Files > BILLING PATIENT

name

BILLING PATIENT

number

354

location

^IBA(354,

description

DO NOT EDIT THIS FILE. Under normal operation it is not necessary to edit the fields in this file directly. The option Manually Change Copay Exemption (Hardships) can be used to update and correct this entry by creating a new exemption. If many patient records have problems the option Print/Verify Patient Exemption Status can be used to correct the entries. The data in this file is updated each time a new (current) exemption is created for a patient. Exemptions are automatically created when changes in patient information change the exemption status or when an expired (older than 1 year) exemption is encountered when determining the exemption status for pharmacy. This file will contain specific information related to billing about individual patients. Current Status of the Medication Copayment Exemption will be kept in this file. Conceptually this is different than the BILLING EXEMPTIONS File which maintains the audit log and historical data related to billing exemptions. Per VHA Directive 10-93-142, this file definition should not be modified.

Fields

#	Name	Location	Type	Details	Index	Description
.01	patient name(+)	0;1	POINTER	2	B	This is the name of the patient as it appears in the patient file.
.03	copay exemption status date(+)	0;3	DATE-TIME		AD	DO NOT EDIT THIS FIELD. It is maintained by the Copay Exemption Software. This is the date that this patients Medication Copay Income Exemption Status was last updated. If this date is not in the current calendar year this patient will be flagged as needing to have his status updated.
.04	copay income exemption status(+)	0;4	SET OF CODES	1:EXEMPT 0:NON-EXEMPT	AEX	DO NOT EDIT THIS FIELD. It is maintained by the Copay Exemption Software. This is the patients current Medication Copay Income Exemption Status. It is updated whenever an entry in the Billing Exemptions file is made. If a patient's income is less than the pension level, effective 10/29/92 the patient is exempt from paying the Medication Copayment. If a patient is receiving a VA Pension, or is receiving Aid and Attendence or House Bound benefits, or his income for the previous year is less than the pension level, he is exempt.
.05	copay exemption reason(+)	0;5	POINTER	354.2	AC	DO NOT EDIT THIS FIELD. It is maintained by the Copay Exemption Software. This is the exemption reason for the current copay exemption. It will be entered by the system.
50	ever had ivm insurance?	IVM;1	BOOLEAN	0:NO 1:YES		This field flags patients who have ever had at least one insurance policy that was identified by the IVM Center.
60	no coverage verification date	60;1	DATE-TIME		AVDT	This field contains the date that verification was made that this patient does not have any type of insurance coverage. When a policy is entered for a patient, this field will be deleted.