Files > BPS TRANSACTION

name

BPS TRANSACTION

number

9002313.59

location

^BPST(

description

Transactions in progress. When complete (status 99), a copy of the record is placed in 9002313.57. Per VHA Directive 2004-038, this file definition should not be modified.

Fields

#	Name	Location	Type	Details	Index	Description
.01	entry number(+)	0;1	FREE TEXT		B	Transaction entry number.
1	status	0;2	NUMERIC		AD	The status of the transaction as a percentage of completion. The text value can be obtained by running $$STATI^BPSOSU(). Note that 99 indicates complete.
1.05	policy number	1;5	NUMERIC			This is the policy number that is being processed for this eligibility verification request.
1.07	pharmacy	1;7	POINTER	9002313.56		Textual description of the Pharmacy involved with this transaction.
1.08	pins piece	1;8	NUMERIC			Pointer to which of the PINS pieces in ^(6) is in use for this claim. Use this to keep track of where you are in billing down the line to various insurers. (Probably won't automatically roll over to next insurer, but maybe we will have an option to edit insurance info, try next insurance, etc.)
1.09	prior authorization number	1;9	FREE TEXT			Number assigned by the processor to identify a prior authorized transaction.
1.11	prescription number	1;11	POINTER	52		This stores a pointer from the PRESCRIPTION (#52) file.
1.1199	rxi internal		COMPUTED			Internal ID to the claims file.
1.12	resubmit after reversal	1;12	SET OF CODES	1:RESUBMIT AFTER REVERSAL 0:DONE 2:RESUBMITTING		Indicator that a transaction has been resubmitted after being backed out.
1.13	ncpdp overrides	1;13	POINTER	9002313.511		Override information for the NCPDP fields.
1.15	prior authorization type code	1;15	FREE TEXT			Indicates the type of authorization made before transaction was submitted.
2	hl7 message id	0;3	FREE TEXT			This is the unique HL7 message ID used for the NCPDP message created for this transaction.
3	claim	0;4	POINTER	9002313.02	AE	Claim number for this transaction.
3.1	claim ien		COMPUTED			Claim internal identifier for this transaction.
4	response	0;5	POINTER	9002313.03	AF	Textual description of the response to this submission.
4.0098	result with reversal		COMPUTED			The overall result.
4.0099	result		COMPUTED			The result of the transmission.
4.1	response ien		COMPUTED			Internal identifier for the response.
5	patient	0;6	POINTER	2	AC	Patient name.
6	submit date	0;7	DATE-TIME			This is the date/time that the RX/Fill was submitted to ECME
7	last update	0;8	DATE-TIME		AH	Last date this record was updated.
9	fill number	1;1	NUMERIC			Prescription fill/refill number.
10	ndc	1;2	FREE TEXT			The NDC number of the drug involved in this transaction.
10.0099	user number		COMPUTED			The DUZ of the user who sent the transaction.
11	pharmacy division	1;4	POINTER	59		The division ID for the transaction.
13	user	0;10	POINTER	200	AG	User name who entered this transaction.
14	position in claim	0;9	NUMERIC			Sequential order in the claim transactions.
15	start time	0;11	DATE-TIME			Time this transaction was started.
16	submit request	0;12	POINTER	9002313.77		IEN of the BPS REQUEST file (#9002313.77)
17	submit request date time	0;13	DATE-TIME		AS	Submit Request Date/Time
18	cob indicator	0;14	SET OF CODES	1:PRIMARY 2:SECONDARY 3:TERTIARY		COB indicator.
19	transaction type	0;15	SET OF CODES	C:CLAIM E:ELIGIBILITY U:UNCLAIM		This is the type of transaction that is being processed: CLAIM - An NCPDP billing request. UNCLAIM - An NCPDP reversal request. ELIGIBILITY - An eligibility verification request.
111	comment multiple	11;0	MULTIPLE	9002313.59111		User's comment
201	result code	2;1	NUMERIC			Code indicating the result of the adjudication of this claim.
202	result text	2;2	FREE TEXT			Textual explanation of the result code.
401	reversal claim	4;1	POINTER	9002313.02	AER	Request to reverse this claim.
402	reversal response	4;2	POINTER	9002313.03	AFR	Response to reversal message.
