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Global: ^AUPNMSP

Package: IHS Patient

Global: ^AUPNMSP


Information

FileMan FileNo FileMan Filename Package
9000037 MSP PATIENT IHS Patient

Description

Directly Accessed By Routines, Total: 12

Package Total Routines
IHS Patient Registration 8 AGED6    AGMSP1    AGMSP2    AGMSP3    AGMSP4    AGMSP5    AGMSP6    AGMSP7
Third Party Billing 2 ABMDE2    ABMDE2X    
IHS Patient 1 AUPNMSP    
Local Area Programs 1 AZAXDPM1    

Accessed By FileMan Db Calls, Total: 9

Package Total Routines
IHS Patient Registration 6 AGED42    AGED61    AGED62    AGMSPFRM    AGMSPI1    AGMSPINT    
IHS Patient 2 AUPN9913    AUPN9914    
Third Party Billing 1 ABMDE2    

Pointer To FileMan Files, Total: 5

Package Total FileMan Files
Utility Tables 3 EMPLOYER(#9999999.75)[.15.27.31.42.45.61]    INSURER(#9999999.18)[.13.19.23.35.48.55]    RELATIONSHIP(#9999999.36)[.39.53.59]
IHS Patient 1 PATIENT(#9000001)[.02]    
Kernel 1 NEW PERSON(#200)[.05]    

Fields, Total: 65

Field # Name Loc Type Details
.01 DATE SURVEY GIVEN 0;1 DATE
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  MAR 30, 2005
  • HELP-PROMPT:  Enter the date the survey was given to the patient.
  • DESCRIPTION:  
    Used to track when the signature was put on file for an MSP patient and that the signature is on file.  This will be used for auditing purposes.
  • TECHNICAL DESCR:  
    Created 8/2/2002 for V7.0 of AG Distributed in AUPN*99.1*8
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
  • CROSS-REFERENCE:  9000037^B
    1)= S ^AUPNMSP("B",$E(X,1,30),DA)=""
    2)= K ^AUPNMSP("B",$E(X,1,30),DA)
.02 PATIENT 0;2 POINTER TO PATIENT FILE (#9000001)
************************REQUIRED FIELD************************
PATIENT(#9000001)

  • LAST EDITED:  APR 08, 2005
  • TECHNICAL DESCR:  
    Created 8/2/02 for V7.0 of AG Distributed in AUPN*99.1*
  • CROSS-REFERENCE:  9000037^C^MUMPS
    1)= D EN^AUPNMSP(X,DA)
    2)= D KILL^AUPNMSP(X,DA)
  • CROSS-REFERENCE:  9000037^D
    1)= S ^AUPNMSP("D",$E(X,1,30),DA)=""
    2)= K ^AUPNMSP("D",$E(X,1,30),DA)
.03 MSP PATIENT 0;3 SET
  • 'Y' FOR YES;
  • 'N' FOR NO;

  • LAST EDITED:  AUG 02, 2002
  • HELP-PROMPT:  Enter YES or NO to indicate if the patient qualifies as a Medicare Secondary Payer patient
  • TECHNICAL DESCR:  
    Created 8/2/02 for V7.0 of AG Distributed in AUPN*99.1*8
.04 MEDICARE SECONDARY REASON 0;4 SET
  • 'E' FOR EMPLOYER GROUP HEALTH PLAN (EGHP);
  • 'L' FOR LARGE GROUP HEALTH PLAN (LGHP);
  • 'D' FOR END STAGE RENAL DISEASE (ESRD);
  • 'V' FOR VETERANS ADMINISTRATION (VA);
  • 'W' FOR WORKMANS COMPENSATION;
  • 'B' FOR BLACK LUNG;
  • 'A' FOR AUTOMOBILE/NO-FAULT;

  • LAST EDITED:  AUG 02, 2002
  • HELP-PROMPT:  Enter the reason why the patient qualifies as a Medicare Secondary Payer
  • TECHNICAL DESCR:  
    Created 8/2/02 for V7.0 of AG Distributed in AUPN*99.1*8
.05 WHO COMPLETED THE FORM 1;1 POINTER TO NEW PERSON FILE (#200) NEW PERSON(#200)

