STANDARD DATA DICTIONARY #352.4 -- NON-BILLABLE CLINICS FILE 3/24/25 PAGE 1
STORED IN ^IBE(352.4, *** NO DATA STORED YET *** SITE: WWW.BMIRWIN.COM UCI: VISTA,VISTA (VERSION 2.0)
DATA NAME GLOBAL DATA
ELEMENT TITLE LOCATION TYPE
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This file shall be used to flag clinics in the HOSPITAL LOCATION (#44) file as either billable or non-billable for Means Test
Billing and Third Party Billing. It may also be used to flag billable clinics so the Third Party auto biller will not create bills
for them. The flagging of clinics is date-sensitive, so the ability to not bill may be turned on or off. Please note that the
default billing action IS TO BILL all clinics; thus, it is only necessary to add entries in this file for clinics where billing is
NOT desired.
The routine IBEFUNC contains the function call to determine if a clinic should be not billed on a specific date.
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: @
CROSS
REFERENCED BY: CLINIC(AIVDT), EFFECTIVE DATE(AIVDT1), TYPE(AIVDT2), CLINIC(AIVDTT), EFFECTIVE DATE(AIVDTT1), TYPE(AIVDTT2),
CLINIC(B)
352.4,.01 CLINIC 0;1 POINTER TO HOSPITAL LOCATION FILE (#44) (Required)
INPUT TRANSFORM: S DIC("S")="I $P(^(0),U,3)=""C""" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X
LAST EDITED: JAN 30, 1996
HELP-PROMPT: Please enter a clinic.
DESCRIPTION: This field is a pointer to the HOSPITAL LOCATION (#44) file and identifies the clinic which is
being flagged as billable or non-billable.
SCREEN: S DIC("S")="I $P(^(0),U,3)=""C"""
EXPLANATION: This screen is used to assure that only clinics in file #44 are selected.
CROSS-REFERENCE: 352.4^B
1)= S ^IBE(352.4,"B",$E(X,1,30),DA)=""
2)= K ^IBE(352.4,"B",$E(X,1,30),DA)
CROSS-REFERENCE: 352.4^AIVDT^MUMPS
1)= I $P($G(^IBE(352.4,DA,0)),"^",4)=1,$P(^(0),"^",2) S ^IBE(352.4,"AIVDT",X,-$P(^(0),"^",2),DA)=""
2)= I $P($G(^IBE(352.4,DA,0)),"^",4)=1,$P(^(0),"^",2) K ^IBE(352.4,"AIVDT",X,-$P(^(0),"^",2),DA)
This cross-reference on the CLINIC (#.01) field and the EFFECTIVE DATE (#.02) field is used to
locate the appropriate record for a clinic on a specific effective date. For Means Test entries
only.
CROSS-REFERENCE: 352.4^AIVDTT^MUMPS
1)= I $P($G(^IBE(352.4,DA,0)),"^",4)>1,$P(^(0),"^",2) S ^IBE(352.4,"AIVDTT"_$P(^(0),"^",4),X,-$P(^(
0),"^",2),DA)=""
2)= I $P($G(^IBE(352.4,DA,0)),"^",4)>1,$P(^(0),"^",2) K ^IBE(352.4,"AIVDTT"_$P(^(0),"^",4),X,-$P(^(
0),"^",2),DA)
Cross-reference on CLINIC STOP CODE (.01) and EFFECTIVE DATE (.02) for quick reference to a clinics
Third Party status on any given date.
352.4,.02 EFFECTIVE DATE 0;2 DATE (Required)
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: JAN 30, 1996
HELP-PROMPT: Please enter the effective date.
DESCRIPTION:
This is the date on which billing for this clinic should be ignored or activated.
CROSS-REFERENCE: 352.4^AIVDT1^MUMPS
1)= I $P($G(^IBE(352.4,DA,0)),"^",4)=1,+^(0) S ^IBE(352.4,"AIVDT",+^(0),-X,DA)=""
2)= I $P($G(^IBE(352.4,DA,0)),"^",4)=1,+^(0) K ^IBE(352.4,"AIVDT",+^(0),-X,DA)
This cross-reference on the CLINIC (#.01) field and the EFFECTIVE DATE (#.02) field is used to
locate the appropriate record for a clinic on a specific effective date. For Means Test entries
only.
CROSS-REFERENCE: 352.4^AIVDTT1^MUMPS
1)= I $P($G(^IBE(352.4,DA,0)),"^",4)>1,+^(0) S ^IBE(352.4,"AIVDTT"_$P(^(0),"^",4),+^(0),-X,DA)=""
2)= I $P($G(^IBE(352.4,DA,0)),"^",4)>1,+^(0) K ^IBE(352.4,"AIVDTT"_$P(^(0),"^",4),+^(0),-X,DA)
Cross-reference on CLINIC STOP CODE (.01) and EFFECTIVE DATE (.02) for quick reference to a clinics
Third Party status on any given date.
352.4,.03 IGNORE MEANS TEST BILLING? 0;3 SET (Required)
'1' FOR YES;
'0' FOR NO;
LAST EDITED: JUL 20, 1993
HELP-PROMPT: Please enter 'YES' or 'NO.'
