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.
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