DO NOT delete entries in this file. DO NOT edit data in this file with VA File Manager. Entries in this file are created by other applications calling approved application specific routines. This file is the link between Accounts Receivable and an application. Integrated billing will attempt to aggregate charges where possible to reduce the number of account entries necessary. Resolution of charges from Accounts Receivable would then be accomplished through Integrated Billing. Entries in this file will not be deleted or edited (except for the status field, cancellation reasons filed, last updated field, and user last updating field). Rather than deleting an entry, an entry is "reversed" by creating an additional entry with the IB ACTION TYPE entry that cancels the original entry. An entry is edited by creating the cancellation entry and then adding an updated new entry. All entries related to the original entry will be related by the PARENT LINK field. There is also an IB ACTION type that is an event, which may include Hospital admissions, NHCU admissions, and outpatient visits. All of the charges associated with an event will be related to that event by the EVENT LINK field. Per VHA Directive 10-93-142, this file definition should not be modified.
.01reference number(+)0;1NUMERICBThis is the station number concatenated with the internal number of this entry in this file. The purpose of this number is to provide a unique number for each entry for each station. Modifying this number may have serious consequences when and where centralized billing and accounting are taking place.
.02patient0;2POINTER2CThis is the patient that received services, care, or medications that caused this entry to be created. If the debtor is the patient, this patient is the debtor.
.03action type0;3POINTER350.1AEThis field points to an entry in the IB ACTION TYPE file. Entries in the IB ACTION TYPE file provide specific information about the type of entry that is being created and provides data necessary to AR and to resolve the data from the application. Applications passing data to IB determine the Action Type and pass this to IB.
.04resulting from0;4FREE TEXTThis will be the soft-link back to the entry in any file that caused this transaction to be set. It will be in the format of: filenumber:entry;[node:sub-entry];[node:sub-entry]... The number of node:sub-entry pieces will depend on the level of multiples that cause the entry. For example, a new prescription might be '52:345678' but the first refill might be '52:345678;1,1'.
.05status0;5POINTER350.21ACThis is the current status of this entry. The IB routines will maintain this field. An entry will be incomplete when it is created, complete when all data needed to pass to AR is there, and Billed after passing to AR and the bill number and/or transaction number have been added. If the entry represents a billable inpatient/NHCU admission (event), the status will be Incomplete while the patient is admitted, and then Complete when the patient has been discharged. All entries created during the Means Test conversion will have the status Converted Record. With Integrated Billing version 2.0, this field is changed from a set of codes field to a pointer which points to the IB ACTION STATUS (#350.21) file. This change will allow new action statuses to be added more easily, and permit various characteristics to be assigned to the statuses to facilitate system processing. IT IS IMPERATIVE THAT THESE NEW POINTED-TO ENTRIES HAVE AN INTERNAL ENTRY NUMBER IN FILE #350.21 WHICH IS EQUAL TO THEIR PREVIOUS CODE VALUE. PLEASE CAREFULLY READ THE IB ACTION STATUS FILE DESCRIPTION FOR MORE INFORMATION.
.06units0;6NUMERICThis is the number of units that will be multiplied times a specific charge that will be calculated to create the total charge. This is passed to IB from the application.
.07total charge0;7NUMERICThis is the total charge for this entry, that will be passed to AR. It is calculated and stored by IB routines. NOTE: Several IB ACTION entries may be combined into one pass to AR so that there may not be a one to one relationship between this entry and one in AR. The TOTAL CHARGE for all entries will always be positive. It is necessary to refer to the IB ACTION TYPE file to determine if this is a NEW, CANCEL or UPDATE. Cancel action types will cause a decrease adjustment to a bill for this amount. New and Update action types will cause an increase adjustment to a bill for this amount.
.08brief description0;8FREE TEXTThis is a brief description of the application entry that caused this IB ACTION entry to be created. For example, for Pharmacy co-payments it might indicate '100999-ENDURAL-2' which would indicate that this was prescription number 100999, the drug name started with ENDURAL and 2 units (30-60 days supply) were given. The logic to calculate this will be supplied by the application and stored with the IB ACTION TYPE entry for this action.
