# | Name | Location | Type | Details | Index | Description |
---|---|---|---|---|---|---|
.01 | bill no. | 0;1 | FREE TEXT | B | This is the unique bill number assigned to this billing episode. New bill numbers consist of no less than 6 characters, preceded by station number if multi-divisional (Example: 662-K000001). Bill numbers for bills that have been cancelled in Integrated Billing (IB) during the process of correcting errors in the original bill add an additional 3 characters, a hyphen and an incremental number (Example: 662-K000001-01). | |
.11 | last interest charge date | .1;1 | DATE-TIME | This field stores the last date interest was charged to this bill. | ||
.12 | last admin charge date | .1;2 | DATE-TIME | This field stores the last date an administrative charge was applied to this bill. | ||
.13 | last penalty charge date | .1;3 | DATE-TIME | This field stores the last date penalty charges were added to this bill. | ||
1 | fiscal year | 2;0 | MULTIPLE | 430.01 | A single bill can have activity that spreads over more than one fiscal year. This multiple field holds a record of each year's appropriation symbol, PAT reference number, original amount, etc. | |
2 | category(+) | 0;2 | POINTER | 430.2 | This is the bill's Category - a pointer to the Category File (Means Test, Vendor, Employee, Tort, etc.). | |
3 | original amount(+) | 0;3 | NUMERIC | This is the original dollar amount of the bill. | ||
4 | gl no.(+) | 0;4 | FREE TEXT | This is the General Ledger Number for the ALD CODE assigned to this bill. | ||
4.5 | bill resulting from(+) | 0;5 | POINTER | 430.6 | The cause of the debt. This field points to the AR Debt List File which contains brief statements describing the source of the bills that are used on the debt collection letters. The type of entry selected must be compatible with the bill's category type. | |
7 | patient(+) | 0;7 | POINTER | 2 | E | This is a pointer to the Patient File. Adding new patients is NOT ALLOWED through this option. |
8 | current status(+) | 0;8 | POINTER | 430.3 | AC | |
9 | debtor(+) | 0;9 | POINTER | 340 | C | This field points to the Debtor File, which in turn is a variable pointer to other files. This allows automatic look-up of debtors based on the category of the bill. Adding new entries to the other files may not be allowed. |
10 | date bill prepared(+) | 0;10 | DATE-TIME | The date the bill was prepared. Time is not allowed. | ||
11 | current balance | COMPUTED | This field computes the current balance of the account. | |||
12 | site | 0;12 | POINTER | 4 | This is a pointer to the Admin. Activity Site Parameter File. Adding new entries is allowed. | |
13 | agent cashier | 0;13 | POINTER | 342.1 | This field is an inactive field and used to point to the AR SITE PARAMETER file (430.5) in AR v3.7. | |
13.1 | account receivable section | 0;6 | POINTER | 342.1 | This field is inactive and use to point to the AR SITE PARAMETER file (430.5) in AR v3.7. | |
14 | date status updated | 0;14 | DATE-TIME | |||
15 | status remark | 0;15 | FREE TEXT | An optional field that holds a brief remark regarding the status, reason for change in status, etc. 3-45 characters. | ||
15.1 | type of care(+) | 0;16 | POINTER | 430.2 | This is a pointer to the AR category file. This entry should be 'NURSING HOME CARE', 'OUTPATIENT CARE' or 'HOSPITAL CARE'. Adding new entries is not allowed. | |
16 | date calm done | 0;11 | DATE-TIME | The date the PAT reference number was assigned and the CALM code sheet was done. | ||
17 | status updated by | 0;17 | POINTER | 200 | This is a pointer to the New Person File. It extracts the name of the person making a change to the bill's status. Adding new entries is not allowed. | |
18 | appropriation symbol | 0;18 | FREE TEXT | This is a free-text field holding the appropriation symbol. 7-10 characters. | ||
19 | secondary insurance carrier | 0;19 | POINTER | 36 | This is a pointer to the Insurance Company File. Adding new entries is not allowed. | |
