Files > NON-BILLABLE CLINIC STOP CODES

name

NON-BILLABLE CLINIC STOP CODES

number

352.3

location

^IBE(352.3,

description

This file shall be used to flag clinic stop codes in the CLINIC STOP (#40.7) file as either billable or non-billable for Means Test Billing and Third Party Billing. It may also be used to flag billable stops so the Third Party auto biller will not create bills for them. The flagging of the stop codes is date-sensitive, so the ability to not bill can be turned on or off. The default billing action is TO BILL ALL stop codes; thus, it is only necessary to add entries to this file if billing of a particular clinic stop code is not desired. The routine IBEFUNC contains the function call to determine if a clinic stop code should not be billed on a specific date. Per VHA Directive 10-93-142, this file definition should not be modified.

Fields

#	Name	Location	Type	Details	Index	Description
.01	clinic stop code(+)	0;1	POINTER	40.7	B	This field is a pointer to the CLINIC STOP (#40.7) file and identifies the clinic stop code which is being established as either billable or non-billable.
.02	effective date(+)	0;2	DATE-TIME			This is the date on which billing for this clinic stop code should be activated or ignored.
.03	ignore means test billing?(+)	0;3	BOOLEAN	1:YES 0:NO		This field is used to determine whether Means Test billing should be activated or ignored, as of the EFFECTIVE DATE (field #.02). Please note that you only need an entry in this file for a clinic stop code for which you would like Means Test billing to be IGNORED.
.04	type(+)	0;4	SET OF CODES	1:MEANS TEST 2:THIRD PARTY		This specifies the type of billing this bill/not bill Stop Code flag applies to.
.05	third party non-billable	0;5	BOOLEAN	1:YES 0:NO		This field is used to determine if the stop code should be billed to a Third Party payer.
.06	third party auto bill	0;6	SET OF CODES	1:NO 0:YES		Enter 'No' if the Third Party auto biller should NOT create bills for visits with this stop code. This should only be set for stops that are billable.