance information that is found for a patient when an
eligibility request is made for a specific insurance company.
350.9,51.24 *MOST POPULAR LAST SAVED BY 51;24 POINTER TO NEW PERSON FILE (#200) (Required)
LAST EDITED: AUG 15, 2022
HELP-PROMPT: This is the user who saved the current 'Most Popular Payer' list.
DESCRIPTION: This is the user who last edited and saved the Most Popular Payer list. If the field MOST POPULAR
LAST SAVE DATE is deleted, this field will be the user who deleted the date. *** Deleted -
IB*2.0*737 ***
NOTES: TRIGGERED by the *MOST POPULAR LAST SAVE DATE field of the IB SITE PARAMETERS File
350.9,51.25 MEDICARE PAYER 51;25 POINTER TO PAYER FILE (#365.12)
LAST EDITED: OCT 22, 2009
HELP-PROMPT: Select the Medicare entry from the Payer file.
DESCRIPTION: This field holds the Medicare WNR payer entry. It is used to identify the Medicare payer for the
insurance buffer lists and any other applications that need to know which payer is the Medicare WNR
payer.
TECHNICAL DESCR: This field is set during the post-install for IB*2*416. It should not have to be changed unless
the Medicare WNR payer entry itself gets changed. This field is only available for editing via
FileMan. Edit with extreme care.
350.9,51.26 RETRY FLAG 51;26 SET
'Y' FOR YES;
'N' FOR NO;
LAST EDITED: SEP 12, 2013
HELP-PROMPT: Should an eIV Inquiry retransmit if no response is received?
DESCRIPTION: A 'Y'es value indicates that an eIV Inquiry will retransmit if no response is received within the
number of TIMEOUT DAYS (51.05) field.
350.9,51.27 270 MASTER SWITCH REALTIME 51;27 SET
'Y' FOR YES;
'N' FOR NO;
LAST EDITED: OCT 07, 2015
HELP-PROMPT: Enter 'YES' if real time 270 transactions can be created and transmitted to the Eligibility
Communicator (EC).
DESCRIPTION: A 'Y'es values indicates that real time 270 transactions can be created and transmitted. A 'N'o
value indicates that real time transactions cannot be created and transmitted.
350.9,51.28 270 MASTER SWITCH NIGHTLY 51;28 SET
'Y' FOR YES;
'N' FOR NO;
LAST EDITED: OCT 07, 2015
HELP-PROMPT: Enter 'YES' if nightly extract 270 transactions can be created and transmitted to the Eligibility
Communicator (EC).
DESCRIPTION: A "Y'es value indicates that nightly extract 270 transactions can be created and transmitted. A
'N'o value indicates that nightly 270 transactions cannot be created and transmitted.
350.9,51.29 DAILY NIF STATUS CHECK TIME 51;29 FREE TEXT
INPUT TRANSFORM: K:(X'?4N)!(X>2400)!($E(X,3,4)'<60) X
LAST EDITED: NOV 13, 2015
HELP-PROMPT: Enter the time in four digit military format.
DESCRIPTION: This is the time of day to check to see if the 'IB NIF TCP' HL7 Logical Link is enabled. If
problems are encountered a message will be sent via MailMan to the
VHAeInsuranceRapidResponse@domain.ext mailgroup.
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
350.9,51.3 MBI PAYER 51;30 POINTER TO PAYER FILE (#365.12)
LAST EDITED: OCT 06, 2017
HELP-PROMPT: Select the CMS MBI entry from the Payer file.
DESCRIPTION: This field holds a pointer to the CMS MBI payer entry. It is the National payer utilized when
requesting a MBI lookup for a Veteran. It is also used when displaying the MBI payer name in the
insurance buffer list and other applications that need to display the MBI payer name.
TECHNICAL DESCR: This field is set via a table update from FSC. It was introduced with IB*2.0*.601.It should not
have to be changed unless the MBI payer entry itself gets changed. This field is only available
for editing via FileMan. Edit with extreme care.
350.9,51.31 EICD PAYER 51;31 POINTER TO PAYER FILE (#365.12)
LAST EDITED: MAY 23, 2018
HELP-PROMPT: Select the EICD entry from the Payer file.
DESCRIPTION: This field identifies the National payer utilized when performing an Electronic Insurance Coverage
Discovery (EICD) inquiry for a Veteran.
TECHNICAL DESCR: This field is a pointer to the EICD payer table (#365.12). It is set via a table update from FSC.
It was introduced with IB*2.0*621 and should not have to change unless the EICD payer gets changed.
It is only editable via FileMan. Edit with extreme care.
350.9,51.32 MEDICARE FRESHNESS DAYS 51;32 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>545)!(X<181)!(X?.E1"."1N.N) X
LAST EDITED: OCT 07, 2019
HELP-PROMPT: Enter the number of days (181-545) data remains "fresh" for Medicare policies.
DESCRIPTION: This parameter determines how "fresh" the insurance verification is for Medicare policies. This
field is a parameter that is used by the Appointment data extract to determine whether a record
should be extracted or not.
TECHNICAL DESCR: For the Appointment data extract, this represents how long to wait before IIV can attempt to
reverify the same insurance for that patient.
If the value is 370, this means that IIV can attempt to reverify insurance for a patient 371 days
after the most recent inquired date.
350.9,51.33 MANILA EIV IIU ENABLED 51;33 SET
'Y' FOR YES;
'N' FOR NO;
LAST EDITED: DEC 10, 2020
HELP-PROMPT: Enter 'YES' if eIV/IIU is Enabled at the VAMC Site (#358) 'Manila'.
DESCRIPTION: A "Y"es means the eIV/IIU software is Enabled for the VAMC site (#358) "Manila"; a "N"o means the
eIV/IIU software is Disabled for the VAMC site (#358) "Manila".
