| # | Name | Location | Type | Details | Index | Description |
|---|---|---|---|---|---|---|
| .01 | name(+) | 0;1 | NUMERIC | B | You may only have one site parameter entry. Its internal number must be 1 and its name must be the same. | |
| .02 | facility name(+) | 0;2 | POINTER | 4 | This is the name of your facility from the institution file. There must be a station number associated with this entry. This value will be used by IFCAP in determining the bill number. | |
| .03 | file in background | 0;3 | BOOLEAN | 1:YES 0:NO | Set this field to 'YES' to cause the IB Background Filer to run as a background job. If it is set to 'NO' or left blank, filing will occur as applications pass data to Integrated Billing. Sites may wish to experiment with running the filer in the foreground (answer 'NO') or filing in the background. For Pharmacy Co-Pay, it is expected that some sites will experience significant delays in Outpatient Pharmacy label printing if filing is not done in the background. | |
| .04 | filer started | 0;4 | DATE-TIME | This is the internal fileman date/time that the IBE filer was last started. This field should be blank if the FILER STOPPED field contains data. If this field contains a date/time and the field FILE IN BACKGROUND is answered 'YES' then it is assumed that an IBE Filer is running. Use the option 'Start the Integrated Billing Background Filer' to start a new filer if needed. This field is updated by the IBE Filer and should not be edited with FileMan. | ||
| .05 | filer stopped | 0;5 | DATE-TIME | This is the internal fileman date/time that the IBE filer was last stopped. This field should be blank if the FILER STARTED field contains data. This field is updated by the IBE Filer. It should not be edited with FileMan. | ||
| .06 | filer last ran | 0;6 | DATE-TIME | This is the date/time that the IBE Filer last passed data to the Accounts Receivable module of IFCAP. This field is updated by the IBE Filer and should not be edited with FileMan. | ||
| .07 | filer uci,vol | 0;7 | FREE TEXT | This is the UCI and Volume set that you want the IBE Filer to run on. Vax sites should leave this blank. It is recommended that the filer run on the volume set that contains either the IB globals or the PRC globals. | ||
| .08 | filer hang time | 0;8 | NUMERIC | This is the number of seconds that the filer will remain idle after finishing all transactions and before checking for more transactions to file. The filer will shut itself down after 2000 hangs with no activity detected. The default value for this field is 2 if left blank. | ||
| .09 | copay background error group | 0;9 | POINTER | 3.8 | This is the mail group that will receive mail bulletins from the IBE filer when an unsuccessful attempt to file is detected. Remember to add users to it. | |
| .1 | filer queued | 0;10 | BOOLEAN | 1:YES 0:NO | This field will be set to 'YES' when a file job is queued and set back to 'NO' when the queued job is started. It will be used to prevent queueing two or more jobs before the first job starts. | |
| .11 | means test billing mail group | 0;11 | POINTER | 3.8 | Members of this mail group will receive bulletins when Means Test billing processing errors have been encountered, and when movements and Means Tests have been edited or deleted for veterans that require Means Test charges. | |
| .12 | per diem start date | 0;12 | DATE-TIME | This is the date that this facility counseled category C patients that they would have to pay the new Per Diem charges and began the Per Diem billing. This field represents the earliest date for which the Hospital ($10) or Nursing Home ($5) Per Diem charge may be billed to a Category C patient. This billing is mandated by Public Law 101-508, which was implemented on November 5, 1990. Please note that the Per Diem billing will not occur if this field is null. | ||
| .13 | copay exemption mail group | 0;13 | POINTER | 3.8 | This mail group will be sent the copay exemption bulletins and error messages. The value of this field is the number of fiscal years, prior to the current fiscal year, for which Category C Billing Clock data should be retained in the system when the option to purge billing clock records is run. If that option is tasked to run automatically, then this parameter is directly accessed and used to determine which data shall be purged from the database (if the value of this field is null or less than one, one previous year's worth of data is retained). If the option is manually invoked, the value of this field is defaulted when the user is prompted for the number of year's worth of data to retain. | |
| .14 | use alerts | 0;14 | BOOLEAN | 1:YES 0:NO | If a facility has installed Version 7 or higher of Kernel, then the site may decide whether to use Alerts or Bulletins for internal messages in Integrated Billing. Initially this functionality will only be available for the Medication Copayment Exemption functionality. If this is a desirable feature it may be expanded in the future. If this field is unanswered, the default is No and IB will use bulletins. | |
| .15 | suppress mt ins bulletin | 0;15 | BOOLEAN | 1:YES 0:NO | This parameter is used to control the bulletin that is posted when any Means Test charge which might be covered by the patient's health insurance is billed. If the site wishes to suppress this bulletin, then this parameter should be answered 'Yes'. | |
| .16 | last ltc completion date | 0;16 | DATE-TIME | This is the last time the LTC background job was completed. | ||
| 1.01 | name of claim form signer | 1;1 | FREE TEXT | This is the name of the signer of third party bills and will be printed on the claim form in the signature block. | ||
| 1.02 | title of claim form signer | 1;2 | FREE TEXT | This is the title of the person signing the claim form as it will appear on the bill. | ||
| 1.03 | *can reviewer authorize? | 1;3 | BOOLEAN | 1:YES 0:NO | Creating a third party bill is a 4 part process. The bill is Entered, Reviewed, Authorized, and Printed. The bill is considered complete and passed to Accounts Receivable immediately after it has been Authorized. This parameter is used to determine if the same person who Reviewed the bill can Authorize the bill. If the paramater CAN INITIATOR REVIEW? and this parameter, CAN REVIEWER AUTHORIZE?, are both answered "YES" then the same individual can perform all 4 parts of the billing process. If either parameter is answered 'NO' then more than one person must be involved in each bill. | |
| 1.04 | *remarks on each edi claim | 1;4 | FREE TEXT | This remark will appear in the CCOM segment of the electronic transmission. November 2007: This field is being removed from the IB site parameter screen with IB patch 377. The CCOM segment is no longer being sent. | ||
| 1.05 | federal tax number(+) | 1;5 | FREE TEXT | This is your facility federal tax number. If unknown, this may be obtained from your Fiscal Service. | ||
| 1.06 | blue cross/shield provider #(+) | 1;6 | FREE TEXT | This is the BC/BS Provider Number which Blue Cross has assigned your facility. | ||
| 1.07 | bill cancellation mailgroup | 1;7 | POINTER | 3.8 | This is the mail group that will recieve automatic notification every time a third party bill is cancelled. This must be answered for the automatic notification to occur. | |
| 1.08 | billing supervisor name(+) | 1;8 | POINTER | 200 | This is the pointer to the PERSON file for the Billing Supervisor. | |
| 1.09 | bill disapproved mailgroup | 1;9 | POINTER | 3.8 | When a third party bill is disapproved the supervisor and initiator of the bill will be notified. If you want additional people to be notified that a bill has been disapproved then you must create a mail group and add the member and then specify the group here. The members of this mail group will then recieve the disapproval bulletin. | |
