Print Page as PDF
REJECT INFORMATION ICR (6749)

REJECT INFORMATION    ICR (6749)

Name Value
NUMBER 6749
IA # 6749
DATE CREATED 2017/03/22
CUSTODIAL PACKAGE OUTPATIENT PHARMACY
USAGE Controlled Subscription
TYPE Routine
DBIC APPROVAL STATUS APPROVED
ROUTINE PSOREJU2
NAME REJECT INFORMATION
GENERAL DESCRIPTION
Pull and return reject information from subfile 52.25.
STATUS Active
KEYWORDS
  • ECME
  • REJECT
DURATION Till Otherwise Agreed
ID PSOREJU2
COMPONENT/ENTRY POINT
COMPONENT/ENTRY POINT COMPONENT DESCRIPTION VARIABLES
GET
GET pulls and returns reject information from
subfile# 52.25, REJECT INFO, of file# 52, PRESCRIPTION.
VARIABLES TYPE VARIABLES DESCRIPTION
RX Input
Rx IEN, pointer to file# 52, PRESCRIPTION.
RFL Input
Refill#.  Will default to most recent fill if blank.
REJDATA Output
This array, passed by reference, will be returned
with the following fields.  REJDATA(REJECT IEN,FIELD), where FIELD may be:
"BIN" - Payer BIN number
"CODE" - Reject Code (79 or 88)
"DATE/TIME" - DATE/TIME Reject was detected
"PAYER MESSAGE" - Message returned by the payer
"REASON" - Reject Reason description (from payer)
"INSURANCE NAME" - Patient's Insurance Company Name
"INSURANCE POINTER" - Patient Insurance Company Pointer
"COB" - Coordination of Benefits
"GROUP NAME" - Patient's Insurance Group Name
"GROUP NUMBER" - Patient's Insurance Group Number
"CARDHOLDER ID" - Patient's Insurance Cardholder ID
"PLAN CONTACT" - Plan's Contact (eg., "1-800-...")
"PLAN PREVIOUS FILL DATE" - Last time Rx was paid by payer
"STATUS" - REJECTS status ("OPEN/UNRESOLVED" or "CLOSED/RESOLVED")
"DUR TEXT" - Payer's DUR description
"DUR ADD MSG TEXT" - Payer's DUR additional description
"OTHER REJECTS" - Other Rejects on the same response
"REASON SVC CODE" - Reason for Service Code If REJECT is closed, the
following fields will be returned:
"CLA CODE" - Clarification Code submitted
"PRIOR AUTH TYPE" - Prior Authorization Type
"PRIOR AUTH NUMBER" - Prior Authorization Type
"CLOSED DATE/TIME" - DATE/TIME Reject was closed
"CLOSED BY" - Name of the user responsible for closing Reject
"CLOSE REASON" - Reason for closing Reject (text)
"CLOSE COMMENTS" - User entered comments at close
REJID Input
Reject IEN in the PRESCRIPTION file.  If this value
is passed, the procedure will return information for only this reject.
OKCL Input
If set to 1, Closed Rejects will also be returned.
CODE Input
If passed, then only rejects with this CODE should be
returned.
RRRFLG Input
If set to 1 with CODE present, also return Reject
Resolution Required rejects.  If set to 1 and CODE is not passed, then only
return RRR rejects.
SUBSCRIBING PACKAGE E CLAIMS MGMT ENGINE
DATE ACTIVATED 2017/04/10