  • LAST EDITED:  JUN 07, 2004
  • DESCRIPTION:  
    This field is a pointer to the person who completed the MSP interview or entered the data.
.06 RECEIVING BL BENEFITS 1;2 SET
************************REQUIRED FIELD************************
  • 'Y' FOR YES;
  • 'N' FOR NO;

  • LAST EDITED:  OCT 13, 2004
  • HELP-PROMPT:  Is the patient receiving Black Lung benefits ?
.07 DATE BLACK LUNG BENEFITS BEGAN 1;3 DATE

  • INPUT TRANSFORM:  S %DT="E" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  JUN 07, 2004
.08 SERVICES PAID BY GOVT PROGRAM 1;4 SET
************************REQUIRED FIELD************************
  • 'Y' FOR YES;
  • 'N' FOR NO;

  • LAST EDITED:  OCT 13, 2004
  • HELP-PROMPT:  Are the services to be paid by a government program such as a research grant ?
.09 HAS THE DVA AGREED TO PAY 1;5 SET
************************REQUIRED FIELD************************
  • 'Y' FOR YES;
  • 'N' FOR NO;

  • LAST EDITED:  OCT 13, 2004
  • HELP-PROMPT:  Has the Department of Veteran Affairs (DVA) agreed to pay for ce at this facility
.11 WAS THIS WORK RELATED 1;6 SET
************************REQUIRED FIELD************************
  • 'Y' FOR YES;
  • 'N' FOR NO;

  • LAST EDITED:  OCT 13, 2004
  • HELP-PROMPT:  Was the illness/injury due to a work related accident/condition ?
.12 DATE OF INJURY/ILLNESS 1;7 DATE

  • INPUT TRANSFORM:  S %DT="E" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  JUN 07, 2004
.13 NAME OF WORKMAN'S COMP PLAN 1;8 POINTER TO INSURER FILE (#9999999.18) INSURER(#9999999.18)

  • INPUT TRANSFORM:  S DIC("S")="I $$ITS^AUTINS(Y,""W"")" D ^DIC K DIC S DIC=$G(DIE),X=+Y K:Y<0 X
  • LAST EDITED:  MAY 02, 2016
  • HELP-PROMPT:  Enter the Workman's Comp insurer for this occurance.
  • SCREEN:  S DIC("S")="I $$ITS^AUTINS(Y,""W"")"
  • EXPLANATION:  ALLOW ONLY WORKMAN'S COMP
.14 PATIENT'S POLICY OR ID NUMBER 1;9 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>20!($L(X)<3) X
  • LAST EDITED:  JUN 07, 2004
  • HELP-PROMPT:  Answer must be 3-20 characters in length.
.15 NAME OF PATIENT'S EMPLOYER 1;10 POINTER TO EMPLOYER FILE (#9999999.75) EMPLOYER(#9999999.75)

  • LAST EDITED:  JUN 07, 2004
  • HELP-PROMPT:  Enter the name of the patient's employer
.16 WAS THIS NON WORK RELATED 2;1 SET
  • 'Y' FOR YES;
  • 'N' FOR NO;

  • LAST EDITED:  JUN 07, 2004
  • HELP-PROMPT:  Was illness/injury due to a non-work related accident ?
.17 DATE OF ACCIDENT 2;2 DATE

  • INPUT TRANSFORM:  S %DT="E" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  JUN 07, 2004
  • HELP-PROMPT:  Date of non-work related accident
.18 TYPE OF ACCIDENT 2;3 SET
  • 'A' FOR AUTOMOBILE;
  • 'N' FOR NON-AUTOMOBILE;
  • 'O' FOR OTHER;

  • LAST EDITED:  JUN 07, 2004
  • HELP-PROMPT:  What type of accident caused the illness/injury ?
.19 NAME OF TPL INSURER 2;4 POINTER TO INSURER FILE (#9999999.18) INSURER(#9999999.18)

