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Global: ^IBA(355.5

Package: Integrated Billing

Global: ^IBA(355.5


Information

FileMan FileNo FileMan Filename Package
355.5 INSURANCE CLAIMS YEAR TO DATE Integrated Billing

Description

Directly Accessed By Routines, Total: 12

Package Total Routines
Integrated Billing 12 IBCNSD    IBCNSD1    IBCNSJ    IBCNSJ1    IBCNSJ13    IBCNSJ21    IBCNSJ4    IBCNSM5
IBCNSU1    ^IBA(355.5    IBCNSUR1    IBYAPT1    

Accessed By FileMan Db Calls, Total: 5

Package Total Routines
Integrated Billing 5 IBCNSD1    IBCNSJ    IBCNSJ13    IBCNSU1    IBYAPT1    

Pointer To FileMan Files, Total: 3

Package Total FileMan Files
Integrated Billing 1 GROUP INSURANCE PLAN(#355.3)[.01]    
Kernel 1 NEW PERSON(#200)[1.021.041.06]
Registration 1 PATIENT(#2)[.02]    

Fields, Total: 29

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

  • LAST EDITED:  AUG 31, 1993
  • DESCRIPTION:  
    Select the patient's health insurance policy against which claims may have been made.
    UNEDITABLE
  • CROSS-REFERENCE:  355.5^B
    1)= S ^IBA(355.5,"B",$E(X,1,30),DA)=""
    2)= K ^IBA(355.5,"B",$E(X,1,30),DA)
  • CROSS-REFERENCE:  355.5^APPY1^MUMPS
    1)= I +$P(^IBA(355.5,DA,0),U,2),-$P(^(0),U,3),+$P(^(0),U,17) S ^IBA(355.5,"APPY",+$P(^(0),U,2),X,-$P(^(0),U,3),+$P(^(0),U,17),DA)=""
    2)= K ^IBA(355.5,"APPY",+$P(^IBA(355.5,DA,0),U,2),X,-$P(^(0),U,3),+$P(^(0),U,17),DA)
    Cross-reference of patients by policy by year.
.02 PATIENT 0;2 POINTER TO PATIENT FILE (#2) PATIENT(#2)

  • LAST EDITED:  DEC 17, 1993
  • DESCRIPTION:  
    Enter the name of the patient who is on this policy.
    UNEDITABLE
  • CROSS-REFERENCE:  355.5^C
    1)= S ^IBA(355.5,"C",$E(X,1,30),DA)=""
    2)= K ^IBA(355.5,"C",$E(X,1,30),DA)
  • CROSS-REFERENCE:  355.5^APPY^MUMPS
    1)= I -$P(^IBA(355.5,DA,0),U,3),+^(0),+$P(^(0),U,17) S ^IBA(355.5,"APPY",X,+^(0),-$P(^(0),U,3),+$P(^(0),U,17),DA)=""
    2)= K ^IBA(355.5,"APPY",X,+^IBA(355.5,DA,0),-$P(^(0),U,3),+$P(^(0),U,17),DA)
    Cross-references patient by policy by year.
.03 BENEFIT YEAR BEGINNING ON 0;3 DATE
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  DEC 17, 1993
  • DESCRIPTION:  
    This is the first day of the year in which the health insurance policy's benefits apply.  Exact date (with month and day) is required.
  • TECHNICAL DESCR:  
    This field must match the year for an entry for this patient and policy in the annual benefits field.  It is automatically stored by the system when creating an entry.  It is not editable.
    WRITE AUTHORITY:  ^
    UNEDITABLE
  • CROSS-REFERENCE:  355.5^APPY2^MUMPS
    1)= I +$P(^IBA(355.5,DA,0),U,2),+^(0),+$P(^(0),U,17) S ^IBA(355.5,"APPY",+$P(^(0),U,2),+^(0),-X,+$P(^(0),U,17),DA)=""
    2)= K ^IBA(355.5,"APPY",+$P(^IBA(355.5,DA,0),U,2),+^(0),-X,+$P(^(0),U,17),DA)
    Cross-reference of patients by policy by year.
.04 DEDUCTIBLE MET? 0;4 SET
  • '0' FOR NO;
  • '1' FOR YES;