TECHNICAL DESCR: This is used in VistA to prevent Manila (Site #358) from creating and sending eIV messages to FSC
and the sharing of verified policies to other VAMCs via IIU.
350.9,51.34 EIV NO GRP NUM A/U 51;34 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>180)!(X<7)!(X?.E1"."1.N) X
LAST EDITED: JUL 20, 2021
HELP-PROMPT: Enter the number of days (7-180) before an expired policy is not considered for eIV auto update
purposes.
DESCRIPTION: Select a value which represents how long ago a policy expiration date must be older than to
evaluate eIV responses without a group number for auto-update consideration. This only applies when
a patient file contains a single active policy and one or more expired policies for the same
insurance company. Value must be a number between 7-180 days.
TECHNICAL DESCR: This field controls how long a policy must be expired before it is not considered in the policy
count for the payer in auto updating.
350.9,52.01 PURGE DAYS 277 RFAI 52;1 NUMBER
Days To Wait To Purge 277 RFAI Transactions
INPUT TRANSFORM: K:+X'=X!(X>3000)!(X<365)!(X?.E1"."1N.N) X
LAST EDITED: OCT 21, 2015
HELP-PROMPT: Type a number between 365 and 3000, 0 decimal digits.
DESCRIPTION: Enter the number of days (between 365 and 3000) to retain 277 RFAI transactions in VistA. A null
entry (the default) indicates the transactions will be stored forever.
350.9,52.02 WORKLIST PURGE DAYS 277 RFAI 52;2 NUMBER
Days To Wait To Purge Entry On RFAI Worklist Response
INPUT TRANSFORM: K:+X'=X!(X>45)!(X<1)!(X?.E1"."1N.N) X
LAST EDITED: OCT 21, 2015
HELP-PROMPT: Type a number between 1 and 45, 0 decimal digits.
DESCRIPTION: Enter the number of days (between 1 and 45) that a 277 RFAI transaction will remain on the RFAI
Worklist unless specifically removed by a user. The default is 20 days.
350.9,53.01 IIU MASTER SWITCH 53;1 SET
IIU Master Switch
'Y' FOR YES;
'N' FOR NO;
LAST EDITED: DEC 10, 2020
HELP-PROMPT: Enter 'Y'es to Enable IIU processing, allowing verified policies to be shared to other VAMCs. Enter
'N'o to Disable this functionality.
DESCRIPTION: A 'Y'es means the IIU processing is Enabled, allowing verified policies to be shared to other
VAMCs. A 'N'o means the IIU processing is Disabled.
TECHNICAL DESCR: This field is used in VistA to allow/prevent the sharing of verified policies to other VAMCs via
the IIU process. This field is controlled by FSC.
350.9,53.02 IIU ENABLED 53;2 SET (BOOLEAN Data Type)
IIU Enabled
LAST EDITED: FEB 18, 2021
HELP-PROMPT: Enter '0' for NO, '1' for YES.
DESCRIPTION: If this field is set to '1' (YES), the receiving VAMC will evaluate the possibility of storing the
active verified policy in the buffer. If this field is set to '0' (NO), the receiving VAMC will
NOT store the policy in the buffer.
TECHNICAL DESCR:
This is user controlled.
350.9,53.03 IIU RECENT VISIT DAYS 53;3 NUMBER
IIU Recent Visit Days
INPUT TRANSFORM: K:+X'=X!(X>500)!(X<1)!(X?.E1"."1.N) X
LAST EDITED: DEC 10, 2020
HELP-PROMPT: Type a whole number between 1 and 500.
DESCRIPTION: A patient must have recently visited the receiving VAMC within this number of days, for the
possibility of storing the active verified policy in the buffer.
TECHNICAL DESCR:
This field is controlled by FSC.
350.9,53.04 IIU MIN DAYS BEFORE SHARING 53;4 NUMBER
IIU Min Days Before Sharing
INPUT TRANSFORM: K:+X'=X!(X>500)!(X<1)!(X?.E1"."1.N) X
LAST EDITED: DEC 10, 2020
HELP-PROMPT: Type a whole number between 1 and 500.
DESCRIPTION: Minimum number of days allowed since the last time the policy information was sent/shared to
another VAMC via IIU.
TECHNICAL DESCR:
This field is controlled by FSC.
350.9,53.05 IIU PURGE SENT RECORDS 53;5 NUMBER
IIU Purge Sent Records
INPUT TRANSFORM: K:+X'=X!(X>365)!(X<3)!(X?.E1"."1.N) X
LAST EDITED: DEC 10, 2020
HELP-PROMPT: Type a whole number between 3 and 365.
DESCRIPTION: Number of days to retain previously sent policies that are stored in the Interfacility Insurance
Update file (#365.19) before purging.
350.9,53.06 IIU PURGE CANDIDATE RECORDS 53;6 NUMBER
IIU Purge Candidate Records
INPUT TRANSFORM: K:+X'=X!(X>14)!(X<3)!(X?.E1"."1.N) X
LAST EDITED: DEC 10, 2020
HELP-PROMPT: Type a whole number between 3 and 14.
DESCRIPTION: Number of days to retain candidate records in the Interfacility Insurance Update file (#365.19)
that are still waiting to be sent to other VAMCs before purging.
350.9,53.07 IIU PURGE RECEIVED RECORDS 53;7 NUMBER
IIU Purge Received Records
INPUT TRANSFORM: K:+X'=X!(X>60)!(X<15)!(X?.E1"."1.N) X
LAST EDITED: DEC 10, 2020
HELP-PROMPT: Type a whole number between 15 and 60.
DESCRIPTION: Number of days to retain previously received Interfacility Insurance Update file (#365.19) before
purging.
