Global: ^BPSR

FileMan FileNo	FileMan Filename	Package
9002313.03	BPS RESPONSES	E Claims Management Engine

Package	Total	Routines
E Claims Management Engine	29	ADDITIONAL MESSAGE MLTPL APPROVED MESSAGE CODE BENEFIT STAGE INFO BPS10P7 BPS10PST BPSNCPD1 BPSOS03 BPSOS57 BPSOSQ4 BPSOSQL BPSPRRX5 BPSPRRX6 BPSRPT2 BPSRPT5 BPSRPT9A BPSSCRLG BPSSCRRJ BPSSCRU3 BPSSCRU5 DAYS SUPPLY LIM TM PD MULTIPLE DUR PPS INTERMEDIARY MULTIPLE OTHER AMOUNTS PAID PREFERRED PRODUCT REPEATING ^BPS(9002313.99 OTHER PAYER ID MLTPL QUAN LIMIT TIME PERIOD MLTPL REJECT CODE RESPONSES
Integrated Billing	5	IBCNBAA IBCNBLE2 IBCNETST IBJTRX IBNCPDP3

Package	Total	Routines
E Claims Management Engine	4	BPSECMPS BPSNCPD3 BPSOS57 BPSRCRI
Integrated Billing	2	IBCNBLE2 IBNCPDP3

Package	Total	FileMan Files
E Claims Management Engine	2	BPS TRANSACTION(#9002313.59)[4, 402] BPS LOG OF TRANSACTIONS(#9002313.57)[4, 402]
Integrated Billing	2	INSURANCE VERIFICATION PROCESSOR(#355.33)[.17] EIV E1 TRANSACTION RESPONSE LOG(#365.3)[.03]
Registration	1	PATIENT(#2)[#2.312(8.04)]

Package	Total	FileMan Files
E Claims Management Engine	8	BPS NCPDP BENEFIT STAGE INDICATOR(#9002313.35)[#9002313.0301(2151)] BPS NCPDP PATIENT PAY COMPONENT QUALIFIER(#9002313.37)[#9002313.0301(2195)] BPS NCPDP OTHER PAYER PROGRAM TYPE(#9002313.38)[#9002313.0301(2147)] BPS NCPDP COMPOUND PROD ID QUALIFIER(#9002313.39)[#9002313.0301(2405)] BPS NCPDP OTHER PHARMACY ID QUALIFIER(#9002313.4)[#9002313.0301(2395)] BPS NCPDP OTHER PRESCRIBER ID QUALIFIER(#9002313.41)[#9002313.0301(2401)] BPS NCPDP INVALID PROVIDER DATA SOURCE(#9002313.42)[#9002313.0301(2387)] BPS CLAIMS(#9002313.02)[.01]

