FileMan FileNo | FileMan Filename | Package |
---|---|---|
9002313.32 | BPS PAYER RESPONSE OVERRIDES | E Claims Management Engine |
Package | Total | Routines |
---|---|---|
E Claims Management Engine | 2 | BPSTEST BPSTEST2 |
Field # | Name | Loc | Type | Details |
---|---|---|---|---|
.01 | TRANSACTION NUMBER | 0;1 | NUMBER | ************************REQUIRED FIELD************************
|
.02 | TYPE | 0;2 | SET |
|
.03 | SUBMISSION RESPONSE | 0;3 | SET |
|
.04 | TOTAL AMOUNT PAID | 0;4 | NUMBER |
|
.05 | REVERSAL RESPONSE | 0;5 | SET |
|
.06 | AMOUNT OF COPAY | 0;6 | NUMBER |
|
.07 | DELAY | 0;7 | NUMBER |
|
.08 | ELIGIBILITY RESPONSE | 0;8 | SET |
|
.09 | NEXT AVAILABLE FILL DATE | 0;9 | DATE |
|
.1 | ADJUDICATED PROGRAM TYPE | 0;10 | SET |
|
.11 | QUAN LIMIT PER SPC TIME PERIOD | 0;11 | NUMBER |
|
.12 | QUANTITY LIMIT TIME PERIOD | 0;12 | NUMBER |
|
.13 | DAYS SUP LIM PER SPC TM PERIOD | 0;13 | NUMBER |
|
.14 | DAYS SUPPLY LIMIT TIME PERIOD | 0;14 | NUMBER |
|
.15 | INGREDIENT COST PAID | 0;15 | NUMBER |
|
.16 | DISPENSING FEE PAID | 0;16 | NUMBER |
|
.17 | REMAINING DEDUCTIBLE AMOUNT | 0;17 | NUMBER |
|
.18 | AMT APPLIED TO PERIODIC DEDUCT | 0;18 | NUMBER |
|
1 | REJECT CODES | 1;0 | POINTER Multiple #9002313.321 | 9002313.321
|
2.01 | PERCENTAGE TAX BASIS PAID | 2;1 | SET |
|
2.02 | OTHER AMOUNT PAID QUALIFIER | 2;2 | FREE TEXT |
|
2.03 | PAYER/HEALTH PLAN ID QUALIFIER | 2;3 | SET |
|
2.04 | HELP DESK TELEPHONE NUMBER EXT | 2;4 | FREE TEXT |
|
2.05 | PRO SERVICE FEE CONT/REIM AMT | 2;5 | NUMBER |
|
2.06 | OTHER PAYER HELPDESK PHONE EXT | 2;6 | NUMBER |
|
2.07 | RESPONSE INTERMED AUTH TYPE ID | 2;7 | FREE TEXT |
|
2.08 | RESPONSE INTERMEDIARY AUTH ID | 2;8 | FREE TEXT |
|
2.09 | RECONCILIATION ID | 2;9 | FREE TEXT |
|
2.1 | PATIENT PAY AMOUNT | 2;10 | NUMBER |
|
2.11 | REASON FOR SERVICE CODE | 2;11 | POINTER TO BPS NCPDP REASON FOR SERVICE CODE FILE (#9002313.23) | BPS NCPDP REASON FOR SERVICE CODE(#9002313.23)
|
3.01 | INTERMEDIARY MESSAGE | 3;1 | FREE TEXT |
|
4.01 | MAXIMUM AGE QUALIFIER | 4;1 | SET |
|
4.02 | MAXIMUM AGE | 4;2 | NUMBER |
|
4.03 | MAXIMUM AMOUNT | 4;3 | NUMBER |
|
4.04 | MAXIMUM AMOUNT QUALIFIER | 4;4 | SET |
|
4.05 | MAXIMUM AMOUNT TIME PERIOD | 4;5 | SET |
|
4.06 | MAX AMT TIME PERIOD START DATE | 4;6 | DATE |
|