350.9,54.01 INSURANCE IMPORT ENABLED 54;1 SET (BOOLEAN Data Type) (Required)
Insurance Import Enabled
LAST EDITED: JUL 18, 2023
HELP-PROMPT: Enter '1' (YES) to enable importing of insurance policies or '0' (NO) to disable importing of
insurance policies.
DESCRIPTION: If this field is set to '1' (YES), the insurance policies will be imported related to the
background execution of remote query. If this field is set to '0' (NO), the insurance policies will
NOT be imported in the buffer.
350.9,54.02 Daily Buffer Rpt Mail Group 54;2 FREE TEXT
INPUT TRANSFORM: K:$L(X)>80!($L(X)<8)!'($$UP^XLFSTR(X)?.E1"@DOMAIN.EXT") X
MAXIMUM LENGTH: 80
LAST EDITED: SEP 08, 2023
HELP-PROMPT: Enter a @DOMAIN.EXT Outlook email address that will receive the Daily Buffer Report (Summary
Version). Answer must be 8-80 characters in length.
DESCRIPTION: This field MUST contain a @DOMAIN.EXT Outlook email address that will receive the Daily Buffer
Report (Summary Version).
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
350.9,60.01 DEFAULT SERVICE TYPE CODE 1 60;1 POINTER TO X12 271 SERVICE TYPE FILE (#365.013) (Required)
LAST EDITED: AUG 09, 2010
HELP-PROMPT: Enter a default service type code.
DESCRIPTION:
First Default Service Type Code sent with eIV Eligibility Inquiry.
350.9,60.02 DEFAULT SERVICE TYPE CODE 2 60;2 POINTER TO X12 271 SERVICE TYPE FILE (#365.013)
LAST EDITED: MAR 06, 2013
HELP-PROMPT: Enter a default service type code.
DESCRIPTION:
Second Default Service Type Code sent with eIV Eligibility Inquiry.
350.9,60.03 DEFAULT SERVICE TYPE CODE 3 60;3 POINTER TO X12 271 SERVICE TYPE FILE (#365.013)
LAST EDITED: MAR 06, 2013
HELP-PROMPT: Enter a default service type code.
DESCRIPTION:
Third Default Service Type Code sent with eIV Eligibility Inquiry.
350.9,60.04 DEFAULT SERVICE TYPE CODE 4 60;4 POINTER TO X12 271 SERVICE TYPE FILE (#365.013)
LAST EDITED: MAR 06, 2013
HELP-PROMPT: Enter a default service type code.
DESCRIPTION:
Fourth Default Service Type Code sent with eIV Eligibility Inquiry.
350.9,60.05 DEFAULT SERVICE TYPE CODE 5 60;5 POINTER TO X12 271 SERVICE TYPE FILE (#365.013)
LAST EDITED: MAR 06, 2013
HELP-PROMPT: Enter a default service type code.
DESCRIPTION:
Fifth Default Service Type Code sent with eIV Eligibility Inquiry.
350.9,60.06 DEFAULT SERVICE TYPE CODE 6 60;6 POINTER TO X12 271 SERVICE TYPE FILE (#365.013)
LAST EDITED: MAR 06, 2013
HELP-PROMPT: Enter a default service type code.
DESCRIPTION:
Sixth Default Service Type Code sent with eIV Eligibility Inquiry.
350.9,60.07 DEFAULT SERVICE TYPE CODE 7 60;7 POINTER TO X12 271 SERVICE TYPE FILE (#365.013)
LAST EDITED: MAR 06, 2013
HELP-PROMPT: Enter a default service type code.
DESCRIPTION:
Seventh Default Service Type Code sent with eIV Eligibility Inquiry.
350.9,60.08 DEFAULT SERVICE TYPE CODE 8 60;8 POINTER TO X12 271 SERVICE TYPE FILE (#365.013)
LAST EDITED: MAR 06, 2013
HELP-PROMPT: Enter a default service type code.
DESCRIPTION:
Eighth Default Service Type Code sent with eIV Eligibility Inquiry.
350.9,60.09 DEFAULT SERVICE TYPE CODE 9 60;9 POINTER TO X12 271 SERVICE TYPE FILE (#365.013)
LAST EDITED: MAR 06, 2013
HELP-PROMPT: Enter a default service type code.
DESCRIPTION:
Ninth Default Service Type Code sent with eIV Eligibility Inquiry.
350.9,60.1 DEFAULT SERVICE TYPE CODE 10 60;10 POINTER TO X12 271 SERVICE TYPE FILE (#365.013)
LAST EDITED: MAR 06, 2013
HELP-PROMPT: Enter a default service type code.
DESCRIPTION:
Tenth Default Service Type Code sent with eIV Eligibility Inquiry.
350.9,60.11 DEFAULT SERVICE TYPE CODE 11 60;11 POINTER TO X12 271 SERVICE TYPE FILE (#365.013)
LAST EDITED: MAR 06, 2013
HELP-PROMPT: Enter a default service type code.
DESCRIPTION:
Eleventh Default Service Type Code sent with eIV Eligibility Inquiry.
350.9,61.01 SITE SELECTED SERVICE CODE 1 61;1 POINTER TO X12 271 SERVICE TYPE FILE (#365.013)
LAST EDITED: AUG 09, 2010
HELP-PROMPT: Enter a site selected service type code.
DESCRIPTION:
First Site Selected Service Type Code to send with eIV Eligibility Inquiry.
350.9,61.02 SITE SELECTED SERVICE CODE 2 61;2 POINTER TO X12 271 SERVICE TYPE FILE (#365.013)
LAST EDITED: AUG 09, 2010
HELP-PROMPT: Enter a site selected service type code.
DESCRIPTION:
Second Site Selected Service Type Code to send with eIV Eligibility Inquiry.
