FileMan FileNo | FileMan Filename | Package |
---|---|---|
356.2 | INSURANCE REVIEW | Integrated Billing |
Package | Total | FileMan Files |
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Integrated Billing | 1 | INSURANCE REVIEW(#356.2)[.18] |
Field # | Name | Loc | Type | Details |
---|---|---|---|---|
.01 | REVIEW DATE | 0;1 | DATE | ************************REQUIRED FIELD************************
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.02 | TRACKING ID | 0;2 | POINTER TO CLAIMS TRACKING FILE (#356) | CLAIMS TRACKING(#356)
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.03 | RELATED REVIEW | 0;3 | POINTER TO HOSPITAL REVIEW FILE (#356.1) | HOSPITAL REVIEW(#356.1)
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.04 | TYPE OF CONTACT | 0;4 | POINTER TO CLAIMS TRACKING REVIEW TYPE FILE (#356.11) | ************************REQUIRED FIELD************************ CLAIMS TRACKING REVIEW TYPE(#356.11)
|
.05 | PATIENT | 0;5 | POINTER TO VA PATIENT FILE (#2) | VA PATIENT(#2)
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.06 | PERSON CONTACTED | 0;6 | FREE TEXT |
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.07 | CONTACT PHONE # | 0;7 | FREE TEXT |
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.08 | INSURANCE COMPANY CONTACTED | 0;8 | POINTER TO INSURANCE COMPANY FILE (#36) | INSURANCE COMPANY(#36)
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.09 | CALL REFERENCE NUMBER | 0;9 | FREE TEXT |
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.1 | APPEAL STATUS | 0;10 | SET |
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.11 | ACTION | 0;11 | POINTER TO CLAIMS TRACKING ACTION FILE (#356.7) | CLAIMS TRACKING ACTION(#356.7)
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.12 | CARE AUTHORIZED FROM | 0;12 | DATE | ************************REQUIRED FIELD************************
|
.13 | CARE AUTHORIZED TO | 0;13 | DATE | ************************REQUIRED FIELD************************
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.14 | DIAGNOSIS AUTHORIZED | 0;14 | POINTER TO ICD DIAGNOSIS FILE (#80) | ICD DIAGNOSIS(#80)
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.15 | DATES OF DENIAL FROM | 0;15 | DATE | ************************REQUIRED FIELD************************
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.16 | DATES OF DENIAL TO | 0;16 | DATE | ************************REQUIRED FIELD************************
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.17 | METHOD OF CONTACT | 0;17 | SET |
