Files > IB BILLING PRACTITIONER ID

name

IB BILLING PRACTITIONER ID

number

355.9

location

^IBA(355.9,

description

This file contains one record for each unique billing provider id number that an individual provider (practitioner) is assigned by an insurance company or by a licensing or government entity. Entries without an insurance company indicate the number is assigned to the practitioner by a licensing or government entity and will apply to all insurance companies. This file contains the id numbers for the following ids: o Assigned by gov't or licensing agency to a practitioner for all ins co o Assigned by an insurance co to an individual practitioner o Assigned by an insurance co to an individual practitioner, but a new number assigned for each care unit entry

Fields

#	Name	Location	Type	Details	Index	Description
.01	practitioner(+)	0;1	VARIABLE-POINTER	200, 355.93	B	This is the practitioner (individual provider) for whom the id number is being defined. This practitioner can either be a VA provider and reside in the NEW PERSON file or can be a NON-VA provider and will reside in the IB NON-VA BILLING PROVIDER file as an individual provider (not as a facility).
.02	insurance co	0;2	POINTER	36		This is the insurance company that has assigned a specific id to the provider. If this data is not entered, the id number will be assumed to apply to all insurance companies for the provider.
.03	provider id care unit	0;3	POINTER	355.96	ACARE	This is the actual data value of the care unit to use to assign this provider id to the insurance company and provider. *** NOT CURRENTLY USED ***
.04	form type applied to(+)	0;4	SET OF CODES	0:BOTH UB-04 AND CMS-1500 FORMS 1:UB-04 FORMS ONLY 2:CMS-1500 FORMS ONLY		This designates whether the id number is to be used for just UB-04 form types, just CMS-1500 form types or both form types.
.05	bill care type(+)	0;5	SET OF CODES	0:BOTH INPATIENT AND OUTPATIENT 1:INPATIENT ONLY 2:OUTPATIENT ONLY 3:PRESCRIPTION ONLY		This designates whether the id number is to be used for just inpatient episodes, just outpatient episodes, both inpatient and outpatient episodes, or for just prescriptions.
.06	provider id type(+)	0;6	POINTER	355.97		This is the indicator of what type of id is being recorded.
.07	provider id(+)	0;7	FREE TEXT		C	This is the provider id that will be used for a claim when all criteria defined on this record have been met.
.15	index value insurance co(+)	0;15	FREE TEXT			This field contains the key value for the insurance company or '*ALL*' if no insurance company is selected. This is to assure uniqueness in the records in the file even if the insurance company is blank.
.16	index value care unit(+)	0;16	FREE TEXT			This field contains the key value for the care unit or '*N/A*' if no care unit is selected. This is to assure uniqueness in the records in the file even if the care unit is blank.