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Global: ^IBA(355.32

Package: Integrated Billing

Global: ^IBA(355.32


Information

FileMan FileNo FileMan Filename Package
355.32 PLAN COVERAGE LIMITATIONS Integrated Billing

Description

Directly Accessed By Routines, Total: 21

Package Total Routines
Integrated Billing 21 IBBFAPI    IBCMDT2    IBCNBCD2    IBCNRP    IBCNRP5    IBCNRPM1    IBCNRPMT    IBCNRPS2
IBCNRRP2    IBCNSC41    IBCNSJ    IBCNSJ51    IBCNSJ52    IBCNSU3    IBCNSUR2    IBCONS1
IBOHLD2    IBOHLS1    IBRBUL    ^IBA(355.32    LIMITATION COMMENT    

Accessed By FileMan Db Calls, Total: 4

Package Total Routines
Integrated Billing 4 IBCMDT2    IBCNBCD2    IBCNSJ    IBCNSJ51    

Pointer To FileMan Files, Total: 3

Package Total FileMan Files
Integrated Billing 2 GROUP INSURANCE PLAN(#355.3)[.01]    PLAN LIMITATION CATEGORY(#355.31)[.02]    
Kernel 1 NEW PERSON(#200)[1.021.04]    

Fields, Total: 9

Field # Name Loc Type Details
.01 PLAN 0;1 POINTER TO GROUP INSURANCE PLAN FILE (#355.3)
************************REQUIRED FIELD************************
GROUP INSURANCE PLAN(#355.3)

  • LAST EDITED:  AUG 16, 1995
  • HELP-PROMPT:  Enter the plan that this limitation applies to.
  • DESCRIPTION:  
    The plan that this limitation will apply to.
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
  • CROSS-REFERENCE:  355.32^B
    1)= S ^IBA(355.32,"B",$E(X,1,30),DA)=""
    2)= K ^IBA(355.32,"B",$E(X,1,30),DA)
  • CROSS-REFERENCE:  355.32^APCD^MUMPS
    1)= I $P($G(^IBA(355.32,DA,0)),U,2)'="",$P(^(0),U,3)'="" S ^IBA(355.32,"APCD",$E(X,1,30),$P(^IBA(355.32,DA,0),U,2),-$P(^IBA(355.32,DA,0),U,3),DA)=""
    2)= I $P($G(^IBA(355.32,DA,0)),U,2)'="",$P(^(0),U,3)'="" K ^IBA(355.32,DA,"APCD",$E(X,1,30),$P(^IBA(355.32,DA,0),U,2),-$P(^IBA(355.32,DA,0),U,3),DA)
    3)= DO NOT DELETE
    Multiple xref on plan, coverage, and -effective date
  • CROSS-REFERENCE:  ^^TRIGGER^355.32^1.01
    1)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(0)=X S Y(1)=$S($D(^IBA(355.32,D0,1)):^(1),1:"") S X=$P(Y(1),U,1)="" I X S X=DIV S Y(1)=$S($D(^IBA(355.32,D0,1)):^(1),1:"") S X=$P(Y(1),U,1),X=X S DIU=X K Y X ^DD(355.32,.01,1,3,1.1) X
    ^DD(355.32,.01,1,3,1.4)
    1.1)= S X=DIV N %I,%H,% D NOW^%DTC S X=%
    1.4)= S DIH=$S($D(^IBA(355.32,DIV(0),1)):^(1),1:""),DIV=X S $P(^(1),U,1)=DIV,DIH=355.32,DIG=1.01 D ^DICR:$O(^DD(DIH,DIG,1,0))>0
    2)= Q
    CREATE CONDITION)= #1.01=""
    CREATE VALUE)= NOW
    DELETE VALUE)= NO EFFECT
    FIELD)= #1.01
    Triggers the date/time entered when creating a new entry.
  • CROSS-REFERENCE:  ^^TRIGGER^355.32^1.02
    1)= X ^DD(355.32,.01,1,4,1.3) I X S X=DIV S Y(1)=$S($D(^IBA(355.32,D0,1)):^(1),1:"") S X=$P(Y(1),U,2),X=X S DIU=X K Y S X=DIV S X=DUZ X ^DD(355.32,.01,1,4,1.4)
    1.3)= K DIV S DIV=X,D0=DA,DIV(0)=D0 S Y(0)=X S Y(1)=$S($D(^IBA(355.32,D0,1)):^(1),1:"") S X=$S('$D(^VA(200,+$P(Y(1),U,2),0)):"",1:$P(^(0),U,1))=""
    1.4)= S DIH=$S($D(^IBA(355.32,DIV(0),1)):^(1),1:""),DIV=X S $P(^(1),U,2)=DIV,DIH=355.32,DIG=1.02 D ^DICR:$O(^DD(DIH,DIG,1,0))>0
    2)= Q
    CREATE CONDITION)= #1.02=""
    CREATE VALUE)= S X=DUZ
    DELETE VALUE)= NO EFFECT
    FIELD)= #1.02
    Triggers the user who created this entry.
.02 COVERAGE CATEGORY 0;2 POINTER TO PLAN LIMITATION CATEGORY FILE (#355.31)
************************REQUIRED FIELD************************
PLAN LIMITATION CATEGORY(#355.31)

