Added new options to the Exported Options section Added new entries to the Glossary section September 2015 Updated for patch IB*2.0*522, ICD-10 PTF Modifications: Updated Registration integration agreement in the External Relations section (p.174). T.B. K.R. April 2015 Updated for patch IB*2.0*516: Added IBVCB, IBVCB1, and IBVCB2 to Routine List for View Cancelled Bill Report (p.54). Updated List Templates (p.95). Added IB VIEW CANCEL BILL to Exported Options (p.142). Deleted IBCN INS BILL PROV FLAG RPT from Exported Options (p.148). M.H. FirstView Team November 2014 Updated for patch IB*2.0*519: Added routines to Routine section (pages 13, 19, 32) Updated File List in Files section to include new files (pages 86) Updated File Flow Chart in Files section (pages 108, 112, 126) Updated Exported Options section to include new option (page 131) Updated External Relations with new DBIA (page 170) Updated Security section to include new files (pages 182-183) Updated Glossary section to include new acronyms (pages 186-187) M.H. FirstView Team September 2014 Patch IB*2.0*461, ICD-10 Class 1 Remediation updates: Updated for ICD-10: p. 179 Added ICD-10 text to Glossary: p. 213 VA PMs: K.T. HP PM: M.K. C.H./B.T./L.R. 5/22/2014 Updated for patch IB*2.0*506: Pages 64, 94, 111, 112, 121-124, and 181 M.H. FirstView Team 1/29/14 Updated for patch IB*2.0*497: M.H.
The Encounter Form Utilities print data on the forms from the Allergy, PIMS, and Problem List packages. The Print Manager, included with the Encounter Form Utilities, will also print out Health Summaries as well as documents from the Outpatient Pharmacy and PIMS packages. Means Test billing data may be transmitted between facilities using the PDX v1.5 package. This may assist sites with the preparation of bills for inpatients who transfer between facilities. Prosthetics information is passed to Claims Tracking and Third Party Billing. The new functionality seen in this software is the direct result of input and feedback received from field users. Task groups made up of representatives from the field were created under the auspices of the MCCR Systems Committee and MCCR EP. These groups had meetings and/or conference calls with the developers and VACO Program Office (MCCR, MAS, and MIRMO) officials on a regular basis to develop the initial specifications and answer questions that arose during the development cycle. The field representatives in these groups included physicians, UR nurses, MAS ADPACs, MCCR coordinators, and billing clerks. An additional group of users was assembled prior to alpha testing to conduct full usability and functional testing of the software. The input from each of the individuals on these groups was invaluable to the software developers. IB version 2.0 includes electronic exchange (EDI) of claim information with third party payers and Medicare via Financial Services Center (FSC) Claims are transmitted electronically from VistA to insurance providers Remittance advice information for claims transmitted is received as mail messages
350.4 BILLABLE AMBULATORY SURGICAL CODES ^IBE(350.4, This file contains the CPT procedure and the associated HCFA rate groups for ambulatory surgeries that may be billed. 350.41 UPDATE BILLABLE AMBULATORY SURGICAL CODE ^IBE(350.41, This file contains updates to the ambulatory surgery procedures which can be billed. 350.5 BASC LOCALITY MODIFIER ^IBE(350.5, This file is used in the calculation of the charge for an ambulatory surgery performed on any given date. 350.6 IB ARCHIVE/PURGE LOG ^IBE(350.6, This file is used to track the archiving and purging operations of the following files used in Integrated Billing List Archive/Purge Log entries: INTEGRATED BILLING ACTION file (#350), CATEGORY C BILLING CLOCK file (#351), and BILL/CLAIMS file (#399). 350.7 AMBULATORY CHECK-OFF SHEET ^IBE(350.7, This file defines the Ambulatory Surgery Check-off Sheets used by outpatient clinics. It contains the CPT print format to be used on the Ambulatory Surgeries Check-off List. 350.71 AMBULATORY SURGERY CHECK-OFF SHEET PRINT FIELDS ^IBE(350.71, This file contains the sub-headers and procedures associated with each check-off sheet defined for the CPT clinic list. 350.8* IB ERROR ^IBE(350.8, If a potential error is detected during a billing process, the full text description of the error will be reported from this file. 350.9 IB SITE PARAMETERS ^IBE(350.9, This file contains the necessary site-specific data to run and manage the Integrated Billing package and the IB Background Filer. Only one entry per facility is allowed. 351 CATEGORY C BILLING CLOCK ^IBE(351, This file is used to create and maintain billing clocks in which Category C patients may be charged for and per diem charges for hospital or nursing home care, as well as outpatient visits. It will initially be populated by the Means Test data conversion and subsequently created and updated by Integrated Billing. Entries in this file should not be deleted or edited through VA FileMan.
