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Sub-Field: 90056.0205

Package: IHS Accounts Receivable

A/R EDI IMPORT(#90056.02)-->90056.0205

Sub-Field: 90056.0205


Information

Parent File Name Number Package
A/R EDI IMPORT(#90056.02) CLAIMS 90056.0205 IHS Accounts Receivable

Details

Field # Name Loc Type Details
.01 E-CLAIM 0;1 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>30!($L(X)<1) X
  • LAST EDITED:  MAY 01, 2008
  • HELP-PROMPT:  Answer must be 1-30 characters in length.
  • CROSS-REFERENCE:  90056.0205^B
    1)= S ^BAREDI("I",DUZ(2),DA(1),30,"B",$E(X,1,30),DA)=""
    2)= K ^BAREDI("I",DUZ(2),DA(1),30,"B",$E(X,1,30),DA)
.02 STATUS 0;2 SET
  • 'B' FOR BUILT;
  • 'X' FOR CLAIM & REASON UNMATCHED;
  • 'C' FOR CLAIM UNMATCHED;
  • 'R' FOR REASON UNMATCHED;
  • 'M' FOR MATCHED;
  • 'N' FOR NOT TO POST;
  • 'P' FOR POSTED;
  • 'E' FOR EXCEPTION;

  • LAST EDITED:  DEC 02, 2010
  • CROSS-REFERENCE:  90056.0205^AC
    1)= S ^BAREDI("I",DUZ(2),DA(1),30,"AC",$E(X,1,30),DA)=""
    2)= K ^BAREDI("I",DUZ(2),DA(1),30,"AC",$E(X,1,30),DA)
.03 E-PROVIDER 0;3 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>30!($L(X)<1) X
  • LAST EDITED:  MAR 21, 2000
  • HELP-PROMPT:  Answer must be 1-30 characters in length.
.04 E-PAYMENT 0;4 NUMBER

  • INPUT TRANSFORM:  S:X["$" X=$P(X,"$",2) K:X'?."-".N.1".".2N!(X>9999999999)!(X<-999999999) X
  • LAST EDITED:  MAR 13, 2000
  • HELP-PROMPT:  Type a Dollar Amount between -999999999 and 9999999999, 2 Decimal Digits
.05 E-BILLED 0;5 NUMBER

  • INPUT TRANSFORM:  S:X["$" X=$P(X,"$",2) K:X'?."-".N.1".".2N!(X>999999999)!(X<-999999999) X
  • LAST EDITED:  MAR 13, 2000
  • HELP-PROMPT:  Type a Dollar Amount between -999999999 and 999999999, 2 Decimal Digits
.06 E-PATIENT 0;6 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>30!($L(X)<1) X
  • LAST EDITED:  MAY 17, 2000
  • HELP-PROMPT:  Answer must be 1-30 characters in length.
  • CROSS-REFERENCE:  90056.0205^C
    1)= S ^BAREDI("I",DUZ(2),DA(1),30,"C",$E(X,1,30),DA)=""
    2)= K ^BAREDI("I",DUZ(2),DA(1),30,"C",$E(X,1,30),DA)
.07 E-HRN/HIC 0;7 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>40!($L(X)<1) X
  • LAST EDITED:  MAR 21, 2000
  • HELP-PROMPT:  Answer must be 1-40 characters in length.
.08 E-DOS BEGIN 0;8 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>30!($L(X)<1) X
  • LAST EDITED:  MAR 20, 2000
  • HELP-PROMPT:  Answer must be 1-30 characters in length.
.09 E-DOS END 0;9 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>30!($L(X)<1) X
  • LAST EDITED:  MAR 13, 2000
  • HELP-PROMPT:  Answer must be 1-30 characters in length.
.11 E-CLAIM STATUS CODE 0;11 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>25!($L(X)<1) X
  • LAST EDITED:  DEC 03, 2007
  • HELP-PROMPT:  Answer must be 1-25 characters in length
  • DESCRIPTION:  This field corresponds to the CLP02 element in the CLP segment CLP02 CLAIM STATUS CODE
    E.G. 1 | Processed as Primary





.12
REVERSAL DATE
12;1
DATE

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:X<1 X
  • LAST EDITED:  DEC 12, 2007
  • HELP-PROMPT:  (No range limit on date)