.09parent charge0;9POINTER350ADThis is a pointer to the original IB ACTION entry that this entry refers to. For a NEW entry, it will point to itself. For all other entries it will point to the original entry. An application then only needs to maintain the pointer to the original entry and can find the most recent entry for this entry as S x=$O(^IB("APDT",parent,0),x=$O(^(x,0)) If x '= parent then this is an updated entry, the pointer to the IB ACTION TYPE file will give you the sequence number which will indicate if this is cancelled or an updated entry.
.1cancellation reason0;10POINTER350.3This is the reason that this charge was cancelled.
.11ar bill number0;11FREE TEXTABILThis is the free text bill number that this entry is charged to. It is in the format of a PAT number. It will be calculated by accounts receivable from the AR BILL NUMBER file for the service in the IB ACTION TYPE entry associated with this entry.
.12ar transaction number0;12NUMERICATThis is the pointer value to the AR TRANSACTION file. An entry that causes a new bill number to be created will not have an AR TRANSACTION file entry associated with it as the charge data will be stored with the original bill.
.13institution0;13POINTER4This is the facility that caused this bill. The station number field of the institution file will be used in determining the reference number. Accounts Receivable will use the station number in the bill number.
.14date billed from0;14DATE-TIMEThis is the first date in the date range covered by this billing action.
.15date billed to0;15DATE-TIMEThis is the last date in the date range covered by this billing action.
.16parent event0;16POINTER350AFThis field is used only for IB ACTION entries (both events and charges) which are associated with Category C billing. This field is a pointer to the IB ACTION event (inpatient/NHCU admission or outpatient visit) for which the charges are being billed. For an event entry, this field will point to itself. For all IB ACTION charges (new, cancelled, and updated) associated with a billable event, this field will point to that event. Note that cancelled and updated actions will still point to the parent (new) action through the Parent Charge (.09) field, in the same manner as Pharmacy co-pay charges.
.17event date0;17DATE-TIMEThis field will only be used for those IB ACTION entries which represent Hospital/NHCU admissions and outpatient visits for which Category C copayment and per diem charges will be billed to the patient. The value of this field will be the admission or visit date. The inverse (negative) value of this date will be cross-referenced by patient for look-up purposes.
.18date last billed0;18DATE-TIMEThis field will only be used for those IB ACTION entries which represent inpatient or NHCU admissions for which Category C copayment and per diem charges will be billed to the patient. The value of this field will be the last day through which charges have been calculated for the admission.
.19ib copay transaction number0;19POINTER354.71This is the transaction number associated with this entry to assist in determining if a patient has reached his cap.
.2clinic stop0;20POINTER352.5This field is used to enter the clinic stop for outpatient co-pay charges.
.21gmt related0;21BOOLEAN1:YES
This is a flag indicating that this charge was decreased due to the patient's GMT Copayment status.
.22pfss account reference0;22POINTER375This is the PFSS Account entry for the Integrated Billing Action copayment charge.
11user adding entry1;1POINTER200This is the person adding an entry in an application that cause the application to create an entry in this file.
12date entry added1;2DATE-TIMEDThis is the date/time that an entry was added to this file. The most recent update to an entry can be determined by finding the last entry in this field.
13user last updating1;3POINTER200This is the person last updating an entry in an application when it caused an update to this entry in this file.
14date last updated1;4DATE-TIMEThis is the date/time that this entry was last updated.
15champva adm date1;5DATE-TIMEThis is the admission date for the episode of CHAMPVA care being billed.
16on hold date1;6DATE-TIMEThis date is used to determine when the patient charge (Status = ON HOLD) should be auto-released to Accounts Receivable as well as to generate reports. The date is set initially when the patient charge is established and placed on hold. The date is reset when a third party claim for the same episode of care is authorized. The new ON HOLD DATE is the authorized date of the third party claim.
17hold-review date1;7DATE-TIMEThis is the date the patient charge was put on HOLD-REVIEW status.

Referenced by 6 types

  1. PRESCRIPTION (52) -- ib number
  2. INTEGRATED BILLING ACTION (350) -- parent charge, parent event
  3. SPECIAL INPATIENT BILLING CASES (351.2) -- billing event
  4. TRICARE PHARMACY TRANSACTIONS (351.5) -- copayment charge
  5. IB COPAY TRANSACTIONS (354.71) -- ib action pointer
  6. IB NCPDP PRESCRIPTION (366.15) -- copayment charge