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Routine: BARADJRD

BARADJRD.m

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  1. BARADJRD ; IHS/SD/LSL - data values for BARADJRA ;
  1.  ;;1.8;IHS ACCOUNTS RECEIVABLE;;OCT 26, 2005
  1.  ;
  1.  ; IHS/SD/LSL - 10/07/2003 - V1.7 Patch 4
  1.  ;      Contains $T values for BARADJRA in regards to NON PAYMENT
  1.  ;
  1.  ; *********************************************************************
  1.  ; ;; IEN ;; DESCRIPTION ;; CATEGORY POINTER
  1.  ; *********************************************************************
  1.  ;
  1. NONPYMT ;
  1.  ;;623;;Pymt Adj Chrgs Pd by Diff Pyr;;4
  1.  ;;624;;Pymt Adj Chrgs Covrd Capit Agr;;4
  1.  ;;625;;Pymt Den StopLoss Ded Not Met;;4
  1.  ;;626;;Expnse Incrrd Prior to Coverag;;4
  1.  ;;627;;Expnse Incrrd Aft Cov Termnatd;;4
  1.  ;;628;;Coverage Not in Effect on DOS;;4
  1.  ;;134;;Time Limit for Filing Expired;;4
  1.  ;;630;;Pymt Adj Pt Not Met Requiremts;;4
  1.  ;;166;;Clm Den Pt Not Identifd Isurd;;4
  1.  ;;632;;Records Indicate Dep Not Elig;;4
  1.  ;;633;;Clm DenInsured No Depend Cove;;4
  1.  ;;17;;Clm Den Insured no Cov for NB;;4
  1.  ;;167;;Benefit Maximum Reached;;4
  1.  ;;636;;Bal does not Exceed CoPymt Amt;;4
  1.  ;;637;;Bal Does not Exceed Deductible;;4
  1.  ;;638;;Serv Not Auth by Designtd Prov;;4
  1.  ;;639;;Srvcs Den At Time Auth Rqsted;;4
  1.  ;;640;;Chrgs DoNotMeet Criteria ER/UC;;4
  1.  ;;168;;Disc Agrmt Pref Prov contract;;4
  1.  ;;21;;Chrgs Excd Max Allowable Amt;;4
  1.  ;;643;;Gramm-Rudman Reduction;;4
  1.  ;;644;;Prompt Pay Discount;;4
  1.  ;;645;;Chrgs Excd Contrct Fee Arrngmt;;4
  1.  ;;122;;Services Not Covered;;4
  1.  ;;648;;Proc Not Covered;;4
  1.  ;;20;;Non Cov Srv Routine Exam;;4
  1.  ;;169;;Non Cov Srv Not Medically Nec;;4
  1.  ;;19;;NonCov Srv Preexsting Cndition;;4
  1.  ;;178;;Prov Not Elig to Prov Serv Bil;;4
  1.  ;;653;;Serv by Mbr of Hshld Not Cover;;4
  1.  ;;654;;Mult Prov Not Cov in This Case;;4
  1.  ;;659;;Chrgs Adj Mult Surg Anesth Rul;;4
  1.  ;;660;;Chrgs Outpt Serv Not Covered;;4
  1.  ;;667;;Lifetime Reserve Days;;4
  1.  ;;669;;Day Outlier Amount;;4
  1.  ;;670;;Cost Outlr Adj to CompAdd Cost;;4
  1.  ;;165;;Primary Payer Amount;;4
  1.  ;;673;;Administrative Days;;4
  1.  ;;674;;Indirect Medical Educ Adj;;4
  1.  ;;675;;Direct Medical Educ Adj;;4
  1.  ;;676;;Disproportionate Share Adj;;4
  1.  ;;677;;Covered Days;;4
  1.  ;;678;;Non Covered Days/Room Chrg Adj;;4
  1.  ;;679;;Cost Report Days;;4
  1.  ;;680;;Outlier Days;;4
  1.  ;;681;;Discharges;;4
  1.  ;;682;;PIP Days;;4
  1.  ;;683;;Total Visits;;4
  1.  ;;684;;Capital Adjustment;;4
  1.  ;;685;;Interest Amount;;4
  1.  ;;686;;Statutory Adjustment;;4
  1.  ;;687;;Transfer Amount;;4
  1.  ;;689;;Pro Fees Removed From Charges;;4