1.01
A-CLAIM
1;1
POINTER TO A/R BILL/IHS FILE (#90050.01)
A/R BILL/IHS(#90050.01)
  • LAST EDITED:  MAR 13, 2000





1.02
A-BILLED

COMPUTED

  • MUMPS CODE:  X ^DD(90056.0205,1.02,9.3) S X=$P(Y(90056.0205,1.02,101),U,13) S D0=Y(90056.0205,1.02,80) S D1=Y(90056.0205,1.02,81)
    9.2 = S Y(90056.0205,1.02,81)=$S($D(D1):D1,1:""),Y(90056.0205,1.02,80)=$S($D(D0):D0,1:""),Y(90056.0205,1.02,1)=$S($D(^BAREDI("I",DUZ(2),D0,30,D1,1)):^(1),1:"")
    9.3 = X ^DD(90056.0205,1.02,9.2) S D0=$P(Y(90056.0205,1.02,1),U,1) S:'$D(^BARBL(DUZ(2),+D0,0)) D0=-1 S Y(90056.0205,1.02,101)=$S($D(^BARBL(DUZ(2),D0,0)):^(0),1:"")
  • ALGORITHM:  1.01:13
  • LAST EDITED:  MAY 11, 2000





1.03
A-PATIENT

COMPUTED

  • MUMPS CODE:  X ^DD(90056.0205,1.03,9.4) S Y(90056.0205,1.03,201)=$S($D(^AUPNPAT(D0,0)):^(0),1:"") S X=$S('$D(^DPT(+$P(Y(90056.0205,1.03,201),U,1),0)):"",1:$P(^(0),U,1)) S D0=Y(90056.0205,1.03,80) S D1=Y(90056.0205,1.03,81)
    9.2 = S Y(90056.0205,1.03,81)=$S($D(D1):D1,1:""),Y(90056.0205,1.03,80)=$S($D(D0):D0,1:""),Y(90056.0205,1.03,1)=$S($D(^BAREDI("I",DUZ(2),D0,30,D1,1)):^(1),1:"")
    9.3 = X ^DD(90056.0205,1.03,9.2) S D0=$P(Y(90056.0205,1.03,1),U,1) S:'$D(^BARBL(DUZ(2),+D0,0)) D0=-1 S Y(90056.0205,1.03,180)=$S($D(D0):D0,1:"")
    9.4 = X ^DD(90056.0205,1.03,9.3) S Y(90056.0205,1.03,101)=$S($D(^BARBL(DUZ(2),D0,1)):^(1),1:""),D0=$P(Y(90056.0205,1.03,101),U,1) S:'$D(^AUPNPAT(+D0,0)) D0=-1
  • ALGORITHM:  1.01:101





1.04
A-HRN

COMPUTED

  • MUMPS CODE:  X ^DD(90056.0205,1.04,9.3) S X=$P(Y(90056.0205,1.04,101),U,7) S D0=Y(90056.0205,1.04,80) S D1=Y(90056.0205,1.04,81)
    9.2 = S Y(90056.0205,1.04,81)=$S($D(D1):D1,1:""),Y(90056.0205,1.04,80)=$S($D(D0):D0,1:""),Y(90056.0205,1.04,1)=$S($D(^BAREDI("I",DUZ(2),D0,30,D1,1)):^(1),1:"")
    9.3 = X ^DD(90056.0205,1.04,9.2) S D0=$P(Y(90056.0205,1.04,1),U,1) S:'$D(^BARBL(DUZ(2),+D0,0)) D0=-1 S Y(90056.0205,1.04,101)=$S($D(^BARBL(DUZ(2),D0,1)):^(1),1:"")
  • ALGORITHM:  1.01:107





1.05
A-DOS BEGIN

COMPUTED DATE

  • MUMPS CODE:  X ^DD(90056.0205,1.05,9.3) S X=$P(Y(90056.0205,1.05,101),U,2) S D0=Y(90056.0205,1.05,80) S D1=Y(90056.0205,1.05,81)
    9.2 = S Y(90056.0205,1.05,81)=$S($D(D1):D1,1:""),Y(90056.0205,1.05,80)=$S($D(D0):D0,1:""),Y(90056.0205,1.05,1)=$S($D(^BAREDI("I",DUZ(2),D0,30,D1,1)):^(1),1:"")
    9.3 = X ^DD(90056.0205,1.05,9.2) S D0=$P(Y(90056.0205,1.05,1),U,1) S:'$D(^BARBL(DUZ(2),+D0,0)) D0=-1 S Y(90056.0205,1.05,101)=$S($D(^BARBL(DUZ(2),D0,1)):^(1),1:"")
  • ALGORITHM:  1.01:102





