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Sub-Field: 9000006.11

Package: IHS Patient

PRIVATE INSURANCE ELIGIBLE(#9000006)-->9000006.11

Sub-Field: 9000006.11


Information

Parent File Name Number Package
PRIVATE INSURANCE ELIGIBLE(#9000006) INSURER 9000006.11 IHS Patient

Details

Field # Name Loc Type Details
.01 INSURER 0;1 POINTER TO INSURER FILE (#9999999.18)
************************REQUIRED FIELD************************
INSURER(#9999999.18)

  • INPUT TRANSFORM:  S DIC("S")="I (($P(^(0),U,1)'=""MEDICARE"")&($P(^(0),U,1)'=""MEDICAID"")&($P(^(0),U,1)'=""RAILROAD RETIREMENT""))" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X
  • LAST EDITED:  MAR 26, 2004
  • HELP-PROMPT:  ENTER PRIVATE INSURANCE COMPANY NAME.
  • DESCRIPTION:  
    This field is a pointer to the INSURER file.  MEDICARE, MEDICAID, and RAILROAD RETIREMENT are not allowed in this file because they are pointed to from files created especially for them.
  • SCREEN:  S DIC("S")="I '(($P(^(0),U,1)=""MEDICARE"")!($P(^(0),U,1)=""MEDICAID"")!($P(^(0),U,1)=""RAILROAD RETIREMENT""))"
  • EXPLANATION:  MEDICARE, MEDICAID, and RAILROAD RETIREMENT not allowed.
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
  • CROSS-REFERENCE:  9000006.11^B
    1)= S ^AUPNPRVT(DA(1),11,"B",$E(X,1,30),DA)=""
    2)= K ^AUPNPRVT(DA(1),11,"B",$E(X,1,30),DA)
  • CROSS-REFERENCE:  9000006^I
    1)= S ^AUPNPRVT("I",$E(X,1,30),DA(1),DA)=""
    2)= K ^AUPNPRVT("I",$E(X,1,30),DA(1),DA)
  • CROSS-REFERENCE:  9000006.11^AC^MUMPS
    1)= D UPDATE1^AGED(DUZ(2),DA(1),7,DA) ;set ZMFI pg7
    2)= Q
    This sets agpatch(,,,zmfi,7)=sub ien
  • CROSS-REFERENCE:  9000006.11^AAVABDW47^MUMPS
    1)= D SET^AUPNDWXR(DA(1),"ELIG")
    2)= D KILL^AUPNDWXR(DA(1),"ELIG")
    Populates AUPNDWAF for the Data Warehouse export.  See routine AUPNDWXR for documentation.
.02 *POLICY NUMBER 0;2 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>30!($L(X)<6) X
  • LAST EDITED:  FEB 26, 2003
  • HELP-PROMPT:  ANSWER MUST BE 6-30 CHARACTERS IN LENGTH
.03 *COVERAGE 0;3 POINTER TO COVERAGE TYPE FILE (#9999999.65) COVERAGE TYPE(#9999999.65)

  • LAST EDITED:  MAY 21, 1991
.04 *NAME OF INSURED 0;4 FREE TEXT

  • INPUT TRANSFORM:  D NAME^AUPNPED
  • LAST EDITED:  MAY 21, 1991
  • HELP-PROMPT:  ENTER INSURED'S NAME (EXAMPLE: MORGAN,JOHN LEE (no space after comma))
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
.05 RELATIONSHIP 0;5 POINTER TO RELATIONSHIP FILE (#9999999.36) RELATIONSHIP(#9999999.36)