350.9,61.03 SITE SELECTED SERIVCE CODE 3 61;3 POINTER TO X12 271 SERVICE TYPE FILE (#365.013)
LAST EDITED: AUG 09, 2010
HELP-PROMPT: Enter a site selected service type code.
DESCRIPTION:
Third Site Selected Service Type Code to send with eIV Eligibility Inquiry.
350.9,61.04 SITE SELECTED SERVICE CODE 4 61;4 POINTER TO X12 271 SERVICE TYPE FILE (#365.013)
LAST EDITED: AUG 09, 2010
HELP-PROMPT: Enter a site selected service type code.
DESCRIPTION:
Fourth Site Selected Service Type Code to send with eIV Eligibility Inquiry.
350.9,61.05 SITE SELECTED SERVICE CODE 5 61;5 POINTER TO X12 271 SERVICE TYPE FILE (#365.013)
LAST EDITED: AUG 09, 2010
HELP-PROMPT: Enter a site selected service type code.
DESCRIPTION:
Fifth Site Selected Service Type Code to send with eIV Eligibility Inquiry.
350.9,61.06 SITE SELECTED SERVICE CODE 6 61;6 POINTER TO X12 271 SERVICE TYPE FILE (#365.013)
LAST EDITED: AUG 09, 2010
HELP-PROMPT: Enter a site selected service type code.
DESCRIPTION:
Sixth Site Selected Service Type Code to send with eIV Eligibility Inquiry.
350.9,61.07 SITE SELECTED SERVICE CODE 7 61;7 POINTER TO X12 271 SERVICE TYPE FILE (#365.013)
LAST EDITED: AUG 09, 2010
HELP-PROMPT: Enter a site selected service type code.
DESCRIPTION:
Seventh Site Selected Service Type Code to send with eIV Eligibility Inquiry.
350.9,61.08 SITE SELECTED SERVICE CODE 8 61;8 POINTER TO X12 271 SERVICE TYPE FILE (#365.013)
LAST EDITED: AUG 09, 2010
HELP-PROMPT: Enter a site selected service type code.
DESCRIPTION:
Eighth Site Selected Service Type Code to send with eIV Eligibility Inquiry.
350.9,61.09 SITE SELECTED SERVICE CODE 9 61;9 POINTER TO X12 271 SERVICE TYPE FILE (#365.013)
LAST EDITED: AUG 09, 2010
HELP-PROMPT: Enter a site selected service type code.
DESCRIPTION:
Ninth Site Selected Service Type Code to send with eIV Eligibility Inquiry.
350.9,62.01 LIMIT LENGTH OF EIV FIELDS? 62;1 SET
'0' FOR NO;
'1' FOR YES;
LAST EDITED: MAY 12, 2013
HELP-PROMPT: Set to YES, if length of values in eIV fields should be limited.
DESCRIPTION: If set to YES, eIV field values will be limited to pre-patch IB*2.0*497 lengths via corresponding
input transforms.
350.9,62.02 CPAC ADM FUTURE DAYS 62;2 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>999)!(X<0)!(X?.E1"."1N.N) X
LAST EDITED: SEP 24, 2014
HELP-PROMPT: Type the number of days into the future (between 0 and 999) to search for CPAC Admissions.
DESCRIPTION: The number of days into the future the CPAC Scheduled Admissions search should use when attempting
to create HCSR Transmission entries for future CPAC Admissions.
350.9,62.03 CPAC APPT PAST DAYS 62;3 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>999)!(X<0)!(X?.E1"."1N.N) X
LAST EDITED: SEP 24, 2014
HELP-PROMPT: Type the number of days into the past (between 0 and 999) to search for CPAC Appointments.
DESCRIPTION: The number of days into the past the CPAC Scheduled Appointments search should use when attempting
to create HCSR Transmission entries for past CPAC Appointments.
350.9,62.04 CPAC ADM PAST DAYS 62;4 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>999)!(X<0)!(X?.E1"."1N.N) X
LAST EDITED: SEP 24, 2014
HELP-PROMPT: Type the number of days into the past (between 0 and 999) to search for CPAC Admissions.
DESCRIPTION: The number of days into the past the CPAC Scheduled Admissions search should use when attempting to
create HCSR Transmission entries for past CPAC Admissions.
350.9,62.05 TRICARE APPT FUTURE DAYS 62;5 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>999)!(X<0)!(X?.E1"."1N.N) X
LAST EDITED: SEP 24, 2014
HELP-PROMPT: Type the number of days into the future (between 0 and 999) to search for TRICARE/CHAMPVA
Appointments.
DESCRIPTION: The number of days into the future the TRICARE/CHAMPVA Scheduled Appointments search should use
when attempting to create HCSR Transmission entries for future TRICARE/CHAMPVA Appointments.
350.9,62.06 TRICARE ADM FUTURE DAYS 62;6 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>999)!(X<0)!(X?.E1"."1N.N) X
LAST EDITED: SEP 24, 2014
HELP-PROMPT: Type the number of days into the future (between 0 and 999) to search for TRICARE/CHAMPVA
Admissions.
DESCRIPTION: The number of days into the future the TRICARE/CHAMPVA Scheduled Admissions search should use when
trying to create HCSR Transmission entries for future TRICARE/CHAMPVA Admissions.
350.9,62.07 TRICARE APPT PAST DAYS 62;7 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>999)!(X<0)!(X?.E1"."1N.N) X
LAST EDITED: SEP 24, 2014
HELP-PROMPT: Type the number of days into the past (between 0 and 999) to search for TRICARE/CHAMPVA
Appointments.
DESCRIPTION: The number of days into the past the TRICARE/CHAMPVA Scheduled Appointments search should use when
trying to create HCSR Transmission entries for past TRICARE/CHAMPVA Appointments.