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.18 | PARENT REVIEW | 0;18 | POINTER TO INSURANCE REVIEW FILE (#356.2) | INSURANCE REVIEW(#356.2)
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.19 | REVIEW STATUS | 0;19 | SET |
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.2 | CASE PENDING | 0;20 | SET |
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.21 | NO COVERAGE | 0;21 | SET |
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.22 | FOLLOW-UP WITH APPEAL | 0;22 | SET |
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.23 | TYPE OF APPEAL | 0;23 | SET |
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.24 | NEXT REVIEW DATE | 0;24 | DATE |
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.25 | NUMBER OF DAYS PENDING APPEAL | 0;25 | NUMBER |
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.26 | OUTPATIENT TREATMENT | 0;26 | FREE TEXT |
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.27 | TREATMENT AUTHORIZED | 0;27 | SET |
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.28 | AUTHORIZATION NUMBER | 0;28 | FREE TEXT |
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.29 | FINAL OUTCOME OF APPEAL | 0;29 | SET |
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1.01 | DATE ENTERED | 1;1 | DATE |
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1.02 | ENTERED BY | 1;2 | POINTER TO NEW PERSON FILE (#200) | NEW PERSON(#200)
|
1.03 | DATE LAST EDITED | 1;3 | DATE |
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1.04 | LAST EDITED BY | 1;4 | POINTER TO NEW PERSON FILE (#200) | NEW PERSON(#200)
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1.05 | HEALTH INSURANCE POLICY | 1;5 | FREE TEXT | ************************REQUIRED FIELD************************
|
1.07 | DENY ENTIRE ADMISSION | 1;7 | SET |
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1.08 | AUTHORIZE ENTIRE ADMISSION | 1;8 | SET |
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11 | COMMENTS | 11;0 | WORD-PROCESSING #356.211 |
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12 | REASONS FOR DENIAL | 12;0 | POINTER Multiple #356.212 | 356.212
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13 | PENALTY | 13;0 | SET Multiple #356.213 | 356.213
|
14 | APPROVE ON APPEAL FROM | 14;0 | DATE Multiple #356.214 | 356.214
|
ICR LINK | Subscribing Package(s) | Fields Referenced | Description |
---|---|---|---|
ICR #5340 |
Name | Field # of Occurrence |
---|---|
^%DT | .01+1, .12+1, .13+1, .15+1, .16+1, .24+1, 1.01+1, 1.03+1 |
^DIC | .04+1, .11+1, .14+1, .18+1 |
^DICR | .05(XREF 3n1.4), .05(XREF 3n2.4), .1(XREF 1n1.4), .11(XREF 4n1.4), .13(XREF 1n1.4), .16(XREF 1n1.4), .19(XREF 2n1.4), .19(XREF 2n2.4), 1.05(XREF 1n1.4), 1.05(XREF 1n2.4) |