1.06
A-DOS END

COMPUTED DATE

  • MUMPS CODE:  X ^DD(90056.0205,1.06,9.3) S X=$P(Y(90056.0205,1.06,101),U,3) S D0=Y(90056.0205,1.06,80) S D1=Y(90056.0205,1.06,81)
    9.2 = S Y(90056.0205,1.06,81)=$S($D(D1):D1,1:""),Y(90056.0205,1.06,80)=$S($D(D0):D0,1:""),Y(90056.0205,1.06,1)=$S($D(^BAREDI("I",DUZ(2),D0,30,D1,1)):^(1),1:"")
    9.3 = X ^DD(90056.0205,1.06,9.2) S D0=$P(Y(90056.0205,1.06,1),U,1) S:'$D(^BARBL(DUZ(2),+D0,0)) D0=-1 S Y(90056.0205,1.06,101)=$S($D(^BARBL(DUZ(2),D0,1)):^(1),1:"")
  • ALGORITHM:  1.01:103





1.07
A-BALLANCE

COMPUTED

  • MUMPS CODE:  X ^DD(90056.0205,1.07,9.3) S X=$P(Y(90056.0205,1.07,101),U,15) S D0=Y(90056.0205,1.07,80) S D1=Y(90056.0205,1.07,81)
    9.2 = S Y(90056.0205,1.07,81)=$S($D(D1):D1,1:""),Y(90056.0205,1.07,80)=$S($D(D0):D0,1:""),Y(90056.0205,1.07,1)=$S($D(^BAREDI("I",DUZ(2),D0,30,D1,1)):^(1),1:"")
    9.3 = X ^DD(90056.0205,1.07,9.2) S D0=$P(Y(90056.0205,1.07,1),U,1) S:'$D(^BARBL(DUZ(2),+D0,0)) D0=-1 S Y(90056.0205,1.07,101)=$S($D(^BARBL(DUZ(2),D0,0)):^(0),1:"")
  • ALGORITHM:  1.01:15





1.08
A-ACCOUNT

COMPUTED

  • MUMPS CODE:  X ^DD(90056.0205,1.08,9.6) S D0=Y(90056.0205,1.08,80) S D1=Y(90056.0205,1.08,81)
    9.2 = S Y(90056.0205,1.08,81)=$S($D(D1):D1,1:""),Y(90056.0205,1.08,80)=$S($D(D0):D0,1:""),Y(90056.0205,1.08,1)=$S($D(^BAREDI("I",DUZ(2),D0,30,D1,1)):^(1),1:"")
    9.3 = X ^DD(90056.0205,1.08,9.2) S D0=$P(Y(90056.0205,1.08,1),U,1) S:'$D(^BARBL(DUZ(2),+D0,0)) D0=-1 S Y(90056.0205,1.08,180)=$S($D(D0):D0,1:"")
    9.4 = X ^DD(90056.0205,1.08,9.3) S Y(90056.0205,1.08,101)=$S($D(^BARBL(DUZ(2),D0,0)):^(0),1:""),D0=$P(Y(90056.0205,1.08,101),U,3) S:'$D(^BARAC(DUZ(2),+D0,0)) D0=-1
    9.5 = X ^DD(90056.0205,1.08,9.4) S Y(90056.0205,1.08,201)=$S($D(^BARAC(DUZ(2),D0,0)):^(0),1:"")
    9.6 = X ^DD(90056.0205,1.08,9.5) S X=$P(Y(90056.0205,1.08,201),U,1),C=$S(X="":-1,'$D(@(U_$P(X,";",2)_"0)")):-1,1:$P(^(0),U,2)),X=$S(X="":X,'$D(^(+X,0)):"",1:$P(^(0),U,1)),Y=X,C=$S($D(^DD(+C,.01,0)):$P(^(0),U,2),1:"D") D:X]
    "" Y^DIQ:C'["D" S X=Y,C=","
  • ALGORITHM:  1.01:3





10
READABLE IMAGE
10;0
WORD-PROCESSING #90056.0206   





20
RECORDS
20;0
Multiple #90056.0207 
90056.0207




30
ADJUSTMENTS
30;0
Multiple #90056.0208 
90056.0208




40
REMARK CODES
40;0
Multiple #90056.0211 
90056.0211
  • TECHNICAL DESCR:  
    Added Remark Code functionality for HIPAA 835 v4010 Transport as of A/R V1.7 Patch 5.  This multiple will hold all remark codes found on this ERA for this Claim.





