This file contains all of the Rate Types which may be used in MCCR Billing. Per VHA Directive 10-93-142, this file definition should not be modified.
.001number11This is the internal file number of this entry.
.01name(+)0;1FREE TEXTBThis is the name/description of this rate type.
.02bill name(+)0;2FREE TEXTThis is the text which will appear on the UB claim form each time a bill of this rate type is printed.
This indicates whether or not this code has been inactivated.
.04abbreviation(+)0;4FREE TEXTThis defines the abbreviation of the name of this rate type which will appear on all of the billing outputs.
.05is this a third party bill?(+)0;5BOOLEAN0:NO
This allows the user to determine whether or not a bill of this rate type is a third party bill.
.06accounts receivable category(+)0;6POINTER430.2This points to the corresponding Accounts Receivable category.
.07who's responsible0;7SET OF CODESp:PATIENT
This field is triggered when an Accounts Receivable Category is entered. It is used to provide consistency between packages so the the debtor for the bill is from the correct file. Debtors can be from the Patient file, the Insurance Company file, or the Institution file.
.08reimbursable insurance?0;8BOOLEAN1:YES
This field should be answered 'YES' if this is a Reimbursable Insurance rate type, all other rate types should be answered 'NO'. This field will be used to determine if a bill is reimbursable Insurance. Primarily, this field will be used by the bill print option to determine if the 7 line statement that begins "For your information..." should be printed on the UB claim form. (Only applies to the UB form types.)
.09nsc statement on ub bills0;9BOOLEAN1:YES
The statement "The undersigned certifies that treatment rendered is not for a service connected disablity." will be printed on UB claim forms of this Rate Type if this field is answered 'YES'. This field should be answered 'YES' for all rate types where the bill can only be for NSC care.
.1electronic transmit0;10SET OF CODES0:NOT ALLOWED
The type of transmission allowed, if any, for bills of this rate type.
.11bill resulting from0;11POINTER430.6This is the default value for the BILL RESULTING FROM (#4.5) field in the ACCOUNTS RECEIVABLE file (#430) that will be used during auto-audit for all bills with this rate type.

Referenced by 4 types

  1. RATE SCHEDULE (363) -- rate type
  2. IB NCPDP PRESCRIPTION (366.15) -- rate type determined
  3. BILL/CLAIMS (399) -- rate type
  4. BPS REQUESTS (9002313.77) -- rate type