| 1.11 | *can initiator review | 1;11 | BOOLEAN | 1:YES 0:NO | Creating a third party bill is a 4 part process. The bill is Entered, Reviewed, Authorized, and Printed. The bill is considered complete and passed to Accounts Receivable immediately after it has been Authorized. This parameter is used to determine if the same person who Reviewed the bill can Authorize the bill. If the paramater CAN REVIEWER AUTHORIZE? and this parameter, CAN INITIATOR REVIEW?, are both answered "YES" then the same individual can perform all 4 parts of the billing process. If either parameter is answered "NO" then more than one person must be involved in each bill. | |
| 1.14 | mas service pointer(+) | 1;14 | POINTER | 49 | Accounts Receivable requires that every bill be associated with a SERVICE/SECTION. This is the Service that will be identified with bills sent to Accounts Receivable from the Integrated Billing Module. | |
| 1.15 | can clerk enter non-ptf codes? | 1;15 | BOOLEAN | 1:YES 0:NO | Answering 'YES' to this parameter will also allow billing clerks to enter CPT and HCPS codes into the billing record as well as ICD diagnosis and Procedure codes that are not in the corresponding PTF record. This parameter only affects inpatient bills. | |
| 1.16 | ask hinq in mccr | 1;16 | BOOLEAN | 1:YES 0:NO | When creating a new bill on a Veteran with unverified eligibility the user may be asked if they would like to put a HINQ request in the HINQ SUSPENSE file if this parameter is answered 'YES'. | |
| 1.17 | use op cpt screen? | 1;17 | BOOLEAN | 1:YES 0:NO | CPT codes for outpatient visits are currently stored as Ambulatory Procedures in the Scheduling Visits file. The user editing a bill will be displayed all CPT codes stored in the Scheduling Visits file for the date range of the bill if the parameter is set to 'YES'. This display screen will prompt the user if they would like to easily import any or all of the CPT codes into the bill. This will include both Ambulatory Procedures and the Billable Ambulatory Surgical Codes. | |
| 1.18 | *default amb surg rev code | 1;18 | POINTER | 399.2 | When billing Billable Ambulatory Surgical Codes (BASC), this will be the default revenue code stored in the bill. If this is not appropriate for any particular insurance company then the field AMBULATORY SURG. REV. CODE in the Insurance Company file may be entered and it will be used for that particular insurance company entry. Field is no longer used, it has been replaced by functionality provided by the Charge Master in IB*2*52. | |
| 1.19 | transfer procedures to sched? | 1;19 | BOOLEAN | 1:YES 0:NO | CPT procedures may be stored as Ambulatory Procedures in the Scheduling Visits file (using the Add/Edit Stop Code option) and they may be stored in the billing record as procedures to print on a bill. There is now a two way sharing of information between these two files. If this parameter is answered 'YES' then as CPT procedures are entered in a bill that are also Ambulatory Procedures, then the user will be prompted as to whether they should be transfered to the Scheduling Visits file also. The reverse of this is the parameter USE OP CPT SCREEN? which allows importing of Ambulatory Procedures into a bill. Only CPT procedures that are either Billable Ambulatory Surgical Codes or either Nationally or Locally active Ambulatory Procedures may be transfered. | |
| 1.2 | hold mt bills w/ins | 1;20 | BOOLEAN | 1:YES 0:NO | If this parameter is answered 'YES' then the automated Category C bills will automatically be placed on hold if the Patient has active Insurance. The bills will need to be released to Accounts Receivable after claim disposition from the Insurance Company. | |
| 1.21 | medicare provider number | 1;21 | FREE TEXT | This is the 1-8 character number provided by Medicare to the facility. | ||
| 1.22 | multiple form types | 1;22 | BOOLEAN | 1:YES 0:NO | Set this field to 'YES' if the facility uses more than one health insurance form type. Therefore, if your site uses the UB form and the CMS-1500 then this should be answered 'YES'. If your site is only using the UB form then answer 'NO'. If this is set to 'NO' or left blank then only the UB type claim forms will be allowed. | |
| 1.23 | can initiator authorize? | 1;23 | BOOLEAN | 1:YES 0:NO | Beginning with IB Version 1.5, the Review step in creating a bill has been eliminated. If this parameter is answered YES and the initiator holds the IB AUTHORIZE key then the initiator of the bill will be allowed to Authorize the Bill. If this is answered no then another user who holds the IB AUTHORIZE key will have to authorize the bill. | |
| 1.24 | basc start date | 1;24 | DATE-TIME | This is the date that facilities can begin billing Ambulatory Surgical Code Rates. The earliest date is the date that IB Version 1.5 was installed at the site or the date the regulation allowing BASC billing was approved. This date will be stored automatically in the file. If this field is null then BASC rates will not automatically calculate. | ||
| 1.25 | default division | 1;25 | POINTER | 40.8 | This field will be used as the default division for all bills and will be automatically added to each bill as it is created. | |
| 1.27 | cms-1500 address column | 1;27 | NUMERIC | This is the column that the mailing address will begin printing on row 1 of the CMS-1500 claim form. | ||
| 1.28 | *default rx refill rev code | 1;28 | POINTER | 399.2 | If entered, this Revenue Code will be used for all prescription refill's on a bill when the revenue codes and charges are automatically calculated. This default will be overridden by the PRESCRIPTION REFILL REV. CODE for an insurance company, if one exists. Field is no longer used, it has been replaced by functionality provided by the Charge Master in IB*2*52. | |
| 1.29 | default rx refill dx | 1;29 | POINTER | 80 | If entered, this diagnosis will be automatically added to every bill that has prescription refills. | |
| 1.3 | default rx refill cpt | 1;30 | POINTER | 81 | If entered, this procedure will automatically be added to every bill that has a prescription refill. | |
| 1.31 | ub-04 address column | 1;31 | NUMERIC | This is the column on which the Mailing Address should begin printing on the UB-04. The purpose of this field is to help in placing the mailing address in the area required so that it is visible through the envelope window. Please note that the UB-04 Mailing Address block (FL 38) has a maximum width of 42 characters. The number entered here will cause the address to be moved to the right and therefore the allowable width of the mailing address will be reduced. | ||
| 1.32 | cms-1500 print legacy id | 1;32 | SET OF CODES | Y:YES N:NO C:CONDITIONAL | This parameter determines whether legacy (example: IDs furnished by an Insurance Company) Provider IDs will appear on locally printed CMS-1500 claims. YES - Legacy IDs will always be printed. NO - Legacy IDs will never be printed. CONDITIONAL - Legacy IDs will be printed only when no NPIs are available. | |
| 1.33 | ub-04 print legacy id | 1;33 | SET OF CODES | Y:YES N:NO C:CONDITIONAL | This parameter determines whether legacy (example: IDs furnished by an Insurance Company) Provider IDs will appear on locally printed UB claims. YES - Legacy IDs will always be printed. NO - Legacy IDs will never be printed. CONDITIONAL - Legacy IDs will be printed only when no NPIs are available. | |
| 2.01 | *agent cashier mail symbol | 2;1 | FREE TEXT | This is the facility mail routing symbol for the Agent Cashier. This may begin with 04 (for Fiscal Service) at most facilities. This field is inactive with IB patch 400. The information in the PAY-TO PROVIDERS subfile (#350.9004) has replaced this field. | ||
