Files > TPB ELIGIBILITY

name
TPB ELIGIBILITY
number
52.91
location
^PS(52.91,
description
Transitional Pharmacy Benefit Project (TPB), Phase I (patch PSO*7*145) introduces a new file called TPB ELIGIBILITY file (#52.91), to store patient data for those who are enrolled in VHA's health care system and eligible for the pharmacy benefit as required by the Directive, Code of Federal Regulations (CFR) 38 CFR Part 17 RIN 2900-AL68, "Medication Prescribed by Non-VA Physicians".
applicationGroups
PS
Fields
#NameLocationTypeDetailsIndexDescription
.01patient(+)0;1POINTER2BThis is the patient IEN who is eligible for this new service.
1date pharmacy benefit began(+)0;2DATE-TIMEThis is the date the entry was made into the file during extraction either from the EWL or from the Schedule Appointment set by the post-install routine. Manual entry to this file is also allowed for eligible patient, and it will be set to the current date.
2inactivation of benefit date0;3DATE-TIMEThis date can be set manually when the patient is no longer eligible for this benefit; or when the Non-VA prescriptions are either Discontinued or Expired; or set automatically due to a Date of Death entered in the Patient file (#2).
3inactivation reason code0;4SET OF CODES1:SEEN BY VA PROVIDER
2:NO/SHOW/CANCELLATION
3:PATIENT ENDED
4:NON-FORMULARY RX NOT ACCEPTED
5:PATIENT EXPIRED
6:ALL RX'S INACTIVE
7:EXCLUSION
8:PATIENT REFUSED APPT
9:PATIENT UNREACHABLE
10:PROGRAM ENDED
This field contains a code representing the reason for inactivating a patient for this benefit. EXCLUSION code 7, is hidden and not user selectable. It is used by the post-install routine during initial extraction.
4desired appointment date0;5DATE-TIMESet by the EWL/Scheduling extract and is obtained from Scheduling file.
5wait type0;6SET OF CODESE:EWL
M:MANUAL
S:SCHEDULED APPOINTMENT
X:SCHEDULED APPOINTMENT & EWL
The type of wait the patient is assigned.
6station number(+)0;7FREE TEXT7 digit STATION NUMBER. First 3 digit station number plus any modifiers.
7institution(+)0;8POINTER4Is set by the EWL/Scheduling extract and is obtained from the Institution File (#4, field .01)
8exclusion reason0;9SET OF CODES1:ACTIVE RX
2:ACTUAL APPT. < 30 DAYS FROM DATE APPT. MADE
3:BOTH
Exclusion reason codes.
9primary care schedule apt date0;10DATE-TIMEThis is the date that a primary care appointment was scheduled. This field is populated only by the post-install routine during initial extraction.
10rx #0;11FREE TEXTRx# if found during the extraction that made the patient flagged as excluded for this service.
11date letter printed0;12DATE-TIMEDate the letter was printed.

Not Referenced