  • LAST EDITED:  MAY 13, 1993
  • DESCRIPTION:  
    If the dollar amount of claims against this policy is less than the the policy's annual deductible, enter "NO".  If it is equal to or greater than the annual deductible, enter "YES".
.05 AMOUNT OF DEDUCTIBLE MET 0;5 NUMBER

  • INPUT TRANSFORM:  S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>999999)!(X<0) X
  • LAST EDITED:  MAY 13, 1993
  • HELP-PROMPT:  Type a Dollar Amount between 0 and 999999, 2 Decimal Digits
  • DESCRIPTION:  
    Enter the dollar amount of claims against this policy.
.06 DEDUCTIBLE (INPT) MET? 0;6 SET
  • '1' FOR YES;
  • '0' FOR NO;

  • LAST EDITED:  MAY 13, 1993
  • DESCRIPTION:  
    If the dollar amount of claims for inpatient services is less than the policy's annual deductible for inpatient services, enter "NO".  If it is equal to or greater than the annual deductible for such services, enter "YES".
.07 AMOUNT OF DEDUCTIBLE (INP) MET 0;7 NUMBER

  • INPUT TRANSFORM:  S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>999999)!(X<0) X
  • LAST EDITED:  MAY 13, 1993
  • HELP-PROMPT:  Type a Dollar Amount between 0 and 999999, 2 Decimal Digits
  • DESCRIPTION:  
    Enter the dollar amount of claims against this policy for inpatient services.
.08 DEDUCTIBLE (OPT) MET? 0;8 SET
  • '0' FOR NO;
  • '1' FOR YES;

  • LAST EDITED:  MAY 13, 1993
  • DESCRIPTION:  If the dollar amount of claims for outpatient services is less than the policy's annual deductible for outpatient services, enter "NO". If it is equal to or greater than the annual deductible for such services, enter
    "YES".
.09 AMOUNT OF DEDUCTIBLE (OPT) MET 0;9 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>999999)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  MAY 13, 1993
  • HELP-PROMPT:  Type a Number between 0 and 999999, 0 Decimal Digits
  • DESCRIPTION:  
    Enter the dollar amount of claims against this policy for outpatient services.
.1 AMT LIFETIME MAX USED (OPT) 0;10 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>9999999)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  DEC 14, 1993
  • HELP-PROMPT:  Type a Number between 0 and 9999999, 0 Decimal Digits
  • DESCRIPTION:  
    Enter the dollar amount of claims against this policy, which can then be compared to the maximum amount available over the life of the policy.
.11 MH DEDUCTIBLE (INP) MET? 0;11 SET
  • '0' FOR NO;
  • '1' FOR YES;

  • LAST EDITED:  MAY 13, 1993
  • DESCRIPTION:  If the dollar amount of claims for inpatient mental health services is less than the policy's annual deductible for these services, enter "NO". If it is equal to or greater than the annual deductible for such services,
    enter "YES".
.12 AMOUNT OF MH (INP) DED MET 0;12 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>999999)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  MAY 13, 1993
  • HELP-PROMPT:  Type a Number between 0 and 999999, 0 Decimal Digits
  • DESCRIPTION:  
    Enter the dollar amount of claims against this policy for inpatient mental health services.
.13 MH DEDUCTIBLE (OPT) MET? 0;13 SET
  • '0' FOR NO;
  • '1' FOR YES;

