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Sub-Field: 9002313.5914

Package: E Claims Management Engine

BPS TRANSACTION(#9002313.59)-->9002313.5914

Sub-Field: 9002313.5914


Information

Parent File Name Number Package
BPS TRANSACTION(#9002313.59) COB OTHER PAYERS 9002313.5914 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<0)!(X?.E1"."1.N) X
  • LAST EDITED:  JUN 14, 2010
  • HELP-PROMPT:  Type a number between 0 and 9, 0 decimal digits.
  • DESCRIPTION:  
    This is a multiple counter field to store the count of the other payers.
  • CROSS-REFERENCE:  9002313.5914^B
    1)= S ^BPST(DA(1),14,"B",$E(X,1,30),DA)=""
    2)= K ^BPST(DA(1),14,"B",$E(X,1,30),DA)
.02 OTHER PAYER COVERAGE TYPE 0;2 SET
  • '01' FOR PRIMARY;
  • '02' FOR SECONDARY;
  • '03' FOR TERTIARY;
  • '98' FOR ZZCOUPON;
  • '99' FOR ZZCOMPOSITE;

  • LAST EDITED:  MAR 02, 2023
  • HELP-PROMPT:  Select other payer coverage type.
  • DESCRIPTION:  
    NCPDP field 338-5C - Code identifying the type of 'Other Payer ID'
.03 OTHER PAYER ID QUALIFIER 0;3 SET
  • '01' FOR STANDARD UNIQUE HEALTH PLAN ID;
  • '02' FOR HEALTH INDUSTRY NUMBER (HIN);
  • '03' FOR BANK INFORMATION NUMBER (BIN);
  • '04' FOR NAT. ASSOC. OF INS. COM.(NAIC);
  • '05' FOR MEDICARE CARRIER NUMBER;
  • '09' FOR COUPON;
  • '99' FOR OTHER;

  • LAST EDITED:  NOV 25, 2014
  • HELP-PROMPT:  Select Other Payer ID Qualifier.
.04 OTHER PAYER ID 0;4 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>10!($L(X)<1) X
  • LAST EDITED:  JUN 14, 2010
  • HELP-PROMPT:  Enter Other Payer ID (1-10 characters).
  • DESCRIPTION:  
    NCPDP field 340-7C - ID assigned to the payer.
.05 OTHER PAYER DATE 0;5 DATE

  • INPUT TRANSFORM:  S %DT="EX" D ^%DT S X=Y K:X<1 X
  • LAST EDITED:  JUN 14, 2010
  • HELP-PROMPT:  Enter the payment/denial date of the claim submitted to the other payer.
  • DESCRIPTION:  
    NCPDP field 443-E8 - Payment or denial date of the claim submitted to the other payer. Used for coordination of benefits.
.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:  JUN 14, 2010
  • HELP-PROMPT:  Enter the count (0-9) of the payer amount paid occurrences.
  • DESCRIPTION:  
    NCPDP field 341-HB - Count of the payer amount paid 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:  JUN 14, 2010
  • HELP-PROMPT:  Enter the count (0-20) of the other payer reject code occurrences.
  • DESCRIPTION:  
    NCPDP field 471-5E - Count of 'Other Payer Reject Code' occurrences.
.11 OTHER PAYER RECONCILIATION ID 0;11 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>30!($L(X)<1) X
    MAXIMUM LENGTH: 30
  • LAST EDITED:  MAY 16, 2018
  • HELP-PROMPT:  Enter an ID between 1 and 30 characters.
  • DESCRIPTION:  NCPDP field C49-9V - Other Payer Reconciliation ID. Reconciliation ID (B98-34) as reported by the Other Payer for Paid/Accepted transactions OR for Information Reporting transactions, the designated default value for
    reporting a previous payer's rejected response as designated in the Other Payer Reject Code value(s) reported in the COB claim.
1 OTHER PAYER AMT PAID MULTIPLE 1;0 Multiple #9002313.59141 9002313.59141

  • LAST EDITED:  JUN 14, 2010
  • DESCRIPTION:  This multiple stores the NCPDP fields:
    431-DV - Other Payer Amount Paid
    342-HC - Other Payer Amount Paid Qualifier
    Up to 9 occurrences are allowed by the NCPDP standard. This limit is dictated by the NCPDP standard and enforced within the ECME claim building process (i.e. the ECME application software). There are no such limits
    built into this data dictionary.
2 OTHER PAYER REJECT MULTIPLE 2;0 Multiple #9002313.59142 9002313.59142

  • LAST EDITED:  JUN 14, 2010
  • DESCRIPTION:  This multiple stores the NCPDP field:
    NCPDP field 472-6E - Other Payer Reject Code
    Up to 20 occurrences are allowed by the NCPDP standard. This limit is dictated by the NCPDP standard and enforced within the ECME claim building process (i.e. the ECME application software). There are no such limits
    built into this data dictionary.
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