| 2.02 | *agent cashier street address | 2;2 | FREE TEXT | This is the street address that checks should be mailed to. This will appear on the on all claim forms as the billing address. This field is inactive with IB patch 400. The information in the PAY-TO PROVIDERS subfile (#350.9004) has replaced this field. | ||
| 2.03 | *agent cashier city | 2;3 | FREE TEXT | This is the City for the Agent Cashier. This will be part of the address that Checks are mailed to and will appear on the claim forms. This field is inactive with IB patch 400. The information in the PAY-TO PROVIDERS subfile (#350.9004) has replaced this field. | ||
| 2.04 | *agent cashier state | 2;4 | POINTER | 5 | This is the state for the Agent Cashier. This will be the State part of the address that checks are mailed to as it appears on the claim forms. This field is inactive with IB patch 400. The information in the PAY-TO PROVIDERS subfile (#350.9004) has replaced this field. | |
| 2.05 | *agent cashier zip code | 2;5 | FREE TEXT | Enter the zip code for the Agent Cashier. This will be the zip code that checks should be mailed to and appears on the claims forms. This field is inactive with IB patch 400. The information in the PAY-TO PROVIDERS subfile (#350.9004) has replaced this field. | ||
| 2.06 | *agent cashier phone number | 2;6 | FREE TEXT | This is the phone number for the agent cashier. This field is inactive with IB patch 400. The information in the PAY-TO PROVIDERS subfile (#350.9004) has replaced this field. | ||
| 2.07 | cancellation remark for fiscal | 2;7 | FREE TEXT | This is the remark which will be sent to Fiscal every time a bill is cancelled in MAS. This remark will explain to Fiscal why the IFCAP billing record is being amended or cancelled. The generic remark, "BILL CANCELLED IN MAS" will be transmitted to Fiscal Service if no remark is entered in this field. The site may enter any remark which is meaningful to MAS and Fiscal. | ||
| 2.08 | inpt health summary | 2;8 | POINTER | 142 | This Health Summary will be displayed when the Health Summary action is chosen for an Inpatient bill in the Joint Billing Inquire option. | |
| 2.09 | outpt health summary | 2;9 | POINTER | 142 | This Health Summary will be displayed when the Health Summary action is chosen for an Outpatient bill in the Joint Billing Inquiry option. | |
| 2.1 | *facility name for billing(+) | 2;10 | FREE TEXT | This is the Facility Name for Billing that will print on the first line of the UB-04 form locator 2 and in box 33 of the CMS-1500. This field is inactive with IB patch 400. The information in the PAY-TO PROVIDERS subfile (#350.9004) has replaced this field. | ||
| 2.11 | site contact phone number | 2;11 | FREE TEXT | This is the phone number associated with the site contact position that EDI inquiries will be directed to when a payer needs to get in touch with the facility. | ||
| 3.01 | *conversion last bill date | 3;1 | DATE-TIME | This field will only be used for the Means Test conversion which is part of the Integrated Billing v1.5 post init. The field will be deleted with the next version of Integrated Billing. This field is updated during the IB v1.5 post init. The value of this field designates the last day through which Means Test charges will be created during the conversion. Please note that this field has been starred for deletion in IB v2.0. This field will be deleted in the version of IB which follows v2.0. | ||
| 3.02 | *conversion break date | 3;2 | DATE-TIME | This field will only be used for the Means Test conversion which is part of the Integrated Billing v1.5 post init. The field will be deleted with the next version of Integrated Billing. This field is updated during the IB v1.5 post init. The value of this field is used by the conversion when creating Hospital/NHCU per diem charges. If a patient owes the per diem on this date, and has accumulated other charges prior to this date, a charge is filed for all previous charges up through the date. The intent of "splitting" charges in this manner is to allow facilities to select a "final" date through which Means Test billing will have been completed manually so that charges created by the conversion may easily be passed to the Accounts Receivable package (and thus billed to the patient). Please note that this field has been starred for deletion in IB v2.0. This field will be deleted in the version of IB which follows v2.0. | ||
| 3.03 | copay exemption conv. started | 3;3 | NUMERIC | This is the number of times the Medication Copayment Exemption Conversion has been started. It is used to tell if the conversion has been restarted. | ||
| 3.04 | copay exemption last dfn | 3;4 | NUMERIC | This is the internal entry number of the last patient completely converted by the Medication Copayment Exemption Conversion. The Conversion processes patients in order of internal entry number. If the conversion stops for any reason it will start with the next internal number after this one. | ||
| 3.05 | total patients converted | 3;5 | NUMERIC | This is the total number of patients in the IB file that were set up with an exemption status during the conversion. | ||
| 3.06 | total patients exempt | 3;6 | NUMERIC | This is the number of patients that were converted to an exempt status. | ||
| 3.07 | total patient non-exempt | 3;7 | NUMERIC | This is the number of patients converted to a non-exempt status. | ||
| 3.08 | count of exempt bills | 3;8 | NUMERIC | This is the number of Medication Copayment IB Actions that were issued to patients who's status is exempt from the start of the exemption legislation to the running of the conversion. | ||
| 3.09 | amount of charges checked | 3;9 | NUMERIC | This is the total dollar amount of charges checked during the Medication Copayment Exemption Conversion issued to patients from the start date of the exemption legislation to the running of the conversion. | ||
| 3.1 | total exempt dollar amount | 3;10 | NUMERIC | This is the total dollar amount of charges checked during the Medication Copayment Exemption Conversion issued to Exempt patients from the start date of the exemption legislation to the running of the conversion. | ||
| 3.11 | amount of non-exempt charges | 3;11 | NUMERIC | This is the total dollar amount of charges checked during the Medication Copayment Exemption Conversion issued to Non-Exempt patients from the start date of the exemption legislation to the running of the conversion. | ||
| 3.12 | amount of canceled charges | 3;12 | NUMERIC | This is the total dollar amount of charges actually canceled during the Medication Copayment Exemption Conversion issued to Exempt patients from the start date of the exemption legislation to the running of the conversion. | ||
| 3.13 | copay exemption start date(+) | 3;13 | DATE-TIME | This is the date/time that the Medication Copayment Exemption Conversion started. It should not be edited. | ||
| 3.14 | copay exemption stop date(+) | 3;14 | DATE-TIME | This is the date/time that the conversion completed. This field should not be edited. It will be stored by the conversion routine when it is finished. | ||
| 3.15 | non-exempt patients converted | 3;15 | NUMERIC | This is the count of patients in the IB Action file that had an exemption status of Non-exempt set up during the conversion. | ||
| 3.16 | total bills during conversion | 3;16 | NUMERIC | This is the total number of IB ACTION entries issued from the effective date of the Income Exemption Legislation until the running of the conversion that were issued to either exempt or non-exempt patients. | ||
| 3.17 | count of bills canceled | 3;17 | NUMERIC | This is the count of bills actually sent to be canceled in the IB ACTION file during the conversion. | ||
| 3.18 | insurance conversion complete(+) | 3;18 | DATE-TIME | This is the date the insurance conversion completes. It is not editable. The data should not be deleted. The v2.0 insurance conversion will automatically set this field to the date it completes. | ||
