FO_INS

 

Field Type Notes

Ins_ID

int

ID field, a counter. Unique

InsCode

varchar(50)

Enter a unique insurance code.

Ins_Name

varchar(50)

Name for this insurance.

Policy_Mask

varchar(50)

Mask character value(s) for the policy number entered.

Multidimensional pipe delimited value, with leading and trailing pipes.

Enter allowed value combinations separated by pipes.

Allowed values:

* = any character

# = numeric character

@ = Text character

IE: |@@####|######|

Allows for the definition of multiple edit masks for each insurance code.

Group_Mask

varchar(50)

Edit mask for the group number entered on the demographic screen.

Enter an edit mask using allowed values.

Allowed values:

# = numeric character

@ = Text character

Type

varchar(5)

Informational

Site-specific use, not used by FAST

DisplayKey

varchar(80)

Informational

Site-specific use, not used by FAST

UseABN

int

Indicates if ABN and medical necessity rules will apply when this insurance is selected for a patient on the demographic screen.

Enter 0, 1, or skip this entry

0 or skip this entry = no medical necessity rules apply

1 = medical necessity rules apply

UseMSP

int

Indicates if MSP rules apply.

Enter 0, 1, or skip this entry

0 or skip this entry = no MSP rules apply

1 = MSP rules apply

UseReferral

int

Indicates if this insurance code requires a referral ID.

Enter 0, 1, or skip this entry

0 or skip this entry = no referral required

1 = referral is required

Causes the system to activate the referral screen in an order.

ReviewCarrier

varchar(50)

Carrier code this insurance code is associated with for medical necessity rules.

Reflected in the FO_CPTReview table.

ReviewCPTs

varchar(8000)

Defines CPT codes checked for medical necessity rules for this insurance code.

Multidimensional pipe delimited value, with leading and trailing pipes.

Enter valid CPT codes separated by pipes.

The system uses this list to speed medical necessity rules by only checking the CPT codes in the list for cross reference in the FO_CPTReview table.

RequiredFields

varchar(300)

Defines list of insurance related fields that are required fields, if present.

Enter single characters from the allowed values.

Allowed values:

P = policy number, also makes the relationship field mandatory

G = insurance group number

I = ICD / Diagnosis

IE: PG makes the policy, relationship and group fields required fields

UserName

varchar(50)

Name of user who last edited the record. Informational

CreateDate

datetime

Date record was created. Informational

FINSystemChargeTo

varchar(50)

Default financial system charge to.

Enter a financial system charge to.

BillPatient

bit

Bit flag to determine if the system assumes that a patient may be billed.

Enter 0 or 1

0 = do not intend to bill patient

1 = bill patient

If the patient should be billed, a transaction should be sent to the FIN system.

EditDate

datetime

Date record was last edited. Informational

AutoVerify

varchar(50)

Indicates to the system that when this insurance is picked as primary on the patient demographic screen, the system may auto verify the patient.

Enter 0, 1, or skip this entry

0 or skip this entry = do not auto verify patient

1 = auto verify patient

User must have permission autoverbyins1 for system to auto verify.

Ins_Rank

varchar(50)

Determines the ranking of the insurance when a search for insurances is performed on the patient demographic screen.

Skip this entry = any spot

Enter an allowed value.

Allowed values:

PRIMARY = for primary spot only

SECONDARY = for secondary and tertiary spot

If SECONDARY, the system only allows the user to use it in the secondary or tertiary spots of the patient demographic screen.

Ins_User_Assignement

varchar(255)

Defines the user group(s) who can search for this insurance code.

Multidimensional pipe delimited value, with leading and trailing pipes.

Enter valid user group codes separated by pipes.

ClientsPerfLabAssignement

varchar(500)

Enter |ALL|

Do NOT change without Rhodesapproval.

This is not the same as the 'C-' portion of performing lab rules definition.

MedNecessityFormCodes

varchar(255)

Defines a list of medical necessity (ABN) related forms available when the ABN button on the order screen is clicked.

Skip this field to default to |ABNENGLISH|ABNSPANISH|

Multidimensional pipe delimited value, with leading and trailing pipes.

Enter allowed values separated by pipes.

Allowed values:

ABNENGLISH

ABNSPANISH

BLANKABNENGLISH

BLANKABNSPANISH

GENERICENGLISH

GENERICSPANISH

BLANKGENERICENGLISH

BLANKGENERICSPANISH

To use custom forms, enter 'FC =' followed by FO_MedicalNecessity_Form_Definition.FormCode

LabPopup

varchar(80)

Text message presented to a lab user when this insurance code is selected on the patient demographic screen.

ClientPopup

varchar(80)

Text message that is presented to a client user when this insurance code is selected on the patient demographic screen.

NotPrimaryIfPolicyStartsWith

varchar(50)

Defines policy number starting character(s) that cause a warning to be displayed.

The warning is displayed if an insurance code is selected and the policy number entered starts with this (these) character(s).

Enter the policy number starting character(s).

DiagCodingMethod

varchar(50)

Enter valid diagnosis coding method, 9 or 10, for this insurance.

Value is referenced for Medical Necessity Rules.

BillFeeSchedule

varchar(80)

Default fee schedule code for this insurance when designated as the primary insurance.

Enter a valid fee schedule code.

BillingOption

varchar(80)

Default billing option code for the default fee schedule code for this insurance when designated as the primary insurance.

Enter a valid billing option code.

HRAFormCode

varchar(50)

Default form code to use for health forms for this insurance.

Enter a valid form code.

>>> NEED to Check Definition <<<

HRAFormFrequencyInDays

bigint

Number of days between HRA form collections.

Enter an integer as the number of days.

>>> NEED to Check Definition <<<

 

Definitions of valid MedNecessityFormCodes for the Medicare ABN form:

ABNENGLISH = English form

BLANKABNENGLISH = Blank English form

ABNSPANISH = Spanish form

BLANKABNSPANISH = Blank Spanish form

GENERICENGLISH = Generic English form

BLANKGENERICENGLISH = Blank Generic English form

GENERICSPANISH = Generic Spanish form

BLANKGENERICSPANISH = Blank Generic Spanish form