394.85 VAQ - STATUS ^VAT(394.85, This file defines all possible statuses of a PDX transaction. Codes must be in the form XXXX-YYYYY where XXXX is the namespace of the package (1-4 upper case characters) and YYYYY is 1-5 characters (upper or lower case) of the package's choosing. [Must pattern match 1.4U1"-"1.5A] 394.86 VAQ - AUTO-NUMBERING ^VAT(394.86, This file is used to implement auto-numbering in the PDX files. Fields with auto-numbering capability will have an entry in this file 394.87 VAQ - WORKLOAD ^VAT(394.87, This file contains statistics concerning the workload done using PDX. PDX workload is considered to be requesting patient information from another facility, manually processing requests from another facility, and uploading PDX data to the Patient File. Work done by the PDX Server is also stored in this file. 394.88 VAQ - WORK ^VAT(394.88, This file contains the type of work being tracked by the VAQ - WORKLOAD file (#394.87). 395 DVB PARAMETERS ^DVB(395, 395.1 ENTITLEMENT CODES ^DVB(395.1, 395.2 ANATOMICAL-LOSS CODES ^DVB(395.2, 395.3 MONTHLY COMPENSATION ^DVB(395.3, 395.4 DIARY DEFINITIONS ^DVB(395.4, 395.5 HINQ SUSPENSE ^DVB(395.5, 395.7 HINQ AUDIT ^DVB(395.7,
356.2 IBT REMOVE NEXT REVIEW Deletes next review data. 356.2 IBT STATUS CHANGE Edits INSURANCE REVIEW STATUS field. 356.22 IB ADD/EDIT 278 Used to create/Edit a 278 request for a selected HCSR Worklist event. 356.22 IB CREATE 278 REQUEST Used to create/Edit a 278 request for a selected HCSR Worklist event. 356.22 IB CREATE 278 REQUEST SHORT Used to create/Edit a 278 request for a selected HCSR Worklist event. 357 IBDF EDIT NEW FORM Used to edit a new form. 357 IBDF EDIT OLD OR COPIED FORM Used to edit an existing form. 357.1 IBDF EDIT HEADER & OUTLINE Used to edit a block's header and outline. 357.1 IBDF EDIT HEADER BLOCK Used to edit the header block of a form. 357.1 IBDF NEW EMPTY BLOCK Used to edit the header, position, outline, and other characteristics of a new block. 357.1 IBDF POSITION COPIED BLOCK Used to position a copied block onto a form. 357.2 IBDF EDIT SELECTION LIST Used to edit a selection list, except for the position and size of the columns. 357.2 IBDF POSITION/SIZE COLUMNS Used to edit the size and position of a selection list's columns. 357.3 IBDF CPT MODIFIER CPT MODIFIER ALL 357.3 IBDF EDIT PLACE HOLDER PRINT ORDER WITHIN GROUP PLACE HOLDER TEXT USE AS SUBHEADER? 357.3 IBDF EDIT SELECTION Used to edit a selection. 357.5 IBDF EDIT DATA FIELD Used to edit a data field. 357.5 IBDF EDIT FORM HEADER Used to edit the form header data field. 357.5 IBDF EDIT LABEL FIELD NAME BLOCK TYPE OF DATA SUBFIELD SUBFIELD LABEL STARTING ROW FOR LABEL STARTING COLUMN FOR LABEL 357.6 IBDF EDIT AVAILABLE HLTH SMRY Used to define a package interface that prints a Health Summary. 357.6 IBDF EDIT AVAILABLE REPORT Used to define a package interface that prints a report other than a Health Summary. 357.6 IBDF EDIT OUTPUT/SELECTION RTN Used to define a package interface of the type output routine or selection routine. 357.69 IB EDIT E&M QUANTITY ALLOW QUANTITY GREATER THAN 1 357.7 IBDF FORM LINE Used to edit a line. 357.8 IBDF EDIT TEXT AREA Used to edit a text area. 357.91 IBDF EDIT MARKING AREA Used to edit a marking area.