| 3.19 | bill/claims conv. complete(+) | 3;19 | DATE-TIME | This is the date that the v2 post-init conversion of the bill/claims file completed. It will automatically be updated by the conversion routine when it completes. | ||
| 3.2 | current inpatients loaded(+) | 3;20 | DATE-TIME | This is the date that the current inpatients were loaded into claims tracking as part of the IB v2 post init. This date will automatically be entered upon completion. | ||
| 4.01 | insurance extended help | 4;1 | SET OF CODES | 0:OFF 1:ON | Should the extended help display be always on in the Insurance Management options. Answer 'ON' if you always want it to display automatically or answer 'OFF' if you do not want to see it. It is recommended that the extended help be turned on initially after v2 is installed. As users become more familiar with the new functionality the parameter can be turned off. | |
| 4.02 | patient or insurance company | 4;2 | VARIABLE-POINTER | 2, 36 | Enter the patient or insurance company you wish to access. | |
| 4.03 | health insurance policy | 4;3 | FREE TEXT | Enter the name of the patient's health insurance policy. | ||
| 4.04 | new insurance mail group | 4;4 | POINTER | 3.8 | Enter the mail group that should receive a bulletin every time an insurance policy is added for a patient that has potential billings associated with it. | |
| 4.05 | central collection mail group | 4;5 | FREE TEXT | The MCCR Program Office has recently requested that the results from the report Rank Insurance Carriers By Amount Billed be transmitted centrally for nation-wide compilation. This field contains the mail group on Forum to which these reports will be sent. The field is being exported with the value G.MCCR DATA@DOMAIN.EXT. It is anticipated that future reports may be sent to this group for compilation. If it becomes necessary to change the mail group name or domain, this field may be edited using Fileman. Do not edit this field without receiving instructions from your supporting ISC. | ||
| 4.06 | insurance company | 4;6 | POINTER | 36 | ||
| 4.07 | ivm center mail group | 4;7 | FREE TEXT | The IVM Center has recently requested that the results from the report IB Billing Activity be transmitted to the IVM Center for nation-wide compilation. This field contains the mail group to which these reports will be sent. The field is being exported with the value G.IVM REPORTS@IVM.DOMAIN.EXT. | ||
| 4.08 | ins. co. deletion task | 4;8 | NUMERIC | This field contains the task number of a job that is scheduled to run which performs all clean-up tasks when an Insurance Company is deleted. After the tasked job runs to completion, the value of this field will be deleted. | ||
| 5.01 | admission sheet header line 1 | 5;1 | FREE TEXT | Enter the text that your facility would like to have printed as the first line of the header on the admission sheet. This is generally the name of your medical center. | ||
| 5.02 | admission sheet header line 2 | 5;2 | FREE TEXT | Enter the text that your facility would like to have printed as the second line of the header on the admission sheet. This is generally the street address of your medical center. | ||
| 5.03 | admission sheet header line 3 | 5;3 | FREE TEXT | Enter the text that your facility would like to have printed as the third line of the header on the admission sheet. This is generally the city, state and zip code of your medical center. | ||
| 6.01 | claims tracking start date | 6;1 | DATE-TIME | If you choose to run the claims tracking module and populate the files with past episodes of care, this is the date that the routine will use to start. This is the main parameter that contro what past care can be entered into claims tracking. At no time does the software automatically add entires older than this date. The one exception is that this parameter does not affect the entries that may be added to claims tracking using the add tracking entry action on the main claims tracking screen. | ||
| 6.02 | inpatient claims tracking | 6;2 | SET OF CODES | 0:OFF 1:INSURED AND UR ONLY 2:ALL PATIENTS | This field determines what inpatients will automatically be added to the claims tracking module. If this parameter is set to "OFF" then no new patients will be added. If this is set to "INSURED AND UR ONLY" then only the insured patients and random sample patients will be added. If this is set to "ALL PATIENTS" then a record of all admissions will be created. If a patient is not insured then each record will be so annotated automatically on creation and no follow-up will be required. The advantage of tracking all patients is that you can determine the percentage of billable cases and make necessary adjustments if the patients are later found to have insurance. The disadvantage is that additional capacity is used. | |
| 6.03 | outpatient claims tracking | 6;3 | SET OF CODES | 0:OFF 1:INSURED ONLY 2:ALL PATIENTS | This field determines if outpatient visit dates will automatically be entered into the claims tracking module. If this is answered "OFF" then no entries will be entered. If this is answered "INSURED ONLY" then only outpatient visits for insured patients will be added. If this parameter is set to ALL PATIENTS then the outpatient visits for all patients will be added to claims tracking. Initially we recommend this parameter be set to INSURED ONLY. | |
| 6.04 | prescription claims tracking | 6;4 | SET OF CODES | 0:OFF 1:INSURED ONLY 2:ALL PATIENTS | This field determines if prescriptions will automatically be entered into the claims tracking module. If this is answered "OFF" then no prescriptions or refills will be entered. If this is answered "INSURED ONLY", then only prescriptions and refills will be added if the patient is insured. If all is choose then an entry for all prescriptions will be entered. If a prescription or refill does not appear to be billable, that is it may be for SC care, or there is a visit date associated with that prescription or refill, this will be so noted in the reason not billable. | |
| 6.05 | prosthetics claims tracking | 6;5 | SET OF CODES | 0:OFF 1:INSURED ONLY 2:ALL PATIENTS | This field will be used to determine if prosthetics should be tracked in the claims tracking module. If this parameter is set to OFF, then no prosthetic entries will be added to claims tracking. If this is set to INSURED ONLY then only parameter entries for insured patients will be added to claims tracking. If this is set to ALL PATIENTS then an entry will be created for all patients prosthetic items. | |
| 6.06 | use admission sheets | 6;6 | BOOLEAN | 0:NO 1:YES | Enter whether your facility is using Admission Sheets as part of the MCCR/UR functionality. If this parameter is answered "YES" then users will be asked for the device to print admissions sheets to. The default device will be from the BILL FORM TYPE file. | |
| 6.07 | random sample date | 6;7 | DATE-TIME | This is the date that random sampling was last re-generated. The IB background job will re-generate a new date, new random numbers, and zero the counters every Sunday night. | ||
| 6.08 | medicine sample size(+) | 6;8 | NUMERIC | This is the number of required Utilization Reviews that you wish to have done each week for Medicine admissions. The minimum recommended by the QA office is one per week. | ||
| 6.09 | medicine weekly admissions | 6;9 | NUMERIC | This is the minimum number of admissions for Medicine that your Medical Center generally averages. This is used along with the Medicine sample size to compute a random number. | ||
| 6.1 | medicine random number | 6;10 | NUMERIC | This is an internally computed random number. It is re-computed each week. When the count of the Medicine admissions reaches a multiple of this number it is considered the random selection. The total number of random selections for UR will not exceed the Medicine sample size. | ||