350.9,62.08 TRICARE ADM PAST DAYS 62;8 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>999)!(X<0)!(X?.E1"."1N.N) X
LAST EDITED: SEP 24, 2014
HELP-PROMPT: Type the number of days into the past (between 0 and 999) to search for TRICARE/CHAMPVA Admissions.
DESCRIPTION: The number of days into the past the TRICARE/CHAMPVA Scheduled Appointments search should use when
trying to create HCSR Transmission entries for past TRICARE/CHAMPVA Admissions.
350.9,62.09 PURGE DAYS 62;9 NUMBER (Required)
INPUT TRANSFORM: K:+X'=X!(X>3000)!(X<365)!(X?.E1"."1.N) X
LAST EDITED: SEP 24, 2014
HELP-PROMPT: Type the number of days to retain HCSR Transmission entries (between 365 and 3000) before removing
them from the file.
DESCRIPTION: The number of days to retain events in the HCSR Worklist (file 356.22) before removing them from
the file.
350.9,62.1 INQUIRY TRIGGER APPT 62;10 NUMBER
Inquiry can be Triggered for Appointment
INPUT TRANSFORM: K:+X'=X!(X>14)!(X<0)!(X?.E1"."1.N) X
LAST EDITED: DEC 08, 2014
HELP-PROMPT: Type the number of days to wait (between 0 and 14) before triggering a 278 inquiry for HCSR
Transmission entries created from appointments..
DESCRIPTION: The number of days after the creation of an HCSR Worklist entry from an appointment to wait before
automatically triggering a 278 Inquiry. Note, if the triggered inquiry does not generate a
response, another inquiry will automatically be triggered again at a future date using this
parameter. Inquiries will continue to be triggered until a response is received or the entry is
purged from the worklist.
350.9,62.11 INQUIRY TRIGGER ADM 62;11 NUMBER
Inquiry can be Triggered for Admission
INPUT TRANSFORM: K:+X'=X!(X>14)!(X<0)!(X?.E1"."1.N) X
LAST EDITED: DEC 08, 2014
HELP-PROMPT: Type the number of days to wait (between 0 and 14) before triggering a 278 Inquiry for HCSR
Transmission entries created from admissions.
DESCRIPTION: The number of days after the creation of an HCSR Worklist entry from an admission to wait before
automatically triggering a 278 Inquiry. Note, if the triggered inquiry does not generate a
response, another inquiry will automatically be triggered again at a future date using this
parameter. Inquiries will continue to be triggered until a response is received or the entry is
purged from the worklist.
350.9,62.12 HSCR RESPONSE PURGE DAYS 62;12 NUMBER
Days to wait to purge entry on HCSR Response
INPUT TRANSFORM: K:+X'=X!(X>45)!(X<1)!(X?.E1"."1.N) X
LAST EDITED: SEP 25, 2014
HELP-PROMPT: Type the number of days (between 1 and 45) to display an entry with a completed response on the
HCSR Response View before removing it.
DESCRIPTION: This is the number of days an HCSR Transmission entry with a completed response status will be
displayed on the HCSR Response Worklist.
350.9,62.13 CPAC APPT FUTURE DAYS 62;13 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>999)!(X<0)!(X?.E1"."1.N) X
LAST EDITED: FEB 10, 2015
HELP-PROMPT: Type a number between 0 and 999, 0 decimal digits.
DESCRIPTION: The number of days into the future the CPAC Scheduled Appointments search should use when
attempting to create HCSR Transmission entries for future CPAC Appointments.
350.9,63 HCSR CLINIC LIST 63;0 POINTER Multiple #350.963 (Add New Entry without Asking)
DESCRIPTION: Contains all of the clinics to be included in the search when trying to create HCSR Transmission
entries for past and future appointments. Entries will not be created for appointments if the
appointment's clinic is not in this list.
350.963,.01 NAME 0;1 POINTER TO HOSPITAL LOCATION FILE (#44)
LAST EDITED: SEP 24, 2014
HELP-PROMPT: Enter a valid Clinic.
DESCRIPTION:
The name of a clinic to search for when creating HCSR Transmission entries for appointments.
CROSS-REFERENCE: 350.963^B
1)= S ^IBE(350.9,DA(1),63,"B",$E(X,1,30),DA)=""
2)= K ^IBE(350.9,DA(1),63,"B",$E(X,1,30),DA)
350.963,.02 INCLUDE FOR ALL PAYERS? 0;2 SET
'0' FOR NO;
'1' FOR YES;
LAST EDITED: MAY 16, 2015
HELP-PROMPT: Set this to YES if clinic should be included in HCSR search for all payers.
DESCRIPTION: If set to YES, this particular clinic will be included in HCSR search for all payers. If set to
NO, clinic will be included in HCSR search only for payers listed in sub-file 350.9631.
350.963,1 INCLUDE CLINIC FOR PAYERS 1;0 POINTER Multiple #350.9631 (Add New Entry without Asking)
LAST EDITED: OCT 22, 2015
DESCRIPTION: If field 350.963/.02 is set to NO, HCSR search for this particular clinic will include only
payers listed in this multiple. If field 350.963/.02 is set to YES, this list has no effect on
how HCSR search works.
350.9631,.01 PAYER 0;1 POINTER TO PAYER FILE (#365.12)
LAST EDITED: MAY 16, 2015
HELP-PROMPT: Select a payer to be included in HCSR search for this clinic.
DESCRIPTION:
This is a payer to be included in HCSR search.
