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Global: ^ABMDPARM(1

Package: Third Party Billing

Global: ^ABMDPARM(1


Information

FileMan FileNo FileMan Filename Package
9002274.5 3P PARAMETERS Third Party Billing

Description

Directly Accessed By Routines, Total: 1

Package Total Routines
Third Party Billing 1 ABMDRFE2    

Accessed By FileMan Db Calls, Total: 2

Package Total Routines
IHS Accounts Receivable 1 BARBL    
Third Party Billing 1 ABMP263    

Pointer To FileMan Files, Total: 11

Package Total FileMan Files
Third Party Billing 4 3P CODES(#9002274.03)[.36]    3P EXPORT MODE(#9002274.08)[.32]    3P FEE TABLE(#9002274.01)[.09]    3P REFERENCE LAB LOCATIONS(#9002274.35)[.412]    
Kernel 3 INSTITUTION(#4)[212]    PROVIDER CLASS(#7)[#9002274.517(.01)]    NEW PERSON(#200)[.37, .38]    
Utility Tables 2 INSURER(#9999999.18)[#9002274.519(.01), #9002274.56(.01)]    LOCATION(#9999999.06)[.01, .23, 417]
MailMan 1 DOMAIN(#4.2)[.39]    
Scheduling 1 CLINIC STOP(#40.7)[#9002274.515(.01)]    

Fields, Total: 70

Field # Name Loc Type Details
.01 FACILITY 0;1 POINTER TO LOCATION FILE (#9999999.06)
************************REQUIRED FIELD************************
LOCATION(#9999999.06)

  • LAST EDITED:  JUN 01, 1993
  • DELETE TEST:  .01,0)= I 1
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
  • CROSS-REFERENCE:  9002274.5^B
    1)= S ^ABMDPARM(DUZ(2),"B",$E(X,1,30),DA)=""
    2)= K ^ABMDPARM(DUZ(2),"B",$E(X,1,30),DA)
.02 *EMERGENCY ROOM FEE 0;2 NUMBER
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>999.99)!(X<0) X
  • LAST EDITED:  MAR 12, 1997
  • HELP-PROMPT:  Type a Dollar Amount between 0 and 999.99, 2 Decimal Digits
.03 OP RX DISPENSE FEE 0;3 NUMBER
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>99.99)!(X<0) X
  • LAST EDITED:  MAY 03, 1995
  • HELP-PROMPT:  Type a Dollar Amount between 0 and 99.99, 2 Decimal Digits
.04 UB-82 LEFT MARGIN 0;4 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>20)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  APR 05, 1990
  • HELP-PROMPT:  Type a Number between 0 and 20, 0 Decimal Digits
.05 UB-82 TOP MARGIN 0;5 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>20)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  APR 05, 1990
  • HELP-PROMPT:  Type a Number between 0 and 20, 0 Decimal Digits
.06 HCFA-1500 LEFT MARGIN 0;6 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>20)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  APR 05, 1990
  • HELP-PROMPT:  Type a Number between 0 and 20, 0 Decimal Digits
.07 HCFA-1500 TOP MARGIN 0;7 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>20)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  APR 05, 1990
  • HELP-PROMPT:  Type a Number between 0 and 20, 0 Decimal Digits
.08 SUPERVISORY APPROVAL REQ'D 0;8 SET
  • 'Y' FOR YES;
  • 'N' FOR NO;
.09 CURRENT DEFAULT FEE SCHEDULE 0;9 POINTER TO 3P FEE TABLE FILE (#9002274.01)
************************REQUIRED FIELD************************
3P FEE TABLE(#9002274.01)

  • LAST EDITED:  AUG 21, 2010
  • HELP-PROMPT:  This field indicates which schedule will be used for itemized billing for those Insurers that do not require the use of their own fee schedule.
  • AUDIT:  YES, ALWAYS
.11 LABEL LEFT MARGIN 0;11 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>20)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  AUG 10, 1990
  • HELP-PROMPT:  Type a Number between 0 and 20, 0 Decimal Digits
.12 LABEL TOP MARGIN 0;12 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>20)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  AUG 10, 1990
  • HELP-PROMPT:  Type a Number between 0 and 20, 0 Decimal Digits
.13 REQUIRE FORCED QUEUEING 0;13 SET
  • 'Y' FOR YES;
  • 'N' FOR NO;