19.1 | tertiary insurance carrier | 0;20 | POINTER | 36 | This is a pointer to the Insurance Company File. Adding new entries is not allowed. | |
20.1 | segment | 0;21 | NUMERIC | This is the number of the billing category's AMIS reporting segment. | ||
21 | hold letter date | 1;1 | DATE-TIME | This is the date a hold is/was placed on follow-up letters for this account. | ||
22 | hold letter reason | 1;2 | SET OF CODES | L:PERSONAL LETTER P:PHONE CALL V:PERSONAL VISIT O:OTHERS | This is the reason a hold was placed on sending follow-up letters. Select from the list of choices. | |
23 | hold letter comments | 1;3 | FREE TEXT | This field allows the user to enter expanded comments on the reason for holding follow-up letters. | ||
31 | date returned to service | 3;1 | DATE-TIME | This is the date a bill was returned to the originating service. | ||
32 | returned by | 3;2 | POINTER | 200 | This is the user from the New Person File who returned the bill to the originating service. Adding a new Person is not allowed. | |
33 | amended date | 3;3 | DATE-TIME | This is the date this bill was amended. | ||
34 | amended by | 3;4 | POINTER | 200 | This is the user from the New Person File who amended this bill. Adding a new Person is not allowed. | |
35 | amended amount | 3;5 | NUMERIC | This is the dollar value of the amendment. It can be a positive or negative figure. | ||
36 | fiscal comments (return) | 3;6 | FREE TEXT | This text field holds Fiscal service comments regarding the return of a bill. | ||
37 | service comments (amend) | 3;7 | FREE TEXT | This text field holds the Service's comments regarding the amendment of a bill. | ||
41 | repayment plan date | 4;1 | DATE-TIME | This is the date a repayment plan was established. | ||
42 | day of mon. payment due | 4;2 | NUMERIC | This is the day of the month that payments are due according to the repayment plan. | ||
43 | repayment amount due | 4;3 | NUMERIC | This is the monthly payment amount agreed upon in the repayment plan. | ||
44 | number of payments | 4;4 | NUMERIC | This is the number of payments agreed upon in the repayment plan. | ||
51 | repayment due dates | 5;0 | MULTIPLE | 430.051 | This multiple field holds information about each payment received during the repayment plan. | |
60 | date account activated | 6;21 | DATE-TIME | |||
61 | letter1 | 6;1 | DATE-TIME | This is the date the first debt collection letter was sent to the debtor. | ||
62 | letter2 | 6;2 | DATE-TIME | This is the date the second debt collection letter was sent to the debtor. | ||
63 | letter3 | 6;3 | DATE-TIME | This is the date the third debt collection letter was sent to the debtor. | ||
64 | referral date | 6;4 | DATE-TIME | AD | This is the date the account was referred to the Regional Counsel or the Department of Justice for collection. | |
65 | referral code | 6;5 | SET OF CODES | RC:REGIONAL COUNSEL DOJ:DEPT.OF JUSTICE DC:REGIONAL COUNSEL | This field indicates where an account was referred to. | |
66 | referral amount | 6;6 | NUMERIC | This is the account balance that was referred. | ||
67 | last int/adm charge date | 6;7 | DATE-TIME | This is the most recent date that Interest/Administrative costs were charged to the account. | ||
68 | letter4 | 6;8 | DATE-TIME | This is the date the fourth debt collection letter was sent to the debtor. | ||
68.1 | last letter date | 6;9 | DATE-TIME | This is the date of the most recent debt collection letter. | ||
68.2 | re-referral date | 6;10 | DATE-TIME | This is the date the account was re-referred to the Regional Counsel or Department of Justice. | ||
68.3 | returned date by rc/doj | 6;11 | DATE-TIME | This is the date a referred account was returned by the Regional Counsel or Department of Justice. | ||
68.4 | referral date to cowc | 6;12 | DATE-TIME | This is the date the account was referred to the DVB Committee on Waivers and Compromise. | ||
