FileMan FileNo | FileMan Filename | Package |
---|---|---|
9002313.59 | BPS TRANSACTION | E Claims Management Engine |
Package | Total | FileMan Files |
---|---|---|
E Claims Management Engine | 4 | BPS ASLEEP PAYERS(#9002313.15)[.04] BPS REQUESTS(#9002313.77)[.06] BPS CLAIMS(#9002313.02)[.08] BPS NCPDP FORMATS(#9002313.92)[1.11] |
Field # | Name | Loc | Type | Details |
---|---|---|---|---|
.01 | ENTRY NUMBER | 0;1 | FREE TEXT | ************************REQUIRED FIELD************************
|
1 | STATUS | 0;2 | NUMBER |
|
1.05 | POLICY NUMBER | 1;5 | NUMBER |
|
1.07 | PHARMACY | 1;7 | POINTER TO BPS PHARMACIES FILE (#9002313.56) | BPS PHARMACIES(#9002313.56)
|
1.08 | PINS PIECE | 1;8 | NUMBER |
|
1.09 | PRIOR AUTHORIZATION NUMBER | 1;9 | FREE TEXT |
|
1.11 | PRESCRIPTION NUMBER | 1;11 | POINTER TO PRESCRIPTION FILE (#52) | PRESCRIPTION(#52)
|
1.1199 | RXI INTERNAL | COMPUTED |
|
|
1.12 | RESUBMIT AFTER REVERSAL | 1;12 | SET |
|
1.13 | NCPDP OVERRIDES | 1;13 | POINTER TO BPS NCPDP OVERRIDE FILE (#9002313.511) | BPS NCPDP OVERRIDE(#9002313.511)
|
1.15 | PRIOR AUTHORIZATION TYPE CODE | 1;15 | FREE TEXT |
|
2 | HL7 MESSAGE ID | 0;3 | FREE TEXT |
|
3 | CLAIM | 0;4 | POINTER TO BPS CLAIMS FILE (#9002313.02) | BPS CLAIMS(#9002313.02)
|
3.1 | CLAIM IEN | COMPUTED |
|
|
4 | RESPONSE | 0;5 | POINTER TO BPS RESPONSES FILE (#9002313.03) | BPS RESPONSES(#9002313.03)
|
4.0098 | RESULT WITH REVERSAL | COMPUTED |
|
|
4.0099 | RESULT | COMPUTED |
|
|
4.1 | RESPONSE IEN | COMPUTED |
|
|
5 | PATIENT | 0;6 | POINTER TO PATIENT FILE (#2) | PATIENT(#2)
|
6 | SUBMIT DATE | 0;7 | DATE |
|
7 | LAST UPDATE | 0;8 | DATE |
|
9 | FILL NUMBER | 1;1 | NUMBER |
|
10 | NDC | 1;2 | FREE TEXT |
|
10.0099 | USER NUMBER | COMPUTED |
|
|
11 | PHARMACY DIVISION | 1;4 | POINTER TO OUTPATIENT SITE FILE (#59) | OUTPATIENT SITE(#59)
|
13 | USER | 0;10 | POINTER TO NEW PERSON FILE (#200) | NEW PERSON(#200)
|
14 | POSITION IN CLAIM | 0;9 | NUMBER |
|
15 | START TIME | 0;11 | DATE |
|
16 | SUBMIT REQUEST | 0;12 | POINTER TO BPS REQUESTS FILE (#9002313.77) | BPS REQUESTS(#9002313.77)
|
17 | SUBMIT REQUEST DATE TIME | 0;13 | DATE |
|
18 | COB INDICATOR | 0;14 | SET |
|
19 | TRANSACTION TYPE | 0;15 | SET |
|
111 | COMMENT MULTIPLE | 11;0 | DATE Multiple #9002313.59111 | 9002313.59111
|
201 | RESULT CODE | 2;1 | NUMBER |
|
