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ANNUAL BENEFITS ACCESS ICR (5339)

ANNUAL BENEFITS ACCESS    ICR (5339)

Name Value
NUMBER 5339
IA # 5339
FILE NUMBER 355.4
GLOBAL ROOT IBA(355.4
DATE CREATED 2009/01/12
CUSTODIAL PACKAGE INTEGRATED BILLING
USAGE Private
TYPE File
DBIC APPROVAL STATUS APPROVED
NAME ANNUAL BENEFITS ACCESS
GENERAL DESCRIPTION

The DSIV package is requesting FileMan read/write access to file #355.4
ANNUAL BENEFITS for the Insurance Capture Buffer application in order to add
and edit entries.

^IBA(355.4,D0,0)
.01  BENEFIT YEAR BEGINNING ON     0;1  FileMan read/write
.01  BENEFIT YEAR BEGINNING ON     0;1  Laygo new entry into file
.02  HEALTH INSURANCE POLICY       0;2  FileMan read/write
.05  MAX. OUT OF POCKET            0;5  FileMan read/write
.06  AMBULANCE COVERAGE (%)        0;6  FileMan read/write
^IBA(355.4,D0,1)
1.01 DATE ENTERED                   1;1  FileMan read/write
1.02 ENTERED BY                     1;2  FileMan read/write
1.03 DATE LAST VERIFIED             1;3  FileMan read
1.04 VERIFIED BY                    1;4  FileMan read
1.05 DATE LAST EDITED               1;5  FileMan read
1.06 LAST EDIT BY                   1;6  FileMan read
1.07 PERSON CONTACTED               1;7  FileMan read/write
1.08 COMMENTS                       1;8  FileMan read/write
1.09 CONTACT'S PHONE NUMBER         1;9  FileMan read/write
^IBA(355.4,D0,2)
2.01 ANNUAL DEDUCTIBLE (OPT)        2;1  FileMan read/write
2.02 PER VISIT DEDUCTIBLE           2;2  FileMan read/write
2.03 OUTPATIENT LIFETIME MAXIMUM    2;3  FileMan read/write
2.04 OUTPATIENT ANNUAL MAXIMUM      2;4  FileMan read/write
2.05 MH LIFETIME OUTPATIENT MAX.    2;5  FileMan read/write
2.06 MH ANNUAL OUTPATIENT MAX.      2;6  FileMan read/write
2.07 DENTAL COVERAGE TYPE           2;7  FileMan read/write
2.08 DENTAL COVERAGE $ OR %         2;8  FileMan read/write
2.09 OUTPATIENT VISIT (%)           2;9  FileMan read/write
2.1  EMERGENCY OUTPATIENT (%)       2;10 FileMan read/write
2.11 MENTAL HEALTH OUTPATIENT (%)   2;11 FileMan read/write
2.12 PRESCRIPTION (%)               2;12 FileMan read/write
2.13 OUTPATIENT SURGERY (%)         2;13 FileMan read/write
2.14 MH OPT. MAX DAYS PER YEAR      2;14 FileMan read/write
2.15 OUTPATIENT VISITS PER YEAR     2;15 FileMan read/write
2.17 ADULT DAY HEALTH CARE          2;17 FileMan read/write
^IBA(355.4,D0,3)
3.01 HOME HEALTH CARE LEVEL         3;1  FileMan read/write
3.02 HOME HEALTH VISITS PER YEAR    3;2  FileMan read/write
3.03 HOME HEALTH MAX DAYS PER YEAR  3;3  FileMan read/write
3.04 HOME HEALTH MED. EQUIPMENT (%) 3;4  FileMan read/write
3.05 HOME HEALTH VISIT DEFINITION   3;5  FileMan read/write
3.06 OCCUPATIONAL THERAPY # VISITS  3;6  FileMan read/write
3.07 PHYSICAL THERAPY # VISITS      3;7  FileMan read/write
3.08 SPEECH THERAPY # VISITS        3;8  FileMan read/write
3.09 MEDICATION COUNSELING # VISITS 3;9  FileMan read/write
^IBA(355.4,D0,4)
4.01 HOSPICE ANNUAL DEDUCTIBLE      4;1  FileMan read/write
4.02 HOSPICE INPATIENT ANNUAL MAX   4;2  FileMan read/write
4.03 HOSPICE INPT. LIFETIME MAX     4;3  FileMan read/write
4.04 ROOM AND BOARD (%)             4;4  FileMan read/write
4.05 OTHER INPATIENT CHARGES (%)    4;5  FileMan read/write
4.06 IV INFUSION OPT.               4;6  FileMan read/write
4.07 IV INFUSION INPT.              4;7  FileMan read/write
4.08 IV ANTIBIOTICS OPT.            4;8  FileMan read/write
4.09 IV ANTIBIOTICS INPT.           4;9  FileMan read/write
^IBA(355.4,D0,5)
5.01 ANNUAL DEDUCTIBLE (INPATIENT)  5;1  FileMan read/write
5.02 PER ADMISSION DEDUCTIBLE       5;2  FileMan read/write
5.03 INPATIENT LIFETIME MAXIMUM     5;3  FileMan read/write
5.04 INPATIENT ANNUAL MAXIMUM       5;4  FileMan read/write
5.05 MH LIFETIME INPATIENT MAXIMUM  5;5  FileMan read/write
5.06 MH ANNUAL INPATIENT MAXIMUM    5;6  FileMan read/write
5.07 DRUG & ALCOHOL LIFETIME MAX    5;7  FileMan read/write
5.08 DRUG & ALCOHOL ANNUAL MAX      5;8  FileMan read/write
5.09 ROOM AND BOARD (%) (NJ3,0),    5;9  FileMan read/write
5.1  NURSING HOME (%) (NJ3,0),      5;10 FileMan read/write
5.11 MENTAL HEALTH INPATIENT (%)    5;11 FileMan read/write
5.12 OTHER INPATIENT CHARGES (%))   5;12 FileMan read/write
5.14 MH INPT. MAX DAYS PER YEAR     5;14 FileMan read/write
STATUS Active
DURATION Till Otherwise Agreed
ID IBA(355.4
SUBSCRIBING PACKAGE INSURANCE CAPTURE BUFFER
CREATOR CLARK,KAREN Y
DATE ACTIVATED 2009/06/11
DATE/TIME EDITED
DATE/TIME EDITED ACTION AT THE REQUEST OF WITH CONCURRENCE OF
2009/06/11 08:26 APPROVED CLARK,KAREN HARPER,AMY
Generated from SEP 10, 2019@ IA Listing Descriptions