2. EPMO Open Source Coordination Office Redaction File Detail Report

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2.1 Files compared

#	Location	File	Last Modified
1	MCCF EDI TAS ePharmacy 031218.zip\MCCF EDI TAS ePharmacy 031218	bps_1_0_p23_um.doc	Wed Feb 14 19:27:48 2018 UTC
2	MCCF EDI TAS ePharmacy 031218.zip\MCCF EDI TAS ePharmacy 031218	bps_1_0_p23_um.doc	Mon Apr 16 19:56:21 2018 UTC

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	1	ELECTRONIC CLAIMS MA NAGEMENT E NGINE (ECM E)
	2	Version 1. 0
	3	USER MANUA L
	4	June 2018
	5	Department of Vetera ns Affairs
	6	Office of Informatio n and Tech nology (OI T)
	7	Product De velopment
	8	Revision H istoryDate Descriptio n (Patch # if applic able)Proje ct Manager Technical Writer06/2 018Updated for BPS1 23
	9	Update Tit le page da te, footer date
	10	Modificati on filter questions CV Change View actio n, Rx Acti vity Log t o add Date of Servic e to ECME Log, Resub mit with E dits actio n, Process Secondary /TRICARE R x to ECME option, Pa yable Clai ms Report, Rejected Claims Rep ort, Rever sal Claims Report, C laims Subm itted Not Yet Releas ed Report, Recent Tr ansactions Report, C losed Clai ms Report, View ePha rmacy Rx R eport Opti onDana Ben nettDeAnn Kelly11/20 17Updated for BPS1 22
	11	Update Tit le page da te, modifi cation to Change Vie w action; change aut o-reverse parameter and auto-r eversal bu lletin; ad d Facility ID Qualif ier and Re conciliati on ID to C laim Log a nd Claim R esponse In quiry; add new actio n PR Print Reports t o VER View ePharmacy Rx.Dana B ennettDeAn n Kelly05/ 2017Update d for BPS* 121Stepha nie Kutson DeAnn Kell y08/2016Up dated for BPS1*20Sh aron Taube nfeldJohn Rogers06/2 016Updated Title Pag e to curre nt OI&T st andards.
	12	Updated fo r BPS119 to reflec t customer requested revisions throughou t screensh ots includ ing numero us changes throughou t to updat e for incl usion of t he Close C laim funct ionality a nd the new Non-Billa ble Status Report (N BS)Therese TarletonV ida Dunie1 0/2015Upda ted for BP S118Shar on Taubenf eldJohn Ro gers11/201 3Updated f or BPS11 5 (made nu merous min or changes throughou t; fixed d efective p age breaks )Sharon Ta ubenfeldFi rstView Te am02/2012U pdated for BPS111S ookie Spen ceChristy Smith10/20 11Updated for BPS1 10Sookie S penceChris ty Smith06 /2011Updat ed for BPS 110 and consistenc ySookie Sp enceLori T orrance12/ 2010Review ed and upd ated revis ions; inse rted TRICA RE disclai merSookie SpenceChri sty Smith1 0/2010Upda ted for ac curacy cha nges per C BOSookie S penceLori Torrance08 /2010Updat ed for BPS 18 and A ddendumSoo kie Spence Jeanne Dod ge-Allen10 /2009Updat ed for pat ch BPS1.0 8 ePharma cy COB Sup portMary A nthony/Tim othy Holme sMary Elle n Gray04/2 009Updated for patch BPS1.07 Mary Antho nyMary Ell en Gray02/ 2007Update d for patc h BPS1.0 2Sookie Sp enceChrist y Smith08/ 2006Update d for inte rim patch BPS1.03S ookie Spen ceNancy Sm ith/
	13	Mary Ellen Gray04/20 06Initial release of the ECME User Manua l.Sookie S penceNancy Smith(Thi s page inc luded for two-sided copying.)
	14	Contents
	15	11
	16	Introducti on
	17
	18
	19	32
	20	Orientatio n
	21
	22
	23	32.1 Worki ng with th e ECME Use r Manual
	24
	25
	26	42.2 Obtai ning Onlin e Help
	27
	28
	29	52.3 Findi ng Related Manuals
	30
	31
	32	73
	33	ECME Menu Structures
	34
	35
	36	93.1 The C omplete EC ME Menu St ructure
	37
	38
	39	113.2 ECME User Scre en
	40
	41
	42	113.3 ECME Pharmacy COB Menu S tructure
	43
	44
	45	113.4 Phar macy ECME Manager Me nu Structu re
	46
	47
	48	123.5 Phar macy Elect ronic Clai ms Reports Menu Stru cture
	49
	50
	51	134
	52	Accessing the ECME M ain Menu
	53
	54
	55	155
	56	Accessing the ECME U ser Screen
	57
	58
	59	205.1 Chan ge View
	60
	61
	62	295.2 Sort List
	63
	64
	65	325.3 Reve rse Payabl e Claim
	66
	67
	68	355.4 Resu bmit Claim
	69
	70
	71	385.5 Clos e Claim
	72
	73
	74	415.5.1 Va riations t o the Clos e claim pr ocess.
	75
	76
	77	435.5.2 Sp ecial Note s regardin g secondar y claims
	78
	79
	80	435.6 Add/ View Comme nts
	81
	82
	83	455.7 Furt her Resear ch Screen
	84
	85
	86	465.7.1 In surance De tails
	87
	88
	89	475.7.2 Vi ew Eligibi lity
	90
	91
	92	485.7.3 Vi ew Prescri ption
	93
	94
	95	505.7.4 Ad d/View Com ments
	96
	97
	98	505.7.5 Cl aims Track ing
	99
	100
	101	525.7.6 Th ird Party Inquiry
	102
	103
	104	535.7.7 On Hold Copa y Listing
	105
	106
	107	545.7.8 Re lease Copa y
	108
	109
	110	565.7.9 IB (Integrat ed Billing ) Events R eport
	111
	112
	113	605.7.10 G roup Plan Menu
	114
	115
	116	615.7.11 E ligibility Inquiry O ption
	117
	118
	119	635.8 Prin t Claim Lo g (hidden action)
	120
	121
	122	665.09 Sen d to Workl ist
	123
	124
	125	695.10 Reo pen Closed Claims (h idden acti on)
	126
	127
	128	715.11 Res ubmit with Edits (hi dden actio n)
	129
	130
	131	765.12 OP ECC Reject Informati on (hidden action)
	132
	133
	134	775.13 Re submit Cla im Without Reversal (hidden ac tion)
	135
	136
	137	795.14 Op en/Close N on Billabl e Entry (h idden acti on)
	138
	139
	140	805.15 Dis play Updat e (hidden action)
	141
	142
	143	825.16 Exi t (from EC ME User Sc reen)
	144
	145
	146	836.
	147	Accessing the ECME P harmacy CO B Menu
	148
	149
	150	836.1 Pote ntial Seco ndary Rx C laims Repo rt
	151
	152
	153	856.2 Pote ntial Clai ms Report for Dual E ligible
	154
	155
	156	876.3 Proc ess Second ary/TRICAR E Rx to EC ME
	157
	158
	159	886.3.1
	160	Submitting Secondary Claims
	161
	162
	163	896.3.2
	164	Submitting Primary C laims for TRICARE an d Dual Eli gibility P atients
	165
	166
	167	917
	168	Accessing the Pharma cy ECME Ma nager Menu
	169
	170
	171	927.1 ECME Transacti on Mainten ance Optio ns
	172
	173
	174	927.1.1 Vi ew/Unstran d Submissi ons Not Co mpleted
	175
	176
	177	947.1.2 RE OPEN a CLO SED ECME C laim
	178
	179
	180	967.2 Phar macy ECME Setup Menu
	181
	182
	183	977.2.1 Ed it Basic E CME Parame ters
	184
	185
	186	997.2.2 Ed it ECME Ph armacy Dat a
	187
	188
	189	1027.2.3 R egister Ph armacy wit h Austin I nformation Technolog y Center
	190
	191
	192	1057.3 Sta tistics Sc reen
	193
	194
	195	1077.3.1 U pdate Cont inuously
	196
	197
	198	1087.3.2 D isplay Upd ate
	199
	200
	201	1087.3.3 Z ero (clear ) Statisti cs
	202
	203
	204	1107.3.4 E xiting the Statistic s Screen
	205
	206
	207	1128
	208	Accessing the Pharma cy Electro nic Claims Reports
	209
	210
	211	1138.1 Cla im Results and Statu s
	212
	213
	214	1168.1.1 P ayable Cla ims Report
	215
	216
	217	1228.1.2 R ejected Cl aims Repor t
	218
	219
	220	1298.1.3 C MOP/ECME A ctivity Re port
	221
	222
	223	1318.1.4 R eversal Cl aims Repor t
	224
	225
	226	1358.1.5 C laims Subm itted, Not Yet Relea sed
	227
	228
	229	1368.1.6 R ecent Tran sactions
	230
	231
	232	1418.1.7 T otals by D ate
	233
	234
	235	1428.1.8 C losed Clai ms Report
	236
	237
	238	1468.1.9 N on-Billabl e Status R eport
	239
	240
	241	1548.1.10 Spending A ccount Rep ort
	242
	243
	244	1608.2 Oth er Reports
	245
	246
	247	1608.2.1 E CME Claims -Response Inquiry Op tion
	248
	249
	250	1638.2.2 P ayer Sheet Detail Re port Optio n
	251
	252
	253	1688.2.3 E CME Setup – Pharmaci es Report
	254
	255
	256	1708.2.4 T urn-around time stat istics
	257
	258
	259	1718.2.5 V iew ePharm acy Rx
	260
	261
	262	1828.2.6 O PECC Produ ctivity Re port
	263
	264
	265	1899
	266	BPS Nightl y Backgrou nd Job
	267
	268
	269	19110
	270	Glossary
	271
	272
	273	20711
	274	Acronyms
	275
	276
	277	20812
	278	Index
	279
	280
	281
	282
	283	1
	284	Introducti on XE "In troduction "
	285	The Electr onic Claim s Manageme nt Engine (ECME) gen erates ele ctronic cl aims in Na tional Cou ncil for P rescriptio n Drug Pro grams (NCP DP) V. D.0 formats, based on t he Outpati ent Pharma cy V. 7.0 workflow. ECME:
	286	Allows pha rmacy clai ms process ing staff to submit, resubmit, and rever se electro nic claims ;
	287	Provides r eports for end users and manag ement on c laims stat us, transa ction hist ory, and s ystem conf iguration standings;
	288	Allows Aut omated Dat a Processi ng Applica tion Coord inator (AD PAC) and I nformation Resources Managemen t Service (IRMS) sta ff to conf igure ECME to pharma cy site sp ecificatio ns.
	289	Allows Eli gibility I nquiry and Verificat ion transa ctions for verificat ion of val id patient pharmacy insurance.
	290	ECME claim s processi ng begins when event s within O utpatient Pharmacy V . 7.0 meet specific criteria, based on I ntegrated Billing (I B) V. 2.0 determinat ion, that indicate t he system should gen erate an e lectronic claim. To build a cl aim throug h ECME, se veral cond itions mus t be met. First, the patient m ust be reg istered an d have pha rmacy pres cription i nsurance c overage. S econd, the patient m ust be a n on-service connected patient o r, if serv ice connec ted; the p rescriptio n must not be for th e service- connected condition. The patie nt must no t have an environmen tal indica tors condi tion, unle ss the pat ient is Ac tive Duty. (If the p atient is Active Dut y, all pre scriptions are billa ble). Fina lly, the d rug must b e billable . Logic em bedded wit hin ECME m anages the creation of the ele ctronic cl aim, which requires integratio n with IB V. 2.0, Ph armacy Dat a Manageme nt, and Na tional Dru g File (ND F) V. 4.0. ECME also generates claims du ring Conso lidated Ma il Outpati ent Pharma cy (CMOP) V. 2.0 pro cessing fo r prescrip tions that meet bill ing requir ements.
	291	The Vetera ns Health Administra tion (VHA) developed ECME soft ware in or der to com ply with t he Health Insurance Portabilit y and Acco untability Act (HIPA A) of 1996 and updat ed it to c omply with the HIPAA rule of 2 009, which requires health car e provider s to trans mit outpat ient pharm acy prescr iption cla ims to pay ers electr onically i n the NCPD P format a nd to rece ive respon ses on a r eal-time b asis. ECME is derive d from the Point of Sale (POS) Applicati on develop ed by the Indian Hea lth Servic e (IHS) an d is assig ned to the BPS names pace.
	292	The ECME U ser Manual helps use rs submit electronic claims, a ids ADPAC and IRMS s taff in co nfiguring ECME to ph armacy sit e specific ations, an d is a ref erence man ual for al l screens and option s within E CME. While the ECME User Manua l does exp lain how t o use the Electronic Managemen t Claims E ngine, it is not int ended to s how how EC ME interac ts with Ou tpatient P harmacy V. 7.0, IB V . 2.0, the Austin In formation Technology Center, a nd other s oftware pa ckages to build, sub mit, recei ve, and pr ocess an e lectronic claim.
	293	The ECME U ser Manual assumes t hat you ar e familiar with the VistA comp uting envi ronment, i ncluding t he Outpati ent Pharma cy V. 7.0 workflow a nd the Dep artment of Veterans Affairs (D VA) FileMa n data str uctures an d terminol ogy.
	294	The ECME U ser Manual consists of the fol lowing sec tions.
	295	ECME Intro duction: Outlines t he history , use, and intent of the ECME software.
	296	ECME Orien tation: S hows how t o use the menus and options to generate an electro nic claim, obtain on line help, and find related ma nuals.
	297	ECME Menu Structures : Lists t he complet e ECME men u structur e. It also lists the ECME User , Manager, and Repor ts menus.
	298	Accessing the ECME M enu: Desc ribes how to gain ac cess to th e ECME mai n Menu.
	299	Accessing the ECME U ser Screen : Describ es the ele ments of s ubmitting pharmacy c laims to i nsurers th rough the ECME syste m.
	300	Accessing the ECME P HARMACY CO B menu: D escribes t he element s of submi tting phar macy claim s to secon dary insur ers and su bmitting T RICARE cla ims.
	301	Accessing the Pharma cy ECME Ma nager Menu : Describ es electro nic claims managemen t features that requ ire manage ment level decisions .
	302	Accessing the Pharma cy Electro nic Claims Reports: Describes the repor ts generat ed by ECME .
	303	ECME Backg round Jobs : Describ es the tas ks perform ed by the Nightly Ba ckground J ob.
	304	Glossary: Defines c ommon ECME -related t erms.
	305	Acronyms: Lists ECM E-related acronyms.
	306	Index: Li sts subjec ts, option s, and men us alphabe tically.
	307	2
	308	Orientatio n XE "Orie ntation"
	309	2.1 Workin g with the ECME User Manual
	310	The Electr onic Claim s Manageme nt Engine (ECME) Use r Manual i s a menu- and option -oriented manual. In most case s, the man ual descri bes a menu or option , shows ho w to acces s it, and uses table s and scre en shots t o describe its field s.
	311	The ECME U ser Manual uses the following methods to enhance r eadability .
	312	Menu optio ns and scr een action s are ital icized.
	313	Example: The Add Ph armacy/OPE CC Comment action tr iggers the system to display t he Pharmac y/OPECC Co mment on t he ECME Us er Screen.
	314	Screen pro mpts are d enoted wit h quotatio n marks ar ound them.
	315	Example: The “Selec t Action:” prompt wi ll display next.
	316	Variable n ames, form al name of options, field and file names , and secu rity keys are comple tely upper case.
	317	Example: The BPS US ER key.
	318	Screen cap tures/dial ogues are shaded and shown in a non-prop ortional f ont.
	319	User respo nses to on line promp ts are in boldface t ype.
	320	Example:
	321	Select Pha rmacy ECME User Menu Option: R PT
	322	<Enter> in dicates yo u must pre ss the Ent er key (or Return ke y) on the keyboard t o proceed to the nex t prompt. Other keys are repre sented wit hin < > an gle bracke ts.
	323	Example:
	324	Select Pha rmacy ECME Manager M enu Option : ?<Enter>
	325	The follow ing symbol s alert yo u to speci al informa tion.
	326	SymbolDesc riptionCau tions you to notice critical i nformation .Indicates especiall y importan t or helpf ul informa tion.Indic ates that you must h old a part icular sec urity key to perform a specifi c task.
	327	Example: You must hold the BPS MANAGE R and BPS MENU keys to access the Pharma cy ECME Ma nager Menu options. 2.2 Obtain ing Online Help XE "Online He lp"
	328	The ECME s oftware pr ovides onl ine help a nd commonl y used sys tem defaul t prompts. You can e nter quest ion marks at any res ponse prom pt. At the end of th e help dis play, Vist A (Veteran s Health I nformation Systems a nd Technol ogy Archit ecture) im mediately returns yo u to the p oint from which you started.
	329	To retriev e Online H elp in any VistA cha racter-bas ed product :
	330	Enter a si ngle quest ion mark ( ?) at a fi eld/prompt to obtain a brief d escription :
	331	If a field is a poin ter, enter ing one qu estion mar k (?) disp lays the H ELP PROMPT field con tents and a list of choices, i f the list is short.
	332	If the lis t is long, the syste m will ask you if th e entire l ist should be displa yed. A Y(E S) respons e will inv oke the di splay. By prefacing the starti ng point w ith an up- arrow (^) as a respo nse, you c an give th e display a starting point. Fo r example, ^M starts an alphab etic listi ng at the letter M i nstead of the letter A while ^ 127 starts any listi ng at the 127th entr y.
	333	Enter two question m arks (??) at a field /prompt fo r a more d etailed de scription. If a fiel d is a poi nter, ente ring two q uestion ma rks displa ys the HEL P PROMPT f ield conte nts and th e list of choices.
	334	Enter thre e question marks (?? ?) at a fi eld/prompt to invoke any addit ional Help text stor ed in Help Frames.
	335	2.3 Findin g Related Manuals XE "Related Manuals"
	336	To learn m ore about the ECME V . 1.0 soft ware, plea se consult the follo wing:
	337	Electronic Claims Ma nagement E ngine (ECM E) V. 1.0 Technical Manual/Sec urity Guid e
	338	All ECME V . 1.0 docu mentation can be fou nd at the VistA Docu mentation Library at http://ww w.va.gov/v dl.
	339	VHA-orient ed HIPAA ( Health Ins urance Por tability a nd Account ability Ac t) informa tion can b e found at http:// URL /hipaa/.
	340	(This page included for two-si ded copyin g.)
	341	3
	342	ECME Menu Structures XE "ECME Menu Struc tures"
	343	This secti on provide s a map of the Elect ronic Clai ms Managem ent Engine (ECME) me nu structu re includi ng a list of all opt ions. ECME is a menu -driven sy stem that allows acc ess based on the sec urity keys that you hold.
	344	Currently, ECME has the follow ing securi ty keys: BPSMENU, B PS USER, B PS MANAGER , BPS MAST ER, BPS SU PERVISOR, and BPS RE PORTS. All users mus t have the BPSMENU k ey in addi tion to th e specific keys list ed below.
	345	The follow ing table lists the type of us ers who wo uld need a ccess to a specific menu and t he ECME Se curity Key s you must hold in o rder to ac cess a par ticular EC ME menu. F or example , the OPEC C (Outpati ent Pharma cy Electro nic Claims Coordinat or) would need acces s to all E CME menus, while a P harmacy Te chnician m ight only need acces s to the M ain Menu, ECME User Screen, an d Reports menus.
	346	Table 3-1: List of U sers with Suggested ECME Menus and Secur ity Keys
	347	Type of Us er*ECME Me nuECME Sec urity Keys OPECCAll E CME Menus
	348	ECME Ma in Menu
	349	ECME Us er Screen
	350	ECME Ph armacy COB
	351	Pharmac y ECME Man ager Menu
	352	Pharmac y Electron ic Claims Reports B PSMENU
	353	BPS USER
	354	BPS MANA GER
	355	BPS REPO RTSPharmac ist, Pharm acy Techni cian ECM E Main Men u
	356	ECME Us er Screen
	357	Pharmac y Electron ic Claims Reports B PSMENU
	358	BPS USER
	359	BPS REPO RTSePharma cy Site Ma nager and back-up ECME Main Menu
	360	ECME Us er Screen
	361	Pharmac y ECME Man ager Menu
	362	Pharmac y Electron ic Claims Reports B PSMENU
	363	BPS USER
	364	BPS MANA GER
	365	BPS MAST ER
	366	BPS REPO RTSADPAC
	367	(Autom ated Data
	368	Proce ssing Appl ication
	369	Coord inator) ECME Main Menu
	370	ECME Ph armacy COB
	371	Pharmac y ECME Man ager Menu
	372	Pharmac y Electron ic Claims Reports B PSMENU
	373	BPS MANA GER
	374	(BPS MA STER is al so
	375	requir ed to acce ss certain
	376	MGR me nu options )
	377	BPS REPO RTSIRMS
	378	(Inform ation Reso urces
	379	Manage ment Servi ce)ECME Ma in Menu
	380	Pharmac y ECME Man ager Menu
	381	Pharmac y Electron ic Claims ReportsBPS MENU
	382	BPS MANA GER
	383	(BPS MA STER is al so
	384	requir ed to acce ss certain
	385	MGR me nu options )
	386	BPS REPO RTSOPECC S upervisorP harmacy El ectronic C laims Repo rtsBPS SUP ERVISOR
	387	BPS REPORT S3.1 The C omplete EC ME Menu St ructure XE "ECME Men u Options"
	388	The comple te list of ECME menu options i s shown be low. The O PECC needs to access all ECME options.
	389	You must h old the BP SMENU and BPS MANAGE R keys to view the P harmacy EC ME Manager Menu opti on. The BP S MASTER k ey is also required to view th e Edit ECM E Pharmacy Data (PHA R), Pharma cy ECME Se tup Menu ( SET), Edit Basic ECM E Paramete rs (BAS), and Regist er Pharmac y with Aus tin Inform ation Tech nology Cen ter (REG) options.U
	390	ECME User Screen
	391	COB
	392	ECME Pharm acy COB .. .
	393	SEC
	394	Potential Secondary Rx Claims Report
	395	TRI
	396	Potential Claims Rep ort for Du al Eligibl e
	397	PRO
	398	Process Se condary/TR ICARE Rx t o ECME
	399	MGR
	400	Pharmacy E CME Manage r Menu . .
	401	MNT
	402	ECME trans action mai ntenance o ptions …
	403
	404	UNS
	405	View/Unstr and Submis sions Not Completed
	406
	407	ROC
	408	Re Open CL OSED Claim
	409	SET
	410	Pharmacy E CME Setup Menu ...
	411
	412	BAS
	413	Edit Basic ECME Para meters
	414
	415	PHAR
	416	Edit ECME Pharmacy D ata
	417
	418	REG
	419	Register P harmacy wi th Austin Informatio n Technolog y Center
	420	STAT
	421	Statistics Screen
	422	RPT
	423	Pharmacy E lectronic Claims Rep orts . .
	424
	425	CLA
	426	Claim Resu lts and St atus . .
	427
	428
	429	PAY
	430	Payable Cl aims Repor t
	431
	432
	433	REJ
	434	Rejected C laims Repo rt
	435
	436
	437	ECMP
	438	CMOP/ECME Activity R eport
	439
	440
	441	REV
	442	Reversal C laims Repo rt
	443
	444
	445	NYR
	446	Claims Sub mitted, No t Yet Rele ased
	447
	448
	449	REC
	450	Recent Tra nsactions
	451
	452
	453	DAY
	454	Totals by Date
	455
	456
	457	CLO
	458	Closed Cla ims Report
	459
	460
	461	NBS
	462	Non-Billab le Status Report
	463
	464
	465	SPA
	466	Spending A ccount Rep ort
	467
	468	OTH
	469	Other Repo rts . .
	470
	471
	472	CRI
	473	ECME Claim s-Response Inquiry
	474
	475
	476	PAY
	477	Payer Shee t Detail R eport
	478
	479
	480	PHAR
	481	ECME Setup - Pharmac ies Report
	482
	483
	484	TAT
	485	Turn-aroun d time sta tistics
	486
	487
	488	VER
	489	View ePhar macy Rx
	490
	491
	492	OPR
	493	OPECC Prod uctivity R eport
	494	3.2 ECME U ser Screen XE "Pharm acy ECME U ser Screen "
	495	The ECME U ser Screen structure is listed below. Th e ECME Use r Screen i s a List M anager scr een that h as multipl e actions contained within the option. O PECCs must have acce ss to this option. I t may be h elpful for Pharmacis ts and the ePharmacy Site Mana ger to hav e access a lso.
	496	You must h old the BP S MENU and BPS USER keys to vi ew the ECM E User Scr een option .U
	497	ECME User Screen
	498	3.3 ECME P harmacy CO B Menu Str ucture
	499	The ECME P harmacy CO B Menu opt ion struct ure is lis ted below. OPECCs mu st be able to access this menu .
	500	You must h old the BP SMENU keys to view t he ECME Ph armacy COB option. C OB
	501	ECME Pharm acy COB . .
	502	SEC Pot ential Sec ondary Rx Claims Rep ort
	503
	504	TRI Po tential Cl aims Repor t for Dual Eligible
	505
	506	PRO Pro cess Secon dary/TRICA RE Rx to E CME
	507	3.4 Pharma cy ECME Ma nager Menu Structure " Pharmacy ECME Mana ger Menu O ptions"
	508	The Pharma cy ECME Ma nager Menu option st ructure is listed be low. ADPAC , IRMS (In formation Resources Management Service) and OPECC staff must be able t o use this menu.
	509	You must h old the BP SMENU and BPS MANAGE R keys to view the P harmacy EC ME Manager Menu opti on.MGR
	510	Pharmacy E CME Manage r Menu . .
	511	MNT
	512	ECME trans action mai ntenance o ptions …
	513
	514	UNS
	515	View/Unstr and Submis sions Not Completed
	516
	517	ROC
	518	Re Open CL OSED Claim
	519	SET
	520	Pharmacy E CME Setup Menu ...
	521
	522	BAS
	523	Edit Basic ECME Para meters
	524
	525	PHAR
	526	Edit ECME Pharmacy D ata
	527
	528	REG
	529	Register P harmacy wi th Austin Automation Center
	530	STAT
	531	Statistics Screen
	532	3.5 Pharma cy Electro nic Claims Reports M enu Struct ure XE " P harmacy El ectronic C laims Repo rts Menu S tructure"
	533	The Pharma cy Electro nic Claims Reports m enu option structure is listed below. OP ECCs and P harmacy st aff involv ed with th e ePharmac y process must be ab le to acce ss this me nu.
	534	You must h old the BP SMENU and BPS REPORT keys to v iew the Ph armacy Ele ctronic Cl aims Repor ts option. The OPECC Productiv ity Report will only display i f the user holds the BPS SUPER VISOR KEY. RPT
	535	Pharmacy E lectronic Claims Rep orts . .
	536
	537	CLA
	538	Claim Resu lts and St atus . .
	539
	540
	541	PAY
	542	Payable Cl aims Repor t
	543
	544
	545	REJ
	546	Rejected C laims Repo rt
	547
	548
	549	ECMP
	550	CMOP/ECME Activity R eport
	551
	552
	553	REV
	554	Reversal C lams Repor t
	555
	556
	557	NYR
	558	Claims Sub mitted, No t Yet Rele ased
	559
	560
	561	REC
	562	Recent Tra nsactions
	563
	564
	565	DAY
	566	Totals by Date
	567
	568
	569	CLO
	570	Closed Cla ims Report
	571
	572
	573	NBS
	574	Non-Billab le Status Report
	575	SPA Spe nding Acco unt Report
	576
	577	OTH
	578	Other Repo rts . .
	579
	580
	581	CRI
	582	ECME Claim s-Response Inquiry
	583
	584
	585	PAY
	586	Payer Shee t Detail R eport
	587
	588
	589	PHAR
	590	ECME Setup - Pharmac ies Report
	591
	592
	593	TAT
	594	Turn-aroun d time sta tistics
	595
	596
	597	VER
	598	View ePhar macy Rx
	599
	600
	601	OPR
	602	OPECC Prod uctivity R eport
	603	4
	604	Accessing the ECME M ain Menu XE "ECME M ain Menu"
	605	The Electr onic Claim s Manageme nt Engine Main Menu option is usually ac cessed thr ough the C ore Applic ations Men u.
	606	You must h old the BP SMENU key to view th e Electron ic Claims Management Engine (E CME) Main Menu.Examp le 4-1: A ccessing t he Electro nic Claims Managemen t Engine M ain Menu
	607	Select Cor e Applicat ions Optio n: ?
	608	Laboratory ...
	609	PIMS MAS MANAGE R ...
	610	Mental Hea lth ...
	611	Military R etirees .. .
	612	Patient Da ta Log
	613	Informatio n Manageme nt Systems (SWIMS) . ..
	614	Voluntary Services' Menu ...
	615	AR Finance AR Manager M enu ...
	616	BPS ECME ...
	617	EN Engineerin g Main Men u ...
	618	FEE Fee Basis Main Menu ...
	619	HL7 HL7 Main M enu ...
	620	IB Integrated Billing M aster Menu ...
	621	NS Nursing Sy stem Manag er's Menu ...
	622	PSO Outpatient Pharmacy Manager .. .
	623	VOL Voluntary Service Ma ster Menu ...
	624	Select Cor e Applicat ions Optio n: BPS EC ME
	625	(This page included for two-si ded copyin g.)
	626	5
	627	Accessing the ECME U ser Screen XE "ECME User Scre en"
	628	The ECME U ser Screen provides access to pharmacy c laims that have been submitted electroni cally to t hird party payers/Ph armacy Ben efit Manag ers (PBM). This opti on allows you to rev iew, close , reverse, or resubm it electro nic claims .
	629	From the E CME User S creen you can access additiona l actions needed to process el ectronic p harmacy cl aims, incl uding the Further Re search act ion, which allows yo u to resea rch insura nce, eligi bility and prescript ion inform ation.
	630	You must h old the BP SMENU AND BPS USER k ey to view the ECME User Scree n option.T his screen is access ed by sele cting the U (ECME Us er Screen) option on the ECME Main Menu screen.
	631	The screen will disp lay nothin g the firs t time you enter thi s menu opt ion. Selec t the Chan ge View op tion, CV, as in sect ion 5.1, a nd specify preferenc es to be d isplayed o n the scre en. The sy stem will then defau lt to thes e settings and displ ay current informati on about a ctive pati ents and p rescriptio ns for the timeframe requested .Example 5 -1: Acces sing the E CME User S creen Opti on
	632	*** ****** ****** ****** ****** **
	633	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	634	* XXXXX V AMC *
	635	* Main M enu *
	636	*** ****** ****** ****** ****** **
	637	U ECME User Screen
	638	COB ECME Pharm acy COB .. .
	639	MGR Pharmacy E CME Manage r Menu ...
	640	RPT Pharmacy E lectronic Claims Rep orts ...
	641	Select ECM E Option: U ECME Us er Screen
	642	Please wai t...
	643	Example 5- 2: Displa ying the E CME User S creen Opti on
	644	PHARMACY E CME Jul 03, 20 10@14:55:0 1 Page : 1 of 30
	645	SELECTED D IVISION(S) : ALL
	646	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	647	Sorted b y: Transac tion date by default
	648	# PATIEN T/DRUG/COM MENTS IN SURANCE/ND C/DOS/RX#/ ECME# STATUS /LOC/TYP/R XINF
	649	1 ECMEPa tient,FIVE (XXXX) I BINSUR1/ VET Pb: 0 Rj:1 AcR v:3 RjRv:0
	650	1.1 CO LCHICINE 0 .6MG 0007 4-3781-01 06/24 1012 97$ 1/ 0000000016 53 M RT DS/N
	651	10/1 9/10 - Cla rification Code 8 su bmitted.
	652	(OPP USER,TWO)
	653	p-Re versal acc epted
	654	Enter ?? f or more ac tions
	655	CV Change View REV Reverse Pa yable Clai m FR Furt her Resear ch
	656	SO Sort L ist RES Resubmit C laim VER View ePharmacy Rx
	657	CMT Add/Vi ew Comment s CLO Close Clai m WRK Send to Workli st
	658	Select Act ion: Next Screen//
	659	This secti on diagram s and desc ribes the different elements o f your ECM E User Scr een.
	660	Dia gram 5-1: ECME User Screen Ar eas
	661
	662
	663
	664
	665
	666
	667	The table below desc ribes the four areas of the EC ME User Sc reen.
	668	Table 5-1: Descript ion of ECM E User Scr een Areas
	669	Screen Are aDescripti onHeader A reaDisplay s the date /time the screen was built, pa ge status, selected division(s ), user an d activity date rang e. Patient /
	670	Rx AreaDis plays info rmation ab out the pa tient and prescripti on:#Line N umber. Seq uential li ne number for each p atient and associate d prescrip tion line( s).Patient Lines # PATIENT (Patient ID) INSURA NCE/ EligI ndicator SummarySta tus
	671	ECMEPatien t,FIVE (X XXX) IBINS UR1/ VET Pb:0 Rj:1 AcRv:3 Rj Rv:0
	672	The first line is th e Patient Summary In formation line, whic h displays the patie nt’s name, (patient ID), insur ance compa ny and pho ne; eligib ility indi cator for the patien t and insu rance: VET = Veteran s, TRI = T RICARE; CV A = CHAMPV A; claim p rogress st atus and a summary s tatus of a ll claims submitted for this p atient wit hin the ti me frame r equested i n the ECME User Scre en paramet ers. The c odes for t he summary status ar e as follo ws:
	673	Pb = Payab le
	674	Rj = Rejec ted
	675	AcRv = Rev ersal Acce pted
	676	RjRv = R eversal Re jected
	677	Exam ple: VET Pb :17 Rj:4 A cRv:0 RjRv :0.Claim/ Prescripti on Informa tion LineT he Prescri ption line (s) follow the patie nt informa tion lines sequentia lly. For e ach fill, an ECME cl aim is sen t to the p ayer and e ach of the se claims is display ed as a se parate lin e on the U ser Screen (ECME Use r Screen).
	678	Drug Nam e ND C DOS RX# Copay Refill/E CME# COLCHIC INE 0.6MG 00074-378 1-01 06/24 101297 $ 1 /00000 0001653
	679	LOC /BillT YPE /RXSta tus /Rele ase Status
	680	M/ RT/ DS /N
	681	These show for each claim:
	682	Drug Name
	683	NDC (Natio nal Drug C ode)
	684	Date of Se rvice
	685	Rx#
	686	$ Patient Copay (if applicable )
	687	Refill#
	688	ECME#
	689	Fill Locat ion
	690	C = Consol idated Mai l Outpatie nt Pharmac y (CMOP)
	691	M = LO CAL MAIL
	692	W = WI NDOW FILL
	693	Bill Type
	694	BB = B ackbill
	695	P2 = PRO option
	696	RS = Res ubmission
	697	RT = Rea l Time Fil l
	698	RX Status
	699	AC = Acti ve
	700	NV = Non-v erified
	701	HL = Hold
	702	SU = Suspe nd
	703	EX = Expir ed
	704	DS = Disco ntinued
	705	DL = Delet ed
	706	?? = Unkno wn
	707	Release St atus
	708	N = Rx NOT Released
	709	R = Rx Rel eased
	710	Coordinati on of Bene fits Indic ator
	711	p- primary claim
	712	s- seconda ry claim
	713	s-Payable (p-Payable )
	714	The status is displa yed only f or those f ill lines (claims) t hat repres ent the mo st recent fill. If t here is mo re than on e fill for the same prescripti on within the time f rame reque sted in th e ECME Use r Screen p arameters, the previ ous fill/c laim is in dicated wi th "*" i nstead of Rx status, and the m ost curren t fill wil l display the RX sta tus. If a fill has b een create d and put on suspens e, the scr een displa ys "*". User-Input Comments The system allows th e ECME use r to enter comments for any cl aim displa yed on the ECME User Screen. T he most re cent comme nt is disp layed unde r the Pres cription I nformation line. If a claim ha s been res ubmitted s ince the m ost recent comment, a message displays i n place of the most recent com ment: “Pr ior commen ts suppres sed – use CMT action for all c omments”.P ayer Retur ned Respon sesThe Pay er Returne d Response informati on is disp layed bene ath the us er-input c omments or beneath t he patient informati on line, i f no comme nts were e ntered. Ea ch respons e will beg in on a se parate lin e.
	715	Valid paye r-returned responses include R ejected (w ith a Nati onal Counc il for Pre scription Drug Progr ams (NCPDP ) rejectio n code des cribed in the ePharm acy Reject s & Resolu tions Guid e on the URL , with add itional li nes of des criptive e rror messa ges), Paya ble, Rever sal Accept ed, Revers al Rejecte d, Strande d, Strande d reversal , Captured , Duplicat e, Other, Cancelled, Corrupt, Unknown st atus and I n Progress . If a cla im is clos ed, “Close d” is adde d to the s tatus, e.g ., “Revers al accepte d/Closed”. Message Wi ndowThis s ection dis plays a pl us (+) sig n, minus ( -) sign or informati onal text (i.e., Ent er ?? for more actio ns). The p lus and mi nus signs, entered a t the acti on prompt, are used to jump fo rward or b ack a scre en.Action AreaA list of Claims Data Entr y options is availab le to you as describ ed in Sect ion 5 of t his manual . A double question mark (??) may be ent ered at th e "Select Action" pr ompt for a list of a ll List Ma nager opti ons availa ble.An opt ion chosen at the pa tient info rmation le vel is per formed on all claim items for that patie nt.The ECM E User Scr een also d isplays no n-billable entries i n addition to billab le claims. TRICARE an d CHAMPVA prescripti ons with p seudo-reje ction code s of eT an d eC displ ay with a few differ ences. The display f or non-bil lable entr ies does n ot include date of s ervice or an ECME nu mber. Also , an open/ closed ind icator dis plays for each pseud o-rejectio n entry an d the open /closed st atus is on ly for dis play purpo ses. The u ser is abl e to filte r based on the statu s by using the Chang e View act ion.
	716	The ECME U ser Screen has sever al actions that help you navig ate it, as shown bel ow. Action s are ente red at the "Select A ction" pro mpt by typ ing the sy nonym for the action (e.g., CV for Chang e View), t he first u nique lett er(s) of t he action name (e.g. , CL for C lose) or t he full na me of the action (e. g., Sort L ist for So rt List).
	717	Example 5- 2: List of all ECME User Scree n Actions
	718	+ Enter ?? f or more ac tions
	719	CV Change View REV Reverse Pa yable Clai m FR Furt her Resear ch
	720	SO Sort L ist RES Resubmit C laim VER View ePharmacy Rx
	721	CMT Add/Vi ew Comment s CLO Close Clai m WRK Send to Workli st
	722	List Manag er provide s generic actions ap plicable t o List Man ager Scree ns. A doub le questio n mark (?? ) may be e ntered at the "Selec t Action" prompt for a list of other act ions avail able. Ente ring the s ynonym is the quicke st way to select an action.
