Routine: IBINI04F

IBINI04F	; ; 21-MAR-1994

	;;Version 2.0 ; INTEGRATED BILLING ;; 21-MAR-94

	Q:'DIFQR(355.1)  F I=1:2 S X=$T(Q+I) Q:X=""  S Y=$E($T(Q+I+1),4,999),X=$E(X,4,999) S:$A(Y)=126 I=I+1,Y=$E(Y,2,999)_$E($T(Q+I+1),5,99) S:$A(Y)=61 Y=$E(Y,2,999) X NO E  S @X=Y

Q	Q

	;;^UTILITY(U,$J,355.1,18,10,5,0)

	;;=companies, or hospital-medical plans.

	;;^UTILITY(U,$J,355.1,20,0)

	;;=HOSPITAL EXPENSE INSURANCE^HEI^1

	;;^UTILITY(U,$J,355.1,20,10,0)

	;;=^^2^2^2930604^

	;;^UTILITY(U,$J,355.1,20,10,1,0)

	;;=Health insurance protection against the costs of hospital care

	;;^UTILITY(U,$J,355.1,20,10,2,0)

	;;=resulting from the illness or injury of an insured person.

	;;^UTILITY(U,$J,355.1,22,0)

	;;=INDIVIDUAL PRACTICE ASSOCATION (IPA)^IPA^1

	;;^UTILITY(U,$J,355.1,22,10,0)

	;;=^^3^3^2930604^

	;;^UTILITY(U,$J,355.1,22,10,1,0)

	;;=An organization in which a program administrator contracts with a

	;;^UTILITY(U,$J,355.1,22,10,2,0)

	;;=number of pysicians who agree to provide treatment to subscribers in

	;;^UTILITY(U,$J,355.1,22,10,3,0)

	;;=their own offices for a fixed capitation payment per month.

	;;^UTILITY(U,$J,355.1,24,0)

	;;=KEY-MAN HEALTH INSURANCE^KMHI^1

	;;^UTILITY(U,$J,355.1,24,10,0)

	;;=^^5^5^2930604^

	;;^UTILITY(U,$J,355.1,24,10,1,0)

	;;=An individual or group insurance policy designed to protect an essential

	;;^UTILITY(U,$J,355.1,24,10,2,0)

	;;=employee or employees of a firm against the loss of income resulting

	;;^UTILITY(U,$J,355.1,24,10,3,0)

	;;=from disability.  If desired, it may be written for the benefit of

	;;^UTILITY(U,$J,355.1,24,10,4,0)

	;;=the employer, who usually continues to pay the salary during periods

	;;^UTILITY(U,$J,355.1,24,10,5,0)

	;;=of disability.

	;;^UTILITY(U,$J,355.1,27,0)

	;;=MAJOR MEDICAL EXPENSE INSURANCE^MMEI^1

	;;^UTILITY(U,$J,355.1,27,10,0)

	;;=^^11^11^2930604^

	;;^UTILITY(U,$J,355.1,27,10,1,0)

	;;=Health insurance to finance the expense of major illnesses and

	;;^UTILITY(U,$J,355.1,27,10,2,0)

	;;=injuries.  Major medical policies usually include a deductible

	;;^UTILITY(U,$J,355.1,27,10,3,0)

	;;=clause, which means that the individual or another insurer

	;;^UTILITY(U,$J,355.1,27,10,4,0)

	;;=contributes toward the cost of the medical expenses.  The

	;;^UTILITY(U,$J,355.1,27,10,5,0)

	;;=larger the deductible, the greater the savings in premium cost.

	;;^UTILITY(U,$J,355.1,27,10,6,0)

	;;=Above this initial deductible, major medical insurance is

	;;^UTILITY(U,$J,355.1,27,10,7,0)

	;;=characterized by large benefit maximums, ranging up to $25,000

	;;^UTILITY(U,$J,355.1,27,10,8,0)

	;;=or even beyond.  The holder is reimbursed for the major part

	;;^UTILITY(U,$J,355.1,27,10,9,0)

	;;=of all charges for the hospital, the doctor, private nurse, medical

	;;^UTILITY(U,$J,355.1,27,10,10,0)

	;;=appliances, and prescribed out-of-hospital treatment, drugs, and

	;;^UTILITY(U,$J,355.1,27,10,11,0)

	;;=medicines.

