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Global: ^ABMNINS(2906

Package: Third Party Billing

Global: ^ABMNINS(2906


Information

FileMan FileNo FileMan Filename Package
9002274.09 3P INSURER Third Party Billing

Description

Pointed To By FileMan Files, Total: 1

Package Total FileMan Files
Third Party Billing 1 3P INSURER(#9002274.09)[#9002274.09112(.03)]    

Pointer To FileMan Files, Total: 13

Package Total FileMan Files
Third Party Billing 6 3P CODES(#9002274.03)[#9002274.091(.11)]    3P EXPORT MODE(#9002274.08)[#9002274.091(.04), #9002274.092(.02), #9002274.0925(.02)]
3P FEE TABLE(#9002274.01)[#9002274.091(.05), #9002274.915(.01)]    3P VISIT TYPE(#9002274.8)[#9002274.091(.01), #9002274.09112(.04), #9002274.092(.045), #9002274.092(.06), #9002274.0925(.06)]    3P INSURER(#9002274.09)[#9002274.09112(.03)]    3P EMC REFERENCE ID(#9002274.11)[#9002274.091(101)]    
Kernel 3 INSTITUTION(#4)[#9002274.091(18)]    STATE(#5)[#9002274.09351(.02)]    NEW PERSON(#200)[#9002274.093(.01), #9002274.09351(.01), #9002274.096(.06), #9002274.096(.08), #9002274.097(.02), #9002274.915(.03)]    
Utility Tables 3 INSURER(#9999999.18)[.01]    PROVIDER CHANGE REASON(#9999999.93)[#9002274.091(.21)]    REVENUE CODES(#9999999.72)[#9002274.091(.03)]    
CPT Files 1 CPT(#81)[#9002274.0905(.01), #9002274.091(.16), #9002274.094(.01)]

Fields, Total: 22

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

  • INPUT TRANSFORM:  S DINUM=X Q
  • LAST EDITED:  OCT 03, 1995
  • NOTES:  XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
  • CROSS-REFERENCE:  9002274.09^B
    1)= S ^ABMNINS(DUZ(2),"B",$E(X,1,30),DA)=""
    2)= K ^ABMNINS(DUZ(2),"B",$E(X,1,30),DA)
.02 EMC SUBMITTER ID 0;2 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>15!($L(X)<1) X
  • LAST EDITED:  JUL 15, 2010
  • HELP-PROMPT:  1-15 characters. Will populate ISA06 of 837 if the Visit Type EMC SUBMITTER ID isn't populated. If both EMC SUB IDs are blank, the Location Federal Tax No is used..
  • DESCRIPTION:  
    1-15 characters.  Will populate ISA06 of 837.  This is used if the EMC SUBMITTER ID for the Visit Type isn't populated.  If both EMC SUBMITTER IDs are blank, the Location Federal Tax No. will be used.
.03 EMC PASSWORD 0;3 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>10!($L(X)<1) X
  • LAST EDITED:  DEC 21, 2005
  • HELP-PROMPT:  Answer must be 1-10 characters in length.
.04 EMC TEST INDICATOR 0;4 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>1!($L(X)<1) X
  • LAST EDITED:  MAR 17, 1997
  • HELP-PROMPT:  1 character, usually 'T' if test mode.
.05 USE PLAN NAME? 0;5 SET
  • '1' FOR YES;
  • '0' FOR NO;

  • LAST EDITED:  NOV 17, 1997
.06 GROUP NUMBER 0;6 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>10!($L(X)<1) X
  • LAST EDITED:  JUL 20, 2001
  • HELP-PROMPT:  Answer must be 1-10 characters in length.
.07 AUTO SEND? 0;7 SET
  • '1' FOR YES;
  • '0' FOR NO;

  • LAST EDITED:  MAR 05, 2003
.0872 HOUR RULE 0;8 SET
  • '0' FOR NO;
  • '1' FOR YES;

  • LAST EDITED:  APR 28, 2003
.09 NPI USAGE 0;9 SET
  • 'N' FOR NPI ONLY;
  • 'B' FOR NPI & LEGACY;
  • 'L' FOR LEGACY ONLY;

  • LAST EDITED:  JAN 16, 2007
.11 TRIBAL SELF-INSURED? 0;11 SET
  • 'Y' FOR YES, TRIBAL SELF-INSURED;
  • 'N' FOR NO, NOT TRIBAL SELF-INSURED;

  • LAST EDITED:  MAY 14, 2008
.12 ICD-10 EFFECTIVE DATE 0;12 DATE
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:X<1 X
  • LAST EDITED:  MAR 27, 2012
  • HELP-PROMPT:  Any DOS prior to this date for this insurer will require ICD9 codes. After this date, ICD10 codes
.13 DECIMAL IN 1500 BOX 21 (DX) 0;13 SET
  • 'Y' FOR YES, PRINT DECIMAL;
  • 'N' FOR NO, NO DECIMAL;

  • LAST EDITED:  FEB 28, 2014
  • HELP-PROMPT:  NO will remove the decimal from box 21 on the 1500 (02/12) format
.14 ALL INCLUSIVE PRINT NDC 0;14 SET
  • 'Y' FOR YES;

  • LAST EDITED:  JUL 11, 2017
  • HELP-PROMPT:  WHEN ALL INCLUSIVE MODE IS SELECTED SHOULD THE NDC PRINT ON THE PAPER CLAIM FORM
1 VISIT TYPE 1;0 POINTER Multiple #9002274.091 9002274.091
2 FORM LOCATOR OVERRIDE 2;0 Multiple #9002274.092 9002274.092
2.5837 SEGMENT OVERRIDE 2.5;0 Multiple #9002274.0925 9002274.0925
3 PROVIDER 3;0 POINTER Multiple #9002274.093 9002274.093
3.5837 PROV QUALIFIER/NUMBERS 3.5;0 SET Multiple #9002274.0935 9002274.0935
4 LAB CPT/HCPCS REQ'ING RESULTS 4;0 POINTER Multiple #9002274.094 9002274.094
5 CPTS REQ'ING NARRATIVE 5;0 POINTER Multiple #9002274.0905 9002274.0905
6 SPLIT PAGE(S) 6;0 SET Multiple #9002274.096 9002274.096
7 AUTO-SPLIT CLAIM RUNS 7;0 DATE Multiple #9002274.097 9002274.097

  • TECHNICAL DESCR:  
    This multiple gets populated in the STIN option that allows the user to split claims.  This multiple is a 'log' of the runs done so if needed we can go back and see who ran what.
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