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Sub-Field: 366.023

Package: Integrated Billing

PHARMACY BENEFITS MANAGER (PBM)(#366.02)-->366.023

Sub-Field: 366.023


Information

Parent File Name Number Package
PHARMACY BENEFITS MANAGER (PBM)(#366.02) APPLICATION 366.023 Integrated Billing

Details

Field # Name Loc Type Details
.01 APPLICATION 0;1 POINTER TO PHARMACY BENEFITS MANAGER (PBM) APPLICATION FILE (#366.12) PHARMACY BENEFITS MANAGER (PBM) APPLICATION(#366.12)

  • LAST EDITED:  NOV 10, 2003
  • HELP-PROMPT:  Answer must be 3-30 characters in length, non-numeric, and can not have a leading puncuation character.
  • DESCRIPTION:  
    The application's (electronic interface application) name.
  • CROSS-REFERENCE:  366.023^B
    1)= S ^IBCNR(366.02,DA(1),3,"B",$E(X,1,30),DA)=""
    2)= K ^IBCNR(366.02,DA(1),3,"B",$E(X,1,30),DA)
.02 NATIONAL ACTIVE? 0;2 SET
  • '0' FOR Not Active;
  • '1' FOR Active;

  • LAST EDITED:  NOV 07, 2003
  • HELP-PROMPT:  Do not edit via FileMan! Are electronic transactions permitted from a national perspective? Enter 'A' for Active (permitted) or 'N' for Not Active (not permitted).
  • DESCRIPTION:  An application (electronic interface application) flag, controlled by the national Eligibility Communicator (EC), indicating if the Pharmacy Benefits Manager (PBM) is active (electronic transactions permitted). Do not
    edit via FileMan.
.03 LOCAL ACTIVE? 0;3 SET
  • '0' FOR Not Active;
  • '1' FOR Active;

  • LAST EDITED:  NOV 07, 2003
  • HELP-PROMPT:  Are electronic transactions permitted from a local perspective? Enter 'A' for Active (permitted) or 'N' for Not Active (not permitted).
  • DESCRIPTION:  
    An application (electronic interface application) flag, controlled by the local site, indicating if the Pharmacy Benefits Manager (PBM) is active (electronic transactions permitted).
.04 USER EDITED LOCAL 0;4 POINTER TO NEW PERSON FILE (#200) NEW PERSON(#200)

  • LAST EDITED:  NOV 07, 2003
  • HELP-PROMPT:  Enter the user's name associated with the last edit of the Application (electronic interface application) Local Active? field.
  • DESCRIPTION:  
    The user's name associated with the last edit of the Application (electronic interface application) Local Active? field.
.05 DATE/TIME LOCAL EDITED 0;5 DATE

  • INPUT TRANSFORM:  S %DT="ESTXR" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  NOV 07, 2003
  • HELP-PROMPT:  Enter the date and time associated with the last edit of the Application (electronic interface application) Local Active? field.
  • DESCRIPTION:  
    The date and time associated with the last edit of the Application (electronic interface application) Local Active? field.
.06 DATE/TIME NATIONAL EDITED 0;6 DATE

  • INPUT TRANSFORM:  S %DT="ESTXR" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  NOV 07, 2003
  • HELP-PROMPT:  Do not edit via FileMan. Enter the date and time associated with the last edit of the Application (electronic interface application) National Active? field.
  • DESCRIPTION:  
    The date and time associated with the last edit of the Application (electronic interface application) National Active? field. Do not edit via FileMan.
.07 AUTO-ACCEPT? 0;7 SET
  • '0' FOR No;
  • '1' FOR Yes;

  • LAST EDITED:  NOV 07, 2003
  • HELP-PROMPT:  Automatically accept incoming information? Enter 'N' for No or 'Y' for Yes.
  • DESCRIPTION:  An application (electronic interface application) flag, indicating whether the site will automatically accept incoming information and file it in the VistA System, rather than storing the information in a temporary file
    for manual intervention.
.08 IDENT REQUIRES SUBSCRIBER ID? 0;8 SET
  • '0' FOR No;
  • '1' FOR Yes;

  • LAST EDITED:  NOV 07, 2003
  • HELP-PROMPT:  Do not edit via FileMan! Subscriber ID required for identification? Enter 'N' for No or 'Y' for Yes.
  • DESCRIPTION:  
    An application (electronic interface application) flag, controlled by the national Eligibility Communicator (EC), indicating if a Subscriber ID is required for identification. Do not edit via FileMan.
.09 USE SSN FOR SUBSCRIBER ID? 0;9 SET
  • '0' FOR No;
  • '1' FOR Yes;

  • LAST EDITED:  NOV 07, 2003
  • HELP-PROMPT:  Do not edit via FileMan! Use SSN for subscriber ID? Enter 'N' for No or 'Y" for Yes.
  • DESCRIPTION:  
    An application (electronic interface application) flag, controlled by the national Eligibility Communicator (EC), indicating if a patient's Social Security Number (SSN) is a valid Subscriber ID. Do not edit via FileMan.
.1 TRANSMIT SSN? 0;10 SET
  • '0' FOR No;
  • '1' FOR Yes;

  • LAST EDITED:  NOV 07, 2003
  • HELP-PROMPT:  Do not edit via FileMan! Transmit SSN? Enter 'N' for No or 'Y' for Yes.
  • DESCRIPTION:  
    An application (electronic interface application) flag, controlled by the national Eligibility Communicator (EC), indicating if a patient's Social Security Number (SSN) can be transmitted. Do not edit via FileMan.
.11 DEACTIVATED? 0;11 SET
  • '0' FOR No;
  • '1' FOR Yes;

  • LAST EDITED:  NOV 07, 2003
  • HELP-PROMPT:  Do not edit via FileMan! Pharmacy Benefits Manager (PBM) deactivated from a national perspective? Enter 'N' for No or 'Y' for Yes.
  • DESCRIPTION:  An application (electronic interface application) flag, controlled by the national Eligibility Communicator (EC), indicating if the Pharmacy Benefits Manager (PBM) has been deactivated (electronic transactions not
    permitted). Do not edit via FileMan.
.12 DATE/TIME DEACTIVATED 0;12 DATE

  • INPUT TRANSFORM:  S %DT="ESTX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  NOV 07, 2003
  • HELP-PROMPT:  Do not edit via FileMan! Enter the date and time associated with the last edit of the Application (electronic interface application) Deactivated? field.
  • DESCRIPTION:  
    The date and time associated with the last edit of the Application (electronic interface application) Deactivated? field. Do not edit via FileMan.
.13 DATE/TIME CREATED 0;13 DATE

  • INPUT TRANSFORM:  S %DT="ESTXR" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  NOV 07, 2003
  • HELP-PROMPT:  Do not edit via FileMan! Enter the date and time associated with the creation of the Application (electronic interface application) sub-file entry.
  • DESCRIPTION:  
    The date and time associated with the creation of the Application (electronic interface application) sub-file entry. Do not edit via FileMan.
.14 FUTURE SERVICE DAYS 0;14 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>9999)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  NOV 07, 2003
  • HELP-PROMPT:  Enter the maximum number of days (0-9999) before the service date for an acceptable claim submission.
  • DESCRIPTION:  
    The application's (electronic interface application) maximum number of days before the service date for an acceptable claim submission.
.15 PAST SERVICE DAYS 0;15 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>9999)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  NOV 07, 2003
  • HELP-PROMPT:  Enter the maximum number of days (0-9999) after the service date for an acce
  • DESCRIPTION:  
    The application's (electronic interface application) maximum number of days after the service date for an acceptable claim submission.
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