	;;^UTILITY(U,$J,355.1,28,0)

	;;=MANAGED CARE SYSTEM (MCS)^MCS^1

	;;^UTILITY(U,$J,355.1,28,10,0)

	;;=^^4^4^2930604^

	;;^UTILITY(U,$J,355.1,28,10,1,0)

	;;=A self-administered, self-insured program that is an agreement

	;;^UTILITY(U,$J,355.1,28,10,2,0)

	;;=between the employer and the employee.  The employee may choose

	;;^UTILITY(U,$J,355.1,28,10,3,0)

	;;=the provider.  Once a procedure or service has been approved,

	;;^UTILITY(U,$J,355.1,28,10,4,0)

	;;=the physician is free to charge his or her regular fee.

	;;^UTILITY(U,$J,355.1,29,0)

	;;=MEDICAID^MD^6

	;;^UTILITY(U,$J,355.1,29,10,0)

	;;=^^3^3^2930604^

	;;^UTILITY(U,$J,355.1,29,10,1,0)

	;;=A plan sponsored jointly by the federal and state governments for

	;;^UTILITY(U,$J,355.1,29,10,2,0)

	;;=people eligible for public assistance and some other low-income

	;;^UTILITY(U,$J,355.1,29,10,3,0)

	;;=people.  Coverage and benefits vary widely from state to state.

IBINI04F  ; ; 21-MAR-1994

 +1       ;;Version 2.0 ; INTEGRATED BILLING ;; 21-MAR-94

 +2        IF 'DIFQR(355.1)

               QUIT

           FOR I=1:2

               SET X=$TEXT(Q+I)

               IF X=""

                   QUIT

               SET Y=$EXTRACT($TEXT(Q+I+1),4,999)

               SET X=$EXTRACT(X,4,999)

               IF $ASCII(Y)=126

                   SET I=I+1

                   SET Y=$EXTRACT(Y,2,999)_$EXTRACT($TEXT(Q+I+1),5,99)

               IF $ASCII(Y)=61

                   SET Y=$EXTRACT(Y,2,999)

               XECUTE NO

              IF '$TEST

                   SET @X=Y

Q          QUIT

 +1       ;;^UTILITY(U,$J,355.1,18,10,5,0)

 +2       ;;=companies, or hospital-medical plans.

 +3       ;;^UTILITY(U,$J,355.1,20,0)

 +4       ;;=HOSPITAL EXPENSE INSURANCE^HEI^1

 +5       ;;^UTILITY(U,$J,355.1,20,10,0)

 +6       ;;=^^2^2^2930604^

 +7       ;;^UTILITY(U,$J,355.1,20,10,1,0)

 +8       ;;=Health insurance protection against the costs of hospital care

 +9       ;;^UTILITY(U,$J,355.1,20,10,2,0)

 +10      ;;=resulting from the illness or injury of an insured person.

 +11      ;;^UTILITY(U,$J,355.1,22,0)

 +12      ;;=INDIVIDUAL PRACTICE ASSOCATION (IPA)^IPA^1

 +13      ;;^UTILITY(U,$J,355.1,22,10,0)

 +14      ;;=^^3^3^2930604^

 +15      ;;^UTILITY(U,$J,355.1,22,10,1,0)

 +16      ;;=An organization in which a program administrator contracts with a

 +17      ;;^UTILITY(U,$J,355.1,22,10,2,0)

 +18      ;;=number of pysicians who agree to provide treatment to subscribers in

 +19      ;;^UTILITY(U,$J,355.1,22,10,3,0)

 +20      ;;=their own offices for a fixed capitation payment per month.