	723	Example 5- 3: Display ing List M anager Act ions by En tering “?? ”
	724	Select Act ion: Next Screen// ? ?
	725	The follow ing action s are also available :
	726	+ Next Screen
	727	- Previ ous Screen
	728	UP Up a Line
	729	DN Down a Line
	730	> Shift View to R ight
	731	< Shift View to L eft
	732	FS First Screen
	733	LS Last Screen
	734	GO Go to Page
	735	RD Re Di splay Scre en
	736	PS Print Screen
	737	PL Print List
	738	SL Searc h List
	739	ADPL Auto Display(On /Off)
	740	Q
	741	Quit
	742	Press RETU RN to cont inue or '^ ' to exit:
	743	ROC Reope n Closed C laims
	744	OCN Open/ Close Non Billable E ntry
	745	DV Print Developer Claim Log
	746	REJ OPECC Reject In formation
	747	RER Resub mit Claim w/o Revers al
	748	EX Exit
	749	LOG Print Claim Log
	750	RED Resub mit Claim w/EDITS
	751	UD Displ ay Update
	752	Enter RETU RN to cont inue or '^ ' to exit:
	753	The follow ing action s are not available for non-bi llable ent ries: REV Reverse P ayable Cla im, CLO Cl ose Claim, LOG Prin t Claim Lo g, WRK Sen d to Workl ist, ROC R eopen Clos ed Claims, RED Resu bmit Claim w/EDITS, RER Resubm it Claim w /o Reversa l, and RH Release Co pay (On FR Further R esearch).A fter selec ting an ac tion, a pr ompt may d isplay for the user to select an item fr om the ECM E User scr een. If t he action requires t he user to select a patient li ne, the sy stem will default a value of 1 for the i tem prompt if there is only on e patient displayed. If the a ction requ ires the u ser to sel ect a clai m line, th e system w ill defaul t a value of 1.1 for the promp t if there is only o ne claim d isplayed.
	754	5.1 Change View XE " Change Vi ew"
	755	The Change View acti on allows you to cus tomize inf ormation y ou want to see displ ayed on th e ECME Use r Screen.
	756	The action is access ed by ente ring CV at the “Sele ct Action: ” prompt o n the ECME User Scre en. The sy stem gives you the o ption to “ SAVE” thes e selectio ns as your “preferre d view”.
	757	(This page included for two-si ded copyin g.)
	758	Example 5. 1-1: Acce ssing the Change Vie w Action
	759	PHARMACY E CME Apr 26, 20 06@11:44:4 5 Page : 1 of 2
	760	SELECTED D IVISION(S) : ALL
	761	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	762	Sor ted by: Pa tient Name
	763	# PATIEN T/DRUG/COM MENTS INSURANC E/NDC/RX#/ ECME# LOC/TYP RXINF
	764	6 ECMEpa tient,Two (XXXX) W EBMD TE/ VET Pb:1 Rj:0 AcRv:0 RjR v:1
	765	6.1 FU ROSEMIDE 1 0MG/M 006 41-2312-25 04/18 100 004065$ 0 /000000504 691 W RT A C/R
	766	p-Pa yable
	767	6.2 CH OLESTYRAMI NE 4G 000 87-0580-01 04/19 100 004066$ 0 /000000504 692 W RT A C/R
	768	p-Re versal rej ected
	769	NN:T ransaction Rejected At Switch Or Interme diary
	770	NC16 -The clear inghouse d id not rep ly in time .
	771	7 ECMEpa tient,One (XXXX) W EBMD TE/ VET ALL payabl e
	772	7.1 AL BUTEROL IN HALER 555 55-4444-22 04/26 100 003744$ 0 /000000504 304 W RT A C/R
	773	p-Pa yable
	774	7.2 AC ETYLCYSTEI NE 20 000 87-0570-09 04/21 100 004054$ 0 /000000504 677 W RT A C/N
	775	p-Pa yable
	776	8 ECMEpa tient,Thre e (XXXX) W EBMD TE/ VET ALL payabl e
	777	+ Enter ?? f or more ac tions
	778	The screen has been updated on APR 26,20 06@14:50:4 7. Press " Q" to quit .
	779	CV Change View REV Reverse Pa yable Clai m FR Furt her Resear ch
	780	SO Sort L ist RES Resubmit C laim VER View ePharmacy Rx
	781	CMT Add/Vi ew Comment s CLO Close Clai m WRK Send to Workli st
	782	Select Act ion: Next Screen//CV Change Vi ew
	783	(This page included for two-si ded copyin g.)
	784	View data by divisio n(s) or al l division s.
	785	Example 5. 1-2: Sele cting View s by Divis ion
	786	Selec t one of t he followi ng:
	787	D DIVISION
	788	A ALL
	789	Select Cer tain Pharm acy (D)ivi sions or ( A)LL: A// DIVISION
	790	Selected :
	791	Select ECM E Pharmacy Division( s): BAY PI NES
	792	BAY PINES
	793	View data by Eligibi lity Type of the cla im.
	794	Example 5. 1-3: Sele cting View s by Eligi bility Typ e
	795	Selec t one of t he followi ng:
	796	V VETERAN
	797	T TRICARE
	798	C CHAMPVA
	799	A ALL
	800	Select One or Many E ligibility Types or (A)ll: A// ?
	801	Enter a si ngle respo nse or mul tiple resp onses sepa rated by c ommas.
	802	Example:
	803	T
	804	T,C
	805	View data for one EC ME user, m any ECME u sers or al l users. T he ECME us er is defi ned as the person wh o last pro cessed/fin ished/resu bmitted, e tc., the p rescriptio n fill.
	806	Example 5. 1-4: Sele cting View s from Ent ries by On e User
	807	Selec t one of t he followi ng:
	808	U USER
	809	A ALL
	810	Display On e or Many ECME (U)se rs or (A)L L: A// USE R
	811	Select Use r: USER
	812	1 E CMEuser,On e UO PHARMA CIST
	813	2 E CMEuser,Tw o UTW PHARMA CIST
	814	3 E CMEuser,Th ree UTH PHARMA CIST
	815	CHOOSE 1-3 : 1 ECMEu ser,One UO PHARMA CIST
	816	Selected :
	817	ECMEuser,O ne
	818	Select Use r:
	819	View data from one p atient, ma ny patient s or all p atients.
	820	Example 5. 1-5: Sele cting View s from Ent ries for O ne Patient
	821	Se lect one o f the foll owing:
	822	P PATIENT
	823	A ALL
	824	Display On e or Many (P)atients or (A)LL: A// PATIE NT
	825	Enter a pa tient to s elect.
	826	Once all p atients ar e selected , hit ente r without making a s election.
	827	Select Pat ient: ECME patient,ON E// ECME
	828	1 ECM Epatient,O ne 1-1-65 666443333 NO NSC VET ERAN
	829	2 ECM Epatient,T wo 1-1-65 666443444 NO NSC VET ERAN
	830	3 ECM Epatient,T hree 1-1-68 666773333 YES SC VET ERAN
	831	ENTER '^' TO STOP, O R
	832	CHOOSE 1-3 : 2 ECMEp atient,Two 1- 1-65 66 6443444 NO NSC VETER AN
	833	Enrollmen t Priority : GROUP 8g Categor y: NOT ENR OLLED End Date: 08/ 01/2005
	834	Selecte d:
	835	ECMEpatie nt,Two
	836	Select Pat ient:
	837	View data about one prescripti on or all prescripti ons.
	838	Example 5. 1-6: Sele cting View s from Ent ries for O ne Prescri ption
	839	Se lect one o f the foll owing:
	840	R RX
	841	A ALL
	842	Display On e or Many (R)x or (A )LL: A// R RX
	843	Enter a pr escription to select .
	844	Once all p rescriptio ns are sel ected, hit enter wit hout makin g a select ion.
	845	Select RX: 123456
	846	Selecte d:
	847	123456
	848	Select RX:
	849	Choose dat a for a da te range o r timefram e of days or hours.
	850	Example 5. 1-7: Sele cting View s by Timef rame of th e Default of Days
	851	Sele ct one of the follow ing:
	852	D Date Range
	853	T Timeframe
	854	Display Ac tivity (D) ate Range or (T)imef rame: T// ?
	855	Date Range will allo w a user t o specify an activit y beginnin g and endi ng date.
	856	Timeframe will allow a user to specify t he activit y by days or hours.
	857	Selec t one of t he followi ng:
	858	D Date Range
	859	T Timeframe
	860	Display Ac tivity (D) ate Range or (T)imef rame: Date Range
	861	(IF BY DAT E RANGE) C hoose a be ginning an d ending d ate.
	862	Example 5. 1-8: Sele cting View s by Date Range
	863	Display Ac tivity (D) ate Range or (T)imef rame: T// d Date Ra nge
	864	Activity B eginning D ate: T ( JAN 11,200 8)
	865	Activity E nding Date : ?
	866	Enter a da te which i s no more than 180 d ays after the Beginn ing Date.
	867	Activity E nding Date :
	868	(IF BY TIM EFRAME) Ac tivity Tim eframe (H) ours or (D )ays: D// <Enter> A
	869	(IF BY TIM EFRAME) Ch oose data for a peri od of days or hours.
	870	Example 5. 1-9: Sele cting View s by Timef rame of th e Default of Days
	871	Selec t one of t he followi ng:
	872	D DAYS
	873	H HOURS
	874	Activity T imeframe ( H)ours or (D)ays: D/ / <Enter> AYS
	875	(IF BY TIM EFRAME) En ter a numb er for the timeframe value for the numbe r of days, or number of hours, to view.
	876	Example 5. 1-10: Sel ecting Vie ws by Time frame Numb er of Days or Hours
	877	Activity T imeframe V alue: (1-9 99): 40// 10
	878	Choose whi ch types o f claims w ill displa y on the U ser Screen .
	879	Example 5. 1-11: Sel ecting Typ es of Clai ms
	880	Selec t one of t he followi ng:
	881	O OPEN CLAIM S
	882	C CLOSED CLA IMS
	883	A ALL
	884	Select Ope n/Closed o r All Clai ms: A// <E nter> LL
	885	Choose whi ch types o f non-bill able entri es will di splay on t he User Sc reen.
	886	Example 5. 1-12: Sel ecting Typ es of Entr ies
	887	Selec t one of t he followi ng:
	888	O Open Non-B illable En tries
	889	C Closed Non -Billable Entries
	890	A ALL
	891	Please note this question only appli es to
	892	TRICAR E or CHAMP VA Non-Bil lable Entr ies.
	893	Display (O )pen or (C )losed or (A)ll Non- Billable E ntries: A/ /
	894	Choose whi ch types o f payer re quests wil l display on the Use r Screen.
	895	Example 5. 1-13: Sel ecting Typ es of Requ ests
	896	Selec t one of t he followi ng:
	897	B BILLING RE QUESTS
	898	R REVERSALS
	899	A ALL
	900	Select Sub mission Ty pe: A// <E nter> LL
	901	View rejec ted claims , payable claims or all claims .
	902	Example 5. 1-14: Sel ecting Vie ws of Clai m Status
	903	Selec t one of t he followi ng:
	904	R REJECTS
	905	P PAYABLES
	906	U UNSTRANDED
	907	A ALL
	908	Display (R )ejects or (P)ayable s or (U)ns tranded or (A)LL: A/ /?
	909	Enter a si ngle respo nse or mul tiple resp onses sepa rated by c ommas.
	910	Example:
	911	P
	912	P,R
	913	View relea sed claims , non-rele ased claim s or all c laims.
	914	Example 5. 1-15: Sel ecting Vie ws of Rele ased Claim s
	915	Selec t one of t he followi ng:
	916	R RELEASED
	917	N NON-RELEAS ED
	918	A ALL
	919	Display (R )eleased R xs or (N)o n-Released Rxs or (A )LL: A// R ELEASED
	920	View CMOP, Mail, Win dow or all claims.
	921	Example 5. 1-16: Sel ecting Vie ws of CMOP Claims
	922	Selec t one of t he followi ng:
	923	C CMOP
	924	M MAIL
	925	W WINDOW
	926	A ALL
	927	Display (C )MOP or (M )ail or (W )indow or (A)LL: A// ?
	928	Enter a si ngle respo nse or mul tiple resp onses sepa rated by c ommas.
	929	Example:
	930	C
	931	C,M
	932	View real time, back bills, bi lls proces sed with t he PRO opt ion, resub missions ( please see Section 6 .3), or al l claims.
	933	Example 5. 1-17: Sel ecting Vie ws of Bill Types
	934	Select one of the fo llowing:
	935	R REALTIME
	936	B BACKBILLS
	937	P PRO OPTION
	938	S RESUBMISSI ON
	939	A ALL
	940	Display (R )ealTime F ills or (B )ackbills or (P)RO O ption or ( A)LL: A// ?
	941	Enter a si ngle respo nse or mul tiple resp onses sepa rated by c ommas.
	942	Example:
	943	B
	944	B,P
	945	View one r eject code or all re ject codes if the op tion “REJE CTS” was c hosen for types of c laims to v iew in (G) Rejected Claims, ab ove.
	946	Example 5. 1-18: Sel ecting Vie ws of One Reject Cod e
	947	Selec t one of t he followi ng:
	948	R REJECT COD E
	949	A ALL
	950	Display Sp ecific (R) eject Code or (A)LL: A// REJEC T CODE
	951	Select Rej ect Code: 29 M /I Number Refills Au thorized
	952	Selected :
	953	29 M /I Number Refills Au thorized
	954	Select Rej ect Code:
	955	View data for a spec ific insur ance compa ny or all insurance companies.
	956	Example 5. 1-19: Sel ecting Vie ws by a Sp ecific Ins urance Com pany
	957	Selec t one of t he followi ng:
	958	I SPECIFIC I NSURANCES( S)
	959	A ALL
	960	Select Cer tain (I)NS URANCE or (A)LL): I/ / <Enter> SPECIFIC INSURANCES (S)
	961	Selected : OPINSUR2
	962	Select INS URANCE: DE VELOPMENT INS 123 HERE S TREET SAN FR ANCISCO
	963	CALIFORN IA Y
	964	Selected : DEVELOPM ENT INS
	965	OPINSUR2
	966	Select INS URANCE: OP INSUR2 25 INS WAY BIRM ALABAMA Y
	967	Selec t one of t he followi ng:
	968	Y YES
	969	N NO
	970	Delete OPI NSUR2 from your list ?: NO// y YES
	971	Selected : DEVELOPM ENT INS
	972	Select INS URANCE:
	973	You must a nswer Y or N to keep the Chang e View act ion select ions as yo ur preferr ed view. I f you ente r Y, the p referred v iew is sto red in ECM E for use when you e nter the E CME User S creen. If you enter N, the dis play will only show the select ed views u ntil you q uit ECME U ser Screen or use th e Change V iew action again.
	974	Example 5. 1-20: Ent ering “Y” to Save Se lections a s User’s P referred V iew
	975	DO YOU WAN T TO SAVE THIS VIEW AS YOUR PR EFERRED VI EW (Y/N)?: YES
	976	Updating s creen...
	977	If a user accesses Change Vie w and they are not c urrently v iewing the saved pre ferred vie w, the use r is asked if they w ant to Res tore the P referred V iew. You must answe r Y or N w hen asked to restore the prefe rred view.
	978	A response of Y will automatic ally resto re the vie w of the E CME User S creen to t he previou sly saved view witho ut the use r answerin g all of t he Change View filte rs.
	979	A response of N, wil l prompt t he user wi th all of the Change View filt ers.
	980	Example 5. 1-21: Ent ering “Y” to Restore User’s Pr eferred Vi ew
	981	Restore yo ur Preferr ed View an d exit Cha nge View ( Y/N)? Y//
	982	Updating s creen...
	983	5.2 Sort L ist XE " S ort List"
	984	The Sort L ist screen action al lows you t o customiz e the sort order of data displ ayed on th e ECME Use r Screen.
	985	Sort Order (Defaults );
	986	T
	987	Transactio n Date/Tim e
	988
	989
	990	(descendin g)
	991	D
	992	Division
	993
	994
	995
	996	(ascending )
	997	I
	998	Insurance Company
	999
	1000
	1001	(ascending )
	1002	C
	1003	Reject Cod e
	1004
	1005
	1006
	1007	(ascending )
	1008	P
	1009	Patient Na me
	1010
	1011
	1012
	1013	(ascending )
	1014	N
	1015	Drug Name
	1016
	1017
	1018
	1019	(ascending )
	1020
	1021	B
	1022	Bill Type [BB/P2/RT]
	1023
	1024
	1025	(ascending )
	1026	L
	1027	Fill Locat ion
	1028
	1029
	1030
	1031	(ascending )
	1032	R
	1033	Released/N on-Release
	1034
	1035
	1036	(ascending )
	1037	A
	1038	Active/Dis continued Rx
	1039
	1040	(ascending )
	1041	Transactio n Date/Tim e (descend ing) is th e secondar y sort for ALL prima ry sort se lections. Sorting is by PATIEN TS (not cl aims), bas ed on the date/time of their m ost recent transacti on.
	1042	Active/Dis continued Rx option sorts clai ms by the Rx status. Access thi s action b y entering SO at the “Select A ction:” pr ompt on th e ECME Use r Screen. The system will give you the o ption to “ SAVE” thes e selectio ns as the User’s “Pr eferred Vi ew”.
	1043	Example 5. 2-1: Acce ssing the Sort List Option
	1044	PHARMACY E CME Apr 30, 20 05@09:10:1 8 Page: 1 of 2
	1045	SELECTED D IVISION(S) : ALL
	1046	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	1047	Sor ted by: Pa tient Name
	1048	# PATIEN T/DRUG/COM MENTS INSURANC E/NDC/RX#/ ECME# LOC /TYP RXINF
	1049	6 ECMEpa tient,Two (XXXX) WEB MD / 89% Pb: 5 Rj:0 AcR v:0 RjRv:0
	1050	6.1 FU ROSEMIDE 1 0MG/M 006 41-2312-25 04/21 100 004065$ 0 /000000504 691 W RT A C/R
	1051	p-Pa yable
	1052	6.2 CH OLESTYRAMI NE 4G 000 87-0580-01 04/21 100 004066$ 0 /000000504 692 W RT A C/R
	1053	p-Re versal rej ected
	1054	NN:T ransaction Rejected At Switch Or Interme diary
	1055	NC16 -The clear inghouse d id not rep ly in time .
	1056	7 ECMEpa tient,One (XXXX) WEBMD TE/ VET ALL payab le
	1057	+ Enter ?? f or more ac tions
	1058	CV Change View REV Reverse Pa yable Clai m FR Furt her Resear ch
	1059	SO Sort L ist RES Resubmit C laim VER View ePharmacy Rx
	1060	CMT Add/Vi ew Comment s CLO Close Clai m WRK Send to Workli st
	1061	Select Act ion: Next Screen//SO Sort Li st
	1062	Example 5. 2-2: Choo sing Patie nt as the User’s Sor t Preferen ce
	1063	Selec t one of t he followi ng:
	1064	T TRANSACTIO N DATE
	1065	D DIVISION
	1066	I INSURANCE
	1067	C REJECT COD E
	1068	P PATIENT NA ME
	1069	N DRUG NAME
	1070	B BILL TYPE (BB/P2/RT)
	1071	L FILL LOCAT ION
	1072	R RELEASED/N ON-RELEASE D
	1073	A ACTIVE/DIS CONTINUED
	1074	ENTER SORT TYPE: P// PATIENT N AME
	1075	Example 5. 2-3: Choo sing User’ s Sort Pre ference as the Prefe rred View
	1076	Selec t one of t he followi ng:
	1077	Y YES
	1078	N NO
	1079	DO YOU WAN T TO SAVE THIS VIEW AS YOUR PR EFERRED VI EW (Y/N)?: YES
	1080	Updating s creen...
	1081	5.3 Revers e Payable Claim XE " Reverse P ayable Cla im"
	1082	The Revers e Payable Claim acti on allows a user to submit a c laim rever sal reques t to the i nsurer for a claim t hat was re turned as “Payable” or “Revers al Rejecte d”. A prim ary claim cannot be reversed i f there is a payable secondary claim. Th e secondar y claim mu st be reve rsed befor e the prim ary claim can be rev ersed.
	1083	Claims tha t have bee n closed w ill be dis played wit h “/Closed ” after th e status. Closed cla ims cannot be revers ed until t hey are fi rst reopen ed. If you attempt t o reverse a claim th at is clos ed, a mess age is dis played tel ling you t hat the cl aim “is Cl osed and c annot be R eversed. R eopen the claim and try again. ”
	1084	Access the action by entering REV at the “Select A ction:” pr ompt on th e ECME Use r Screen.
	1085	Example 5. 3-1: Acce ssing and Executing the Revers e Payable Claim Acti on
	1086	PHARMACY E CME Aug 10, 20 05@10:31:2 2 Page: 1 8 of 42
	1087	SELECTED D IVISION(S) : ALL
	1088	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	1089	Sor ted by: Pa tient Name
	1090	+# PATIEN T/DRUG/COM MENTS INSURANC E/NDC/RX#/ ECME# LOC /TYP RXINF
	1091	7 ECMEpa tient,One (XXXX) WE BMD TE/ VET A LL payable
	1092	7.1 AL BUTEROL IN HALER 555 55-4444-22 08/08 100 003744$ 0 /000000504 304 W RT A C/R
	1093	p-Pa yable
	1094	7.2 AC ETYLCYSTEI NE 20 000 87-0570-09 08/01 100 004054$ 0 /000000504 677 W RT A C/N
	1095	p-Pa yable
	1096	+ Enter ?? f or more ac tions
	1097	CV Change View REV Reverse Pa yable Clai m FR Furt her Resear ch
	1098	SO Sort L ist RES Resubmit C laim VER View ePharmacy Rx
	1099	CMT Add/Vi ew Comment s CLO Close Clai m WRK Send to Workli st
	1100	Select Act ion: Next Screen// R EV Rever se Payable Claim
	1101	You will s ee the fol lowing mes sage, if y ou attempt to revers e a primar y claim wh en there i s a payabl e secondar y claim.
	1102	Example 5. 3-2: Ente ring the L ine Item f or a Claim with a Pa yable Seco ndary Clai m
	1103	1.12 FLU RAZEPAM 15 MG C 00140 -0065-14 0 3/04 10232 2$ 2/00000 0113596 W RT AC/R
	1104	cannot be Reversed i f the seco ndary clai m is payab le.
	1105	Please rev erse the s econdary c laim first .
	1106	You are p rompted fo r the line item of t he payable claim to be reverse d. Remembe r, if you enter the patient li ne number, a claim r everse req uest will be created for all o f the paya ble claims for that patient.
	1107	Example 5. 3-3: Ente ring the L ine Item f or the Cla im Reversa l Request
	1108	Enter the line numb ers for th e Payable claim(s) t o be Rever sed.
	1109	Select: 7 .1
	1110	The select ed line it em is redi splayed an d you are required t o enter te xt to expl ain the re versal rea son.
	1111	Example 5. 3-4: Typi ng Text fo r Required Reversal Reason
	1112	You've cho sen to REV ERSE the f ollowing p rescriptio n for ECME patient,Si x
	1113	7.1 AL BUTEROL IN HALER 555 55-4444-22 02/28 100 003744$ 0 /000000504 304 W RT A C/R
	1114	Enter REQU IRED REVER SAL REASON : RX IS FO R SC CONDI TION
	1115	This respo nse must h ave at lea st 0 chara cters and no more
	1116	than 60 ch aracters a nd must no t contain embedded u parrow
	1117	The system asks if y ou are sur e you want to contin ue with th e transact ion. You c an answer Y or N. If you type in Y, the claim reve rsal reque st is subm itted.
	1118	Example 5. 3-5: Ente ring “Y” t o Continue Claim Rev ersal Requ est
	1119	Enter REQU IRED REVER SAL REASON : Drug is only billa ble throug h CMOP
	1120	Are you su re?(Y/N)? YES
	1121	The system asks if y ou want to mark the claim as n on-billabl e in Claim s Tracking , and ther efore rele ase the pa tient copa y (if any) . Enter Y or N. If y ou enter Y , you will be prompt ed for a C laims Trac king Non-B illable Re ason and a Comment. If the rev ersal is a ccepted by the payer , the ECME claim wil l be close d and a cl ose event will then be sent to IB with t he non-bil lable reas on and com ment provi ded by the user. IB should mar k the epis ode as non -billable and releas e the firs t-party co pay.
	1122	Example 5. 3-6: Ente ring “Y” t o Mark the Claim as Non-billab le
	1123	Do you wan t to mark the claim as non-bil lable in C laims Trac king and r elease the Patient C opay (if a ny) (Yes/N o)? No//Ye s
	1124	Select CLA IMS TRACKI NG NON-BIL LABLE REAS ONS NAME: ??
	1125	Choose from:
	1126	1 NOT INSURED
	1127	2 SC T REATMENT
	1128	3 AGEN T ORANGE
	1129	4 IONI ZING RADIA TION
	1130	5 SOUT HWEST ASIA
	1131	7 COVE RAGE CANCE LED
	1132	10 INVA LID PRESCR IPTION ENT RY
	1133	12 PRES CRIPTION D ELETED
	1134	13 PRES CRIPTION N OT RELEASE D
	1135	14 DRUG NOT BILLA BLE
	1136	21 MILI TARY SEXUA L TRAUMA
	1137	29 HEAD /NECK CANC ER
	1138	30 COMB AT VETERAN
	1139	33 90 D AY RX FILL NOT COVER ED
	1140	34 NOT A CONTRACT ED PROVIDE R
	1141	35 INVAL ID MULTIPL ES PER DAY SUPP
	1142	36 REFI LL TOO SOO N
	1143	37 INVA LID NDC FR OM CMOP
	1144	38 PRO JECT 112/S HAD
	1145	39 NON COVERED D RUG PER PL AN
	1146	40 FIL ING TIMEFR AME NOT ME T
	1147	61 NO PHARMACY C OVERAGE
	1148	85 NPI /TAXONOMY ISSUES
	1149	86 RX DUR REJECT
	1150	87 RX PRIOR AUTH NOT OBTAI NED
	1151	88 RX MEDICARE P ART D
	1152	89 RX DISCOUNT C ARD
	1153	91 DAT E OF BIRTH MISMATCH
	1154	999 OTH ER
	1155	Select CLA IMS TRACKI NG NON-BIL LABLE REAS ONS NAME: 2 SC TREA TMENT
	1156	Comment : RX IS FOR SC CONDIT ION
	1157	Are you su re (Y/N)? YES
	1158	If the rev ersal is a pproved by the third -party pay er, the cl aim will b e marked a s non-bill able.
	1159	The system submits a claim rev ersal requ est to the payer for each sele cted claim .
	1160	Example 5. 3-7: Clai m Reversal Request i s Submitte d
	1161	Processing Primary c laim...
	1162	Claim Stat us:
	1163	Reversing. ..
	1164	IN PROGRES S-Building the trans action
	1165	IN PROGRES S-Transmit ting
	1166	IN PROGRES S-Parsing response
	1167	E REVERSAL ACCEPTED
	1168	Reversal A ccepted
	1169	1 claim re versal sub mitted.
	1170	Enter RETU RN to cont inue or '^ ' to exit:
	1171	The payer will eithe r “Accept” or “Rejec t” the cla im reversa l request. The payer return st atus is di splayed on the Payer Returned Response l ine.
	1172	Example 5. 3-8: Acce pted Payab le Claim R eversal Re quest
	1173	PHARMACY E CME Aug 10, 20 05@10:31:2 2 Page: 1 8 of 42
	1174	SELECTED D IVISION(S) : ALL
	1175	Transmitte d by ALL u sers Activity Date Rang e: within the past X X day(s)
	1176	Sor ted by: Pa tient Name
	1177	+# PATIEN T/DRUG/COM MENTS INSURANC E/NDC/RX#/ ECME# LOC /TYP RXINF
	1178	7 ECMEPa tient,Six (XXXX) WE BMD TE/ VET A LL payable
	1179	7.1 AL BUTEROL IN HALER 555 55-4444-22 02/28 100 003744$ 0 /000000504 304 W RT D S/R
	1180	p-Re versal Acc epted
	1181	5.4 Resubm it Claim X E " Resubm it Claim"
	1182	The Resubm it Claim a ction send s a claim reversal r equest to the insure r, followe d by a new claim for the same prescripti on, with t he new or updated da ta for the se conditi ons:
	1183	If the cla im was ini tially ret urned as “ Payable”, the system sends a c laim rever sal reques t. If the payer “Acc epts” the reversal r equest, th e claim re submission is sent. If the pay er “Reject s” the rev ersal requ est, the c laim is NO T resubmit ted.
	1184	If the cla im was ini tially ret urned as “ Rejected” or non-bil lable, the system im mediately sends the claim subm ission to the payer and the re versal req uest is NO T sent.
	1185	The Resubm it action is accesse d by enter ing RES at the “Sele ct Action: ” prompt o n the ECME User Scre en.
	1186	Example 5. 6-1: Acces sing and E xecuting t he Resubmi t Claim Ac tion
	1187	PHARMACY E CME Jul 22, 20 08@14:41:5 5 Page : 1 of 29
	1188	SELECTED D IVISION(S) : ALL
	1189	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	1190	Sorted by: Transa ction Date
	1191	# PATIEN T/DRUG/COM MENTS IN SURANCE/ND C/DOS/RX#/ ECME# LOC/TYP R XINF
	1192	1 ECMEpa tient,One (XXXX) OP INSUR1/ VE T Pb:2 Rj: 4 AcRv:4 R jRv:0
	1193	1.1 RE SERPINE 0. 1MG S 000 83-0035-40 07/19 100 598$ 1 /000000000 520 W RT A C/N
	1194	p-In progress- Waiting t o start
	1195	1.2 LI DOCAINE 0. 5% W/ 001 86-0140-01 07/19 100 704$ 1 /000000000 623 W RT A C/N
	1196	p-In progress- Transmitt ing
	1197	1.3 IM IPRAMINE 2 5MG T 007 79-0588-30 07/19 100 820$ 1 /000000000 740 W RT * */N
	1198	p-Re jected
	1199	07:M /I Cardhol der ID
	1200	1.4 FL URAZEPAM 1 5MG C 007 81-2806-05 07/18 100 948$ 0 /000000000 870 W RT * */N
	1201	p-Re jected
	1202	07:M /I Cardhol der ID
	1203	1.5 DA CARBAZINE 100MG 000 26-8151-10 07/21 100 958$ 2 /000000000 880 W RT * */N
	1204	p-Re versal acc epted
	1205	+ Enter ?? f or more ac tions
	1206	CV Change View REV Reverse Pa yable Clai m FR Furt her Resear ch
	1207	SO Sort L ist RES Resubmit C laim VER View ePharmacy Rx
	1208	CMT Add/Vi ew Comment s CLO Close Clai m WRK Send to Workli st
	1209	Select Act ion: Next Screen// r es Resub mit Claim
	1210	You are pr ompted for the line item(s) of the claim to be res ubmitted.
	1211	You may al so submit multiple l ine items separated by commas (e.g. “1.1 ,1.2”), or a range o f line ite ms separat ed by a hy phen (e.g. “1.1-1.3” ).Example 5.4-2: Ent ering the Line Item for the Cl aim Resubm ission Req uest
	1212	Enter the line numbe rs for the claim(s) to be resu bmitted.
	1213	Select ite m(s): 1.5
	1214	Claims tha t have bee n closed w ill be dis played wit h “/Closed ” after th e status. Closed cla ims cannot be resubm itted unti l they are reopened. If you at tempt to r esubmit a claim that is closed , a messag e is displ ayed telli ng you tha t you cann ot resubmi t.
	1215	Example 5. 4-3: Resu bmitting a Closed Cl aim
	1216	You've cho sen to RES UBMIT the following prescripti on
	1217	1.2 AM ITRIPTYLIN E HCL 006 03-2212-32 10/11 205 6098 0 /000001616 051 M RT D S/N
	1218	Are you su re?(Y/N)? y YES
	1219	>> Cannot Resubmit
	1220	1.2 AM ITRIPTYLIN E HCL 006 03-2212-32 10/11 205 6098 0 /000001616 051 M RT D S/N
	1221	because t he claim i s Closed. Reopen the claim and try again .
	1222	0 claims h ave been r esubmitted .
	1223	The primar y claim ca nnot be re submitted if there i s a payabl e secondar y claim. I n these ca ses, you m ust revers e the seco ndary clai m.
	1224	If you att empt to re submit a p rimary cla im when th ere is a p ayable sec ondary cla im, you wi ll see the following message, which will discontin ue the cla ims resubm ission pro cess.
	1225	Example 5. 4-4: Enter ing the Li ne Item fo r a Claim that has a Payable S econdary C laim
	1226	The claim:
	1227	1.12 FLU RAZEPAM 15 MG C 00140 -0065-14 0 3/04 10232 2$ 2/00000 0113596 W RT AC/R
	1228	cannot be Resubmitte d if the s econdary c laim is pa yable.
	1229	Please rev erse the s econdary c laim first .
	1230	Otherwise, the syste m redispla ys the lin e item for resubmiss ion, then asks if yo u are sure you want to continu e with the transacti on. You ca n enter Y or N. If y ou answer Y, the cla im resubmi ssion proc ess contin ues.
	1231	Example 5. 4-5: Enter ing “Y” to Continue Claim Resu bmission R equest
	1232	You've cho sen to RES UBMIT the following prescripti on for ECM Epatient,O ne
	1233	100MG 000 26-8151-10 06/26 100 958$ 2 /000000000 880 W RT * */N
	1234	Are you su re?(Y/N)? y YES
	1235	ECME will allow mult iple submi ssions of the same p rescriptio n and fill to be pla ced on the request q ueue at th e same tim e. The ECM E engine w ill proces s all requ ests in th e order th at they ar e received . Note tha t even tho ugh a requ est may be placed on the queue , whether or not it is process ed will de pend on th e outcome of the pre vious requ est. For i nstance, i f there ar e two entr ies on the queue and the secon d is reque sting a re versal, it may not b e processe d if the p revious re quest come s back wit h an E REV ERSAL ACCE PTED statu s. If ther e is alrea dy a submi ssion in t he queue f or this pr escription and fill, a message is displa yed and yo u are aske d if you w ant to pro ceed.
	1236	Example 5. 4-6: Ente ring “Y” t o Place Mu ltiple Sub missions i n the Queu e
	1237	The claim is in prog ress. The request wi ll be sche duled and processed after
	1238	the previo us request (s) are co mpleted. P lease be a ware that the result of
	1239	the resubm it depends on the pa yer's resp onse to th e prior in complete r equests.
	1240	Do you wan t to proce ed?(Y/N)? y YES
	1241	The claim resubmissi on request is submit ted and th e progress is displa yed.
	1242	Example 5. 4-7: Disp laying a S uccessfull y Resubmit ted Claim
	1243	Claim Stat us:
	1244	IN PROGRES S-Waiting to start
	1245	IN PROGRES S-Building the claim
	1246	IN PROGRES S-Transmit ting
	1247	E PAYABLE
	1248	Veteran Pr escription 100958 su ccessfully submitted to ECME f or claim g eneration.
	1249	1 claim ha s been res ubmitted.
	1250	Enter RETU RN to cont inue or '^ ' to exit: <ENTER>
	1251	Updating s creen for resubmitte d claims.. .
	1252	The line i tem will d isplay the status of a claim t hat was re submitted and the Bi ll Type in dicator of “RS”. The “RS” indi cates a re submitted claim. The resubmit indicator will also display fo r a non-bi llable pre scription that has b een resubm itted, eve n if there is no cla im because the presc ription re mained non -billable.
	1253	Example 5. 4-8: Displ aying the Claim Stat us after a Resubmiss ion
	1254	PHARMACY E CME Jul 12, 20 08@14:42:4 6 Page : 1 of 29
	1255	SELECTED D IVISION(S) : ALL
	1256	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	1257	Sorted by: Transa ction Date
	1258	# PATIEN T/DRUG/COM MENTS IN SURANCE/ND C/DOS/RX#/ ECME# LOC/TYP R XINF
	1259	1 ECMEpa tient,One (XXXX) OP INSUR1/ VE T Pb:2 Rj: 4 AcRv:4 R jRv:0
	1260	1.1 RE SERPINE 0. 1MG S 000 83-0035-40 07/09 100 598$ 1 /000000000 520 W RT A C/N
	1261	p-In progress- Waiting t o start
	1262	1.2 LI DOCAINE 0. 5% W/ 001 86-0140-01 07/09 100 704$ 1 /000000000 623 W RT A C/N
	1263	p-In progress- Waiting t o start
	1264	1.3 IM IPRAMINE 2 5MG T 007 79-0588-30 07/09 100 820$ 1 /000000000 740 W RT * */N
	1265	p-Re jected
	1266	07:M /I Cardhol der ID
	1267	1.4 FL URAZEPAM 1 5MG C 007 81-2806-05 07/08 100 948$ 0 /000000000 870 W RT * */N
	1268	p-Re jected
	1269	07:M /I Cardhol der ID
	1270	1.5 DA CARBAZINE 100MG 000 26-8151-10 07/06 100 958$ 2 /000000000 880 W RS * */N
	1271	p-Pa yable
	1272	+ Enter ?? f or more ac tions
	1273	CV Change View REV Reverse Pa yable Clai m FR Furt her Resear ch
	1274	SO Sort L ist RES Resubmit C laim VER View ePharmacy Rx
	1275	CMT Add/Vi ew Comment s CLO Close Clai m WRK Send to Workli st
	1276	Select Act ion: Next Screen//
	1277	5.5 Close Claim XE " Close Cla im"
	1278	This actio n allows y ou to clos e claims t hat were i nitially r eturned as “Rejected ”, and rev ersals tha t were “Re leased and Accepted” .
	1279	Claims tha t have alr eady been closed are displayed with “/Cl osed” afte r the stat us. If you attempt t o close a claim that is alread y closed, the follow ing messag e is displ ayed, “Thi s claim is already c losed.”
	1280	The Close Claim acti on will pr event a cl aim from b eing close d if it is currently open on t he Pharmac y Worklist . If you a ttempt to close a cl aim that i s open in the Pharma cy Worklis t, a messa ge will be displayed that the claim cann ot be clos ed because it is ope n in the P harmacy Wo rklist.
	1281	PHARMACY E CME Jul 15, 20 14@18:43:0 2 Page: 1 of 1
	1282	SELECTED D IVISION(S) : GENERIC CITY
	1283	Transmitte d by Trans mitter, Pe rson Ac tivity Dat e Range: w ithin the past 365 d ay(s)
	1284	Sorted b y: Transac tion date by default
	1285	# PATIEN T/DRUG/COM MENTS IN SURANCE/ND C/DOS/RX#/ ECME# STATUS/LOC /TYP/RXINF
	1286	1
	1287	1.1 AB ACAVIR SUL FATE 0017 3066101 07 /15 ###### #0/00000## #7412 M RT SU/N
	1288	07/1 5/14 - IGN ORED - tes t of cmop
	1289	p-Re jected
	1290	NN:T ransaction Rejected At Switch Or Interme diary
	1291	NC16 -The clear inghouse d id not rep ly in time .
	1292	Enter ?? f or more ac tions
	1293	CV Change View REV Reverse Pa yable Clai m FR Furt her Resear ch
	1294	SO Sort L ist RES Resubmit C laim VER View ePharmacy Rx
	1295	CMT Add/Vi ew Comment s CLO Close Clai m WRK Send to Workli st
	1296	Select Act ion: Quit/ /CLO
	1297	Enter the line numbe rs for the claim(s) to be clos ed.
	1298	Select ite m(s): 1.1
	1299	You've cho sen to clo se the fol lowing pre scription( s) for
	1300	Oppatient, ONE :
	1301	1.1 AB ACAVIR SUL FATE 0017 3066101 07 /15 ###### #0/00000## #7412 M RT SU/N
	1302	NN:T ransaction Rejected At Switch Or Interme diary
	1303	NC16 -The clear inghouse d id not rep ly in time .
	1304	ALL Select ed Rxs wil l be CLOSE D using th e same inf ormation g athered in the
	1305	following prompts.
