| $$NABP(RXP,BFILL) |
Returns the value in the Service Provider ID (201-B1)
field of the last NCPDP claim submitted for the passed in RX and fill. Note
that as of the NPI release (BPS*1.0*2), this API may return either NPI or
NABP/NCPDP, depending on what was sent in the claim.
|
| VARIABLES |
TYPE |
VARIABLES DESCRIPTION |
RXP |
Input |
Pointer to the PRESCRIPTION file (#52). This is a
required parameter.
|
BFILL |
Input |
Fill/refill number. If this is not passed in, it
will be defaulted to 0.
|
$$NABP |
Output |
NPI number or NABP/NCPDP, depending on what was sent
in the NCPDP claim. Note that if the Prescription IEN is not passed in, this
function will return NULL.
|
|
$$CLAIM(RXI,RXR,COB) |
This API is used to retrieve information about a
claim for an specific prescription, fill, and coordination of benefit value.
|
| VARIABLES |
TYPE |
VARIABLES DESCRIPTION |
RXI |
Input |
Prescription IEN (Pointer to the PRESCRIPTION File
(#52). This parameter is required.
|
RXR |
Input |
Fill Number (0 for Original, 1 for 1st refill, 2 for
the 2nd refill, etc.). If this parameter is missing, it will default to zero.
|
COB |
Input |
Coordination of Benefit value (1-Primary,
2-Secondary, 3-Tertiary). If not passed in, primary is assumed.
|
$$CLAIM |
Output |
The following information is returned ("^" pieces):
1 - BPS TRANSACTION file (#9002313.59) pointer
2 - BPS CLAIMS file (#9002313.02) pointer
3 - BPS RESPONSES file (#9002313.03) pointer
4 - BPS CLAIMS file (#9002313.02) pointer for REVERSAL Claim
5 - BPS RESPONSES file (#9002313.03) pointer for REVERSAL Claim
6 - The ECME Number sent in the last ECME Claim
|
|
$$DIVNCPDP(BPSDIV) |
This API returns the NPI and NABP/NCPDP numbers for a
specific outpatient site
|
| VARIABLES |
TYPE |
VARIABLES DESCRIPTION |
BPSDIV |
Input |
This is a pointer to the Outpatient Site file -
Required
|
$$DIVNCPDP |
Output |
The function returns the NCPDP and NPI numbers
associated with the Outpatient Site in the format NCPDP Number^NPI Number. If
the Outpatient Site is not passed in or if the identifiers could not be
determined, the function will return just a caret ("^").
|
|
$$ADDCOMM(BPRX,BPREF,BPRCMNT,BPBKG) |
This api is used to pass user entered comments about
Rejects back to ECME.
|
| VARIABLES |
TYPE |
VARIABLES DESCRIPTION |
BPRX |
Input |
Prescription IEN (Pointer to the PRESCRIPTION File
(#52)). This parameter is required. If it not passed in, the API will return
-1 indicating the comment was not filed.
|
BPREF |
Input |
Fill Number (0 for Original, 1 for 1st refill, 2 for
the 2nd refill, etc.). If not passed in, it will be defaulted to zero.
|
$$ADDCOMM |
Output |
1 - Comments added successfully
-1 - Comments not added
|
BPRCMNT |
Input |
Comments to be added to the BPS TRANSACTION file
(#9002313.59). Note that this value will be truncated to 63 characters prior
to filing. This parameter is required. If missing, the API will return -1
indicating no comment was filed.
|
BPBKG |
Input |
Optional parameter to indicate if the API was called
by a background process.
If this parameter value is 1 then the comment is stored in BPS TRANSACTION
(#9002313.59) file with POSTMASTER as the user entering the comment.
|
|
GETDAT(RX,FIL,COB,LDOS,LDSUP) |
This API is used to get the LAST DATE OF SERVICE and
LAST DAYS SUPPLY from the most recent claim submitted for a prescription and
fill.
|
| VARIABLES |
TYPE |
VARIABLES DESCRIPTION |
RX |
Input |
The RX IEN from the PRESCRIPTION file (#52). This
parameter is required. If not passed in, the API will not continue.
|
FIL |
Input |
The prescription fill number. This parameter is
required. If not passed in, the API will not continue.
|
COB |
Input |
Coordination of Benefits indicator. This parameter
is optional. If not passed in, the API will default it to 1, meaning PRIMARY.
|
LDOS |
Both |
Last Date of Service from the most recent claim
submitted for the prescription and fill. This parameter is required to be
passed by reference. If not passed then GETDAT will not return the expected
value.
|
LDSUP |
Both |
Last Days Supply from the most recent claim submitted
for the prescription and fill. This parameter is required to be passed by
reference. If not passed then GETDAT will not return the expected value.
|
|
$$AMT(RX,RFILL,COB) |
This API returns the Gross Amount Due for the given
Rx, Fill and COB from the BPS TRANSACTION FILE (9002313.59), (Field #902.15).
