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TABLE Driven Health Insurance Claim Preparation

IP.com Disclosure Number: IPCOM000061327D
Original Publication Date: 1986-Jul-01
Included in the Prior Art Database: 2005-Mar-09
Document File: 1 page(s) / 13K

Publishing Venue

IBM

Related People

Sutherland, RW: AUTHOR

Abstract

This article describes a method for printing many different Health Insurance Claims using online tables to specify the location of the data on the forms. Health Care providers are required by health insurers to submit claims using many different forms. These forms usually require that the same set of data appear on the forms in different locations. Even with the advent of the Uniform Bill of 1982 (UB82), each insurer requires something different on the form. The Table Driven Health Insurance Claim Preparation facility of the Patient Care System - Patient Accounting Program (5668-13) assists Health Care Providers in specifying forms for Patient Bills, Insurance Bills and Insurance Claims.

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TABLE Driven Health Insurance Claim Preparation

This article describes a method for printing many different Health Insurance Claims using online tables to specify the location of the data on the forms. Health Care providers are required by health insurers to submit claims using many different forms. These forms usually require that the same set of data appear on the forms in different locations. Even with the advent of the Uniform Bill of 1982 (UB82), each insurer requires something different on the form. The Table Driven Health Insurance Claim Preparation facility of the Patient Care System - Patient Accounting Program (5668-13) assists Health Care Providers in specifying forms for Patient Bills, Insurance Bills and Insurance Claims. Using the facilities of Patient Care System - Application Execution System (5796-BCE) for screen and program management, the user can add new tables and update current tables online. A batch program reads the tables and produces the bills and claims. The user begins by specifying the identification of the form. This form code is assigned to each insurer. When the patient has a particular insurer, the form code identifies where the data is to print. After the user specifies the form code, a series of screens are presented that allow the user to specify the location of the data on the form. For example, the patient's name is to appear beginning on line 3 column 10. The user enters that data and any special editing criteria. In the case of the name, the user has the choice of Last, First and "M.I.", or First, Middle, and Last. For dollar and quantity fields, the user...