DESCRIPTION: This field is used to determine whether Means Test billing should be ignored or activated, as of
the EFFECTIVE DATE (field #.02).
Please note that you only need an entry in this file for a clinic for which you would like Means
Test billing to be IGNORED.
352.4,.04 TYPE 0;4 SET (Required)
'1' FOR MEANS TEST;
'2' FOR THIRD PARTY;
LAST EDITED: JAN 30, 1996
HELP-PROMPT: Enter the type of billing this entry applies to.
DESCRIPTION:
This specifies the type of billing this bill/not bill Clinic flag applies to.
CROSS-REFERENCE: 352.4^AIVDT2^MUMPS
1)= I X=1,+$G(^IBE(352.4,DA,0)),$P(^(0),"^",2) S ^IBE(352.4,"AIVDT",+^(0),-$P(^(0),"^",2),DA)=""
2)= I X=1,+$G(^IBE(352.4,DA,0)),$P(^(0),"^",2) K ^IBE(352.4,"AIVDT",+^(0),-$P(^(0),"^",2),DA)
Cross-reference on CLINIC STOP CODE (.01) and EFFECTIVE DATE (.02) for quick reference to a clinics
Means Test status on any given date.
CROSS-REFERENCE: 352.4^AIVDTT2^MUMPS
1)= I X>1,+$G(^IBE(352.4,DA,0)),$P(^(0),"^",2) S ^IBE(352.4,"AIVDTT"_X,+^(0),-$P(^(0),"^",2),DA)=""
2)= I X>1,+$G(^IBE(352.4,DA,0)),$P(^(0),"^",2) K ^IBE(352.4,"AIVDTT"_X,+^(0),-$P(^(0),"^",2),DA)
Cross-reference on CLINIC STOP CODE (.01) and EFFECTIVE DATE (.02) for quick reference to a clinics
Third Party status on any given date.
352.4,.05 THIRD PARTY NON-BILLABLE 0;5 SET
'1' FOR YES;
'0' FOR NO;
LAST EDITED: JAN 30, 1996
HELP-PROMPT: Enter 'Yes' if this clinic is not billable to a third party.
DESCRIPTION:
This field is used to determine if the clinic should be billed to a Third Party payer.
CROSS-REFERENCE: ^^TRIGGER^352.4^.06
1)= X ^DD(352.4,.05,1,1,1.3) I X S X=DIV S Y(1)=$S($D(^IBE(352.4,D0,0)):^(0),1:"") S X=$P(Y(1),U,6)
,X=X S DIU=X K Y S X="" X ^DD(352.4,.05,1,1,1.4)
1.3)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(0)=X S Y(2)=$C(59)_$S($D(^DD(352.4,.06,0)):$P(^(0),U,3),1:"
"),Y(1)=$S($D(^IBE(352.4,D0,0)):^(0),1:"") S X=$P($P(Y(2),$C(59)_$P(Y(1),U,6)_":",2),$C(59),1)="NO"
1.4)= S DIH=$S($D(^IBE(352.4,DIV(0),0)):^(0),1:""),DIV=X S $P(^(0),U,6)=DIV,DIH=352.4,DIG=.06 D ^DI
CR:$O(^DD(DIH,DIG,1,0))>0
2)= X ^DD(352.4,.05,1,1,2.3) I X S X=DIV S Y(1)=$S($D(^IBE(352.4,D0,0)):^(0),1:"") S X=$P(Y(1),U,6)
,X=X S DIU=X K Y S X="" X ^DD(352.4,.05,1,1,2.4)
2.3)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(0)=X S Y(2)=$C(59)_$S($D(^DD(352.4,.06,0)):$P(^(0),U,3),1:"
"),Y(1)=$S($D(^IBE(352.4,D0,0)):^(0),1:"") S X=$P($P(Y(2),$C(59)_$P(Y(1),U,6)_":",2),$C(59),1)="NO"
2.4)= S DIH=$S($D(^IBE(352.4,DIV(0),0)):^(0),1:""),DIV=X S $P(^(0),U,6)=DIV,DIH=352.4,DIG=.06 D ^DI
CR:$O(^DD(DIH,DIG,1,0))>0
CREATE CONDITION)= THIRD PARTY AUTO BILL="NO"
CREATE VALUE)= @
DELETE CONDITION)= THIRD PARTY AUTO BILL="NO"
DELETE VALUE)= @
FIELD)= THIRD PARTY AUTO BILL
Deletes the flag that stops auto billing for this clinic whenever the non-billable status of the
clinic changes.
352.4,.06 THIRD PARTY AUTO BILL 0;6 SET
'1' FOR NO;
'0' FOR YES;
LAST EDITED: JAN 30, 1996
HELP-PROMPT: Should visits with this clinic be automatically billed?
DESCRIPTION: Enter 'No' if the Third Party auto biller should NOT create bills for visits with this clinic.
This should only be set for clinics that are billable.
NOTES: TRIGGERED by the THIRD PARTY NON-BILLABLE field of the NON-BILLABLE CLINICS File
FILES POINTED TO FIELDS
HOSPITAL LOCATION (#44) CLINIC (#.01)
INPUT TEMPLATE(S):
PRINT TEMPLATE(S):
SORT TEMPLATE(S):
FORM(S)/BLOCK(S):