Fields, Total: 23

Field #	Name	Loc	Type	Details
.01	BPS CLAIM	0;1	POINTER TO BPS CLAIMS FILE (#9002313.02)	**********************REQUIRED FIELD********************** BPS CLAIMS(#9002313.02) LAST EDITED: `FEB 07, 2008` HELP-PROMPT: `Select the BPS Claim.` DESCRIPTION: `Identifier for BPS responses.` CROSS-REFERENCE: `9002313.03^B` `1)= S ^BPSR("B",$E(X,1,30),DA)=""` `2)= K ^BPSR("B",$E(X,1,30),DA)`
.02	DATE RESPONSE RECEIVED	0;2	DATE	INPUT TRANSFORM: `S %DT="ESTXR" D ^%DT S X=Y K:Y<1 X` LAST EDITED: `FEB 07, 2008` HELP-PROMPT: `Enter the date the Response was received.` DESCRIPTION: `Date that response was received on the system.` CROSS-REFERENCE: `9002313.03^AE` `1)= S ^BPSR("AE",$E(X,1,30),DA)=""` `2)= K ^BPSR("AE",$E(X,1,30),DA)`
102	VERSION/RELEASE NUMBER	100;2	FREE TEXT	INPUT TRANSFORM: `K:$L(X)>2!($L(X)<2) X` LAST EDITED: `MAR 30, 2021` HELP-PROMPT: `Answer must be 2 characters in length.` DESCRIPTION: `NCPDP Version/Release Number.`
103	TRANSACTION CODE	100;3	FREE TEXT	INPUT TRANSFORM: `K:$L(X)>2!($L(X)<2) X` LAST EDITED: `FEB 07, 2008` HELP-PROMPT: `Answer must be 2 characters in length.` DESCRIPTION: `Code identifying the type of transaction.`
109	TRANSACTION COUNT	100;9	NUMBER	INPUT TRANSFORM: `K:+X'=X!(X>4)!(X<1)!(X?.E1"."1.N) X` LAST EDITED: `JUN 18, 2008` HELP-PROMPT: `Type a number between 1 and 4, 0 Decimal Digits` DESCRIPTION: `Count of transactions in the transmission.`
115	MEDICAID ID NUMBER	100;15	FREE TEXT	INPUT TRANSFORM: `K:$L(X)>22!($L(X)<1) X` LAST EDITED: `MAR 30, 2021` HELP-PROMPT: `Answer must be 1-22 characters.` DESCRIPTION: `This is used to store NCPDP field 115-N5 (Medicaid ID Number), which is defined as "A unique member identification number assigned by the Medicaid Agency."`
116	MEDICAID AGENCY NUMBER	100;16	FREE TEXT	INPUT TRANSFORM: `K:$L(X)>17!($L(X)<1) X` LAST EDITED: `JUL 22, 2010` HELP-PROMPT: `Answer must be 1-17 characters.` DESCRIPTION: `This is used to store NCPDP field 116-N6 (Medicaid Agency Number), which is defined as "Number assigned by processor to identify the individual Medicaid Agency or representative."`
201	SERVICE PROVIDER ID	200;1	FREE TEXT	INPUT TRANSFORM: `K:$L(X)>15!($L(X)<1) X` LAST EDITED: `FEB 07, 2008` HELP-PROMPT: `Answer must be 1-15 characters in length.` DESCRIPTION: `ID assigned to a pharmacy or provider.`
202	SERV PROVIDER ID QUALIFIER	200;2	FREE TEXT	INPUT TRANSFORM: `K:$L(X)>2!($L(X)<1) X` LAST EDITED: `MAR 30, 2021` HELP-PROMPT: `Answer must be 1-2 characters in length.` DESCRIPTION: `Code qualifying the 'Service Provider ID' (2Ø1)`
301	GROUP ID	300;1	FREE TEXT	INPUT TRANSFORM: `K:$L(X)>15!($L(X)<1) X` LAST EDITED: `FEB 07, 2008` HELP-PROMPT: `Answer must be 1-15 characters in length.` DESCRIPTION: `ID assigned to the cardholder group or employer group.`
302	CARDHOLDER ID	300;2	FREE TEXT	INPUT TRANSFORM: `K:$L(X)>22!($L(X)<1) X` LAST EDITED: `JUL 22, 2010` HELP-PROMPT: `Answer must be 1-22 characters.` DESCRIPTION: `This is used to store NCPDP field 302-C2 (Cardholder ID), which is defined as "Insurance ID assigned to the cardholder or identification number used by the plan."`
304	DATE OF BIRTH	300;4	FREE TEXT	INPUT TRANSFORM: `K:$L(X)>10!($L(X)<1) X` LAST EDITED: `JUL 22, 2010` HELP-PROMPT: `Answer must be 1-10 characters.` DESCRIPTION: `This is used to store NCPDP field 304-C4 (Date Of Birth), which is defined as "Date of birth of patient."`
310	PATIENT FIRST NAME	300;10	FREE TEXT	INPUT TRANSFORM: `K:$L(X)>14!($L(X)<1) X` LAST EDITED: `JUL 22, 2010` HELP-PROMPT: `Answer must be 1-14 characters.` DESCRIPTION: `This is used to store NCPDP field 310-CA (Patient First Name), which is defined as "Individual first name."`
311	PATIENT LAST NAME	310;1	FREE TEXT	INPUT TRANSFORM: `K:$L(X)>17!($L(X)<1) X` LAST EDITED: `AUG 31, 2010` HELP-PROMPT: `Answer must be 1-17 characters in length.` DESCRIPTION: `This is used to store NCPDP field 311-CB (Patient Last Name), which is defined as "Individual last name."` TECHNICAL DESCR: `REQUEST PATIENT SEGMENT. RESPONSE PATIENT SEGMENT.`
401	DATE OF SERVICE	400;1	FREE TEXT	INPUT TRANSFORM: `K:$L(X)>8!($L(X)<8) X` OUTPUT TRANSFORM: `S Y=$$FM3EXT^BPSOSU1(Y)` LAST EDITED: `JUN 18, 2008` HELP-PROMPT: `Answer must be 8 characters in length.` DESCRIPTION: `Identifies date the prescription was filled or professional service rendered.`
501	HEADER RESPONSE STATUS	500;1	SET	'A' FOR ACCEPTED; 'R' FOR REJECTED; LAST EDITED: `MAR 30, 2021` HELP-PROMPT: `Enter the status of the response from the payer.` DESCRIPTION: `A code indicating the status of this response.`
504	MESSAGE	504;1	FREE TEXT	INPUT TRANSFORM: `K:$L(X)>250!($L(X)<1) X` LAST EDITED: `FEB 07, 2008` HELP-PROMPT: `Answer must be 1-250 characters in length.` DESCRIPTION: `Free form message.`
524	PLAN ID	500;24	FREE TEXT	INPUT TRANSFORM: `K:$L(X)>8!($L(X)<8) X` LAST EDITED: `MAR 30, 2021` HELP-PROMPT: `Answer must be 8 characters in length.` DESCRIPTION: `Assigned by the processor to identify a set of parameters, benefit, or coverage criteria used to adjudicate a claim.`
545	NETWORK REIMBURSEMENT ID	540;5	FREE TEXT	INPUT TRANSFORM: `K:$L(X)>10!($L(X)<1) X` LAST EDITED: `FEB 07, 2008` HELP-PROMPT: `Answer must be 1-10 characters in length.` DESCRIPTION: `Field defined by the processor. It identifies the network, for the covered member, used to calculate the reimbursement to the pharmacy.`
568	PAYER/HEALTH PLAN ID QUALIFIER	560;8	SET	'01' FOR STANDARD UNIQUE HEALTH PLAN ID; '02' FOR HIN; '03' FOR BIN; '04' FOR NAIC; '99' FOR OTHER; LAST EDITED: `MAR 30, 2021` HELP-PROMPT: `Enter a code specifying the type of payer ID.` DESCRIPTION: `Code indicating the type of payer ID.` TECHNICAL DESCR: `NCPDP field 568-J7.`
569	PAYER/HEALTH PLAN ID	560;9	FREE TEXT	INPUT TRANSFORM: `K:$L(X)>10!($L(X)<1) X` LAST EDITED: `MAR 30, 2021` HELP-PROMPT: `Answer must be 1-10 characters in length.` DESCRIPTION: `Payer identification - the payer this claim was submitted to.`
1000	RESPONSES	1000;0	Multiple #9002313.0301	9002313.0301 LAST EDITED: `FEB 07, 2008` DESCRIPTION: `This is the transaction response data returned by the third-party payer.`
9999	RAW DATA RECEIVED	M;0	WORD-PROCESSING #9002313.39999	HELP-PROMPT: `Enter the raw NCPDP data received from the payer.` DESCRIPTION: `This is to store the raw data received from the payer.` LAST EDITED: `JUN 18, 2008` DESCRIPTION: `A copy of the raw data packet received. This could be of use in diagnosing weird problems, such as the time a packet was apparently shifted two places.`