  • LAST EDITED:  APR 23, 1991
  • HELP-PROMPT:  If this field is answered 'Yes' then all print jobs that are sent to a system printer will be queued automatically.
.14 DISPLAY LONG ICD/CPT NARRATIVE 0;14 SET
  • 'Y' FOR YES;
  • 'N' FOR NO;

  • LAST EDITED:  APR 23, 1991
  • HELP-PROMPT:  This field controls whether the short or extended description of the ICD or CPT narrative is displayed by the Claim Editor.
.15 SETUP COMPLETED 0;15 SET
  • 'Y' FOR YES;
  • 'N' FOR NO;

  • LAST EDITED:  MAR 03, 1992
.16 BACKBILLING LIMIT (MONTHS) 0;16 NUMBER
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  K:+X'=X!(X>99)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  APR 23, 1991
  • HELP-PROMPT:  Type a Number between 0 and 99, 0 Decimal Digits
.17 HCFA 1500 - BLCK 31 0;17 SET
  • '1' FOR ATTENDING/OPERATING PROVIDERS;
  • '2' FOR APPROVING OFFICIAL;
  • '3' FOR NEW PERSON (POINTER TO 200);

  • LAST EDITED:  JUL 06, 1995
  • HELP-PROMPT:  This field determines what is to be printed in Block 31 on the HCFA 1500.
.18 BILL ALL PATIENTS 0;18 SET
  • '1' FOR ALL;
  • '0' FOR NO;
  • '2' FOR IP;

  • LAST EDITED:  MAR 18, 2003
  • HELP-PROMPT:  This field controls whether the system creates a claim for all patients regardless of whether the patient has third party eligibility or is an Indian Beneficiary.
.185 SHOW BENE PAT ALL BILLS? 0;10 SET
  • '0' FOR NO;
  • '1' FOR YES;

  • LAST EDITED:  JUN 10, 2003
.19 INIT BACK BILL DATE 0;19 DATE

  • INPUT TRANSFORM:  S %DT="E" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  MAR 28, 1991
.21 DATE LAST VISIT-ELIG CHK 2;1 DATE

  • INPUT TRANSFORM:  S %DT="E" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  MAR 30, 1991
.22 AO EXPORT MODE 2;2 SET
  • 'F' FOR File;
  • 'T' FOR 9-Trk Tape;
  • 'D' FOR Floppy Disk;
  • 'C' FOR Cartridge Tape;

  • LAST EDITED:  APR 23, 1991
  • HELP-PROMPT:  The answer to this field will determine the mode for exporting data to the Area Office tracking System.
.23 FACILITY TO RECEIVE PAYMENT 2;3 POINTER TO LOCATION FILE (#9999999.06)
************************REQUIRED FIELD************************
LOCATION(#9999999.06)

  • LAST EDITED:  APR 23, 1991
  • HELP-PROMPT:  The Payment Address and Federal Tax Number, used by the Billing System, will correspond to that specified for the facility entered in this field.
  • AUDIT:  EDITED OR DELETED
.24 BILL NUMBER SUFFIX 2;4 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>4!($L(X)<1) X
  • LAST EDITED:  SEP 10, 1993
  • HELP-PROMPT:  Answer must be 1-4 characters in length.
.25 PROMPT FOR MODIFIERS 2;5 SET
  • '1' FOR YES;
  • '0' FOR NO;

  • LAST EDITED:  MAY 28, 1991
  • HELP-PROMPT:  The answer to this field determines whether a Modifier can be designated for a CPT procedure. If answered Yes, the user will be prompted for a Modifier when adding or editing a CPT procedure.
.26 PRINTABLE NAME OF PAYMENT SITE 2;6 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>25!($L(X)<3) X
  • LAST EDITED:  AUG 24, 2005
  • HELP-PROMPT:  Enter the printable name of the site that will receive payment, the answer must be 3-25 characters in length.
  • AUDIT:  YES, ALWAYS
.27 AUTO SET LEVEL OF SERVICE 2;7 SET
  • '1' FOR YES;
  • '0' FOR NO;