CROSS-REFERENCE: 350.9631^B
1)= S ^IBE(350.9,DA(2),63,DA(1),1,"B",$E(X,1,30),DA)=""
2)= K ^IBE(350.9,DA(2),63,DA(1),1,"B",$E(X,1,30),DA)
350.9,64 HCSR WARD LIST 64;0 POINTER Multiple #350.964 (Add New Entry without Asking)
DESCRIPTION: Contains all of the wards to be included in the search when trying to create HCSR Transmission
entries for past and future admissions. Entries will not be created for admissions if the
admission's ward is not included in this list.
350.964,.01 NAME 0;1 POINTER TO WARD LOCATION FILE (#42)
LAST EDITED: SEP 30, 2015
HELP-PROMPT: Enter a valid Ward.
DESCRIPTION: The name of a ward to include in the search when creating HCSR Transmission entries for
admissions.
CROSS-REFERENCE: 350.964^B
1)= S ^IBE(350.9,DA(1),64,"B",$E(X,1,30),DA)=""
2)= K ^IBE(350.9,DA(1),64,"B",$E(X,1,30),DA)
350.964,.02 INCLUDE FOR ALL PAYERS? 0;2 SET
'0' FOR NO;
'1' FOR YES;
LAST EDITED: SEP 30, 2015
HELP-PROMPT: Set this to YES if ward should be included in HCSR search for all payers.
DESCRIPTION: If set to YES, this particular ward will be included in HCSR search for all payers. If set to NO,
ward will be included in HCSR search only for payers listed in sub-file 350.9641.
350.964,1 INCLUDE WARD FOR PAYERS 1;0 POINTER Multiple #350.9641 (Add New Entry without Asking)
LAST EDITED: OCT 22, 2015
DESCRIPTION: If field 350.964/.02 is set to NO, HCSR search for this particular ward will include only payers
listed in this multiple. If field 350.964/.02 is set to YES, this list has no effect on how HCSR
search works.
350.9641,.01 PAYER 0;1 POINTER TO PAYER FILE (#365.12)
LAST EDITED: SEP 30, 2015
HELP-PROMPT: Select a payer to be included in HCSR search for this ward.
DESCRIPTION:
This is a payer to be included in HCSR search.
CROSS-REFERENCE: 350.9641^B
1)= S ^IBE(350.9,DA(2),64,DA(1),1,"B",$E(X,1,30),DA)=""
2)= K ^IBE(350.9,DA(2),64,DA(1),1,"B",$E(X,1,30),DA)
350.9,65 HCSR INSCO APPT LIST 65;0 POINTER Multiple #350.965 (Add New Entry without Asking)
DESCRIPTION: Contains all of the insurance companies to be excluded from the search when trying to create HCSR
Transmission entries for past and future appointments. Entries will not be created if the insurance
company of the patient is included in this list.
350.965,.01 NAME 0;1 POINTER TO INSURANCE COMPANY FILE (#36)
LAST EDITED: SEP 24, 2014
HELP-PROMPT: Enter a valid Insurance Company Name.
DESCRIPTION: The name of an insurance company to exclude from the search for when creating HCSR Transmission
entries for appointments.
CROSS-REFERENCE: 350.965^B
1)= S ^IBE(350.9,DA(1),65,"B",$E(X,1,30),DA)=""
2)= K ^IBE(350.9,DA(1),65,"B",$E(X,1,30),DA)
350.965,.02 PROTECTED 0;2 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>1)!(X<0)!(X?.E1"."1.N) X
LAST EDITED: SEP 24, 2014
HELP-PROMPT: Enter '0' if the insurance was entered by a user. Enter 1 if it was automatically added by the
system.
DESCRIPTION: This field is used to determine if the insurance was added automatically by the system (1) or
manually by the user (0).
350.9,66 HCSR INSCO ADM LIST 66;0 POINTER Multiple #350.966 (Add New Entry without Asking)
DESCRIPTION: Contains all of the insurance companies to be excluded from the search when trying to create HCSR
Transmission entries for past and future admissions. Entries will not be created if the insurance
company of the patient is included in this list.
350.966,.01 NAME 0;1 POINTER TO INSURANCE COMPANY FILE (#36)
LAST EDITED: SEP 24, 2014
HELP-PROMPT: Enter a valid Insurance Company name.
DESCRIPTION: The name of an insurance company to exclude from the search for when creating HCSR Transmission
entries for admissions.
CROSS-REFERENCE: 350.966^B
1)= S ^IBE(350.9,DA(1),66,"B",$E(X,1,30),DA)=""
2)= K ^IBE(350.9,DA(1),66,"B",$E(X,1,30),DA)
350.966,.02 PROTECTED 0;2 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>1)!(X<0)!(X?.E1"."1.N) X
LAST EDITED: SEP 19, 2014
HELP-PROMPT: Enter '0' if the insurance was entered by a user. Enter '1' if the insurance was entered
automatically by the system.
DESCRIPTION: This field is used to determine if the insurance was added automatically by the system (1) or
manually by the user (0).
350.9,70.01 HPID/OEID ACTIVE? 70;1 SET
'0' FOR Not Active;
'1' FOR Active;
LAST EDITED: APR 24, 2014
HELP-PROMPT: Enter 'Active' if your NIF link is active.
DESCRIPTION: This parameter indicates whether or not the National Insurance File (NIF) is ready to communicate
with your VISTA site.
350.9,70.02 SHRPE ACTIVATION DATE 70;2 DATE
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:3171101>X X
LAST EDITED: JAN 30, 2018
HELP-PROMPT: Type a date not earlier than NOV 01, 2017.
DESCRIPTION: This is the date that legislation was passed to allow SHPRE visit copayment and prescription
prorated amounts will be allowed (if supply is under 30 days). A check is done using this piece to
determine if the above functions are allowed.
