IBINI04P ; ; 21-MAR-1994
;;Version 2.0 ; INTEGRATED BILLING ;; 21-MAR-94
Q:'DIFQ(355.3) 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
;;^DD(355.3,.04,1,1,2)
;;=K ^IBA(355.3,"E",$E(X,1,30),DA)
;;^DD(355.3,.04,1,1,"DT")
;;=2930525
;;^DD(355.3,.04,1,2,0)
;;=355.3^AGNU^MUMPS
;;^DD(355.3,.04,1,2,1)
;;=S:+^IBA(355.3,DA,0) ^IBA(355.3,"AGNU",+^(0),X,DA)=""
;;^DD(355.3,.04,1,2,2)
;;=K ^IBA(355.3,"AGNU",+^IBA(355.3,DA,0),X,DA)
;;^DD(355.3,.04,1,2,"%D",0)
;;=^^1^1^2930527^
;;^DD(355.3,.04,1,2,"%D",1,0)
;;=Cross reference of insurance companies and group names.
;;^DD(355.3,.04,1,2,"DT")
;;=2930527
;;^DD(355.3,.04,3)
;;=Answer must be 2-17 characters in length.
;;^DD(355.3,.04,21,0)
;;=^^3^3^2930603^
;;^DD(355.3,.04,21,1,0)
;;=If this is a group policy enter the number which identifies this policy,
;;^DD(355.3,.04,21,2,0)
;;=i.e. group number/code that the insurance company uses to identify this
;;^DD(355.3,.04,21,3,0)
;;=plan. Answer must be between 1 and 17 characters.
;;^DD(355.3,.04,"DT")
;;=2930611
;;^DD(355.3,.05,0)
;;=IS UTILIZATION REVIEW REQUIRED^S^1:YES;0:NO;^0;5^Q
;;^DD(355.3,.05,3)
;;=Answer "YES" if this policy requires Utilization Review for all billable cases. Otherwise, answer "NO".
;;^DD(355.3,.05,21,0)
;;=^^5^5^2930604^^
;;^DD(355.3,.05,21,1,0)
;;=Answer "YES" if Utilization Review is required by the insurance company
;;^DD(355.3,.05,21,2,0)
;;=for this policy. Answer "NO" if it is not required. The UR staff will
;;^DD(355.3,.05,21,3,0)
;;=automatically be required to follow-up on all billable cases where this
;;^DD(355.3,.05,21,4,0)
;;=field is answered "YES". If the field is answered "NO" then UR follow-up
;;^DD(355.3,.05,21,5,0)
;;=will be considered optional.
;;^DD(355.3,.05,"DT")
;;=2930223
;;^DD(355.3,.06,0)
;;=IS PRE-CERTIFICATION REQUIRED?^S^1:YES;0:NO;^0;6^Q
;;^DD(355.3,.06,3)
;;=Answer "YES" if pre-certification is required by this policy. Otherwise answer "NO".
;;^DD(355.3,.06,21,0)
;;=^^5^5^2930603^
;;^DD(355.3,.06,21,1,0)
;;=Answer "YES" if this policy requires Pre-certification of all non-emergent
;;^DD(355.3,.06,21,2,0)
;;=admissions. Answer "NO" if pre-certification is not required.
;;^DD(355.3,.06,21,3,0)
;;=If pre-certification is required but not obtained, follow-up will be
;;^DD(355.3,.06,21,4,0)
;;=required by the MCCR tracking module.
;;^DD(355.3,.06,21,5,0)
;;=|
;;^DD(355.3,.06,"DT")
;;=2930223
;;^DD(355.3,.07,0)
;;=EXCLUDE PRE-EXISTING CONDITION^S^1:YES;0:NO;^0;7^Q
;;^DD(355.3,.07,3)
;;=Answer "YES" if this policy excludes any pre existing conditions. Otherwise answer "NO".