  • LAST EDITED:  OCT 01, 1991
  • HELP-PROMPT:  Answer 'NO' if the Professional Service should not automatically be set to a Minimal Level when the Attending Provider is a physician.
.28 INACTIVE DAYS BEFORE PURGE 2;8 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>730)!(X<30)!(X?.E1"."1N.N) X
  • LAST EDITED:  APR 13, 1995
  • HELP-PROMPT:  Type a Number between 30 and 730, 0 Decimal Digits
.29 DEFAULT HCFA-1500 2;9 SET
  • '1' FOR Old Version dated 1-84;
  • '2' FOR New Version dated 12-90;
  • '3' FOR Y2K Version dated 10-98;
  • '4' FOR 08/05 Version dated 01/07;
  • '5' FOR 02/12 Version dated 02/12;

  • LAST EDITED:  MAR 26, 2014
  • HELP-PROMPT:  Determines which version of the HCFA-1500 will be used as the default.
.3 UB-92 Form Locater 38 2;10 SET
  • 'P' FOR POLICY HOLDER;
  • 'I' FOR INSURER ADDRESS;
  • 'B' FOR BLANK;

  • LAST EDITED:  NOV 19, 2001
.31 INSTALL LEVEL 3;1 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>99)!(X<1)!(X?.E1"."1N.N) X
  • LAST EDITED:  MAR 03, 1992
  • HELP-PROMPT:  Type a Number between 1 and 99, 0 Decimal Digits
.311 DEFAULT DENTAL CODE PREFIX 3;11 SET
  • '0' FOR 0;
  • 'S' FOR S;
  • 'D' FOR D;

  • LAST EDITED:  SEP 21, 2000
  • HELP-PROMPT:  This value will print before all dental codes
.312 VA STATION NUMBER 3;12 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>5!($L(X)<3) X
  • LAST EDITED:  APR 01, 2013
  • HELP-PROMPT:  Answer must be 3-5 characters in length.
.313 VA CONTRACT NUMBER 3;13 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>20!($L(X)<3) X
  • LAST EDITED:  MAY 24, 2013
  • HELP-PROMPT:  Answer must be 3-20 characters in length.
.32 DEFAULT DENTAL FORM 3;2 POINTER TO 3P EXPORT MODE FILE (#9002274.08) 3P EXPORT MODE(#9002274.08)

  • INPUT TRANSFORM:  S DIC("S")="I $P(^(0),U,6),$P(^(0),U,9)'=0" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X
  • LAST EDITED:  MAR 04, 1992
  • HELP-PROMPT:  Select the form that is to be used for billing Dental Visits.
  • SCREEN:  S DIC("S")="I $P(^(0),U,6),$P(^(0),U,9)'=0"
  • EXPLANATION:  Only those forms that are related to dental can be selected.
.33 APPEND HRN TO BILL NUMBER 3;3 SET
  • '1' FOR YES;
  • '0' FOR NO;

  • LAST EDITED:  MAY 01, 1992
  • HELP-PROMPT:  If this field is answered 'YES' the Health Record Number will be appended to the Bill Number when forms are printed.
.34 EMC FILE PREFERENCE 3;4 SET
  • 'K' FOR KERMIT HOLDING FILE;
  • 'H' FOR HOST FILE;
  • 'M' FOR MAIL SERVER;

  • LAST EDITED:  FEB 07, 1997
.35 EXPORT INSURER TYPES 3;5 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>10 X
  • LAST EDITED:  JUL 28, 1994
  • HELP-PROMPT:  Answer must be 1-10 characters in length.
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
.36 PLACE OF SERVICE CODE 3;6 POINTER TO 3P CODES FILE (#9002274.03) 3P CODES(#9002274.03)

  • INPUT TRANSFORM:  S DIC("S")="I $P(^(0),U,2)=""H""" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X
  • LAST EDITED:  JAN 04, 1996
  • HELP-PROMPT:  Enter the PLACE OF SERVICE code for this facility, this field corresponds to the PLACE OF SERVICE code on the HCFA-1500.
  • SCREEN:  S DIC("S")="I $P(^(0),U,2)=""H"""
  • EXPLANATION:  Only HCFA PLACE of SERVICE codes are selectable.
.37 HCFA-1500 SIGNATURE 3;7 POINTER TO NEW PERSON FILE (#200) NEW PERSON(#200)

  • LAST EDITED:  JUL 06, 1995
.38 UB-92 SIGNATURE 3;8 POINTER TO NEW PERSON FILE (#200) NEW PERSON(#200)

  • LAST EDITED:  JUL 06, 1995
.39 EMC MM DOMAIN 3;9 POINTER TO DOMAIN FILE (#4.2) DOMAIN(#4.2)