The value is in internal numeric format (i.e. 188.2 or 65.0895).
|
| VARIABLES |
TYPE |
VARIABLES DESCRIPTION |
RX |
Input |
This is a pointer to the Prescription file #52
(Required).
|
RFILL |
Input |
This is the fill number of the prescription
(Optional). Defaults to original fill if not passed.
|
COB |
Input |
This is the COB payer sequence number of the ECME
bill (Optional). Defaults to 1 (Primary) if not passed.
|
$$AMT |
Output |
The function value is the value of the Gross Amount
Due field (#902.15) from the #9002313.59902 subfile of the BPS Transaction
file.
|
|
$$NFLDT(RX,RFILL,COB) |
This API returns the Next Available Fill Date from
BPS RESPONSES File #9002313.03.
|
| VARIABLES |
TYPE |
VARIABLES DESCRIPTION |
RX |
Input |
Pointer to the Prescription file #52 (Required).
|
RFILL |
Input |
This is the fill number of the prescription
(Required).
|
COB |
Input |
This is the COB payer sequence number of the original
bill (optional). Defaults to 1 (primary) if not passed.
|
$$NFLDT |
Output |
Next Available Fill Date.
|
|
$$BBILL(RX,RFILL,COB) |
Back Bill indicator from BPS CLAIMS file #9002313.02.
Returns 1 if RX ACTION code of "BB", "P2" or "P2S" is found. Otherwise
returns 0.
|
| VARIABLES |
TYPE |
VARIABLES DESCRIPTION |
RX |
Input |
This is a pointer to the Prescription file #52
(Required).
|
RFILL |
Input |
Fill/refill number (Optional). Defaults to 0
(original fill) if not passed.
|
COB |
Input |
This is the COB payer sequence number of the original
bill (optional). Defaults to 1 (primary) if not passed.
|
$$BBILL |
Output |
Back Bill Indicator
1 - Back Bill 0 - Not a Back Bill
|
|
$$ELIG(RX,RFILL,COB) |
This API returns the Eligibility for the given Rx,
Fill and COB.
|
| VARIABLES |
TYPE |
VARIABLES DESCRIPTION |
RX |
Input |
This is the pointer to the Prescription file #52
(Required).
|
RFILL |
Input |
Fill/Refill number (Optional). Defaults to 0
(origianl fill) if not passed.
|
COB |
Input |
This is the COB payer sequence number of the ECME
bill (Optional). Defaults to 1 (primary) if not passed.
|
$$ELIG |
Output |
The function value is the value of the Gross Amount
Due field (#901.04) from the BPS Transaction file #9002313.59.
|
|
$$GETBAMT(RXIEN,FILL,COB) |
Retrieves the Billed Gross Amount Due (Field #430)
from the BPS CLAIMS FILE (#9002313.02). This function retrieves the external
dollar.cents format.
|
| VARIABLES |
TYPE |
VARIABLES DESCRIPTION |
RXIEN |
Input |
Prescription IEN pointer to the PRESCRIPTION File
(#52). This parameter is required.
|
FILL |
Input |
Fill Number (0 for Original, 1 for 1st refill, 2 for
the 2nd refill, etc.). If this parameter is missing, it will default to the
latest fill.
|
COB |
Input |
Coordination of Benefits value (1-Primary,
2-Secondary). If not passed in, it defaults to Primary.
|
$$GETBAMT |
Output |
Return value of the Gross Amount Due from the BPS
CLAIMS FILE #9002313.02 (Field #430).
|
|
$$GETCOB(RXIEN,FILL) |
This API returns the Coordination of Benefits (COB)
Payer sequence for usage by Outpatient Pharmacy.
|
| VARIABLES |
TYPE |
VARIABLES DESCRIPTION |
RXIEN |
Input |
Pointer to the Prescription file #52 (Required).
|
FILL |
Input |
This is the fill number of the prescription
(Required).
|
$$GETCOB |
Output |
"" (the null string) - If the Prescription/Fill is
not found in the BPS Transaction file.
-1 - If there are multiple COB payer sequences found in the BPS Transaction
file (#9002313.59) for this prescription.
Otherwise, the function value is a pieced string: COB^BPS Transaction IEN
(pointer to file #9002313.59)
|
|
$$RESUBMIT(RX,REFILL,COB) |
This API returns whether or not the ECME prescription
is an ECME resubmitted prescription. The return value is either 0 or 1.
|
| VARIABLES |
TYPE |
VARIABLES DESCRIPTION |
RX |
Input |
Pointer to the Prescription file #52 (Required).
|
REFILL |
Input |
This is the fill number of the prescription
(Optional). Defaults to the most recent fill number.
|
COB |
Input |
This is the Coordination of Benefits (COB) payer
sequence number (Optional). Defaults to 1 (Primary payer).
|
$$RESUBMIT |
Output |
Either 0 or 1. 1 if the ECME prescription is
classified as an ECME resubmission. 0 otherwise.
|
|
