FileMan FileNo | FileMan Filename | Package |
---|---|---|
9002313.77 | BPS REQUESTS | E Claims Management Engine |
Package | Total | Routines |
---|---|---|
E Claims Management Engine | 3 | BPSOSRX4 BPSUSCR1 BPSUSCR2 |
Package | Total | FileMan Files |
---|---|---|
E Claims Management Engine | 3 | BPS REQUESTS(#9002313.77)[.05] BPS TRANSACTION(#9002313.59)[16, 405] BPS LOG OF TRANSACTIONS(#9002313.57)[16, 405] |
Field # | Name | Loc | Type | Details |
---|---|---|---|---|
.01 | KEY1 | 0;1 | NUMBER | ************************REQUIRED FIELD************************
|
.02 | KEY2 | 0;2 | NUMBER | ************************REQUIRED FIELD************************
|
.03 | ACTING COB | 0;3 | SET |
|
.04 | PROCESS FLAG | 0;4 | SET | ************************REQUIRED FIELD************************
|
.05 | NEXT REQUEST | 0;5 | POINTER TO BPS REQUESTS FILE (#9002313.77) | BPS REQUESTS(#9002313.77)
|
.06 | ECME TRANSACTION RECORD | 0;6 | POINTER TO BPS TRANSACTION FILE (#9002313.59) | BPS TRANSACTION(#9002313.59)
|
.07 | WAITING RESOLUTION? | 0;7 | SET |
|
.08 | DONT PROCESS UNTIL | 0;8 | DATE |
|
1.01 | RX ACTION | 1;1 | FREE TEXT |
|
1.02 | OUTPATIENT SITE | 1;2 | POINTER TO OUTPATIENT SITE FILE (#59) | OUTPATIENT SITE(#59)
|
1.04 | TRANSACTION TYPE | 1;4 | SET |
|
1.05 | BILLING DETERMINATION | 1;5 | SET |
|
1.06 | ELIGIBILITY | 1;6 | SET |
|
1.07 | CLAIM STATUS | 1;7 | FREE TEXT |
|
1.08 | RATE TYPE | 1;8 | POINTER TO RATE TYPE FILE (#399.3) | RATE TYPE(#399.3)
|
1.09 | PRIMARY PAYER BILL | 1;9 | POINTER TO BILL/CLAIMS FILE (#399) | BILL/CLAIMS(#399)
|
1.1 | PRIOR PAYMENT | 1;10 | NUMBER |
|
1.11 | COB OTHER PAYMENTS COUNT | 1;11 | NUMBER |
|
1.12 | OTHER COVERAGE CODE | 1;12 | SET |
|
1.13 | RX NUMBER | 1;13 | POINTER TO PRESCRIPTION FILE (#52) | PRESCRIPTION(#52)
|
1.14 | FILL NO | 1;14 | NUMBER |
|
1.15 | PATIENT | 1;15 | POINTER TO PATIENT FILE (#2) | PATIENT(#2)
|
1.16 | POLICY NUMBER | 1;16 | NUMBER |
|
2.01 | DATE OF SERVICE | 2;1 | DATE |
|
2.02 | REVERSAL REASON | 2;2 | FREE TEXT |
|
2.03 | DURREC | 2;3 | FREE TEXT |
|
2.04 | OVERRIDE CODE | 2;4 | POINTER TO BPS NCPDP OVERRIDE FILE (#9002313.511) | BPS NCPDP OVERRIDE(#9002313.511)
|
2.05 | CLARIFICATION CODE | 2;5 | FREE TEXT |
|
2.06 | BILL NDC | 2;6 | FREE TEXT |
|
2.07 | PRE AUTH TYPE CODE | 2;7 | FREE TEXT |
|
2.08 | PRE AUTH NUM SUB | 2;8 | FREE TEXT |
|
2.09 | SC AND EI OVERRIDE FLAG | 2;9 | SET |
|