  • INPUT TRANSFORM:  S DIC("S")="I $$ITS^AUTINS(Y,""T"")" D ^DIC K DIC S DIC=$G(DIE),X=+Y K:Y<0 X
  • LAST EDITED:  MAY 02, 2016
  • HELP-PROMPT:  Enter the Third Party Liability insurer name
  • SCREEN:  S DIC("S")="I $$ITS^AUTINS(Y,""T"")"
  • EXPLANATION:  ALLOW ONLY THIRD PARTY INSURERS
.21 INSURANCE CLAIM NUMBER 2;5 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>20!($L(X)<3) X
  • LAST EDITED:  JUN 07, 2004
  • HELP-PROMPT:  Answer must be 3-20 characters in length.
.22 WAS ANOTHER PARTY RESPONSIBLE 2;6 SET
  • 'Y' FOR YES;
  • 'N' FOR NO;

  • LAST EDITED:  JUN 07, 2004
  • HELP-PROMPT:  Was another party responsible for this accident ?
.23 RESPONSIBLE PARTY INSURER 2;7 POINTER TO INSURER FILE (#9999999.18) INSURER(#9999999.18)

  • LAST EDITED:  JUN 07, 2004
  • HELP-PROMPT:  Enter the responsible party insurer
.24 INSURANCE CLAIM NUMBER 2;8 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>20!($L(X)<3) X
  • LAST EDITED:  JUN 07, 2004
  • HELP-PROMPT:  Answer must be 3-20 characters in length.
.25 ENTITLED TO MEDICARE BASED ON 3;1 SET
  • 'A' FOR AGE;
  • 'D' FOR DISABILITY;
  • 'E' FOR ESRD;

  • LAST EDITED:  APR 06, 2005
  • HELP-PROMPT:  Enter "A" foe Age, or "D" for Disability or "E" for ESRD
  • DESCRIPTION:  
    Enter "A" for Age, "D" for Disability, or "E" for ESRD or any combination.
.26 ARE YOU CURRENTLY EMPLOYED 4;1 SET
  • 'Y' FOR YES;
  • 'N' FOR NO;

  • LAST EDITED:  JUN 07, 2004
.27 PATIENT'S EMPLOYER 4;2 POINTER TO EMPLOYER FILE (#9999999.75) EMPLOYER(#9999999.75)

  • LAST EDITED:  JUN 07, 2004
  • HELP-PROMPT:  Enter the patient's employer
.28 P4 DATE OF RETIREMENT 4;3 DATE

  • INPUT TRANSFORM:  S %DT="E" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  JUN 09, 2004
.29 IS SPOUSE CURRENTLY EMPLOYED 4;4 SET
  • 'Y' FOR YES;
  • 'N' FOR NO;

  • LAST EDITED:  JUN 07, 2004
  • HELP-PROMPT:  Is the patient's spouse currently employed ?
.31 SPOUSE'S EMPLOYER 4;5 POINTER TO EMPLOYER FILE (#9999999.75) EMPLOYER(#9999999.75)

  • LAST EDITED:  JUN 07, 2004
  • HELP-PROMPT:  Enter the patient's spouse's employer
.32 SPOUSE'S DATE OF RETIREMENT 4;6 DATE

  • INPUT TRANSFORM:  S %DT="E" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  JUN 09, 2004
.33 GHP BASED ON SPOUSE EMP 4;7 SET
  • 'Y' FOR YES;
  • 'N' FOR NO;

  • LAST EDITED:  JUN 07, 2004
  • HELP-PROMPT:  Does the patient have group health plan (GHP) coverage based on their or a spouse's employment ?
.34 DOES GHP EMPLOY 20 OR MORE 4;8 SET
  • 'Y' FOR YES;
  • 'N' FOR NO;

  • LAST EDITED:  JUN 07, 2004
  • HELP-PROMPT:  Does the employer that sponsors your GHP employ 20 or more employees ?
.35 NAME OF GHP 4;9 POINTER TO INSURER FILE (#9999999.18) INSURER(#9999999.18)