Y^DIQ | ID.02+1, ID.04+1, ID.05+1, ID.08+1 |
$$INSCO^IBTRC2 | 1.05(XREF 1n1.1) |
$$TRANS^IBTRC2 | 1.05OT+1 |
DD^IBTRC2 | 1.05+1 |
DDHELP^IBTRC2 | 1.05(HELP ) |
$$HIP^IBTRC3 | .05(XREF 3S) |
HELP^IBTUTL3 | .12(HELP ), .13(HELP ), .15(HELP ), .16(HELP ), 1.07(HELP ), 1.08(HELP ) |
$$AFDT^IBTUTL4 | .12+1 |
$$ATDT^IBTUTL4 | .13+1 |
$$DFDT^IBTUTL4 | .15+1 |
$$DTDT^IBTUTL4 | .16+1 |
Name | Line Occurrences (* Changed, ! Killed) |
---|---|
^DD( | .05(XREF 3n1.4), .05(XREF 3n2.4), .1(XREF 1n1.4), .11(XREF 4n1.4), .13(XREF 1n1.4), .16(XREF 1n1.4), .19(XREF 2n1.4), .19(XREF 2n2.4), 1.05(XREF 1n1.4), 1.05(XREF 1n2.4) |
^DD(2 | ID.05+1 |
^DD(356 | ID.02+1 |
^DD(356.11 | ID.04+1 |
^DD(356.2 | .05(XREF 3S), .05(XREF 3n1.3), .05(XREF 3K), .1(XREF 1S), .11(XREF 4S), .13(XREF 1S), .16(XREF 1S), .19(XREF 2S), .19(XREF 2K), 1.05(XREF 1S) , 1.05(XREF 1K) |
^DD(36 | ID.08+1 |
^DIC(36 - [#36] | ID.08+1 |
^DPT - [#2] | ID.05+1 |
^IBE(356.11 - [#356.11] | ID.04+1 |
^IBT(356 - [#356] | ID.02+1 |
^IBT(356.2 - [#356.2] | .01(XREF 1S), .01(XREF 1K), .01(XREF 2S), .01(XREF 2K), .01(XREF 3S), .01(XREF 3K), .02(XREF 1S), .02(XREF 1K), .02(XREF 2S), .02(XREF 2K) , .02(XREF 3S), .02(XREF 3K), .02(XREF 4S), .02(XREF 4K), .03(XREF 1S), .03(XREF 1K), .04(XREF 1S), .04(XREF 1K), .04(XREF 2S), .04(XREF 2K) , .05(XREF 1S), .05(XREF 1K), .05(XREF 2S), .05(XREF 2K), .05(XREF 3S), .05(XREF 3n1.3), .05(XREF 3n1.4), .05(XREF 3K), .05(XREF 3n2.4), .05(XREF 4S) , .05(XREF 4K), .08(XREF 1S), .08(XREF 1K), .1(XREF 1S), .1(XREF 1n1.4), .11(XREF 1S), .11(XREF 1K), .11(XREF 2S), .11(XREF 2K), .11(XREF 3S) , .11(XREF 3K), .11(XREF 4S), .11(XREF 4n1.4), .13(XREF 1S), .13(XREF 1n1.4), .16(XREF 1S), .16(XREF 1n1.4), .18(XREF 1S), .18(XREF 1K), .19(XREF 1S) , .19(XREF 1K), .19(XREF 2S), .19(XREF 2n1.4), .19(XREF 2K), .19(XREF 2n2.4), .24(XREF 1S), .24(XREF 1K), .28(XREF 1S), .28(XREF 1K), 1.05(XREF 1S) , 1.05(XREF 1n1.1), 1.05(XREF 1n1.4), 1.05(XREF 1K), 1.05(XREF 1n2.4) |
Name | Field # of Occurrence |
---|---|
^(0 | ID.02+1, ID.04+1, ID.05+1, ID.08+1, .01(XREF 2S), .01(XREF 3S), .02(XREF 2S), .02(XREF 3S), .02(XREF 4S), .04(XREF 2S) , .05(XREF 2S), .08(XREF 1S), .1(XREF 1S), .1(XREF 1n1.4), .11(XREF 2S), .11(XREF 3S), .11(XREF 4S), .11(XREF 4n1.4), .13(XREF 1S), .13(XREF 1n1.4) , .16(XREF 1S), .16(XREF 1n1.4), .19(XREF 2S), .19(XREF 2n1.4), .19(XREF 2K), .19(XREF 2n2.4), .28(XREF 1S), 1.05(XREF 1S), 1.05(XREF 1n1.4), 1.05(XREF 1K) , 1.05(XREF 1n2.4) |
^(1 | .05(XREF 3S), .05(XREF 3n1.3), .05(XREF 3n1.4), .05(XREF 3K), .05(XREF 3n2.4) |