| 6.11 | medicine entries met | 6;11 | NUMERIC | This is the number of random selections generated this week. | ||
| 6.12 | medicine admission counter | 6;12 | NUMERIC | This is the number of admissions for this service counted by the claims tracking module so far this week. | ||
| 6.13 | surgery sample size | 6;13 | NUMERIC | This is the number of required Utilization Reviews that you wish to have done each week for Surgery admissions. The minimum recommended by the QA office is one per week. | ||
| 6.14 | surgery weekly admissions | 6;14 | NUMERIC | This is the minimum number of admissions for Surgery that your Medical Center generally averages. This is used along with the Surgery sample size to compute a random number. | ||
| 6.15 | surgery random number | 6;15 | NUMERIC | This is an internally computed random number. It is re-computed each week. When the count of the Surgery admissions reaches a multiple of this number it is considered the random selection. The total number of random selections for UR will not exceed the Surgery sample size. | ||
| 6.16 | surgery entries met | 6;16 | NUMERIC | This is the number of random selections generated this week. | ||
| 6.17 | surgery admission counter | 6;17 | NUMERIC | This is the number of admissions for this service counted by the claims tracking module so far this week. | ||
| 6.18 | psych sample size | 6;18 | NUMERIC | This is the number of required Utilization Reviews that you wish to have done each week for Psychiatry admissions. The minimum recommended by the QA office is one per week. | ||
| 6.19 | psych weekly admissions | 6;19 | NUMERIC | This is the minimum number of admissions for Psychiatry that your Medical Center generally averages. This is used along with the Psychiatry sample size to compute a random number. | ||
| 6.2 | psych random number | 6;20 | NUMERIC | This is an internally computed random number. It is re-computed each week. When the count of the Psychiatry admissions reaches a multiple of this number it is considered the random selection. The total number of random selections for UR will not exceed the Psychiatry sample size. | ||
| 6.21 | psych entries met | 6;21 | NUMERIC | This is the number of random selections generated this week. | ||
| 6.22 | psych admission counter | 6;22 | NUMERIC | This is the number of admissions for this service counted by the claims tracking module so far this week. | ||
| 6.23 | reports add to claims tracking | 6;23 | BOOLEAN | 0:NO 1:YES | This field determines whether or not you wish to allow the Veterans with Insurance reports to add entries to Claims tracking. If you answer 'YES' then admisssions and outpatient visits found as billable but not found in claims tracking will be added to claims tracking for billing information purposes only. No review will be set up. This is to allow flagging of these visits as unbillable so that they can be removed from these reports. Answering 'YES' does not guarantee that the entry will be added. The related parameters about whether Claims Tracking is turned on and the Claims Tracking Start Date will override this parameter. | |
| 6.24 | auto print unbilled list | 6;24 | BOOLEAN | 0:NO 1:YES | Enter 'Yes' if you would like a detailed patient listing of unbilled cases automatically printed each month, when the option Auto-Generate Unbilled Amounts Report runs on the first of each month. If you answer 'Yes' you must enter the printer in the DEFAULT PRINTER (BILLING) field of the BILL FORM TYPE File (353). If you answer 'NO' the option will not generate a detailed listing of cases. You will only receive the mailman message with the totals. A detailed listing may be reprinted using the option Re-Generate Unbilled Amounts Report (IBT RE-GEN UNBILLED REPORT). | |
| 6.25 | unbilled mail group | 6;25 | POINTER | 3.8 | Enter the name of the mail group that will receive the monthly mail message that contains the data for the unbilled amounts report. Generally this will include the Chief of Accounting and others who are responsible for inputting the code sheets to Austin. | |
| 7.01 | auto biller frequency | 7;1 | NUMERIC | Enter the number of days between each execution of the automated biller. For example, if the auto biller should run only once a week, enter 7. If the auto biller should run every night, enter 1. This will not effect the date range of the bills themselves, but will only effect the date they are created. If this is left blank or zero then the auto biller will never run. | ||
| 7.02 | last auto biller date | 7;2 | DATE-TIME | This is generally set by the system. | ||
| 7.03 | inpatient status (ab) | 7;3 | SET OF CODES | 1:Closed 2:Released 3:Transmitted | This is the status that a PTF record must be in before the automated biller will attempt to create an inpatient bill. The auto biller will use the Frequency, Billing Cycle and Days Delay parameters to decide when to try to create an inpatient bill. However, the auto biller can not set up a bill until the PTF record is Closed. Of the two dates, the date calculated from the site parameters or the date that the PTF record meets the Status entered here, the bill will be created on the later date. | |
| 7.04 | number of days pt charges held(+) | 7;4 | NUMERIC | Patient charges with a status of ON HOLD will be automatically released to the Accounts Receivable package after this number of days has passed. The MCCR Program Office has determined that charges will be released after this number days if no payment has been received from the patient's insurance carrier for the episode of care. | ||
| 7.05 | default rx refill dx icd-10 | 7;5 | POINTER | 80 | If entered, this diagnosis will be automatically added to every bill that has prescription refills. ICD-10 Diagnosis only. Should be a generic ICD-10 code such as Z76.0 - Encounter for issue of repeat prescription. | |
| 8.01 | live transmit 837 queue | 8;1 | FREE TEXT | This is the name of the transmission queue that will be used to send live 837 transactions to Austin. | ||
| 8.02 | days to wait to purge msgs | 8;2 | NUMERIC | This is the # of days after an electronic status message has been marked as having been reviewed that the purge message option can delete it from the BILL STATUS MESSAGE file (#361). | ||
| 8.03 | auto transmit bill frequency | 8;3 | NUMERIC | This is the desired number of days between each execution of the automated bill transmitter where all bills in the BILL TRANSMIT file that are in a status of READY FOR EXTRACT will be extracted and sent to the queue for electronic processing. For example, if the automated bill transmitter should run only once a week, this number would be 7. If the automated bill transmitter should run every night, then the number should be 1. If this is left blank or zero then the automated bill transmitter background job will never run. | ||
| 8.04 | max # bills in a batch | 8;4 | NUMERIC | The maximum number of bills to be allowed to be batched together for transmission purposes. This should be kept to a manageable level as when one bill in a batch is rejected, the entire batch is returned to the site unprocessed. However, one bill per batch is very inefficient for transmission purposes. | ||
| 8.05 | last 837 auto-transmit date | 8;5 | DATE-TIME | This is the last date that the auto-transmit of bills ran at this facility. | ||
| 8.06 | hours to transmit bills | 8;6 | FREE TEXT | This field contains the times of the day when EDI transmission of bills should occur. There is a maximum of 4 times that may be entered and each time must be separated from the previous one by a semi-colon. Times must be entered in 4 digit military format, without punctuation as indicated: HHMM;HHMM;HHMM;HHMM. The IB nightly job will queue 1-4 jobs to automatically start EDI transmission at these designated times for that day if the time is after the time the nightly job is running. If the time is before the time the nightly job is running, the transmission is queued for the following day. If no times are entered, EDI transmission will take place as part of the nightly job. | ||