  • LAST EDITED:  JUN 07, 2004
  • HELP-PROMPT:  Enter the group health plan
.36 P4 POLICY ID NUMBER 4;10 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>20!($L(X)<3) X
  • LAST EDITED:  JUN 09, 2004
  • HELP-PROMPT:  Answer must be 3-20 characters in length.
.37 P4 GROUP ID NUMBER 4;11 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>20!($L(X)<3) X
  • LAST EDITED:  JUN 09, 2004
  • HELP-PROMPT:  Answer must be 3-20 characters in length.
.38 P4 POLICY HOLDER 4;12 FREE TEXT

  • INPUT TRANSFORM:  D NAME^AUPNPED
  • LAST EDITED:  JUN 09, 2004
  • HELP-PROMPT:  Enter name using format: LAST,FIRST MIDDLE up to 30 characters
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
.39 P4 RELATIONSHIP TO PATIENT 4;13 POINTER TO RELATIONSHIP FILE (#9999999.36) RELATIONSHIP(#9999999.36)

  • LAST EDITED:  JUN 09, 2004
  • HELP-PROMPT:  Enter the ralationship to patient
.41 ARE YOU CURRENTLY EMPLOYED 5;1 SET
  • 'Y' FOR YES;
  • 'N' FOR NO;

  • LAST EDITED:  JUN 18, 2004
.42 P5 EMPLOYER 5;2 POINTER TO EMPLOYER FILE (#9999999.75) EMPLOYER(#9999999.75)

  • LAST EDITED:  JUN 09, 2004
  • HELP-PROMPT:  Is the patient currently employed ?
.43 P5 DATE OF RETIREMENT 5;3 DATE

  • INPUT TRANSFORM:  S %DT="E" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  JUN 09, 2004
.44 FAMILY MBR EMPLOYED 5;4 SET
  • 'Y' FOR YES;
  • 'N' FOR NO;

  • LAST EDITED:  JUN 07, 2004
  • HELP-PROMPT:  Is a family member currently employed ?
.45 FAMILY MBR'S EMPLOYER 5;5 POINTER TO EMPLOYER FILE (#9999999.75) EMPLOYER(#9999999.75)

  • LAST EDITED:  JUN 07, 2004
  • HELP-PROMPT:  Enter family member's employer
.46 GHP BASED ON MBR EMPLOY 5;6 SET
  • 'Y' FOR YES;
  • 'N' FOR NO;

  • LAST EDITED:  JUN 07, 2004
  • HELP-PROMPT:  Do you have group health plan (GHP) coverage based on your own, or a family member's current employment ?
.47 GHP EMPLOY 100 OR MORE 5;7 SET
  • 'Y' FOR YES;
  • 'N' FOR NO;

  • LAST EDITED:  JUN 07, 2004
  • HELP-PROMPT:  Does the employer that sponsors your GHP employ 100 or more employees ?
.48 GHP NAME 5;8 POINTER TO INSURER FILE (#9999999.18) INSURER(#9999999.18)

  • LAST EDITED:  JUN 07, 2004
  • HELP-PROMPT:  Enter the GHP name
.49 P5 POLICY ID NUMBER 5;9 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>20!($L(X)<3) X
  • LAST EDITED:  JUN 09, 2004
  • HELP-PROMPT:  Answer must be 3-20 characters in length.
.51 P5 GROUP ID NUMBER 5;10 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>20!($L(X)<3) X
  • LAST EDITED:  JUN 09, 2004
  • HELP-PROMPT:  Answer must be 3-20 characters in length.
.52 P5 POLICY HOLDER 5;11 FREE TEXT

  • INPUT TRANSFORM:  D NAME^AUPNPED
  • LAST EDITED:  JUN 09, 2004
  • HELP-PROMPT:  Answer must be 3-30 characters in length.
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
.53 P5 RELATIONSHIP TO PATIENT 5;12 POINTER TO RELATIONSHIP FILE (#9999999.36) RELATIONSHIP(#9999999.36)

  • LAST EDITED:  JUN 09, 2004
.54 DO YOU HAVE GHP 6;1 SET
  • 'Y' FOR YES;
  • 'N' FOR NO;