  • LAST EDITED:  MAY 13, 1993
  • DESCRIPTION:  If the dollar amount of claims for outpatient mental health services is less than the policy's annual deductible for these services, enter "NO". If it is equal to or greater than the annual deductible for such services,
    enter "YES".
.14 AMOUNT OF MH (OPT) DED MET 0;14 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>999999)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  MAY 13, 1993
  • HELP-PROMPT:  Type a Number between 0 and 999999, 0 Decimal Digits
  • DESCRIPTION:  
    Enter the dollar amount of claims against this policy for outpatient mental health services.
.15 PRE-EXISTING CONDITIONS 0;15 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>30!($L(X)<3) X
  • LAST EDITED:  MAY 13, 1993
  • HELP-PROMPT:  Answer must be 3-30 characters in length.
  • DESCRIPTION:  
    Enter the patient's pre-existing conditions.
.16 COORDINATION OF BENEFITS DATA 0;16 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>30!($L(X)<3) X
  • LAST EDITED:  MAY 13, 1993
  • HELP-PROMPT:  Answer must be 3-30 characters in length.
  • DESCRIPTION:  
    If the patient is included in a policy held by a family member, e.g.  spouse, enter that information here.
.17 PATIENT POLICY POINTER 0;17 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>999999)!(X<1)!(X?.E1"."1N.N) X
  • LAST EDITED:  AUG 31, 1993
  • HELP-PROMPT:  Type a Number between 1 and 999999, 0 Decimal Digits
    DELETE AUTHORITY: ^
    WRITE AUTHORITY:  ^
    UNEDITABLE
  • CROSS-REFERENCE:  355.5^APPY3^MUMPS
    1)= I $P(^IBA(355.5,DA,0),U,2),+^(0),-$P(^(0),U,3) S ^IBA(355.5,"APPY",+$P(^(0),U,2),+^(0),-$P(^(0),U,3),X,DA)=""
    2)= K ^IBA(355.5,"APPY",+$P(^(0),U,2),+^(0),-$P(^(0),U,3),X,DA)
    Cross-references patients by policy by year.
.18 AMT. MH LIFET. MAX USED (INPT) 0;18 NUMBER

  • INPUT TRANSFORM:  S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>9999999)!(X<0) X
  • LAST EDITED:  DEC 14, 1993
  • HELP-PROMPT:  Type a Dollar Amount between 0 and 9999999, 2 Decimal Digits
  • DESCRIPTION:  
    Enter the dollar amount of claims against this policy for mental health services.
.19 AMT LIFETIME MAX USED (INPT) 0;19 NUMBER

  • INPUT TRANSFORM:  S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>9999999)!(X<0) X
  • LAST EDITED:  DEC 14, 1993
  • HELP-PROMPT:  Type a Dollar Amount between 0 and 9999999, 0 Decimal Digits
  • DESCRIPTION:  
    Enter the dollar amount of inpatient claims against this policy, which can then be compared to the maxium amount available over the life of the policy.
.2 AMT MH LIFET MAX USED (OPT) 0;20 NUMBER

  • INPUT TRANSFORM:  S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>9999999)!(X<0) X
  • LAST EDITED:  DEC 14, 1993
  • HELP-PROMPT:  Type a Dollar Amount between 0 and 9999999, 0 Decimal Digits
  • DESCRIPTION:  
    Enter the dollar amount of MH claims against this policy, which can then be compared to the maximum amount available over the life of the policy.
1.01 DATE ENTERED 1;1 DATE

  • INPUT TRANSFORM:  S %DT="ETX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  MAY 13, 1993
  • DESCRIPTION:  
    This is the date that this entry was created.  It is automatically triggered by the creation of the entry.
    WRITE AUTHORITY:  ^
1.02 ENTERED BY 1;2 POINTER TO NEW PERSON FILE (#200) NEW PERSON(#200)

  • LAST EDITED:  MAY 13, 1993
  • DESCRIPTION:  
    This is the user who created this entry.  It is automatically triggered by the creation of this entry.
    WRITE AUTHORITY:  ^
1.03 DATE LAST VERIFIED 1;3 DATE

  • INPUT TRANSFORM:  S %DT="ETX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  JUL 07, 1993
  • DESCRIPTION:  
    This is the date that the entry was verified.  It is automatically triggered by the verification process.
1.04 VERIFIED BY 1;4 POINTER TO NEW PERSON FILE (#200) NEW PERSON(#200)

