Global: ^IBE(350.9

You may only have one site parameter entry.  Its internal number must be 1 and its name must be the same.

1)= S ^IBE(350.9,"B",$E(X,1,30),DA)=""

2)= K ^IBE(350.9,"B",$E(X,1,30),DA)

This is the name of your facility from the institution file.  There must be a station number associated with this entry.  This value will be used by IFCAP in determining the bill number.

with running the filer in the foreground (answer 'NO') or filing in the background.  For Pharmacy Co-Pay, it is expected that some sites will experience significant delays in Outpatient Pharmacy label printing if filing is

not done in the background.

If this field contains a date/time and the field FILE IN BACKGROUND is answered 'YES' then it is assumed that an IBE Filer is running.  Use the option 'Start the Integrated Billing Background Filer' to start a new filer if

needed.  This field is updated by the IBE Filer and should not be edited with FileMan.

This field is updated by the IBE Filer.  It should not be edited with FileMan.

This field is updated by the IBE Filer and should not be edited with FileMan.

This is the UCI and Volume set that you want the IBE Filer to run on.  Vax sites should leave this blank.  It is recommended that the filer run on the volume set that contains either the IB globals or the PRC globals.

The default value for this field is 2 if left blank.

This is the mail group that will receive mail bulletins from the IBE filer when an unsuccessful attempt to file is detected.  Remember to add users to it.

This field will be set to 'YES' when a file job is queued and set back to 'NO' when the queued job is started.  It will be used to prevent queueing two or more jobs before the first job starts.

Members of this mail group will receive bulletins when Means Test/Category C billing processing errors have been encountered, and when movements and Means Tests for Category C patients have been edited or deleted.

This field represents the earliest date for which the Hospital ($10) or Nursing Home ($5) Per Diem charge may be billed to a Category C patient.  This billing is mandated by Public Law 101-508, which was implemented on

November 5, 1990.

Please note that the Per Diem billing will not occur if this field is null.

This mail group will be sent the copay exemption bulletins and error messages.

the Medication Copayment Exemption functionality.  If this is a desirable feature it may be expanded in the future.

If this field is unanswered, the default is No and IB will use bulletins.

The node ^DD(200,0,"VR") is checked for version number.  If the value of this node is less than 7 then the user will not be able to turn this feature on.

parameter should be answered 'Yes'.

This is the name of the signer of third party bills and will be printed on the claim form in the signature block.

This is the title of the person signing the claim form as it will appear on the bill.

parameter is used to determine if the same person who Reviewed the bill can Authorize the bill.  If the paramater CAN INITIATOR REVIEW? and this parameter, CAN REVIEWER AUTHORIZE?, are both answered "YES" then the same

individual can perform all 4 parts of the billing process.  If either parameter is answered 'NO' then more than one person must be involved in each bill.

This field should be deleted in the next release of IB after v2.0.

Enter any remarks that need to appear on every UB claim form.  This remark will print in the remarks section of every UB-82 and UB-92.

This is your facility federal tax number.  If unknown, this may be obtained from your Fiscal Service.

This is not editable from the billing screens.  Printed in Form Locator 6 of the UB-82 and in Form Locator 5 of the UB-92.

This is the BC/BS Provider Number which Blue Cross has assigned your facility.

This is the mail group that will recieve automatic notification every time a third party bill is cancelled.  This must be answered for the automatic notification to occur.

This is the pointer to the PERSON file for the Billing Supervisor.

member and then specify the group here.  The members of this mail group will then recieve the disapproval bulletin.

The revenue code '001', TOTAL CHARGES, may be printed on each bill with the total charges if this parameter is set to 'YES'.

parameter is used to determine if the same person who Reviewed the bill can Authorize the bill.  If the paramater CAN REVIEWER AUTHORIZE? and this parameter, CAN INITIATOR REVIEW?, are both answered "YES" then the same

individual can perform all 4 parts of the billing process.  If either parameter is answered "NO" then more than one person must be involved in each bill.

