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Global: ^IBE(355.1

Package: Integrated Billing

Global: ^IBE(355.1

Information

FileMan FileNo	FileMan Filename	Package
355.1	TYPE OF PLAN	Integrated Billing

Description

This file contains the standard types of plans that an insurance company may provide. The type of plan may be dependent on the type of coverage provided by the insurance company and may affect the type of benefits that are available for the plan. Per VHA Directive 10-93-142, this file definition should not be modified.

Directly Accessed By Routines, Total: 9

Package	Total	Routines
Integrated Billing	8	IBCNS1 IBCNSM IBCNSM5 IBCNSP0 IBRFN2 IBTOAT1 IBTOBI1 ^IBE(355.1
Order Entry Results Reporting	1	ORDV07

Accessed By FileMan Db Calls, Total: 1

Package	Total	Routines
Health Summary	1	GMTSDEM2

Pointed To By FileMan Files, Total: 1

Package	Total	FileMan Files
Integrated Billing	1	GROUP INSURANCE PLAN(#355.3)[.09]

Fields, Total: 4

Field #	Name	Loc	Type	Details
.01	NAME	0;1	FREE TEXT	**********************REQUIRED FIELD********************** INPUT TRANSFORM: `K:$L(X)>40!($L(X)<3)!'(X'?1P.E) X` LAST EDITED: `FEB 25, 1993` HELP-PROMPT: `Enter the name of this type of policy that best describes the policy. Answer must be 3-40 characters in length.` DESCRIPTION: `There are a number of different types of policies, some have very specific types of coverage while others cover a much broader range of care. This is the name of the type of policy. Select the name that best describes` the type of policy. This is a list of standard types of policies. The type of policy may be dependent on the type of coverage provided by the insurance company and may affect the type of benefits that are available for the policy. This will be used in determining if the reimbursement from the insurance company is appropriate for this policy. CROSS-REFERENCE: `355.1^B` 1)= S ^IBE(355.1,"B",$E(X,1,30),DA)="" 2)= K ^IBE(355.1,"B",$E(X,1,30),DA)
.02	ABBREVIATION	0;2	FREE TEXT	INPUT TRANSFORM: `K:X[""""!($A(X)=45) X I $D(X) K:$L(X)>8!($L(X)<2) X` LAST EDITED: `JUN 03, 1993` HELP-PROMPT: `Enter the standard abbreviation. Answer must be 2-8 characters in length.` DESCRIPTION: Enter the standard abbreviation for this type of policy. The abbreviation will be used on standard displays of policy information where space is limited. CROSS-REFERENCE: `355.1^D` 1)= S ^IBE(355.1,"D",$E(X,1,30),DA)="" 2)= K ^IBE(355.1,"D",$E(X,1,30),DA)
.03	MAJOR CATEGORY	0;3	SET	'1' FOR MAJOR MEDICAL; '2' FOR DENTAL; '3' FOR HMO; '4' FOR PPO; '5' FOR MEDICARE; '6' FOR MEDICAIDE; '7' FOR CHAMPUS; '8' FOR WORKMANS COMP; '9' FOR INDEMNITY; '10' FOR PRESCRIPTION; '11' FOR MEDICARE SUPPLEMENTAL; '12' FOR ALL OTHER; LAST EDITED: `JAN 11, 1994` DESCRIPTION: Each type of policy must be identified with a major category. It is the major category field that will be used to determine the type of policy internally by the computer. WRITE AUTHORITY: @ CROSS-REFERENCE: `355.1^C` 1)= S ^IBE(355.1,"C",$E(X,1,30),DA)="" 2)= K ^IBE(355.1,"C",$E(X,1,30),DA)
10	DESCRIPTION	10;0	WORD-PROCESSING #355.11	DESCRIPTION: Enter a one or two sentence description of the type of policy.