50
NCPDP REJ/PAY CODES
50;0
Multiple #90056.0212 
90056.0212
  • TECHNICAL DESCR:  
    Added for A/R V1.7 Patch 5.  Intended to capture NCPDP Reject Payment codes from the LQ segment of the 835.  LQ contains NCPDP Reject Payment codes if LQ01="RX" and Remittance Advice Remark Codes if LQ01="HE"





71
COMMENT
7;1
FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>250!($L(X)<3) X
  • LAST EDITED:  JAN 07, 2011
  • HELP-PROMPT:  Answer must be 3-250 characters in length
  • DESCRIPTION:  
    Enter a comment regarding the status change that was made to this claim





201
CHECK/EFT TRACE
2;1
FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>30!($L(X)<1) X
  • LAST EDITED:  NOV 10, 2010
  • HELP-PROMPT:  Answer must be 1-30 characters in length.
  • CROSS-REFERENCE:  90056.02^F
    1)= S ^BAREDI("I",DUZ(2),"F",$E(X,1,30),DA(1),DA)=""
    2)= K ^BAREDI("I",DUZ(2),"F",$E(X,1,30),DA(1),DA)
  • CROSS-REFERENCE:  90056.02^G^MUMPS
    1)= S ^BAREDI("I",DUZ(2),"G",DA(1),$E(X,1,30))=""
    2)= K ^BAREDI("I",DUZ(2),"G",DA(1),$E(X,1,30))
    This cross reference will list all the checks in an ERA file.





202
RPMS CHECK MATCH
2;2
POINTER TO A/R EDI CHECKS FILE (#90056.22)
A/R EDI CHECKS(#90056.22)
  • LAST EDITED:  SEP 29, 2003





204
*CLAIM STATUS
2;4
POINTER TO A/R EDI EDI CLAIM ERROR CODES FILE (#90056.21)
A/R EDI EDI CLAIM ERROR CODES(#90056.21)
  • LAST EDITED:  APR 16, 2008





205
BPR MONETARY AMOUNT
2;5
NUMBER

  • INPUT TRANSFORM:  S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>9999999999)!(X<0)!(X?.E1"."3.N) X
  • LAST EDITED:  JUL 10, 2008
  • HELP-PROMPT:  Type a Dollar amount between 0 and 9999999999, 2 Decimal Digits





301
REV TREASURY DEP NUMBER/IPAC
3;1
FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>20!($L(X)<3) X
  • LAST EDITED:  FEB 29, 2008
  • HELP-PROMPT:  Answer must be 3-20 characters in length





302
PAYER CLAIM CONTROL # (ICN)
3;2
FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>30!($L(X)<1) X
  • LAST EDITED:  APR 15, 2008
  • HELP-PROMPT:  Answer must be 1-30 characters in length





401
REASON NOT TO POST
4;0
POINTER Multiple #90056.0205401
90056.0205401
  • LAST EDITED:  APR 16, 2008





501
POST THIS CLAIM AS TYPE
5;1
POINTER TO A/R TABLE ENTRY/IHS FILE (#90052.02)
A/R TABLE ENTRY/IHS(#90052.02)
  • LAST EDITED:  JUL 10, 2008





601
PAYMENT CREDIT APPLIED TO
6;1
POINTER TO A/R BILL/IHS FILE (#90050.01)
A/R BILL/IHS(#90050.01)
  • LAST EDITED:  JUN 18, 2008
  • DESCRIPTION:  
    WHEN A REVERSAL IS MATCHED TO A PAYMENT THIS FIELD WILL HOLD THE A/R BILL THE REVERSAL IS MATCHED TO.





602
PAYMENT CREDIT APPLIED FROM
6;2
POINTER TO A/R BILL/IHS FILE (#90050.01)
A/R BILL/IHS(#90050.01)
  • LAST EDITED:  JUN 18, 2008
  • DESCRIPTION:  
    WHEN A REVERSAL IS MATCHED TO A PAYMENT THIS WILL HOLD THE A/R BILL OF THE REVERSAL IT WAS MATCHED TO





901
COVERAGE EXPIRATION DATE
9;1
DATE

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:X<1 X
  • LAST EDITED:  SEP 22, 2011
  • HELP-PROMPT:  (No range limit on date)





902
CLAIM RECEIVED DATE
9;2
DATE

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:X<1 X
  • LAST EDITED:  SEP 22, 2011
  • HELP-PROMPT:  (No range limit on date)







    



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