| 8.07 | only 1 ins co per claim batch | 8;7 | BOOLEAN | 1:YES 0:NO | This field indicates whether or not the site wishes to limit bill claim batches to contain only a single insurance company. | |
| 8.09 | test transmit 837 queue | 8;9 | FREE TEXT | This is the name of the transmission queue that will be used to send test 837 transactions to Austin. | ||
| 8.1 | edi/mra activated | 8;10 | SET OF CODES | 0:NOT EDI OR MRA 1:EDI ONLY 2:MRA ONLY 3:BOTH EDI AND MRA | This parameter controls whether EDI and/or requests for MRA are available functions for your site. | |
| 8.11 | automatic mra eob process? | 8;11 | BOOLEAN | 0:NO 1:YES | This field controls whether or not incoming Medicare Remittance Advice (MRA) EOB's can be automatically processed so that the secondary bill is automatically generated and automatically authorized and sent to the secondary payer. If this field is NO, then all incoming MRA EOB's will remain on the MRA management worklist and manual processing of the MRA EOB's will be necessary. | |
| 8.12 | allow mra eob processing? | 8;12 | BOOLEAN | 0:NO 1:YES | This field controls whether or not Medicare Remittance Advice (MRA) EOB's are allowed to be processed so that a bill can become a secondary bill and be authorized to the secondary payer. This field is checked by both the manual Process COB action from the MRA management worklist and also by the automatic MRA process. | |
| 8.13 | date mra first activated | 8;13 | DATE-TIME | This is the date Medicare Remittance Advice (MRA) was activated at site. | ||
| 8.14 | cms-1500 auto printer | 8;14 | POINTER | 3.5 | This is the printer that will be used to automatically print CMS-1500s when an electronic non-Medicare EOB is received and the subsequent insurance company requires printed claims. | |
| 8.15 | ub-04 auto printer | 8;15 | POINTER | 3.5 | This is the printer that will be used to automatically print UB-04s when an electronic non-Medicare EOB is received and the subsequent insurance company requires printed claims. | |
| 8.16 | eob auto printer | 8;16 | POINTER | 3.5 | This is the printer that will be used for automatically printing EOBs of automatically-processed claims when the subsequent insurance company requires printed secondary or tertiary claims. | |
| 8.17 | automatic reg eob process? | 8;17 | BOOLEAN | 0:NO 1:YES | This field controls whether or not incoming Regular (Non-Medicare) EOBs can be automatically processed so that the subsequent bill is automatically generated and automatically authorized and sent to the next payer. If this field is NO, then all incoming Regular (Non-Medicare) EOBs will remain on the COB management worklist and manual processing of the EOBs will be necessary. | |
| 8.19 | mra auto printer | 8;19 | POINTER | 3.5 | This is the printer that will be used for automatically printing MRAs of automatically-processed claims when the subsequent insurance company requires printed secondary or tertiary claims. MRAs need to have a device set up for 132 character printing. | |
| 9.01 | billing port | 9;1 | FREE TEXT | This is the logical port which is opened to transmit pharmacy transactions to the TRICARE fiscal intermediary. If there is no value in this field, the Pharmacy billing engine cannot be started. | ||
| 9.02 | awp port | 9;2 | FREE TEXT | This is the logical port which is opened to receive AWP updates from the TRICARE fiscal intermediary. If this field has no value, the AWP update engine cannot be started. | ||
| 9.03 | tcp/ip address | 9;3 | FREE TEXT | This field holds the TCP/IP address needed to reach the Pharmacy billing commercial software package. The billing interface cannot be started if there is no value on this field. | ||
| 9.04 | primary billing task | 9;4 | FREE TEXT | This is the task number for the primary billing transaction engine which communicates with the Pharmacy billing commercial software package. This field will be deleted during an orderly shutdown or when an error occurs. If this field is deleted, the secondary billing job will become the primary. | ||
| 9.05 | secondary billing task | 9;5 | FREE TEXT | This is the task number for the secondary billing transaction engine. This task is normally idled and becomes activated if the primary task errors out. | ||
| 9.06 | primary awp task | 9;6 | FREE TEXT | This is the task number for the primary AWP update task. This task communicates with the Pharmacy billing commercial software package to receive updates to the AWP (Average Wholesale Pricelist). If this field becomes null, the secondary task will become the primary task. | ||
| 9.07 | secondary awp task | 9;7 | FREE TEXT | This is the task number for the secondary AWP update task. This task is normally idled and becomes activated if the primary task errors out. | ||
| 9.08 | date primary task started | 9;8 | DATE-TIME | This is the date/time in which the primary billing transaction engine began running. | ||
| 9.09 | date primary task last ran | 9;9 | DATE-TIME | This date/time is the last time that the primary billing transaction engine passed a transaction to the commercial software package. | ||
| 9.1 | shutdown background jobs | 9;10 | BOOLEAN | 0:NO 1:YES | This field will be used to control both the Billing transaction and AWP update tasks. If this field is set to Yes, both of these sets of jobs will shutdown in an orderly fashion. | |
| 9.11 | task uci,vol | 9;11 | FREE TEXT | If this field has a value, this will be the volume and uci in which the engines will be tasked to run. | ||
| 9.12 | awp charge set | 9;12 | POINTER | 363.1 | The value of this field points to a Charge Set in file #363.1 which will be used to retrieve the Average Wholesale Price (AWP) of a drug when the TRICARE Pharmacy Billing software interface is running. | |
| 9.13 | prescriber id | 9;13 | FREE TEXT | The Prescriber ID is assigned by the TRICARE fiscal intermediary to a facility. The ID is used in the TRICARE pharmacy billing transmission to identify the facility to the intermediary. There must be a value in this field in order to start the TRICARE pharmacy billing interface task. | ||
| 9.14 | dea# override presc. id | 9;14 | BOOLEAN | 0:NO 1:YES | Answering yes to this field, causes the DEA# from the NEW PERSON (#200) file to override the Prescriber ID as the provider reference sent to the fiscal intermediary when billing Tricare RX. If this field is answered as NO, left unanswered, or answered YES but the DEA# is not available for the provider, then the Prescriber ID is sent as the provider reference. | |
| 9.15 | pharm calc compound code | 9;15 | BOOLEAN | 0:NO 1:YES | Answering YES to this prompt will send the values calculated in the Pharmacy package, for compound code, to the fiscal intermediary when billing Tricare RX. Pharmacy evaluates the drug to be either a compound drug ( code=2 ) or a non compound drug ( code = 1 ). If this field is left blank or is answered NO, a code of 0 will be sent. | |
| 10.01 | patient or facility | 10;1 | VARIABLE-POINTER | 351.6, 4 | This field definition is used by the Patient or Preferred Facility selection when using the FileMan Reader only. No data needs to be set in this field. | |
| 10.02 | tp inpatient active | 10;2 | BOOLEAN | 0:NO 1:YES | This flag will identify if the facility has Transfer Pricing turned on for Inpatient tracking. If this field is blank, Transfer Pricing will be off for Inpatient tracking. | |
| 10.03 | tp outpatient active | 10;3 | BOOLEAN | 0:NO 1:YES | This flag will identify if the facility has Transfer Pricing turned on for Outpatient tracking. If this field is blank, Transfer Pricing will be off for Outpatient tracking. | |