	1306	Are you su re?(Y/N)? y YES
	1307	The Prescr iption is currently open in th e pharmaci st’s Third Party Pay er Reject Worklist. The claim cannot be closed unt il action is taken b y the phar macist.
	1308	PHARMACY E CME Jul 15, 20 14@18:43:0 2 Page: 1 of 1
	1309	SELECTED D IVISION(S) : GENERIC CITY
	1310	Transmitte d by Trans mitter, Pe rson Ac tivity Dat e Range: w ithin the past 365 d ay(s)
	1311	Sorted b y: Transac tion date by default
	1312	# PATIEN T/DRUG/COM MENTS IN SURANCE/ND C/DOS/RX#/ ECME# STATUS/LOC /TYP/RXINF
	1313	1
	1314	1.1 AB ACAVIR SUL FATE 0017 3066101 07 /15 ###### #0/00000## #7412 M RT SU/N
	1315	07/1 5/14 - IGN ORED - tes t of cmop
	1316	p-Re jected
	1317	NN:T ransaction Rejected At Switch Or Interme diary
	1318	NC16 -The clear inghouse d id not rep ly in time .
	1319	Enter ?? f or more ac tions
	1320	CU Contin uous Updat e REV Reverse Pa yable Clai m FR Furt her Resear ch
	1321	UD Displa y Update RES Resubmit C laim LOG Prin t Claim Lo g
	1322	CV Change View CLO Close Clai m WRK Send to Workli st
	1323	SO Sort L ist CMT Add/View C omments EX Exit
	1324	Select Act ion: Quit/ /
	1325	The CLOSE action can not be app lied to th e secondar y claim if the prima ry claim h as already been clos ed. The se condary cl aim is con sidered cl osed when the primar y claim is closed.
	1326	This actio n is acces sed by ent ering CLO at the “Se lect Actio n:” prompt on the EC ME User Sc reen. The system pro mpts you f or the lin e number(s ) for the claim(s) y ou are clo sing.
	1327	Example 5. 5-1: Enter ing a Pres cription L ine Item t o Close On e Rejected Claim
	1328	PHARMACY E CME Aug 02, 20 05@12:19 Page: 1 of 7 0
	1329	SELECTED D IVISION(S) : ALL
	1330	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	1331	Sor ted by: Pa tient Name
	1332	# PATIEN T/DRUG/COM MENTS INSURANC E/NDC/RX#/ ECME# LOC/TYP RXINF
	1333	7 ECMEpa tient,Two (XXXX) WEB MD / VET Pb :3 Rj:1 Ac Rv:0 RjRv: 0
	1334	7.1 DE SIPRAMINE 25MG T 000 68-0011-10 08/02 100 003962$ 0 /000000504 559 W RT * */N
	1335	p-Re jected
	1336	07:M /I Cardhol der ID Num ber
	1337	22:M /I Dispens e As Writt en(DAW)/Pr oduct Sele ction Code
	1338	34:M /I Submiss ion Clarif ication Co de
	1339	7.2 CO DEINE SULF ATE 30 000 02-1010-02 08/02 100 82$ 0 /000000504 561 W RT E X/N
	1340	p-Re jected
	1341	07:M /I Cardhol der ID Num ber
	1342	23:M /I Ingredi ent Cost S ubmitted
	1343	8 ECMEpat ient,Two (XXXX) WEB MD / VET AL L payable
	1344	8.1 TE STOSTERONE ENTH. 000 03-0328-40 07/30 90 9238$ 0/00000110 5472 M RT AC/N
	1345	p-Pa yable
	1346	+ Enter ?? f or more ac tions
	1347	CV Change View REV Reverse Pa yable Clai m FR Furt her Resear ch
	1348	SO Sort L ist RES Resubmit C laim VER View ePharmacy Rx
	1349	CMT Add/Vi ew Comment s CLO Close Clai m WRK Send to Workli st
	1350	Select Lin e Item(s): Next Scre en// CLO Close Cla im
	1351	Enter the line numbe rs for the claim(s) to be clos ed.
	1352	Select Lin e Item(s): 7.1
	1353	The system redisplay s the sele cted line item(s), t hen notes that all p rescriptio n line ite ms for pat ient line items will be closed using the same info rmation en tered into the non-b illable re asons name prompt. Y ou are the n asked if you want to continu e.
	1354	Example 5. 5-2: Ente ring “Y” t o Continue Close Cla im Request
	1355	You've cho sen to clo se the fol lowing pre scription( s) for
	1356	ECMEpatien t,Two:
	1357	7.1 DE SIPRAMINE 25MG T 000 68-0011-10 03/20 100 003962$ 0 /000000504 559 W RT * */N
	1358	07:M /I Cardhol der ID Num ber
	1359	22:M /I Dispens e As Writt en(DAW)/Pr oduct Sele ction Code
	1360	34:M /I Submiss ion Clarif ication Co de
	1361	ALL Select ed Rxs wil l be CLOSE D using th e same inf ormation g athered in the follo wing promp ts.
	1362	Are you su re?(Y/N)? YES
	1363	You are pr ompted for a non-bil lable reas on code.
	1364	Example 5. 5-3: List ing Non-Bi llable Rea son Codes
	1365	PHARMACY E CME Aug 12, 20 05@12:19 Pa ge: 1 o f 70
	1366	Select CLA IMS TRACKI NG NON-BIL LABLE REAS ONS NAME: ??
	1367	Choose from:
	1368	1 NOT INSURED
	1369	2 SC T REATMENT
	1370	3 AGEN T ORANGE
	1371	4 IONI ZING RADIA TION
	1372	5 SOUT HWEST ASIA
	1373	7 COVE RAGE CANCE LED
	1374	10 INVA LID PRESCR IPTION ENT RY
	1375	12 PRES CRIPTION D ELETED
	1376	13 PRES CRIPTION N OT RELEASE D
	1377	14 DRUG NOT BILLA BLE
	1378	21 MILI TARY SEXUA L TRAUMA
	1379	29 HEAD /NECK CANC ER
	1380	30 COMB AT VETERAN
	1381	33 90 D AY RX FILL NOT COVER ED
	1382	34 NOT A CONTRACT ED PROVIDE R
	1383	35 INVA LID MULTIP LES PER DA Y SUPP
	1384	36 REFI LL TOO SOO N
	1385	37 INVA LID NDC FR OM CMOP
	1386	38 PROJ ECT 112/SH AD
	1387	39 NON COVERED DR UG PER PLA N
	1388	40 FILI NG TIMEFRA ME NOT MET
	1389	61 NO P HARMACY CO VERAGE
	1390	85 NPI/ TAXONOMY I SSUES
	1391	86 RX D UR REJECT
	1392	87 RX P RIOR AUTH NOT OBTAIN ED
	1393	88 RX M EDICARE PA RT D
	1394	89 RX D ISCOUNT CA RD
	1395	91 DATE OF BIRTH MISMATCH
	1396	999 OTHE R
	1397	Select CLA IMS TRACKI NG NON-BIL LABLE REAS ONS NAME: 61 NO PHA RMACY COVE RAGE
	1398	You are p rompted fo r a commen t (explana tion), and again whe ther you w ant to con tinue.
	1399	Example 5. 5-4: Ente ring a Com ment and A nswering ‘ Are You Su re?’ Quest ion
	1400	Comment : ECME Rejec t: Insuran ce does no t cover Rx s
	1401	Are you su re?(Y/N)? YES
	1402	Closing Cl aim VA2006 =1712884=0 00010=0006 693...OK
	1403	1 claim ha s been clo sed.
	1404	Enter RETU RN to cont inue or '^ ' to exit: <Enter>
	1405	Updating s creen for closed cla ims...
	1406	5.5.1 Vari ations to the Close claim proc ess. XE " Variation s to the C lose claim process"
	1407	If the Non -Billable Reason sel ected is “ OTHER”, th e system p rompts you with two choices: ” NON-BILLAB LE” or “DR OP TO PAPE R”.
	1408	If you sel ect (N)ON- BILLABLE E PISODE, th e Claims T racking en try displa ys the Bil lable Epis ode flag = “N” with the Non-Bi llable Rea son that y ou selecte d. Note th at Billabl e Episode flag will be changed back to " Y" if a se condary cl aim is lat er generat ed and is returned a s payable.
	1409	If you sel ect (D)ROP TO PAPER, the syste m stores t he selecte d Non-Bill able Reaso n in the C lose Claim Comments, updates t he Claims Tracking e ntry to di splay the Billable E pisode fla g = “Y”, c reates the next bill date as T +1 and sto res Claims Tracking comments i ncluding t he initial Non-billa ble Reason . The next scheduled billing r un will pi ck up this bill as l ong as the prescript ion has be en release d.
	1410	Example 5. 5.1-1: Cl osing a Pr escription
	1411	You've cho sen to clo se the fol lowing pre scription( s) for
	1412	ECMEPatien t,FIVE :
	1413	4.1 CO LCHICINE 0 .6MG 0007 4378101 06 /24 101297 $ 1/00 0000001653 M RT DS/N
	1414	ALL Select ed Rxs wil l be CLOSE D using th e same inf ormation g athered in the
	1415	following prompts.
	1416	Are you su re?(Y/N)? YES
	1417	Select CLA IMS TRACKI NG NON-BIL LABLE REAS ONS NAME: OTHER
	1418	Selec t one of t he followi ng:
	1419	N NON-BILLAB LE
	1420	D DROP TO PA PER
	1421	Treat as ( N)on-Billa ble Episod e or (D)ro p Bill to Paper?: NO N-BILLABLE
	1422	Comment : Insurance does not cover Rxs
	1423	Release Pa tient CoPa y(Y/N)? YE S
	1424	Are you su re?(Y/N)? NO
	1425	Example 5. 5.1-2: En tering Non -Billable Episode fo r Reason C ode 31
	1426	Select CLA IMS TRACKI NG NON-BIL LABLE REAS ONS NAME: 31 90 DAY RX FILL N OT COVERED
	1427	Selec t one of t he followi ng:
	1428	N NON-BILLA BLE
	1429	D DROP TO P APER
	1430	Treat as ( N)on-Billa ble Episod e or (D)ro p Bill to Paper?: Se lect: N No n-billable
	1431	The appli cation wil l prompt y ou for a c omment. Th e text can be up to 40 charact ers and mu st not con tain any e mbedded up -arrows (^ ).
	1432	Example 5. 5.1-3: En tering a C omment
	1433	Comment : ECME Rejec t: Plan do es not cov er 90-day fills
	1434	You can e nter Y or N to choos e to conti nue the cl ose claim request or not.
	1435	Example 5. 5.1-4: Ent ering “Y” to Continu e Close Cl aim Reques t
	1436	Are you su re?(Y/N)? Y YES
	1437	If the Rx# display i s followed by a “$”, the ECME user is gi ven the fo llowing pr ompt to an swer wheth er the pat ient copay can be re leased als o or not. If you sel ect Y, the patient c opay bill will be au tomaticall y removed from hold status for ALL selec ted claims .
	1438	Example 5. 5.1-5: Rel easing Pat ient Copay
	1439	Release Pa tient CoPa y(Y/N)? Y YES
	1440	When the c laim is su ccessfully closed, t he display shows tha t the tran saction we nt through “OK” and states tha t the clai m was clos ed.
	1441	Example 5. 5.1-6: Di splaying S ystem Clos ing the Cl aim
	1442	Closing Cl aim VA2005 -1111111-1 23456-0000 501...OK
	1443	1 claim ha s been clo sed.
	1444	Enter RET URN to con tinue or ' ^' to exit :/ <Enter>
	1445	Updating s creen for closed cla ims...
	1446	The closed claim tra nsaction m ay no long er be disp layed with the patie nt’s other prescript ion line i tems depen ding on th e filters set in Cha nge View. The system will noti fy Integra ted Billin g of the c losed clai m so that Claims Tra cking can be updated .
	1447	Example 5. 5.1-7: Clo sed Item i s No Longe r Displaye d
	1448	PHARMACY E CME Aug 12, 20 05@13:13:1 5 Page : 1 of 69
	1449	SELECTED D IVISION(S) : ALL
	1450	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	1451	Sor ted by: Pa tient Name
	1452	# PATIEN T/DRUG/COM MENTS INSURANC E/NDC/RX#/ ECME# LOC/TYP RXINF
	1453	7 ECMEpa tient,Two (XXXX) WEB MD / VET P b:3 Rj:1 A cRv:0 RjRv :0
	1454	7.1 CO DEINE SULF ATE 30 000 02-1010-02 08/03 100 82$ 0 /000000504 561 W RT E X/N
	1455	p-Re jected
	1456	07:M /I Cardhol der ID Num ber
	1457	23:M /I Ingredi ent Cost S ubmitted
	1458	8 ECMEpat ient, Thre e (XXXX ) WEBMD / VET A LL payable
	1459	8.1 TE STOSTERONE ENTH. 000 03-0328-40 08/03 90 9238$ 0/00000110 5472 M RT AC/N
	1460	p-Pa yable
	1461	9 ECMEpat ient,22 (XXXX) WE BMD / VET A LL payable
	1462	9.1 HY DROCODONE 5/ACET 557 78-8998-88 08/12 909 254$ 1 /000001105 496 C RT A C/N
	1463	+ Enter ?? f or more ac tions
	1464	5.5.2 Spec ial Notes regarding secondary claims XE " Variati ons to the Close cla im process "
	1465	If a prima ry claim i s successf ully close d and ther e is secon dary insur ance for t hat claim, a seconda ry insuran ce notific ation is d isplayed s o that the user will know to b ill the se condary pa yer.
	1466	Example 5. 5.2-1: Sec ondary Ins urance Not ification
	1467	This patie nt has ADD ITIONAL in surance wi th Rx Cove rage that may be use d to bill this claim . The syst em will ch ange the C T entry to a NON-BIL LABLE Epis ode. If ap propriate, please go to the EC ME Pharmac y COB menu and use t he PRO - P rocess Sec ondary/TRI CARE Rx to ECME opti on to crea te an ePha rmacy seco ndary clai m.
	1468	Patient: EC MEpatient, One
	1469	Date of se rvice: JU N 29, 2010
	1470	Insurance: EC MEInsuranc e,One
	1471	Group numb er: 10 001
	1472	BISOPROL OL 2.5MG/ 51285-004 7-02 06/29 2055810$ 0/00000 1615758 W RT AC/R
	1473	Do you wan t to print the infor mation (ab ove) conce rning addi tional ins urance?
	1474	(Y/N)? n NO
	1475	5.6 Add/Vi ew Comment s XE " Add /View Comm ents"
	1476	The system allows th e ECME use r to enter comments for any cl aim displa yed on the ECME User Screen. T here are t wo types o f comments that can be added: OPECC Com ments and Pharmacy/O PECC Comme nts. More details ar e in parag raph B. be low. The m ost recent comment w ill be dis played und er the Pre scription Informatio n line. I f a claim has been r esubmitted , a messag e displays in place of the mos t recent c omment: “ Prior comm ents suppr essed – us e CMT acti on for all comments” . The mes sage indic ating the prior comm ents were suppressed is not ca ptured in CMT Add/Vi ew Comment s.
	1477	Access thi s action b y entering CMT at th e “Select Action:” p rompt on t he ECME Us er Screen. The syste m prompts you for a line selec tion to id entify the line item (s) to con tain a com ment. You are allowe d to selec t more tha n one clai m to add t he same co mment to o r can sele ct the pat ient summa ry line to add the s ame commen t to all c laims that are liste d under th is patient .
	1478	Example 5. 6-1: Enter ing a Pres cription L ine Item t o Add a Co mment
	1479	PHARMACY E CME Jul 02, 20 05@22:19 Page: 1 of 7 0
	1480	SELECTED D IVISION(S) : ALL
	1481	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	1482	Sor ted by: Pa tient Name
	1483	# PATIEN T/DRUG/COM MENTS INSURANC E/NDC/RX#/ ECME# LOC/TYP RXINF
	1484	1 ECMEpa tient,Two (XXXX) WEB MD / VET Pb :3 Rj:1 Ac Rv:0 RjRv: 0
	1485	1.1 TA MOXIFEN CI TRATE 000 93-0784-86 07/01 909 392$ 0 /000001105 634 W ** D S/R
	1486	p-Re jected
	1487	NN:T ransaction Rejected At Switch Or Interme diary
	1488	NC40 -Request f rom an unk nown site. Registrat ion is req uired
	1489	1.2 DE SIPRAMINE HCL 25 000 68-0011-10 07/01 909 393$ 0 /000001105 635 W ** A C/R
	1490	p-Pa yable
	1491	1.3 DI AZEPAM 5MG /ML IN 001 40-1933-06 07/01 909 394$ 0 /000001105 636 W ** A C/N
	1492	p-Pa yable
	1493	+ Enter ?? f or more ac tions
	1494	CV Change View REV Reverse Pa yable Clai m FR Furt her Resear ch
	1495	SO Sort L ist RES Resubmit C laim VER View ePharmacy Rx
	1496	CMT Add/Vi ew Comment s CLO Close Clai m WRK Send to Workli st
	1497	Select Act ion: Next Screen// C MT Add/V iew Commen ts
	1498	Enter the line numbe r for whic h you wish to Add/Vi ew comment s.
	1499	Select: 1. 2
	1500	The Add/Vi ew Comment s list man ager scree n displays with mult iple actio ns. Both c omment act ions allow the user to enter a comment f or display on the EC ME User Sc reen; howe ver, the a ction to A dd Pharmac y/OPECC Co mment also displays the commen t on the O utpatient Pharmacy T hird Party Payer Rej ects Workl ist. Afte r selectin g a commen t action, the system displays the select ed line it em and pro mpts you t o enter a comment
	1501	Example 5. 6-2: Displ aying the Prescripti on Line It em to Add a Comment or Quit
	1502	O Add OP ECC Commen t EX Exit
	1503	P Add Ph armacy/OPE CC Comment
	1504	Select act ion: Next Screen// O Add OPE CC Comment
	1505	Enter the line numbe r for whic h you wish to Add co mments.
	1506	Select ite m: 12.1//
	1507	The system prompts f or the com ment and a llows you to enter 7 0 characte rs of free form text. The syste m will tra ck the use r who ente red the co mment.
	1508	Example 5. 6-3: Addin g a commen t to a Pre scription Line Item
	1509	Enter Comm ent: This shows a te st comment line for a prescrip tion line item.
	1510	The commen t that has been adde d is displ ayed with the date o f the entr y, and a P harmacy/OP ECC Commen t is indic ated by “( Pharm)”. T he system then promp ts you for a comment action, t o Quit (th e default) or Exit.
	1511	Example 5. 6-4: Displ aying the Added Comm ent and Pr ompting fo r Another
	1512	ADD/VIEW C OMMENTS Jul 02, 20 05@22:19 Page: 1 of 1
	1513	PHARMACY E CME
	1514	SELECTED D IVISION(S) : ALL
	1515	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	1516	# PATIEN T/DRUG/COM MENTS INSURANC E/NDC/RX#/ ECME# LOC/TYP RXINF
	1517	1.1 DE SIPRAMINE HCL 25 000 68-0011-10 07/01 909 393$ 0 /000001105 635 W ** A C/R
	1518	08/1 5/05 - Thi s shows a test comme nt line fo r a prescr iption lin e item.
	1519	(LAS T,FIRST NA ME)
	1520	p-Payable
	1521	07/ 11/15 (Pha rm) - TEST COMMENT F OR PHARMAC Y/OPECC CO MMENT
	1522	(LAS T,FIRST NA ME)
	1523	p-P ayable
	1524	Enter ?? f or more ac tions
	1525	O Add OP ECC Commen t EX Exit
	1526	P Add Ph armacy/OPE CC Comment
	1527
	1528	Select act ion: Next Screen//
	1529	Comments c an also be generated automatic ally by th e system. The Outpat ient Pharm acy system allows pr escription s with spe cified cla im rejecti ons to be sent to th e Pharmacy Worklist automatica lly. There are two t ypes of us er-defined rejection s for Vete ran prescr iptions: ( 1) Transfe r Rejects, and (2) R eject Reso lution Req uired Reje cts. The T ransfer Re ject comme nt is “Aut o Send to Pharmacy W orklist du e to Trans fer Reject Code” and the Rejec t Resoluti on Require d Reject c omment is “Auto Send to Pharma cy Worklis t due to R eject Reso lution Req uired”. I n addition , TRICARE and CHAMPV A prescrip tions are sent to th e Pharmacy Worklist if the cla im is reje cted for a ny reason. The TRICA RE and CHA MPVA comme nt is “Aut o Send to Pharmacy W orklist & OPECC – CV A/TRI”.
	1530	5.7 Furthe r Research Screen XE " Further Research Screen"
	1531	The Furthe r Research Screen al lows you t o access d ifferent s ets of dat a within V istA for q uick probl em resolut ion. The F urther Res earch Scre en allows you to acc ess (or ju mp to) opt ions in ot her VistA applicatio ns.
	1532	Enter FR a t the “Sel ect Action :” prompt on the ECM E User Scr een.
	1533	Example 5. 7-1: Acces sing the F urther Res earch Acti on
	1534	PHARMACY E CME July 26, 2 005@11:31: 22 Page: 18 of 42
	1535	SELECTED D IVISION(S) : ALL
	1536	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	1537	Sor ted by: Pa tient Name
	1538	+# PATIEN T/DRUG/COM MENTS INSURANC E/NDC/RX#/ ECME# LOC /TYP RXINF
	1539	16 ECMEpa tient,One (XXXX ) WEBMD / VE T ALL pay able
	1540	16.1 ET ANERCEPT 2 5MG/VI 584 06-0425-34 07/22 909 504$ 0 /000001105 747 M RT A C/N
	1541	p-Pa yable
	1542	16.2 ET ANERCEPT 2 5MG/VI 584 06-0425-34 07/22 909 504$ 1 /000001105 747 M RT A C/N
	1543	p-Pa yable
	1544	16.3 DI VALPROEX 1 25MG T 000 74-6212-13 07/22 909 505$ 0 /000001105 748 M RT A C/N
	1545	p-Pa yable
	1546	16.4 CO LLAGENASE OINT 504 84-0527-30 07/22 909 506$ 0 /000001105 749 M RT A C/N
	1547	p-Pa yable
	1548	16.5 NA FCILLIN 1 GM. IN 002 09-6950-22 07/22 909 507$ 0 /000001105 750 M RT A C/N
	1549	p-Pa yable
	1550	+ Enter ?? for more actions
	1551	CV Change View REV Reverse Pa yable Clai m FR Furt her Resear ch
	1552	SO Sort L ist RES Resubmit C laim VER View ePharmacy Rx
	1553	CMT Add/Vi ew Comment s CLO Close Clai m WRK Send to Workli st
	1554	Select Act ion: Next Screen// F R Further Research
	1555	The system re-displa ys the ECM E User Scr een with m ultiple ne w “Researc h” options .
	1556	Example 5. 7-2: Displ aying Mult iple Furth er Researc h Menu Opt ions
	1557	FURTHER RE SEARCH SCR EEN Nov 03, 20 10@15:27:5 4 Page: 1 of 30
	1558	SELECTED D IVISION(S) : ALL
	1559	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	1560	Sorted b y: Transac tion date by default
	1561	# PATIEN T/DRUG/COM MENTS IN SURANCE/ND C/DOS/RX#/ ECME# S TATUS/LOC/ TYP/RXINF
	1562	1 ECMEPa tient,SIX (XXXX) OPI NSUR2/2055 557898 VET Pb:10 Rj:2 AcRv :0 RjRv:1
	1563	1.1 SI METHICONE 40MG 0258 7542934 10 /06 110033 5$ 0/00 0000003119 W RT AC/R
	1564	p-Re jected
	1565	85:C laim Not P rocessed
	1566	NN:T ransaction Rejected At Switch Or Interme diary
	1567	02:M /I Version /Release N umber
	1568	EV11 7-D0 IS IN VALID VERS ION NUMBER
	1569	1.2 TR IAMTERENE 50MG, 0048 4359030 10 /26 110033 6$ 0/00 0000003120 W RT DS/R
	1570	p-Re versal Oth er
	1571	1.3 AM YL NITRITE 0.3M 0022 3700212 10 /27 110033 7$ 0/00 0000003122 W RT DS/R
	1572	p-Re versal Oth er
	1573	1.4 TR IAMTERENE 50MG, 0048 4359030 10 /27 110033 9$ 0/00 0000003124 W RT AC/R
	1574	p-Pa yable
	1575	+ Enter ?? f or more ac tions
	1576	INS Insur ance detai ls CT Claims Tr acking EVNT IB Events Rep ort
	1577	VE View Eligibilit y TPJI Third Par ty Inquiry GRPL Gro up Plan Me nu
	1578	VP View Prescripti on OH On Hold C opay List EX Exi t
	1579	CMT Add/V iew Commen ts RH Release C opay
	1580	Select act ion:Next S creen//
	1581	5.7.1 Insu rance Deta ils XE "In surance De tails"
	1582	This actio n allows y ou to view insurance details f or a singl e patient line item. The Insur ance Detai ls action allows you to access the Patie nt Insuran ce Info Vi ew/Edit op tion, loca ted on the Patient I nsurance M enu in the Integrate d Billing software.
	1583	Enter INS at the “Se lect Actio n” prompt, and a sin gle line i tem to vie w the Insu rance Deta ils inform ation for a patient.
	1584	Example 5. 7.1-1: Acc essing Ins urance Det ails Optio n
	1585	FURTHER RE SEARCH SCR EEN Nov 03, 20 10@15:27:5 4 Page: 1 of 30
	1586	SELECTED D IVISION(S) : ALL
	1587	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	1588	Sorted b y: Transac tion date by default
	1589	# PATIEN T/DRUG/COM MENTS IN SURANCE/ND C/DOS/RX#/ ECME# S TATUS/LOC/ TYP/RXINF
	1590	1 ECMEPa tient,SIX (XXXX) OPI NSUR2/2055 557898 VET Pb:10 Rj:2 AcRv :0 RjRv:1
	1591	1.1 SI METHICONE 40MG 0258 7542934 10 /06 110033 5$ 0/00 0000003119 W RT AC/R
	1592	p-Re jected
	1593	85:C laim Not P rocessed
	1594	NN:T ransaction Rejected At Switch Or Interme diary
	1595	02:M /I Version /Release N umber
	1596	EV11 7-D0 IS IN VALID VERS ION NUMBER
	1597	1.2 TR IAMTERENE 50MG, 0048 4359030 10 /26 110033 6$ 0/00 0000003120 W RT DS/R
	1598	p-Re versal Oth er
	1599	1.3 AM YL NITRITE 0.3M 0022 3700212 10 /27 110033 7$ 0/00 0000003122 W RT DS/R
	1600	p-Re versal Oth er
	1601	1.4 TR IAMTERENE 50MG, 0048 4359030 10 /27 110033 9$ 0/00 0000003124 W RT AC/R
	1602	p-Pa yable
	1603	+ Enter ?? f or more ac tions
	1604	INS Insur ance detai ls CT Claims Tr acking EVNT IB Events Rep ort
	1605	VE View Eligibilit y TPJI Third Par ty Inquiry GRPL Gro up Plan Me nu
	1606	VP View Prescripti on OH On Hold C opay List EX Exi t
	1607	CMT Add/V iew Commen ts RH Release C opay
	1608	Select act ion:Next S creen// IN S Insuran ce details
	1609	Please sel ect a SING LE Patient Line item for viewi ng Insuran ce
	1610	Select ite m: 1.4
	1611	While in P atient Ins urance Inf o View/Edi t, you wil l have acc ess to all of the ac tions at t he bottom of the Ins urance Scr een. When you enter QUIT, the system wil l return t o the Furt her Resear ch Screen.
	1612	Example 5. 7.1-2: Di splaying I nsurance D etails Act ions
	1613	Patient In surance In formation Aug 09, 20 06@12:56:4 9 Page: 1 of 1
	1614	Insurance Management for Patie nt: ECMEpa tient,One 0000
	1615	Insura nce Co. Ty pe of Poli cy Group Ho lder Eff ect. Expir es
	1616	1 WEBMD PRESCRIPT ION 10 000 SELF 01/01/00
	1617	Enter ?? f or more ac tions >>>
	1618	VP View P olicy Info BU Benefits U sed EX Exit
	1619	AB Annual Benefits INS View Insur ance Co.
	1620	Select Act ion:Quit// QUIT
	1621	5.7.2 View Eligibili ty XE " Vi ew Eligibi lity"
	1622	The View E ligibility action al lows you t o view the Patient E ligibility Screen.
	1623	The full s et of menu options i s availabl e only for users wit h IB INSUR ANCE SUPER VISOR and IB INSURAN CE COMPANY ADD secur ity keys.E nter VE to view elig ibility in formation for a sing le patient .
	1624	Example 5. 7.2-1: Acc essing Vie w Eligibil ity Option
	1625	FURTHER RE SEARCH SCR EEN Nov 03, 20 10@15:27:5 4 Page: 1 of 30
	1626	SELECTED D IVISION(S) : ALL
	1627	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	1628	Sorted b y: Transac tion date by default
	1629	# PATIEN T/DRUG/COM MENTS IN SURANCE/ND C/DOS/RX#/ ECME# S TATUS/LOC/ TYP/RXINF
	1630	1 ECMEPa tient,SIX (XXXX) OPI NSUR2/2055 557898 VET Pb:10 Rj:2 AcRv :0 RjRv:1
	1631	1.1 SI METHICONE 40MG 0258 7542934 10 /06 110033 5$ 0/00 0000003119 W RT AC/R
	1632	p-Re jected
	1633	85:C laim Not P rocessed
	1634	NN:T ransaction Rejected At Switch Or Interme diary
	1635	02:M /I Version /Release N umber
	1636	EV11 7-D0 IS IN VALID VERS ION NUMBER
	1637	1.2 TR IAMTERENE 50MG, 0048 4359030 10 /26 110033 6$ 0/00 0000003120 W RT DS/R
	1638	p-Re versal Oth er
	1639	1.3 AM YL NITRITE 0.3M 0022 3700212 10 /27 110033 7$ 0/00 0000003122 W RT DS/R
	1640	p-Re versal Oth er
	1641	1.4 TR IAMTERENE 50MG, 0048 4359030 10 /27 110033 9$ 0/00 0000003124 W RT AC/R
	1642	p-Pa yable
	1643	+ Enter ?? f or more ac tions
	1644	INS Insur ance detai ls CT Claims Tr acking EVNT IB Events Rep ort
	1645	VE View Eligibilit y TPJI Third Par ty Inquiry GRPL Gro up Plan Me nu
	1646	VP View Prescripti on OH On Hold C opay List EX Exi t
	1647	CMT Add/V iew Commen ts RH Release C opay
	1648	Select act ion:Next S creen// VE View El igibility
	1649	Please sel ect a SING LE Patient Line item for viewi ng Eligibi lity
	1650	Select ite m: 1.4
	1651	While in t he View El igibility action, yo u will hav e access t o only the EXIT/QUIT action at the botto m of the P atient Eli gibility S creen. Whe n you ente r QUIT, th e system w ill return to the Fu rther Rese arch Scree n.
	1652	Example 5. 7.2-2: Di splaying V iew Eligib ility Opti ons.
	1653	Patient El igibility Aug 15, 20 05@11:14:1 2 Page: 1 of 1
	1654	ECMEPat ient,Six 5959 DOB: 01/02/66
	1655	Means T est: YES Ins ured: Yes
	1656	Date of T est: 07/29 /05 A/O Expo sure:
	1657	Co-pay E xemption T est: Rad. Expo sure:
	1658	Date of T est:
	1659	Patient ha s agreed t o pay dedu ctible
	1660	Prima ry Elig. C ode: NSC
	1661	Serv ice Connec ted: No
	1662	Rated Disabilit ies: None
	1663	Enter ?? f or more ac tions
	1664	EX Exit
	1665	Select Act ion: Quit/ /
	1666	5.7.3 View Prescript ion XE " V iew Prescr iption"
	1667	This actio n allows y ou to view details f or a singl e prescrip tion. It a ccesses th e View Pre scription option, lo cated on t he Rx Pres criptions Menu in th e Outpatie nt Pharmac y Manager software.
	1668	When VP is entered a t the “Sel ect Action :” field, you will b e prompted for the l ine item o f the pres cription y ou wish to display.
	1669	Example 5. 7.3-1: Acc essing Vie w Prescrip tion Actio n
	1670	FURTHER RE SEARCH SCR EEN Nov 03, 20 10@15:27:5 4 Page: 1 of 30
	1671	SELECTED D IVISION(S) : ALL
	1672	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	1673	Sorted b y: Transac tion date by default
	1674	# PATIEN T/DRUG/COM MENTS IN SURANCE/ND C/DOS/RX#/ ECME# S TATUS/LOC/ TYP/RXINF
	1675	1 ECMEPa tient,SIX (XXXX) OPI NSUR2/2055 557898 VET Pb:10 Rj:2 AcRv :0 RjRv:1
	1676	1.1 SI METHICONE 40MG 0258 7542934 10 /06 110033 5$ 0/00 0000003119 W RT AC/R
	1677	p-Re jected
	1678	85:C laim Not P rocessed
	1679	NN:T ransaction Rejected At Switch Or Interme diary
	1680	02:M /I Version /Release N umber
	1681	EV11 7-D0 IS IN VALID VERS ION NUMBER
	1682	1.2 TR IAMTERENE 50MG, 0048 4359030 10 /26 110033 6$ 0/00 0000003120 W RT DS/R
	1683	p-Re versal Oth er
	1684	1.3 AM YL NITRITE 0.3M 0022 3700212 10 /27 110033 7$ 0/00 0000003122 W RT DS/R
	1685	p-Re versal Oth er
	1686	1.4 TR IAMTERENE 50MG, 0048 4359030 10 /27 110033 9$ 0/00 0000003124 W RT AC/R
	1687	p-Pa yable
	1688	+ Enter ?? f or more ac tions
	1689	INS Insur ance detai ls CT Claims Tr acking EVNT IB Events Rep ort
	1690	VE View Eligibilit y TPJI Third Par ty Inquiry GRPL Gro up Plan Me nu
	1691	VP View Prescripti on OH On Hold C opay List EX Exi t
	1692	CMT Add/V iew Commen ts RH Release C opay
	1693	Select act ion:Next S creen// VP View Pr escription
	1694	Please sel ect a SING LE Rx Line item for viewing a Prescripti on
	1695	Select ite m: 1.4
	1696	Once a sin gle prescr iption lin e item is entered, t he system displays t he followi ng screens for the s elected pr escription . When you enter QUI T, the sys tem will r eturn you to the Fur ther Resea rch Screen .
	1697	Example 5. 7.3-2: Di splaying V iew Prescr iption Opt ions.
	1698	Rx Activit y Log Nov 03, 20 XX@15:27:5 4 Page: 1 of 5
	1699	ECMEPatie nt,Six
	1700	PID: XXX X Ht(cm): _______ ( ______)
	1701	DOB: MAY X,XXXX (X X) Wt(kg): _ ______ (__ ____)
	1702	Rx # : XXXXXX$
	1703	Orde rable Item : TRIAMTER ENE 50MG
	1704	CMOP Drug : TRIAMTER ENE 50MG T AB
	1705	*Dosage : 50MG
	1706	Verb : TAKE
	1707	Disp ense Units : 1
	1708	Noun : TABLET
	1709	*Route : ORAL
	1710	*Schedule : 2X
	1711	Patient In structions
	1712	SIG : TAKE ONE TABLET BY MOUTH 2X
	1713	Pati ent Status : OPT NSC
	1714	Issue Date : 10/07/XX Fil l Date: 10 /07/XX
	1715	Last Fill Date : 10/07/XX (Window)
	1716	Last Re lease Date : Lot #:
	1717	Expires : 10/08/XX MFG:
	1718	D ays Supply : 90 QTY (TAB) : 11
	1719	# of Refills : 3 Rem aining: 3
	1720	Provider : OPINSUR2
	1721	Routing: W indow
	1722	Copies : 1
	1723	Method of Pickup :
	1724	Clinic : Not on F ile
	1725	Division : XXXXXXXX XX
	1726	Pharmacist :
	1727	Patient Counseling : NO
	1728	Remarks :
	1729	F inished By : PSOuser, Two
	1730	Entry B y: PSOuser ,Two Entry Date: 10/ 6/XX 11:45 :57
	1731	Original F ill Releas ed: Routing: W indow
	1732	Refill Log :
	1733	# Log Dat e Refill Date Qty Routi ng Lot # Phar macist
	1734	========== ========== ========== ========== ========== ========== ========== =========
	1735	There are NO Refills For this Prescripti on
	1736	Partial Fi lls:
	1737	# Log Da te Date Qty Routing Lot # Pharm acist
	1738	========== ========== ========== ========== ========== ========== ========== =========
	1739	There are NO Partial s for this Prescript ion
	1740	Activity L og:
	1741	# Date Reas on Rx Ref Init iator Of A ctivity
	1742	========== ========== ========== ========== ========== ========== ========== =========
	1743	1 08/03/ XX EDIT ORIGINAL PSOu ser,Two
	1744	Comments: FILL DATE (3050801),
	1745	Copay Acti vity Log:
	1746	# Date Reas on Rx Ref Initiato r Of Activ ity
	1747	========== ========== ========== ========== ========== ========== ========== =========
	1748	There's NO Copay act ivity to r eport
	1749	Label Log:
	1750	# Date Rx R ef Printed By
	1751	========== ========== ========== ========== ========== ========== ========== =========
	1752	1 08/01/ XX ORIG INAL PSOuser, Three
	1753	Comments: From RX nu mber XXXXX X
	1754	2 08/03/ 05 ORIG INAL PSOuser, Three
	1755	Comments: From RX nu mber XXXXX X (Reprint )
	1756	Rx Activit y Log Nov 03, 20 10@15:27:5 4 Page: 5 of 5
	1757	ECMEPatie nt,Six
	1758	PID: XXX X Ht(cm) : _______ (______)
	1759	DOB: JAN X, XXXX ( XX) Wt(kg): _______ (_ _____)+
	1760	ECME Log:
	1761	# Date Rx R ef Initiator Of Activi ty
	1762	========== ========== ========== ========== ========== ========== ========== =========
	1763	1 5/22/0 6@19:00:24 ORIGIN AL PSOuser,Th ree
	1764	Comments: Submitted to ECME:CM OP TRANSMI SSION(NDC: 00049-3980 -60)
	1765	2 7/6/06 @19:01:04 REFILL 1 PSOuser,Th ree
	1766	Comments: Submitted to ECME:CM OP TRANSMI SSION(NDC: 00049-3980 -60)
	1767	3 7/7/06 @14:39:19 REFILL 1 PSOuser,Th ree
	1768	Comments: Submitted to ECME:RE JECT WORKL IST-DUR OV ERRIDE COD ES(DD/M0/1 B)-E
	1769	PAYABLE-p MEDCO
	1770	4 7/8/06 @12:48:02 REFILL 1 PSOuser,Th ree
	1771	Comments: CHAMPVA-EC ME RED Res ubmit Clai m w/Edits: Date of S ervice
	1772	(7/6/2006) -pMEDCO
	1773	ECME REJEC T Log:
	1774	# Date/Ti me Rcvd Rx Ref Reject Ty pe STA TUS Da te/Time Re solved
	1775	========== ========== ========== ========== ========== ========== ========== =========
	1776	1 7/6/06@ 19:02:08 REFILL 1 DUR RES OLVED 7/ 7/06@14:39 :19
	1777	Comments: AUTOMATICA LLY CLOSED (CLAIM RE -SUBMITTED )
	1778	Enter ?? f or more ac tions
	1779	Selec t Action:Q uit//
	1780	5.7.4 Add/ View Comme nts XE " A dd/View Co mments"
	1781	When CMT i s entered at the “Se lect Actio n:” field, you will access the Add/View Comments a s describe d in Secti on 5.8. Th e only dif ference is that when you selec t QUIT, yo u will be returned t o the Furt her Resear ch Screen.