202 | RESULT TEXT | 2;2 | FREE TEXT |
|
301 | NON-BILLABLE REASON | 3;1 | FREE TEXT |
|
302 | NON-BILLABLE CLOSED | 3;2 | SET |
|
303 | NON-BILLABLE DATE CLOSED | 3;3 | DATE |
|
304 | NON-BILLABLE CLOSED BY | 3;4 | POINTER TO NEW PERSON FILE (#200) | NEW PERSON(#200)
|
305 | NON-BILLABLE CLOSED COMMENT | 3;5 | FREE TEXT |
|
306 | NON-BILLABLE DATE RE-OPENED | 3;6 | DATE |
|
307 | NON-BILLABLE RE-OPENED BY | 3;7 | POINTER TO NEW PERSON FILE (#200) | NEW PERSON(#200)
|
308 | NON-BILLABLE RE-OPENED COMMENT | 3;8 | FREE TEXT |
|
401 | REVERSAL CLAIM | 4;1 | POINTER TO BPS CLAIMS FILE (#9002313.02) | BPS CLAIMS(#9002313.02)
|
402 | REVERSAL RESPONSE | 4;2 | POINTER TO BPS RESPONSES FILE (#9002313.03) | BPS RESPONSES(#9002313.03)
|
404 | REVERSAL REASON | 4;4 | FREE TEXT |
|
405 | REVERSAL REQUEST | 4;5 | POINTER TO BPS REQUESTS FILE (#9002313.77) | BPS REQUESTS(#9002313.77)
|
406 | REVERSAL REQUEST DATE TIME | 4;6 | DATE |
|
501 | QUANTITY | 5;1 | NUMBER |
|
502 | UNIT PRICE | 5;2 | NUMBER |
|
503 | SUBTOTAL | 5;3 | NUMBER |
|
504 | DISPENSING FEE | 5;4 | NUMBER |
|
505 | TOTAL PRICE | 5;5 | NUMBER |
|
507 | ADMINISTRATIVE FEE | 5;7 | FREE TEXT |
|
508 | UNIT OF MEASURE | 5;8 | FREE TEXT |
|
509 | BILLING QUANTITY | 5;9 | NUMBER |
|
510 | BILLING UNIT | 5;10 | FREE TEXT |
|
801 | ASLEEP PAYER | 8;1 | POINTER TO BPS ASLEEP PAYERS FILE (#9002313.15) | BPS ASLEEP PAYERS(#9002313.15)
|
901 | CURRENT VA INSURER | 9;1 | FREE TEXT |
|
901.04 | ELIGIBILITY | 9;4 | SET |
|
902 | PATIENT INSURANCE MULTIPLE | 10;0 | POINTER Multiple #9002313.59902 | 9002313.59902
|
1201 | RX ACTION | 12;1 | FREE TEXT |
|
1202 | DATE OF SERVICE | 12;2 | DATE |
|
1203 | SUBMISSION CLARIFICATION CODE | 12;3 | FREE TEXT |
|
1204 | COB OTHER PAYMENTS COUNT | 12;4 | NUMBER |
|
1205 | OTHER COVERAGE CODE | 12;5 | SET |
|
1300 | DUR DATA | 13;0 | Multiple #9002313.5913 | 9002313.5913
|
1400 | COB OTHER PAYERS | 14;0 | Multiple #9002313.5914 | 9002313.5914
|
9999.96 | NET PAID BY INSURER | COMPUTED |
|
|
9999.97 | ELAPSED TIME (PRINTABLE) | COMPUTED |
|
|
9999.98 | ELAPSED TIME (SECONDS) | COMPUTED |
|
|
9999.99 | RESULT CATEGORY | COMPUTED |
|
Name | Field # of Occurrence |
---|---|
^%DT | 6+1, 7+1, 15+1, 17+1, 303+1, 306+1, 406+1, 1202+1 |
$$NETPAID1^BPSOS03 | 9999.96+1 |
$$CATEG^BPSOSUC | 4.0098+1, 4.0099+1, 9999.99+1 |