TECHNICAL DESCR: As per the SHRPE project, we will be checking for a patient's active National flag for High Risk
for Suicide, and this date is set at the date of service, the patient will have Visit copayments
waived and prescriptions less than 30 days will be prorated. This date is necessary (it will be
defined in IB*2.0*614 as NULL), the field will be set to Uneditable to prevent accidental revision.
350.9,71.01 COVID-19 RELIEF END DATE 71;1 DATE
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: MAR 25, 2021
HELP-PROMPT: Please enter the end date for Covid-19 relief.
DESCRIPTION:
This parameter contains the end date for COVID-19 relief.
350.9,71.02 COMPACT EFFECTIVE DATE 71;2 DATE
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: NOV 01, 2021
HELP-PROMPT: Please enter the start date of COMPACT ACT Benefit.
DESCRIPTION:
This parameter contains the start date of COMPACT ACT Benefit.
350.9,71.03 CLELAND-DOLE EFFECTIVE DATE 71;3 DATE
INPUT TRANSFORM: S %DT="E" D ^%DT S X=Y K:Y<1 X
LAST EDITED: APR 10, 2023
HELP-PROMPT: Enter the start date for CLELAND-DOLE Mental Health Benefits.
DESCRIPTION:
This parameter contains the start date for CLELAND-DOLE Mental Health Benefits.
350.9,71.04 CLELAND-DOLE END DATE 71;4 DATE
INPUT TRANSFORM: S %DT="E" D ^%DT S X=Y K:Y<1 X
LAST EDITED: APR 10, 2023
HELP-PROMPT: Enter the end date for the CLELAND-DOLE Health Benefits
DESCRIPTION:
This parameter contains the end date for CLELAND-DOLE Mental Health Benefits.
350.9,81 PRIMARY PAYER ID TYPES MED 81;0 POINTER Multiple #350.981 (Add New Entry without Asking)
DESCRIPTION: This ID Type designates the type of claims which are processed by a different Administration
Contractor than normal claims. It determines which Alternate Institutional or Professional Payer
Primary ID will be transmitted for Medicare Plans.
350.981,.01 PRIMARY PAYER ID TYPES MED 0;1 POINTER TO IB ALTERNATE PRIMARY ID TYPE FILE (#355.98) (Multiply asked)
LAST EDITED: NOV 18, 2015
HELP-PROMPT: Enter a Primary ID Type for Medicare Claims.
DESCRIPTION: This ID Type designates the type of claims which are processed by a different Administration
Contractor than normal claims. It determines which Alternate Institutional or Professional Payer
Primary ID will be transmitted for Medicare Plans.
CROSS-REFERENCE: 350.981^B
1)= S ^IBE(350.9,DA(1),81,"B",$E(X,1,30),DA)=""
2)= K ^IBE(350.9,DA(1),81,"B",$E(X,1,30),DA)
350.9,82 PRIMARY PAYER ID TYPES COM 82;0 POINTER Multiple #350.982 (Add New Entry without Asking)
DESCRIPTION: This ID Type designates the type of claims which are processed by a different Administration
Contractor than normal claims. It determines which Alternate Institutional or Professional Payer
Primary ID will be transmitted for Commercial Plans.
350.982,.01 PRIMARY PAYER ID TYPES COM 0;1 POINTER TO IB ALTERNATE PRIMARY ID TYPE FILE (#355.98) (Multiply asked)
LAST EDITED: NOV 18, 2015
HELP-PROMPT: Enter a Primary ID Type for commercial claims.
DESCRIPTION: This ID Type designates the type of claims which are processed by a different Administration
Contractor than normal claims. It determines which Alternate Institutional or Professional Payer
Primary ID will be transmitted for Commercial Plans.
CROSS-REFERENCE: 350.982^B
1)= S ^IBE(350.9,DA(1),82,"B",$E(X,1,30),DA)=""
2)= K ^IBE(350.9,DA(1),82,"B",$E(X,1,30),DA)
350.9,99 INS. CO's WITHHOLDING SUPPLIMENTAL PAYMENTS 99;0 POINTER Multiple #350.999 (Add New Entry without Asking)
DESCRIPTION: This sub-file contains pointers to the INSURANCE COMPANY (#36) file. The sub-file is populated
from the option Edit List of Ins. Co. Witholding Payments [IB MRA EDIT INS CO LIST] or the Queue
MRA Extract [IB MRA EXTRACT].
The insurance companies listed in this sub-file represent the companies for which means test bills
will be extracted.
350.999,.01 INS. CO'S FOR MRA EXTRACT 0;1 POINTER TO INSURANCE COMPANY FILE (#36) (Multiply asked)
LAST EDITED: JAN 23, 2001
HELP-PROMPT: Enter an Insurance company for the MRA Extract
DESCRIPTION: This sub-file contains pointers to the INSURANCE COMPANY (#36) file. The sub-file is populated
from the option Edit List of Ins. Co. Witholding Payments [IB MRA EDIT INS CO LIST] or the Queue
MRA Extract [IB MRA EXTRACT].
The insurance companies listed in this sub-file represent the companies for which means test
bills will be extracted.