^(2 | .05(XREF 3n1.3) |
>> | Not killed explicitly |
* | Changed |
! | Killed |
~ | Newed |
Name | Field # of Occurrence |
---|---|
>> %DT | .01+1*, .12+1*, .13+1*, .15+1*, .16+1*, .24+1*, 1.01+1*, 1.03+1* |
%I | ID.02+1*!, ID.04+1*!, ID.05+1*!, ID.08+1*! |
>> C | ID.02+1*, ID.04+1*, ID.05+1*, ID.08+1* |
>> D0 | .05(XREF 3S), .05(XREF 3n1.3), .05(XREF 3K), .1(XREF 1S), .11(XREF 4S), .13(XREF 1S), .16(XREF 1S), .19(XREF 2S), .19(XREF 2K), 1.05(XREF 1S) , 1.05(XREF 1K) |
>> DA | .01(XREF 1S), .01(XREF 1K), .01(XREF 2S), .01(XREF 2K), .01(XREF 3S), .01(XREF 3K), .02(XREF 1S), .02(XREF 1K), .02(XREF 2S), .02(XREF 2K) , .02(XREF 3S), .02(XREF 3K), .02(XREF 4S), .02(XREF 4K), .03(XREF 1S), .03(XREF 1K), .04(XREF 1S), .04(XREF 1K), .04(XREF 2S), .04(XREF 2K) , .05(XREF 1S), .05(XREF 1K), .05(XREF 2S), .05(XREF 2K), .05(XREF 3S), .05(XREF 3n1.3), .05(XREF 3K), .05(XREF 4S), .05(XREF 4K), .08(XREF 1S) , .08(XREF 1K), .1(XREF 1S), .11(XREF 1S), .11(XREF 1K), .11(XREF 2S), .11(XREF 2K), .11(XREF 3S), .11(XREF 3K), .11(XREF 4S), .12+1 , .12(HELP ), .13+1, .13(HELP ), .13(XREF 1S), .15+1, .15(HELP ), .16+1, .16(HELP ), .16(XREF 1S), .18(XREF 1S) , .18(XREF 1K), .19(XREF 1S), .19(XREF 1K), .19(XREF 2S), .19(XREF 2K), .24(XREF 1S), .24(XREF 1K), .28(XREF 1S), .28(XREF 1K), 1.05+1 , 1.05OT+1, 1.05(HELP ), 1.05(XREF 1S), 1.05(XREF 1n1.1), 1.05(XREF 1K), 1.07(HELP ), 1.08(HELP ) |
DIC | ID.02+1, ID.04+1, ID.05+1, ID.08+1, .04+1!*, .11+1!*, .14+1!*, .18+1!* |
DIC("S" | .04+1*, .04SCR+1*, .11+1*, .11SCR+1*, .14+1*, .14SCR+1*, .18+1*, .18SCR+1*, 1.07SCR+1*, 1.08SCR+1* |
>> DIE | .04+1, .11+1, .14+1, .18+1 |
>> DIG | .05(XREF 3n1.4), .05(XREF 3n2.4), .1(XREF 1n1.4), .11(XREF 4n1.4), .13(XREF 1n1.4), .16(XREF 1n1.4), .19(XREF 2n1.4), .19(XREF 2n2.4), 1.05(XREF 1n1.4), 1.05(XREF 1n2.4) |
>> DIH | .05(XREF 3n1.4), .05(XREF 3n2.4), .1(XREF 1n1.4), .11(XREF 4n1.4), .13(XREF 1n1.4), .16(XREF 1n1.4), .19(XREF 2n1.4), .19(XREF 2n2.4), 1.05(XREF 1n1.4), 1.05(XREF 1n2.4) |
>> DIU | .05(XREF 3S), .05(XREF 3K), .1(XREF 1S), .11(XREF 4S), .13(XREF 1S), .16(XREF 1S), .19(XREF 2S), .19(XREF 2K), 1.05(XREF 1S), 1.05(XREF 1K) |
DIV | .05(XREF 3S), .05(XREF 3n1.3), .05(XREF 3n1.4), .05(XREF 3K), .05(XREF 3n2.4), .1(XREF 1S), .1(XREF 1n1.4), .11(XREF 4S), .11(XREF 4n1.4), .13(XREF 1S) , .13(XREF 1n1.4), .16(XREF 1S), .16(XREF 1n1.4), .19(XREF 2S), .19(XREF 2n1.4), .19(XREF 2K), .19(XREF 2n2.4), 1.05(XREF 1S), 1.05(XREF 1n1.1), 1.05(XREF 1n1.4) , 1.05(XREF 1K), 1.05(XREF 1n2.4) |