 +21      ;;^UTILITY(U,$J,355.1,24,0)

 +22      ;;=KEY-MAN HEALTH INSURANCE^KMHI^1

 +23      ;;^UTILITY(U,$J,355.1,24,10,0)

 +24      ;;=^^5^5^2930604^

 +25      ;;^UTILITY(U,$J,355.1,24,10,1,0)

 +26      ;;=An individual or group insurance policy designed to protect an essential

 +27      ;;^UTILITY(U,$J,355.1,24,10,2,0)

 +28      ;;=employee or employees of a firm against the loss of income resulting

 +29      ;;^UTILITY(U,$J,355.1,24,10,3,0)

 +30      ;;=from disability.  If desired, it may be written for the benefit of

 +31      ;;^UTILITY(U,$J,355.1,24,10,4,0)

 +32      ;;=the employer, who usually continues to pay the salary during periods

 +33      ;;^UTILITY(U,$J,355.1,24,10,5,0)

 +34      ;;=of disability.

 +35      ;;^UTILITY(U,$J,355.1,27,0)

 +36      ;;=MAJOR MEDICAL EXPENSE INSURANCE^MMEI^1

 +37      ;;^UTILITY(U,$J,355.1,27,10,0)

 +38      ;;=^^11^11^2930604^

 +39      ;;^UTILITY(U,$J,355.1,27,10,1,0)

 +40      ;;=Health insurance to finance the expense of major illnesses and

 +41      ;;^UTILITY(U,$J,355.1,27,10,2,0)

 +42      ;;=injuries.  Major medical policies usually include a deductible

 +43      ;;^UTILITY(U,$J,355.1,27,10,3,0)

 +44      ;;=clause, which means that the individual or another insurer

 +45      ;;^UTILITY(U,$J,355.1,27,10,4,0)

 +46      ;;=contributes toward the cost of the medical expenses.  The

 +47      ;;^UTILITY(U,$J,355.1,27,10,5,0)

 +48      ;;=larger the deductible, the greater the savings in premium cost.

 +49      ;;^UTILITY(U,$J,355.1,27,10,6,0)

 +50      ;;=Above this initial deductible, major medical insurance is

 +51      ;;^UTILITY(U,$J,355.1,27,10,7,0)

 +52      ;;=characterized by large benefit maximums, ranging up to $25,000

 +53      ;;^UTILITY(U,$J,355.1,27,10,8,0)

 +54      ;;=or even beyond.  The holder is reimbursed for the major part

 +55      ;;^UTILITY(U,$J,355.1,27,10,9,0)

 +56      ;;=of all charges for the hospital, the doctor, private nurse, medical

 +57      ;;^UTILITY(U,$J,355.1,27,10,10,0)

 +58      ;;=appliances, and prescribed out-of-hospital treatment, drugs, and

 +59      ;;^UTILITY(U,$J,355.1,27,10,11,0)

 +60      ;;=medicines.

 +61      ;;^UTILITY(U,$J,355.1,28,0)

 +62      ;;=MANAGED CARE SYSTEM (MCS)^MCS^1

 +63      ;;^UTILITY(U,$J,355.1,28,10,0)

 +64      ;;=^^4^4^2930604^

 +65      ;;^UTILITY(U,$J,355.1,28,10,1,0)

 +66      ;;=A self-administered, self-insured program that is an agreement

 +67      ;;^UTILITY(U,$J,355.1,28,10,2,0)

 +68      ;;=between the employer and the employee.  The employee may choose

 +69      ;;^UTILITY(U,$J,355.1,28,10,3,0)

 +70      ;;=the provider.  Once a procedure or service has been approved,

 +71      ;;^UTILITY(U,$J,355.1,28,10,4,0)

 +72      ;;=the physician is free to charge his or her regular fee.

 +73      ;;^UTILITY(U,$J,355.1,29,0)

 +74      ;;=MEDICAID^MD^6

 +75      ;;^UTILITY(U,$J,355.1,29,10,0)

 +76      ;;=^^3^3^2930604^

 +77      ;;^UTILITY(U,$J,355.1,29,10,1,0)

 +78      ;;=A plan sponsored jointly by the federal and state governments for

 +79      ;;^UTILITY(U,$J,355.1,29,10,2,0)

 +80      ;;=people eligible for public assistance and some other low-income

 +81      ;;^UTILITY(U,$J,355.1,29,10,3,0)

 +82      ;;=people.  Coverage and benefits vary widely from state to state.

IBINI04F.m