  • INPUT TRANSFORM:  S DIC("S")="I $P(^(0),U,2)]""""" D ^DIC K DIC S DIC=DIE,X=+Y K:Y<0 X
  • LAST EDITED:  MAR 26, 2004
  • HELP-PROMPT:  ENTER RELATIONSHIP IN NARRATIVE FORM SUCH AS SPOUSE, SON, ETC. ENTRY MUST BE 3-15 CHARACTERS IN LENGTH.
  • SCREEN:  S DIC("S")="I $P(^(0),U,2)]"""""
  • EXPLANATION:  Standard Billing Form Relationships Only
  • CROSS-REFERENCE:  9000006.11^AD^MUMPS
    1)= D UPDATE1^AGED(DUZ(2),DA(1),7,DA)
    2)= Q
    Sets AGPATCH(,,,zmfi,7)=sub ien
  • CROSS-REFERENCE:  9000006.11^AAVABDW48^MUMPS
    1)= D SET^AUPNDWXR(DA(1),"ELIG")
    2)= D KILL^AUPNDWXR(DA(1),"ELIG")
    Populates AUPNDWAF for the Data Warehouse export.  See routine AUPNDWXR for documentation.
.06 ELIG. DATE 0;6 DATE

  • INPUT TRANSFORM:  S %DT="E" D ^%DT S X=Y K:DT+20000X) X
  • LAST EDITED:  MAR 26, 2004
  • HELP-PROMPT:  Type a date between 1960 and two years from today.
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
  • CROSS-REFERENCE:  9000006^AC^MUMPS
    1)= D PI^AUPNLBCK
    2)= Q
  • CROSS-REFERENCE:  9000006.11^AE^MUMPS
    1)= D UPDATE1^AGED($G(DUZ(2)),DA(1),7,DA)
    2)= Q
    SETS ^AGPATCH(,,,ZMFI,7)=SUB IEN
  • CROSS-REFERENCE:  9000006.11^AAVABDW49^MUMPS
    1)= D SET^AUPNDWXR(DA(1),"ELIG")
    2)= D KILL^AUPNDWXR(DA(1),"ELIG")
    Populates AUPNDWAF for the Data Warehouse export.  See routine AUPNDWXR for documentation.
.07 ELIG. END DATE 0;7 DATE

  • INPUT TRANSFORM:  S %DT="E" D ^%DT S X=Y K:DT+20000X) X I $D(X) K:X<$P(^AUPNPRVT(DA(1),11,DA,0),U,6) X
  • LAST EDITED:  MAR 26, 2004
  • HELP-PROMPT:  Type a date between 1960 and two years from today which is greater than the Elig start date.
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
  • CROSS-REFERENCE:  9000006.11^AF^MUMPS
    1)= D UPDATE1^AGED($G(DUZ(2)),DA(1),7,DA)
    2)= Q
    SETS ^AGPATCH(,,,ZMFI,7)=SUB IEN
  • CROSS-REFERENCE:  9000006.11^AAVABDW50^MUMPS
    1)= D SET^AUPNDWXR(DA(1),"ELIG")
    2)= D KILL^AUPNDWXR(DA(1),"ELIG")
    Populates AUPNDWAF for the Data Warehouse export.  See routine AUPNDWXR for documentation.
.08 POLICY HOLDER 0;8 POINTER TO POLICY HOLDER FILE (#9000003.1) POLICY HOLDER(#9000003.1)

  • LAST EDITED:  MAR 26, 2004
  • CROSS-REFERENCE:  9000006^C
    1)= S ^AUPNPRVT("C",$E(X,1,30),DA(1),DA)=""
    2)= K ^AUPNPRVT("C",$E(X,1,30),DA(1),DA)
  • CROSS-REFERENCE:  9000006.11^AG^MUMPS
    1)= D UPDATE1^AGED($G(DUZ(2)),DA(1),7,DA)
    2)= Q
    SETS ^AGPATCH(,,,ZMFI,7)=SUB IEN
  • CROSS-REFERENCE:  9000006.11^AAVABDW51^MUMPS
    1)= D SET^AUPNDWXR(DA(1),"ELIG")
    2)= D KILL^AUPNDWXR(DA(1),"ELIG")
    Populates AUPNDWAF for the Data Warehouse export.  See routine AUPNDWXR for documentation.
.09 VERIFIED COVERAGE DATE 0;9 DATE

