BPSOSH2 ;BHAM ISC/SD/lwj/DLF - Assemble formatted claim ;06/01/2004
Source file <BPSOSH2.m>
| Name | Comments | DBIA/ICR reference |
|---|---|---|
| XLOOP(NODES,IEN,BPS,REC) | ;EP - from BPSECA1
|
|
| SEGID(ND) | ; function, returns Segment ID
; Field 111 is the Segment Identifier - for each segment, other than ; the header, a unique value must be sent in this field ; to identify which segment is being sent. This value is not stored ; in the claim - as it changes with each of the 20 segments. The ; field does appear as part of the NCPDP Format, but is simply not stored. ; 01 = Patient 02 = Pharmacy Provider 03 = Prescriber ; 04 = Insurance 05 = COB/Other Payment 06 = Workers' Comp ; 07 = Claim 08 = DUR/PPS 09 = Coupon ; 10 = Compound 11 = Pricing 12 = Prior Auth ; 13 = Clinical 14 = Additional Doc 15 = Facility ; 16 = Narrative 17 = Purchaser 18 = Service Provider ; 19 = Intermediary 37 = Last Known 4Rx |
|
| PROCDUR | ; The DUR/PPS segment can repeat itself for any given
; transaction within a claim. This means we have to have special ; programming to handle the repeating fields. |
|
| PROCCOB | ;The COB OTHER PAYMENTS segment can repeat itself for any given
; transaction within a claim. This means we have to have special ; programming to handle the repeating fields. |
|
| AMTPAID | ; (#342) OTHER PAYER AMT PAID QUALIFIER multiple
|
|
| REJCODES | ; (#472) OTHER PAYER REJECT CODE
|
|
| PATPAID | ; (#353.01) OTHER PAYER-PATIENT RESPONSIBILITY multiple
|
|
| BENSTAGE | ; (#392.01) BENEFIT STAGE MLTPL multiple
|
|
| SUBCLAR(DATAFND,BPSIEN,SEGREC) | ;
; BPSIEN, SEGREC passed by ref., SEGREC is updated with repeating fields ; 420-DK Submission Clarification Code, a repeating group |
|
| OAMTCLMD(DATAFND,BPSIEN,SEGREC) | ;
; BPSIEN, SEGREC passed by ref., SEGREC updated with pairs of repeating fields ; (#478.01) OTHER AMT CLAIMED MULTIPLE (sub-file 9002313.0601) |
| FileNo | Call Tags |
|---|---|
| ^BPSC - [#9002313.02] | GET1^DIQ |
| 9002313.5112 | GET1^DIQ |
| ^BPST - [#9002313.59] | GET1^DIQ |
| ^BPSF(9002313.91 - [#9002313.91] | GET1^DIQ |
