STANDARD DATA DICTIONARY #364.8 -- PAYER ID - COB SWITCH FILE 3/24/25 PAGE 1
STORED IN ^IBA(364.8, (1510 ENTRIES) SITE: WWW.BMIRWIN.COM UCI: VISTA,VISTA (VERSION 2.0)
DATA NAME GLOBAL DATA
ELEMENT TITLE LOCATION TYPE
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This file is the VistA version of FSC's tbl.Payers table, used to perform COB Payer ID switching for Medicare Supplemental claims.
DD ACCESS: @
RD ACCESS: @
WR ACCESS: @
DEL ACCESS: @
LAYGO ACCESS: @
AUDIT ACCESS: @
IDENTIFIED BY: TPA ID (#.02), CLAIM OFFICE ID (#.03), CLAIM TYPE (#.04)[R], EXCLUDED SERVICE CLAIM TYPE (#.11)
PRIMARY KEY: A (#136)
Uniqueness Index: IBTASDB (#1024)
File, Field: 1) PRIMARY ID (364.8,.01) 2) CLAIM TYPE (364.8,.04)
CROSS
REFERENCED BY: PRIMARY ID(B), TPA ID(C)
INDEXED BY: PRIMARY ID & CLAIM TYPE (IBATSDB), PRIMARY ID & CLAIM TYPE (IBTASDB)
LAST MODIFIED: OCT 25,2023@13:25:53
364.8,.01 PRIMARY ID 0;1 FREE TEXT (Required) (audited) (Key field)
INPUT TRANSFORM: K:$L(X)>5!($L(X)<5)!'(X'?1P.E) X
MAXIMUM LENGTH: 5
LAST EDITED: FEB 21, 2023
HELP-PROMPT: Enter the Payer ID that is enabled for Medicare Supplemental EDI claims submission. ID must be 5
characters in length.
DESCRIPTION:
This is the Payer ID that is enabled for COB EDI submission on a Medicare Supplemental claim.
AUDIT: YES, ALWAYS
CROSS-REFERENCE: 364.8^B
1)= S ^IBA(364.8,"B",$E(X,1,30),DA)=""
2)= K ^IBA(364.8,"B",$E(X,1,30),DA)
RECORD INDEXES: IBATSDB (#1023), IBTASDB (#1024)
364.8,.02 TPA ID 0;2 FREE TEXT (audited)
INPUT TRANSFORM: K:$L(X)>5!($L(X)<5) X
MAXIMUM LENGTH: 5
LAST EDITED: FEB 21, 2023
HELP-PROMPT: Enter the Third Party Administrator Payer ID for the Primary Payer ID selected. ID must be 5
characters in length.
DESCRIPTION:
This is the Third Party Administrator Payer ID for the Primary Payer ID.
AUDIT: YES, ALWAYS
CROSS-REFERENCE: 364.8^C
1)= S ^IBA(364.8,"C",$E(X,1,30),DA)=""
2)= K ^IBA(364.8,"C",$E(X,1,30),DA)
This index will be used to lookup the Third Party Administrator payer ID for a given Medicare
Supplemental payer.
364.8,.03 CLAIM OFFICE ID 0;3 FREE TEXT (audited)
INPUT TRANSFORM: K:$L(X)>4!($L(X)<4) X
MAXIMUM LENGTH: 4
LAST EDITED: FEB 21, 2023
HELP-PROMPT: Enter the Claim Office ID for the Payer ID selected. ID must be 4 characters in length.
DESCRIPTION:
This is the Claim Office ID to be used for this Primary Payer ID.
AUDIT: YES, ALWAYS
364.8,.04 CLAIM TYPE 0;4 SET (Required) (audited) (Key field)
'1' FOR ALL CLAIM TYPES;
'2' FOR PROFESSIONAL CLAIMS;
'3' FOR INSTITUTIONAL CLAIMS;
LAST EDITED: JAN 24, 2023
HELP-PROMPT: Please enter the claim type for which this payer ID map applies to.
DESCRIPTION:
This is the Claim Type for which this Payer ID map applies to.
AUDIT: YES, ALWAYS
RECORD INDEXES: IBATSDB (#1023), IBTASDB (#1024)
364.8,.05 DATE/TIME LAST MODIFIED 0;5 DATE
INPUT TRANSFORM: S %DT="ETXR" D ^%DT S X=Y K:Y<1 X
LAST EDITED: FEB 21, 2023
HELP-PROMPT: Please enter the date and time this entry was last modified.
DESCRIPTION:
This is the date and time this entry was last modified.
364.8,.06 LAST USED 0;6 DATE
INPUT TRANSFORM: S %DT="ETXR" D ^%DT S X=Y K:Y<1 X
LAST EDITED: NOV 03, 2022
HELP-PROMPT: Please enter the last date and time this Payer ID map was used for an 837 processing.
DESCRIPTION:
This is the last date/time this Payer ID Switch map was used for 837 processing.