This field should be deleted in the next release of IB after v2.0.

Accounts Receivable requires that every bill be associated with a SERVICE/SECTION.  This is the Service that will be identified with bills sent to Accounts Receivable from the Integrated Billing Module.

parameter only affects inpatient bills.

When creating a new bill on a Veteran with unverified eligibility the user may be asked if they would like to put a HINQ request in the HINQ SUSPENSE file if this parameter is answered 'YES'.

of the bill if the parameter is set to 'YES'.  This display screen will prompt the user if they would like to easily import any or all of the CPT codes into the bill.  This will include both Ambulatory Procedures and the

Billable Ambulatory Surgical Codes.

in the Insurance Company file may be entered and it will be used for that particular insurance company entry.

way sharing of information between these two files.  If this parameter is answered 'YES' then as CPT procedures are entered in a bill that are also Ambulatory Procedures, then the user will be prompted as to whether they

should be transfered to the Scheduling Visits file also.  The reverse of this is the parameter USE OP CPT SCREEN? which allows importing of Ambulatory Procedures into a bill.

Only CPT procedures that are either Billable Ambulatory Surgical Codes or either Nationally or Locally active Ambulatory Procedures may be transfered.

disposition from the Insurance Company.

forms and the HCFA 1500 then this should be answered 'YES'.  If your site is only using the UB forms (UB-82 and/or UB-92) then answer 'NO'.  If this is set to 'NO' or left blank then only the UB type claim forms will be

allowed.

Authorize the Bill.  If this is answered no then another user who holds the IB AUTHORIZE key will have to authorize the bill.

This date will be stored automatically in the file.

If this field is null then BASC rates will not automatically calculate.

This field will be used as the default answer to the division question when entering Billable Ambulatory Surgeries into a bill.

other UB form defined as it's form type.

on the UB-82 must then be printed on the UB-92.

This is the column that the mailing address will begin printing on row 1 of the HCFA 1500 form.

type of envelope they use.  The first 5 rows are the only blank space on the form available for the mailing address.

an insurance company, if one exists.

If entered, this diagnosis will be automatically added to every bill that has prescription refills.

Should probably be a genaric code like V68.1 ISSUE REPEAT PRESCRIPT.

If entered, this procedure will automatically be added to every bill that has a prescription refill.

Should probably be a genaric code like 99070 SPECIAL SUPPLIES.

Please note that on the UB-92 the Mailing Address block (FL 38) has a maximum width of 40 characters.  The number entered here will cause the address be moved to the right and therefore the allowable width of the mailing

address will be reduced.

This is the facility mail routing symbol for the Agent Cashier.  This may begin with 04 (for Fiscal Service) at most facilities.

This is the street address that checks should be mailed to.  This will appear on the on all claim forms as the billing address.

This is the City for the Agent Cashier.  This will be part of the address that Checks are mailed to and will appear on the claim forms.

This is the state for the Agent Cashier.  This will be the State part of the address that checks are mailed to as it appears on the claim forms.

Enter the zip code for the Agent Cashier.  This will be the zip code that checks will be mailed to as it should appear on the claim forms.

This is the phone number for the agent cashier.

MAS" will be transmitted to Fiscal Service if no remark is entered in this field.  The site may enter any remark which is meaningful to MAS and Fiscal.

This field is updated during the IB v1.5 post init.  The value of this field designates the last day through which Means Test charges will be created during the conversion.

Please note that this field has been starred for deletion in IB v2.0.  This field will be deleted in the version of IB which follows v2.0.

This field is updated during the IB v1.5 post init.  The value of this field is used by the conversion when creating Hospital/NHCU per diem charges.  If a patient owes the per diem on this date, and has accumulated other

charges prior to this date, a charge is filed for all previous charges up through the date.  The intent of "splitting" charges in this manner is to allow facilities to select a "final" date through which Means Test billing

will have been completed manually so that charges created by the conversion may easily be passed to the Accounts Receivable package (and thus billed to the patient).