	1782	5.7.5 Clai ms Trackin g XE "Clai ms Trackin g"
	1783	This actio n accesses the Claim s Tracking Edit Scre en of the Claims Tra cking Edit for Billi ng option in the Int egrated Bi lling soft ware.
	1784	Enter the CT action and then e nter a sin gle prescr iption lin e item to track a cl aim.
	1785	Example 5. 7.5-1: Acc essing Cla ims Tracki ng Option
	1786	FURTHER RE SEARCH SCR EEN Nov 03, 20 10@15:27:5 4 Page: 1 of 30
	1787	SELECTED D IVISION(S) : ALL
	1788	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 1 day(s)
	1789	Sorted b y: Transac tion date by default
	1790	# PATIEN T/DRUG/COM MENTS IN SURANCE/ND C/DOS/RX#/ ECME# S TATUS/LOC/ TYP/RXINF
	1791	1 ECMEPa tient,SIX (XXXX) OPI NSUR2/2055 557898 VET Pb:10 Rj:2 AcRv :0 RjRv:1
	1792	1.1 SI METHICONE 40MG 0258 7542934 10 /06 110033 5$ 0/00 0000003119 W RT AC/R
	1793	p-Re jected
	1794	85:C laim Not P rocessed
	1795	NN:T ransaction Rejected At Switch Or Interme diary
	1796	02:M /I Version /Release N umber
	1797	EV11 7-D0 IS IN VALID VERS ION NUMBER
	1798	1.2 TR IAMTERENE 50MG, 0048 4359030 10 /06 110033 6$ 0/00 0000003120 W RT DS/R
	1799	p-Re versal Oth er
	1800	1.3 AM YL NITRITE 0.3M 0022 3700212 10 /07 110033 7$ 0/00 0000003122 W RT DS/R
	1801	p-Re versal Oth er
	1802	1.4 TR IAMTERENE 50MG, 0048 4359030 10 /07 110033 9$ 0/00 0000003124 W RT AC/R
	1803	p-Pa yable
	1804	+ Enter ?? f or more ac tions
	1805	INS Insur ance detai ls CT Claims Tr acking EVNT IB Events Rep ort
	1806	VE View Eligibilit y TPJI Third Par ty Inquiry GRPL Gro up Plan Me nu
	1807	VP View Prescripti on OH On Hold C opay List EX Exi t
	1808	CMT Add/V iew Commen ts RH Release C opay
	1809	Select act ion:Next S creen// C T Claims Tracking
	1810	Please sel ect a SING LE Rx Line item when accessing Claims Tr acking.
	1811	Select ite m: 1.1.... ...
	1812	While in t he Claims Tracking a ction, you will have menu acce ss to all Claims opt ions at th e bottom. Entering E XIT or QUI T will end the Claim s Tracking and retur n you to t he Further Research screen.
	1813	Example 5. 7.5-2: Di splaying C laims Trac king Optio ns
	1814	CLAIMS TRA CKING EDIT Nov 03, 20 10@15:27:5 4 Page: 1 of 3
	1815	Expanded C laims Trac king Info for: ECME Patient, T wo ROI:
	1816	For: PRESC RIPTION RE FILL on 11 /04/05
	1817	+
	1818	Visit Type: PRE SCRIPTION REFILL Author ization #:
	1819	Prescript ion #: XXX XXXX No . Days App roved: 0
	1820	Fill Date: Nov 04, 2005 Second Opinion R equired:
	1821	Drug: ALL OPURINOL 3 00MG, 30'S Second Opinion O btained:
	1822	Qua ntity: 1
	1823	Days S upply: 1 Review In formation
	1824	2 NDC#: 510 79-0206-20 Insuranc e Claim: Y ES
	1825	Phys ician: ECM EProvider, Two Follow- up Type:
	1826	Random Sample:
	1827	Special Co ndition:
	1828	Local A ddition:
	1829	Ins. R eviewer:
	1830	Hospital R eviewer:
	1831	Billing Informatio n
	1832	+ Enter ?? f or more ac tions
	1833	BI Billin g Info Edi t TA Treatment Auth. EX Exit
	1834	RI Review Info SE Submit Cla im to ECME
	1835	Select Act ion:Next S creen// <E nter>
	1836	CLAIMS TRA CKING EDIT Nov 03, 20 10@15:27:5 4 Page: 2 of 3
	1837	Expanded C laims Trac king Info for: ECMEp atient,Two ROI:
	1838	For: PRESC RIPTION RE FILL on 11 /04/05
	1839	+
	1840	Episo de Billabl e: NO Total Cha rges: $ 0
	1841	Non-Bill able Reaso n: PRESCRI PTION NOT REL Estima ted Recv ( Pri): $
	1842	Nex t Bill Dat e: Estima ted Recv ( Sec): $
	1843	Work. Com p/OWCP/Tor t: Estima ted Recv ( ter): $
	1844	I nitial Bil l: Mean s Test Cha rges: $
	1845	Bill Statu s: Amount Paid: $ 0
	1846	Hospital Reviews E ntered
	1847	Insuranc e Reviews Entered
	1848	Service Connected Conditions :
	1849	Service C onnected: NO
	1850	+ Enter ?? f or more ac tions
	1851	BI Billin g Info Edi t TA Treatment Auth. EX Exit
	1852	RI Review Info SE Submit Cla im to ECME
	1853	Select Act ion:Next S creen//<En ter>
	1854	CLAIMS TRA CKING EDIT Nov 03, 20 10@15:27:5 4 Page: 3 of 3
	1855	Expanded C laims Trac king Info for: ECMEp atient,Two ROI:
	1856	For: PRESC RIPTION RE FILL on 11 /04/05
	1857	+
	1858	NONE STAT ED
	1859	Enter ?? f or more ac tions
	1860	BI Billin g Info Edi t TA Treatment Auth. EX Exit
	1861	RI Review Info SE Submit Cla im to ECME
	1862	Select Act ion:Quit//
	1863	5.7.6 Thir d Party In quiry XE " Third Par ty Inquiry "
	1864	The “TPJI” action al lows you t o access t he Third P arty Joint Inquiry o ption in t he Integra ted Billin g software .
	1865	Enter the TPJI actio n and then enter a s ingle pres cription l ine item t o access t he Third P arty (Join t) Inquiry claim inf ormation.
	1866	Example 5. 7.6-1: Acc essing Thi rd Party ( Joint) Inq uiry Optio n
	1867	FURTHER RE SEARCH SCR EEN Nov 03, 20 10@15:27:5 4 Page: 1 of 30
	1868	SELECTED D IVISION(S) : ALL
	1869	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	1870	Sorted b y: Transac tion date by default
	1871	# PATIEN T/DRUG/COM MENTS IN SURANCE/ND C/DOS/RX#/ ECME# S TATUS/LOC/ TYP/RXINF
	1872	1 ECMEPa tient,SIX (XXXX) OPI NSUR2/2055 557898 VET Pb:10 Rj:2 AcRv :0 RjRv:1
	1873	1.1 SI METHICONE 40MG 0258 7542934 10 /06 110033 5$ 0/00 0000003119 W RT AC/R
	1874	p-Re jected
	1875	85:C laim Not P rocessed
	1876	NN:T ransaction Rejected At Switch Or Interme diary
	1877	02:M /I Version /Release N umber
	1878	EV11 7-D0 IS IN VALID VERS ION NUMBER
	1879	1.2 TR IAMTERENE 50MG, 0048 4359030 10 /26 110033 6$ 0/00 0000003120 W RT DS/R
	1880	p-Re versal Oth er
	1881	1.3 AM YL NITRITE 0.3M 0022 3700212 10 /27 110033 7$ 0/00 0000003122 W RT DS/R
	1882	p-Re versal Oth er
	1883	1.4 TR IAMTERENE 50MG, 0048 4359030 10 /27 110033 9$ 0/00 0000003124 W RT AC/R
	1884	p-Pa yable
	1885	+ Enter ?? f or more ac tions
	1886	INS Insur ance detai ls CT Claims Tr acking EVNT IB Events Rep ort
	1887	VE View Eligibilit y TPJI Third Par ty Inquiry GRPL Gro up Plan Me nu
	1888	VP View Prescripti on OH On Hold C opay List EX Exi t
	1889	CMT Add/V iew Commen ts RH Release C opay
	1890	Select act ion:Next S creen// T PJI Thir d Party In quiry
	1891	Please sel ect a SING LE Patient Line item when acce ssing TPJI
	1892	Select ite m:
	1893	While in T hird Party (Joint) I nquiry, yo u have acc ess to all actions d isplayed a t the bott om of the screen. En ter QUIT t o return t o the main Further R esearch Sc reen.
	1894	Example 5. 7.6-2: Di splaying T hird Party (Joint) I nquiry Opt ions.
	1895	Third Part y Active B ills Nov 03, 20 10@15:27:5 4 Page: 1 of 1
	1896	ECMEPatien t,SIX (XXX X)NSC
	1897	Bill # From To MT? Type Stat Rate Insure r Orig Am t Curr Amt
	1898	1 K400K9C e 06/15/0 5 06/15/05 YES OP A REIM IN WEBMD 45.00 45.00
	1899	2 K400K9D e 06/15/0 5 06/15/05 YES OP A REIM IN WEBMD 45.00 45.00
	1900	…
	1901	\|r Referre d \|* MT on Hold \|+ M ulti Carri ers \|
	1902	CI Claim Informatio n IL Inactive B ills PI Pati ent Insura nce
	1903	CP Change Patient HS Health Sum mary EL Pati ent Eligib ility
	1904	Select Act ion: Quit/ /
	1905	5.7.7 On H old Copay Listing XE " On-Hold Copay Lis ting"
	1906	This optio n lists On Hold copa y informat ion for a single pat ient. The OH action allows you to access the List Current/Pa st Held Ch arges by P t option, located on the On Ho ld Menu (w hich is lo cated on t he Automat ed Means T est Billin g Menu) in Integrate d Billing software.
	1907	The On Hol d Copay Li sting requ ires that a device w ith 132 co lumn width be used. It will no t display correctly using 80 c olumn widt h devices. Enter the OH action and then e nter a sin gle patien t line ite m to acces s the On H old Copay Listing op tion.
	1908	Example 5. 7.7-1: Acc essing On Hold Copay Listing O ption
	1909	FURTHER RE SEARCH SCR EEN Nov 03, 20 10@15:27:5 4 Page: 1 of 30
	1910	SELECTED D IVISION(S) : ALL
	1911	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	1912	Sorted b y: Transac tion date by default
	1913	# PATIEN T/DRUG/COM MENTS IN SURANCE/ND C/DOS/RX#/ ECME# S TATUS/LOC/ TYP/RXINF
	1914	1 ECMEPa tient,SIX (XXXX) OPI NSUR2/2055 557898 VET Pb:10 Rj:2 AcRv :0 RjRv:1
	1915	1.1 SI METHICONE 40MG 0258 7542934 10 /26 110033 5$ 0/00 0000003119 W RT AC/R
	1916	p-Re jected
	1917	85:C laim Not P rocessed
	1918	NN:T ransaction Rejected At Switch Or Interme diary
	1919	02:M /I Version /Release N umber
	1920	EV11 7-D0 IS IN VALID VERS ION NUMBER
	1921	1.2 TR IAMTERENE 50MG, 0048 4359030 10 /26 110033 6$ 0/00 0000003120 W RT DS/R
	1922	p-Re versal Oth er
	1923	1.3 AM YL NITRITE 0.3M 0022 3700212 10 /27 110033 7$ 0/00 0000003122 W RT DS/R
	1924	p-Re versal Oth er
	1925	1.4 TR IAMTERENE 50MG, 0048 4359030 10 /27 110033 9$ 0/00 0000003124 W RT AC/R
	1926	p-Pa yable
	1927	+ Enter ?? f or more ac tions
	1928	INS Insur ance detai ls CT Claims Tr acking EVNT IB Events Rep ort
	1929	VE View Eligibilit y TPJI Third Par ty Inquiry GRPL Gro up Plan Me nu
	1930	VP View Prescripti on OH On Hold C opay List EX Exi t
	1931	CMT Add/V iew Commen ts RH Release C opay
	1932	Select act ion:Next S creen// O H On Hol d Copay Li sting
	1933	Please sel ect a SING LE Patient Line item when acce ssing On H old Copay Listing
	1934	Select ite m: 1
	1935	You are pr ompted for a start a nd end dat e for the report.
	1936	Example 5. 7.7-2: Ent ering On H old Copay Report Sta rt and End Dates
	1937	Start with DATE: T-3 (AUG 14, 2005)
	1938	Go to DATE: T (AUG 17, 2 005)
	1939	You are pr ompted to choose whe ther to in clude Phar macy Co-pa y charges or not.
	1940	Example 5. 7.7-3: En tering “Y” to Includ e Pharmacy Co-pay Ch arges on R eport
	1941	Include Ph armacy Co- pay charge s on this report? NO // YES
	1942	*** Margin width of this outpu t is 132 * **
	1943	* This o utput shou ld be queu ed *
	1944	DEVICE: HO ME// 132 PRINTER
	1945	Print the report at 132 charac ters.
	1946	Example 5. 9.7-4: Pr inted On H old Copay Listing Re port
	1947	List of al l HELD bil ls for EC MEPatient, SIX (XXXX) AUG 8,200 6 PAGE 1
	1948	PATIENT CH ARGES C ORRESPONDI NG THIRD P ARTY BILLS
	1949	========== ========== ========== ========== ========== ========== ========== =======\|\|= ========== ========== ========== =========
	1950	From/ Date AR IB \|\| AR
	1951	Action ID Type Bill# Fill Dt to AR Charge Status Status\|\| Bill# Cla ssf($Typ) ST Charg e % Paid
	1952	========== ========== ========== ========== ========== ========== ========== =======\|\|= ========== ========== ========== =========
	1953	'* ' = outpt visit on s ame day as Rx fill d ate \|\|
	1954	========== ========== ========== ========== ========== ========== ========== =======\|\|= ========== ========== ========== =========
	1955	5002877 NSC R X Rx #: 100003994 ECME # 0 0000123457 9 \|\|
	1956	12/30/0 5 8.00 ON HOLD\|\|
	1957	Enter RETU RN to cont inue or '^ ' to exit:
	1958	5.7.8 Rele ase Copay XE " Relea se Copay"
	1959	This actio n accesses the Relea se Charges 'On Hold' option, l ocated on the On Hol d Menu (wh ich is loc ated on th e Automate d Means Te st Billing Menu) in the Integr ated Billi ng softwar e. If you select a s ingle Rx L ine item, the system defaults the to the REF# of t he selecte d Rx.
	1960	Enter RH t o access t he Release Copay opt ion. You m ay select a single P atient lin e item or a single R x line ite m.
	1961	Example 5. 7.8-1: Acc essing Rel ease Copay Option
	1962	FURTHER RE SEARCH SCR EEN Nov 03, 20 10@15:27:5 4 Page: 1 of 30
	1963	SELECTED D IVISION(S) : ALL
	1964	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	1965	Sorted b y: Transac tion date by default
	1966	# PATIEN T/DRUG/COM MENTS IN SURANCE/ND C/DOS/RX#/ ECME# S TATUS/LOC/ TYP/RXINF
	1967	1 ECMEPa tient,SIX (XXXX) OPI NSUR2/2055 557898 VET Pb:10 Rj:2 AcRv :0 RjRv:1
	1968	1.1 SI METHICONE 40MG 0258 7542934 10 /06 110033 5$ 0/00 0000003119 W RT AC/R
	1969	p-Re jected
	1970	85:C laim Not P rocessed
	1971	NN:T ransaction Rejected At Switch Or Interme diary
	1972	02:M /I Version /Release N umber
	1973	EV11 7-D0 IS IN VALID VERS ION NUMBER
	1974	1.2 TR IAMTERENE 50MG, 0048 4359030 10 /26 110033 6$ 0/00 0000003120 W RT DS/R
	1975	p-Re versal Oth er
	1976	1.3 AM YL NITRITE 0.3M 0022 3700212 10 /27 110033 7$ 0/00 0000003122 W RT DS/R
	1977	p-Re versal Oth er
	1978	1.4 TR IAMTERENE 50MG, 0048 4359030 10 /27 110033 9$ 0/00 0000003124 W RT AC/R
	1979	p-Pa yable
	1980	+ Enter ?? f or more ac tions
	1981	INS Insur ance detai ls CT Claims Tr acking EVNT IB Events Rep ort
	1982	VE View Eligibilit y TPJI Third Par ty Inquiry GRPL Gro up Plan Me nu
	1983	VP View Prescripti on OH On Hold C opay List EX Exi t
	1984	CMT Add/V iew Commen ts RH Release C opay
	1985	Select act ion:Next S creen// RH Relea se Copay
	1986	Please sel ect a SING LE Patient Line item or a SING LE Rx Line item when accessing
	1987	Release C opay from Hold.
	1988	Select ite m: 9
	1989	All copay charges on hold for the select ed patient or prescr iption are listed. S elect the line numbe r (referen ce number) of the it em for the release o f that cop ay, then a nswer Y to okay the charge to Accounts R eceivable. The selec tion is re displayed and you ar e advised that the l isted char ge has bee n passed t o Accounts Receivabl e.
	1990	Example 5. 7.8-2: Lis ting On Ho ld Copay C harges for Release C opay Optio n
	1991	ECMEPatien t,,SIX Pt ID: 000-00 -0000
	1992	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------
	1993	The follow ing IB Act ions for t his patien t are ON H OLD:
	1994	========== ========== ========== ========== ========== ========== ========== ==========
	1995	REF Act ion ID Bi ll Type Bill # Fr/Fl Dt To/Rls Dt Charge
	1996	========== ========== ========== ========== ========== ========== ========== ==========
	1997	1 000 596570 Rx #: 909708 08/01/05 08/01/05 21.00
	1998	EC ME #: 0000 00000000
	1999	2 000 596574 Rx #: 909693 08/01/05 08/01/05 21.00
	2000	EC ME #: 0000 00000000
	2001	3 000 596575 Rx #: 909694 08/01/05 08/01/05 21.00
	2002	EC ME #: 0000 00000000
	2003	4 000 596580 Rx #: 909728 08/01/05 08/01/05 21.00
	2004	EC ME #: 0000 00000000
	2005	5 000 596581 Rx #: 909703 08/01/05 08/01/05 21.00
	2006	EC ME #: 0000 00000000
	2007	6 000 596601 Rx #: 909698 08/01/05 08/03/05 21.00
	2008	EC ME #: 0000 00000000
	2009	Select IB Actions (R EF #) to r elease (or '^' to ex it): 2
	2010	OK to pass this char ge to Acco unts Recei vable? YES
	2011	Passing ch arges to A ccounts Re ceivable.. .
	2012	========== ========== ========== ========== ========== ========== ========== ==========
	2013	REF Act ion ID Bi ll Type Bill # Fr/Fl Dt To/Rls Dt Charge
	2014	========== ========== ========== ========== ========== ========== ========== ==========
	2015	2 000 596574 Rx #: 909693 K400KDC 08/01/05 08/01/05 21.00
	2016	EC ME #: 0000 00000000
	2017	The charge listed ab ove has be en passed to Account s Receivab le.
	2018	Enter RETU RN to cont inue or '^ ' to exit:
	2019	5.7.9 IB ( Integrated Billing) Events Rep ort XE " I B (Integra ted Billin g) Events Report"
	2020	The “EVNT” action al lows you t o access t he IB e-Ph armacy Men u Option, ECME Billi ng Events Report.
	2021	Enter EVN T to acces s the IB E vents Repo rt option. You may s elect a si ngle Patie nt line it em or a si ngle Rx li ne item.
	2022	Example 5. 7.9-1: Acc essing IB Events Rep ort Option
	2023	FURTHER RE SEARCH SCR EEN Nov 03, 20 10@15:27:5 4 Page: 1 of 30
	2024	SELECTED D IVISION(S) : ALL
	2025	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	2026	Sorted b y: Transac tion date by default
	2027	# PATIEN T/DRUG/COM MENTS IN SURANCE/ND C/DOS/RX#/ ECME# S TATUS/LOC/ TYP/RXINF
	2028	1 ECMEPa tient,,SIX (XXXX) OP INSUR2/205 5557898 VET Pb:1 0 Rj:2 AcR v:0 RjRv:1
	2029	1.1 SI METHICONE 40MG 0258 7542934 10 /06 110033 5$ 0/00 0000003119 W RT AC/R
	2030	p-Re jected
	2031	85:C laim Not P rocessed
	2032	NN:T ransaction Rejected At Switch Or Interme diary
	2033	02:M /I Version /Release N umber
	2034	EV11 7-D0 IS IN VALID VERS ION NUMBER
	2035	1.2 TR IAMTERENE 50MG, 0048 4359030 10 /26 110033 6$ 0/00 0000003120 W RT DS/R
	2036	p-Re versal Oth er
	2037	1.3 AM YL NITRITE 0.3M 0022 3700212 10 /27 110033 7$ 0/00 0000003122 W RT DS/R
	2038	p-Re versal Oth er
	2039	1.4 TR IAMTERENE 50MG, 0048 4359030 10 /27 110033 9$ 0/00 0000003124 W RT AC/R
	2040	p-Pa yable
	2041	+ Enter ?? f or more ac tions
	2042	INS Insur ance detai ls CT Claims Tr acking EVNT IB Events Rep ort
	2043	VE View Eligibilit y TPJI Third Par ty Inquiry GRPL Gro up Plan Me nu
	2044	VP View Prescripti on OH On Hold C opay List EX Exi t
	2045	CMT Add/V iew Commen ts RH Release C opay
	2046	Select act ion:Next S creen// EVNT IB Ev ents Repor t
	2047	Please sel ect a SING LE Patient Line item or a SING LE Rx Line item when accessing
	2048	The IB Ev ents Repor t.
	2049	Select ite m: 2
	2050	You are p rompted fo r a start and end da te for thi s report.
	2051	Example 5. 7.9-2: Ent ering Date s to Inclu de in IB E vents Repo rt Listing
	2052	START WITH DATE: TOD AY//T-60 (JUN 23, 2 005)
	2053	GO TO DATE : TODAY//T (AUG 22, 2005)
	2054	You are pr ompted to select M ( Mail), W ( window), C (CMOP) or A (All) e vents for the select ed line it em report.
	2055	Example 5. 7.9-3: Cho osing Defa ult ‘All’ for Types of Events for IB Eve nts Report
	2056	Selec t one of t he followi ng:
	2057	M MAIL
	2058	W WINDOW
	2059	C CMOP
	2060	A ALL
	2061	(M)AIL, (W )INDOW, (C )CMOP, (A) LL: ALL// <Enter> ALL
	2062	You are pr ompted to select S ( SUMMARY RE PORT) or D (DETAILED REPORT) a nd a print device.
	2063	Example 5. 7.9-4: Sel ecting Sum mary Type for IB Eve nts Report
	2064	S SUMMARY RE PORT
	2065	D DETAILED R EPORT
	2066	(S)UMMARY REPORT, (D )ETAILED R EPORT: SUM MARY REPOR T// <Ente r> SUMMARY REPORT
	2067	DEVICE: HO ME//
	2068	PAGE 1
	2069	BILLI NG ECME EV ENTS ON 06 /23/05 TO 08/22/05 (SUMMARY)
	2070	RX# FILL DAT E PA TIENT NAME DRUG
	2071	========== ========== ========== ========== ========== ========== ========== ==========
	2072	1 909693 0 08/0 1/05 EC MEPatient, SIX EPOETI N ALFA,REC OMB 20,000 UNT/
	2073	FINI SH 08/0 1/05 11:32 a Status:E CME Billab le
	2074	SUBM IT 08/0 1/05 11:34 a Status:O K
	2075	REVE RSAL 08/0 1/05 3:19p Status:E CME Claim reversed, no Bill to cancel
	2076	FINI SH 08/0 1/05 3:20p Status:E CME Billab le
	2077	SUBM IT 08/0 1/05 3:20p Status:O K
	2078	RELE ASE 08/0 1/05 3:20p Status:O K
	2079	---------- ---------- ---------- ---------- ---------- ---------- ---------- ----------
	2080	2 909694 0 08/0 1/05 EC MEPatient, Seven CYCL OPHOSPHAMI DE 1000MG INJ
	2081	FINI SH 08/0 1/05 11:44 a Status:E CME Billab le
	2082	SUBM IT 08/0 1/05 11:45 a Status:O K
	2083	REVE RSAL 08/0 1/05 3:37p Status:E CME Claim reversed, no Bill to cancel
	2084	FINI SH 08/0 1/05 3:38p Status:E CME Billab le
	2085	SUBM IT 08/0 1/05 3:38p Status:O K
	2086	RELE ASE 08/0 1/05 3:38p Status:O K
	2087	BILL ING 08/0 1/05 3:38p Status:B ill# K400K BC created
	2088	REVE RSAL 08/0 5/05 3:09p Status:B ill# K400K BC cancell ed
	2089	Press RETU RN to cont inue, '^' to exit:
	2090	Example 5. 7.9-5: Sel ecting a D etailed Ty pe for IB Events Rep ort
	2091	S SUMMARY RE PORT
	2092	D DETAILED R EPORT
	2093	(S)UMMARY REPORT, (D )ETAILED R EPORT: SUM MARY REPOR T// DETAIL ED REPORT
	2094	DEVICE: HO ME//
	2095	PAGE 1
	2096	BILLING EC ME EVENTS ON 07/06/1 1 TO 09/04 /11 (DETAI LED) for X XXXXX VAMC DIVISIO
	2097	RX# FILL DAT E PA TIENT NAME DRUG
	2098	========== ========== ========== ========== ========== ========== ========== ==========
	2099	1 205478 9 0 06/0 8/11 EC MEPATIENT, SIX C LONAZEPAM 1MG TAB
	2100	FINI SH 08/1 0/11 6:35p Status:E CME Billab le
	2101	ELIGIBILIT Y:
	2102	DRUG:CLONA ZEPAM 1MG TAB
	2103	NDC:57664- 0274-08, B ILLED QTY: 30, COST:. 024, DEA:4 CPR
	2104	PLAN: INS URANCE: WE BMD COB: S
	2105	BIN:123456 , PCN:1123 456789, PA YER SHEET B1:WBTESTB 1
	2106	PAYER SHEE T B2:WBTES TB2, PAYER SHEET B3: WBTESTB1
	2107	DISPENSING FEE:11.40 , BASIS OF COST DETE RM:COST CA LCULATIONS
	2108	COST:12.12 , GROSS AM T DUE:12.1 2, ADMIN F EE:0.00
	2109	USER:ECMEu ser,Two
	2110	SUBM IT 08/1 0/11 6:35p Status:O K
	2111	ECME#:0000 01614656, FILL DATE :06/08/11, RELEASE DATE:06/08 /11
	2112	PAYER RESP ONSE: PAYA BLE
	2113	PLAN:, INS URANCE: WE BMD
	2114	USER:ECMEu ser,Three
	2115	BILL ING 08/1 0/11 6:35p Status:B ill K10004 V created with ERROR s
	2116	Press RETU RN to cont inue, '^' to exit:
	2117	PAGE 2
	2118	BILLING EC ME EVENTS ON 07/06/1 1 TO 09/04 /11 (DETAI LED) for X XXXXX VAMC DIVISIO
	2119	RX# FILL DAT E PA TIENT NAME DRUG
	2120	========== ========== ========== ========== ========== ========== ========== ==========
	2121	ERROR DESC RIPTION: C annot esta blish rece ivable in AR (second ary ins).
	2122	ECME#:0000 01614656, FILL DATE :06/08/11, RELEASE DATE:06/08 /11
	2123	DRUG:CLONA ZEPAM 1MG TAB
	2124	NDC:57664- 0274-08, B ILLED QTY: 30, DAYS S UPPLY:30
	2125	BILLED:12. 12, PAID:6 8.32
	2126	PLAN:, INS URANCE: WE BMD
	2127	USER:ECMEu ser,One
	2128	REVE RSAL 08/1 1/11 1:18p Status:
	2129	ECME#:0000 01614656, FILL DATE :06/08/11, RELEASE DATE:06/08 /11
	2130	PAYER RESP ONSE: ACCE PTED
	2131	PLAN:, INS URANCE: WE BMD
	2132	USER:ECMEu ser,Two
	2133	REVERSAL R EASON:TST
	2134	FINI SH 08/1 1/11 1:20p Status:E CME Billab le
	2135	ELIGIBILIT Y:
	2136	DRUG:CLONA ZEPAM 1MG TAB
	2137	NDC:57664- 0274-08, B ILLED QTY: 30, COST:. 024, DEA:4 CPR
	2138	Press RETU RN to cont inue, '^' to exit:
	2139	PAGE 3
	2140	BILLING EC ME EVENTS ON 07/06/1 1 TO 09/04 /11 (DETAI LED) for DNS ENNE VAMC DIVISIO
	2141	RX# FILL DAT E PA TIENT NAME DRUG
	2142	========== ========== ========== ========== ========== ========== ========== ==========
	2143	PLAN: INS URANCE: WE BMD COB: S
	2144	BIN:123456 , PCN:1123 456789, PA YER SHEET B1:WBTESTB 1
	2145	PAYER SHEE T B2:WBTES TB2, PAYER SHEET B3: WBTESTB1
	2146	DISPENSING FEE:11.40 , BASIS OF COST DETE RM:COST CA LCULATIONS
	2147	COST:12.12 , GROSS AM T DUE:12.1 2, ADMIN F EE:0.00
	2148	USER:ECMEu ser,Two
	2149	SUBM IT 08/1 1/11 1:20p Status:O K
	2150	ECME#:0000 01614656, FILL DATE :06/08/11, RELEASE DATE:06/08 /11
	2151	PAYER RESP ONSE: REJE CTED
	2152	PLAN:, INS URANCE: WE BMD
	2153	USER:ECMEu ser,One
	2154	---------- ---------- ---------- ---------- ---------- ---------- ---------- ----------
	2155	2 205480 3 0 05/0 6/11 EC MEPATIENT, SIX L IDOCAINE 0 .5% (5MG/M L) 50ML M
	2156	FINI SH 08/1 0/11 6:07p Status:E CME Billab le
	2157	ELIGIBILIT Y:
	2158	DRUG:LIDOC AINE 0.5% (5MG/ML) 5 0ML MDV
	2159	NDC:00409- 4278-01, B ILLED QTY: 30, COST:1 .486, DEA: 6P
	2160	Press RETU RN to cont inue, '^' to exit:
	2161	5.7.10 Gro up Plan Me nu XE "Gro up Plan Me nu"
	2162	The “GRPL” action al lows you t o access t he Group P lan Menu. This menu includes t hree selec tions - Ed it PLAN AP PLICATION Sub-file ( EPLA), Mat ch Group P lan to a P harmacy Pl an (MGP), and Match Multiple G roup Plans to a Phar macy Plan (MMGP).
	2163	Enter GRP L to acces s the Grou p Plan Men u option.
	2164	Example 5. 7.10-1: Ac cessing Gr oup Plan M enu
	2165	FURTHER RE SEARCH SCR EEN Nov 03, 20 10@15:27:5 4 Page: 1 of 30
	2166	SELECTED D IVISION(S) : ALL
	2167	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	2168	Sorted b y: Transac tion date by default
	2169	# PATIEN T/DRUG/COM MENTS IN SURANCE/ND C/DOS/RX#/ ECME# S TATUS/LOC/ TYP/RXINF
	2170	1 ECMEPa tient,,SIX (XXXX) OP INSUR2/205 5557898 VET Pb:1 0 Rj:2 AcR v:0 RjRv:1
	2171	1.1 SI METHICONE 40MG 0258 7542934 10 /26 110033 5$ 0/00 0000003119 W RT AC/R
	2172	p-Re jected
	2173	85:C laim Not P rocessed
	2174	NN:T ransaction Rejected At Switch Or Interme diary
	2175	02:M /I Version /Release N umber
	2176	EV11 7-D0 IS IN VALID VERS ION NUMBER
	2177	1.2 TR IAMTERENE 50MG, 0048 4359030 10 /26 110033 6$ 0/00 0000003120 W RT DS/R
	2178	p-Re versal Oth er
	2179	1.3 AM YL NITRITE 0.3M 0022 3700212 10 /27 110033 7$ 0/00 0000003122 W RT DS/R
	2180	p-Re versal Oth er
	2181	1.4 TR IAMTERENE 50MG, 0048 4359030 10 /27 110033 9$ 0/00 0000003124 W RT AC/R
	2182	p-Pa yable
	2183	+ Enter ?? f or more ac tions
	2184	INS Insur ance detai ls CT Claims Tr acking EVNT IB Events Rep ort
	2185	VE View Eligibilit y TPJI Third Par ty Inquiry GRPL Gro up Plan Me nu
	2186	VP View Prescripti on OH On Hold C opay List EX Exi t
	2187	CMT Add/V iew Commen ts RH Release C opay
	2188	Select act ion:Next S creen// GRPL Gr oup Plan M enu
	2189	- -- Group P lan Menu - --
	2190	EPLA Edit PLAN APPLI CATION Sub file
	2191	MGP Match Group Pla n to a Pha rmacy Plan
	2192	MMGP Match Multiple Group Plan s to a Pha rmacy Plan
	2193	Select Ite m(s):
	2194	5.7.11 Eli gibility I nquiry Opt ion XE " V iew Prescr iption"
	2195	The hidden “ELIG” Op tion acces ses the El igibility Inquiry Op tion, whic h allows t he sites t o verify p harmacy in surance fo r patients by sendin g an eligi bility ver ification submission to the th ird party payer.
	2196	When ELIG is entered at the “S elect Acti on:” field , you will be prompt ed for the line item of the pr escription you wish to display .
	2197	You can ed it the Rel ationship Code, Pers on Code, a nd Insuran ce Effecti ve Date.
	2198	Example 5. 7.11-1: Ac cessing El igibility Inquiry Op tion
	2199	FURTHER RE SEARCH SCR EEN Nov 03, 20 10@15:27:5 4 Page: 1 of 30
	2200	SELECTED D IVISION(S) : ALL
	2201	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	2202	Sorted b y: Transac tion date by default
	2203	# PATIEN T/DRUG/COM MENTS IN SURANCE/ND C/DOS/RX#/ ECME# S TATUS/LOC/ TYP/RXINF
	2204	1 ECMEPa tient,,SIX (XXXX) OP INSUR2/205 5557898 VET Pb:1 0 Rj:2 AcR v:0 RjRv:1
	2205	1.1 SI METHICONE 40MG 0258 7542934 10 /06 110033 5$ 0/00 0000003119 W RT AC/R
	2206	p-Re jected
	2207	85:C laim Not P rocessed
	2208	NN:T ransaction Rejected At Switch Or Interme diary
	2209	02:M /I Version /Release N umber
	2210	EV11 7-D0 IS IN VALID VERS ION NUMBER
	2211	1.2 TR IAMTERENE 50MG, 0048 4359030 10 /26 110033 6$ 0/00 0000003120 W RT DS/R
	2212	p-Re versal Oth er
	2213	1.3 AM YL NITRITE 0.3M 0022 3700212 10 /27 110033 7$ 0/00 0000003122 W RT DS/R
	2214	p-Re versal Oth er
	2215	1.4 TR IAMTERENE 50MG, 0048 4359030 10 /27 110033 9$ 0/00 0000003124 W RT AC/R
	2216	p-Pa yable
	2217	+ Enter ?? f or more ac tions
	2218	INS Insur ance detai ls CT Claims Tr acking EVNT IB Events Rep ort
	2219	VE View Eligibilit y TPJI Third Par ty Inquiry GRPL Gro up Plan Me nu
	2220	VP View Prescripti on OH On Hold C opay List EX Exi t
	2221	CMT Add/V iew Commen ts RH Release C opay
	2222	Select act ion:Next S creen// EL IG ELIG
	2223	Enter the line numbe r for the claim to b e submitte d for Elig ibility Ve rification
	2224	Select ite m: 1.1
	2225
	2226
	2227	You've cho sen to VER IFY Eligib ility of t he followi ng prescri ption for ECMEPATIEN T,
	2228	SIX
	2229	1.1 SI METHICONE 40MG 0258 7542934 10 /26 110033 5$ 0/00 0000003119 W RT AC/R
	2230	Are you su re?(Y/N)? YES
	2231	Relationsh ip Code: 1 // CARDHOLDER
	2232	Person Cod e: 01//
	2233	Effective Date: 10/ 06/2010// 11/3/2010
	2234
	2235	Are you su re?(Y/N)? YES
	2236
	2237	Not submit table: Eli gibility P ayer Sheet Not Found .
	2238
	2239	Enter RETU RN to cont inue or '^ ' to exit:
	2240	When you e nter QUIT, the syste m will ret urn you to the Furth er Researc h Screen.
	2241	When EX is entered a t the “Sel ect Action :” prompt from the F urther Res earch Scre en, the sy stem will return to the ECME U ser Screen .