| 10.04 | tp pharmacy active | 10;4 | BOOLEAN | 0:NO 1:YES | This flag will identify if the facility has Transfer Pricing turned on for Prescription tracking. If this field is blank, Transfer Pricing will be off for Prescription tracking. | |
| 10.05 | tp prosthetics active | 10;5 | BOOLEAN | 0:NO 1:YES | This flag will identify if the facility has Transfer Pricing turned on for Prosthetics tracking. If this field is blank, Transfer Pricing will be off for Prosthetics tracking. | |
| 11.01 | hipaa ncpdp active flag | 11;1 | SET OF CODES | 1:Active 0:Not Active | This field is used to activate the e-Pharmacy interface. | |
| 11.03 | default pay-to provider | 11;3 | NUMERIC | This field is the internal entry number to the 350.9004 pay-to provider sub-file. It should not be edited by FileMan directly. It is set by the Pay-To provider maintenance application in the IB Site Parameters edit option. | ||
| 11.04 | default tricare pay-to prov | 11;4 | NUMERIC | This field is the internal entry number to the 350.929 TRICARE pay-to provider sub-file. It should not be edited by FileMan directly. It is set by the Pay-To provider maintenance application in the IB Site Parameters edit option. | ||
| 13.01 | hms directory | 13;1 | FREE TEXT | Name of the directory where Extract/Result files are stored as needed by HMS Data Extractor. | ||
| 13.02 | eii active | 13;2 | BOOLEAN | 1:YES 0:NO | This is a flag to indicate whether the eII software is enabled/active. | |
| 13.03 | result file name | 13;3 | FREE TEXT | Name of the Result file as it is configured in HMS Data Extractor software. | ||
| 13.04 | day of month result file due | 13;4 | NUMERIC | Day of the month when Result file is due be received from HMS through AITC. if "0" entered or empty, due check would not be calculated. For a day , say 31 that does not exist for a given month, eII software will assume last day of that month. This includes last day of February whether it is a leap year or not. | ||
| 13.05 | days before late message sent | 13;5 | NUMERIC | Number of days after the Result File Due day of the month, before the Result file arrival from HMS is considered overdue. If the Result file is not received by this time a late message is sent to IRM mail group. | ||
| 13.06 | max ext file que confirm time | 13;6 | NUMERIC | Maximum number of hours (usually 24 hours) to wait for confirmation message(s) to be received after an Extract file message is sent to AITC. When this time is exceeded, a no confirmation message is sent to the IBCNF EII IRM mail group. | ||
| 13.07 | max num of records per message | 13;7 | NUMERIC | Extract file records are sent via one or more Mailman messages to ATIC DMI Queues. This field is the maximum number (usually 100) of records per message. | ||
| 13.08 | extract files | 13.08;0 | MULTIPLE | 350.9006 | This sub-file contains configuration information for each extracted file type. | |
| 19 | pay-to providers | 19;0 | MULTIPLE | 350.9004 | This multiple contains the list of Pay-To Providers for this VistA database. | |
| 20 | billing provider fac types | 20;0 | MULTIPLE | 350.9005 | This multiple field contains a list of the valid Billing Provider facility types and also whether or not a facility type may also be a Pay-To Provider. | |
| 29 | tricare pay-to providers | 29;0 | MULTIPLE | 350.929 | This multiple contains the list of TRICARE-specific Pay-To Providers for this VistA database. | |
| 50.01 | running claimsmanager? | 50;1 | BOOLEAN | 1:YES 0:NO | This field will contain a 1 if the site is running the Ingenix ClaimsManager interface and software and a 0 or "" if it is not. | |
| 50.02 | claimsmanager working ok? | 50;2 | BOOLEAN | 1:YES 0:NO | This field will normally contain a 1 (yes), but may be set to 0 (no) in order to halt the processing of claims through ClaimsManager. This would normally be used to correct a communication problem or any other problem that was preventing the claim from processing in ClaimsManager. | |
| 50.03 | general error msg mail group | 50;3 | POINTER | 3.8 | This field will point to the mail group that will receive the error messages to be received at the user level. If more than one mail group is desired, they may be added as a REMOTE USER in the mail group that is entered in this field. | |
| 50.04 | comm err msg mail group | 50;4 | POINTER | 3.8 | This field will point to the mail group that will receive messages that a Communication Error exists. This would normally include the technical support personnel. | |
| 50.05 | claimsmanager tcp/ip | 50;5 | FREE TEXT | This is the tcp/ip address for the Ingenix ClaimsManager server. | ||
| 50.06 | claimsmanager ports | 50.06;0 | MULTIPLE | 350.9001 | This is the ports used by the Ingenix ClaimsManager. | |
| 50.07 | mailman message flag | 50;7 | SET OF CODES | P:PRIORITY N:NORMAL | This field is either 'P' for Priority MailMan messages or 'N' for Normal MailMan messages. This only applies to the MailMan messages that are created and sent when one user is assigning a bill to another user. | |
| 51.01 | freshness days(+) | 51;1 | NUMERIC | This parameter determines how "fresh" the insurance verification This field is a parameter that is used by two of the data extracts to determine whether a record should be extracted or not. For both the Insurance Buffer extract and the Appointment extract, this represents how long to wait before IIV can attempt to reverify the same insurance for that patient. If the value is 10, this means that IIV can attempt to reverify insurance for a patient 11 days after the most recently inquired date. A specific date is always asked of the payer when trying to identify patients eligibility. | ||
| 51.02 | daily mailman msg | 51;2 | BOOLEAN | 1:YES 0:NO | This field determines whether the daily eIV Statistical Report should be sent via MailMan. This report contains information about the electronic insurance verification process - both inquiries and responses. | |
| 51.03 | daily msg time | 51;3 | FREE TEXT | Enter the time in four digit military format. Examples: 0100 = 1 AM 1300 = 1 PM | ||
| 51.04 | messages mailgroup(+) | 51;4 | POINTER | 3.8 | This field identifies the mail group to whom the daily eIV Statistical Report and eIV error messages will be sent via MailMan. | |
| 51.05 | timeout days | 51;5 | NUMERIC | This field defines how many days without an insurance response is considered to be a communication timeout. | ||
| 51.06 | number retries | 51;6 | NUMERIC | This field specifies how many retries to attempt when a communication timeout occurs before it is considered a communication failure. An entry of zero indicates that when a communication timeout occurs, no retries shall be attempted and the inquiry will be considered a communication failure. | ||
| 51.07 | timeout mailman msg | 51;7 | BOOLEAN | 1:YES 0:NO | This field allows the site to send a MailMan message for each communication timeout. | |
| 51.08 | inquire inactive insurance | 51;8 | BOOLEAN | 1:YES 0:NO | This field helps guide both the No Insurance data extract and Appointment data extract to attempt to request information for a patient's inactive insurance if no active insurance is found. | |
| 51.09 | inquire popular payers | 51;9 | BOOLEAN | 1:YES 0:NO | This field guides both the No Insurance data extract and the Appointment data extract to attempt to request information for a patient, who has no previous insurance and/or no active insurance in VISTA, based upon the list of Most Popular Payers. | |
| 51.1 | no. popular payers | 51;10 | NUMERIC | This field is the number of the most popular payers that should be queried if the Inquire Popular Payers parameter is set to 'Yes'. | ||
