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Global: ^BPS(9002313.31

Package: E Claims Management Engine

Global: ^BPS(9002313.31

Information

FileMan FileNo	FileMan Filename	Package
9002313.31	BPS CERTIFICATION	E Claims Management Engine

Description

Data for development use in certifying software when required by switches and claims end processors. Also contains test claim used by MGR/TEST option. This file is completely overwritten by installation.

Accessed By FileMan Db Calls, Total: 1

Pointed To By FileMan Files, Total: 4

Pointer To FileMan Files, Total: 5

Fields, Total: 10

Field #	Name	Loc	Type	Details
.01	NAME	0;1	FREE TEXT	**********************REQUIRED FIELD********************** INPUT TRANSFORM: `K:$L(X)>30!($L(X)<3)!'(X'?1P.E) X` LAST EDITED: `JAN 16, 2004` HELP-PROMPT: `Answer must be 3-30 characters in length.` DESCRIPTION: `Name of the certification - typically whichever Processor the certification is being done for.` CROSS-REFERENCE: `9002313.31^B` `1)= S ^BPS(9002313.31,"B",$E(X,1,30),DA)=""` `2)= K ^BPS(9002313.31,"B",$E(X,1,30),DA)`
.03	CLAIM	0;3	POINTER TO BPS CLAIMS FILE (#9002313.02)	BPS CLAIMS(#9002313.02) LAST EDITED: `MAR 14, 2007` HELP-PROMPT: `Enter the BPS Claim number` DESCRIPTION: `This is the last BPS CLAIMS (#9002313.02) record that was created.`
.04	BILLING PAYER SHEET	0;4	POINTER TO BPS NCPDP FORMATS FILE (#9002313.92)	BPS NCPDP FORMATS(#9002313.92) LAST EDITED: `JAN 05, 2011` HELP-PROMPT: `Enter the billing payer sheet to be used for this certification claim.` DESCRIPTION: `This is the payer sheet to be used for Certification Testing when the test claim is a billing request.`
.05	REVERSAL PAYER SHEET	0;5	POINTER TO BPS NCPDP FORMATS FILE (#9002313.92)	BPS NCPDP FORMATS(#9002313.92) LAST EDITED: `JAN 05, 2011` HELP-PROMPT: `Enter the reversal payer sheet used for certification testing.` DESCRIPTION: `This is the payer sheet that will be used for certification testing when the test is a reversal.`
.06	MAX CLAIMS PER TRANSMISSION	0;6	NUMBER	INPUT TRANSFORM: `K:+X'=X!(X>4)!(X<1)!(X?.E1"."1.N) X` LAST EDITED: `JAN 04, 2011` HELP-PROMPT: `Type a number between 1 and 4, 0 decimal digits.` DESCRIPTION: `This is the maximum number of claims that can be bundled in a transmission. If not entered, the certification code will set this to 1.`
.07	COB INDICATOR	0;7	SET	'1' FOR PRIMARY; '2' FOR SECONDARY; '3' FOR TERTIARY; LAST EDITED: `JAN 05, 2011` HELP-PROMPT: `Enter whether this claim is for the primary, secondary, or tertiary payer.` DESCRIPTION: `This field is used to indicate the order of the payer (first-primary, second-secondary, third-tertiary).`
.08	ELIGIBILITY PAYER SHEET	0;8	POINTER TO BPS NCPDP FORMATS FILE (#9002313.92)	BPS NCPDP FORMATS(#9002313.92) LAST EDITED: `AUG 17, 2011` HELP-PROMPT: `Enter the eligibility payer sheet to be used for this certification claim.` DESCRIPTION: `This is the payer sheet to be used for Certification Testing when the test claim is an eligibility verification claim.`
1	NCPDP FIELD #	1;0	POINTER Multiple #9002313.311	9002313.311 DESCRIPTION: `Contains field information for any NCPDP fields which need to be defaulted.`
2	RX IN POSITION #	2;0	Multiple #9002313.312	9002313.312 DESCRIPTION: `The prescription order when submitting multiple claims in one transmission.`
903	PATIENT IEN	4;2	POINTER TO PATIENT FILE (#2)	PATIENT(#2) LAST EDITED: `NOV 05, 2003` DESCRIPTION: `Pointer to the patient file to link the patient being used for certification to the certification being performed.`

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