	2242	Example 5. 7.11-2: En tering the EXIT Acti on from Fu rther Rese arch Scree n
	2243	FURTHER RE SEARCH SCR EEN Nov 03, 20 10@15:27:5 4 Page: 1 of 30
	2244	SELECTED D IVISION(S) : ALL
	2245	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	2246	Sorted b y: Transac tion date by default
	2247	# PATIEN T/DRUG/COM MENTS IN SURANCE/ND C/DOS/RX#/ ECME# S TATUS/LOC/ TYP/RXINF
	2248	1 ECMEPa tient,,SIX (XXXX) OP INSUR2/205 5557898 VET Pb:1 0 Rj:2 AcR v:0 RjRv:1
	2249	1.1 SI METHICONE 40MG 0258 7542934 10 /06 110033 5$ 0/00 0000003119 W RT AC/R
	2250	p-Re jected
	2251	85:C laim Not P rocessed
	2252	NN:T ransaction Rejected At Switch Or Interme diary
	2253	02:M /I Version /Release N umber
	2254	EV11 7-D0 IS IN VALID VERS ION NUMBER
	2255	1.2 TR IAMTERENE 50MG, 0048 4359030 10 /26 110033 6$ 0/00 0000003120 W RT DS/R
	2256	p-Re versal Oth er
	2257	1.3 AM YL NITRITE 0.3M 0022 3700212 10 /27 110033 7$ 0/00 0000003122 W RT DS/R
	2258	p-Re versal Oth er
	2259	1.4 TR IAMTERENE 50MG, 0048 4359030 10 /27 110033 9$ 0/00 0000003124 W RT AC/R
	2260	p-Pa yable
	2261	+ Enter ?? f or more ac tions
	2262	INS Insur ance detai ls CT Claims Tr acking EVNT IB Events Rep ort
	2263	VE View Eligibilit y TPJI Third Par ty Inquiry GRPL Gro up Plan Me nu
	2264	VP View Prescripti on OH On Hold C opay List EX Exi t
	2265	CMT Add/V iew Commen ts RH Release C opay
	2266	Select act ion:Next S creen// E X Exit
	2267	5.8 Print Claim Log (hidden ac tion) XE " Print Cla im Log"
	2268	The Print Claim Log option all ows you to print a d etailed hi story in r everse chr onological order of the third party clai ms and res ponses.
	2269	Enter the LOG action and a sin gle prescr iption lin e item to view the c laim log i nformation for a pre scription.
	2270	Example 5. 10-1: Acc essing the Print Cla im Log Opt ion
	2271	PHARMACY E CME Aug 12, 20 05@02:40:3 4 Page: 1 of 81
	2272	SELECTED D IVISION(S) : ALL
	2273	Transmitte d by ALL u sers Activity Date Rang e: within the past 3 0 day(s)
	2274	Sor ted by: Pa tient Name
	2275	# PATIEN T/DRUG/COM MENTS INSURANC E/NDC/RX#/ ECME# LOC /TYP RXINF
	2276	1 ECMEPa tient,,SIX (XXXX) OP INSUR2/205 5557898 VET Pb:1 0 Rj:2 AcR v:0 RjRv:1
	2277	1.1 SI METHICONE 40MG 0258 7542934 10 /06 110033 5$ 0/00 0000003119 W RT AC/R
	2278	p-Re jected
	2279	85:C laim Not P rocessed
	2280	NN:T ransaction Rejected At Switch Or Interme diary
	2281	02:M /I Version /Release N umber
	2282	EV11 7-D0 IS IN VALID VERS ION NUMBER
	2283	1.2 TR IAMTERENE 50MG, 0048 4359030 10 /06 110033 6$ 0/00 0000003120 W RT DS/R
	2284	p-Re versal Oth er
	2285	1.3 AM YL NITRITE 0.3M 0022 3700212 10 /07 110033 7$ 0/00 0000003122 W RT DS/R
	2286	p-Re versal Oth er
	2287	1.4 TR IAMTERENE 50MG, 0048 4359030 10 /07 110033 9$ 0/00 0000003124 W RT AC/R
	2288	p-Pa yable
	2289	+ Enter ?? f or more ac tions
	2290	CV Change View REV Reverse Pa yable Clai m FR Furt her Resear ch
	2291	SO Sort L ist RES Resubmit C laim VER View ePharmacy Rx
	2292	CMT Add/Vi ew Comment s CLO Close Clai m WRK Send to Workli st
	2293	Select Act ion: Next Screen// L OG Print Claim Log
	2294	Enter the line numbe r for whic h you wish to print claim logs .
	2295	Select ite m: 5.1
	2296	As the dat a pages pr int to you r screen, there are options to print the informati on to a de vice (type PRINT and the devic e name) or exit (typ e EXIT) or continue to display informati on, which is the def ault (pres s <Enter>) .
	2297	Example 5. 8-2: Disp laying Cla im Log Dat a for a Se lected Pre scription Line Item
	2298	PHARMACY E CME A ug 22, 200 5@13:58:50 Page: 1 of 7
	2299	Claim Log informatio n
	2300	Pharmacy E CME Log
	2301	Rx #: 9093 93/0 EC ME#: 00000 1105635
	2302	Drug: AMOX ICILLIN 25 0MG CAP
	2303	Pat ient: ECME patient,On e (0000) S ex: M DOB: J AN 1, 1954 (57)
	2304	Submi tted: JUN 15,2005@15 :19:11
	2305	By: ECME user,One
	2306	VA Cla im #: VA20 05=1234567 893=123456 =0000502
	2307	+ Enter ?? f or more ac tions
	2308	PR Print Data EX Exit
	2309	Select act ion:Next S creen// <E nter>
	2310	PHARMACY E CME Sep 11, 20 05@11:36:1 4 Page: 2 of 7
	2311	Claim Log informatio n
	2312	+
	2313	Transactio n Informat ion (#661) ---------- ---------- ---------- ---------- ---------
	2314	Created on : JUN 15,2 005@16:25: 48
	2315	Submitted By: ECMEUS ER,FOUR
	2316	Transactio n Type: RE QUEST
	2317	Date of Se rvice: 06/ 15/2005
	2318	NDC Code: 00068-0011 -10
	2319	NCPDP Qty: 60 ( )
	2320	Days Suppl y: 30
	2321	Division : ALBANY IS C
	2322	NPI#: 4000 000016
	2323	ECME Pharm acy: XXXXX XXXX
	2324	Billed Qty : 90 (EA) Unit Co st: .752 Gross A mt Due: 79 .08
	2325	Ingredient Cost: 67. 68 Dispe nsing Fee: 11.40
	2326	U&C Charge : 79.08 A dmin Fee: 0.00
	2327	Insurance Name: WEBM D
	2328	Rx Coordin ation of B enefits: P RIMARY
	2329	BIN: 12345 6
	2330	PCN: 11234 56789
	2331	Group ID: WEBMDTEST
	2332	Cardholder ID:
	2333	Patient Re lationship Code: CAR DHOLDER
	2334	Cardholder First Nam e: One
	2335	Cardholder Last Name : ECMEpati ent
	2336	Facility I D Qualifie r:
	2337	+ Enter ?? f or more ac tions
	2338	PR Print Data EX Exit
	2339	Select act ion:Next S creen// <E nter>
	2340	PHARMACY E CME Sep 11, 20 05@11:39:0 7 Page: 3 of 7
	2341	Claim Log informatio n
	2342	+
	2343	Plan ID: 8 729
	2344	Payer Shee t IEN: WBT ESTB1
	2345	B2 Payer S heet IEN: WBTESTB2
	2346	B3 Rebill Payer Shee t: WBTESTB 1
	2347	Certify Mo de:
	2348	Cert IEN:
	2349	+ Enter ?? f or more ac tions
	2350	PR Print Data EX Exit
	2351	Select act ion:Next S creen// <E nter>
	2352	PHARMACY E CME Sep 11, 20 05@11:39:5 1 Page: 4 of 7
	2353	Claim Log informatio n
	2354	+
	2355	Response I nformation (#661)--- ---------- ---------- ---------- ---------- ---------
	2356	Response R eceived: J UN 15,2005 @16:25:49
	2357	Date of Se rvice: 06/ 15/2005
	2358	Transactio n Response Status: P aid
	2359	Total Amou nt Paid: $ 40.00
	2360	Ingredient Cost Paid : $48.00 Dispensin g Fee Paid : $1.00
	2361	Patient Re sp (INS): ($9.00)
	2362	Reconcilia tion ID:
	2363	Reject cod e(s):
	2364	Payer Mess age:
	2365	Payer Addi tional Mes sage:
	2366	Reason for Service C ode: AD
	2367	DUR Text: AMOXICILLI N 250MG CA P
	2368	DUR Additi onal Text: The text would disp lay here
	2369	+ Enter ?? f or more ac tions
	2370	PR Print Data EX Exit
	2371	Select act ion:Next S creen// <E nter>
	2372	PHARMACY E CME Sep 11, 20 05@11:39:5 1 Page: 5 of 7
	2373	Claim Log informatio n
	2374	+
	2375	Transactio n Informat ion (#659) ---------- ---------- ---------- ---------- ---------
	2376	Created on : JUN 15,2 005@15:07: 34
	2377	Transactio n Type: RE QUEST
	2378	Date of Se rvice: 06/ 15/2005
	2379	NDC Code: 00068-0011 -10
	2380	NCPDP Qty: 60 ( )
	2381	Days Suppl y: 30
	2382	Division : ALBANY IS C
	2383	NPI#: 4000 000016
	2384	ECME Pharm acy: BAY P INES
	2385	Billed Qty : 90 (EA) Unit C ost: .752 Gross Amt Due: 7 9.08
	2386	Ingredient Cost: 67. 68 Dispe nsing Fee: 11.40
	2387	U&C Charge : 79.08 A dmin Fee: 0.00
	2388	Insurance Name: WEBM D
	2389	Rx Coordin ation of B enefits: P RIMARY
	2390	BIN: 12345 6
	2391	PCN: 11234 56789
	2392	Group ID: WEBMDTEST
	2393	Cardholder ID:
	2394	Patient Re lationship Code: CAR DHOLDER
	2395	Cardholder First Nam e: One
	2396	Cardholder Last Name : ECMEpati ent
	2397	Facility I D Qualifie r:
	2398	+ Enter ?? for more a ctions
	2399	PR Print Data EX Exit
	2400	Select act ion:Next S creen// <E nter>
	2401	PHARMACY E CME Sep 11, 20 05@11:42:4 1 Page: 6 of 7
	2402	Claim Log informatio n
	2403	+
	2404	Plan ID: 8 729
	2405	Payer Shee t IEN: WBT ESTB1
	2406	B2 Payer S heet IEN: WBTESTB2
	2407	B3 Rebill Payer Shee t: WBTESTB 1
	2408	Certify Mo de:
	2409	Cert IEN:
	2410	+ Enter ?? f or more ac tions
	2411	PR Print Data EX Exit
	2412	Select act ion:Next S creen// <E nter>
	2413	After the last data page has d isplayed o n your scr een, press ing <Enter > will def ault to “Q UIT” and t he system returns to the ECME User Scree n.
	2414	PHARMACY E CME Sep 11, 20 05@11:43:0 1 Page: 7 of 7
	2415	Claim Log informatio n
	2416	+
	2417	Response I nformation (#659)--- ---------- ---------- ---------- ---------- ---------
	2418	Response R eceived: J UN 15,2005 @15:18:30
	2419	Date of Se rvice: 06/ 15/2005
	2420	Transactio n Response Status: R ejected
	2421	Total Amou nt Paid: $ 0
	2422	Ingredient Cost Paid : Dispe nsing Fee Paid:
	2423	Patient Re sp (INS):
	2424	Reconcilia tion ID:
	2425	Reject cod e(s):
	2426	NN:Transa ction Reje cted At Sw itch Or In termediary
	2427	Payer Mess age: NC40- Request fr om an unkn own site. Registrat ion is req uired
	2428	Payer Addi tional Mes sage:
	2429	Reason for Service C ode: AD
	2430	DUR Text: AMOXICILLI N 250MG CA P
	2431	DUR Additi onal Text: The text would disp lay here
	2432	Enter ?? f or more ac tions
	2433	PR Print Data EX Exit
	2434	Select act ion:Quit// <Enter> QUIT
	2435	5.09 Send to Worklis t XE " Se nd to Work list"
	2436	The Send t o Worklist action al lows you t o send rej ected clai ms to the Pharmacy W orklist. D epending o n Pharmacy settings, all or on ly claims with certa in reject codes may be sent to the Pharm acy Workli st from th e ECME Use r Screen.
	2437	Claims tha t have bee n closed w ill be dis played wit h “/Closed ” after th e status. Closed cla ims cannot be sent t o the Phar macy Work List. If y ou attempt to resubm it a claim that is c losed, a m essage is displayed telling yo u that the claim “is closed an d cannot b e sent to the Pharma cy Work Li st”.
	2438	Enter WRK at the Sel ect Action prompt, a nd a singl e line ite m for the claim you wish to se nd.
	2439	Example 5. 09-1: Acc essing the Send to W orklist Op tion, and Entering a Line Item .
	2440	PHARMACY E CME Jul 03, 20 08@12:04:0 2 Page: 1 of 41
	2441	SELECTED D IVISION(S) : ALL
	2442	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	2443	Sorted b y: Transac tion date by default
	2444	# PATIEN T/DRUG/COM MENTS IN SURANCE/ND C/DOS/RX#/ ECME# LOC/ TYP RXINF
	2445	1 ECMEpa tient,One (XXXX) NON TRIC/ V ET Pb:0 Rj :6 AcRv:3 RjRv:2
	2446	1.1 AL BUTEROL 0. 5% IN 503 83-0741-20 07/03 205 4905$ 1 /000001614 782 W RT * */R
	2447	p-Re jected
	2448	07:M /I Cardhol der ID
	2449	1.2 JA PANESE ENC EPHAL 492 81-0680-30 06/27 205 5040$ 0 /000001614 918 W RT * */N
	2450	p-In progress- Parsing r esponse
	2451	1.3 JA PANESE ENC EPHAL 492 81-0680-30 07/03 205 5040$ 1 /000001614 918 W RT D IS/N
	2452	p-In progress- Parsing r esponse
	2453	1.4 OL ANZAPINE 1 0MG T 000 02-4117-30 06/29 205 5048$ 0 /000001614 926 W RT D IS/N
	2454	p-In progress- Parsing r esponse
	2455	1.5 OL ANZAPINE 1 0MG T 000 02-4117-30 06/29 205 5049$ 0 /000001614 927 W RT * */N
	2456	p-Re versal acc epted/Clos ed
	2457	1.6 OL ANZAPINE 1 0MG T 000 02-4117-30 07/03 205 5049$ 1 /000001614 927 W RT A C/N
	2458	+ Enter ?? f or more ac tions
	2459	CV Change View REV Reverse Pa yable Clai m FR Furt her Resear ch
	2460	SO Sort L ist RES Resubmit C laim VER View ePharmacy Rx
	2461	CMT Add/Vi ew Comment s CLO Close Clai m WRK Send to Workli st
	2462	Select Act ion: Next Screen// w rk Send to Worklis t
	2463	Enter the line numbe rs for the claim(s) to send to the Pharm acy Workli st.
	2464	Select ite m(s): 1.1
	2465	You've cho sen to sen d to Pharm acy Work L ist the fo llowing:
	2466	1.1 AL BUTEROL 0. 5% IN 503 83-0741-20 06/03 205 4905$ 1 /000001614 782 W RT * */R
	2467	Comment fo r Pharmacy : Needs t o be resol ved in Pha rmacy.
	2468	Eligible c laim(s) wi ll be sent to the Ph armacy Wor klist...
	2469	Are you su re?(Y/N)? y YES
	2470	1.1 AL BUTEROL 0. 5% IN 503 83-0741-20 07/03 205 4905$ 1 /000001614 782 W RT * */R
	2471	has been s ent to the Pharmacy Work List.
	2472	Enter RETU RN to cont inue or '^ ' to exit:
	2473	Updating s creen...
	2474	The system updates t he ECME Us er Screen with the d ate, the s tatus, any comments entered, a nd the nam e of the u ser who co mpleted th e action.
	2475	Example 5. 09-2: The Updated U ser Screen
	2476	PHARMACY E CME Jul 03, 20 08@12:04:4 8 Page: 1 of 41
	2477	SELECTED D IVISION(S) : ALL
	2478	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	2479	Sorted b y: Transac tion date by default
	2480	# PATIEN T/DRUG/COM MENTS IN SURANCE/ND C/DOS/RX#/ ECME# LOC/ TYP RXINF
	2481	1 ECMEpa tient,One (XXXX) NON TRIC/ V ET Pb:0 Rj :6 AcRv:3 RjRv:2
	2482	1.1 AL BUTEROL 0. 5% IN 503 83-0741-20 06/03 205 4905$ 1 /000001614 782 W RT * */R
	2483	07/2 3/08 - Sen t to Pharm acy: Needs to be res olved in P harmacy.
	2484	(ECM EUSER,FOUR )
	2485	p-Re jected
	2486	07:M /I Cardhol der ID
	2487	1.2 JA PANESE ENC EPHAL 492 81-0680-30 06/27 205 5040$ 0 /000001614 918 W RT * */N
	2488	p-In progress- Parsing r esponse
	2489	1.3 JA PANESE ENC EPHAL 492 81-0680-30 07/03 205 5040$ 1 /000001614 918 W RT D S/N
	2490	p-In progress- Parsing r esponse
	2491	1.4 OL ANZAPINE 1 0MG T 000 02-4117-30 06/29 205 5048$ 0 /000001614 926 W RT D S/N
	2492	p-In progress- Parsing r esponse
	2493	1.5 OL ANZAPINE 1 0MG T 000 02-4117-30 06/29 205 5049$ 0 /000001614 927 W RT * */N
	2494	+ Enter ?? f or more ac tions
	2495	CV Change View REV Reverse Pa yable Clai m FR Furt her Resear ch
	2496	SO Sort L ist RES Resubmit C laim VER View ePharmacy Rx
	2497	CMT Add/Vi ew Comment s CLO Close Clai m WRK Send to Workli st
	2498	Select Act ion: Next Screen//
	2499	If an inva lid claim is selecte d, other m essages ma y appear.
	2500	Example 5. 09-3: Sel ected Clai m Already on the Pha rmacy Work list
	2501	1.15 TAZAROTENE 0.1% T 0 0023-0042- 03 07/15 2 055208$ 0/0000016 15107 W RT AC/N
	2502	07/1 5/08 - Sen t to Pharm acy:testin g
	2503	+ Enter ?? f or more ac tions
	2504	CV Change View REV Reverse Pa yable Clai m FR Furt her Resear ch
	2505	SO Sort L ist RES Resubmit C laim VER View ePharmacy Rx
	2506	CMT Add/Vi ew Comment s CLO Close Clai m WRK Send to Workli st
	2507	Select Act ion: Next Screen// w rk Send to Worklis t
	2508	Enter the line numbe rs for the claim(s) to send to the Pharm acy Workli st.
	2509	Select ite m(s): 1.15
	2510	You've cho sen to sen d to Pharm acy Work L ist the fo llowing:
	2511	1.15 TA ZAROTENE 0 .1% T 000 23-0042-03 07/15 205 5208$ 0 /000001615 107 W RT A C/N
	2512	was ALREAD Y sent to the Pharma cy Work Li st.
	2513	Enter the line numbe rs for the claim(s) to send to the Pharm acy Workli st.
	2514	Select ite m(s):
	2515	Example 5. 09-4: Sel ected Clai m Doesn’t Have an El igible Rej ect Code
	2516	Enter the line numbe rs for the claim(s) to send to the Pharm acy Workli st.
	2517	Select ite m(s):
	2518	You've cho sen to sen d to Pharm acy Work L ist the fo llowing:
	2519	1.11 ALLOP URINOL 100 MG 00364- 0632-02 02 /18 788538 $ 0/00 0001459640 W RT AC/N
	2520	doesn't ha ve eligibl e reject c ode to be sent to th e Pharmacy Work List .
	2521	Example 5. 09-5: Sel ected Clai m Has Not Been Rejec ted
	2522	Enter the line numbe rs for the claim(s) to send to the Pharm acy Workli st.
	2523	Select ite m(s):
	2524	You've cho sen to sen d to Pharm acy Work L ist the fo llowing:
	2525	1.11 ACARB OSE 25MG T AB 00026- 2863-51 03 /03 788628 $ 0/00 0001459751 W RT DS/N
	2526	was not re jected and cannot be sent to t he Pharmac y Work Lis t.
	2527	Example 5. 09-6: Sel ected Clai m is Close d
	2528	1.22 ERYT HRITYL TET RAN 00223 -0916-01 0 4/03 10202 8$ 3/0 0000000240 3 W RT DL/ N
	2529	04/0 6/09 - RX DELETED
	2530	(ECM Eemployee, One)
	2531	p-Re jected/Clo sed
	2532	88:D UR Reject Error
	2533	1.23 ME THANTHELIN E 50M 000 14-1501-31 03/13 102 029$ 0 /000000002 404 W RT A C/N
	2534	p-Re jected
	2535	79:R efill Too Soon
	2536	+--------- Enter ?? f or more ac tions----- ---------- ---------- ---------- ----------
	2537	CV Change View REV Reverse Pa yable Clai m FR Furt her Resear ch
	2538	SO Sort L ist RES Resubmit C laim VER View ePharmacy Rx
	2539	CMT Add/Vi ew Comment s CLO Close Clai m WRK Send to Workli st
	2540	Select Act ion: Next Screen// W RK Send to Worklis t
	2541	Enter the line numbe rs for the claim(s) to send to the Pharm acy Workli st.
	2542	Select ite m(s): 1.22
	2543	You've cho sen to sen d to Pharm acy Work L ist the fo llowing:
	2544	1.22 ER YTHRITYL T ETRAN 002 23-0916-01 04/03 102 028$ 3 /000000002 403 W RT D E/N
	2545	is closed and cannot be sent t o the Phar macy Work List.
	2546	Enter the line numbe rs for the claim(s) to send to the Pharm acy Workli st.
	2547	Select ite m(s):
	2548	5.10 Reope n Closed C laims (hid den action ) XE " Reo pen Closed Claims (h idden opti on)"
	2549	The Reopen Closed Cl aims hidde n action a llows you to reopen closed cla ims direct ly from th e User Scr een instea d of havin g to acces s this fun ctionality from the ECME Trans action Mai ntenance O ptions men u. The BPS MANAGER s ecurity ke y is requi red to use this opti on.
	2550	Enter ROC at the “Se lect Actio n:” prompt to access the optio n, and sel ect a line item.
	2551	Example 5. 10-1: Acc essing the Reopen Cl osed Claim s Option
	2552	PHARMACY E CME Mar 27, 20 09@16:26:5 0 Page: 1 of 41
	2553	SELECTED D IVISION(S) : ALL
	2554	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	2555	Sorted b y: Transac tion date by default
	2556	-#--PATIEN T/DRUG/COM MENTS IN SURANCE/ND C/DOS/RX#/ ECME# LOC/ TYP RXINF
	2557	1 ECMEpa tient,One (XXXX) OP INSUR2/205 5557898 VET ALL pa yable
	2558	1.1 DO XEPIN 25MG CAP 008 39-7221-06 03/27 102 105$ 0 /000000002 484 W BB A C/R
	2559	p-Pa yable
	2560	1.2 ME THAZOLAMID E 50M 000 05-5470-23 03/27 102 106$ 0 /000000002 485 W BB A C/R
	2561	p-Pa yable
	2562	2 ECMEpa tient,Two (XXXX) OP INSUR1/ VET Pb:53 Rj:28 AcRv :21 RjRv:6
	2563	2.1 ME DROXYPROGE STRON 000 09-0050-02 06/20 101 171$ 0 /000000001 521 W RT D S/N
	2564	06/2 0/08 - Cla rification Code 99 s ubmitted.
	2565	(ECM Euser,One)
	2566	p-Re versal acc epted
	2567	2.2 RE SERPINE 0. 1MG S 985 21-4587-02 03/26 101 237A$ 0 /000000001 695 C RT D S/R
	2568	p- R ejected/Cl osed
	2569	2.3 FU ROSEMIDE 1 0MG/M 510 79-0935-20 03/21 101 646$ 0 /000000002 014 W RT D S/N
	2570	+--------- Enter ?? f or more ac tions----- ---------- ---------- ---------- ----------
	2571	CV Change View REV Reverse Pa yable Clai m FR Furt her Resear ch
	2572	SO Sort L ist RES Resubmit C laim VER View ePharmacy Rx
	2573	CMT Add/Vi ew Comment s CLO Close Clai m WRK Send to Workli st
	2574	Select Act ion: Next Screen// R OC ROC
	2575	Enter the line numbe r for the claim you want to re open.
	2576	Select ite m(s): 2.2
	2577	You've cho sen to reo pen the fo llowing pr escription s(s) for
	2578	ECMEpatien t,One:
	2579	2.2 RE SERPINE 0. 1MG S 985 21-4587-02 03/26 101 237A$ 0 /000000001 695 C RT DS/R
	2580	All Select ed Rxs wil l be reope ned using the same i nformation gathered in the
	2581	following prompts.
	2582	Are you su re?(Y/N)? YES
	2583	You are pr ompted to enter Reop en Comment s, after c laim infor mation is displayed. Once you enter a co mment, you are asked if you wa nt to reop en this cl aim.
	2584	Example 5. 10-2: Ente ring Text Comment fo r Reopened Closed Cl aim
	2585	REOPEN COM MENTS: Cla im reopene d for new refill
	2586	ARE YOU SU RE YOU WAN T TO RE-OP EN THIS CL AIM? (Y/N) ? No// YES
	2587	ReOpening Claim: VA2 009=400000 0016=10522 0=0005843 ... OK
	2588	1 claim ha s been reo pened.
	2589	Enter RETU RN to cont inue or '^ ' to exit: <Enter>
	2590	Once the c laim has b een succes sfully reo pened, the screen is updated a nd re-disp layed.
	2591	Example 5. 10-3: The User Scree n is Updat ed and Re- Displayed
	2592	Updating s creen for reopened c laims...
	2593	PHARMACY E CME Mar 27, 20 09@16:28:3 2 Page: 1 of 41
	2594	SELECTED D IVISION(S) : ALL
	2595	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	2596	Sorted b y: Transac tion date by default
	2597	-#--PATIEN T/DRUG/COM MENTS IN SURANCE/ND C/DOS/RX#/ ECME# LOC/ TYP RXINF
	2598	1 ECMEpa tient,One (XXXX) OP INSUR2/205 5557898 VET ALL pa yable
	2599	1.1 DO XEPIN 25MG CAP 008 39-7221-06 03/27 102 105$ 0 /000000002 484 W BB A C/R
	2600	p-Pa yable
	2601	1.2 ME THAZOLAMID E 50M 000 05-5470-23 03/27 102 106$ 0 /000000002 485 W BB A C/R
	2602	p-Pa yable
	2603	2 ECMEpa tient,Two (XXXX) OP INSUR1/ VET Pb:53 Rj:28 AcRv :21 RjRv:6
	2604	2.1 ME DROXYPROGE STRON 000 09-0050-02 03/20 101 171$ 0 /000000001 521 W RT D S/N
	2605	06/2 0/08 - Cla rification Code 99 s ubmitted.
	2606	(ECM Euser,One)
	2607	p-Re versal acc epted
	2608	2.2 RE SERPINE 0. 1MG S 985 21-4587-02 03/26 101 237A$ 0 /000000001 695 C RT D S/R
	2609	p-Re jected
	2610	2.3 FU ROSEMIDE 1 0MG/M 510 79-0935-20 03/21 101 646$ 0 /000000002 014 W RT D S/N
	2611	CV Change View REV Reverse Pa yable Clai m FR Furt her Resear ch
	2612	SO Sort L ist RES Resubmit C laim VER View ePharmacy Rx
	2613	CMT Add/Vi ew Comment s CLO Close Clai m WRK Send to Workli st
	2614	Select Act ion: Next Screen//
	2615	5.11 Resub mit with E dits (hidd en action) XE " Resu bmit with Edits (hid den option )"
	2616	The Resubm it with Ed its hidden action al lows you t o edit pre viously re jected ele ctronic ph armacy cla ims and to resubmit them with the edited informati on. The da ta fields that can b e edited t o enable r esubmissio n are the Pharmacy R elationshi p Code, Ph armacy Per son Code, Prior Auth orization Number, Pr ior Author ization Ty pe Code, u p to three Submissio n Clarific ation Code s (if the conditions explained below do not exist) , Date of Service, P atient Res idence Cod e, Pharmac y Service Type Code, Delay Rea son Code, and/or NCP DP Field N ame or Num ber. (The Date of Se rvice prom pt is only asked if the prescr iption has been rele ased.) If the claim selected is for sec ondary ins urance, th e Coordina tion of Be nefits inf ormation c an also be edited.
	2617	The relati onship cod e describe s the rela tionship t his patien t has to t he holder of this in surance po licy. The standard N CPDP Patie nt Relatio nship Code list foll ows. Howev er, it is important to note th at some pa yers use t heir own s et of code s for this field, so the field should be populated based upo n the paye r's expect ations.
	2618
	2619	0 Not Sp ecified
	2620
	2621	1 Cardho lder
	2622
	2623	2 Spouse
	2624
	2625	3 Child
	2626
	2627	4 Other
	2628	The Person Code is t he specifi c person c ode assign ed to the patient by the payer . The Prio r Authoriz ation numb er is the number sub mitted by the provid er to iden tify the p rior autho rization. For more i nformation on the Co ordination of Benefi ts fields, see the P rocess Sec ondary/TRI CARE Rx to ECME sect ion of thi s document .
	2629	The Submis sion Clari fication C ode cannot be edited if eithe r of these condition s exists:
	2630	An unresol ved reject is on the pharmacis ts’ workli st
	2631	A resolved reject of RTS (79-R efill Too Soon) or D UR (88-Dru g Utilizat ion Review ) is from the last c laim respo nse.
	2632	If neither condition exists, t he Submiss ion Clarif ication Co de is edit able. If either con dition exi sts, the S ubmission Clarificat ion Code p rompt is b ypassed an d a messag e is displ ayed on th e screen i ndicating the field cannot be edited.
	2633	You've cho sen to RES UBMIT the following prescripti on for ECM Epatient,f our
	2634	1.2 AL BUTEROL 0. 5% IN 2420 8034720 02 /22 000000 0 0/00 0000000003 W RT DS/N
	2635	Are you su re?(Y/N)? YES
	2636	Pharmacy R elationshi p Code: 1/ / C ARDHOLDER
	2637	Pharmacy P erson Code : 125//
	2638	Prior Auth orization Number: 00 000000000/ /
	2639	Prior Auth orization Type Code: 0// NOT SPEC IFIED
	2640	Submission Clarifica tion Code 1: 1 NO OVE RRIDE
	2641	**OPECC c annot edit Sub. Clar . Code fie ld for thi s reject - refer to Pharmacist
	2642	Patient Re sidence Co de: 1//
	2643	By answeri ng YES to Submit NCP DP Field N ot on Paye r Sheet, i t becomes possible t o submit a NCPDP fie ld that is not on th e payer sh eet. When prompted for the fi eld name o r number, enter “??” for a lis t of possi ble choice s. Fields already o n the paye r sheet ar e excluded from the list of po ssible cho ices. Als o excluded are any f ields that do not ha ve logic t o pull dat a from Vis tA (i.e. f ields that will alwa ys be <bla nk>).
	2644	Submit NCP DP Field N ot on Paye r Sheet (Y /N)? N// Y ES
	2645	Enter a va lid NCPDP Field name or number . Enter ' ??' for
	2646	a list of possible c hoices. F ields alre ady on the payer she et
	2647	are exclud ed from th e list of possible c hoices. A lso exclud ed
	2648	are any fi elds that do not hav e logic to pull data from Vist A
	2649	(i.e. fiel ds that wi ll always be <blank> ).
	2650	NCPDP Fiel d Name or Number: ? ?
	2651	Choose from:
	2652	498.12 PRE SCRIBER TE LEPHONE NU MBER
	2653	678 TIME O F SERVICE
	2654	B08 PATIEN T STREET A DDRESS LIN E 1
	2655	B09 PATIEN T STREET A DDRESS LIN E 2
	2656	B27 PRESCR IBER STREE T ADDR LIN E 1
	2657	B28 PRESCR IBER STREE T ADDR LIN E 2
	2658	B38 PATIEN T ID ASSOC COUNTRY C ODE
	2659	B41 PRES I D ASSOC CO UNTRY CODE
	2660	B42 PRESCR IBER COUNT RY CODE
	2661	B98 RECONC ILIATION I D
	2662	NCPDP Fiel d Name or Number: 6 78 T IME OF SER VICE
	2663	Value to transmi t: 085354
	2664	Transmit w ith claim (Y/N)? Y//
	2665	Claims tha t have bee n closed w ill be dis played wit h “/Closed ” after th e status. Closed cla ims cannot be resubm itted with edits. If you attem pt to resu bmit a cla im that is closed, a message i s displaye d telling you that t he claim i s “Closed and cannot be Resubm itted w/Ed its.”
	2666	Enter RED at the “Se lect Actio n:” prompt to choose the presc ription li ne to resu bmit.
	2667	Example 5. 11-1: Acc essing the Resubmit with Edits Option
	2668	PHARMACY E CME Aug 12, 20 11@02:40:3 4 Page: 1 of 81
	2669	SELECTED D IVISION(S) : ALL
	2670	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	2671	Sor ted by: Pa tient Name
	2672	# PATIEN T/DRUG/COM MENTS INSURANC E/NDC/RX#/ ECME# LOC /TYP RXINF
	2673	5 ECMEpa tient,Two (XXXX) WE BMD / VET AL L payable
	2674	5.1 LE UCOVORIN 5 MG/ML 007 03-5140-01 08/12 109 58860$ 0 /000009378 798 W RT A C/N
	2675	p-Re versal rej ected
	2676	6 ECMEpa tient,One (XXXX) WEB MD / VET Pb: 3 Rj:1 AcR v:1 RjRv:0
	2677	6.1 GR ANULEX SPR AY 4O 005 14-0001-01 08/12 109 58847 0 /000009378 705 W RT A C/R
	2678	p-Pa yable
	2679	6.2 AC ARBOSE 100 MG TA 000 26-2862-51 08/12 525 36284 1 /000009378 782 W RT D S/N
	2680	03/2 0/06 - RX DISCONTINU ED
	2681	p-Re jected
	2682	08:M /I Person Code
	2683	+ Enter ?? f or more ac tions
	2684	CV Change View REV Reverse Pa yable Clai m FR Furt her Resear ch
	2685	SO Sort L ist RES Resubmit C laim VER View ePharmacy Rx
	2686	CMT Add/Vi ew Comment s CLO Close Clai m WRK Send to Workli st
	2687	Select Act ion: Quit/ / RED RE D
	2688	Enter the line numbe r for the claim to b e submitte d.
	2689	Example 5. 11-2: Ent ering the Line Item for the Cl aim Resubm ission Req uest
	2690	Enter the line numbe r for the claim to b e resubmit ted:
	2691	Select ite m: 6.2
	2692	If you att empt to re submit a p rimary cla im when th ere is a p ayable sec ondary cla im, you wi ll see the following message, which will discontin ue the cla ims resubm ission pro cess.
	2693	Example 5. 11-3: Ente ring the L ine Item f or a Claim that has a Payable Secondary Claim
	2694	The claim:
	2695	1.12 FLU RAZEPAM 15 MG C 00140 -0065-14 0 3/04 10232 2$ 2/00000 0113596 W RT AC/R
	2696	cannot be Resubmitte d if the s econdary c laim is pa yable.
	2697	Please rev erse the s econdary c laim first .
	2698	You can en ter Y or N to the “A RE YOU SUR E?” prompt . If you a nswer Y, t he claim r esubmissio n process will conti nue.
	2699	Example 5. 11-4: Ente ring Yes t o “Are You Sure” Pro mpt
	2700	You've cho sen to RES UBMIT the following prescripti on for ECM Epatient, One
	2701	1.2 LI DOCAINE 0. 5% W/ 001 86-0140-01 07/09 100 704$ 1 /000000000 623 W RT A C/N
	2702	ARE YOU SU RE? (Y/N)? No// YES
	2703	You can ed it the Pha rmacy Rela tionship C ode, Pharm acy Person Code, Pri or Authori zation Num ber, Prior Authoriza tion Type Code, up t o three Su bmission C larificati on Codes ( if the con ditions ex plained ab ove are no t met), Da te of Serv ice, Patie nt Residen ce Code, P harmacy Se rvice Type Code and/ or Delay R eason Code .
	2704	Example 5. 11-5: Edit ing Prompt s
	2705	Pharmacy R elationshi p Code: <E nter>
	2706	Pharmacy P erson Code : 23
	2707	Prior Auth orization Number: 00 000000000/ /
	2708	Prior Auth orization Type Code: 0// NOT SPEC IFIED
	2709	Submission Clarifica tion Code 1: 5// THERAP Y CHANGE
	2710	Submission Clarifica tion Code 2:
	2711
	2712	Select one of the fo llowing:
	2713	1. 01/19/2 010 Curre nt Date of Service
	2714	2. 01/19/2 010 Fill Date
	2715	3. 01/20/2 010 Relea se Date
	2716	Date of Se rvice: 1// 2 01/19/2 010 Fill D ate
	2717	Patient Re sidence Co de: 1// HOME
	2718	Pharmacy S ervice Typ e Code: 1/ / R ETAIL
	2719	Delay Reas on Code:
	2720	The Resubm it with Ed its (RED) option wil l display the inform ation that will be u sed to pop ulate the Coordinati on of Bene fit fields in the se condary cl aim. If an y of the i nformation is missin g, the use r will be required t o edit the secondary claim inf ormation. If all the informati on is pres ent, the u ser is giv en the opt ion to edi t the data that will be sent o n the seco ndary clai m. The use r will als o be able to enter t he rate ty pe for the secondary claim.