  • LAST EDITED:  OCT 31, 1995
.41 IV DISPENSE FEE ADMIXTURE 4;1 NUMBER

  • INPUT TRANSFORM:  S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>999)!(X<0) X
  • LAST EDITED:  JUN 21, 1995
  • HELP-PROMPT:  Type a Dollar Amount between 0 and 999, 2 Decimal Digits
.411 IN-HOUSE DEFAULT CLIA# 4;11 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>10!($L(X)<10)!'(X?2N1U7N) X
  • LAST EDITED:  JUN 28, 2005
  • HELP-PROMPT:  Answer must be 10 characters in length with a format of ##A#######
.412 REFERENCE LAB DEFAULT CLIA# 4;12 POINTER TO 3P REFERENCE LAB LOCATIONS FILE (#9002274.35) 3P REFERENCE LAB LOCATIONS(#9002274.35)

  • LAST EDITED:  MAR 23, 2010
  • HELP-PROMPT:  Use option RLTM to add entries to select from.
  • DESCRIPTION:  
    Add Reference Lab entries using option RLTM
.42 IV DISPENSE FEE PIGGYBACK 4;2 NUMBER

  • INPUT TRANSFORM:  S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>999)!(X<0) X
  • LAST EDITED:  JUN 21, 1995
  • HELP-PROMPT:  Type a Dollar Amount between 0 and 999, 2 Decimal Digits
.43 IV DISPENSE FEE HYPERAL 4;3 NUMBER

  • INPUT TRANSFORM:  S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>999)!(X<0) X
  • LAST EDITED:  JUN 21, 1995
  • HELP-PROMPT:  Type a Dollar Amount between 0 and 999, 2 Decimal Digits
.44 IV DISPENSE FEE SYRINGE 4;4 NUMBER

  • INPUT TRANSFORM:  S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>999)!(X<0) X
  • LAST EDITED:  JUN 21, 1995
  • HELP-PROMPT:  Type a Dollar Amount between 0 and 999, 2 Decimal Digits
.45 IV DISPENSE FEE CHEMOTHERAPY 4;5 NUMBER

  • INPUT TRANSFORM:  S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>999)!(X<0) X
  • LAST EDITED:  JUN 21, 1995
  • HELP-PROMPT:  Type a Dollar Amount between 0 and 999, 2 Decimal Digits
.46 INPATIENT RX DISPENSE FEE 4;6 NUMBER

  • INPUT TRANSFORM:  S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>999)!(X<0) X
  • LAST EDITED:  MAY 03, 1995
  • HELP-PROMPT:  Type a Dollar Amount between 0 and 999, 2 Decimal Digits
.47 DEFAULT EMC PATH 4;7 FREE TEXT

  • INPUT TRANSFORM:  D ^ABM47IT
  • LAST EDITED:  APR 07, 1997
  • HELP-PROMPT:  Answer must be 1-25 characters in length.
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
.48 ORPHAN LAG TIME 4;8 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>180)!(X<3)!(X?.E1"."1N.N) X
  • LAST EDITED:  JUN 27, 1997
  • HELP-PROMPT:  Type a Number between 3 and 180, 0 Decimal Digits
  • DESCRIPTION:  
    Number of days that the claim generator waits for PCC data entry before creating claims for orphans.
.49 USE A/R PARENT/SATELLITE? 4;9 SET
  • '1' FOR YES;
  • '0' FOR NO;

  • LAST EDITED:  NOV 17, 1999
.51 MEDICARE B 5;1 SET
  • '1' FOR ONLY;
  • '0' FOR YES;
  • '2' FOR NO;

  • LAST EDITED:  AUG 05, 2003
  • HELP-PROMPT:  Answer must be 1-25 characters in length.
  • DESCRIPTION:  YES-Allows the system to generate an Outpatient claim. These claims are generated with a Visit Type of 131 and are usually set up in the Insurer File as All-Inclusive. These are used mainly for FQHC sites that don't have
    the Part B authority since the all-inclusive rate includes Part B.
    NO-Allows the system to generate an Outpatient claim AND a Professional Component claim.  There are two claims that generate--Visit Type 131-Outpatient and Visit Type 999-Professional Component.  The 131-Outpatient
    Facilities that are Hospital-Based will generally set their prompts up for this.
    ONLY-Allows the system to generate a professional claim.  These claims are generated with a Visit Type of 999-Professional Component.  These claims are generated with the intention of billing a fee-for-service (itemized)
    claim for Medicare services.  This is used primarily for Freestanding Health Centers.