68.5 | referred amount to cowc | 6;13 | NUMERIC | This is the balance of an account referred to the DVB Committee on Waivers and Compromise. | ||
68.6 | irs offset letter | 6;14 | DATE-TIME | This field stores the last date an IRS Offset letter was printed that contained the amount due from the bill. | ||
68.7 | date forwarded to irs | 6;15 | DATE-TIME | This is the date the receivable was forwarded to the IRS. | ||
68.8 | irs principal balance | 6;16 | NUMERIC | This is the principal balance of the receivable forwarded to the IRS. | ||
68.9 | irs interest balance | 6;17 | NUMERIC | This is the Interest Balance forwarded to the IRS. | ||
68.91 | irs admin. balance | 6;18 | NUMERIC | This is the Administrative Balance forwarded to the IRS. | ||
68.92 | original irs letter amount | 6;19 | NUMERIC | This is the Original Amount of the bill forwarded to the IRS. | ||
68.93 | original irs offset amount | 6;20 | NUMERIC | This is the Original IRS Offset Amount. | ||
68.94 | referral reason code(+) | 6;22 | SET OF CODES | 1:LITIGATION ISSUES 2:VET NOT RESP FOR COST OF CARE 3:REFUSAL TO PAY GOV HOSPITAL 4:VETERAN PAID DIRECTLY 5:MCCR REF WITH RC CONSENT | This is a code for the transmission to Regional Counsel to let them know the reason for the referral. This is required for the transmission. | |
68.95 | referral comment(+) | 6;23 | FREE TEXT | Enter specific information on the account pertaining to the reason for referral; date, time of call and contact person the staff spoke with at the Regional Counsel. | ||
69 | over letter3 | COMPUTED | This field computes the length of time since the third debt collection letter was mailed. | |||
70 | delinquent days | COMPUTED | This field computes the number of days an account is delinquent by subtracting the date of the first debt collection letter from the current date. | |||
71 | principal balance(+) | 7;1 | NUMERIC | This field is set to the original amount when a new bill is established. | ||
72 | interest balance | 7;2 | NUMERIC | This is the balance due for interest charges on this bill. | ||
73 | administrative cost balance | 7;3 | NUMERIC | This is the balance due for administrative costs on this bill. | ||
74 | marshal fee | 7;4 | NUMERIC | This is the amount of the Marshal Fee included in this bill. | ||
75 | court cost | 7;5 | NUMERIC | This is the amount of court costs included in this bill. | ||
77 | total paid principal | 7;7 | NUMERIC | This is the total amount received toward this bill's principal balance. | ||
78 | total paid interest | 7;8 | NUMERIC | This is the total amount received toward this bill's interest charges. | ||
79 | total paid administrative cost | 7;9 | NUMERIC | This is the total amount received toward this bill's administrative cost charges. | ||
79.1 | total paid marshal fee | 7;10 | NUMERIC | This is the total amount received toward this bill's Marshal Fee. | ||
79.12 | outstanding pb | 7;12 | NUMERIC | This is the total outstanding principal balance for this debtor's account. | ||
79.13 | outstanding ib | 7;13 | NUMERIC | This is the total outstanding principal interest balance for this debtor's account. | ||
79.14 | outstanding ab | 7;14 | NUMERIC | This is the total outstanding administrative cost charges for this debtor's account. | ||
79.15 | outstanding mf | 7;15 | NUMERIC | This is the total outstanding marshal's fee for this debtor's account. | ||
79.16 | outstanding cc | 7;16 | NUMERIC | This is the total outstanding court cost for this debtor's account. | ||
79.17 | excess payment amount | 7;17 | NUMERIC | This field stores the amount of a patient's excess payment. | ||
79.18 | refunded amount | 7;18 | NUMERIC | This field stores the dollar amount that has been refunded to the patient. | ||
79.19 | refunded date | 7;19 | DATE-TIME | This field stores the date the refund was made. | ||
79.2 | total paid court cost | 7;11 | NUMERIC | This is the total amount received toward this bill's court costs. | ||
