This file stores the response information returned by the third-party payer. Most of the fields have 'raw' NCPCP data so it is formatted per the NCPDP specifications. Per VHA Directive 2004-038, this file definition should not be modified.
.01bps claim(+)0;1POINTER9002313.02BIdentifier for BPS responses.
.02date response received0;2DATE-TIMEAEDate that response was received on the system.
102version release number100;2FREE TEXTNCPDP Version/Release Number.
103transaction code100;3FREE TEXTCode identifying the type of transaction.
109transaction count100;9NUMERICCount of transactions in the transmission.
115medicaid id indicator100;15FREE TEXTThis is used to store NCPDP field 115-N5 (Medicaid ID Number), which is defined as "A unique member identification number assigned by the Medicaid Agency."
116medicaid agency number100;16FREE TEXTThis is used to store NCPDP field 116-N6 (Medicaid Agency Number), which is defined as "Number assigned by processor to identify the individual Medicaid Agency or representative."
201service provider id200;1FREE TEXTID assigned to a pharmacy or provider.
202service provider id qualifier200;2FREE TEXTCode qualifying the 'Service Provider ID' (2Ø1)
301group id300;1FREE TEXTID assigned to the cardholder group or employer group.
302cardholder id300;2FREE TEXTThis is used to store NCPDP field 302-C2 (Cardholder ID), which is defined as "Insurance ID assigned to the cardholder or identification number used by the plan."
304date of birth300;4FREE TEXTThis is used to store NCPDP field 304-C4 (Date Of Birth), which is defined as "Date of birth of patient."
310patient first name300;10FREE TEXTThis is used to store NCPDP field 310-CA (Patient First Name), which is defined as "Individual first name."
311patient last name310;1FREE TEXTThis is used to store NCPDP field 311-CB (Patient Last Name), which is defined as "Individual last name."
401date of service400;1FREE TEXTIdentifies date the prescription was filled or professional service rendered.
501response status500;1SET OF CODESA:ACCEPTED
A code indicating the status of this response.
504message504;1FREE TEXTFree form message.
524plan identification500;24FREE TEXTAssigned by the processor to identify a set of parameters, benefit, or coverage criteria used to adjudicate a claim.
545network reimbursement id540;5FREE TEXTField defined by the processor. It identifies the network, for the covered member, used to calculate the reimbursement to the pharmacy.
568payer id qualifier560;8SET OF CODES01:Standard Unique Health Plan Identifier
Code indicating the type of payer ID.
569payer id560;9FREE TEXTPayer identification - the payer this claim was submitted to.
1000responses1000;0MULTIPLE9002313.0301This is the transaction response data returned by the third-party payer.
9999raw data receivedM;0WORD-PROCESSINGThis is to store the raw data received from the payer.

Referenced by 3 types

  1. INSURANCE VERIFICATION PROCESSOR (355.33) -- bps response
  2. BPS LOG OF TRANSACTIONS (9002313.57) -- response, reversal response
  3. BPS TRANSACTION (9002313.59) -- response, reversal response