Please note that this field has been starred for deletion in IB v2.0.  This field will be deleted in the version of IB which follows v2.0.

This is the number of times the Medication Copayment Exemption Conversion has been started.  It is used to tell if the conversion has been restarted.

cause an orderly shut down on the completion of a single patient.  After the conversion shuts down, the value of this field should be returned to its original value.

If a second conversion is started this field will be updated causing the first conversion to stop.  At that point it is possible that a patient may be double processed, possible causing the double decreasing of charges in

AR for that patient.

for any reason it will start with the next internal number after this one.

WRITE AUTHORITY:  ^

This is the total number of patients in the IB file that were set up with an exemption status during the conversion.

WRITE AUTHORITY:  ^

This is the number of patients that were converted to an exempt status.

WRITE AUTHORITY:  ^

This is the number of patients converted to a non-exempt status.

WRITE AUTHORITY:  ^

This is the number of Medication Copayment IB Actions that were issued to patients who's status is exempt from the start of the exemption legislation to the running of the conversion.

WRITE AUTHORITY:  ^

This is the total dollar amount of charges checked during the Medication Copayment Exemption Conversion issued to patients from the start date of the exemption legislation to the running of the conversion.

WRITE AUTHORITY:  ^

This is the total dollar amount of charges checked during the Medication Copayment Exemption Conversion issued to Exempt patients from the start date of the exemption legislation to the running of the conversion.

WRITE AUTHORITY:  ^

This is the total dollar amount of charges checked during the Medication Copayment Exemption Conversion issued to Non-Exempt patients from the start date of the exemption legislation to the running of the conversion.

WRITE AUTHORITY:  ^

This is the total dollar amount of charges actually canceled during the Medication Copayment Exemption Conversion issued to Exempt patients from the start date of the exemption legislation to the running of the conversion.

WRITE AUTHORITY:  ^

This is the date/time that the Medication Copayment Exemption Conversion started.  It should not be edited.

WRITE AUTHORITY:  ^

DFN UPDATED (3.04) in this file may also need to be edited.

Normally it is not recommended that the conversion be re-run after it has run once.  Re-running the conversion will not cause updating of patients with current exemptions, nor will it cause re-cancellation of charges

cancelled previously.

WRITE AUTHORITY:  ^

UNEDITABLE

This is the count of patients in the IB Action file that had an exemption status of Non-exempt set up during the conversion.

WRITE AUTHORITY:  ^

This is the total number of IB ACTION entries issued from the effective date of the Income Exemption Legislation until the running of the conversion that were issued to either exempt or non-exempt patients.

WRITE AUTHORITY:  ^

This is the count of bills actually sent to be canceled in the IB ACTION file during the conversion.

WRITE AUTHORITY:  ^

The v2.0 insurance conversion will automatically set this field to the date it completes.

UNEDITABLE

This is the date that the v2 post-init conversion of the bill/claims file completed.  It will automatically be updated by the conversion routine when it completes.

UNEDITABLE

This is the date that the current inpatients were loaded into claims tracking as part of the IB v2 post init.  This date will automatically be entered upon completion.

UNEDITABLE

It is recommended that the extended help be turned on initially after v2 is installed.  As users become more familiar with the new functionality the parameter can be turned off.

Enter the patient or insurance company you wish to access.

This field does not contain data.  It is used as a file definition by the reader to do a variable pointer look up that is not tied to any data base element.

Enter the name of the patient's health insurance policy.

This field does not contain data.  It is used by the reader to provide a definition to do a lookup that is not tied to a particular data base element.

Enter the mail group that should receive a bulletin every time an insurance policy is added for a patient that has potential billings associated with it.

which these reports will be sent.

The field is being exported with the value G.MCCR DATA@FORUM.VA.GOV.  It is anticipated that future reports may be sent to this group for compilation.  If it becomes necessary to change the mail group name or domain, this

field may be edited using Fileman.  Do not edit this field without receiving instructions from your supporting ISC.

Enter the text that your facility would like to have printed as the first line of the header on the admission sheet.  This is generally the name of your medical center.