79.21 | refunded by | 7;21 | POINTER | 200 | This field stores the name of the person who approved the refund. It is a pointer to the New Person File. | |
81 | irs location cost | 8;1 | NUMERIC | This is the amount charged to the bill for an IRS locator search. | ||
82 | credit rep. cost | 8;2 | NUMERIC | This is the amount charged to the bill for a credit report locator check. | ||
83 | dmv location cost | 8;3 | NUMERIC | This is the amount charged to the bill for a state agency/department of motor vehicles locator search. | ||
83.1 | dmv location check | 8;18 | BOOLEAN | Y:YES N:NO | This flag indicates whether or not a state agency/department of motor vehicles locator check was done. | |
84 | consumer rep. agency cost | 8;4 | NUMERIC | This is the amount charged to the bill for a consumer rep. agency locator search. | ||
85 | postal location cost | 8;5 | NUMERIC | This is the amount charged to the bill for a US Postal Service locator search. | ||
86 | able to pay | 8;6 | BOOLEAN | Y:YES N:NO | This flag indicates whether or not the debtor is able to pay this bill. | |
87 | able to locate | 8;7 | BOOLEAN | Y:YES N:NO | This flag indicates whether or not the debtor could be located. | |
88 | postal loc.date sent | 8;8 | DATE-TIME | This is the date a request to locate the debtor was sent to the US Postal Service. | ||
89 | postal loc.date received | 8;9 | DATE-TIME | This is the date a reply was received to the Postal locator request. | ||
89.1 | irs able to locate | 8;10 | BOOLEAN | Y:YES N:NO | This flag indicates whether or not the IRS was able to locate the debtor. | |
89.2 | irs loc. date sent | 8;11 | DATE-TIME | This is the date a request to locate the debtor was sent to the IRS. | ||
89.3 | irs loc. date received | 8;12 | DATE-TIME | This is the date a reply was received to the IRS locator request. | ||
89.4 | credit rep. able to pay | 8;13 | BOOLEAN | Y:YES N:NO | This flag indicates whether or not the credit report says the debtor is able to pay the bill. | |
89.5 | credit rept. date sent | 8;14 | DATE-TIME | This is the date a request for a credit report was sent. | ||
89.6 | credit rep. date received | 8;15 | DATE-TIME | This is the date the requested credit report was received. | ||
89.7 | patient folder reviewed | 8;16 | BOOLEAN | Y:YES N:NO | This flag indicates whether or not the debtor's Patient Folder was reviewed for locator information. | |
89.8 | date folder reviewed | 8;17 | DATE-TIME | This is the date the debtor's Patient Folder was reviewed. | ||
90 | approved by (fiscal) | 9;1 | POINTER | 200 | This is the person in Fiscal who approved the bill. | |
91 | ar electronic signature | 9;2 | FREE TEXT | |||
92 | ar date signed | 9;3 | DATE-TIME | This is the date the bill was signed in Fiscal. | ||
93 | ar appr.official's title | 9;4 | FREE TEXT | This is the approving official's title. | ||
94 | approved by (billing) | 9;5 | POINTER | 200 | This is the person who approved the bill in the Service or Section. | |
95 | previous status | 9;6 | POINTER | 430.3 | This is the former status of the bill if it has been changed. | |
96 | approved date (service) | 9;7 | DATE-TIME | This is the date the bill was approved in the Service or Section. | ||
97 | processed by (service) | 9;8 | POINTER | 200 | This is the person in the Service or Section who processed the bill. | |
98 | comments | 10;0 | WORD-PROCESSING | This word processing field allows the AR Clerk or Supervisor to add optional comments at the time the bill is audited. | ||
100 | form type(+) | 100;1 | SET OF CODES | 1:1081 2:1080 3:1114 | This response indicates the type of form for the bill. (1080, 1081 or 1114). | |
101 | service(+) | 100;2 | POINTER | 49 | This is the Service or Section that originated the bill. | |
104 | voucher number | 100;4 | FREE TEXT | This is the billing Service/Section's voucher number. It is used on the 1080, 1081 and 1114 bill forms. | ||