	2721	Example 5. 11-6: Ente ring the s econdary c laim infor mation wit h payment informatio n
	2722	Data for S econdary C laim
	2723	---------- ---------- ----
	2724	Insurance: ECME INS URANCE2 COB: SECON DARY
	2725	Rate Type: REIMBURS ABLE INS.
	2726	Other Cove rage Code: 02 (OTHE R COVERAGE EXISTS - PAYMENT CO LLECTED)
	2727	Other Paye r Coverage Type: 01 (PRIMARY)
	2728	Other Paye r ID Quali fier: 03 (BANK INFO RMATION NU MBER (BIN) )
	2729	Other Paye r ID: 123 456
	2730	Other Paye r Date: J un 28, 201 0
	2731	Other Paye r Paid Qua lifier: 0 8 (SUM OF ALL REIMBU RSEMENT)
	2732	Other Paye r Amount P aid: 40.0 0
	2733	Do you wan t to edit this Secon dary Claim Informati on (Y/N)? N// y YES
	2734	Insura nce CO B Subscri ber ID Gro up Ho lder Eff ective Ex pires
	2735	====== ======= == == ======= ====== === ======= == ====== === ======= == ========
	2736	1 ECME I NSURAN PRI 12340987 T-GR OUP1 PAT IENT 10/2 0/2006 06/ 00/2011
	2737	2 ECME I NSURAN SEC D-GR OUP1 PAT IENT 07/0 9/2006 06/ 00/2011
	2738	SECONDARY INSURANCE POLICY: 2/ / ECME I NSURANCE1 (SECONDARY ) - D-GROU P1
	2739	SELECT RAT E TYPE: RE IMBURSABLE INS.// Who's Re sponsible: INSURER
	2740	OTHER COVE RAGE CODE: 02// O THER COVER AGE EXISTS - PAYMENT COLLECTED
	2741	OTHER PAYE R ID: 1234 56//
	2742	OTHER PAYE R DATE: J un 28, 201 0//
	2743	Edit Paid Amounts or Reject Co des (PAID AMOUNTS/RE JECT CODES ): PAID A MOUNTS//
	2744	OTHER PAYE R AMOUNT P AID QUALIF IER: 08// SUM OF ALL REIMBU RSEMENT
	2745	OTHER PAYE R AMOUNT P AID: (0-9 99999): 40 .00// 40. 00
	2746	OTHER PAYE R PATIENT RESPONSIBI LITY AMOUN T QUALIFIE R: 06 (AMT REPORTED BY PRIOR P AYER)
	2747	OTHER PAYE R PATIENT RESPONSIBI LITY AMOUN T: 12.38
	2748	Example 5. 11-7: Ente ring the s econdary c laim infor mation wit h reject i nformation
	2749	Data for S econdary C laim
	2750	---------- ---------- ----
	2751	Insurance: DAVE INS URANCE COB: SECON DARY
	2752	Rate Type: REIMBURS ABLE INS.
	2753	Other Cove rage Code: 03 (OTHE R COVERAGE EXISTS - THIS CLAIM NOT COVER ED)
	2754	Other Paye r Coverage Type: 01 (PRIMARY)
	2755	Other Paye r ID Quali fier: 03 (BANK INFO RMATION NU MBER (BIN) )
	2756	Other Paye r ID: 610 459
	2757	Other Paye r Date: A ug 16, 201 0
	2758	Other Paye r Reject C ode: 34:M /I Submiss ion Clarif ication Co de
	2759	Other Paye r Reject C ode: 07:M /I Cardhol der ID
	2760	Other Paye r Reject C ode: JE:M /I Percent age Sales Tax Basis Submitted
	2761	Do you wan t to edit this Secon dary Claim Informati on (Y/N)? N// y YES
	2762	Insura nce CO B Subscri ber ID Gro up Ho lder Eff ective Ex pires
	2763	====== ======= == == ======= ====== === ======= == ====== === ======= == ========
	2764	1 DAVE I NSURANC SE C SI32432 D-G ROUP1 PA TIENT 05/ 09/2007
	2765	SECONDARY INSURANCE POLICY: 1/ / DAVE I NSURANCE ( SECONDARY) - D-GROUP 1
	2766	SELECT RAT E TYPE: RE IMBURSABLE INS.// Who's Re sponsible: INSURER
	2767	OTHER COVE RAGE CODE: 03// O THER COVER AGE EXISTS - THIS CL AIM NOT CO VERED
	2768	OTHER PAYE R ID: 6104 59//
	2769	OTHER PAYE R DATE: A ug 16, 201 0//
	2770	Edit Paid Amounts or Reject Co des (PAID AMOUNTS/RE JECT CODES ): REJECT CODES//
	2771	OTHER PAYE R REJECT C ODE: 34// M/I Submissio n Clarific ation Code
	2772	OTHER PAYE R REJECT C ODE: 07// M/I Cardholde r ID
	2773	OTHER PAYE R REJECT C ODE: JE// M/I Percentag e Sales Ta x Basis Su bmitted
	2774	OTHER PAYE R REJECT C ODE:
	2775	The Resubm it with Ed its (RED) option wil l prompt i f the clai m is corre ct and if the claim should be submitted to the thi rd party i nsurance. If the use r answers 'Yes' to b oth of the se prompts , the clai m will be submitted. If the us er chooses “No”, the action wi ll be canc elled.
	2776	Example 5. 11-8: Answ ering “Is the Claim Correct?” Prompt
	2777	IS THIS CL AIM CORREC T?(Y/N)? Y // ES
	2778	SUBMIT CLA IM TO ECME INSURANCE 1 ?(Y/N)? Y// ES
	2779	Veteran Pr escription 103689 su ccessfully submitted to ECME f or claim g eneration.
	2780	Example 5. 11-9: Answ ering “Are you sure? ” Prompt
	2781	Are you su re?(Y/N)? YES
	2782	Veteran Pr escription 100003433 A successf ully submi tted to EC ME for cla im generat ion.
	2783	Claim Stat us:
	2784	IN PROGRES S-Waiting to start
	2785
	2786	IN PROGRES S-Waiting for packet build
	2787	IN PROGRES S-Packet b eing built
	2788	IN PROGRES S-Transmit ting
	2789	E PAYABLE
	2790	Veteran Pr escription 100003433 A successf ully submi tted to EC ME for cla im generat ion.
	2791	1 claim ha s been res ubmitted.
	2792	Enter RETU RN to cont inue or '^ ' to exit: <Enter>
	2793	Updating s creen for resubmitte d claim...
	2794	5.12 OPEC C Reject I nformation (hidden a ction)
	2795	The OPECC Reject Inf ormation h idden acti on allows the user t o view det ails assoc iated with a rejecte d claim. T his action is only a vailable f or claims with open rejections and non-b illable pr escription s with pse udo-reject ions of eC or eT.
	2796	Access the action by entering REJ at the “Select A ction:” pr ompt on th e ECME Use r Screen.
	2797	Example 5. 12-1: Acc essing and Executing the OPECC Reject In formation Action
	2798	PHARMACY E CME Aug 10, 20 05@10:31:2 2 Page: 1 8 of 42
	2799	SELECTED D IVISION(S) : ALL
	2800	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	2801	Sor ted by: Pa tient Name
	2802	+# PATIEN T/DRUG/COM MENTS INSURANC E/NDC/RX#/ ECME# LOC /TYP RXINF
	2803	7 ECMEpa tient,One (XXXX) WE BMD TE/ VET A LL payable
	2804	7.1 PR EDNISONE 1 MG TA 0024 2074475 09 /16 100803 0/00 0000111872 W RS AC/N
	2805	09/1 0/15 – The comment g oes here.
	2806	(USE R, ONE)
	2807	p-Re jected
	2808	79:R efill Too Soon
	2809	+ Enter ?? f or more ac tions
	2810	CV Change View REV Reverse Pa yable Clai m FR Furt her Resear ch
	2811	SO Sort L ist RES Resubmit C laim VER View ePharmacy Rx
	2812	CMT Add/Vi ew Comment s CLO Close Clai m WRK Send to Workli st
	2813	Select Act ion: Next Screen// R EJ REJ OPECC Reje ct Informa tion
	2814	You will s ee the fol lowing mes sage, if y ou attempt to select a claim w hen there is no reje ction.
	2815	Example 5. 12-2: Ent ering the Line Item for a Clai m with no rejection
	2816	This claim is not a valid sele ction for the OPECC Reject Inf ormation s creen.
	2817	This scree n is for e ither reje cted claim s or non-b illable cl aims.
	2818	Enter RETU RN to cont inue or '^ ' to exit:
	2819	You are p rompted fo r the line item of t he rejecte d claim or non-billa ble prescr iption ent ry.
	2820	Example 5. 12-3: Ent ering the Line Item for the OP ECC Reject Informati on Action
	2821	Select Act ion: Next Screen// R EJ REJ OPECC Reje ct Informa tion
	2822	Select ite m: 7.1
	2823	The OPECC Reject Inf ormation S creen disp lays.
	2824	Example 5. 12-4: OPE CC Reject Informatio n Screen D isplay
	2825	OPECC Reje ct Informa tion Oct 28, 20 15@14:45:4 2 Page: 1 of 3
	2826	Division : XXXXXX N PI: 111009 9999 NCP DP: 531000 0XX TAX I D: XX-XXXX XXX
	2827	Patient : PATIENT,O NE(XXXP) Sex: M DOB: JUL X X,19XX(XX)
	2828	Rx# : 100XXX/0 ECME #: 0000001 11872 Da te of Serv ice: Sep 1 6, 2015
	2829	Drug : PREDNISON E 1MG TAB NDC C ode: 00242 -0744-75
	2830	REJECT Inf ormation ( Veteran) RESUBMISSI ON
	2831	Current EC ME Status: E REJECTE D
	2832	Rejects re ceived fro m Payer on 09/16/201 5 5:26:39 pm.
	2833	Code De scription
	2834	79 - Re fill Too S oon
	2835	Next Avail Fill: 10/ 31/2015
	2836	Payer Mess age : EMD 1000: CLA IM PAID
	2837	Payer Addl Msg : EMD 1000: CLA IM PAID RX :00000010X XXFILL:201 5-09-16
	2838	BIN :610144 PC N:TEST
	2839	OPECC COMM ENTS
	2840	- 09/10/15 5:17 pm – First com ment for O PECC scree n (USER,ON E)
	2841	PHARMACIST COMMENTS
	2842	- 05/12/15 8:23 am – Second co mment for Pharmacist (USER,TWO )
	2843	INSURANCE Informatio n
	2844	Insurance : VET CNF
	2845	Contact : 333 -444-5555
	2846	BIN : 610 144
	2847	PCN : TES T
	2848	Group Numb er : 246
	2849	Cardholder ID : 123 4567890
	2850	Effective Date : 01/ 25/2015
	2851	There are four actio ns availab le from th e OPECC Re ject Infor mation scr een: VW V iew Rx, VE R View ECM E Rx, MP M ed Profile , and PI P at Info.
	2852	Example 5. 12-5: Act ions Avail able from the OPECC Reject Inf ormation S creen
	2853	+ Enter ?? f or more ac tions
	2854	VW View R x VER View E CME Rx MP Med Pr ofile PI Pat In fo
	2855	Select: Ne xt Screen/ /
	2856	5.13 Resu bmit Claim Without R eversal (h idden acti on) XE " R esubmit Cl aim"
	2857	The Resubm it Claim w /o Reversa l action r esubmits a claim to the insure r without submitting a reversa l first, r egardless of the Vis tA claim s tatus. Thi s action s hould be u sed in ins tances whe re the pay er shows t he claim w as reverse d and Vist A shows a payable cl aim. This action is not availa ble if any non-cance lled bill exists..
	2858	The action is access ed by ente ring RER a t the “Sel ect Action :” prompt on the ECM E User Scr een.
	2859	Example 5. 13-1: Acce ssing and Executing the Resubm it Claim W /O Reversa l Action
	2860	Select Act ion: Next Screen// R ER RER Resubmit C laim w/o R eversal
	2861	You are pr ompted for the line item(s) of the claim to be res ubmitted.
	2862	You may al so submit multiple l ine items separated by commas (e.g. “1.1 ,1.2”), or a range o f line ite ms separat ed by a hy phen (e.g. “1.1-1.3” ).Example 5.13-2: En tering the Line Item for the C laim Resub mission Re quest
	2863	Note: This actio n will res ubmit clai ms without performin g a revers al.
	2864	This actio n should b e used in instances where the payer show s the
	2865	claim was reversed a nd VistA s hows a pay able claim . This act ion will
	2866	NOT submit a reversa l regardle ss of the current Vi stA claim status.
	2867	Enter the line numbe rs for the claim(s) to be resu bmitted w/ o reversal .
	2868	Select ite m(s):
	2869	The system redisplay s the line item for resubmissi on, then a sks if you are sure you want t o continue with the transactio n. You can enter Y o r N. If yo u answer Y , the clai m resubmis sion proce ss continu es.
	2870	Example 5. 13-5: Ente ring “Y” t o Continue Claim Res ubmission Request
	2871	You've cho sen to RES UBMIT W/O REVERSAL t he followi ng Rx for PATIENT,TW O
	2872	1.4 PR EDNISONE 1 MG TA 0024 2074475 10 /28 100XXX 0/00 0000112XXX W RT AC/N
	2873	Are you su re?(Y/N)? YES
	2874	ECME will allow mult iple submi ssions of the same p rescriptio n and fill to be pla ced on the request q ueue at th e same tim e. The ECM E engine w ill proces s all requ ests in th e order th at they ar e received . If there is alread y a submis sion in th e queue fo r this pre scription and fill, a message is display ed and you are asked if you wa nt to proc eed.
	2875	Example 5. 13-6: Ent ering “Y” to Place M ultiple Su bmissions in the Que ue
	2876	The claim is in prog ress. The request wi ll be sche duled and processed after
	2877	the previo us request (s) are co mpleted. P lease be a ware that the result of
	2878	the resubm it depends on the pa yer's resp onse to th e prior in complete r equests.
	2879	Do you wan t to proce ed?(Y/N)? y YES
	2880	The claim resubmissi on request is submit ted and th e progress is displa yed.
	2881	Example 5. 13-7: Dis playing a Successful ly Resubmi tted Claim
	2882	Claim Stat us:
	2883	IN PROGRES S-Waiting to start
	2884	IN PROGRES S-Building the claim
	2885	IN PROGRES S-Transmit ting
	2886	E PAYABLE
	2887	Veteran Pr escription 100958 su ccessfully submitted to ECME f or claim g eneration.
	2888	1 claim ha s been res ubmitted.
	2889	Enter RETU RN to cont inue or '^ ' to exit: <ENTER>
	2890	Updating s creen for resubmitte d claims.. .
	2891	The line i tem will d isplay the status of a claim t hat was re submitted and the Bi ll Type in dicator of “RS” . Th e “RS” ind icates a r esubmitted claim. Th e resubmit indicator will also display f or a non-b illable pr escription that has been resub mitted, ev en if ther e is no cl aim becaus e the pres cription r emained no n-billable .
	2892	Example 5. 13-8: Disp laying the Claim Sta tus after a Resubmis sion
	2893	PHARMACY E CME Oct 28, 20 15@16:29:3 2 Page: 2 of 52
	2894	SELECTED D IVISION(S) : ALL
	2895	Transmitte d by ALL u sers Activity Date Rang e: within the past 9 99 day(s)
	2896	Sorted b y: Transac tion date by default
	2897	+# PATIEN T/DRUG/COM MENTS IN SURANCE/ND C/DOS/RX#/ ECME# STATUS/LOC /TYP/RXINF
	2898	1.4 PR EDNISONE 1 MG TA 0024 2074475 10 /28 100XXX 0/00 0000112XXX W RS AC/N
	2899	p-Pa yable
	2900	5.14 Open /Close Non Billable Entry (hid den action )
	2901	The Open/C lose Non B illable En try action marks a n on-billabl e entry as open or c losed. The action on ly applies to non-bi llable ent ries, not claims tha t have bee n submitte d to a thi rd party p ayer.
	2902	The action behaves l ike a togg le. If the entry is currently Open and t he action is selecte d, the use r will Clo se the ent ry. If the entry is currently Closed and the actio n is selec ted, the u ser will O pen the en try.
	2903	The action is access ed by ente ring OCN a t the “Sel ect Action :” prompt on the ECM E User Scr een.
	2904	Example 5. 14-1: Acce ssing and Executing the Open/C lose Non B illable En try Action
	2905	Select Act ion: Next Screen// O CN OCN Open/Close Non-Billa ble Entry
	2906	You are pr ompted for the line item(s) of the claim to be ope ned or clo sed.
	2907	Example 5. 14-2: Ente ring the L ine Item f or the Ope n/Close No n Billable Entry
	2908	Enter the line numbe r for the entry to b e opened o r closed.
	2909	Select ite m:
	2910	The system redisplay s the line item for resubmissi on, then p rompts for a comment . Next the system as ks if the user is su re. You ca n enter Y or N. If y ou answer Y, the ent ry is mark ed as Open or Closed .
	2911	Example 5. 14-5: Answ er Prompts for Open/ Close Non Billable e ntry
	2912	You've cho sen to CLO SE the fol lowing ent ry for
	2913	PATIENT,ON E :
	2914	3.1 MI LK OF MAGN ESIA 0034 9821742 100SSS 0/ W RS EX/N
	2915	p-No n-Billable /Open
	2916	eT:T RICARE-RX NOT BILLAB LE (DRUG N OT BILLABL E)
	2917	The Select ed Entry w ill be CLO SED.
	2918	Comment : Enter a co mment now
	2919	Are you su re? (Y/N)? YES
	2920	Closing En try
	2921	Enter RETU RN to cont inue or '^ ' to exit:
	2922	5.15 Displ ay Update (hidden ac tion) XE " Display U pdate"
	2923	The Displa y Update a ction revi ses the EC ME User Sc reen with the latest informati on about t he status of patient s’ prescri ptions usi ng the cur rent filte r settings . This act ion update s the ECME User Scre en only on ce.
	2924	This hidde n action i s accessed by enteri ng UD at t he “Select Action:” prompt on the ECME User Scree n.
	2925	Example 5. 15-1: Acc essing the Display U pdate Acti on
	2926	PHARMACY E CME Apr 26, 20 06@11:44:4 5 Page : 1 of 2
	2927	SELECTED D IVISION(S) : ALL
	2928	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	2929	Sor ted by: Pa tient Name
	2930	# PATIEN T/DRUG/COM MENTS INSURANC E/NDC/RX#/ ECME# LOC/TYP RXINF
	2931	6 ECMEpa tient,Two (XXXX) WEBMD TE/ VET Pb:1 Rj:0 AcRv:0 Rj Rv:1
	2932	6.1 FU ROSEMIDE 1 0MG/M 006 41-2312-25 04/22 100 004065$ 0 /000000504 691 W RT A C/R
	2933	p-Pa yable
	2934	6.2 CH OLESTYRAMI NE 4G 000 87-0580-01 04/22 100 004066$ 0 /000000504 692 W RT A C/R
	2935	p-Re versal rej ected
	2936	NN:T ransaction Rejected At Switch Or Interme diary
	2937	NC16 -The clear inghouse d id not rep ly in time .
	2938	7 ECMEpa tient,One (XXXX) WEBMD TE/ VET ALL payab le
	2939	7.1 AL BUTEROL IN HALER 555 55-4444-22 04/26 100 003744$ 0 /000000504 304 W RT A C/R
	2940	p-Pa yable
	2941	7.2 AC ETYLCYSTEI NE 20 000 87-0570-09 04/21 100 004054$ 0 /000000504 677 W RT A C/N
	2942	s-Pa yable (p-P ayable)
	2943	8 ECMEpa tient,Thre e (XXXX) WEBMD TE/ VET ALL payab le
	2944	+ Enter ?? f or more ac tions
	2945	The screen has been updated on APR 26,20 06@14:50:4 7. Press " Q" to quit .
	2946	CV Change View REV Reverse Pa yable Clai m FR Furt her Resear ch
	2947	SO Sort L ist RES Resubmit C laim VER View ePharmacy Rx
	2948	CMT Add/Vi ew Comment s CLO Close Clai m WRK Send to Workli st
	2949	Select Act ion: Next Screen// U D Displa y Update
	2950	Updating s creen...
	2951	5.16 Exit (from ECME User Scre en) XE " Exit from ECME User Screen"
	2952	When EXIT or QUIT is entered a t the “Sel ect Action :” prompt, the syste m will ret urn the us er to the ECME Main Menu.
	2953	6.
	2954	Accessing the ECME P harmacy CO B Menu XE "Accessing the ECME Pharmacy C OB Menu"
	2955	The ECME P harmacy CO B Menu opt ion allows users to manually s end claims to second ary insura nce compan ies; gener ate primar y claims f or patient s with dua l eligibil ity; and v iew report s that sup port secon dary billi ng and pri mary billi ng for TRI CARE patie nts.
	2956	Example 6- 1: Accessi ng the ECM E Pharmacy COB Menu
	2957	*** ****** ****** ****** ****** **
	2958	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	2959	* XXXXXX VAMC *
	2960	* Main M enu *
	2961	*** ****** ****** ****** ****** **
	2962	U ECME User Screen
	2963	COB ECME Pharm acy COB .. .
	2964	MGR Pharmacy E CME Manage r Menu ...
	2965	RPT Pharmacy E lectronic Claims Rep orts ...
	2966	Select ECM E Option: MGR Pharm acy ECME M anager Men u
	2967	Example 6- 2: Display ing the EC ME Pharmac y COB Menu
	2968	*** ****** ****** ****** ****** **
	2969	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	2970	* XXXXXXX VAMC *
	2971	* Phar macy ECME Manager Me nu *
	2972	*** ****** ****** ****** ****** **
	2973	SEC Potential Secondary Rx Claims Report
	2974	TRI Potential Claims Rep ort for Du al Eligibl e
	2975	PRO Process Se condary/TR ICARE Rx t o ECME
	2976	Select ECM E Pharmacy COB Optio n:
	2977	6.1 Potent ial Second ary Rx Cla ims Report XE " Pote ntial Seco ndary Rx C laims Repo rt"
	2978	The Potent ial Second ary Rx Cla ims Report is design ed to help the OPECC (Outpatie nt Pharmac y Electron ic Claims Coordinato r) to iden tify poten tial Rx cl aims for a secondary insurance payer wit h pharmacy coverage, including both elec tronic and paper. Th is report will inclu de prescri ption clai ms where t he primary claim is payable or the prima ry claims has been r ejected an d closed. Below are some scena rios where a claim w ill not ap pear on th e report:
	2979	A prescrip tion where the secon dary claim is closed in ECME.
	2980	A prescrip tion where the secon dary claim is payabl e in ECME.
	2981	A prescrip tion where the prima ry payer p aid the fu ll amount as there i s no more revenue to collect f rom any ot her payers .
	2982	If a claim is determ ined to be electroni cally bill able, the OPECC acco mplishes t his throug h the Proc ess Second ary/TRICAR E Rx to EC ME option. If the cl aim must b e billed i n paper fo rmat, the OPECC foll ows the cu rrent proc edures for initiatin g a second ary bill w ith the bi lling staf f.
	2983	Access the Potential Secondary Rx Claims Report by entering SEC at the “ECME Pha rmacy COB Option:” p rompt on t he ECME Ph armacy COB Menu.
	2984	Example 6. 1-1: Acces sing the P otential S econdary R x Claims R eport
	2985	*** ****** ****** ****** ****** **
	2986	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	2987	* XXXXXX VAMC *
	2988	* Pharmacy Electroni c Claims R eports *
	2989	*** ****** ****** ****** ****** **
	2990	SEC Potential Secondary Rx Claims Report
	2991	TRI Potential Claims Rep ort for Du al Eligibl e
	2992	PRO Process Se condary/TR ICARE Rx t o ECME
	2993	Select ECM E Pharmacy COB Optio n: SEC Po tential Se condary Rx Claims Re port
	2994	After you have selec ted one, m any, or al l division s and a da te range, choose you r primary (required) and secon dary (opti onal) sort criteria.
	2995	Example 6. 1-2: Gener ating the Potential Secondary Rx Claims Report
	2996	SELECTION CRITERIA
	2997	Selec t one of t he followi ng:
	2998	D DIVISION
	2999	A ALL
	3000	Select Cer tain Pharm acy (D)ivi sions or ( A)LL: ALL
	3001	EARLIEST D ATE: t (A PR 14, 200 9)
	3002	LATEST D ATE: T// < ENTER> (A PR 14, 200 9)
	3003	SORT CRITE RIA
	3004	Primary So rt: (N/P/ S/D): Divi sion// ??
	3005	Enter a co de from th e list to indicate t he Primary sort orde r.
	3006	Selec t one of t he followi ng:
	3007	N Patient Na me
	3008	P Payer
	3009	S Date Of Se rvice
	3010	D Division
	3011	Primary So rt: (N/P/ S/D): Divi sion// <EN TER>
	3012	Secondary Sort: (N/ P/S): <ENT ER>
	3013	DEVICE: HO ME// <ENTE R> UCX/TE LNET Ri ght Margin : 80// <EN TER>
	3014	Collecting Potential Secondary data.
	3015	Enter RETU RN to cont inue or '^ ' to exit: <ENTER>
	3016	========== ========== ========== ========== ========== ========== ========== =========
	3017	Potential Secondary Rx Claims Report 4/14/09 - 4/14/09 Page: 1
	3018	Selected D ivisions: ALL
	3019	Sorted By: Division;
	3020	Bill# RX# Fill Pati ent PatID COB Date Payers
	3021	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------
	3022	Division: XXXXXX
	3023	K9000LG 102179 4 ECME patient,On e 0000 p 4/14/ 09 ECME I NSURANCE1
	3024	t ECME I NSURANCE2
	3025	K0000QD 2055862 0 ECME patient,On e 0000 p 7/13/ 10 ECME I NSURANCE1
	3026	s ECME I NSURANCE2
	3027	- ECME I NSURANCE3
	3028	(P) Rej 2055865 0 ECME patient,On e 0000 p 7/13/ 10 ECME I NSURANCE1
	3029	s ECME I NSURANCE2
	3030	t ECME I NSURANCE3
	3031	(P) Rej 2055866 0 ECME patient,Tw o 4444 p 7/14/1 0 ECME IN SURANCE1
	3032	s ECME I NSURANCE2
	3033	Bill# "(P) Rej" indi cates a re jected/clo sed primar y ECME cla im
	3034	COB "-" in dicates a blank COB field in t he pt. ins . policy
	3035	6.2 XE "Po tential Cl aims Repor t for Dual Eligible" Potentia l Claims R eport for Dual Eligi ble
	3036	The Potent ial Claims Report fo r Dual Eli gible atte mpts to id entify pot ential pha rmacy clai ms for TRI CARE and C HAMPVA pay ers. This report inc ludes pres criptions that have been relea sed, but h ave not ye t been bil led for an y patient with dual eligibilit y (e.g. Ve teran, CHA MPVA and T RICARE) wh o has an a ctive insu rance plan with phar macy cover age and a Type of Pl an of TRIC ARE or CHA MPVA. If t he Claims Tracking e ntry for t he specifi c prescrip tion/fill is identif ied as bei ng non-bil lable, the n it will not appear on this r eport.
	3037	If a claim is determ ined to be electroni cally bill able, the OPECC can submit the prescript ion throug h the Proc ess Second ary/TRICAR E Rx to EC ME option.
	3038	Access the Potential Claims Re port for D ual Eligib leby enter ing TRI at the “ECME Pharmacy COB Option :” prompt on the ECM E Pharmacy COB Menu.
	3039	Example 6. 2-1: Acces sing the P otential C laims Repo rt for Dua l Eligible
	3040	*** ****** ****** ****** ****** **
	3041	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	3042	* XXXXX V AMC *
	3043	* Pharmacy Electroni c Claims R eports *
	3044	*** ****** ****** ****** ****** **
	3045	SEC Potential Secondary Rx Claims Report
	3046	TRI Potential Claims Rep ort for Du al Eligibl e
	3047	PRO Process Se condary/TR ICARE Rx t o ECME
	3048	Select ECM E Pharmacy COB Optio n: TRI Po tential Cl aims Repor t for Dual Eligible
	3049	After you have selec ted one, m any, or al l division s, the pat ient eligi bility cri teria (TRI CARE, CHAM PVA or all ) and a da te range, choose you r primary (required) and secon dary (opti onal) sort criteria.
	3050	Example 6. 2-2: Gener ating the Potential TRICARE Cl aims Repor t
	3051	Selec t one of t he followi ng:
	3052	D DIVISION
	3053	A ALL
	3054	Select Cer tain Pharm acy (D)ivi sions or ( A)LL: ALL
	3055	Selec t one of t he followi ng:
	3056	T TRICARE
	3057	C CHAMPVA
	3058	A ALL
	3059	Display (T )RICARE or (C)HAMPVA or (A)LL Entries: A // LL
	3060	EARLIEST D ATE: t-10 (APR 06, 2009)
	3061	LATEST D ATE: T// (APR 16, 2009)
	3062	SORT CRITE RIA
	3063	Primary So rt: (N/P/ S/D/E): Di vision//
	3064	Secondary Sort: (N/ P/S/E):
	3065	Tertiary S ort: (N/P /S/E):
	3066	DEVICE: HO ME// ;;999 9 TELNET TERMINAL
	3067	Collecting TRICARE d ata.
	3068	Enter RETU RN to cont inue or '^ ' to exit:
	3069	========== ========== ========== ========== ========== ========== ========== ==========
	3070	Potential TRICARE Rx Claims Re port 8 /1/80 - 7/ 28/14 Page: 1
	3071	Selected D ivisions: ALL
	3072	Selected P atient Eli gibility: ALL
	3073
	3074	Sorted By: Division;
	3075	'*' indica tes the HP ID/OEID fa iled valid ation chec ks
	3076	RX# F ill Date Patient Pat ID COB Eli g Payers H PID/OEID
	3077	---------- ---------- ---------- ---------- ---------- ---------- ---------- ----------
	3078	Division: XXXXX VAMC
	3079	100407 2 9/9/10 OPTRICAR E,ONE 16 0P p TRI C TRICARE- 23 TEST 6 999999999*
	3080	100408 1 9/9/10 OPTRICAR E,ONE 16 0P p TRI C TRICARE- 23 TEST 6 999999999*
	3081	6.3 Proces s Secondar y/TRICARE Rx to ECME XE "Proce ss Seconda ry/Tricare Rx to ECM E"
	3082	The Proces s Secondar y/TRICARE Rx to ECME option al lows the O PECC to su bmit claim s for pres criptions/ refills th at were en tered for Secondary claims, TR ICARE pati ents or pa tients wit h dual eli gibility ( e.g. Veter an and TRI CARE). The se claims are identi fied using the Poten tial Secon dary Rx Cl aims Repor t and Pote ntial Clai ms Report for Dual E ligible.
	3083	This optio n submits the claim to the thi rd party p ayer. Any further pr ocessing o n the clai m must the n be done through th e actions available on the ECM E User Scr een.
	3084	When proce ssing a cl aim for TR ICARE, CHA MPVA and d ual eligib ility pati ents, user s will be asked for the patien t’s name, the fill/r efill numb er from th e list pro vided, and an approp riate bill ing Rate T ype. If th e user sel ects a CHA MPVA Rate Type (CHAM PVA or CHA MPVA REIMB . INS.), t he claim w ill be pro cessed as a CHAMPVA claim. If the user s elects a T RICARE Rat e Type (TR ICARE or T RICARE REI MB. INS.), the claim will be p rocessed a s a TRICAR E claim. I f the user selects a Reimbursa ble Insura nce type, it will be processed as a regu lar non-TR ICARE and non-CHAMPV A claim. T he Date of Service i s determin ed based o n the date of servic e algorith m used in Outpatient Pharmacy.
	3085	Claims can also be r esubmitted using the Process S econdary/T RICARE RX to ECME op tion. Seco ndary Clai ms that ar e rejected by insura nce compan ies becaus e of missi ng or inco rrect data received, or Primar y Claims t hat have b een reject ed or reve rsed, may be resubmi tted. This option is not inten ded to use for Payab le claims. Payable c laims must be revers ed using t he Reverse Payable C laim Actio n on the E CME User S creen befo re they ca n be resub mitted via this opti on. Inform ation prev iously ent ered for t he claim w ill appear as the de faults.
	3086	You must h old the BP SUSER key to use the Process S econdary/T RICARE Rx to ECME op tion. Acce ss the Pro cess Secon dary/TRICA RE Rx to E CME option by enteri ng PRO at the “ECME Pharmacy C OB Option: ” prompt o n the ECME Pharmacy COB Menu.
	3087	Example 6. 3-1: Acces sing the P rocess Sec ondary/TRI CARE Rx to ECME opti on
	3088	*** ****** ****** ****** ****** **
	3089	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	3090	* XXXXXX V AMC *
	3091	* Pharmacy Electroni c Claims R eports *
	3092	*** ****** ****** ****** ****** **
	3093	SEC Potential Secondary Rx Claims Report
	3094	TRI Potential Claims Rep ort for Du al Eligibl e
	3095	PRO Process Se condary/TR ICARE Rx t o ECME
	3096	Select ECM E Pharmacy COB Optio n: PRO Pr ocess Seco ndary/TRIC ARE Rx to ECME
	3097	6.3.1
	3098	Submitting Secondary Claims XE "Submitti ng Seconda ry Claims"
	3099
	3100	XE "Submi tting Seco ndary Clai ms"
	3101	The Proces s Secondar y/TRICARE Rx to ECME (PRO) opt ion will p rompt for a Rx#.
	3102	The Proces s Secondar y/TRICARE Rx to ECME (PRO) opt ion will d isplay the Rx inform ation to a llow the u ser to ens ure the co rrect Rx# was entere d and prom pt the use r to confi rm they wi sh to cont inue.
	3103	The Proces s Secondar y/TRICARE Rx to ECME (PRO) opt ion will a sk the use r to selec t a fill/r efill from the list provided b y the soft ware.
	3104	The Proces s Secondar y/TRICARE Rx to ECME (PRO) opt ion will a sk the use r to selec t the Paye r Sequence to bill ( primary or secondary ).
	3105	The Proces s Secondar y/TRICARE Rx to ECME (PRO) opt ion will a sk the use r if they wish to ed it the ins urance com pany data. If the us er enters YES to thi s prompt, they will be able to edit the user's ins urance via the Patie nt Insuran ce Informa tion Scree n
	3106	Example 6. 3.1-1: Ini tial Promp ts for the Process S econdary/T RICARE Rx to ECME op tion
	3107	Select PRE SCRIPTION RX #: 1003 0 LI DOCAINE 0. 5% W/EPI I NJ MDV
	3108	Patient RX# Dru g Name RX Stat us
	3109	ECMEPatie nt, Two 100 30 L IDOCAINE 0 .5% W/EPI INJ ACTIV E
	3110	DO YOU WAN T TO CONTI NUE?(Y/N)? Y// ES
	3111	RX #10030 has the fo llowing fi lls:
	3112	Fill Date
	3113	==== ==========
	3114	0 07/02/2010
	3115	1 10/12/2010
	3116	SELECT A F ILL TO BIL L: 07/02/2 010
	3117	Select pay er sequenc e for bill ing:
	3118	1 PRIM ARY
	3119	2 SECO NDARY
	3120	SELECT PAY ER SEQUENC E: 2 SECO NDARY
	3121	Drug name NDC Da te RX# RE F# TYPE STATUS
	3122	========== ========== ========== ========== ========== ========== ========== =========
	3123	LIDOCAINE 0. 001860 14001 09 /10 10030$ 0/00 03098 W RT **/R REJECTED
	3124	There is a n existing rejected/ reversed s econdary e -claim(s) for the RX /refill.
	3125	Do you wan t to submi t a new se condary cl aim(Y/N)? N// YES
	3126	DO YOU WIS H TO ADD/E DIT INSURA NCE COMPAN Y DATA FOR THIS PATI ENT?(Y/N)? N// O
	3127	Data for S econdary C laim
	3128	---------- ---------- ----
	3129	Insurance: INSURANC E3 COB: SECONDARY
	3130	Rate Type: REIMBURS ABLE INS.
	3131	Other Cove rage Code: 02 (OTHE R COVERAGE EXISTS - PAYMENT CO LLECTED)
	3132	Other Paye r Coverage Type: 01 (PRIMARY)
	3133	Other Paye r ID Quali fier: 03 (BANK INFO RMATION NU MBER (BIN) )
	3134	Other Paye r ID: 123 456
	3135	Other Paye r Date: O ct 15, 201 0
	3136	Other Paye r Paid Qua lifier: 0 7 (DRUG BE NEFIT)
	3137	Other Paye r Amount P aid: 40.0 0
	3138	Other Paye r Patient Responsibi lity Amoun t Qualifie r: 06 (AMT REPORTED BY PRIOR P AYER)
	3139	Other Paye r Patient Responsibi lity Amoun t: $12.38
	3140	Do you wan t to edit this Secon dary Claim Informati on (Y/N)? N// YES
	3141	Insura nce CO B Subscri ber ID Gro up Ho lder Eff ective Ex pires
	3142	====== ======= == == ======= ====== === ======= == ====== === ======= == ========
	3143	1 INSURA NC2 PR I AAA INS . PA TIENT 03/ 10/2010
	3144	2 INSURA N3 SE C 5487357 9430 GR PA TIENT 03/ 26/2010
	3145	SECONDARY INSURANCE POLICY: 2/ / INSURA NCE3 (SECO NDARY) - B RIAN'S GRP
	3146	SELECT RAT E TYPE: RE IMBURSABLE INS.// Who's Re sponsible: INSURER
	3147	OTHER COVE RAGE CODE: 02// O THER COVER AGE EXISTS - PAYMENT COLLECTED
	3148	OTHER PAYE R ID: 1234 56//
	3149	OTHER PAYE R DATE: O ct 15, 201 0//
	3150	Edit Paid Amounts or Reject Co des (PAID AMOUNTS/RE JECT CODES ): PAID A MOUNTS//
	3151	OTHER PAYE R AMOUNT P AID QUALIF IER: 07// DRUG BE NEFIT
	3152	OTHER PAYE R AMOUNT P AID: (0-9 99999): 40 .00//
	3153	OTHER PAYE R AMOUNT P AID QUALIF IER:
	3154	SUBMIT CLA IM TO INSU RANCE3 ?(Y /N)? Y// E S
	3155	Veteran Pr escription 10030 suc cessfully submitted to ECME fo r claim ge neration.
	3156	Processing Secondary claim...
	3157	Claim Stat us:
	3158	IN PROGRES S-Building the claim
	3159	IN PROGRES S-Building the HL7 p acket
	3160	IN PROGRES S-Transmit ting
	3161	E PAYABLE
	3162	6.3.2
	3163	Submitting Primary C laims for TRICARE an d Dual Eli gibility P atients XE "Submitti ng Primary Claims fo r TRICARE and Dual E ligibility Patients"
	3164	This secti on shows a n example of how the option ca n be used to submit claims for prescript ions/refil ls entered for TRICA RE patient s or patie nts with d ual eligib ility (e.g . Veteran and TRICAR E) and tha t were ide ntified by the Poten tial Claim s Report f or Dual El igible.
	3165	When proce ssing a cl aim for TR ICARE and dual eligi bility pat ients, use rs are ask ed for pat ient’s nam e and the fill/refil l from the list prov ided by th e software .
