- IBINI04G ; ; 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,$J,355.1,30,0)
- ;;=MEDI-CAL^MCAL^6
- ;;^UTILITY(U,$J,355.1,30,10,0)
- ;;=^^1^1^2930604^
- ;;^UTILITY(U,$J,355.1,30,10,1,0)
- ;;=California's version of the nationwide program known as Medicaid.
- ;;^UTILITY(U,$J,355.1,32,0)
- ;;=MEDICAL EXPENSE INSURANCE^MEI^1
- ;;^UTILITY(U,$J,355.1,32,10,0)
- ;;=^^5^5^2940111^^
- ;;^UTILITY(U,$J,355.1,32,10,1,0)
- ;;=A form of health insurance that provides benefits for medical care
- ;;^UTILITY(U,$J,355.1,32,10,2,0)
- ;;=on an outpatient basis. The company may limit the amount it will
- ;;^UTILITY(U,$J,355.1,32,10,3,0)
- ;;=pay per call or the total amount for all calls. It may also exclude
- ;;^UTILITY(U,$J,355.1,32,10,4,0)
- ;;=the first few calls made by the physician at the beginning of an
- ;;^UTILITY(U,$J,355.1,32,10,5,0)
- ;;=illness.
- ;;^UTILITY(U,$J,355.1,33,0)
- ;;=MEDICARE (M)^MR^5
- ;;^UTILITY(U,$J,355.1,33,10,0)
- ;;=^^4^4^2930604^
- ;;^UTILITY(U,$J,355.1,33,10,1,0)
- ;;=The hospital insurance system and supplementary medical insurance for
- ;;^UTILITY(U,$J,355.1,33,10,2,0)
- ;;=the aged created by the 1965 Amendments to the Social Security Act
- ;;^UTILITY(U,$J,355.1,33,10,3,0)
- ;;=and operated under the provisions of the act. Benefits are also
- ;;^UTILITY(U,$J,355.1,33,10,4,0)
- ;;=extended to the totally disabled and the blind.
- ;;^UTILITY(U,$J,355.1,34,0)
- ;;=MEDICARE/MEDICAID (MEDI-CAL)^MM^5
- ;;^UTILITY(U,$J,355.1,34,10,0)
- ;;=^^2^2^2930604^
- ;;^UTILITY(U,$J,355.1,34,10,1,0)
- ;;=This program, also known as Medi-Medi, covers those persons
- ;;^UTILITY(U,$J,355.1,34,10,2,0)
- ;;=protected under both Medicare and Medicaid (or Medi-Cal).
- ;;^UTILITY(U,$J,355.1,35,0)
- ;;=MEDIGAP INSURANCE^MG^11
- ;;^UTILITY(U,$J,355.1,35,10,0)
- ;;=^^2^2^2931008^^^^
- ;;^UTILITY(U,$J,355.1,35,10,1,0)
- ;;=Supplemental insurance designed to fill in some, though never all,
- ;;^UTILITY(U,$J,355.1,35,10,2,0)
- ;;=of the gaps in Medicare's coverage. Also known as Medifill.
- ;;^UTILITY(U,$J,355.1,36,0)
- ;;=NO-FAULT INSURANCE^^1
- ;;^UTILITY(U,$J,355.1,36,10,0)
- ;;=^^4^4^2930604^
- ;;^UTILITY(U,$J,355.1,36,10,1,0)
- ;;=Automobile insurance that provides coverage against injury or other
- ;;^UTILITY(U,$J,355.1,36,10,2,0)
- ;;=loss without the need to determine responsibility for an accident.
- ;;^UTILITY(U,$J,355.1,36,10,3,0)
- ;;=Coverage and benefits vary widely; at present plans exist in many
- ;;^UTILITY(U,$J,355.1,36,10,4,0)
- ;;=states.