$$TIMEDIF^BPSOSUD | 9999.97+1 |
$$TIMEDIFI^BPSOSUD | 9999.98+1 |
Name | Line Occurrences (* Changed, ! Killed) |
---|---|
^BPST - [#9002313.59] | 1.1199+1, 3.1+1, 4.1+1, 10.0099+1, 9999.97+1, 9999.98+1 |
^BPST("AC" | 5(XREF 1S), 5(XREF 1K) |
^BPST("AD" | 1(XREF 1S), 1(XREF 1K) |
^BPST("AE" | 3(XREF 1S), 3(XREF 1K) |
^BPST("AER" | 401(XREF 1S), 401(XREF 1K) |
^BPST("AF" | 4(XREF 1S), 4(XREF 1K) |
^BPST("AFR" | 402(XREF 1S), 402(XREF 1K) |
^BPST("AG" | 13(XREF 1S), 13(XREF 1K) |
^BPST("AH" | 7(XREF 1S), 7(XREF 1K) |
^BPST("AS" | 17(XREF 1S), 17(XREF 1K) |
^BPST("ASL" | 801(XREF 1S), 801(XREF 1K) |
^BPST("B" | .01(XREF 1S), .01(XREF 1K) |
^BPSTL - [#9002313.57] | 9999.96+1 |
Name | Field # of Occurrence |
---|---|
^(0 | 3.1+1, 4.1+1, 10.0099+1 |
^(1 | 1.1199+1 |
>> | Not killed explicitly |
* | Changed |
! | Killed |
~ | Newed |
Name | Field # of Occurrence |
---|---|
>> %DT | 6+1*, 7+1*, 15+1*, 17+1*, 303+1*, 306+1*, 406+1*, 1202+1* |
>> D0 | 1.1199+1, 3.1+1, 4.0098+1, 4.0099+1, 4.1+1, 10.0099+1, 9999.96+1, 9999.97+1, 9999.98+1, 9999.99+1 |
>> DA | .01(XREF 1S), .01(XREF 1K), 1(XREF 1S), 1(XREF 1K), 3(XREF 1S), 3(XREF 1K), 4(XREF 1S), 4(XREF 1K), 5(XREF 1S), 5(XREF 1K) , 7(XREF 1S), 7(XREF 1K), 13(XREF 1S), 13(XREF 1K), 17(XREF 1S), 17(XREF 1K), 401(XREF 1S), 401(XREF 1K), 402(XREF 1S), 402(XREF 1K) , 801(XREF 1S), 801(XREF 1K) |
POSITION | 9999.96+1~* |
RESP | 9999.96+1~* |
U | 1.1199+1, 3.1+1, 4.1+1, 10.0099+1, 9999.96+1, 9999.97+1, 9999.98+1 |
X | .01+1!, .01(XREF 1S), .01(XREF 1K), 1+1!, 1(XREF 1S), 1(XREF 1K), 1.05+1!, 1.08+1!, 1.09+1!, 1.1199+1* , 1.15+1!, 2+1!, 3(XREF 1S), 3(XREF 1K), 3.1+1*, 4(XREF 1S), 4(XREF 1K), 4.0098+1*, 4.0099+1*, 4.1+1* , 5(XREF 1S), 5(XREF 1K), 6+1*!, 7+1*!, 7(XREF 1S), 7(XREF 1K), 9+1!, 10+1!, 10.0099+1*, 13(XREF 1S) , 13(XREF 1K), 14+1!, 15+1*!, 17+1*!, 17(XREF 1S), 17(XREF 1K), 201+1!, 202+1!, 301+1!, 303+1*! , 305+1!, 306+1*!, 308+1!, 401(XREF 1S), 401(XREF 1K), 402(XREF 1S), 402(XREF 1K), 404+1!, 406+1*!, 501+1! , 502+1!, 503+1!, 504+1*!, 505+1*!, 505OT+1*, 507+1!, 508+1!, 509+1!, 510+1!, 801(XREF 1S) , 801(XREF 1K), 901+1!, 1201+1!, 1202+1*!, 1203+1!, 1204+1!, 9999.96+1*, 9999.97+1*, 9999.98+1*, 9999.99+1* |
>> Y | 6+1, 7+1, 15+1, 17+1, 303+1, 306+1, 406+1, 505OT+1, 1202+1 |
>> Y( | 1.1199+1*, 3.1+1*, 4.1+1*, 10.0099+1* |
>> Y(0 | 505OT+1* |