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Global: ^BPSR

Package: E Claims Management Engine

Global: ^BPSR


Information

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

Description

Directly Accessed By Routines, Total: 19

Package Total Routines
E Claims Management Engine 16 BPS10P7    BPS10PST    BPSNCPD1    BPSOS03    BPSOS57    BPSOSQ4    BPSOSQL    BPSPRRX5
BPSPRRX6    BPSRPT2    BPSRPT5    BPSRPT9A    BPSSCRLG    BPSSCRRJ    BPSSCRU3    BPSSCRU5
Integrated Billing 3 IBCNBLE2    IBJTRX    IBNCPDP3    

Accessed By FileMan Db Calls, Total: 6

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

Pointed To By FileMan Files, Total: 3

Package Total FileMan Files
E Claims Management Engine 2 BPS TRANSACTION(#9002313.59)[4402]    BPS LOG OF TRANSACTIONS(#9002313.57)[4402]    
Integrated Billing 1 INSURANCE VERIFICATION PROCESSOR(#355.33)[.17]    

Pointer To FileMan Files, Total: 4

Package Total FileMan Files
E Claims Management Engine 4 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 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:  FEB 07, 2008
  • 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 INDICATOR 100;15 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 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 SERVICE PROVIDER ID QUALIFIER 200;2 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>2!($L(X)<1) X
  • LAST EDITED:  FEB 07, 2008
  • HELP-PROMPT:  Answer must be 1-2 characters in length.
  • DESCRIPTION:  
    Code qualifying the 'Service Provider ID' (21)
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 RESPONSE STATUS 500;1 SET
  • 'A' FOR ACCEPTED;
  • 'R' FOR REJECTED;

  • LAST EDITED:  JUN 17, 2008
  • 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 IDENTIFICATION 500;24 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>8!($L(X)<8) X
  • LAST EDITED:  FEB 07, 2008
  • 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 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:  FEB 25, 2015
  • 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 ID 560;9 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:  
    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.
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