| 51.11 | popular insur co. from date | 51;11 | DATE-TIME | This field is the date that the calculation of the Most Popular Insurance Companies starts with when searching through the Bill/Claims File (#399). *** OBSOLETE - 12/15/2003 *** | ||
| 51.12 | popular insur co. thru date | 51;12 | DATE-TIME | This field is the date that the calculation of the Most Popular Insurance Companies ends with when searching through the Bill/Claims File (#399). *** OBSOLETE - 12/15/2003 *** | ||
| 51.13 | hl7 response processing(+) | 51;13 | SET OF CODES | B:Batch I:Immediate | This field allows the site to tell the Eligibility Communicator how eIV responses should be returned to the site. Batch means that EC will hold all messages and return them between the HL7 Start Time and HL7 Stop Time. Immediate means that EC will return a response as soon as it is received from the payer. | |
| 51.14 | hl7 start time(+) | 51;14 | FREE TEXT | Enter the time in military format. This time represents when the site has told the Eligibility Communicator to begin sending eIV responses to the site. This field only applies when the HL7 Response Processing is set to 'B'atch processing. It is recommended that this be a time during low CPU processing. Examples: 0100 = 1 AM 1300 = 1 PM | ||
| 51.15 | hl7 maximum number(+) | 51;15 | NUMERIC | This field allows a site to restrict the daily number of HL7 messages created and sent during the HL7 process for eIV. This feature can be used to manage the amount of eIV HL7 traffic flowing through the HL7 package. | ||
| 51.16 | contact person(+) | 51;16 | POINTER | 200 | This field identifies the person that the Financial Services Center or the Eligibility Communicator shall contact if there are any problems that need to be addressed; e.g. communication problems. This information will be sent nightly to FSC/EC to keep it up to date. | |
| 51.17 | batch extracts | 51.17;0 | MULTIPLE | 350.9002 | This field identifies each of the three data extracts that eIV uses to find insurance data via verification inquiries. Extracts are defined for Insurance Buffer, Appointments, and Non-Verified Insurance. | |
| 51.18 | popular payers | 51.18;0 | MULTIPLE | 350.9003 | ||
| 51.19 | hl7 stop time(+) | 51;19 | FREE TEXT | Enter the time in military format. This time represents when the site has told the Eligibility Communicator to stop sending eIV responses to the site. This field only applies when the HL7 Response Processing is set to 'Batch' processing. Examples: 0100 = 1 AM 1300 = 1 PM | ||
| 51.2 | failure mailman msg | 51;20 | BOOLEAN | 1:YES 0:NO | This field allows the site to send a MailMan message for each communication failure. A communication failure is defined as having exhausted all retries. | |
| 51.21 | most popular last save date | 51;21 | DATE-TIME | This is the date/time on which the Most Popular Payer list was last saved. This field is not available for edit by users. | ||
| 51.22 | registration complete | 51;22 | BOOLEAN | 1:YES 0:NO | This field indicates whether application acknowledgement has been received and processed from the Eligibility Communicator. If the registration message failed at the EC, no further processing of eIV messages will occur. | |
| 51.23 | inquire secondary insurances | 51;23 | BOOLEAN | 1:YES 0:NO | This field contains an indicator that controls whether outgoing electronic verification requests should return any additional or secondary insurance information that is found for a patient when an eligibility request is made for a specific insurance company. | |
| 51.24 | most popular last saved by(+) | 51;24 | POINTER | 200 | This is the user who last editted and saved the Most Popular Payer list. If the field MOST POPULAR LAST SAVE DATE is deleted, this field will be the user who deleted the date. | |
| 51.25 | medicare payer | 51;25 | POINTER | 365.12 | This field holds the Medicare WNR payer entry. It is used to identify the Medicare payer for the insurance buffer lists and any other applications that need to know which payer is the Medicare WNR payer. | |
| 51.26 | retry flag | 51;26 | BOOLEAN | Y:YES N:NO | A 'Y'es value indicates that an eIV Inquiry will retransmit if no response is received within the number of TIMEOUT DAYS (51.05) field. | |
| 60.01 | default service type code 1(+) | 60;1 | POINTER | 365.013 | First Default Service Type Code sent with eIV Eligibility Inquiry. | |
| 60.02 | default service type code 2 | 60;2 | POINTER | 365.013 | Second Default Service Type Code sent with eIV Eligibility Inquiry. | |
| 60.03 | default service type code 3 | 60;3 | POINTER | 365.013 | Third Default Service Type Code sent with eIV Eligibility Inquiry. | |
| 60.04 | default service type code 4 | 60;4 | POINTER | 365.013 | Fourth Default Service Type Code sent with eIV Eligibility Inquiry. | |
| 60.05 | default service type code 5 | 60;5 | POINTER | 365.013 | Fifth Default Service Type Code sent with eIV Eligibility Inquiry. | |
| 60.06 | default service type code 6 | 60;6 | POINTER | 365.013 | Sixth Default Service Type Code sent with eIV Eligibility Inquiry. | |
| 60.07 | default service type code 7 | 60;7 | POINTER | 365.013 | Seventh Default Service Type Code sent with eIV Eligibility Inquiry. | |
| 60.08 | default service type code 8 | 60;8 | POINTER | 365.013 | Eighth Default Service Type Code sent with eIV Eligibility Inquiry. | |
| 60.09 | default service type code 9 | 60;9 | POINTER | 365.013 | Ninth Default Service Type Code sent with eIV Eligibility Inquiry. | |
| 60.1 | default service type code 10 | 60;10 | POINTER | 365.013 | Tenth Default Service Type Code sent with eIV Eligibility Inquiry. | |
| 60.11 | default service type code 11 | 60;11 | POINTER | 365.013 | Eleventh Default Service Type Code sent with eIV Eligibility Inquiry. | |
| 61.01 | site selected service code 1 | 61;1 | POINTER | 365.013 | First Site Selected Service Type Code to send with eIV Eligibility Inquiry. | |
| 61.02 | site selected service code 2 | 61;2 | POINTER | 365.013 | Second Site Selected Service Type Code to send with eIV Eligibility Inquiry. | |
| 61.03 | site selected serivce code 3 | 61;3 | POINTER | 365.013 | Third Site Selected Service Type Code to send with eIV Eligibility Inquiry. | |
| 61.04 | site selected service code 4 | 61;4 | POINTER | 365.013 | Fourth Site Selected Service Type Code to send with eIV Eligibility Inquiry. | |
| 61.05 | site selected service code 5 | 61;5 | POINTER | 365.013 | Fifth Site Selected Service Type Code to send with eIV Eligibility Inquiry. | |
| 61.06 | site selected service code 6 | 61;6 | POINTER | 365.013 | Sixth Site Selected Service Type Code to send with eIV Eligibility Inquiry. | |
| 61.07 | site selected service code 7 | 61;7 | POINTER | 365.013 | Seventh Site Selected Service Type Code to send with eIV Eligibility Inquiry. | |
| 61.08 | site selected service code 8 | 61;8 | POINTER | 365.013 | Eighth Site Selected Service Type Code to send with eIV Eligibility Inquiry. | |
| 61.09 | site selected service code 9 | 61;9 | POINTER | 365.013 | Ninth Site Selected Service Type Code to send with eIV Eligibility Inquiry. | |
| 62.01 | limit length of eiv fields? | 62;1 | BOOLEAN | 0:NO 1:YES | If set to YES, eIV field values will be limited to pre-patch IB*2.0*497 lengths via corresponding input transforms. | |
| 70.01 | hpid/oeid active? | 70;1 | SET OF CODES | 0:Not Active 1:Active | This parameter indicates whether or not the National Insurance File (NIF) is ready to communicate with your VISTA site. | |
| 99 | ins. co's withholding supplimental payments | 99;0 | MULTIPLE | 350.999 | This sub-file contains pointers to the INSURANCE COMPANY (#36) file. The sub-file is populated from the option Edit List of Ins. Co. Witholding Payments [IB MRA EDIT INS CO LIST] or the Queue MRA Extract [IB MRA EXTRACT]. The insurance companies listed in this sub-file represent the companies for which means test bills will be extracted. |
Not Referenced