| # | Name | Location | Type | Details | Index | Description |
|---|---|---|---|---|---|---|
| .01 | patient(+) | 0;1 | POINTER | 2 | B | This field contains the patient for the paid Fee claim that may have vendor and/or 5010 provider information automated to IB. |
| .02 | program | 0;2 | SET OF CODES | 3:OUTPATIENT 9:INPATIENT | This field identifies the Fee program for the paid claim. Vendor and 5010 provider data is pulled from either the FEE BASIS PAYMENT(#162) file for Outpatient, or the FEE BASIS INVOICE(#162.5) file for Inpatient during IB automation. | |
| .03 | fb internal control number | 0;3 | FREE TEXT | This value is retrieved from the PAID message from Central Fee to identify the payment or invoice. Outpatient claim control numbers are formatted as comma-delimited strings that point to the specific line item in a claim. Inpatient claim control numbers are pointers to the FEE BASIS INVOICE(#162.5) file. | ||
| .04 | process date | 0;4 | DATE-TIME | AC | This field contains the date the MailMan message from Central Fee was processed by the server. | |
| .05 | li number | 0;5 | NUMERIC | The Line Item number from the FEE BASIS entry being processed. | ||
| .06 | provider type | 0;6 | SET OF CODES | V:VENDOR A:ATTENDING O:OPERATING R:RENDERING S:SERVICING F:REFERRING L:LI RENDERING | This field identifies the provider type that is associated with this Line Item. | |
| .07 | ib non/other provider | 0;7 | POINTER | 355.93 | This is the provider of Fee Basis services in the IB file. | |
| .08 | npi added | 0;8 | SET OF CODES | 0:NO NPI UPDATES ATTEMPTED 1:NPI DATA INVALID 2:NPI MATCHED ACTIVE, NO UPDATES 3:NPI MATCHED INACTIVE, NO UPDATES 4:NPI MATCHED ACTIVE, IB UPDATED 5:NPI NEW, IB RECORD CREATED | This field provides information about updates to the NPI(#41.01) field of the record in the IB/NON OTHER VA BILLING PROVIDER (#355.93) file as pointed to by field #.07 in this file. | |
| .09 | taxonomy added | 0;9 | SET OF CODES | 0:NO TXY UPDATES ATTEMPTED 1:TXY CODE NOT FOUND IN 8932.1 2:MATCHED PRIMARY, NO UPDATES 3:MATCHED NON-PRIMARY, IB TXY UPDATES 4:NEW, IB TXY ENTRY CREATED | This field provides information about updates to the TAXONOMY CODE(#42) field of the record in the IB/NON OTHER VA PROVIDER(#355.93) file as pointed to by field #.07 in this file. |
Not Referenced