| .01 | reference number(+) | 0;1 | NUMERIC | | B | This 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. |
| .02 | patient | 0;2 | POINTER | 2 | C | This 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. |
| .03 | action type | 0;3 | POINTER | 350.1 | AE | This 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. |
| .04 | resulting from | 0;4 | FREE TEXT | | | This 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'. |
| .05 | status | 0;5 | POINTER | 350.21 | AC | This 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. |
| .06 | units | 0;6 | NUMERIC | | | This 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. |
| .07 | total charge | 0;7 | NUMERIC | | | This 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. |
| .08 | brief description | 0;8 | FREE TEXT | | | This 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. |
| .09 | parent charge | 0;9 | POINTER | 350 | AD | This 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. |
| .1 | cancellation reason | 0;10 | POINTER | 350.3 | | This is the reason that this charge was cancelled. |
| .11 | ar bill number | 0;11 | FREE TEXT | | ABIL | This 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. |
| .12 | ar transaction number | 0;12 | NUMERIC | | AT | This 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. |
| .13 | institution | 0;13 | POINTER | 4 | | This 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. |
| .14 | date billed from | 0;14 | DATE-TIME | | | This is the first date in the date range covered by this billing action. |
| .15 | date billed to | 0;15 | DATE-TIME | | | This is the last date in the date range covered by this billing action. |
| .16 | parent event | 0;16 | POINTER | 350 | AF | This 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. |
| .17 | event date | 0;17 | DATE-TIME | | | This 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. |
| .18 | date last billed | 0;18 | DATE-TIME | | | This 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. |
| .19 | ib copay transaction number | 0;19 | POINTER | 354.71 | | This is the transaction number associated with this entry to assist
in determining if a patient has reached his cap. |
| .2 | clinic stop | 0;20 | POINTER | 352.5 | | This field is used to enter the clinic stop for outpatient co-pay
charges. |
| .21 | gmt related | 0;21 | BOOLEAN | 1:YES
| | This is a flag indicating that this charge was decreased due to the
patient's GMT Copayment status. |
| .22 | pfss account reference | 0;22 | POINTER | 375 | | This is the PFSS Account entry for the Integrated Billing Action copayment
charge. |
| 11 | user adding entry | 1;1 | POINTER | 200 | | This is the person adding an entry in an application that cause the
application to create an entry in this file. |
| 12 | date entry added | 1;2 | DATE-TIME | | D | This 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. |
| 13 | user last updating | 1;3 | POINTER | 200 | | This is the person last updating an entry in an application when it
caused an update to this entry in this file. |
| 14 | date last updated | 1;4 | DATE-TIME | | | This is the date/time that this entry was last updated. |
| 15 | champva adm date | 1;5 | DATE-TIME | | | This is the admission date for the episode of CHAMPVA care being billed. |
| 16 | on hold date | 1;6 | DATE-TIME | | | This 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. |
| 17 | hold-review date | 1;7 | DATE-TIME | | | This is the date the patient charge was put on HOLD-REVIEW status. |