  • LAST EDITED:  MAY 13, 1993
  • DESCRIPTION:  
    This is the person who verified the entry.  It is automatically triggered by the verification process.
1.05 DATE LAST EDITED 1;5 DATE

  • INPUT TRANSFORM:  S %DT="ETX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  JUL 07, 1993
  • DESCRIPTION:  
    This is the date that the entry was last edited.  It is automatically triggered whenever editing takes place.
    WRITE AUTHORITY:  ^
1.06 EDITED BY 1;6 POINTER TO NEW PERSON FILE (#200) NEW PERSON(#200)

  • LAST EDITED:  MAY 13, 1993
  • DESCRIPTION:  
    This is the name of the person who last edited the entry.  It is automatically triggered whenever editing takes place.
    WRITE AUTHORITY:  ^
1.07 PERSON CONTACTED 1;7 FREE TEXT
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  K:$L(X)>30!($L(X)<3) X
  • LAST EDITED:  JUL 02, 1993
  • HELP-PROMPT:  Answer must be 3-30 characters in length.
  • DESCRIPTION:  
    Give the name of the person at the insurance company with whom you verified insurance claims information.
1.08 COMMENT - CLAIMS FILED 1;8 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>80!($L(X)<3) X
  • LAST EDITED:  JUN 11, 1993
  • HELP-PROMPT:  Answer must be 3-80 characters in length.
  • DESCRIPTION:  
    Enter any pertinent information here that you did not enter above.
1.09 CONTACT'S PHONE NUMBER 1;9 FREE TEXT
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  K:$L(X)>20!($L(X)<7) X
  • LAST EDITED:  JUL 02, 1993
  • HELP-PROMPT:  Answer must be 7-20 characters in length.
  • DESCRIPTION:  
    Give the telephone number of the person who verified insurance claims information.

External References

Name Field # of Occurrence
^%DT .03+1, 1.01+1, 1.03+1, 1.05+1

Global Variables Directly Accessed

Name Line Occurrences  (* Changed,  ! Killed)
^IBA(355.5 - [#355.5] .01(XREF 1S), .01(XREF 1K), .01(XREF 2S), .01(XREF 2K), .02(XREF 1S), .02(XREF 1K), .02(XREF 2S), .02(XREF 2K), .03(XREF 1S), .03(XREF 1K)
.17(XREF 1S), .17(XREF 1K)

Naked Globals

Name Field # of Occurrence
^(0 .01(XREF 2S), .01(XREF 2K), .02(XREF 2S), .02(XREF 2K), .03(XREF 1S), .03(XREF 1K), .17(XREF 1S), .17(XREF 1K)

Local Variables

Legend:

>> Not killed explicitly
* Changed
! Killed
~ Newed

Name Field # of Occurrence
>> %DT .03+1*, 1.01+1*, 1.03+1*, 1.05+1*
>> DA .01(XREF 1S), .01(XREF 1K), .01(XREF 2S), .01(XREF 2K), .02(XREF 1S), .02(XREF 1K), .02(XREF 2S), .02(XREF 2K), .03(XREF 1S), .03(XREF 1K)
.17(XREF 1S), .17(XREF 1K)
U .01(XREF 2S), .01(XREF 2K), .02(XREF 2S), .02(XREF 2K), .03(XREF 1S), .03(XREF 1K), .17(XREF 1S), .17(XREF 1K)
X .01(XREF 1S), .01(XREF 1K), .01(XREF 2S), .01(XREF 2K), .02(XREF 1S), .02(XREF 1K), .02(XREF 2S), .02(XREF 2K), .03+1*!, .03(XREF 1S)
.03(XREF 1K), .05+1*!, .07+1*!, .09+1!, .1+1!, .12+1!, .14+1!, .15+1!, .16+1!, .17+1!
.17(XREF 1S), .17(XREF 1K), .18+1*!, .19+1*!, .2+1*!, 1.01+1*!, 1.03+1*!, 1.05+1*!, 1.07+1!, 1.08+1!
, 1.09+1!
>> Y .03+1, 1.01+1, 1.03+1, 1.05+1
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