VistA Analysis » VistA Reference » RPCs » DSIF UNA ADD PAYMENT
DSIF UNA ADD PAYMENT
Add/edit Unauthorized payments
Properties
| Property | Value |
|---|---|
| Label | EN |
| MUMPS Implementation | DSIFPAU |
| Return Type | SINGLE VALUE |
Input Parameters
| Name | Type | Maximum Data Length | Required | Description |
|---|---|---|---|---|
| DSIFIN | LITERAL | 255 | true | ; Piece 1 ^ Veteran IEN (FBVET) ; 2 ^ Fee Vendor IEN ; 3 ^ Fee Basis Unauthorized Claims IEN (#162.7) (FBDA) ; 4 ^ Ancillary Payment (1=Y, null =no) ; 5 ^ Selected Batch IEN ; 6 ^ Date Correct Invoice Received or Last Date of Service for Authorizations ; 7 ^ Invoice # ; 8 ^ Patient Account # ; 9 ^ EDI Claim ; 10 ^ Service connected condition (Y/N) ; 11 ^ Anesthesia Time (minutes ,between 15 - 999 no decimal) ; 12 ^ Date of Service (FM date) ; 13 ^ Site of Service Zip Code ; 14 ^ CPT code (#81 external value) ; 15 ^ Amount Claimed ; 16 ^ Prompt payment (1-Yes, Null N) ; 17 ^ Medical denial (1-Yes, Null N) [We may not need this] ; 18 ^ Multiple service same day (1-Yes, Null N) |
| DSIFIN1 | LITERAL | 255 | true | ; DSIFIN1 - Input string, pieces below ; Piece 1 ^ Exempt from pricer (1 - Yes, Null for no) ; 2 ^ Medicare ID Number ; 3 ^ IEN of Fee Basis Batch File (#161.7) ; 4 ^ Vendor's Invoice Date ; 5 ^ Patient Control Number ; 6 ^ FPPS CLAIM ID for the EDI claim ; 7 ^ FPPS LINE ITEM number ; 8 ^ New CH payment (1 for Yes) ; 9 ^ Primary Diagnosis (opt: external value) |
| MODIFIERS | LITERAL | 30 | true | CPT modifiers, comma delimited, 4 maximum example: 65,34,GT |
| CHDATA | LIST | 255 | true | ;Input Parameters ; CHDATA - List of CHDATA formatted FIELD # ^ Internal Value ; 1 ^ Invoice Date Received (Opt - FM Date) ; 2 ^ Vendor (REQ - IEN to file 161.2 or changed) ; 5 ^ Treatment from date (Opt - FM date);1 (Special flag for treatment dates) (1 means bypass the treatment date verification and allow the user to input any date) ; 6 ^ Treatment to date (Opt - FM date) ; 6.5 ^ Dsch Type Code (Opt - Pntr to FEE BASIS DISPOSITION CODE File #162.6) ; 6.6 ^ Billed Charges (Req - Numeric - Dollar Amount between .01 and 999999.99) ; 6.7 ^ Payment by Medicare/Fed Agency (Req - Y = Yes, N = No) ; (Answer 'Yes' if Medicare or some other federal agency has paid some of the bill for contract hospital.) ; 7 ^ Amount Claimed (Req - Numeric - Dollar Amount between .01 and 999999) ; (Amount Claimed cannot be greater than the 'BILLED CHARGES') ; 8 ^ Amount Paid ; 12 ^ Payment type: R - Reimbursement, V - Vendor, S - Statistical, SR - Stat-reimbursement ; 20 ^ Batch IEN (Req - Pntr to file #161.7, must