CROSS-REFERENCE: 350.999^B
1)= S ^IBE(350.9,DA(1),99,"B",$E(X,1,30),DA)=""
2)= K ^IBE(350.9,DA(1),99,"B",$E(X,1,30),DA)
FILES POINTED TO FIELDS
CHARGE SET (#363.1) AWP CHARGE SET (#9.12)
CPT (#81) DEFAULT RX REFILL CPT (#1.3)
CMN CPT CODES:CMN CPT CODES (#.01)
DEVICE (#3.5) CMS-1500 AUTO PRINTER (#8.14)
UB-04 AUTO PRINTER (#8.15)
EOB AUTO PRINTER (#8.16)
MRA AUTO PRINTER (#8.19)
FACILITY TYPE (#4.1) BILLING PROVIDER FAC TYPES:BILLING PROVIDER FAC TYPES (#.01)
HEALTH SUMMARY TYPE (#142) INPT HEALTH SUMMARY (#2.08)
OUTPT HEALTH SUMMARY (#2.09)
HOSPITAL LOCATION (#44) HCSR CLINIC LIST:NAME (#.01)
IB ALTERNATE PRIMARY ID TYPE
(#355.98) PRIMARY PAYER ID TYPES MED:PRIMARY PAYER ID TYPES MED (#.01)
PRIMARY PAYER ID TYPES COM:PRIMARY PAYER ID TYPES COM (#.01)
ICD DIAGNOSIS (#80) DEFAULT RX REFILL DX (#1.29)
DEFAULT RX REFILL DX ICD-10 (#7.05)
INSTITUTION (#4) FACILITY NAME (#.02)
PATIENT OR FACILITY (#10.01)
FIELD^NL^1.05^10:FACILITY (#.01)
TRICARE PAY-TO PROVIDERS:TC FACILITY (#.01)
INSURANCE COMPANY (#36) PATIENT OR INSURANCE COMPANY (#4.02)
INSURANCE COMPANY (#4.06)
HCSR INSCO APPT LIST:NAME (#.01)
HCSR INSCO ADM LIST:NAME (#.01)
INS. CO's WITHHOLDING SUPPLIMENTAL PAYMENTS:INS. CO'S FOR MRA EXTRACT (#.01)
MAIL GROUP (#3.8) COPAY BACKGROUND ERROR GROUP (#.09)
MEANS TEST BILLING MAIL GROUP (#.11)
COPAY EXEMPTION MAIL GROUP (#.13)
BILL CANCELLATION MAILGROUP (#1.07)
BILL DISAPPROVED MAILGROUP (#1.09)
NEW INSURANCE MAIL GROUP (#4.04)
UNBILLED MAIL GROUP (#6.25)
GENERAL ERROR MSG MAIL GROUP (#50.03)
COMM ERR MSG MAIL GROUP (#50.04)
MESSAGES MAILGROUP (#51.04)
MEDICAL CENTER DIVISION (#40.8) DEFAULT DIVISION (#1.25)
NEW PERSON (#200) BILLING SUPERVISOR NAME (#1.08)
*CONTACT PERSON (#51.16)
*MOST POPULAR LAST SAVED BY (#51.24)
PATIENT (#2) PATIENT OR INSURANCE COMPANY (#4.02)
PAYER (#365.12) MEDICARE PAYER (#51.25)
MBI PAYER (#51.3)
EICD PAYER (#51.31)
*POPULAR PAYERS:*POPULAR PAYER (#.01)
INCLUDE CLINIC FOR PAYERS:PAYER (#.01)
INCLUDE WARD FOR PAYERS:PAYER (#.01)
RATE TYPE (#399.3) NON-MCCF RATE TYPES FOR PTP:NON-MCCF RATE TYPES FOR PTP (#.01)
REVENUE CODE (#399.2) *DEFAULT AMB SURG REV CODE (#1.18)
*DEFAULT RX REFILL REV CODE (#1.28)
PRINTED CLAIMS RC EXCLUSIONS:REVENUE CODE (#.01)
SERVICE/SECTION (#49) MAS SERVICE POINTER (#1.14)
STATE (#5) *AGENT CASHIER STATE (#2.04)
FIELD^NL^1.05^10:STATE (#1.04)
TRICARE PAY-TO PROVIDERS:TC STATE (#1.04)
TRANSFER PRICING PATIENT
(#351.6) PATIENT OR FACILITY (#10.01)
WARD LOCATION (#42) HCSR WARD LIST:NAME (#.01)
X12 271 SERVICE TYPE (#365.013) DEFAULT SERVICE TYPE CODE 1 (#60.01)
DEFAULT SERVICE TYPE CODE 2 (#60.02)
DEFAULT SERVICE TYPE CODE 3 (#60.03)
DEFAULT SERVICE TYPE CODE 4 (#60.04)
DEFAULT SERVICE TYPE CODE 5 (#60.05)
DEFAULT SERVICE TYPE CODE 6 (#60.06)
DEFAULT SERVICE TYPE CODE 7 (#60.07)
DEFAULT SERVICE TYPE CODE 8 (#60.08)
DEFAULT SERVICE TYPE CODE 9 (#60.09)
DEFAULT SERVICE TYPE CODE 10 (#60.1)
DEFAULT SERVICE TYPE CODE 11 (#60.11)
SITE SELECTED SERVICE CODE 1 (#61.01)
SITE SELECTED SERVICE CODE 2 (#61.02)
SITE SELECTED SERIVCE CODE 3 (#61.03)
SITE SELECTED SERVICE CODE 4 (#61.04)
SITE SELECTED SERVICE CODE 5 (#61.05)
SITE SELECTED SERVICE CODE 6 (#61.06)
SITE SELECTED SERVICE CODE 7 (#61.07)
SITE SELECTED SERVICE CODE 8 (#61.08)
SITE SELECTED SERVICE CODE 9 (#61.09)
INPUT TEMPLATE(S):
IB EDIT CLEAR MAR 04, 1991@08:03 USER #1453
Clear Integrated Billing Filer Parameters.
IB EDIT SITE PARAM FEB 04, 1993@08:59 USER #1453
Enter/edit Integrated Billing Site Parameters.
IBCNE GENERAL PARAMETER EDIT SEP 07, 2023@14:53 USER #0
IBCNF EDIT CONFIGURATION OCT 21, 2011@14:03 USER #0
PRINT TEMPLATE(S):
SORT TEMPLATE(S):
FORM(S)/BLOCK(S):