404	reversal reason	4;4	FREE TEXT			Reason for the reversal
405	reversal request	4;5	POINTER	9002313.77		Reversal Request IEN
406	reversal request date time	4;6	DATE-TIME			Reversal Request Date/Time
501	quantity	5;1	NUMERIC			This is the quantity that will be used for the NCPDP field 442-E7 (QUANTITY DISPENSED) of the NCPDP submission.
502	unit price	5;2	NUMERIC			Price per unit of prescription.
503	subtotal	5;3	NUMERIC			= QUANTITY * UNIT PRICE This is probably what we want to send as the INGREDIENT COST field in the NCPDP message.
504	dispensing fee	5;4	NUMERIC			Storing it here, since it can vary by insurer (or maybe by Pharmacy, too? maybe we want to put a field in 9002313.56)
505	total price	5;5	NUMERIC			=SUBTOTAL + DISPENSING FEE
507	administrative fee	5;7	FREE TEXT			Any fee charged for handling of the paperwork.
508	unit of measure	5;8	FREE TEXT			Enter the Unit of Measure for the drug. This is usually GR (grams), ML (milliliters), or EA (Each).
509	billing quantity	5;9	NUMERIC			This is the quantity from the prescription and is used to calculate the ingredient cost. It may be different than the quantity used in the actual NCPDP submission.
510	billing unit	5;10	FREE TEXT			This is the billing units associated with the billing quantity.
801	asleep payer	8;1	POINTER	9002313.15	ASL	This field identifies an asleep payer for this transaction.
901	current va insurer	9;1	FREE TEXT			The insurer being submitted to currently, if there are Primary, Secondary, and tertiary insurers defined.
901.04	eligibility	9;4	SET OF CODES	V:VETERAN T:TRICARE C:CHAMPVA		The insurance eligibility type of the claim.
902	patient insurance multiple	10;0	MULTIPLE	9002313.59902		List of the insurers for the patient.
1201	rx action	12;1	FREE TEXT			This is the action that is being performed on this request. It is either the BWHERE parameter passed into BPSNCPDP or 'ELIG' for an eligibility verification request. The list of BWHERE values are documented at the top of routine BPSNCPD3.
1202	date of service	12;2	DATE-TIME			Date to be used for the 401-D1 (DATE OF SERVICE) field for the claim
1203	submission clarification code	12;3	FREE TEXT			Submission Clarification Code
1204	cob other payments count	12;4	NUMERIC			NCPDP field 337-4C - Coordination of Benefits/Other Payments Count This value corresponds to the number of multiple entries in the #1400 multiple field - COB OTHER PAYERS.
1205	other coverage code	12;5	SET OF CODES	00:NOT SPECIFIED 01:NO OTH COVERAGE 02:PYMT COLLECT/OTH PAYER 03:CLAIM NOT COVER/OTH PAYER 04:PYMT NOT COLLECT/OTH PAYER 05:PLAN DENIAL 06:NONPARTICIPAT PROV/OTH PAYER 07:OTH COVER NOT EFFECT ON DOS 08:COPAY BILLING		NCPDP field 308-C8 - code indicating whether or not the patient has other insurance coverage.
1300	dur data	13;0	MULTIPLE	9002313.5913		This multiple will track the Drug Utilization Review (DUR) information passed by Outpatient Pharmacy to ECME and that will eventually be put in the DUR segment of the NCPDP claim.
1400	cob other payers	14;0	MULTIPLE	9002313.5914		This multiple structure stores information about each of the other payers involved in the payment or rejection of the claim. NCPDP has a maximum of 9 occurrences here with a recommendation of less than or equal to 3 occurrences. However, VA only stores data for at most 3 insurance policies for any given claim. So at most there will only be 2 occurrences of this other payer multiple.
9999.96	net paid by insurer		COMPUTED			Amount paid after the discounts and deductible have been subtracted.
9999.97	elapsed time (printable)		COMPUTED			The elapsed time between the filling of the prescription and the return of the response from the payer.
9999.98	elapsed time (seconds)		COMPUTED			The number of seconds between the placing of the order and the receipt of the response.
9999.99	result category		COMPUTED			The category of the response. "P"aid "R"ejected "A"ccepted