2.1 | DELAY REASON CODE | 2;10 | POINTER TO BPS NCPDP DELAY REASON CODE FILE (#9002313.29) | BPS NCPDP DELAY REASON CODE(#9002313.29)
|
3 | DUR | 3;0 | Multiple #9002313.771 | 9002313.771
|
4.01 | QUANTITY | 4;1 | NUMBER |
|
4.02 | UNIT PRICE | 4;2 | NUMBER |
|
4.03 | NDC | 4;3 | FREE TEXT |
|
4.04 | REFILL | 4;4 | NUMBER |
|
4.05 | CERTIFY MODE | 4;5 | SET |
|
4.06 | CERTIFICATION IEN | 4;6 | POINTER TO BPS CERTIFICATION FILE (#9002313.31) | BPS CERTIFICATION(#9002313.31)
|
4.07 | UNIT OF MEASURE | 4;7 | FREE TEXT |
|
4.08 | BILLING QUANTITY | 4;8 | NUMBER |
|
4.09 | BILLING UNIT | 4;9 | FREE TEXT |
|
5 | INSURER DATA | 5;0 | SET Multiple #9002313.772 | 9002313.772
|
6.01 | REQUEST DATE AND TIME | 6;1 | DATE |
|
6.02 | USER WHO MADE THE REQUEST | 6;2 | POINTER TO NEW PERSON FILE (#200) | NEW PERSON(#200)
|
6.03 | ACTIVATED DATE TIME | 6;3 | DATE |
|
6.04 | USER WHO ACTIVATED REQUEST | 6;4 | POINTER TO NEW PERSON FILE (#200) | NEW PERSON(#200)
|
6.05 | DATE AND TIME UPDATED | 6;5 | DATE |
|
6.06 | USER WHO UPDATED THE REQUEST | 6;6 | POINTER TO NEW PERSON FILE (#200) | NEW PERSON(#200)
|
7.01 | CLOSE AFT REV | 7;1 | SET |
|
7.02 | CLOSE AFT REV REASON | 7;2 | POINTER TO CLAIMS TRACKING NON-BILLABLE REASONS FILE (#356.8) | CLAIMS TRACKING NON-BILLABLE REASONS(#356.8)
|
7.03 | CLOSE AFT REV COMMENT | 7;3 | FREE TEXT |
|
8 | COB OTHER PAYERS | 8;0 | Multiple #9002313.778 | 9002313.778
|
9.01 | INACTIVATION REASON | 9;1 | FREE TEXT |
|
Name | Field # of Occurrence |
---|---|
^%DT | .08+1, 2.01+1, 6.01+1, 6.03+1, 6.05+1 |
>> | Not killed explicitly |
* | Changed |
! | Killed |
~ | Newed |
Name | Field # of Occurrence |
---|---|
>> %DT | .08+1*, 2.01+1*, 6.01+1*, 6.03+1*, 6.05+1* |
>> DA | IXACSL+1, IXACKL+1, IXANSL+1, IXANKL+1, IXANP1CC+1, IXDSL+1, IXDKL+1, .01(XREF 1S), .01(XREF 1K), .06(XREF 1S) , .06(XREF 1K), 6.05(XREF 1S), 6.05(XREF 1K) |
X | IXANP1CC+1*, .01+1!, .01(XREF 1S), .01(XREF 1K), .02+1!, .06(XREF 1S), .06(XREF 1K), .08+1*!, 1.01+1!, 1.07+1! , 1.1+1*!, 1.11+1!, 1.14+1!, 1.16+1!, 2.01+1*!, 2.02+1!, 2.03+1!, 2.05+1!, 2.06+1!, 2.07+1! , 2.08+1!, 4.01+1!, 4.02+1!, 4.03+1!, 4.04+1!, 4.07+1!, 4.08+1!, 4.09+1!, 6.01+1*!, 6.03+1*! , 6.05+1*!, 6.05(XREF 1S), 6.05(XREF 1K), 7.03+1!, 9.01+1! |
X(1 | IXACSL+1, IXACKL+1, IXDSL+1, IXDKL+1 |
X(2 | IXACSL+1, IXACKL+1, IXANSL+1, IXANKL+1, IXDSL+1, IXDKL+1 |
X(3 | IXACSL+1, IXACKL+1, IXANSL+1, IXDSL+1, IXDKL+1 |
X(4 | IXACSL+1, IXANSL+1, IXDSL+1, IXDKL+1 |
X(5 | IXANSL+1 |
>> Y | .08+1, 2.01+1, 6.01+1, 6.03+1, 6.05+1 |