;;^DD(355.3,.07,21,0)
;;=^^7^7^2940213^^^^
;;^DD(355.3,.07,21,1,0)
;;=Answer "YES" if the policy excludes any pre existing conditions. Answer
;;^DD(355.3,.07,21,2,0)
;;="NO" if the policy covers any pre existing conditions. If a patient has
;;^DD(355.3,.07,21,3,0)
;;=pre-exisiting conditions that are not covered they should be entered in
;;^DD(355.3,.07,21,4,0)
;;=the patient policy comment field.
;;^DD(355.3,.07,21,5,0)
;;=
;;^DD(355.3,.07,21,6,0)
;;=
;;^DD(355.3,.07,21,7,0)
;;=
;;^DD(355.3,.07,"DT")
;;=2930702
;;^DD(355.3,.08,0)
;;=BENEFITS ASSIGNABLE?^S^1:YES;0:NO;^0;8^Q
;;^DD(355.3,.08,3)
;;=
;;^DD(355.3,.08,21,0)
;;=^^4^4^2940213^
;;^DD(355.3,.08,21,1,0)
;;=If this policy will allow assignment of benefits then answer YES,
;;^DD(355.3,.08,21,2,0)
;;=otherwise answer NO. Normally this field will be answered YES.
;;^DD(355.3,.08,21,3,0)
;;=However, it may be useful to track policies that do not allow for
;;^DD(355.3,.08,21,4,0)
;;=assignment of benefits.
;;^DD(355.3,.08,"DT")
;;=2930223
;;^DD(355.3,.09,0)
;;=TYPE OF PLAN^P355.1'^IBE(355.1,^0;9^Q
IBINI04P ; ; 21-MAR-1994
+1 ;;Version 2.0 ; INTEGRATED BILLING ;; 21-MAR-94
+2 IF 'DIFQ(355.3)
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 '$TEST
SET @X=Y
Q QUIT
+1 ;;^DD(355.3,.04,1,1,2)
+2 ;;=K ^IBA(355.3,"E",$E(X,1,30),DA)
+3 ;;^DD(355.3,.04,1,1,"DT")
+4 ;;=2930525
+5 ;;^DD(355.3,.04,1,2,0)
+6 ;;=355.3^AGNU^MUMPS
+7 ;;^DD(355.3,.04,1,2,1)
+8 ;;=S:+^IBA(355.3,DA,0) ^IBA(355.3,"AGNU",+^(0),X,DA)=""
+9 ;;^DD(355.3,.04,1,2,2)
+10 ;;=K ^IBA(355.3,"AGNU",+^IBA(355.3,DA,0),X,DA)
+11 ;;^DD(355.3,.04,1,2,"%D",0)
+12 ;;=^^1^1^2930527^
+13 ;;^DD(355.3,.04,1,2,"%D",1,0)
+14 ;;=Cross reference of insurance companies and group names.
+15 ;;^DD(355.3,.04,1,2,"DT")
+16 ;;=2930527
+17 ;;^DD(355.3,.04,3)
+18 ;;=Answer must be 2-17 characters in length.
+19 ;;^DD(355.3,.04,21,0)
+20 ;;=^^3^3^2930603^
+21 ;;^DD(355.3,.04,21,1,0)
+22 ;;=If this is a group policy enter the number which identifies this policy,
+23 ;;^DD(355.3,.04,21,2,0)
+24 ;;=i.e. group number/code that the insurance company uses to identify this
+25 ;;^DD(355.3,.04,21,3,0)
+26 ;;=plan. Answer must be between 1 and 17 characters.
+27 ;;^DD(355.3,.04,"DT")
+28 ;;=2930611
+29 ;;^DD(355.3,.05,0)
+30 ;;=IS UTILIZATION REVIEW REQUIRED^S^1:YES;0:NO;^0;5^Q
+31 ;;^DD(355.3,.05,3)
+32 ;;=Answer "YES" if this policy requires Utilization Review for all billable cases. Otherwise, answer "NO".