>>	Not killed explicitly
*	Changed
!	Killed
~	Newed

Name	Field # of Occurrence
>> %DT	.02+1*
>> DA	.01(XREF 1S), .01(XREF 1K), .02(XREF 1S), .02(XREF 1K)
X	.01(XREF 1S), .01(XREF 1K), .02+1*!, .02(XREF 1S), .02(XREF 1K), 102+1!, 103+1!, 109+1!, 115+1!, 116+1! , 201+1!, 202+1!, 301+1!, 302+1!, 304+1!, 310+1!, 311+1!, 401+1!, 504+1!, 524+1! , 545+1!, 569+1!
>> Y	.02+1, 401OT+1*
>> Y(0	401OT+1*

Customize PDF page

Package: E Claims Management Engine

Global: ^BPSR

Information

Description

Directly Accessed By Routines, Total: 39

Accessed By FileMan Db Calls, Total: 6

Pointed To By FileMan Files, Total: 5

Pointer To FileMan Files, Total: 8

Fields, Total: 23

External References

Global Variables Directly Accessed

Local Variables

Legend:

Name	Line Occurrences (* Changed, ! Killed)
^BPSR("AE"	.02(XREF 1S), .02(XREF 1K)
^BPSR("B"	.01(XREF 1S), .01(XREF 1K)