  • LAST EDITED:  AUG 08, 1995
  • HELP-PROMPT:  Enter the type of coverage that will be limited.
  • DESCRIPTION:  
    The type of coverage that the insurance company plan has reimbursement limits on.
  • CROSS-REFERENCE:  355.32^APCD1^MUMPS
    1)= I $P($G(^IBA(355.32,DA,0)),U)'="",$P(^(0),U,3)'="" S ^IBA(355.32,"APCD",$P(^IBA(355.32,DA,0),U),$E(X,1,30),-$P(^IBA(355.32,DA,0),U,3),DA)=""
    2)= I $P($G(^IBA(355.32,DA,0)),U)'="",$P(^(0),U,3)'="" K ^IBA(355.32,"APCD",$P(^IBA(355.32,DA,0),U),$E(X,1,30),-$P(^IBA(355.32,DA,0),U,3),DA)
    3)= DO NOT DELETE
    Multiple xref on plan, coverage, and -effective date
.03 EFFECTIVE DATE 0;3 DATE
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  JUL 27, 1995
  • HELP-PROMPT:  Enter the date that this limitation is effective.
  • DESCRIPTION:  
    The date on which the type of coverage for this limitation becomes limited for insurance billing purposes.
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
  • CROSS-REFERENCE:  355.32^APCD2^MUMPS
    1)= I $P($G(^IBA(355.32,DA,0)),U)'="",$P(^(0),U,2)'="" S ^IBA(355.32,"APCD",$P(^IBA(355.32,DA,0),U),$P(^IBA(355.32,DA,0),U,2),-$E(X,1,30),DA)=""
    2)= I $P($G(^IBA(355.32,DA,0)),U)'="",$P(^(0),U,2)'="" K ^IBA(355.32,"APCD",$P(^IBA(355.32,DA,0),U),$P(^IBA(355.32,DA,0),U,2),-$E(X,1,30),DA)
    3)= DO NOT DELETE
    Multiple xref on plan, coverage, and -effective date
.04 COVERAGE STATUS 0;4 SET
************************REQUIRED FIELD************************
  • '0' FOR NOT COVERED;
  • '1' FOR COVERED;
  • '2' FOR CONDITIONAL COVERAGE;

  • LAST EDITED:  AUG 29, 1995
  • HELP-PROMPT:  The status of this coverage for this plan as of the effective date.
  • DESCRIPTION:  
    This is the status of the coverage associated with this record on the effective date associated with this record.
1.01 DATE ENTERED 1;1 DATE

  • INPUT TRANSFORM:  S %DT="ETX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  AUG 16, 1995
  • DESCRIPTION:  
    This is the date this limitation was entered.  It is triggered by the creation of this entry.
  • NOTES:  TRIGGERED by the PLAN field of the PLAN COVERAGE LIMITATIONS File
1.02 ENTERED BY 1;2 POINTER TO NEW PERSON FILE (#200) NEW PERSON(#200)

  • LAST EDITED:  AUG 16, 1995
  • DESCRIPTION:  
    This is the user who created this entry.  It is automatically triggered by the creation of this entry.
  • NOTES:  TRIGGERED by the PLAN field of the PLAN COVERAGE LIMITATIONS File
1.03 DATE LAST EDITED 1;3 DATE

  • INPUT TRANSFORM:  S %DT="ETX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  AUG 16, 1995
  • DESCRIPTION:  
    This is the date this limitation was last edited.  It is automatically updated any time the limitation is edited using one of the options provided.
1.04 LAST EDITED BY 1;4 POINTER TO NEW PERSON FILE (#200) NEW PERSON(#200)