.52
UNCODED DX LAG TIME (DAYS)
5;2
NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>180)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  MAY 03, 2005
  • HELP-PROMPT:  Enter number of days lag time for Uncoded Dxs





.53
ISA08 VALUE
5;3
SET

  • 'C00400' FOR C00400;
  • 'C00900' FOR C00900;
  • '04401' FOR 04401;
  • '04402' FOR 04402;
  • LAST EDITED:  APR 24, 2008





.54
MAMMOGRAPHY CERTIFICATION
5;4
FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>80!($L(X)<3) X
  • LAST EDITED:  DEC 04, 2009
  • HELP-PROMPT:  Answer must be 3-80 characters in length





6
DISPLAY UNBILLABLE INSURER(S)
6;0
POINTER Multiple #9002274.56
9002274.56




11
CLAIM PAGE(s) TO BE SKIPPED
11;0
SET Multiple #9002274.511 
9002274.511
  • LAST EDITED:  FEB 27, 1996





15
DEFAULT UNBILLABLE CLINICS
15;0
POINTER Multiple #9002274.515
9002274.515




17
DFLT INVALID PRV DISCIPLINES
17;0
POINTER Multiple #9002274.517
9002274.517




19
INSURERS W/O 837 PRV SEGMENT
19;0
POINTER Multiple #9002274.519 
9002274.519




211
STATEMENT HEADER PRINT
2;11
FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>80!($L(X)<3) X
  • LAST EDITED:  MAR 23, 2007
  • HELP-PROMPT:  Answer must be 3-80 characters in length





212
USE NPI OF
2;12
POINTER TO INSTITUTION FILE (#4)
INSTITUTION(#4)
  • INPUT TRANSFORM:  S DIC("S")="I $G(^ABMDPARM(Y,0))&(Y'=DUZ(2))" D ^DIC K DIC S DIC=$G(DIE),X=+Y K:Y<0 X
  • LAST EDITED:  MAY 14, 2007
  • HELP-PROMPT:  Enter entry from 3P Parameters file
  • SCREEN:  S DIC("S")="I $G(^ABMDPARM(Y,0))&(Y'=DUZ(2))"
  • EXPLANATION:  Only entries that are in the 3P Parameters file
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER





213
USE POA INDICATOR?
2;13
SET

  • 'Y' FOR YES;
  • 'N' FOR NO;
  • LAST EDITED:  NOV 16, 2007
  • DESCRIPTION:  CMS requires all inpatient acute care facilities to submit a Present on Admission indicator.  This indicator is used to evaluate and determine reimbursement for inpatient services.  Critical Access hospitals are exempt
    from using the POA.





214
PRINT STATEMENT DATE
2;14
SET

  • 'Y' FOR YES;
  • 'N' FOR NO;
  • LAST EDITED:  APR 30, 2010





413
UFMS DIRECTORY
4;13
FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>80!($L(X)<1) X
  • LAST EDITED:  APR 27, 2007
  • HELP-PROMPT:  Non-public directory for UFMS export file





414
UFMS EXPORT
4;14
SET

  • '1' FOR YES (EXPORT);
  • '0' FOR NO (DON'T EXPORT);
  • LAST EDITED:  JUN 25, 2007
  • HELP-PROMPT:  Answering NO will stop data from being exported to UFMS





415
UFMS CASHIERING
4;15
SET

  • '1' FOR YES (Do Cashiering Sessions);
  • '0' FOR NO (Don't do Cashiering Sessions);
  • LAST EDITED:  JUN 25, 2007
  • HELP-PROMPT:  Answering NO will turn off the Cashiering sessions as well as UFMS export





416
UFMS DISPLAY DEFAULT NUMBER
4;16
NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>999)!(X<5)!(X?.E1"."1.N) X
  • LAST EDITED:  NOV 13, 2007
  • HELP-PROMPT:  Type a number between 5 and 999, 0 Decimal Digits





417
UFMS USE ASUFAC OF
4;17
POINTER TO LOCATION FILE (#9999999.06)
LOCATION(#9999999.06)
  • INPUT TRANSFORM:  I $G(^ABMDPARM(Y,0))&(Y'=DUZ(2))
  • LAST EDITED:  AUG 13, 2007
  • HELP-PROMPT:  Entry into this field will use entered ASUFAC for visit location ASUFAC
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER







    



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