Enter the text that your facility would like to have printed as the second line of the header on the admission sheet.  This is generally the street address of your medical center.

Enter the text that your facility would like to have printed as the third line of the header on the admission sheet.  This is generally the city, state and zip code of your medical center.

This is the main parameter that contro what past care can be entered into claims tracking.  At no time does the software automatically add entires older than this date.  The one exception is that this parameter does not

affect the entries that may be added to claims tracking using the add tracking entry action on the main claims tracking screen.

insured patients and random sample patients will be added.  If this is set to "ALL PATIENTS" then a record of all admissions will be created.

If a patient is not insured then each record will be so annotated automatically on creation and no follow-up will be required.  The advantage of tracking all patients is that you can determine the percentage of billable

cases and make necessary adjustments if the patients are later found to have insurance.  The disadvantage is that additional capacity is used.

outpatient visits for insured patients will be added.  If this parameter is set to ALL PATIENTS then the outpatient visits for all patients will be added to claims tracking.

Initially we recommend this parameter be set to INSURED ONLY.

only prescriptions and refills will be added if the patient is insured.  If all is choose then an entry for all prescriptions will be entered.

If a prescription or refill does not appear to be billable, that is it may be for SC care, or there is a visit date associated with that prescription or refill, this will be so noted in the reason not billable.

ONLY then only parameter entries for insured patients will be added to claims tracking.  If this is set to ALL PATIENTS then an entry will be created for all patients prosthetic items.

will be from the BILL FORM TYPE file.

This is the date that random sampling was last re-generated.  The IB background job will re-generate a new date, new random numbers, and zero the counters every Sunday night.

This is the number of required Utilization Reviews that you wish to have done each week for Medicine admissions.  The minimum recommended by the QA office is one per week.

This is the minimum number of admissions for Medicine that your Medical Center generally averages.  This is used along with the Medicine sample size to compute a random number.

selections for UR will not exceed the Medicine sample size.

This is the number of random selections generated this week.

This is the number of admissions for this service counted by the claims tracking module so far this week.

This is the number of required Utilization Reviews that you wish to have done each week for Surgery admissions.  The minimum recommended by the QA office is one per week.

This is the minimum number of admissions for Surgery that your Medical Center generally averages.  This is used along with the Surgery sample size to compute a random number.

selections for UR will not exceed the Surgery sample size.

This is the number of random selections generated this week.

This is the number of admissions for this service counted by the claims tracking module so far this week.

This is the number of required Utilization Reviews that you wish to have done each week for Psychiatry admissions.  The minimum recommended by the QA office is one per week.

This is the minimum number of admissions for Psychiatry that your Medical Center generally averages.  This is used along with the Psychiatry sample size to compute a random number.

selections for UR will not exceed the Psychiatry sample size.

This is the number of random selections generated this week.

This is the number of admissions for this service counted by the claims tracking module so far this week.

claims tracking will be added to claims tracking for billing information purposes only.  No review will be set up.  This is to allow flagging of these visits as unbillable so that they can be removed from these reports.

Answering 'YES' does not guarantee that the entry will be added.  The related parameters about whether Claims Tracking is turned on and the Claims Tracking Start Date will override this parameter.

This will not effect the date range of the bills themselves, but will only effect the date they are created.

If this is left blank or zero then the auto biller will never run.

This is generally set by the system.

The auto biller will use the Frequency, Billing Cycle and Days Delay parameters to decide when to try to create an inpatient bill.  However, the auto biller can not set up a bill until the PTF record is Closed.  Of the two

dates, the date calculated from the site parameters or the date that the PTF record meets the Status entered here, the bill will be created on the later date.

Some sites want to wait until the PTF is closed before a bill is created because they know it will be coded at that time.  Others do not want to bill until the PTF record has been transmitted and they know that it is

complete.

After this had been added it was decided that an auto bill should not be created for inpatients until after the PTF record has been closed.  So, the option of creating an auto bill when the PTF record was still open was

removed.