  1.  ;;690;;Ingredient Cost Adj;;4
  1.  ;;695;;Ben Adj Plan Proc Not Followed;;4
  1.  ;;696;;Non-covered Charge(s);;4
  1.  ;;697;;Pymt IncludeAllow for Diff Srv;;4
  1.  ;;699;;MSP Adjustment Amount;;4
  1.  ;;23;;Pymt Made to Pt/Insrd/Rsp Prty;;4
  1.  ;;702;;Major Medical Adjustment;;4
  1.  ;;703;;Provider Promotional Discount;;4
  1.  ;;704;;Managed Care Withholding;;4
  1.  ;;705;;Tax Withholding;;4
  1.  ;;706;;Pt Pymt Optn/Elect Not inEffct;;4
  1.  ;;708;;Pymt Reduce-Guidelines Not Met;;4
  1.  ;;709;;Clm not Covered by Payer;;4
  1.  ;;711;;Not Cov Unlss Prov Acpts Asnmt;;4
  1.  ;;180;;Pymt Adj Not Furn or Prov toPT;;4
  1.  ;;713;;Pymt Den Srv Prov Outside US;;4
  1.  ;;714;;Proc/Src Not approved by FDA;;4
  1.  ;;715;;Pymt Adj Proc Postponed Cancel;;4
  1.  ;;716;;Pyt Den Adv Indmn Ntc NotCmply;;4
  1.  ;;717;;Pymt Adj Transp Covrd CloseFac;;4
  1.  ;;718;;Charges Redcd for ESRD Support;;4
  1.  ;;719;;Max Benefits for Time Period;;4
  1.  ;;720;;Pt Cov'd by Managed Care Plan;;4
  1.  ;;721;;Indemnification Adjustment;;4
  1.  ;;722;;Psychiatric Reduction;;4
  1.  ;;728;;NB Srvc Cov'd in Mothers Allow;;4
  1.  ;;164;;Pymt Den Prior Info Incorrect;;4
  1.  ;;730;;Claim Submission Fee;;4
  1.  ;;731;;Clm Specific Negotiated Disct;;4
  1.  ;;732;;Pre-Arranged Demo Proj Adj;;4
  1.  ;;734;;Tech Fees Removed From Charges;;4
  1.  ;;735;;Clm Den Intrm bill Cannot Proc;;4
  1.  ;;736;;Clm Adj Plan Proc Prior Payer;;4
  1.  ;;141;;Pymt/Red for Req charges/taxes;;4
  1.  ;;738;;Clm Den Appeal Proc Not Follow;;4
  1.  ;;739;;Contracted funding Agreement;;4
  1.  ;;125;;Clm Adj Spans Elig/Inelig Date;;4
  1.  ;;742;;Clm Adj Mnth Medcd Pt Liab Amt;;4
  1.  ;;744;;Incentive Adjustment;;4
  1.  ;;801;;Claim Denied Charges;;4
  1.  ;;802;;Contractual Adjustment;;4
  1.  ;;803;;MSP Liability Met;;4
  1.  ;;804;;Medicare Claim PPS Day Outlier;;4
  1.  ;;805;;Medicare Claim PPS CostOutlier;;4
  1.  ;;806;;PriorHosp 30day transf not met;;4
  1.  ;;807;;Presumptive pymt adjustment;;4
  1.  ;;808;;Clm Den Ungroupable DRG;;4
  1.  ;;851;;Non-Covered Visits;;4
  1.  ;;852;;Covered Visits;;4
  1.  ;;853;;Covered Charges;;4
  1.  ;;855;;Pymt Adj Guidelines Not Met;;4
  1.  ;;856;;Pymt Adj Due to Type of Prvder;;4
  1.  ;;857;;Prov Not Certified for Proc;;4
  1.  ;;858;;Clm Not Covd Altrnt Serv Avail;;4
  1.  ;;859;;Srvc Not Covd Pt Enrll Hospice;;4
  1.  ;;860;;Amt Reduced Portion of Proc pd;;4
  1.  ;;861;;Clm transfer to proper payer;;4
  1.  ;;864;;Pymt Den 1 Vt Per Prov Per Day;;4
  1.  ;;865;;Pymt Adj Proc Not Pd Separate;;4
  1.  ;;867;;Adj Not Prescr by MD,RX Incmpl;;4
  1.  ;;869;;Clm Adj Post Rev Org Finding;;4
  1.  ;;870;;PymtAdj Proc Prtly by DiffProv;;4
  1.  ;;871;;ChrgRdc Proc Prtly by DiffProv;;4
  1.  ;;915;;ClmLacks Indctn Srv Sprvs byMD;;4
  1.  ;;END