106 | description | 101;0 | MULTIPLE | 430.02 | This is a description of the bill. | |
107 | billing agency | 100;7 | POINTER | 342.1 | This is the billing agency from the AR Site Parameter file. | |
108 | agency location code (alc) | 100;3 | FREE TEXT | This is the Agency Location Code. | ||
110 | document number | 100;8 | NUMERIC | This is the Document Number used on the 1081 bill form. | ||
111 | approving official (service) | 104;1 | POINTER | 200 | This is the person in the Service or Section who approved the bill. | |
112 | electronic signature | 104;2 | FREE TEXT | |||
113 | date signed (approved) | 104;3 | DATE-TIME | This is the date the bill was approved in the Service or Section. | ||
114 | appr. official's title | 104;4 | FREE TEXT | This is the title of the person who approved the bill in the Service or Section. | ||
121 | date sent to dmc | 12;1 | DATE-TIME | This is the date that the bill was first sent to the Debt Management Center. | ||
122 | dmc principal balance | 12;2 | NUMERIC | This is the current principal balance for the bill that is at the Debt Management Center. | ||
123 | dmc interest balance | 12;3 | NUMERIC | This is the current interest balance for the bill that is at the Debt Management Center. | ||
124 | dmc admin balance | 12;4 | NUMERIC | This is the current administrative cost balance for the bill that is at the Debt Management Center. | ||
125 | dmc debt valid | 12.1;1 | SET OF CODES | Y:YES N:NO P:PENDING | If the field value is NULL the nightly DMC job will prevent the debt from being referred to DMC when the debtor is SC 50% to 100% or in Receipt of a VA Pension. It will then set this field value to PENDING so the users will know this is what occurred. If a user sets this field value to YES and the debt meets all criteria to be sent to DMC it will be referred to DMC even if the debtor is SC 50% to 100% or in Receipt of a VA Pension. If a user sets this value to NO the debt will not be referred to DMC. Users should only interactively be able to set the value to YES or NO. PENDING is reserved for the nightly DMC job. | |
126 | dmc debt valid edited by | 12.1;2 | POINTER | 200 | This is a pointer to the New Person File. It extracts the name of the last person making a change to the DMC Debt Valid field. Adding new entries to the New Person File is not allowed. | |
127 | dmc debt valid edited date | 12.1;3 | DATE-TIME | This is the Date and Time a user last edited the DMC Debt Valid Field. | ||
131 | medicare cont. adjustment | 13;1 | NUMERIC | This field will reflect the Medicare contractual adjustment for a bill. | ||
132 | medicare unreimbursable | 13;2 | NUMERIC | This field will reflect the Medicare Unreimbursable Expense for a bill. | ||
141 | date bill referred to top | 14;1 | DATE-TIME | This field contains the date that the bill was originally referred to TOP. | ||
142 | top refund status | 14;2 | SET OF CODES | 1:REFUND 2:REFUND TRANSMITTED 3:REVERSAL 4:REVERSAL TRANSMITTED | TREF | This field contains the current status of a TOP refund. |
143 | top trace number | 14;3 | FREE TEXT | This field contains the trace number attached to the refund. | ||
144 | top refund year | 14;4 | FREE TEXT | This field contains the calendar year for which the refund is granted. | ||
200 | receivable code | COMPUTED | Identifies bill as Federal/Non-federal. | |||
200.2 | type of bill | 200;8 | FREE TEXT | This is the type of bill code from the UB-82 bill form. | ||
201 | beginning budget fy | 11;15 | FREE TEXT | Beginning Fiscal Year of accounting FUND. | ||
202 | ending budget fy | 11;16 | FREE TEXT | Ending Fiscal Year of accounting FUND. | ||
203 | fund(+) | 11;17 | FREE TEXT | FMS Accounting FUND. | ||
204 | admin office | 11;18 | SET OF CODES | 10:VHA 20:VBA 30:NCS | Administrative Office code used by FMS. | |
205 | organizational ctrl point | 11;19 | FREE TEXT | FMS accounting field. | ||