be a "B9" type and Open) ; 21 ^ Purpose of Visit pointer (#161.82) ; 22 ^ Patient type code: '00' FOR SURGICAL; '10' FOR MEDICAL; '60' FOR HOME NURSING SERVICE; '85' FOR PSYCHIATRIC-CONTRACT; '86' FOR PSYCHIATRIC; '95' FOR NEUROLOGICAL-CONTRACT;'96' FOR NEUROLOGICAL; ; 23 ^ Primary service facility pointer (#4) ; 24 ^ Dsch DRG (Opt - Pntr to DRG File #80.2 use Dsch date of 7078 for code set versioning) ; (NOTE: This field should contain the discharge DRG that is returned from the Austin Pricer System. ; 24.5 ^ DRG weight (Opt numeric) ; 25 ^ Resubmission (Opt - 1 = Yes) ; (Entry into this field indicates that this invoice is a resubmission. Failure to annotate an invoice ; in such a manner would cause Austin to reject the payment as duplicate.) ; 26 ^ NVH Pricer amount (Dollar Amount between .01 and 999999.99, 2 Decimal Digits) ; 30 ^ ICD1 (Req - Pntr to ICD-9 File #80 **) ; 30.02 ^ POA1 ; 31 ^ ICD2 (Opt - Pntr to ICD-9 File #80 **) ; 31.02 ^ POA2 ; 32 ^ ICD3 (Opt - Pntr to ICD-9 File #80 **) ; 32.02 ^ POA3 ; 33 ^ ICD4 (Opt - Pntr to ICD-9 File #80 **) ; 33.02 ^ POA4 ; 34 ^ ICD5 (Opt - Pntr to ICD-9 File #80 **) ; 34.02 ^ POA5 ; 35 ^ ICD6 (Opt - Pntr to ICD-9 File #80 **) ; 35.02 ^ POA6 ; 35.1 ^ ICD7 (Opt - Pntr to ICD-9 File #80 **) ; 35.12 ^ POA7 ; 35.2 ^ ICD8 (Opt - Pntr to ICD-9 File #80 **) ; 35.22 ^ POA8 ; 35.3 ^ ICD9 (Opt - Pntr to ICD-9 File #80 **) ; 35.32 ^ POA9 ; 35.4 ^ ICD10 (Opt - Pntr to ICD-9 File #80 **) ; 35.42 ^ POA10 ; 35.5 ^ ICD11 (Opt - Pntr to ICD-9 File #80 **) ; 35.52 ^ POA11 ; 35.6 ^ ICD12 (Opt - Pntr to ICD-9 File #80 **) ; 35.62 ^ POA12 ; 35.7 ^ ICD13 (Opt - Pntr to ICD-9 File #80 **) ; 35.72 ^ POA13 ; 35.8 ^ ICD14 (Opt - Pntr to ICD-9 File #80 **) ; 35.82 ^ POA14 ; 35.9 ^ ICD15 (Opt - Pntr to ICD-9 File #80 **) ; 35.92 ^ POA15 ; 36 ^ ICD16 (Opt - Pntr to ICD-9 File #80 **) ; 36.02 ^ POA16 ; 36.1 ^ ICD17 (Opt - Pntr to ICD-9 File #80 **) ; 36.12 ^ POA17 ; 36.2 ^ ICD18 (Opt - Pntr to ICD-9 File #80 **) ; 36.22 ^ POA18 ; 36.3 ^ ICD19 (Opt - Pntr to ICD-9 File #80 **) ; 36.32 ^ POA19 ; 36.4 ^ ICD20 (Opt - Pntr to ICD-9 File #80 **) ; 36.42 ^ POA20 ; 36.5 ^ ICD21 (Opt - Pntr to ICD-9 File #80 **) ; 36.52 ^ POA21 ; 36.6 ^ ICD22 (Opt - Pntr to ICD-9 File #80 **) ; 36.62 ^ POA22 ; 36.7 ^ ICD23 (Opt - Pntr to ICD-9 File #80 **) ; 36.72 ^ POA23 ; 36.8 ^ ICD24 (Opt - Pntr to ICD-9 File #80 **) ; 36.82 ^ POA24 ; 36.9 ^ ICD25 (Opt - Pntr to ICD-9 File #80 **) ; 36.92 ^ POA25 ; 39 ^ ADMITTING DIAGNOSIS ; 40 ^ PROC1 (Opt - Pntr to ICD OPERATION/PROCEDURE File #80.1 ; 41 ^ PROC2 (Opt - Pntr to ICD OPERATION/PROCEDURE File #80.1 ; 42 ^ PROC3 (Opt - Pntr to ICD OPERATION/PROCEDURE File #80.1 ; 43 ^ PROC4 (Opt - Pntr to ICD OPERATION/PROCEDURE File #80.1 ; 44 ^ PROC5 (Opt - Pntr to ICD OPERATION/PROCEDURE File #80.1 ; 46 ^ Vendor Invoice Date (Req - FM Date) ; 47 ^ Prompt Pay Type (0 = No, 1 = Yes) ; 54 ^ Covered Days (Opt, minimum = 1 - Calculated with FM if not passed) ; 55 ^ Patient Control Number (Req - Free Text 1 - 20 characters) ; 56 ^ FPPS Claim ID ; 57 ^ FPPS Line Item ; 60 ^ CONTRACT ; 64 ^ ATTENDING PROV NAME ; 65 ^ ATTENDING PROV NPI ; 66 ^ ATTENDING PROV TAXONOMY CODE ; 67 ^ OPERATING PROV NAME ; 68 ^ OPERATING PROV NPI ; 69 ^ RENDERING PROV NAME ; 70 ^ RENDERING PROV NPI ; 71 ^ RENDERING PROV TAXONOMY CODE ; 72 ^ SERVICING PROV NAME ; 73 ^ SERVICING PROV NPI ; 74 ^ REFERRING PROV NAME ; 75 ^ REFERRING PROV NPI ; 79 ^ .01 ^ LINE ITEM NUMBER ; 79 ^ .02 ^ FEE BASIS INVOICE (162.579) RENDERING PROV NAME ; 79 ^ .03 ^ FEE BASIS INVOICE (162.579) RENDERING PROV NPI ; 79 ^ .04 ^ FEE BASIS INVOICE (162.579) RENDERING PROV TAXONOMY CODE |
| REMARKS | LITERAL | 255 | true | FBRRMK - (Optional), literal passed by reference ; FBRRMK=FBRRMKC^(repeat if necessary) ; FBRRMKC = remittance remark (internal value file 161.93) |
| ADJUSTMENTS | LITERAL | 255 | true | array of adjustments to file array does not have to contain any data or be defined, format: ; FBADJ=FBADJR;FBADJG;FBADJA^(repeat if necessary) ; FBADJR = adjustment reason (internal value file 161.91) ; FBADJG = adjustment group (internal value file 161.92) ; FBADJA = adjustment amount (dollar value) |
| MEDDATA | LITERAL | 255 | true | (Required for Med payments) ; 1 ^ DSIFID (DATE OF SERVICE NUMBER;SERVICE PROVIDED NUMBER [DFN;VENIEN already passed]) ; 2 ^ Units Pd (optional) ; 3 ^ FPPS Line item number ; 4 ^ Place of service IEN ; 5 ^ Fee schedule amount ; 6 ^ Fee schedule ("F","R" or NULL only) ; 7 ^ Amount paid (Optional) ; 8 ^ Suspend code IEN of FILE (#161.27) ; 9 ^ Revenue Code IEN of File (#399.2) ; 54 ^ CONTRACT (#54) ; 58 ^ ATTENDING PROV NAME (#58) ; 59 ^ ATTENDING PROV NPI (#59) ; 60 ^ ATTENDING PROV TAXONOMY CODE (#60) ; 61 ^ OPERATING PROV NAME (#61) ; 62 ^ OPERATING PROV NPI (#62) ; 63 ^ RENDERING PROV NAME (#63) ; 64 ^ RENDERING PROV NPI (#64) ; 65 ^ RENDERING PROV TAXONOMY CODE (#65) ; 66 ^ SERVICING PROV NAME (#66) ; 67 ^ SERVICING PROV NPI (#67) ; 68 ^ REFERRING PROV NAME (#68) ; 69 ^ REFERRING PROV NPI (#69) ; 73 ^ LI RENDERING PROV NAME (#73) (these are payment line specific) ; 74 ^ LI RENDERING PROV NPI (#74) ; 75 ^ LI RENDERING PROV TAXONOMY (#75) |
Document generated on August 31st 2022, 2:55:43 pm