367.1 HPID/OEID TRANSMISSION QUEUE 367.11 INSURANCE COMPANY ID TYPE 368 HEALTH CARE CLAIM RFAI (277) 399 BILL/CLAIMS 779.004 COUNTRY CODE 81.3 CPT MODIFIER 36 INSURANCE COMPANY 95.3 LAB LOINC 200 NEW PERSON 2 PATIENT 399.2 REVENUE CODE 5 STATE 365.021 X12 271 CONTACT QUALIFIER 368.001 X12 277 CLAIM STATUS CATEGORY 368.002 X12 277 PRODUCT OR SERVICE ID 5.11 ZIP CODE 368.001 X12 277 CLAIM STATUS CATEGORY FILE 368 HEALTH CARE CLAIM RFAI (277) 368.002 X12 277 PRODUCT OR SERVICE ID QUAL 368 HEALTH CARE CLAIM RFAI (277) 372 PFSS SITE PARAMETERS FILE 373 PFSS CHARGE CACHE FILE 375 PFSS ACCOUNT FILE
IBCE 837 EDI REPORTS This menu contains the options needed to define the types of electronic reports from the clearinghouse that the site needs to see and defines the text that should/should not allow automatic review and file for informational status messages. It also contains an option to purge old status messages, reports for maintaining the integrity of the return message subsystem and the option for reviewing electronically returned messages. IBCE 837 MANUAL TRANSMIT This job batches and transmits bills that are in authorized or Request MRA status for insurance companies flagged to transmit electronically via EDI. This job can be executed at any time to transmit bills awaiting extract. IBCE BATCH STATUS DETAIL IBCE BATCHES PENDING TOO LONG This report lists all batches by batch type that have been in a PENDING status and have not yet received confirmation of receipt from Austin for more than 1 day. Report includes pending since date and mail message # the batch is contained in. IBCE CLAIMS STATUS AWAITING Used by bill staff to review the most current status messages received for a bill(s) and do follow-up on the bills. Users will be able to select a bill from the list to view the details and the entire message text as well as to mark the message as reviewed or under review and document user comments. IBCE COB MANAGEMENT This will be a list manager screen with the option available to print an associated report. Using the screen, billing staff will be able to follow up on bills for secondary and tertiary billing for non-MRA bills. IBCE EDI BATCHES INCOMPLETE This report lists all batches that have been resubmitted, but not all bills were included. These are batches that have at least one bill still not resubmitted or canceled. IBCE EDI VIEW/PRINT EXTRACT This option will display the EDI extract data for a bill. IBCE ELEC REPORT DISPOSITION This option allows the site to determine which clearinghouse generated electronic canned reports are to be sent to the EDI mail group and which should be totally ignored when received at the site. IBCE ELECTRONIC ERROR REPORT This report provides a tool for billing personnel to identify the who, what, and where of errors in electronic billing process.
