| DESCRIPTION OF ENHANCEMENTS |
1. A modification was made to the Reject Information screen under the
INSURANCE Information
Insurance : OPP INSURANCE Coord. Of Benefits: PRIMARY
Contact :
Group Name : D-GROUP1
Group Number : D00001
Cardholder ID :
2. A COB field(#27) was added to the PRESCRIPTION file (#52),
REJECT INFO sub-file (#52.25) to store the COB for the Third Party
Insurance Rejects for the fill. The Set of Codes will be stored as "1" for
Third Party Payer Rejects - Worklist [PSO REJECTS WORKLIST] option and the
Primary, "2" for Secondary, and "3" for Tertiary. Tertiary billing will
not be implemented with this patch group, but is included for future use.
DATA NAME GLOBAL DATA
ELEMENT TITLE LOCATION TYPE
--------------------------------------------------------------------------
52.25,27 COB 2;7 SET
'1' FOR PRIMARY;
'2' FOR SECONDARY;
Third Party Payer Rejects - View/Process [PSO REJECTS VIEW/PROCESS] option
'3' FOR TERTIARY;
LAST EDITED: JAN 20, 2009
DESCRIPTION: This field contains the Coordination of
Benefits indicator for the third party
insurance rejection for the fill. This
field can contain 1 for Primary, 2 for
Secondary, or 3 for Tertiary.
3. A modification was made to the Patient Medication Profile screen
under the ePharmacy Medication Profile (View Only) [PSO PMP] option to
to incorporate the Coordination of Benefits (COB) indicator to be
modify the ECME LOG section to change the "Comments:" preface from
"Submitted to ECME:" to "ECME:" for non reversals. Second modification was
made to add the COB indicator with insurance provider to the suffix of the
"Comments:." The COB indicator will be denoted with a lower case "p" for
Primary, "s" for Secondary and a "t" for Tertiary, which will be followed
by the name of the insurance provider in capital letters.
Example:
ECME Log:
displayed in the insurance section. The indicator will be displayed as
# Date/Time Rx Ref Initiator Of Activity
==========================================================================
1 1/28/09@11:37:56 ORIGINAL OPUSER,ONE
Comments: ECME:WINDOW FILL(NDC:00046-1066-05)-E PAYABLE-pOPP INSURANCE
"Coord. Of Benefits:" followed by either PRIMARY, SECONDARY, or TERTIARY.
Example:
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