364.8,.07 NUMBER OF TIMES USED 0;7 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>9999999999)!(X<0)!(X?.E1"."1N.N) X
LAST EDITED: NOV 01, 2022
HELP-PROMPT: Enter the number of times this Payer ID switch map has been used.
DESCRIPTION:
This is a count of the number of times the 837 process has used this Payer ID switch map.
364.8,.08 TEST or PRODUCTION 0;8 SET (BOOLEAN Data Type) (audited)
LAST EDITED: NOV 09, 2022
HELP-PROMPT: Please enter a zero (0) for 'live' status, a one (1) for 'test' status.
DESCRIPTION: This value identifies if this Payer ID switch map is in 'test' mode or is live for production. A
value of 0 indicates 'live for production' and a value of 1 indicates this entry is in 'test'
status.
AUDIT: YES, ALWAYS
364.8,.09 DELETED / INACTIVE 0;9 SET (BOOLEAN Data Type) (audited)
LAST EDITED: NOV 09, 2022
HELP-PROMPT: Please enter a one (1) to inactivate this Payer ID switch map.
DESCRIPTION: A value of 1 found in this field indicates that this Payer ID switch map has been inactivated or
deleted.
AUDIT: YES, ALWAYS
364.8,.11 EXCLUDED SERVICE CLAIM TYPE 0;11 SET (audited)
'1' FOR ALL CLAIM TYPES;
'2' FOR PROFESSIONAL CLAIMS;
'3' FOR INSTITUTIONAL CLAIMS;
LAST EDITED: DEC 19, 2022
HELP-PROMPT: Please enter the claim form type for which this Payer ID is enabled for Excluded Service
processing.
DESCRIPTION:
This value indicates what claim form types are to be allowed for Excluded Service processing.
AUDIT: YES, ALWAYS
364.8,.12 EXCLUDED SERVICE LAST UPDATED 0;12 DATE
INPUT TRANSFORM: S %DT="ETXR" D ^%DT S X=Y K:Y<1 X
LAST EDITED: NOV 03, 2022
HELP-PROMPT: Please enter the date and time the Excluded Service information was last updated.
DESCRIPTION: This field represents the last date/time the Excluded Service info (fields .10 and .11) were
modified.
364.8,.13 EXCLUDED SERVICE LAST USED 0;13 DATE
INPUT TRANSFORM: S %DT="ETXR" D ^%DT S X=Y K:Y<1 X
LAST EDITED: NOV 03, 2022
HELP-PROMPT: Please enter the last date and time this Excluded Service exception entry was used.
DESCRIPTION: This date/time represents the last time this Payer ID was checked for this Excluded Service
exception.
364.8,.14 EXCLUDED SERVICE # TIMES USED 0;14 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>9999999999)!(X<0)!(X?.E1"."1N.N) X
LAST EDITED: NOV 01, 2022
HELP-PROMPT: Enter the number of times this Payer ID has been used for Excluded Service processing.
DESCRIPTION: This field represents the number of times this Payer ID has been used for Excluded Service
processing.
364.8,.15 LAST CLAIM NUMBER 0;15 FREE TEXT
INPUT TRANSFORM: K:$L(X)>10!($L(X)<7) X
MAXIMUM LENGTH: 10
LAST EDITED: FEB 21, 2023
HELP-PROMPT: Enter the last Claim number that used this Payer ID map. Claim Number must be between 7 and 10
characters in length.
DESCRIPTION:
This is the last Claim number that used this Payer ID switch map.
File #364.8
Record Indexes:
IBATSDB (#1023) RECORD REGULAR IR LOOKUP & SORTING
Short Descr: Uniqueness Index for Key 'A' of File #364.8
Set Logic: S ^IBA(364.8,"IBATSDB",X(1),X(2),DA)=""
Kill Logic: K ^IBA(364.8,"IBATSDB",X(1),X(2),DA)
Whole Kill: K ^IBA(364.8,"IBATSDB")
X(1): PRIMARY ID (364.8,.01) (Subscr 1)
X(2): CLAIM TYPE (364.8,.04) (Subscr 2)
IBTASDB (#1024) RECORD REGULAR IR LOOKUP & SORTING
Unique for: Key A (#136), File #364.8
Short Descr: Uniqueness Index for Key 'A' of File #364.8
Set Logic: S ^IBA(364.8,"IBTASDB",X(1),X(2),DA)=""
Kill Logic: K ^IBA(364.8,"IBTASDB",X(1),X(2),DA)
Whole Kill: K ^IBA(364.8,"IBTASDB")
X(1): PRIMARY ID (364.8,.01) (Subscr 1)
X(2): CLAIM TYPE (364.8,.04) (Subscr 2)
INPUT TEMPLATE(S):
PRINT TEMPLATE(S):
SORT TEMPLATE(S):
FORM(S)/BLOCK(S):