E CLAIMS MGMT ENGINE 4695 DBIA4695 E CLAIMS MGMT ENGINE 4696 DBIA4696 E CLAIMS MGMT ENGINE 4697 DBIA4697 E CLAIMS MGMT ENGINE 4698 DBIA4698 E CLAIMS MGMT ENGINE 4710 DBIA4710 E CLAIMS MGMT ENGINE 4729 API FOR RX BILLING INFO E CLAIMS MGMT ENGINE 5185 Update IB NDC NON COVERED BY PLAN FILE #366.16 E CLAIMS MGMT ENGINE 5210 IB DRUGS NON COVERED REPORT E CLAIMS MGMT ENGINE 5355 BILL INFORMATION E CLAIMS MGMT ENGINE 5361 IBOSRX E CLAIMS MGMT ENGINE 5572 IBNCPDPU E CLAIMS MGMT ENGINE 5576 DBIA5576 E CLAIMS MGMT ENGINE 5711 IB NCPDP EVENT LOG FILE E CLAIMS MGMT ENGINE 5712 PRINT IB ECME BILLING EVENTS REPORT E CLAIMS MGMT ENGINE 5713 IB LIST MANAGER DISPLAY DATA E CLAIMS MGMT ENGINE 5714 IB PHARMACY INSURANCE E CLAIMS MGMT ENGINE 6061 IBCNHUT1 (HPID/OEID) E CLAIMS MGMT ENGINE 6131 IBNCPEV3 E CLAIMS MGMT ENGINE 6136 DB6136 E CLAIMS MGMT ENGINE 6243 EPHARMACY BILLABLE STATUS E CLAIMS MGMT ENGINE 6244 RETRIEVE SESITIVE DIAGNOSIS DRUG FROM DRUG FILE E CLAIMS MGMT ENGINE 6250 E-PHARMACY HL7 PROCESSING ENROLLMENT APPLICATION SYSTEM 3302 DBIA3302 ENROLLMENT APPLICATION SYSTEM 3717 DBIA3717 ENROLLMENT APPLICATION SYSTEM 3777 DBIA3777 ENROLLMENT APPLICATION SYSTEM 4862 DBIA4862 FEE BASIS 228 DBIA228-A FEE BASIS 396 DBIA396 FEE BASIS 705 DBIA228-B FEE BASIS 4128 REVENUE CODE FEE BASIS CLAIMS SYSTEM 5281 FBCS File #353.1 Read only FEE BASIS CLAIMS SYSTEM 5282 FBCS File #353.2 Read only INCOME VERIFICATION MATCH 257 DBIA257 INCOME VERIFICATION MATCH 324 DBIA324 INCOME VERIFICATION MATCH 944 DBIA944 INCOME VERIFICATION MATCH 945 DBIA945 INCOME VERIFICATION MATCH 946 DBIA946 INCOME VERIFICATION MATCH 947 DBIA947 INCOME VERIFICATION MATCH 948 DBIA948
366.1 IB INSURANCE INCONSISTENT DATA 366.14 IB NCPDP EVENT LOG 366.17 IB NCPDP NON-BILLABLE REASONS 366.2 IB INSURANCE CONSISTENCY ELEMENTS 367 HPID/OEID RESPONSE @ 367.1 HPID/OEID TRANSMISSION QUEUE @ 367.11 INSURANCE COMPANY ID TYPE @ @ @ @ 399 BILL/CLAIMS @ @ @ @ @ (This page included for two-sided copying.)
Block A rectangular region on an encounter form. Attributes include position, size, outline type, and header. All other form components are contained within a particular block, and their position is relative to the block's position. Category C Category C patients are responsible for making as a result of Means Test legislation. Check-off Sheet A site configurable printed form containing CPT codes, descriptions, and dollar amounts (optional). Each check-off sheet may be assigned to an individual clinic or multiple clinics. Claims Tracking This is a new module in Integrated Billing that allows for the tracking of an episode of care from scheduling through final disposition of a bill. Collateral Visit A visit by a non-veteran patient whose appointment is related to or associated with a service-connected patient's treatment. Column A selection list contains one or more columns, a column being a rectangular area that contains a portion of the entries on a selection list. Attributes include position and height. Concurrent Reviews Review of patients by the hospital Utilization Review performed during the patient's hospital stay. Consistency Checker Review of patients by the hospital Utilization Review performed during the patient's hospital stay. Continuous Patient Patients continuously hospitalized at the same level of care since July 1, 1986. Converted Charges During the conversion, the BILLS/CLAIMS file (#399) is checked to insure that each outpatient visit has been billed. For each visit without an established bill, one is established and given a status of CONVERTED. Co-payment The charges required by legislation, that a patient is billed for services or supplies.