206 | fcp/proj | 11;20 | FREE TEXT | FMS accounting field. | ||
239 | insured name | 202;1 | FREE TEXT | This is the individual in whose name the insurance is carried. | ||
240 | insured sex | 202;2 | SET OF CODES | M:MALE F:FEMALE U:UNKNOWN | This is the insured individual's sex. | |
241 | pt relationship | 202;3 | FREE TEXT | This is the two-digit code for the relationship between the insured individual and the patient. It comes from the UB-82 bill form. | ||
242 | cert ssn hic id no. | 202;4 | FREE TEXT | This is the Certificate/Social Security Number/Health Insurance Claim/Identification Number from the UB-82 bill form. | ||
243 | group name | 202;5 | FREE TEXT | This is the name of the group through which the insurance is provided. | ||
244 | group number | 202;6 | FREE TEXT | This is the identification number of the group providing insurance. | ||
245 | employee information data | 202;7 | FREE TEXT | This is the employee information data code from the UB-82 bill form. | ||
246 | employment status code | 202;8 | FREE TEXT | This is the employment status code from the UB-82 bill form. | ||
247 | employer name | 202;9 | FREE TEXT | This is the employer's name from the UB-82 bill form. | ||
248 | employee id number | 202;10 | FREE TEXT | This is the employee's identification number from the UB-82 bill form. | ||
249 | employer location | 202;11 | FREE TEXT | This is the employer's location from the UB-82 bill form. | ||
250 | control point | 11;1 | FREE TEXT | IFCAP control point. | ||
251 | cost center(+) | 11;2 | FREE TEXT | This field is required for spending transactions and is used to record expenditure of funds by various organizations within DVA. | ||
252 | sub cost center | 11;3 | FREE TEXT | This code is a further breakdown of the Cost Center. | ||
253 | boc (sub account)(+) | 11;21 | FREE TEXT | This code is equivalent to the CALM subaccount. Required for spending transactions and is used to determine the budget operating expense account to effect. | ||
254 | sub boc | 11;5 | FREE TEXT | This code is a further breakdown of the Budget Object Code. | ||
255 | revenue source(+) | 11;6 | POINTER | 347.3 | This code is required for revenue transactions. It is used to group collected revenue and to determine whether the revenue will credit actual reimbursement receivables for the associated fund. | |
255.1 | rsc (calc for accrued bills) | 11;23 | FREE TEXT | This field was added with patch PRCA*4.5*90. This field is used to store the calculated revenue source code for bills which are accrued. It is calculated and set in the field by the routine RCXFMSUR. | ||
256 | sub-rev source | 11;7 | FREE TEXT | This code is a further breakdown of the Revenue Source Code. | ||
257 | station | 11;8 | FREE TEXT | FMS accounting station number. | ||
258 | federal/non-federal/employee | 11;9 | SET OF CODES | 0:FEDERAL 1:NON-FEDERAL 2:EMPLOYEE | FMS accounting field to identify type of bill. | |
259 | refund/reibursment | 11;10 | SET OF CODES | 01:REFUND 02:REIMBURSEMENT 3:SF REIBURSMENT 4:SF REFUND 24:INELIG. HEALTH 09:GENERAL FUND 20:EMPLOYEE 50:TORT FEASOR | Identifies bill category for FMS | |
260 | sat station | 11;11 | FREE TEXT | This field is the Satellite station number | ||
261 | job number | 11;12 | FREE TEXT | FMS accounting element. | ||
262 | xprogam | 11;13 | FREE TEXT | FMS accounting element. | ||
263 | reporting category | 11;14 | FREE TEXT | FMS accounting element. | ||
264 | fms line number | 11;4 | FREE TEXT | This field contains the line number assigned to an FMS billing document. This field will only be populated if the line number is different than 001. Line number 001 is the default line number (for null entries). | ||
265 | vendor id | 11;22 | FREE TEXT | This field contains the vendor ID that was sent on the billing document. | ||
266 | fms transmission date | 203;1 | DATE-TIME | FMS | This field contains the date this document was transmitted to FMS. |