Home   Package List   Routine Alphabetical List   Global Alphabetical List   FileMan Files List   FileMan Sub-Files List   Package Component Lists   Package-Namespace Mapping  
Info |  Desc |  Accessed By FileMan Db Calls |  Pointer To FileMan Files |  Fields
Print Page as PDF
Global: ^BPSACR

Package: E Claims Management Engine

Global: ^BPSACR


Information

FileMan FileNo FileMan Filename Package
9002313.94 BPS AUTO CLOSE REJECT CODE E Claims Management Engine

Description

Accessed By FileMan Db Calls, Total: 2

Package Total Routines
E Claims Management Engine 1 BPSACR    
Outpatient Pharmacy 1 PSOACR    

Pointer To FileMan Files, Total: 2

Package Total FileMan Files
E Claims Management Engine 1 BPS NCPDP REJECT CODES(#9002313.93)[.01]    
Integrated Billing 1 CLAIMS TRACKING NON-BILLABLE REASONS(#356.8)[.02]    

Fields, Total: 3

Field # Name Loc Type Details
.01 AUTO CLOSE REJECT CODE 0;1 POINTER TO BPS NCPDP REJECT CODES FILE (#9002313.93)
************************REQUIRED FIELD************************
BPS NCPDP REJECT CODES(#9002313.93)

  • LAST EDITED:  FEB 04, 2025
  • HELP-PROMPT:  Enter an NCPDP Reject Code.
  • DESCRIPTION:  
    This field is a pointer to the BPS NCPDP REJECT CODES file (#9002313.93). This field indicates reject codes that will be defined as auto close rejects.
  • CROSS-REFERENCE:  9002313.94^B
    1)= S ^BPSACR("B",$E(X,1,30),DA)=""
    2)= K ^BPSACR("B",$E(X,1,30),DA)
  • FIELD INDEX:  C (#1759) REGULAR IR LOOKUP & SORTING
    Short Descr: SORT
    Description: This index allows the auto close reject codes to be displayed in ascending order in the ePharmacy Claim Parameters option.
    Set Logic: S ^BPSACR("C",X(1),X(2),DA)=""
    Kill Logic: K ^BPSACR("C",X(1),X(2),DA)
    Whole Kill: K ^BPSACR("C")
    X(1): Computed Code: S X=$$GET1^DIQ(9002313.94,DA,.01)
    (Subscr 1)
    X(2): AUTO CLOSE REJECT CODE (9002313.94,.01) (Subscr 2) (forwards)
.02 RNB PTR 0;2 POINTER TO CLAIMS TRACKING NON-BILLABLE REASONS FILE (#356.8)
************************REQUIRED FIELD************************
CLAIMS TRACKING NON-BILLABLE REASONS(#356.8)

  • INPUT TRANSFORM:  S DIC("S")="I ($P(^(0),U,2)=1),($P(^(0),U,5)'=1),($P(^(0),U,3)'=1)" D ^DIC K DIC S DIC=$G(DIE),X=+Y K:Y<0 X
  • LAST EDITED:  FEB 04, 2025
  • HELP-PROMPT:  Enter a Claims Tracking Non-Billable Reason code.
  • DESCRIPTION:  When a pharmacist ignores a reject, which is defined as an auto close reject, a Claims Tracking Non-Billable Reason will be applied in Claims Tracking. This field is the pointer to the code in file #356.8 that will be
    applied.
  • SCREEN:  S DIC("S")="I ($P(^(0),U,2)=1),($P(^(0),U,5)'=1),($P(^(0),U,3)'=1)"
  • EXPLANATION:  Active Non-Billable Reason Required
.03 DOLLAR THRESHOLD 0;3 NUMBER
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  K:+X'=X!(X>99999)!(X<0)!(X?.E1"."1.N) X
  • LAST EDITED:  FEB 04, 2025
  • HELP-PROMPT:  Type a number between 0 and 99999, 0 decimal digits. A value of zero will result in all claims with this reject code auto closing if the reject is ignored by the pharmacist.
  • DESCRIPTION:  If the value of this field is set to 0, then all claims with this reject code will be auto closed by the system if the reject is ignored by the pharmacist.
    OR
    If the Gross Amount Due is greater than or equal to the value of this field then the claim will not be auto closed by the system if the reject is ignored by the pharmacist.
  • TECHNICAL DESCR:  
    The Gross Amount Due value is stored in field 902.15 of the Patient Insurance Multiple (#902) of the BPS Transaction File (#9002313.59).
Info |  Desc |  Accessed By FileMan Db Calls |  Pointer To FileMan Files |  Fields