- ;;^UTILITY(U,$J,355.1,40,0)
- ;;=PREFERRED PROVIDER ORGANIZATION (PPO)^PPO^4
- ;;^UTILITY(U,$J,355.1,40,10,0)
- ;;=^^4^4^2930604^^
- ;;^UTILITY(U,$J,355.1,40,10,1,0)
- ;;=An entity that serves as a broker to contract for comprehensive
- ;;^UTILITY(U,$J,355.1,40,10,2,0)
- ;;=health care services, with both hospitals and physicians, on
- ;;^UTILITY(U,$J,355.1,40,10,3,0)
- ;;=behalf of an employer or other specific groups of patients,
- ;;^UTILITY(U,$J,355.1,40,10,4,0)
- ;;=at prearranged discounted rates or on a fee schedule.
- ;;^UTILITY(U,$J,355.1,41,0)
- ;;=PREPAID GROUP PRACTICE PLAN^PGPP^3
- ;;^UTILITY(U,$J,355.1,41,10,0)
- ;;=^^8^8^2930604^^
- ;;^UTILITY(U,$J,355.1,41,10,1,0)
- ;;=A plan under which specified health services are rendered by
- ;;^UTILITY(U,$J,355.1,41,10,2,0)
- ;;=participating physicians to an enrolled group of persons, with
- ;;^UTILITY(U,$J,355.1,41,10,3,0)
- ;;=fixed periodic payments made in advance, by or on behalf of
- ;;^UTILITY(U,$J,355.1,41,10,4,0)
- ;;=each person or family. If a health insurance carrier is
- ;;^UTILITY(U,$J,355.1,41,10,5,0)
- ;;=involved, it contracts to pay in advance for the full range
- ;;^UTILITY(U,$J,355.1,41,10,6,0)
- ;;=of health services to which the insured is entitled under
- IBINI04G ; ; 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,355.1,30,0)
- +2 ;;=MEDI-CAL^MCAL^6
- +3 ;;^UTILITY(U,$J,355.1,30,10,0)
- +4 ;;=^^1^1^2930604^
- +5 ;;^UTILITY(U,$J,355.1,30,10,1,0)
- +6 ;;=California's version of the nationwide program known as Medicaid.
- +7 ;;^UTILITY(U,$J,355.1,32,0)
- +8 ;;=MEDICAL EXPENSE INSURANCE^MEI^1
- +9 ;;^UTILITY(U,$J,355.1,32,10,0)
- +10 ;;=^^5^5^2940111^^
- +11 ;;^UTILITY(U,$J,355.1,32,10,1,0)
- +12 ;;=A form of health insurance that provides benefits for medical care
- +13 ;;^UTILITY(U,$J,355.1,32,10,2,0)
- +14 ;;=on an outpatient basis. The company may limit the amount it will
- +15 ;;^UTILITY(U,$J,355.1,32,10,3,0)
- +16 ;;=pay per call or the total amount for all calls. It may also exclude
- +17 ;;^UTILITY(U,$J,355.1,32,10,4,0)
- +18 ;;=the first few calls made by the physician at the beginning of an
- +19 ;;^UTILITY(U,$J,355.1,32,10,5,0)
- +20 ;;=illness.
- +21 ;;^UTILITY(U,$J,355.1,33,0)
- +22 ;;=MEDICARE (M)^MR^5
- +23 ;;^UTILITY(U,$J,355.1,33,10,0)
- +24 ;;=^^4^4^2930604^
- +25 ;;^UTILITY(U,$J,355.1,33,10,1,0)
- +26 ;;=The hospital insurance system and supplementary medical insurance for
- +27 ;;^UTILITY(U,$J,355.1,33,10,2,0)
- +28 ;;=the aged created by the 1965 Amendments to the Social Security Act
- +29 ;;^UTILITY(U,$J,355.1,33,10,3,0)
- +30 ;;=and operated under the provisions of the act. Benefits are also
- +31 ;;^UTILITY(U,$J,355.1,33,10,4,0)
- +32 ;;=extended to the totally disabled and the blind.