  • LAST EDITED:  JUN 07, 2004
  • HELP-PROMPT:  Do you have group health plan (GHP) coverage ?
.55 NAME OF GHP 6;2 POINTER TO INSURER FILE (#9999999.18) INSURER(#9999999.18)

  • LAST EDITED:  JUN 07, 2004
.56 P6 POLICY ID NUMBER 6;3 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>20!($L(X)<3) X
  • LAST EDITED:  JUN 09, 2004
  • HELP-PROMPT:  Answer must be 3-20 characters in length.
.57 P6 GROUP ID NUMBER 6;4 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>20!($L(X)<3) X
  • LAST EDITED:  JUN 09, 2004
  • HELP-PROMPT:  Answer must be 3-20 characters in length.
.58 P6 POLICY HOLDER 6;5 FREE TEXT

  • INPUT TRANSFORM:  D NAME^AUPNPED
  • LAST EDITED:  JUN 09, 2004
  • HELP-PROMPT:  Answer must be 3-30 characters in length.
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
.59 P6 RELATIONSHIP TO PATIENT 6;6 POINTER TO RELATIONSHIP FILE (#9999999.36) RELATIONSHIP(#9999999.36)

  • LAST EDITED:  JUN 09, 2004
.61 P6 EMPLOYER 6;7 POINTER TO EMPLOYER FILE (#9999999.75) EMPLOYER(#9999999.75)

  • LAST EDITED:  JUN 09, 2004
.62 REC'D KIDNEY TRANSPLANT 6;8 SET
  • 'Y' FOR YES;
  • 'N' FOR NO;

  • LAST EDITED:  JUN 07, 2004
  • HELP-PROMPT:  Have you received a kidney transplant ?
.63 DATE OF TRANSPLANT 6;9 DATE

  • INPUT TRANSFORM:  S %DT="E" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  JUN 07, 2004
.64 REC'D MAINT DIALYSIS TREAT. 6;10 SET
  • 'Y' FOR YES;
  • 'N' FOR NO;

  • LAST EDITED:  JUN 07, 2004
  • HELP-PROMPT:  Have you received maintenance dialysis treatments ?
.65 DATE DIALYSIS BEGAN 6;11 DATE

  • INPUT TRANSFORM:  S %DT="E" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  JUN 07, 2004
.66 DATE TRAINING STARTED 6;12 DATE

  • INPUT TRANSFORM:  S %DT="E" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  JUN 07, 2004
  • HELP-PROMPT:  If you have participated in a self dialysis training program, provide date training started.
.67 WITHIN 30 MONTH PERIOD 6;13 SET
  • 'Y' FOR YES;
  • 'N' FOR NO;

  • LAST EDITED:  JUN 07, 2004
  • HELP-PROMPT:  Are you within the 30 month coordination period ?
.68 MCR BASED ON AGE,ESRD,DISABIL 6;14 SET
  • 'Y' FOR YES;
  • 'N' FOR NO;

  • LAST EDITED:  JUN 07, 2004
  • HELP-PROMPT:  Are you entitled to Medicare on the basis of either ESRD and age or ESRD and disability ?
.69 INIT ENTITLEMENT TO MCR 6;15 SET
  • 'Y' FOR YES;
  • 'N' FOR NO;

  • LAST EDITED:  JUN 07, 2004
  • HELP-PROMPT:  Was your initial entitlement to Medicare (including simultaneous entitlement) based on ESRD ?
.71 WORK AGED OR DISAB APPLY 6;16 SET
  • 'Y' FOR YES;
  • 'N' FOR NO;

  • LAST EDITED:  JUN 07, 2004
  • HELP-PROMPT:  Does the working aged or disability MSP provision apply(i.e., is the GHP primary based on age or disability entitlement) ?
100 SIGNATURE DATE 7;1 DATE

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:DT
  • LAST EDITED:  NOV 25, 2014
  • HELP-PROMPT:  ENTER THE DATE THE PATIENT SIGNED THE FORM.
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
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