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Sub-Field: 9002313.3123

Package: E Claims Management Engine

BPS CERTIFICATION(#9002313.31)-->9002313.312-->9002313.3123

Sub-Field: 9002313.3123


Information

Parent File Name Number Package
9002313.312 COB MULTIPLE 9002313.3123 E Claims Management Engine

Details

Field # Name Loc Type Details
.01 OTHER PAYER COUNTER 0;1 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>9)!(X<1)!(X?.E1"."1.N) X
  • LAST EDITED:  JAN 05, 2011
  • HELP-PROMPT:  Type a number between 1 and 9, 0 decimal digits.
  • DESCRIPTION:  
    This is a counter field to store the count of the other payers.
  • CROSS-REFERENCE:  9002313.3123^B
    1)= S ^BPS(9002313.31,DA(2),2,DA(1),3,"B",$E(X,1,30),DA)=""
    2)= K ^BPS(9002313.31,DA(2),2,DA(1),3,"B",$E(X,1,30),DA)
.02 OTHER PAYER COVERAGE TYPE 0;2 SET

  • LAST EDITED:  APR 01, 2013
  • HELP-PROMPT:  Select the other payer coverage type.
  • DESCRIPTION:  
    This stores the value for NCPDP field 338-5C, which is the code indicating whether the other payer is primary, secondary, etc.
.03 OTHER PAYER ID QUALIFIER 0;3 SET

  • LAST EDITED:  NOV 25, 2014
  • HELP-PROMPT:  Select the Other Payer ID Qualifier.
  • DESCRIPTION:  
    This value will be placed in the NCPDP field 339-6C, which is the code qualifying the 'Other Payer ID' (340-7C) field.
.04 OTHER PAYER ID 0;4 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>10!($L(X)<1) X
  • LAST EDITED:  JAN 05, 2011
  • HELP-PROMPT:  Enter the Other Payer ID (1-10 characters).
  • DESCRIPTION:  
    This will be used for the value in NCPDP field 340-7C, which is the ID assigned to the Other Payer.
.05 OTHER PAYER DATE 0;5 DATE

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:X<1 X
  • LAST EDITED:  FEB 10, 2011
  • HELP-PROMPT:  Enter the payment/denial date of the claim submitted to the other payer.
  • DESCRIPTION:  
    This will be used for NCPDP field 443-E8, which is the payment or denial date of the claim submitted to the other payer.
.06 OTHER PAYER AMOUNT PAID COUNT 0;6 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>9)!(X<0)!(X?.E1"."1.N) X
  • LAST EDITED:  JAN 05, 2011
  • HELP-PROMPT:  Enter the count (0-9) of the Other Payer Paid Amount occurrences.
  • DESCRIPTION:  
    This will be used for NCPDP field 341-HB, which is the count of the Other Payer Paid Amount occurrences.
.07 OTHER PAYER REJECT COUNT 0;7 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>20)!(X<0)!(X?.E1"."1.N) X
  • LAST EDITED:  JAN 05, 2011
  • HELP-PROMPT:  Enter the count (0-20) of the Other Payer Reject Code occurrences.
  • DESCRIPTION:  
    This is used for NCPDP field 471-5E, which is the count of Other Payer Reject Code occurrences.
1 OTHER PAYER AMT PAID MULTIPLE 1;0 Multiple #9002313.31231 9002313.31231

  • DESCRIPTION:  
    This multiple can contain up to 9 occurrences of paid amounts from the other payer.
2 OTHER PAYER REJECT MULTIPLE 2;0 Multiple #9002313.31232 9002313.31232

  • DESCRIPTION:  
    This multiple will store the reject codes returned by the other payer. There can be up to 20 occurrences per the NCPDP documentation.
3 OTHER PAYER PATIENT RESP MULT 3;0 Multiple #9002313.31233 9002313.31233

  • DESCRIPTION:  
    This multiple holds the paid amounts that are the responsibility of the patient from a previous payer.
4 BENEFIT STAGE MULT 4;0 Multiple #9002313.31234 9002313.31234

  • DESCRIPTION:  
    This multiple can contain up to four occurrences of Medicare Part D beneficiary benefit stages.
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