+33 ;;^DD(355.3,.05,21,0)
+34 ;;=^^5^5^2930604^^
+35 ;;^DD(355.3,.05,21,1,0)
+36 ;;=Answer "YES" if Utilization Review is required by the insurance company
+37 ;;^DD(355.3,.05,21,2,0)
+38 ;;=for this policy. Answer "NO" if it is not required. The UR staff will
+39 ;;^DD(355.3,.05,21,3,0)
+40 ;;=automatically be required to follow-up on all billable cases where this
+41 ;;^DD(355.3,.05,21,4,0)
+42 ;;=field is answered "YES". If the field is answered "NO" then UR follow-up
+43 ;;^DD(355.3,.05,21,5,0)
+44 ;;=will be considered optional.
+45 ;;^DD(355.3,.05,"DT")
+46 ;;=2930223
+47 ;;^DD(355.3,.06,0)
+48 ;;=IS PRE-CERTIFICATION REQUIRED?^S^1:YES;0:NO;^0;6^Q
+49 ;;^DD(355.3,.06,3)
+50 ;;=Answer "YES" if pre-certification is required by this policy. Otherwise answer "NO".
+51 ;;^DD(355.3,.06,21,0)
+52 ;;=^^5^5^2930603^
+53 ;;^DD(355.3,.06,21,1,0)
+54 ;;=Answer "YES" if this policy requires Pre-certification of all non-emergent
+55 ;;^DD(355.3,.06,21,2,0)
+56 ;;=admissions. Answer "NO" if pre-certification is not required.
+57 ;;^DD(355.3,.06,21,3,0)
+58 ;;=If pre-certification is required but not obtained, follow-up will be
+59 ;;^DD(355.3,.06,21,4,0)
+60 ;;=required by the MCCR tracking module.
+61 ;;^DD(355.3,.06,21,5,0)
+62 ;;=|
+63 ;;^DD(355.3,.06,"DT")
+64 ;;=2930223
+65 ;;^DD(355.3,.07,0)
+66 ;;=EXCLUDE PRE-EXISTING CONDITION^S^1:YES;0:NO;^0;7^Q
+67 ;;^DD(355.3,.07,3)
+68 ;;=Answer "YES" if this policy excludes any pre existing conditions. Otherwise answer "NO".
+69 ;;^DD(355.3,.07,21,0)
+70 ;;=^^7^7^2940213^^^^
+71 ;;^DD(355.3,.07,21,1,0)
+72 ;;=Answer "YES" if the policy excludes any pre existing conditions. Answer
+73 ;;^DD(355.3,.07,21,2,0)
+74 ;;="NO" if the policy covers any pre existing conditions. If a patient has
+75 ;;^DD(355.3,.07,21,3,0)
+76 ;;=pre-exisiting conditions that are not covered they should be entered in
+77 ;;^DD(355.3,.07,21,4,0)
+78 ;;=the patient policy comment field.
+79 ;;^DD(355.3,.07,21,5,0)
+80 ;;=
+81 ;;^DD(355.3,.07,21,6,0)
+82 ;;=
+83 ;;^DD(355.3,.07,21,7,0)
+84 ;;=
+85 ;;^DD(355.3,.07,"DT")
+86 ;;=2930702
+87 ;;^DD(355.3,.08,0)
+88 ;;=BENEFITS ASSIGNABLE?^S^1:YES;0:NO;^0;8^Q
+89 ;;^DD(355.3,.08,3)
+90 ;;=
+91 ;;^DD(355.3,.08,21,0)
+92 ;;=^^4^4^2940213^
+93 ;;^DD(355.3,.08,21,1,0)
+94 ;;=If this policy will allow assignment of benefits then answer YES,
+95 ;;^DD(355.3,.08,21,2,0)
+96 ;;=otherwise answer NO. Normally this field will be answered YES.
+97 ;;^DD(355.3,.08,21,3,0)
+98 ;;=However, it may be useful to track policies that do not allow for
+99 ;;^DD(355.3,.08,21,4,0)
+100 ;;=assignment of benefits.
+101 ;;^DD(355.3,.08,"DT")
+102 ;;=2930223
+103 ;;^DD(355.3,.09,0)
+104 ;;=TYPE OF PLAN^P355.1'^IBE(355.1,^0;9^Q