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  MAR 29, 2010
  • CROSS-REFERENCE:  ^^TRIGGER^9000006.11^.11
    1)= K DIV S DIV=X,D0=DA(1),DIV(0)=D0,D1=DA,DIV(1)=D1 S Y(1)=$S($D(^AUPNPRVT(D0,11,D1,0)):^(0),1:"") S X=$P(Y(1),U,11),X=X S DIU=X K Y S X=DIV S X=DUZ X ^DD(9000006.11,.09,1,1,1.4)
    1.4)= S DIH=$S($D(^AUPNPRVT(DIV(0),11,DIV(1),0)):^(0),1:""),DIV=X S $P(^(0),U,11)=DIV,DIH=9000006.11,DIG=.11 D ^DICR:$O(^DD(DIH,DIG,1,0))>0
    2)= K DIV S DIV=X,D0=DA(1),DIV(0)=D0,D1=DA,DIV(1)=D1 S Y(1)=$S($D(^AUPNPRVT(D0,11,D1,0)):^(0),1:"") S X=$P(Y(1),U,11),X=X S DIU=X K Y S X=DIV S X=DUZ X ^DD(9000006.11,.09,1,1,2.4)
    2.4)= S DIH=$S($D(^AUPNPRVT(DIV(0),11,DIV(1),0)):^(0),1:""),DIV=X S $P(^(0),U,11)=DIV,DIH=9000006.11,DIG=.11 D ^DICR:$O(^DD(DIH,DIG,1,0))>0
    CREATE VALUE)= S X=DUZ
    DELETE VALUE)= S X=DUZ
    FIELD)= #.11
  • CROSS-REFERENCE:  9000006^AVCD
    1)= S ^AUPNPRVT("AVCD",$E(X,1,30),DA(1),DA)=""
    2)= K ^AUPNPRVT("AVCD",$E(X,1,30),DA(1),DA)
.11 VERIFIED BY 0;11 POINTER TO NEW PERSON FILE (#200) NEW PERSON(#200)

  • LAST EDITED:  OCT 25, 1995
    WRITE AUTHORITY:  ^
  • NOTES:  TRIGGERED by the VERIFIED COVERAGE DATE field of the INSURER sub-field of the PRIVATE INSURANCE ELIGIBLE File
.12 PERSON CODE 0;12 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>10!($L(X)<2) X
  • LAST EDITED:  JAN 29, 2001
  • HELP-PROMPT:  Answer must be 2-10 characters in length.
.14 PRIMARY CARE PROVIDER 0;14 FREE TEXT

  • INPUT TRANSFORM:  D NAME^AUPNPED
  • LAST EDITED:  JUN 20, 2002
  • HELP-PROMPT:  Not a required field. Enter the name of the primary care provider for this patient's plan. Usually required for HMO/Managed Care plans.
  • TECHNICAL DESCR:  
    Created 6/7/2002 for V7.0 of AG Distributed in AUPN*99.1*8
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
.15 PI CARD COPY ON FILE 0;15 SET
  • 'Y' FOR YES;
  • 'N' FOR NO;

  • LAST EDITED:  JUN 20, 2002
  • HELP-PROMPT:  Type in YES or NO to indicate if the patient's Private Insurance card copy was obtained and placed into the chart
  • TECHNICAL DESCR:  
    Created 6/7/2002 for V7.0 of AG Distributed in AUPN*99.1*8
.16 DATE PI CC WAS OBTAINED 0;16 DATE

  • INPUT TRANSFORM:  S %DT="E" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  JUN 20, 2002
  • HELP-PROMPT:  Enter the date the Private Insurance card was placed into patient's chart
  • TECHNICAL DESCR:  
    Created 6/7/2002 for V7.0 of AG Distributed in AUPN*99.1*8
21 MEMBER NUMBER 2;1 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>20!($L(X)<1) X
  • LAST EDITED:  APR 29, 2005
  • HELP-PROMPT:  Answer must be 1-20 characters in length
  • TECHNICAL DESCR:  
    Created 7/29/02 for V7.0 of AG Distributed in AUPN*99.1*8
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