  • LAST EDITED:  AUG 16, 1995
  • DESCRIPTION:  
    This is the user who last edited this limitation.  It is automatically updated any time a person edits this limitation using one of the options provided.
2 LIMITATION COMMENT 2;0 Multiple #355.321 355.321

ICR, Total: 1

ICR LINK Subscribing Package(s) Fields Referenced Description
ICR #5341
  • INSURANCE CAPTURE BUFFER
  • External References

    Name Field # of Occurrence
    ^%DT .03+1, 1.01+1, 1.03+1
    NOW^%DTC .01(XREF 3n1.1)
    ^DICR .01(XREF 3n1.4), .01(XREF 4n1.4)
    Y^DIQ ID.02+1

    Global Variables Directly Accessed

    Name Line Occurrences  (* Changed,  ! Killed)
    ^DD( .01(XREF 3n1.4), .01(XREF 4n1.4)
    ^DD(355.31 ID.02+1
    ^DD(355.32 .01(XREF 3S), .01(XREF 4S)
    ^IBA(355.32 - [#355.32] .01(XREF 1S), .01(XREF 1K), .01(XREF 2S), .01(XREF 2K), .01(XREF 3S), .01(XREF 3n1.4), .01(XREF 4S), .01(XREF 4n1.3), .01(XREF 4n1.4), .02(XREF 1S)
    .02(XREF 1K), .03(XREF 1S), .03(XREF 1K)
    ^IBE(355.31 - [#355.31] ID.02+1
    ^VA(200 - [#200] .01(XREF 4n1.3)

    Naked Globals

    Name Field # of Occurrence
    ^(0 ID.02+1, ID.03+1, .01(XREF 2S), .01(XREF 2K), .01(XREF 4n1.3), .02(XREF 1S), .02(XREF 1K), .03(XREF 1S), .03(XREF 1K)
    ^(1 .01(XREF 3S), .01(XREF 3n1.4), .01(XREF 4S), .01(XREF 4n1.3), .01(XREF 4n1.4)

    Local Variables

    Legend:

    >> Not killed explicitly
    * Changed
    ! Killed
    ~ Newed

    Name Field # of Occurrence
    % .01(XREF 3n1.1)
    >> %DT .03+1*, 1.01+1*, 1.03+1*
    %H .01(XREF 3n1.1)
    %I ID.02+1*!, .01(XREF 3n1.1)
    >> C ID.02+1*
    >> D0 .01(XREF 3S), .01(XREF 4S), .01(XREF 4n1.3)
    >> DA .01(XREF 1S), .01(XREF 1K), .01(XREF 2S), .01(XREF 2K), .01(XREF 3S), .01(XREF 4n1.3), .02(XREF 1S), .02(XREF 1K), .03(XREF 1S), .03(XREF 1K)
    >> DIC ID.02+1
    >> DIG .01(XREF 3n1.4), .01(XREF 4n1.4)
    >> DIH .01(XREF 3n1.4), .01(XREF 4n1.4)
    >> DIU .01(XREF 3S), .01(XREF 4S)
    DIV .01(XREF 3S), .01(XREF 3n1.1), .01(XREF 3n1.4), .01(XREF 4S), .01(XREF 4n1.3), .01(XREF 4n1.4)
    DIV(0 .01(XREF 3S), .01(XREF 3n1.4), .01(XREF 4n1.3), .01(XREF 4n1.4)
    DUZ .01(XREF 4S)
    U ID.02+1, ID.03+1, .01(XREF 2S), .01(XREF 2K), .01(XREF 3S), .01(XREF 3n1.4), .01(XREF 4S), .01(XREF 4n1.3), .01(XREF 4n1.4), .02(XREF 1S)
    .02(XREF 1K), .03(XREF 1S), .03(XREF 1K)
    X .01(XREF 1S), .01(XREF 1K), .01(XREF 2S), .01(XREF 2K), .01(XREF 3S), .01(XREF 3n1.1), .01(XREF 3n1.4), .01(XREF 4S), .01(XREF 4n1.3), .01(XREF 4n1.4)
    .02(XREF 1S), .02(XREF 1K), .03+1*!, .03(XREF 1S), .03(XREF 1K), 1.01+1*!, 1.03+1*!
    Y ID.02+1*, .01(XREF 3S), .01(XREF 4S), .03+1, 1.01+1, 1.03+1
    Y(0 .01(XREF 3S), .01(XREF 4n1.3)
    Y(1 .01(XREF 3S), .01(XREF 4S), .01(XREF 4n1.3)
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