4.07 | MAX AMT TIME PERIOD END DATE | 4;7 | DATE |
|
4.08 | MAX AMT TIME PERIOD UNITS | 4;8 | NUMBER |
|
4.09 | MINIMUM AGE QUALIFIER | 4;9 | SET |
|
4.1 | MINIMUM AGE | 4;10 | NUMBER |
|
4.11 | OTHER PAYER PROGRAM TYPE | 4;11 | POINTER TO BPS NCPDP OTHER PAYER PROGRAM TYPE FILE (#9002313.38) | BPS NCPDP OTHER PAYER PROGRAM TYPE(#9002313.38)
|
4.12 | PATIENT PAY COMPONENT AMOUNT | 4;12 | NUMBER |
|
4.13 | PATIENT PAY COMPONENT COUNT | 4;13 | NUMBER |
|
4.14 | PATIENT PAY COMPONENT QUAL | 4;14 | POINTER TO BPS NCPDP PATIENT PAY COMPONENT QUALIFIER FILE (#9002313.37) | BPS NCPDP PATIENT PAY COMPONENT QUALIFIER(#9002313.37)
|
4.15 | MINIMUM AMOUNT | 4;15 | NUMBER |
|
4.16 | MINIMUM AMOUNT QUALIFIER | 4;16 | SET |
|
4.17 | OTHER PAYER NAME | 4;17 | FREE TEXT |
|
4.18 | REMAINING AMOUNT | 4;18 | NUMBER |
|
4.19 | REMAINING AMOUNT QUALIFIER | 4;19 | SET |
|
4.2 | OTHER PAYER RELATIONSHIP TYPE | 4;20 | SET |
|
5.01 | INVALID PROVIDER DATA SOURCE | 5;1 | POINTER TO BPS NCPDP INVALID PROVIDER DATA SOURCE FILE (#9002313.42) | BPS NCPDP INVALID PROVIDER DATA SOURCE(#9002313.42)
|
5.02 | FORMULARY ALTERNATIVE EFF DATE | 5;2 | DATE |
|
5.03 | DUR/DUE CO-AGENT DESCRIPTION | 5;3 | FREE TEXT |
|
5.04 | UNIT OF PRIOR DISPENSED QTY | 5;4 | SET |
|
5.05 | OTHER PHARMACY ID QUALIFIER | 5;5 | POINTER TO BPS NCPDP OTHER PHARMACY ID QUALIFIER FILE (#9002313.4) | BPS NCPDP OTHER PHARMACY ID QUALIFIER(#9002313.4)
|
5.06 | OTHER PHARMACY NAME | 5;6 | FREE TEXT |
|
5.07 | OTHER PHARMACY TELEPHONE | 5;7 | NUMBER |
|
5.08 | OTHER PRESCRIBER LAST NAME | 5;8 | FREE TEXT |
|
5.09 | OTHER PRESCRIBER ID QUALIFIER | 5;9 | POINTER TO BPS NCPDP OTHER PRESCRIBER ID QUALIFIER FILE (#9002313.41) | BPS NCPDP OTHER PRESCRIBER ID QUALIFIER(#9002313.41)
|
5.1 | OTHER PRESCRIBER ID | 5;10 | FREE TEXT |
|
5.11 | OTHER PRESCRIBER PHONE NUMBER | 5;11 | NUMBER |
|
5.12 | DUR/DUE COMPOUND PRODUCT ID | 5;12 | FREE TEXT |
|
5.13 | DUR/DUE CMPND PRDUCT ID QUALIF | 5;13 | POINTER TO BPS NCPDP COMPOUND PROD ID QUALIFIER FILE (#9002313.39) | BPS NCPDP COMPOUND PROD ID QUALIFIER(#9002313.39)
|
5.14 | DUR/DUE MAXIMUM DAILY DOSE QTY | 5;14 | NUMBER |
|
5.15 | DUR/DUE MAX DAILY DOSE - UNIT | 5;15 | SET |
|
5.16 | DUR/DUE MINIMUM DAILY DOSE QTY | 5;16 | NUMBER |
|
5.17 | DUR/DUE MIN DAILY DOSE - UNIT | 5;17 | SET |
|