	3166	Example 6. 3.2-1: Pro mpt for th e Process Secondary/ TRICARE Rx to ECME o ption
	3167	Select ECM E Pharmacy COB Optio n: PRO Pr ocess Seco ndary/ TRI CARE Rx to ECME
	3168	Select PRE SCRIPTION RX #: 1030 27 B ETHANECHOL 10MG TAB
	3169	Patient RX# Drug Nam e RX Status
	3170	ECMEpatie nt,One 103027 BETHANEC HOL 10MG T AB ACTIVE
	3171	DO YOU WAN T TO CONTI NUE?(Y/N)? Y// ES
	3172	RX #103027 has the f ollowing f ills:
	3173	Fill Date
	3174	==== ==========
	3175	0 10/27/2009
	3176	SELECT A F ILL TO BIL L: 0 10/2 7/2009
	3177	Select pay er sequenc e for bill ing:
	3178	1 PRIM ARY
	3179	2 SECO NDARY
	3180	SELECT PAY ER SEQUENC E: 1 PRIM ARY
	3181	SELECT RAT E TYPE: ?
	3182	Answer wi th RATE TY PE NUMBER, or NAME
	3183	Do you wa nt the ent ire 17-Ent ry RATE TY PE List? y (Yes)
	3184	Choose from:
	3185	1 CRIM E VICTIM Who's Resp onsible: I NSURER
	3186	2 DENT AL Who's Responsibl e: PATIENT
	3187	3 HUMA NITARIAN Who's Resp onsible: P ATIENT
	3188	4 INTE RAGENCY W ho's Respo nsible: OT HER (INSTI TUTION)
	3189	5 MEAN S TEST Wh o's Respon sible: PAT IENT
	3190	6 MEDI CARE ESRD Who's Res ponsible: OTHER (INS TITUTION)
	3191	7 NO F AULT INS. Who's Res ponsible: INSURER
	3192	8 REIM BURSABLE I NS. Who's Responsib le: INSURE R
	3193	9 SHAR ING AGREEM ENT Who's Responsib le: OTHER (INSTITUTI ON)
	3194	10 TORT FEASOR W ho's Respo nsible: IN SURER
	3195	11 WORK ERS' COMP. Who's Re sponsible: INSURER
	3196	12 CATE GORY C Wh o's Respon sible: PAT IENT
	3197	13 CHAM PVA REIMB. INS. Who 's Respons ible: INSU RER
	3198	14 CHAM PVA Who's Responsib le: INSURE R
	3199	15 TRIC ARE REIMB. INS. Who 's Respons ible: INSU RER
	3200	16 TRIC ARE Who's Responsib le: INSURE R
	3201	17 INEL IGIBLE Wh o's Respon sible: PAT IENT
	3202	SELECT RAT E TYPE: 15 TRICARE REIMB. INS . Who's R esponsible : INSURER
	3203	DO YOU WIS H TO ADD/E DIT INSURA NCE COMPAN Y DATA FOR THIS PATI ENT?(Y/N)? N// NO
	3204	Insuranc e COB Subscrib er ID Grou p Hol der Eff ective Ex pires
	3205	======== ====== === = ======== ===== ==== ====== === ====== === ======= == ========
	3206	EXPRESS SCRIP PRI XXXXXX DODA PAT IENT 12/ 27/2008
	3207	PRIMARY IN SURANCE PO LICY: SH T RICARE (PR IMARY) - T RICARE PLA N
	3208	SUBMIT CLA IM TO SH T RICARE ?(Y /N)? Y// y YES
	3209	TRICARE Pr escription 2055242 s ubmitted t o ECME for claim gen eration.
	3210	7
	3211	Accessing the Pharma cy ECME Ma nager Menu XE "Acces sing Pharm acy ECME M anager Men u"
	3212	The Pharma cy ECME Ma nager Menu option al lows Autom ated Data Processing Applicati on Coordin ators (ADP AC) and In formation Resources Management Service ( IRMS) to c onfigure t he Electro nic Claims Managemen t Engine ( ECME) syst em with ph armacy sit e-specific options. It is acce ssed by en tering MGR at the “S elect ECME Option:” prompt on the ECME M ain Menu o ption.
	3213	You must h old the BP S MANAGER key to vie w the Phar macy ECME Manager Me nu option. Example 7 -1: Access ing the Ph armacy ECM E Manager Menu Optio n
	3214	*** ****** ****** ****** ****** **
	3215	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	3216	* XXXXXX VAMC *
	3217	* Main M enu *
	3218	*** ****** ****** ****** ****** **
	3219	U ECME User Screen
	3220	COB ECME Pharm acy COB .. .
	3221	MGR Pharmacy E CME Manage r Menu ...
	3222	RPT Pharmacy E lectronic Claims Rep orts ...
	3223	Select ECM E Option: MGR Pharm acy ECME M anager Men u
	3224	Example 7- 2: Display ing Pharma cy ECME Ma nager Menu Options
	3225	*** ****** ****** ****** ****** **
	3226	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	3227	* XXXXXXX VAMC *
	3228	* Phar macy ECME Manager Me nu *
	3229	*** ****** ****** ****** ****** **
	3230	MNT ECME trans action mai ntenance o ptions ...
	3231	SET Pharmacy E CME Setup Menu ...
	3232	STAT Statistics Screen
	3233	Select Pha rmacy ECME Manager M enu Option :
	3234	You must h old the BP SMENU and BPS MANAGE R keys to view the S tatistics Screen (ST AT) and EC ME transac tion maint enance opt ions (MNT) options. You must a lso hold t he BPS MAS TER key to view the Edit Basic ECME Para meters (BA S), the Ed it ECME Ph armacy Dat a (PHAR), the Regist er Pharmac y with Aus tin Inform ation Tech nology Cen ter (REG), and the P harmacy EC ME Setup M enu (SET) options. 7 .1 ECME Tr ansaction Maintenanc e Options XE "ECME T ransaction Maintenan ce Options ”
	3235	This optio n provides functiona lity that provides u nique prog rammatic s olutions t o address ECME proce ssing requ irements. The only o ption iden tified so far is the functiona lity to un strand cla ims.
	3236	Example 7. 1-1: Acces sing the E CME Transa ction Main tenance Op tions
	3237	*** ****** ****** ****** ****** **
	3238	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	3239	* XXXXX V AMC *
	3240	* Phar macy ECME Manager Me nu *
	3241	*** ****** ****** ****** ****** **
	3242	MNT ECME trans action mai ntenance o ptions ...
	3243	SET Pharmacy E CME Setup Menu ...
	3244	STAT Statistics Screen
	3245	Select Pha rmacy ECME Manager M enu Option : MNT ECM E transact ion mainte nance opti ons
	3246	**** ****** ****** ****** ****** ***
	3247	* Elec tronic Cla ims Manage ment Engin e (ECME) v 1.0 *
	3248	* XXXXX VAMC *
	3249	* B PS MENU MA INTENANCE *
	3250	**** ****** ****** ****** ****** ***
	3251	UNS View/Unstr and Submis sions Not Completed
	3252	ROC Re Open CL OSED Claim
	3253	Select ECM E transact ion mainte nance opti ons Option :
	3254	7.1.1 View /Unstrand Submission s Not Comp leted XE " View/Unstr and Claims ”
	3255	This optio n provides you with options to override any curren t transmis sion statu s of claim s that hav e not reac hed the po int of com pletion to a status of “Done”.
	3256	When a cla im is unst randed via this opti on, the st atus of th e claim is changed t o ‘E UNSTR ANDED’ for billing r equests an d ‘E REVER SAL UNSTRA NDED’ for reversals. This stat us message is displa yed on the ECME User Screen, t he Further Research menu, the Developer Log action of the EC ME user sc reen, and the Recent Transacti on report.
	3257	Even thoug h you perf orm the Vi ew/Unstran d Submissi ons Not Co mpleted op tion, the final adju dicating p ayer claim status of either 'P ayable' or 'Rejected ' will not be known unless fur ther actio n is taken on the cl aim. This will requi re manual interventi on for the claim to be resubmi tted to th e adjudica ting payer after thi s option i s run.(A) Enter UNS at the “S elect ECME transacti on mainten ance optio ns Option: ” to acces s the unst rand optio ns.
	3258	Example 7. 1.1-1: Acc essing the View/Unst rand Submi ssions Not Completed Option
	3259	UNS View/Unstr and Submis sions Not Completed
	3260	ROC Re Open CL OSED Claim
	3261	Select ECM E transact ion mainte nance opti ons Option : UNS Vie w/Unstrand Submissio ns Not Com pleted
	3262	Please be aware that if there are submis sions appe aring on t he ECME Us er Screen
	3263	with a sta tus of 'In progress - Transmit ting', the n there ma y be a pro blem
	3264	with HL7 o r with sys tem connec tivity wit h the Aust in Automat ion Center (AAC).
	3265	Please con tact your IRM to ver ify that c onnectivit y to the A AC is work ing
	3266	and the HL 7 link BPS NCPDP is processing messages before usi ng this op tion
	3267	to unstran d submissi ons with a status of 'In progr ess - Tran smitting'.
	3268	Do you wan t to conti nue? NO//
	3269	(B) You wi ll be prom pted for a date rang e to displ ay all str anded clai ms. The sy stem will accept a d ate range with or wi thout a ti me attache d to it.
	3270	First Tran saction Da te: If a date only is entered for a sta rt date, t he system will assum e the star t date is the date e ntered and the time will be th e beginnin g of the 2 4 hour clo ck (.0001) otherwise the syste m will acc ept the en tered time parameter .
	3271	Last Trans action Dat e: If a d ate only i s entered for the en ding date range, the system wi ll assume the ending of a 24 h our clock (.2359) ex cept if yo u enter th e current date. If y ou enter t oday’s dat e as the e nding date of the da te range, the system will auto matically assign the ending ti me to be 3 0 minutes prior to t he current time to e nsure that you do no t interrup t any tran smissions that may b e currentl y processi ng.
	3272	Example 7. 1.1-2: Ent ering Date Range for View/Unst rand Submi ssions Not Completed Option
	3273	FIRST TRAN SACTION DA TE: // T-1 20
	3274	LAST TRANS ACTION DAT E: T// T
	3275	Please wai t...
	3276	Example 7. 1.1-3: Di splaying t he View/Un strand Sub missions N ot Complet ed Actions
	3277	ECME UNSTR AND SUBMIS SIONS Oct 08, 20 10@15:12:0 8 Page: 1 of 1
	3278	Submission s Stranded from 09/2 8/2010 thr ough 10/08 /2010
	3279	Sorted by Transactio n Date
	3280	## Trans DT Patie nt Name ID RX/Fill D OS Ins Co
	3281	* CLA IMS *
	3282	1 10/07/ 2010 ECMEp atient,One 2637 101297/1 06/24/2009 AETNA
	3283	In Pro gress - Do ne
	3284	2 10/07/ 2010 ECMEp atient,One 2637 101320/1 04/27/2009 AETNA
	3285	In Pro gress - Do ne
	3286	3 10/07/ 2010 2637 1100349/0 10/07/201 0 AETNA
	3287	In Pro gress - Pr ocessing r equest
	3288	* REVER SALS *
	3289	4 10/07/ 2010 ECMEp atient,One 2637 101298/1 06/25/2009 AETNA
	3290	In Pro gress - Do ne
	3291	* E LIGIBILITY INQUIRIES *
	3292	5 10/08/ 2010 ECMEp atient,One 2637 10/ 08/2010 AE TNA
	3293	In Pro gress - Pa rsing resp onse
	3294	Enter ?? f or more ac tions >>>
	3295	ALL Unstra nd Current Submissio ns PRT Print Current Su bmissions
	3296	SEL Select Submissio ns to Unst rand EX Exit
	3297	7.1.2 REOP EN a CLOSE D ECME Cla im XE " V ariations to the Clo se claim p rocess"
	3298	The Reopen a Closed Claim opti on allows you to reo pen an ele ctronic cl aim after it has bee n Closed. The prescr iption can be Releas ed or Not Released. You are pr ompted to enter a pa tient name and date range to s elect clos ed claims by date of service. Once a cla im is Reop ened, you may resubm it the cla im to the payer for payment.
	3299	Enter ROC at the “Se lect ECME transactio n maintena nce option s Option:” to access the Re Op en CLOSED Claim opti on.
	3300	Example 7. 1.2-1: Acc essing the Re Open C LOSED Clai m Option
	3301	UNS View/Unstr and Submis sions Not Completed
	3302	ROC Re Open CL OSED Claim
	3303	Select ECM E transact ion mainte nance opti ons Option : ROC Re Open CLOSE D Claim
	3304	You will b e prompted for a pat ient name.
	3305	Example 7. 1.2-2: Ent ering Pati ent Name t o Display Closed Cla ims for th is Option
	3306	Select PATIENT NA ME: ECMEpa tient,One 6 -1-60 6 66006666
	3307	NSC VET ERAN
	3308	You will b e prompted for a dat e range fo r the date s of servi ce of clos ed claims.
	3309	Example 7. 1.2-3: Ent ering Date s of Servi ce for Clo sed Claims Listing
	3310	START W ITH DATE:T ODAY//6/13 /06 (Jun 1 3, 2006)
	3311	GO TO DATE :TODAY//T (JUL 05, 2006)
	3312	Enter Reop en and cho ose the li ne item of the close d claim th at will be reopened.
	3313	Example 7. 1.2-4: Cho osing to R eopen a Cl osed Claim and Selec ting a Lin e Item
	3314	REOPEN CLO SED CLAIM Jul 05, 20 06@15:29:2 1 Page: 1 of 1
	3315	PATIENT: E CMEpatient ,One ( XXXX) Closed cla ims from 0 7/05/06 to 07/05/06
	3316	# DRUG NDC DO S RX# REF/ ECME# LOC RX IN FO
	3317	1 RESER PINE 0.25M G 00083- 0036-45 07 /05 100004 093$ 0/00 0000504727 W RT AC /R
	3318	Enter ?? f or more ac tions
	3319	RE Reopen Claim EX Exit
	3320	Select act ion: Quit/ / R Reop en Claim
	3321	Select ite m: 1
	3322	You are pr ompted to enter a te xt comment , Reopen C omments, a fter claim informati on is disp layed.
	3323	Example 7. 1.2-5: Ent ering Text Comment f or Reopene d Closed C laim
	3324	PATIENT NAME: ECM Epatient,O ne RX#: 100000000 $ 0 DRU G: RESERPI NE 0.25MG
	3325	CLOSED JUL 5,200 6@15:13:42
	3326	ECME#: 000005047 27, DOS: J UL 5,2006, RELEASE D ATE: JUL 5 ,2006@15:1 2:11
	3327	PLAN: HIPPA05 IN SURANCE: M EDCO
	3328	CLOSE REASON: RE FILL TOO S OON
	3329	DROP T O PAPER: N O
	3330	CLOSE USER: ECME user,One
	3331	You have s elected th e CLOSED e lectronic claim list ed above.
	3332	REOPEN COM MENTS: Cla im reopene d for new refill
	3333	Example 7. 1.2-6: Ent ering Yes to “Are Yo u Sure” Pr ompt
	3334	ARE YOU SU RE YOU WAN T TO RE-OP EN THIS CL AIM? (Y/N) ? No// YES
	3335	ReOpening Claim: VA2 006=171288 4=000014=0 006687 ... OK
	3336	1 claim ha s been reo pened.
	3337	Enter RETU RN to cont inue or '^ ' to exit:
	3338	7.2 Pharma cy ECME Se tup Menu X E "Pharmac y ECME Set up Menu”
	3339	The Pharma cy ECME Se tup Menu o ption allo ws the ADP AC or IRMS to config ure ECME t o VAMC spe cification s.
	3340	You must h old the BP SMENU, BPS MANAGER, and BPS MA STER keys to view th e Pharmacy ECME Setu p Menu (SE T) option. Access the menu by e ntering “S ET” at the “Select P harmacy EC ME Setup M enu Option :” prompt in the Pha rmacy ECME Manager M enu option .
	3341	Example 7. 2-1: Acces sing the P harmacy EC ME Manager Menu Opti on
	3342	*** ****** ****** ****** ****** **
	3343	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	3344	* XXXX V AMC *
	3345	* Phar macy ECME Manager Me nu *
	3346	*** ****** ****** ****** ****** **
	3347	MNT ECME trans action mai ntenance o ptions ...
	3348	SET Pharmacy E CME Setup Menu ...
	3349	STAT Statistics Screen
	3350	Select Pha rmacy ECME Manager M enu Option : SET Pha rmacy ECME Setup Men u
	3351	You must h old the BP S MASTER k ey to view the Edit Basic ECME Parameter s (BAS), E dit ECME P harmacy Da ta (PHAR), and Regis ter Pharma cy with Au stin Autom ation Cent er (REG) o ptions.Exa mple 7.2-2 : Pharmacy ECME Setu p Menu Opt ions
	3352	*** ****** ****** ****** ****** **
	3353	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	3354	* XXXXXXX VAMC *
	3355	* Pha rmacy ECME Setup Men u *
	3356	*** ****** ****** ****** ****** **
	3357	BAS Edit Basic ECME Para meters
	3358	PHAR Edit ECME Pharmacy D ata
	3359	REG Register P harmacy wi th Austin Informati on Technol ogy Center
	3360	Select Pha rmacy ECME Setup Men u Option:
	3361	7.2.1 Edit Basic ECM E Paramete rs XE "Edi t Basic Ph armacy ECM E Paramete rs”
	3362	The Edit B asic ECME Parameters option al lows the A DPAC or IR MS to dete rmine how data will be input t o ECME.
	3363	This optio n should n ot be used after the initial s etup unles s any of t he informa tion chang es for the pharmacy. Access the menu by e ntering BA S at the “ Select Pha rmacy ECME Setup Men u Option:” prompt in the Pharm acy ECME S etup Menu option.
	3364	Example 7. 2.1-1: Acc essing the Edit Basi c ECME Par ameters Op tion
	3365	*** ****** ****** ****** ****** **
	3366	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	3367	* XXXXXX VAMC *
	3368	* Pha rmacy ECME Setup Men u *
	3369	*** ****** ****** ****** ****** **
	3370	BAS Edit Basic ECME Para meters
	3371	PHAR Edit ECME Pharmacy D ata
	3372	REG Register P harmacy wi th Austin Informatio n Technolo gy Center
	3373	Select Pha rmacy ECME Setup Men u Option: BAS Edit Basic ECME Parameter s
	3374	The Edit B asic ECME Parameters option al lows you t o enter/ed it the num ber of sec onds that the Outpat ient Pharm acy applic ation wait s for a re sponse to come back from the t hird party payer. As delivered , the syst em will ha ve a defau lt timeout of 10 sec onds but i t is up to each site to determ ine how lo ng their p harmacists wait for a response from the payer. The ECME time out can be populated once the system is installed. After thi s amount o f time has passed, c laims proc essing wil l continue but you w ill not se e messages indicatin g the proc ess.
	3375	This optio n will pro mpt for th e Default Eligibilit y Pharmacy . Once ent ered, this Pharmacy will be pl aced on th e NCPDP El igibility Verificati on request when it i s initiate d by the n ew option in IB.
	3376	One import ant reason for this is DUR (Dr ug Utiliza tion Revie w) /79 rej ects. If t he payer i ndicates t hat there is a probl em with th e drug (e. g., overdo se), the p harmacists will have to act on that resp onse.This option als o allows y ou to set the “Insur er Asleep” interval time and n umber of r etries. Th e Insurer Asleep Int erval para meter allo ws an inpu t between 0 and 29 m inutes wit h a defaul t of 20. T he Insurer Asleep Re tries para meter allo ws an inpu t between 0 and 99 r etries wit h a defaul t of 10. I f either t he Insurer Asleep In terval or the Insure r Asleep R etries par ameter is set to 0, the functi onality wi ll be disa bled. If t he user do es disable this func tionality, any claim s that are in an Ins urer Aslee p state wi ll automat ically be resubmitte d to the p ayer.
	3377	Occasional ly, Emdeon or the th ird-party payer will return a reject cod e indicati ng that th e destinat ion system is not av ailable. A s one exam ple, the t hird-party payer may be down f or regular system ma intenance and any cl aims submi tted durin g this tim e will be rejected. When this situation does occur , Emdeon o r the thir d-party pa yer will g enerally r eturn one or more of the NCPDP system pr ocessing r eject code s shown in the table below. Th ese reject codes are automatic ally resub mitted by ECME at th e interval s specifie d in the “ insurer as leep” para meter.
	3378	Reject Cod eExplanati on90Host H ung Up91Ho st Respons e Error92S ystem Unav ailable/Ho st Unavail able95Time Out96Sche duled Down time97Paye r Unavaila ble98Conne ction To P ayer Is Do wnExample 7.2.1-2: E ntering Ed it Basic E CME Parame ters
	3379	Select Pha rmacy ECME Setup Men u Option: BAS Edit Basic ECME Parameter s
	3380	Edit Pharm acy ECME c onfigurati on
	3381	ECME timeo ut? (0 to 30 seconds ): 30//
	3382	Insurer As leep Inter val (0 to 29 minutes ): 5//
	3383	Insurer As leep Retri es (0 to 9 9): 3//
	3384	Default El igibility Pharmacy: PHARMACY-1 //
	3385	7.2.2 Edit ECME Phar macy Data XE "Edit E CME Pharma cy Data"
	3386	The Edit E CME Pharma cy Data op tion enabl es pharmac y users to edit spec ific param eters that affect th e electron ic submiss ion of thi rd party p rescriptio n claims. The pharma cy site wi ll use thi s option t o control whether th e transmis sion of pr escription s to the C MOP dispen sing site will autom atically s ubmit elec tronic thi rd party p rescriptio n claims t o the insu rance paye rs. This o ption is a lso where the pharma cy site wi ll set the parameter of how ma ny days wi ll pass be fore a rev ersal is a utomatical ly process ed for a n on-release d prescrip tion.
	3387	You must h old the BP S MASTER k ey to view the Edit Basic ECME Parameter s (BAS), E dit ECME P harmacy Da ta (PHAR), and Regis ter Pharma cy with Au stin Autom ation Cent er (REG) o ptions.
	3388	Access the option by entering PHAR at th e “Select Pharmacy E CME Manage r Menu Opt ion:” prom pt in the Pharmacy E CME Manage r Menu opt ion.
	3389	Example 7. 2.2-1: Acc essing the Edit ECME Pharmacy Data Optio n
	3390	*** ****** ****** ****** ****** **
	3391	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	3392	* XXXXXX VAMC *
	3393	* Pha rmacy ECME Setup Men u *
	3394	*** ****** ****** ****** ****** **
	3395	BAS Edit Basic ECME Para meters
	3396	PHAR Edit ECME Pharmacy D ata
	3397	REG Register P harmacy wi th Austin Informatio n Technolo gy Center
	3398	Select Pha rmacy ECME Manager M enu Option : PHAR Ed it Pharmac y ECME Pha rmacy Data
	3399	Example 7. 2.2-2: Ent ering Edit ECME Phar macy Data Options
	3400	Select BPS PHARMACIE S NAME: XX XXXX VAMC PHARMACY
	3401	NAME: XXXX XX VAMC PH ARMACY
	3402	STATUS: AC TIVE
	3403	NCPDP #: 1 111111
	3404	NPI: 12345 67893
	3405	Select OUT PATIENT SI TE: XXXXXX VAMC PHAR MACY // <E NTER>
	3406	OUTPATIE NT SITE: X XXXXX VAMC PHARMACY // <ENTER>
	3407	Select OUT PATIENT SI TE: <ENTE R>
	3408	CMOP SWITC H: CMOP ON // <ENTER>
	3409	AUTO-REVER SE PARAMET ER: 5// 5
	3410	DEFAULT DE A #: AG123 45
	3411	The follow ing table describes the Edit E CME Pharma cy Data op tion field s:
	3412	Table 7.2. 2-1: Descr iption of Edit ECME Pharmacy D ata Option Fields
	3413	EntryDescr iptionBPS PHARMACIE S NAMEPhar macy in a specific V AMC (Depar tment of V eterans Af fairs Medi cal Center ) database . The phar macy user may enter a new BPS pharmacy, which must be 3-30 a lphabetica l characte rs.NAMEDis play-only field that displays the full p harmacy na me entered .NCPDP #A 7-digit nu mber assig ned to the specified pharmacy by the Nat ional Coun cil for Pr escription Drug Prog rams (NCPD P). It is also known as NABP.N PINational Provider Identifier . A 10-dig it number required b y the Heal th Insuran ce Portabi lity and A ccountabil ity Act of 1996 (HIP AA) to ide ntify indi vidual and organizat ional prov iders, suc h as outpa tient site s. The NPI has a usa ge require ment date beginning May 23, 20 08.STATUST he status of the BPS Pharmacy is either ACTIVE or INACTIVE. The STATUS of the ph armacy may be revise d through the Regist er Pharmac y with Aus tin Inform ation Tech nology Cen ter option .OUTPATIEN T SITESOne or more O utpatient Sites (fro m File 59) may be li nked with a single B PS Pharmac y entry. H owever, an Outpatien t Site can only be l inked with a single BPS Pharma cy. All of the sites linked wi th a BPS P harmacy sh ould have the same N CPDP numbe r. When an Outpatien t Site is linked to an active BPS Pharma cy entry, the ECME s witch for that site is conside red ENABLE D. If an O utpatient Site is li nked to an incorrect BPS Pharm acy, it mu st be remo ved from t he incorre ct entry b efore it c an be link ed to the correct en try.CMOPON if the tr ansmission of prescr iptions to the CMOP (Consolida ted Mail O utpatient Pharmacy) dispensing site will automatic ally submi t electron ic third p arty presc ription cl aims to th e insuranc e payers. See note b elow for e xplanation of claims generated before an d after sw itch is tu rned on or off.AUTO- REVERSE PA RAMETEREnt er numbers from 3 to 10 for th e number o f days to wait befor e ECME rev erses non- released p rescriptio n claims w ith a PAYA BLE payer- returned r esponse. E ach site’s business practice w ill dictat e what thi s value sh ould be.DE FAULT DEA #The pharm acy’s Drug Enforceme nt Adminis tration (D EA) number . An Outpa tient Site is consid ered ECME active if the Outpat ient Site is linked to a BPS P harmacy, a nd if that BPS Pharm acy is ACT IVE. Once an Outpati ent Site i s ECME act ive, claim s for the Outpatient Site can be transmi tted to th e third-pa rty payer.
	3414	If an Outp atient Sit e is activ ated after a claim i s already sent to EC ME, ECME w ill NOT ge nerate an electronic claim.
	3415	If an Outp atient Sit e is inact ivated (by unlinking it from a BPS Pharm acy or by changing t he STATUS field), re versals fo r that sit e will be processed but new su bmissions will not.7 .2.3 Regis ter Pharma cy with Au stin Infor mation Tec hnology Ce nter
	3416	The Regist er Pharmac y with Aus tin Inform ation Tech nology Cen ter option allows th e ADPAC to register a pharmacy with the Austin In formation Technology Center an d update t he contact informati on. This r egistratio n should o nly be per formed on initializa tion of th e pharmacy with ECME . Once the pharmacy has been s et up to u se ECME, t he Edit EC ME Pharmac y Data opt ion should be used t o make any changes.
	3417	The automa ted regist ration pro cess will send an em ail to the Primary S ite Contac t if the r egistratio n has any errors or warnings t o report. The Altern ate Site C ontact wil l be used when the e mail addre ss for the Primary S ite contac t is missi ng. If the alternate site cont act does n ot have an email add ress, the message wi ll be sent to the BP S OPECC ma il group. In additio n, if eith er the pri mary or al ternate si te contact is missin g their em ail addres s, it will be report ed as a wa rning duri ng manual registrati on. Follow ing is a s ample emai l.
	3418	Example 7. 2.3-1: ECM E Pharmacy Registrat ion Proble m Message Subj: ECME Registrat ion Proble m. [#1415 87] 06/09/ 08@15:36 4 lines
	3419	From: ECME PACKAGE In 'IN' ba sket. Pa ge 1 New
	3420	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------
	3421	Source Pro cess: ECME Pharmacy Registrati on
	3422	ECME Pharm acy Regist ration HL7 Message n ot created .
	3423	PHARMAC Y NAME: TE ST PHARMAC Y 2
	3424	** NPI NUM BER - Miss ing/Invali d
	3425	Enter mess age action (in IN ba sket): Del ete//
	3426	This optio n should n ot be used after the initial s etup unles s any of t he informa tion chang es for the pharmacy. You must h old the BP S MASTER k ey to view the Edit Basic ECME Parameter s (BAS), E dit ECME P harmacy Da ta (PHAR), and Regis ter Pharma cy with Au stin Autom ation Cent er (REG) o ptions.
	3427	Access the menu by e ntering RE G at the “ Select Pha rmacy ECME Setup Men u Option:” prompt in the Pharm acy ECME S etup Menu option. Th e system w ill valida te the dat a and then send an e Pharmacy m essage to the Austin Informati on Technol ogy Center , which no tifies the m that the prospecti ve site is ready to transmit e lectronic pharmacy c laims.
	3428	Example 7. 2.3-2: Acc essing the Register Pharmacy w ith Austin Informati on Technol ogy Center Option
	3429	*** ****** ****** ****** ****** **
	3430	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	3431	* XXXXX V AMC *
	3432	* Pha rmacy ECME Setup Men u *
	3433	*** ****** ****** ****** ****** **
	3434	BAS Edit Basic ECME Para meters
	3435	PHAR Edit ECME Pharmacy D ata
	3436	REG Register P harmacy wi th Austin Informatio n Technolo gy Center
	3437	Select Pha rmacy ECME Setup Men u Option: REG Regis ter Pharma cy with Au stin Infor mation Tec hnology Ce nter
	3438	Example 7. 2.3-3: Reg ister Phar macy with Austin Inf ormation T echnology Center wit h Austin I nformation Technolog y Center O ption
	3439	E CME Site R egistratio n
	3440	-- PRIMAR Y SITE CON TACT DATA --
	3441	SITE CONTA CT: ECMEUS ER,ONE// < ENTER>
	3442	OFFICE P HONE: XXX- XXX-XXXX// <ENTER>
	3443	EMAIL AD DRESS: ECM EUSER.ONE@ FORUM.VA.G OV// <ENTE R>
	3444	-- ALTERN ATE SITE C ONTACT DAT A --
	3445	ALTERNATE SITE CONTA CT: ECMEUS ER,TWO// < ENTER>
	3446	OFFICE P HONE: XXX- XXX-XXXX// <ENTER>
	3447	EMAIL ADDR ESS: PII //
	3448	Replace < ENTER>
	3449	-- Applica tion Regis tration Va lidation R esults:
	3450	DOMAIN NAME - Req uired - VA LID: XXXXX XXX.XXXXXX -XXX-XXXX. XXX.XX.XXX
	3451	TCP/IP ADDRESS FO R "EPHARM OUT" - Req uired - VA LID: XX.XX X.XXX.XXX
	3452	"EPHARM OUT" PORT NUMBER - Required - VALID: XX XX
	3453	SITE NU MBER - Req uired - VA LID: XXX
	3454	INTERFA CE VERSION - Require d - VALID: 3
	3455	CONTACT NAME - VA LID: ECMEU SER,ONE
	3456	CONTACT MEANS - V ALID: NET INTERNET ECMEUSER.O NE@FORUM.V A.GOV
	3457	ALTERNA TE CONTACT NAME - VA LID: ECMEU SER,TWO
	3458	ALTERNATE CONTACT ME ANS - VALI D: NET INTERN ET PII
	3459	* * Applicat ion Regist ration Dat a VALID **
	3460	Enter RETU RN to cont inue or '^ ' to exit: <ENTER>
	3461	Enter/veri fy Pharmac y Registra tion Data
	3462	Select BPS PHARMACIE S NAME: TE ST PHARMAC Y 3
	3463	--SITE DA TA
	3464	STATUS: IN ACTIVE// < ENTER>
	3465	NCPDP #: X XXXXXX// < ENTER>
	3466	DEFAULT DE A #: XXXXX XXX// <ENT ER>
	3467	SITE ADDRE SS NAME: 1 11 MAIN ST R// <ENTER >
	3468	SITE ADDRE SS 1: 111 MAIN STREE T// <ENTER >
	3469	SITE ADDRE SS 2: <ENT ER>
	3470	SITE CITY: BROOKLYN/ / <ENTER>
	3471	SITE STATE : NEW YORK // <ENTER>
	3472	SITE ZIP C ODE: 11223 // <ENTER>
	3473	REMITTANCE ADDRESS N AME: 1111 TEST STR// <ENTER>
	3474	REMIT ADDR ESS 1: 111 TEST STRE ET// <ENTE R>
	3475	REMIT ADDR ESS 2: <EN TER>
	3476	REMIT CITY : TOPEKA// <ENTER>
	3477	REMIT STAT E: KANSAS/ / <ENTER>
	3478	REMIT ZIP: 66606// < ENTER>
	3479	--PRIMARY CONTACT D ATA
	3480	VA CONTACT : ECMEUSER ,ONE// <EN TER>
	3481	OFFICE P HONE: XXX- XXX-XXXX// <ENTER>
	3482	EMAIL AD DRESS: ECM EUSER.ONE@ FORUM.VA.G OV
	3483	Replace < ENTER>
	3484	TITLE: O I&T STAFF/ / <ENTER>
	3485	--ALTERNA TE CONTACT DATA
	3486	VA ALTERNA TE CONTACT : ECMEUSER ,THREE L// <ENTER>
	3487	OFFICE P HONE: XXX- XXX-XXXX// <ENTER>
	3488	EMAIL ADDR ESS: PII Replace <E NTER>
	3489	TITLE: O I&T STAFF/ / <ENTER>
	3490	--PHARMAC IST DATA
	3491	VA LEAD PH ARMACIST: ECMEUSER,F OUR// <ENT ER>
	3492	OFFICE P HONE: XXX- XXX-XXXX / / <ENTER>
	3493	EMAIL AD DRESS: <EN TER>
	3494	TITLE: O I&T STAFF/ / <ENTER>
	3495	VA LEAD PH ARMACIST L ICENSE #: XXXXXXX// <ENTER>
	3496	-- Pharmac y Registra tion Valid ation Resu lts --
	3497	PHARMAC Y NAME: TE ST PHARMAC Y 3
	3498	-- Pharmac y Registra tion Data VALID. --
	3499	Enter/veri fy Pharmac y Registra tion Data
	3500	Select BPS PHARMACIE S NAME: <E NTER>
	3501	Applicatio n Registra tion Data is VALID
	3502	Pharmacy R egistratio n Data is:
	3503	VALID for TEST P HARMACY 1 and will b e transmit ted.
	3504	*INVALID for TEST P HARMACY 2 and will N OT be tran smitted.
	3505	VALID for TEST P HARMACY 3 and will b e transmit ted.
	3506	Send Appli cation Reg istration: Y/N ? n NO
	3507	Press RETU RN to cont inue...
	3508	7.3 Statis tics Scree n XE "Stat istics Scr een”
	3509	The Statis tics Scree n option a llows ADPA CS and IRM S to view statistics and trans mission pr ogress for all ECME claims.
	3510	You must h old the BP SMENU and BPS MANAGE R keys to view the S tatistics Screen opt ion.Access the menu by enterin g STAT at the “Selec t Pharmacy ECME Mana ger Menu O ption:” pr ompt in th e Pharmacy ECME Mana ger Menu o ption.
	3511	Statistics collectio n begins a t the mome nt of ECME installat ion and co ntinues un til either you use t he Z (clea r) action or ECME is uninstall ed. It dep ends on th e each sit e's busine ss practic e as far a s how ofte n or if th e stats ar e cleared. Example 7. 3-1: Acces sing the S tatistics Screen Opt ion
	3512	*** ****** ****** ****** ****** **
	3513	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	3514	* XXXXXX VAMC *
	3515	* Phar macy ECME Manager Me nu *
	3516	*** ****** ****** ****** ****** **
	3517	MNT ECME trans action mai ntenance o ptions ...
	3518	SET Pharmacy E CME Setup Menu ...
	3519	STAT Statistics Screen
	3520	Select Pha rmacy ECME Manager M enu Option : STAT Sta tistics Sc reen
	3521	Example 7. 3-2: Stati stics Scre en
	3522	ECME STATI STICS Nov 03, 20 10@16:50:3 0 Page: 1 of 1
	3523	Communicat ions stati stics last cleared o n AUG 18,2 003@16:36: 28
	3524	* CLAIM STATUS * * CLAIM RES ULTS *
	3525	Waiting to start 0 P aid claims 2,93 4
	3526	Building the trans action 0 R ejected cl aims 2,17 1
	3527	Building the claim 0 D ropped to Paper 1 5
	3528	Building the HL7 p acket 1 D uplicate c laims 0
	3529	Preparin g for tran smit 0 C aptured cl aims 0
	3530	Transmit ting 0 A ccepted Re versals 2,06 7
	3531	Parsing response 0 R ejected Re versals 16 6
	3532	Processi ng respons e 0 A ccepted El igibility 7
	3533	R ejected El igibility 4 4
	3534	E rrors 1 4
	3535	Enter ?? f or more ac tions
	3536	UC Updat e continuo usly Z Zero (cle ar) stats
	3537	U1 Displ ay update EX Exit
	3538	Select Act ion:U1//
	3539	This secti on diagram s and desc ribes the different elements o f the Stat istics Scr een.
	3540	Diagram 7. 3-1: Stati stics Opti on Areas
	3541
	3542
	3543
	3544
	3545
	3546
	3547	The table below desc ribes the Statistics Screen op tion areas :
	3548	Table 7.3- 1: Descrip tion of St atistics S creen Opti on
	3549	Screen Are asDescript ionHeader AreaDispla ys the dat e for whic h you requ ested the Statistics Screen op tion.Stats AreaDispl ays statis tics for a ll ECME cl aims. Clai m Status r eports sta tistics of ECME tran sactions i n progress . Claim Re sults give s statisti cs about c ompleted E CME transa ctions.Mes sage Windo wThis sect ion displa ys informa tional tex t (i.e., E nter ?? fo r more act ions). Act ion AreaAv ailable op tions. A d ouble ques tion mark (??) may b e entered at the "Se lect Actio n:" prompt for a lis t of all L ist Manage r options available. 7.3.1 Upda te Continu ously XE " Update Con tinuously”
	3550	The system can updat e the clai ms statist ics every 3 seconds.
	3551	Enter UC to display statistic s that wil l be updat ed every 3 seconds.
	3552	Example 7. 3.1-1: Acc essing Upd ate Contin uously Opt ion
	3553	ECME STATI STICS Nov 03, 20 10@16:50:3 0 Page: 1 of 1
	3554	Communicat ions stati stics last cleared o n AUG 18,2 003@16:36: 28
	3555	* CLAIM STATUS * * CLAIM RES ULTS *
	3556	Waiting to start 0 P aid claims 2,93 4
	3557	Building the trans action 0 R ejected cl aims 2,17 1
	3558	Building the claim 0 D ropped to Paper 1 5
	3559	Building the HL7 p acket 1 D uplicate c laims 0
	3560	Preparin g for tran smit 0 C aptured cl aims 0
	3561	Transmit ting 0 A ccepted Re versals 2,06 7
	3562	Parsing response 0 R ejected Re versals 16 6
	3563	Processi ng respons e 0 A ccepted El igibility 7
	3564	R ejected El igibility 4 4
	3565	E rrors 1 4
	3566	Enter ?? f or more ac tions
	3567	UC Updat e continuo usly Z Zero (cle ar) stats
	3568	U1 Displ ay update EX Exit
	3569	Select Act ion:U1//UC Update co ntinuously
	3570	Press ^ or Q to stop the updat ing. The s ystem will go back t o the Stat istics Scr een.
	3571	Example 7. 3.1-2: Dis playing Cl aims Statu s and Resu lts in Upd ate Contin uously Mod e
	3572	ECME STATI STICS Nov 03, 20 10@16:50:3 0 Page: 1 of 1
	3573	Communicat ions stati stics last cleared o n AUG 18,2 003@16:36: 28
	3574	* CLAIM STATUS * * CLAIM RES ULTS *
	3575	Waiting to start 0 P aid claims 2,93 4
	3576	Building the trans action 0 R ejected cl aims 2,17 1
	3577	Building the claim 0 D ropped to Paper 1 5
	3578	Building the HL7 p acket 1 D uplicate c laims 0
	3579	Preparin g for tran smit 0 C aptured cl aims 0
	3580	Transmit ting 0 A ccepted Re versals 2,06 7
	3581	Parsing response 0 R ejected Re versals 16 6
	3582	Processi ng respons e 0 A ccepted El igibility 7
	3583	R ejected El igibility 4 4
	3584	E rrors 1 4
	3585	In continu ous update mode: pre ss Q to Qu it
	3586	Q Quit
	3587	7.3.2 Disp lay Update XE "Displ ay Update”
	3588	You can up date the s tatistics once every time the option U1 is entered .
	3589	Example 7. 3.2-1: Acc essing Dis play Updat e Option
	3590	ECME STATI STICS Nov 03, 20 10@16:50:3 0 Page: 1 of 1
	3591	Communicat ions stati stics last cleared o n AUG 18,2 003@16:36: 28
	3592	* CLAIM STATUS * * CLAIM RES ULTS *
	3593	Waiting to start 0 P aid claims 2,93 4
	3594	Building the trans action 0 R ejected cl aims 2,17 1
	3595	Building the claim 0 D ropped to Paper 1 5
	3596	Building the HL7 p acket 1 D uplicate c laims 0
	3597	Preparin g for tran smit 0 C aptured cl aims 0
	3598	Transmit ting 0 A ccepted Re versals 2,06 7
	3599	Parsing response 0 R ejected Re versals 16 6
	3600	Processi ng respons e 0 A ccepted El igibility 7
	3601	R ejected El igibility 4 4
	3602	E rrors 1 4
	3603	Enter ?? f or more ac tions
	3604	UC Updat e continuo usly Z Zero (cle ar) stats
	3605	U1 Displ ay update EX Exit
	3606	Select Act ion:U1//U1 Display u pdate
	3607	7.3.3 Zero (clear) S tatistics XE "Zero ( clear) Sta tistics”
	3608	The system can reset the displ ayed claim s statisti cs to zero . This is useful for looking a t short-te rm average s, such as during a time of he avy activi ty.