Found Entries, Total: 38

NAME: ACCIDENT AND HEALTH INSURANCE	NAME: AVIATION TRIP INSURANCE	NAME: BLUE CROSS/BLUE SHIELD	NAME: CATASTROPHIC INSURANCE	NAME: CHAMPUS	NAME: CHAMPUS SUPPLEMENTAL	NAME: COINSURANCE	NAME: COMPREHENSIVE MAJOR MEDICAL
NAME: DENTAL INSURANCE	NAME: DUAL COVERAGE	NAME: HEALTH MAINTENANCE ORGANIZ	NAME: HOSPITAL EXPENSE INSURANCE	NAME: HOSPITAL-MEDICAL INSURANCE	NAME: INDEMNITY	NAME: INDIVIDUAL PRACTICE ASSOCATION (IPA)	NAME: KEY-MAN HEALTH INSURANCE
NAME: LABS, PROCEDURES, X-RAY, ETC. (ONLY)	NAME: MAJOR MEDICAL EXPENSE INSURANCE	NAME: MANAGED CARE SYSTEM (MCS)	NAME: MEDI-CAL	NAME: MEDICAID	NAME: MEDICAL EXPENSE INSURANCE	NAME: MEDICARE (M)	NAME: MEDICARE/MEDICAID (MEDI-CAL)
NAME: MEDIGAP INSURANCE	NAME: MENTAL HEALTH ONLY	NAME: NO-FAULT INSURANCE	NAME: PREFERRED PROVIDER ORGANIZATION (PPO)	NAME: PREPAID GROUP PRACTICE PLAN	NAME: PRESCRIPTION ONLY	NAME: QUALIFIED IMPAIRMENT INSURANCE	NAME: REGULAR MEDICAL EXPENSE INSURANCE
NAME: SENIOR CITIZEN POLICIES	NAME: SPECIAL CLASS INSURANCE	NAME: SPECIAL RISK INSURANCE	NAME: SPECIFIED DISEASE INSURANCE	NAME: SURGICAL EXPENSE INSURANCE	NAME: WORKERS' COMPENSATION INSURANCE

ICR, Total: 4

ICR LINK	Subscribing Package(s)	Fields Referenced	Description
ICR #951	INCOME VERIFICATION MATCH HEALTH SUMMARY ORDER ENTRY/RESULTS REPORTING	NAME (.01). Access: Direct Global Read & w/Fileman	The NAME of the type of plan is directly read anddisplayed to the user when the entire IVM policy is displayed to the user forreview.
ICR #1045	INCOME VERIFICATION NAT'L DB	NAME (.01). Access: Direct Global Read & w/Fileman	Standard types of plans that an insurance company mayprovide.
ICR #3595	HEALTH SUMMARY FEE BASIS	NAME (.01). Access: Read w/Fileman
ICR #3828	ACCOUNTS RECEIVABLE INSURANCE CAPTURE BUFFER	NAME (.01). Access: Direct Global Read & w/Fileman MAJOR CATEGORY (.03). Access: Direct Global Read & w/Fileman

Global Variables Directly Accessed

Name	Line Occurrences (* Changed, ! Killed)
^IBE(355.1 - [#355.1]	.01(XREF 1S), .01(XREF 1K), .02(XREF 1S), .02(XREF 1K), .03(XREF 1S), .03(XREF 1K)

Local Variables

Legend:

>>	Not killed explicitly
*	Changed
!	Killed
~	Newed

Name	Field # of Occurrence
>> DA	.01(XREF 1S), .01(XREF 1K), .02(XREF 1S), .02(XREF 1K), .03(XREF 1S), .03(XREF 1K)
>> DIC	ID.03+1
X	.01+1!, .01(XREF 1S), .01(XREF 1K), .02+1!, .02(XREF 1S), .02(XREF 1K), .03(XREF 1S), .03(XREF 1K)

Info | Desc | Directly Accessed By Routines | Accessed By FileMan Db Calls | Pointed To By FileMan Files | Fields | ICR | Found Entries | Global Variables Directly Accessed | Local Variables | All