DIV(0 | .05(XREF 3n1.3), .05(XREF 3n1.4), .05(XREF 3K), .05(XREF 3n2.4), .1(XREF 1S), .1(XREF 1n1.4), .11(XREF 4S), .11(XREF 4n1.4), .13(XREF 1S), .13(XREF 1n1.4) , .16(XREF 1S), .16(XREF 1n1.4), .19(XREF 2S), .19(XREF 2n1.4), .19(XREF 2K), .19(XREF 2n2.4), 1.05(XREF 1S), 1.05(XREF 1n1.4), 1.05(XREF 1K), 1.05(XREF 1n2.4) |
DT | .19(XREF 2S) |
U | ID.02+1, ID.04+1, ID.05+1, ID.08+1, .01(XREF 2S), .01(XREF 2K), .01(XREF 3S), .01(XREF 3K), .02(XREF 3S), .02(XREF 3K) , .02(XREF 4S), .02(XREF 4K), .04(XREF 2S), .04(XREF 2K), .05(XREF 2S), .05(XREF 2K), .05(XREF 3S), .05(XREF 3n1.3), .05(XREF 3n1.4), .05(XREF 3K) , .05(XREF 3n2.4), .08(XREF 1S), .08(XREF 1K), .1(XREF 1S), .1(XREF 1n1.4), .11(XREF 2S), .11(XREF 2K), .11(XREF 3S), .11(XREF 3K), .11(XREF 4S) , .11(XREF 4n1.4), .13(XREF 1S), .13(XREF 1n1.4), .16(XREF 1S), .16(XREF 1n1.4), .19(XREF 2S), .19(XREF 2n1.4), .19(XREF 2K), .19(XREF 2n2.4), .28(XREF 1S) , .28(XREF 1K), 1.05(XREF 1S), 1.05(XREF 1n1.1), 1.05(XREF 1n1.4), 1.05(XREF 1K), 1.05(XREF 1n2.4) |
X | .01+1*!, .01(XREF 1S), .01(XREF 1K), .01(XREF 2S), .01(XREF 2K), .01(XREF 3S), .01(XREF 3K), .02(XREF 1S), .02(XREF 1K), .02(XREF 2S) , .02(XREF 2K), .02(XREF 3S), .02(XREF 3K), .02(XREF 4S), .02(XREF 4K), .03(XREF 1S), .03(XREF 1K), .04+1*!, .04(XREF 1S), .04(XREF 1K) , .04(XREF 2S), .04(XREF 2K), .05(XREF 1S), .05(XREF 1K), .05(XREF 2S), .05(XREF 2K), .05(XREF 3S), .05(XREF 3n1.3), .05(XREF 3n1.4), .05(XREF 3K) , .05(XREF 3n2.4), .05(XREF 4S), .05(XREF 4K), .06+1!, .07+1!, .08(XREF 1S), .08(XREF 1K), .09+1!, .1(XREF 1S), .1(XREF 1n1.4) , .11+1*!, .11(XREF 1S), .11(XREF 1K), .11(XREF 2S), .11(XREF 2K), .11(XREF 3S), .11(XREF 3K), .11(XREF 4S), .11(XREF 4n1.4), .12+1*! , .13+1*!, .13(XREF 1S), .13(XREF 1n1.4), .14+1*!, .15+1*!, .16+1*!, .16(XREF 1S), .16(XREF 1n1.4), .18+1*!, .18(XREF 1S) , .18(XREF 1K), .19(XREF 1S), .19(XREF 1K), .19(XREF 2S), .19(XREF 2n1.4), .19(XREF 2K), .19(XREF 2n2.4), .24+1*!, .24(XREF 1S), .24(XREF 1K) , .25+1!, .26+1!, .28+1!, .28(XREF 1S), .28(XREF 1K), 1.01+1*!, 1.03+1*!, 1.05+1!, 1.05(XREF 1S), 1.05(XREF 1n1.1) , 1.05(XREF 1n1.4), 1.05(XREF 1K), 1.05(XREF 1n2.4) |
Y | ID.02+1*, ID.04+1*, ID.05+1*, ID.08+1*, .01+1, .04+1, .05(XREF 3S), .05(XREF 3n1.3), .05(XREF 3K), .1(XREF 1S) , .11+1, .11(XREF 4S), .12+1, .13+1, .13(XREF 1S), .14+1, .15+1, .16+1, .16(XREF 1S), .18+1 , .19(XREF 2S), .19(XREF 2K), .24+1, 1.01+1, 1.03+1, 1.05OT+1*, 1.05(XREF 1S), 1.05(XREF 1K) |
Y(0 | .05(XREF 3n1.3), .1(XREF 1S), .11(XREF 4S), .19(XREF 2S), .19(XREF 2K), 1.05OT+1* |
Y(1 | .05(XREF 3S), .05(XREF 3n1.3), .05(XREF 3K), .1(XREF 1S), .11(XREF 4S), .13(XREF 1S), .16(XREF 1S), .19(XREF 2S), .19(XREF 2K), 1.05(XREF 1S) , 1.05(XREF 1K) |