- +33 ;;^UTILITY(U,$J,355.1,34,0)
- +34 ;;=MEDICARE/MEDICAID (MEDI-CAL)^MM^5
- +35 ;;^UTILITY(U,$J,355.1,34,10,0)
- +36 ;;=^^2^2^2930604^
- +37 ;;^UTILITY(U,$J,355.1,34,10,1,0)
- +38 ;;=This program, also known as Medi-Medi, covers those persons
- +39 ;;^UTILITY(U,$J,355.1,34,10,2,0)
- +40 ;;=protected under both Medicare and Medicaid (or Medi-Cal).
- +41 ;;^UTILITY(U,$J,355.1,35,0)
- +42 ;;=MEDIGAP INSURANCE^MG^11
- +43 ;;^UTILITY(U,$J,355.1,35,10,0)
- +44 ;;=^^2^2^2931008^^^^
- +45 ;;^UTILITY(U,$J,355.1,35,10,1,0)
- +46 ;;=Supplemental insurance designed to fill in some, though never all,
- +47 ;;^UTILITY(U,$J,355.1,35,10,2,0)
- +48 ;;=of the gaps in Medicare's coverage. Also known as Medifill.
- +49 ;;^UTILITY(U,$J,355.1,36,0)
- +50 ;;=NO-FAULT INSURANCE^^1
- +51 ;;^UTILITY(U,$J,355.1,36,10,0)
- +52 ;;=^^4^4^2930604^
- +53 ;;^UTILITY(U,$J,355.1,36,10,1,0)
- +54 ;;=Automobile insurance that provides coverage against injury or other
- +55 ;;^UTILITY(U,$J,355.1,36,10,2,0)
- +56 ;;=loss without the need to determine responsibility for an accident.
- +57 ;;^UTILITY(U,$J,355.1,36,10,3,0)
- +58 ;;=Coverage and benefits vary widely; at present plans exist in many
- +59 ;;^UTILITY(U,$J,355.1,36,10,4,0)
- +60 ;;=states.
- +61 ;;^UTILITY(U,$J,355.1,40,0)
- +62 ;;=PREFERRED PROVIDER ORGANIZATION (PPO)^PPO^4
- +63 ;;^UTILITY(U,$J,355.1,40,10,0)
- +64 ;;=^^4^4^2930604^^
- +65 ;;^UTILITY(U,$J,355.1,40,10,1,0)
- +66 ;;=An entity that serves as a broker to contract for comprehensive
- +67 ;;^UTILITY(U,$J,355.1,40,10,2,0)
- +68 ;;=health care services, with both hospitals and physicians, on
- +69 ;;^UTILITY(U,$J,355.1,40,10,3,0)
- +70 ;;=behalf of an employer or other specific groups of patients,
- +71 ;;^UTILITY(U,$J,355.1,40,10,4,0)
- +72 ;;=at prearranged discounted rates or on a fee schedule.
- +73 ;;^UTILITY(U,$J,355.1,41,0)
- +74 ;;=PREPAID GROUP PRACTICE PLAN^PGPP^3
- +75 ;;^UTILITY(U,$J,355.1,41,10,0)
- +76 ;;=^^8^8^2930604^^
- +77 ;;^UTILITY(U,$J,355.1,41,10,1,0)
- +78 ;;=A plan under which specified health services are rendered by
- +79 ;;^UTILITY(U,$J,355.1,41,10,2,0)
- +80 ;;=participating physicians to an enrolled group of persons, with
- +81 ;;^UTILITY(U,$J,355.1,41,10,3,0)
- +82 ;;=fixed periodic payments made in advance, by or on behalf of
- +83 ;;^UTILITY(U,$J,355.1,41,10,4,0)
- +84 ;;=each person or family. If a health insurance carrier is
- +85 ;;^UTILITY(U,$J,355.1,41,10,5,0)
- +86 ;;=involved, it contracts to pay in advance for the full range
- +87 ;;^UTILITY(U,$J,355.1,41,10,6,0)
- +88 ;;=of health services to which the insured is entitled under