	3609	Enter Z to access th e Zero (cl ear) stats option.
	3610	Example 7. 3.3-1: Acc essing Zer o (clear) stats Opti on
	3611	ECME STATI STICS Nov 03, 20 10@16:50:3 0 Page: 1 of 1
	3612	Communicat ions stati stics last cleared o n AUG 18,2 003@16:36: 28
	3613	* CLAIM STATUS * * CLAIM RES ULTS *
	3614	Waiting to start 0 P aid claims 2,93 4
	3615	Building the trans action 0 R ejected cl aims 2,17 1
	3616	Building the claim 0 D ropped to Paper 1 5
	3617	Building the HL7 p acket 1 D uplicate c laims 0
	3618	Preparin g for tran smit 0 C aptured cl aims 0
	3619	Transmit ting 0 A ccepted Re versals 2,06 7
	3620	Parsing response 0 R ejected Re versals 16 6
	3621	Processi ng respons e 0 A ccepted El igibility 7
	3622	R ejected El igibility 4 4
	3623	E rrors 1 4
	3624	Enter ?? f or more ac tions
	3625	UC Updat e continuo usly Z Zero (cle ar) stats
	3626	U1 Displ ay update EX Exit
	3627	Select Act ion:U1//Z Z (clear ) stats
	3628	You may ch oose to ei ther zero out (refre sh) the di splayed co py of the statistics by enteri ng L (Loca l) or to z ero out th e permanen t copy by entering P .
	3629	Choosing P ermanent C opy will p ermanently zero out the statis tics in th e database . You need to realiz e that if this selec tion is ch osen, ther e will no longer be activity h istory.Exa mple 7.3.3 -2: Enteri ng Zero (c lear) stat s Option t o Delete L ocal Claim Results S tatistics
	3630	Selec t one of t he followi ng:
	3631	L Local Copy
	3632	P Permanent Copy
	3633	Delete (L) ocal Copy or (P)erma nent Copy of the sta tistics: L ocal Copy/ / L Local Copy
	3634	When the s ystem asks if you ar e sure, en ter Y to c ontinue or N to stop the delet ion.
	3635	Example 7. 3.3-3: Ent ering Yes to “Are Yo u Sure” Pr ompt
	3636	Are you su re? N// YE S
	3637	Enter Z to access th e Zero (cl ear) stats option.
	3638	Example 7. 3.3-4: Dis playing Ze roed Claim s Statisti cs
	3639	ECME STATI STICS Nov 03, 20 10@16:50:3 0 Page: 1 of 1
	3640	Communicat ions stati stics last cleared o n AUG 18,2 003@16:36: 28
	3641	* CLAIM STATUS * * CLAIM RES ULTS *
	3642	Waiting to start 0 P aid claims 2,93 4
	3643	Building the trans action 0 R ejected cl aims 2,17 1
	3644	Building the claim 0 D ropped to Paper 1 5
	3645	Building the HL7 p acket 1 D uplicate c laims 0
	3646	Preparin g for tran smit 0 C aptured cl aims 0
	3647	Transmit ting 0 A ccepted Re versals 2,06 7
	3648	Parsing response 0 R ejected Re versals 16 6
	3649	Processi ng respons e 0 A ccepted El igibility 7
	3650	R ejected El igibility 4 4
	3651	E rrors 1 4
	3652	Enter ?? for more a ctions
	3653	UC Updat e continuo usly Z Zero (cle ar) stats
	3654	U1 Displ ay update EX Exit
	3655	Select Act ion:U1// Z Zero (c lear) stat s
	3656	Delete (L) ocal Copy or (P)erma nent Copy of the sta tistics: L ocal Copy/ / Local Co py
	3657	Are you su re? N// YE S
	3658	7.3.4 Exit ing the St atistics S creen
	3659	Enter EX o r Q to exi t out of t he Statist ics Screen and retur n to the P harmacy EC ME Manager Menu.
	3660	Example 7. 3.4-1: Acc essing Exi t Option
	3661	ECME STATI STICS Nov 03, 20 10@16:50:3 0 Page: 1 of 1
	3662	Communicat ions stati stics last cleared o n AUG 18,2 003@16:36: 28
	3663	* CLAIM STATUS * * CLAIM RES ULTS *
	3664	Waiting to start 0 P aid claims 2,93 4
	3665	Building the trans action 0 R ejected cl aims 2,17 1
	3666	Building the claim 0 D ropped to Paper 1 5
	3667	Building the HL7 p acket 1 D uplicate c laims 0
	3668	Preparin g for tran smit 0 C aptured cl aims 0
	3669	Transmit ting 0 A ccepted Re versals 2,06 7
	3670	Parsing response 0 R ejected Re versals 16 6
	3671	Processi ng respons e 0 A ccepted El igibility 7
	3672	R ejected El igibility 4 4
	3673	E rrors 1 4
	3674	Enter ?? f or more ac tions
	3675	UC Updat e continuo usly Z Zero (cle ar) stats
	3676	U1 Displ ay update EX Exit
	3677	Select Act ion:U1// E X Exit
	3678	(This page included for two-si ded copyin g.)
	3679	8
	3680	Accessing the Pharma cy Electro nic Claims Reports XE "Pharma cy Electro nic Claims Reports"
	3681	The Pharma cy Electro nic Claims Reports o ption is a menu that allows yo u to obtai n detailed informati on about c laims, tra nsactions, Electroni c Claims M anagement Engine (EC ME) activi ties, and system con figuration s.
	3682	You must h old the BP SMENU and BPS REPORT S keys to view the P harmacy El ectronic C laims Repo rts option . Access i t by enter ing RPT at the “Sele ct ECME Op tion:” pro mpt on the ECME Main Menu opti on screen.
	3683	Example 8- 1: Accessi ng the Pha rmacy Elec tronic Cla ims Report s Option
	3684	*** ****** ****** ****** ****** **
	3685	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	3686	* XXXXX V AMC *
	3687	* Main M enu *
	3688	*** ****** ****** ****** ****** **
	3689	U ECME User Screen
	3690	COB ECME Pharm acy COB .. .
	3691	MGR Pharmacy E CME Manage r Menu ...
	3692	RPT Pharmacy E lectronic Claims Rep orts ...
	3693	Select ECM E Option: RPT Pharm acy Electr onic Claim s Reports
	3694	Example 8- 2: Display ing Pharma cy Electro nic Claims Reports O ptions
	3695	*** ****** ****** ****** ****** **
	3696	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	3697	* XXXXX V AMC *
	3698	* Pharmacy Electroni c Claims R eports *
	3699	*** ****** ****** ****** ****** **
	3700	CLA Claim Resu lts and St atus ...
	3701	OTH Other Repo rts ...
	3702	Select Pha rmacy Elec tronic Cla ims Report s Option:
	3703	8.1 Claim Results an d Status X E " Claim Results an d Status"
	3704	The Claim Results an d Status o ption is a menu that allows yo u to obtai n reports about the statuses o f claims.
	3705	Access Cla im Results and Statu s by enter ing CLA at the “Sele ct Pharmac y Electron ic Claims Reports Op tion:” pro mpt on the Pharmacy Electronic Claims Re ports opti on screen.
	3706	Example 8. 1-1: Acces sing the C laim Resul ts and Sta tus Option
	3707	*** ****** ****** ****** ****** **
	3708	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	3709	* XXXXX VAMC *
	3710	* Pharmacy Electroni c Claims R eports *
	3711	*** ****** ****** ****** ****** **
	3712	CLA Claim Resu lts and St atus ...
	3713	OTH Other Repo rts ...
	3714	Select Pha rmacy Elec tronic Cla ims Report s Option: CLA Claim Results a nd Status
	3715	You have a choice of Claims Re sults and Status rep orts to ch oose from.
	3716	Example 8. 1-2: Displ aying All Claims Res ults and S tatus Opti ons
	3717	*** ****** ****** ****** ****** **
	3718	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	3719	* XXXXXX VAMC *
	3720	* Cla im Results and Statu s *
	3721	*** ****** ****** ****** ****** **
	3722	PAY Payable Cl aims Repor t
	3723	REJ Rejected C laims Repo rt
	3724	ECMP CMOP/ECME Activity R eport
	3725	REV Reversal C laims Repo rt
	3726	NYR Claims Sub mitted, No t Yet Rele ased
	3727	REC Recent Tra nsactions
	3728	DAY Totals by Date
	3729	CLO Closed Cla ims Report
	3730	NBS Non-Billab le Status Report
	3731	SPA Spending A ccount Rep ort
	3732	Select Cla im Results and Statu s Option:
	3733	Items/filt ers that p ertain to ALL ECME C laims Resu lts and St atus REPOR TS will be displayed for every option ch osen. You can select these opt ions using the same method as in other V istA appli cations an d as descr ibed in th e Change V iew sectio n.
	3734	Most of th e Claim Re sults and Status rep orts requi re that a device wit h 132 colu mn width b e used. Th ey will no t display correctly using 80 c olumn widt h devices. Example 8. 1-3: Displ aying ECME Report It em/Filter Options fo r ALL REPO RTS
	3735	Selec t one of t he followi ng:
	3736	D DIVISION
	3737	A ALL
	3738	Select Cer tain Pharm acy (D)ivi sions or ( A)LL: <Ent er> ALL
	3739	Selec t one of t he followi ng:
	3740	S Summary
	3741	D Detail
	3742	Display (S )ummary or (D)etail Format: De tail// Sum mary
	3743	Selec t one of t he followi ng:
	3744	I SPECIFIC I NSURANCE(S )
	3745	A ALL
	3746	Select Cer tain (I)NS URANCE or (A)LL): A/ / I SPECI FIC INSURA NCES(S)
	3747	Select INS URANCE: IB INSUR1 123 ANY WHERE ST HER NDON V IRGINIA
	3748	Y
	3749	Selected :
	3750	IBINSUR1
	3751	Select INS URANCE: DE VELOPMENT INS 123 HERE S TREET SAN FR ANCISCO
	3752	CALIFORN IA Y
	3753	Selected :
	3754	DEVELOPMEN T INS
	3755	IBINSUR1
	3756	Select INS URANCE: <E nter>
	3757	Selec t one of t he followi ng:
	3758	C CMOP
	3759	M Mail
	3760	W Window
	3761	A ALL
	3762	Display (C )MOP or (M )ail or (W )indow or (A)LL: ALL // <Enter> ALL
	3763	Selec t one of t he followi ng:
	3764	R Real Time Fills
	3765	B Backbill
	3766	P PRO Option
	3767	S Resubmissi on
	3768	A ALL
	3769	Display (R )ealTime, (B)ackbill s, (P)RO O ption, Re( S)ubmissio n or (A)LL : A// <Ent er> ALL
	3770	Selec t one of t he followi ng:
	3771	D Drug
	3772	C Drug Class
	3773	A ALL
	3774	Display Sp ecific (D) rug or Dru g (C)lass or (A)LL: ALL// <Ent er> ALL
	3775	In additio n to the “ ALL REPORT S” prompts , all of t he Claims Results an d Status R EPORTS exc ept the EC MP report display an other prom pt that wi ll allow y ou to capt ure the re port data in Excel s preadsheet format. I f you answ er Y, addi tional dir ections ar e supplied .
	3776	Example 8. 1-4: Reque sting Repo rt Data in Excel Spr eadsheet F ormat
	3777	Do you wan t to captu re report data for a n Excel do cument? NO // YES
	3778	Befor e continui ng, please set up yo ur termina l to captu re the
	3779	detai l report d ata. On so me termina ls, this c an be done by
	3780	click ing on the 'Tools' m enu above, then clic k on 'Capt ure
	3781	Incom ing Data' to save to Desktop. This repor t may take a
	3782	while to run.
	3783	Note: To avoid undesired wrapping o f the data saved to the
	3784	file, ple ase enter '0;256;999 ' at the ' DEVICE:' p rompt.
	3785	8.1.1 Paya ble Claims Report XE " Payable Claims"
	3786	The Payabl e Claims R eport opti on produce s a report that list s PAYABLE electronic claims th at have be en success fully tran smitted to the payer and have not been r eversed.
	3787	You must h old the BP SMENU and BPS REPORT S keys to view the P ayable Cla ims Report option. T he Payable Claims Re port optio n has the most acces sible info rmation on payable c laims from the BPS C laims File . A FileMa n inquiry into the B PS Claims File will find that the inform ation is i n NCPDP (N ational Co uncil for Prescripti on Drug Pr ograms) V. D.0 form ats. Acces s the repo rt by ente ring PAY a t the “Sel ect Claim Results an d Status O ption:” pr ompt on th e Claim Re sults and Status opt ion screen .
	3788	Example 8. 1.1-1: Acc essing the Payable C laims Repo rt Option
	3789	*** ****** ****** ****** ****** **
	3790	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	3791	* XXXXX V AMC *
	3792	* Cla im Results and Statu s *
	3793	*** ****** ****** ****** ****** **
	3794	PAY Payable Cl aims Repor t
	3795	REJ Rejected C laims Repo rt
	3796	ECMP CMOP/ECME Activity R eport
	3797	REV Reversal C laims Repo rt
	3798	NYR Claims Sub mitted, No t Yet Rele ased
	3799	REC Recent Tra nsactions
	3800	DAY Totals by Date
	3801	CLO Closed Cla ims Report
	3802	NBS Non-Billab le Status Report
	3803	SPA Spending A ccount Rep ort
	3804	Select Cla im Results and Statu s Option: PAY Payab le Claims Report
	3805	After you have made selections from the “ALL REPOR TS” prompt s, you wil l be promp ted to sel ect a repo rt date ra nge; Relea sed, Not R eleased or All claim s; Certain Eligibili ty Type or All; and Excel disp lay format and devic e selectio n.
	3806	Example 8. 1.1-2: Add itional pr ompts aske d by the P ayable Cla ims Report Option
	3807	START WITH TRANSACTI ON DATE: T -1// T-99
	3808	GO TO TR ANSACTION DATE: T// <Enter>
	3809	Selec t one of t he followi ng:
	3810	R RELEASED
	3811	N NOT RELEAS ED
	3812	A ALL
	3813	Include Rx s - (R)ELE ASED or (N )OT RELEAS ED or (A)L L: RELEASE D// ALL
	3814	Selec t one of t he followi ng:
	3815	V VETERAN
	3816	T TRICARE
	3817	C CHAMPVA
	3818	A ALL
	3819	Include Ce rtain Elig ibility Ty pe or (A)l l: V// ALL
	3820	Data field s VA Ingre dient Cost , VA Dispe nsing Fee, Ingredien t Cost Pai d, Dispens ing Fee Pa id and Pat ient Respo nsibility (INS) will only be i ncluded wh en the rep ort is cap tured for an Excel d ocument. All additi onal data fields may not be pr esent for all report s.
	3821	Do you wan t to captu re report data for a n Excel do cument? NO // <Enter>
	3822	WARNING - THIS REPOR T REQUIRES THAT A DE VICE WITH 132 COLUMN WIDTH BE USED.
	3823	IT WILL NO T DISPLAY CORRECTLY USING 80 C OLUMN WIDT H DEVICES
	3824	DEVICE: HO ME// <Ente r> IP net work
	3825	Please wai t...
	3826	(This page included for two-si ded copyin g.)
	3827	Example 8. 1.1-3: Pay able Claim s Report
	3828	ECME PAYAB LE CLAIMS DETAIL REP ORT Print Da te: MAY 21 , 2008@11: 41:54 Pag e: 1
	3829	DIVISION(S ): ALL Fi ll Locatio ns: C,M,W Fill type : RT,BB,RS
	3830	Insurance: DEVELOPME NT INS, IB INSUR1 D rugs/Class es: ALL
	3831	Eligibilit y: ALL
	3832	ALL PRESCR IPTIONS BY TRANSACTI ON DATE: F rom 02/12/ 08 through 05/21/08
	3833	========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== =====
	3834	PATIENT NA ME Pt. ID ELIG RX# REF/ECM E# DA TE $B ILLED $ INS RESPON SE $CO LLECT
	3835	DRUG NDC REL EASED ON RX INFO BILL# C OB
	3836	========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== =====
	3837	DIVISION: PHARMACY-1
	3838	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- -----
	3839	DEVELOPMEN T INS
	3840	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- -----
	3841	ECMEpatien t,One (XX XX) TRI 100222$ 2/000000 111264 04/15/0 8 51 .00 40.00
	3842	AMITRI PTYLINE 10 MG TAB 00182-10 18-10 04/ 15/08 W RT A C/R K8000K9 p
	3843	ECMEpatien t, Three (XX XX) VET 222$ 0/000000 000492 03/1 0/08 51.00 68 .32
	3844	METHAD ONE 10MG T AB W RT E X/N
	3845	-------- -- - ---------
	3846	SUBTOTALS for INS:DE VELOPMENT INS 102. 00 108.32 0.00
	3847	COUNT 2 2 2
	3848	MEAN 51. 00 54.16 0.00
	3849	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- -----
	3850	IBINSUR1
	3851	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- -----
	3852	ECMEpatien t, Two (XX XX) VET 100574$ 0/000000 000484 03/0 5/08 51.00 40 .00
	3853	NEODEC ADRON OPHT MALIC SOL. 00006-76 39-03 03/ 05/08 W RT A C/R K8000H6 p
	3854	ECMEpatien t, Two (XX XX) VET 100575$ 0/000000 000485 03/0 5/08 51.00 40 .00
	3855	PENTAE RYTHRITOL 10MG TAB 00725-20 64-10 03/ 05/08 W RT A C/R K8000H7 p
	3856	...
	3857	SUBTOTALS for INS:IB INSUR1 2142. 00 1652.28 5.00
	3858	COUNT 42 42 42
	3859	MEAN 51. 00 39.34 0.12
	3860	-------- -- --------- ----- -----
	3861	SUBTOTALS for DIV:PH ARMACY-1 2244. 00 1760.60 5.00
	3862	COUNT 44 44 44
	3863	MEAN 51. 00 40.01 0.11
	3864	-------- -- --------- ----- -----
	3865	GRAND TOTA LS 2244. 00 1760.60 5.00
	3866	COUNT 44 44 44
	3867	MEAN 51. 00 40.01 0.11
	3868	Press RETU RN to cont inue:
	3869	(This page included for two-si ded copyin g.)
	3870	8.1.2 Reje cted Claim s Report X E " Payabl e Rejected Claims"
	3871	The Reject ed Claims Report opt ion produc es a repor t that lis ts electro nic claims that have been succ essfully t ransmitted to the pa yer and ha ve been re jected.
	3872	You must h old the BP SMENU and BPS REPORT S keys to view the R ejected Cl aims Repor t option. The Reject ed Claims Report opt ion has th e most acc essible in formation on rejecte d claims f rom the BP S Claims F ile. A Fil eMan inqui ry into th e BPS Clai ms File wi ll find th at the inf ormation i s in NCPDP V. D.0 fo rmats. Acc ess the re port by en tering REJ at the “S elect Clai m Results and Status Option:” prompt on the Claim Results an d Status o ption scre en.
	3873	Example 8. 1.2-1: Acc essing the Rejected Claims Rep ort Option
	3874	*** ****** ****** ****** ****** **
	3875	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	3876	* XXXXX V AMC *
	3877	* Cla im Results and Statu s *
	3878	*** ****** ****** ****** ****** **
	3879	PAY Payable Cl aims Repor t
	3880	REJ Rejected C laims Repo rt
	3881	ECMP CMOP/ECME Activity R eport
	3882	REV Reversal C laims Repo rt
	3883	NYR Claims Sub mitted, No t Yet Rele ased
	3884	REC Recent Tra nsactions
	3885	DAY Totals by Date
	3886	CLO Closed Cla ims Report
	3887	NBS Non-Billab le Status Report
	3888	SPA Spending A ccount Rep ort
	3889	Select Cla im Results and Statu s Option: REJ Rejec ted Claims Report
	3890	After you have made selections from the “ALL REPOR TS” prompt s, you wil l be given the follo wing promp ts for dat e range, R eleased/No t Released /All claim s, All/Spe cific Reje ct Codes, Veteran/TR ICARE/CHAM PVA/All El igibility, Excel dis play forma t and devi ce selecti on.
	3891	Example 8. 1.2-2: Add itional pr ompts aske d by the R ejected Cl aims Repor t Option
	3892	START WITH TRANSACTI ON DATE: T -1// T-30
	3893	GO TO TR ANSACTION DATE: T// <Enter>
	3894	Selec t one of t he followi ng:
	3895	R RELEASED
	3896	N NOT RELEAS ED
	3897	A ALL
	3898	Include Rx s - (R)ELE ASED or (N )OT RELEAS ED or (A)L L: RELEASE D// ALL
	3899	Selec t one of t he followi ng:
	3900	S Specific R eject Code
	3901	A ALL
	3902	Include (S )pecific R eject Code or (A)LL: ALL// <En ter>
	3903	Selec t one of t he followi ng:
	3904	O OPEN
	3905	C CLOSED
	3906	A ALL
	3907	Include (O )pen, (C)l osed, or ( A)ll Claim s: O// ALL
	3908	Selec t one of t he followi ng:
	3909	V VETERAN
	3910	T TRICARE
	3911	C CHAMPVA
	3912	A ALL
	3913	Include Ce rtain Elig ibility Ty pe or (A)l l: V// ALL
	3914	Selec t one of t he followi ng:
	3915	O OPEN
	3916	C CLOSED
	3917	A ALL
	3918	Include (O )pen, (C)l osed, or ( A)ll Claim s: O// PEN
	3919	Selec t one of t he followi ng:
	3920	S SPECIFIC P RESCRIBER( S)
	3921	A ALL PRESCR IBERS
	3922	Select Spe cific Pres criber(s) or include ALL Presc ribers: A/ / LL PRESC RIBERS
	3923	Selec t one of t he followi ng:
	3924	P Patient
	3925	A ALL
	3926	Display Se lected (P) atients or (A)LL: AL L//
	3927	Selec t one of t he followi ng:
	3928	R Range
	3929	A ALL
	3930	Select (R) ange for B illed Amou nt or (A)L L: ALL//
	3931	Data field s VA Ingre dient Cost , VA Dispe nsing Fee, Ingredien t Cost Pai d,
	3932	Dispensing Fee Paid and Patien t Responsi bility (IN S) will on ly be incl uded
	3933	when the r eport is c aptured fo r an Excel document. All addi tional dat a fields
	3934	may not be present f or all rep orts.
	3935	Do you wan t to captu re report data for a n Excel do cument? NO // <Enter>
	3936	WARNING - THIS REPOR T REQUIRES THAT A DE VICE WITH 132 COLUMN WIDTH BE USED.
	3937	IT WILL NO T DISPLAY CORRECTLY USING 80 C OLUMN WIDT H DEVICES
	3938	DEVICE: HO ME// <Ente r> IP net work
	3939	Please wai t...
	3940	Example 8. 1.2-3: Rej ected Clai ms Report
	3941	ECME REJEC TED CLAIMS DETAIL RE PORT Prin t Date: MA Y 21, 2008 @17:20:35 Page: 1
	3942	DIVISION(S ): ALL Fill Locat ions: C,M, W Fill ty pe: RT,BB, RS
	3943	Insurance: IBINSUR1, OPINSUR1 Drugs/ Classes: A LL
	3944	Reject Cod e: ALL Elig ibility: A LL Open/Close d: ALL
	3945	Prescriber : ALL Patient: A LL
	3946	ALL PRESCR IPTIONS BY TRANSACTI ON DATE: F rom 05/01/ 08 through 05/21/08
	3947	========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== =========
	3948	PATIENT NA ME Pt.ID ELIG RX# REF/ ECME# DATE RELEASED O N RX INFO CO B OPEN/ CLOSED
	3949	CARDHOL D.ID GR OUP ID $B ILLED QT Y NDC# PRESCRI BER ID NAME
	3950	========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== =========
	3951	DIVISION: PHARMACY-1
	3952	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------
	3953	IBINSUR1
	3954	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------
	3955	ECMEPATIEN T,ONE (XXXX) VET 100 888$ 0/00 0000000808 0 5/04/08 0 5/04/08 W RT D S/R s Op en
	3956	123456 55 5 51.00 90 00777 -0877-03 9998887 777 ECMEPRESCR IBER,ONE
	3957	FENOPROFEN 300MG CAP
	3958	Claim ID: VA2008=400 0000016=00 0010=00018 15
	3959	07:M/I Car dholder ID Number
	3960	ECMEPATIEN T,ONE (XXXX) VET 100 892$ 0/00 0000000812 0 5/04/08 0 5/04/08 W RT D S/R s Closed
	3961	123456 55 5 51.00 90 00777 -0877-03 9998887 777 ECMEPRESCR IBER,ONE
	3962	FENOPROFEN 300MG CAP
	3963	Claim ID: VA2008=400 0000016=00 0010=00018 22
	3964	07:M/I Car dholder ID Number
	3965	ECMEPATIEN T,ONE (XXXX) VET 100 893$ 0/00 0000000813 0 5/04/08 0 5/04/08 W RT D S/R p Closed
	3966	123456 55 5 51.00 90 00777 -0877-03 9998887 777 ECMEPRESCR IBER,ONE
	3967	FENOPROFEN 300MG CAP
	3968	Claim ID: VA2008=400 0000016=00 0010=00018 23
	3969	07:M/I Car dholder ID Number
	3970	--------- -
	3971	SUBTOTALS for INS:IB INSUR1 153.0 0
	3972	COUNT 3
	3973	MEAN 51.0 0
	3974	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------
	3975	OPINSUR1
	3976	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------
	3977	ECMEPATIEN T,TWO (XXXX) VET 100 896$ 0/00 0000000816 0 5/06/08 W RT DS /N p Open
	3978	111 51.00 1 80 0000 3-0626-50 9995552 277 ECMEPRESCR IBER,FIVE
	3979	CHLORAL HY DRATE 500M G CAP
	3980	Claim ID: VA2008=400 0000016=00 0010=00018 33
	3981	12:M/I Pat ient Locat ion
	3982	ECMEPATIEN T,TWO (XXXX) VET 100 899$ 0/00 0000000819 0 5/06/08 W RT DS /N p Open
	3983	111 51.00 1 80 0014 9-0030-66 9995552 277 ECMEPRESCR IBER,FIVE
	3984	DANTROLENE 25MG CAP
	3985	Claim ID: VA2008=400 0000016=00 0010=00018 34
	3986	75:Prior A uthorizati on Require d
	3987	ECMEPATIEN T,TWO (XXXX) VET 100 901$ 0/00 0000000821 0 5/06/08 W RT DS /N p Open
	3988	111 51.00 9 0 0059 1-5521-04 9995552 277 ECMEPRESCR IBER,FIVE
	3989	PHENYLBUTA ZONE 100MG TAB
	3990	05/06/08 - Prior Aut horization Code (8/3 2432242) s ubmitted.
	3991	Claim ID: VA2008=400 0000016=00 0010=00018 35
	3992	75:Prior A uthorizati on Require d
	3993	ECMEPATIEN T,TWO (XXXX) VET 100 902$ 0/00 0000000822 0 5/06/08 W RT DS /N p Open
	3994	111 51.00 1 80 0002 3-4534-67 9995552 277 ECMEPRESCR IBER,FIVE
	3995	BACLOFEN 1 0MG TABS
	3996	05/06/08 - Clarifica tion Code 4,3 submit ted.
	3997	Claim ID: VA2008=400 0000016=00 0010=00018 40
	3998	79:Refill Too Soon
	3999	ECMEPATIEN T,TWO (XXXX) VET 100 903$ 0/00 0000000823 0 5/06/08 W RT DS /N s Open
	4000	111 51.00 1 80 0002 3-4534-67 9995552 277 ECMEPRESCR IBER,FIVE
	4001	BACLOFEN 1 0MG TABS
	4002	05/06/08 - Clarifica tion Code 4,3 submit ted.
	4003	Claim ID: VA2008=400 0000016=00 0010=00018 41
	4004	79:Refill Too Soon
	4005	ECMEPATIEN T,TWO (XXXX) VET 100 906$ 0/00 0000000826 0 5/06/08 M RT DS /N p Open
	4006	111 51.00 1 80 0083 9-7221-06 9995552 277 ECMEPRESCR IBER,FIVE
	4007	DOXEPIN 25 MG CAP
	4008	05/06/08 - Clarifica tion Code 4,3 submit ted.
	4009	Claim ID: VA2008=400 0000016=00 0010=00018 43
	4010	79:Refill Too Soon
	4011	ECMEPATIEN T,TWO (XXXX) VET 100 907$ 0/00 0000000827 0 5/06/08 M RT AC /N p Open
	4012	111 51.00 1 80 0008 1-0635-35 9995552 277 ECMEPRESCR IBER,FIVE
	4013	CHLORAMBUC IL 2MG TAB
	4014	Claim ID: VA2008=400 0000016=00 0010=00018 45
	4015	79:Refill Too Soon
	4016	ECMEPATIEN T,TWO (XXXX) VET 100 915$ 0/00 0000000835 0 5/07/08 W RT DS /N p Open
	4017	111 51.00 1 80 0002 3-4534-67 9995552 277 ECMEPRESCR IBER,FIVE
	4018	BACLOFEN 1 0MG TABS
	4019	05/07/08 - DAFASFDAF DASFDASFAS
	4020	Claim ID: VA2008=400 0000016=00 0010=00018 68
	4021	75:Prior A uthorizati on Require d
	4022	ECMEPATIEN T,TWO (XXXX) VET 100 938$ 0/00 0000000858 0 5/08/08 W RT AC /N p Open
	4023	111 51.00 3 0 0002 4-2253-04 9995552 277 ECMEPRESCR IBER,FIVE
	4024	STANOZOLOL 2MG
	4025	Claim ID: VA2008=400 0000016=00 0010=00018 92
	4026	75:Prior A uthorizati on Require d
	4027	ECMEPATIEN T,TWO (XXXX) VET 100 939$ 0/00 0000000859 0 5/08/08 W RT DS /N p Open
	4028	111 51.00 1 80 0007 8-0005-10 9995552 277 ECMEPRESCR IBER,FIVE
	4029	THIORIDAZI NE 100MG T AB
	4030	05/08/08 - FDDSFADFA
	4031	Claim ID: VA2008=400 0000016=00 0010=00018 93
	4032	75:Prior A uthorizati on Require d
	4033	ECMEPATIEN T,TWO (XXXX) VET 100 942$ 0/00 0000000862 0 5/08/08 W RT AC /N p Open
	4034	111 51.00 1 80 0002 8-0105-10 9995552 277 ECMEPRESCR IBER,FIVE
	4035	TERBUTALIN E 5MG TABS
	4036	Claim ID: VA2008=400 0000016=00 0010=00018 94
	4037	75:Prior A uthorizati on Require d
	4038	79:Refill Too Soon
	4039	ECMEPATIEN T,TWO (XXXX) VET 100 945$ 0/00 0000000865 0 5/08/08 W RT DS /N p Open
	4040	111 51.00 1 80 0004 5-0412-60 9995552 277 ECMEPRESCR IBER,FIVE
	4041	TOLMETIN 2 00MG TABS
	4042	Claim ID: VA2008=400 0000016=00 0010=00018 97
	4043	75:Prior A uthorizati on Require d
	4044	79:Refill Too Soon
	4045	ECMEPATIEN T,TWO (XXXX) VET 101 002$ 0/00 0000000926 0 5/14/08 W RT DS /N p Open
	4046	111 51.00 1 80 0002 3-4534-67 9995552 277 ECMEPRESCR IBER,FIVE
	4047	BACLOFEN 1 0MG TABS
	4048	Claim ID: VA2008=400 0000016=00 0010=00019 89
	4049	64:Claim S ubmitted D oes Not Ma tch Prior Authorizat ion
	4050	ECMEPATIEN T,TWO (XXXX) VET 101 011$ 0/00 0000000935 0 5/14/08 W RT D S/N p Open
	4051	111 51.00 1 80 0078 1-1367-10 9995552 277 ECMEPRESCR IBER,FIVE
	4052	BENZTROPIN E 2MG TAB
	4053	Claim ID: VA2008=400 0000016=00 0010=00020 05
	4054	12:M/I Pat ient Locat ion
	4055	Press RETU RN to cont inue, '^' to exit:
	4056	(This page included for two-si ded copyin g.)
	4057	8.1.3 CMOP /ECME Acti vity Repor t XE " CMO P/ECME Act ivity Repo rt"
	4058	The CMOP/E CME Activi ty Report option pro duces a re port used for monito ring Conso lidated Ma il Outpati ent Pharma cy (CMOP) activity d uring both the Contr olled Subs tances and General C MOP Transm issions. T he report contains r eference i nformation from mult iple VistA sources. You will n ot be prom pted for s elections from the “ ALL REPORT S” section , but you need to se lect a rep ort date r ange, a di vision or all divisi ons and a printer de vice. This report is not a 132 column re port and y ou can cho ose to dis play it on the scree n
	4059	You must h old the BP SMENU and BPS REPORT S keys to view the C MOP/ECME A ctivity Re port optio n. Access the report by enteri ng ECMP at the “Sele ct Claim R esults and Status Op tion:” pro mpt on the Claim Res ults and S tatus opti on screen.
	4060	Example 8. 1.3-1: Acc essing the CMOP/ECME Activity Report Opt ion
	4061	*** ****** ****** ****** ****** **
	4062	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	4063	* XXXXX V AMC *
	4064	* Cla im Results and Statu s *
	4065	*** ****** ****** ****** ****** **
	4066	PAY Payable Cl aims Repor t
	4067	REJ Rejected C laims Repo rt
	4068	ECMP CMOP/ECME Activity R eport
	4069	REV Reversal C laims Repo rt
	4070	NYR Claims Sub mitted, No t Yet Rele ased
	4071	REC Recent Tra nsactions
	4072	DAY Totals by Date
	4073	CLO Closed Cla ims Report
	4074	NBS Non-Billab le Status Report
	4075	SPA Spending A ccount Rep ort
	4076	Select Cla im Results and Statu s Option: ECMP CMOP /ECME Acti vity Repor t
	4077	ENTER BEGI NNING TRAN SMISSION D ATE: 8/31
	4078	ENTER ENDI NG TRANSMI SSION DATE : 9/1
	4079	SELECTION OF DIVISIO N(S)
	4080	Selec t one of t he followi ng:
	4081	A ALL DIVISI ONS
	4082	S SELECT DIV ISIONS
	4083	Enter resp onse: SELE CT DIVISIO NS
	4084	1 XXXXX XXXXX
	4085	2 YYYYY YYYYY
	4086	3 ZZZZZ ZZZZZ
	4087	Select Div ision(s) : (1-4): 1
	4088	You have s elected:
	4089	1 XXXXX XXXXX
	4090	Is this co rrect? YES // <Enter>
	4091	Do you wan t to captu re report data for a n Excel do cument? NO // <Enter>
	4092	Select Pri nter: HOME ;132;999 IP network
	4093	Example 8. 1.3-2: CMO P/ECME Act ivity Repo rt
	4094	CMOP/ ECME ACTIV ITY REPORT for XXXXX XXXXX
	4095	For AUG 31 ,2005 thr u SEP 1,2 005 Printed: N OV 23,2005 @10:25:49
	4096	========== ========== ========== ========== ========== ========== ========== ========== =========
	4097	TRA NSMISSION: 2671
	4098	STA TUS: TRANS MITTED
	4099	DIV ISION: XXXXX XXXXX
	4100	CMO P SYSTEM: LEAVE NWORTH
	4101	TRA NSMISSION DATE/TIME: AUG 3 1, 2005@16 :17:14
	4102	TOT AL PATIENT S: 3
	4103	TOT AL RXS: 3
	4104	NAME ECME#/ RX#/FL# NDC S ENT NDC RECV D CMOP-STAT
	4105	DRUG INSUR ANCE PAY- STAT BILL # REL-DA TE
	4106	========== ========== ========== ========== ========== ========== ========== ========== =========
	4107	ECMEpatien t,One (XXX X) 000001 106254/909 911$e/0 00000-0158 -23 TRANS MI
	4108	AT ORVASTATIN CALCI WEBMD E PA YAB
	4109	8.1.4 Reve rsal Claim s Report X E " Revers al Claims Report"
	4110	The Revers al Claims Report opt ion lists claims tha t have bee n successf ully trans mitted to the payer to REVERSE a previou sly PAYABL E claim an d have not been RESU BMITTED.
	4111	You must h old the BP SMENU and BPS REPORT S keys to view the R eversal Cl aims Repor t option. Access the report by entering REV at the “Select C laim Resul ts and Sta tus Option :” prompt on the Cla im Results and Statu s option s creen.
	4112	Example 8. 1.4-1: Acc essing the Reversal Claims Rep ort Option
	4113	*** ****** ****** ****** ****** **
	4114	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	4115	* XXXXX V AMC *
	4116	* Cla im Results and Statu s *
	4117	*** ****** ****** ****** ****** **
	4118	PAY Payable Cl aims Repor t
	4119	REJ Rejected C laims Repo rt
	4120	ECMP CMOP/ECME Activity R eport
	4121	REV Reversal C laims Repo rt
	4122	NYR Claims Sub mitted, No t Yet Rele ased
	4123	REC Recent Tra nsactions
	4124	DAY Totals by Date
	4125	CLO Closed Cla ims Report
	4126	NBS Non-Billab le Status Report
	4127	SPA Spending A ccount Rep ort
	4128	Select Cla im Results and Statu s Option: REV Rever sal Claims Report
	4129	After you have made selections from the “ALL REPOR TS” prompt s, you wil l be given the follo wing promp ts for dat e range, R eleased/No t Released /All Claim s, Auto-Re versed/All Claims, A ccepted/Re jected/All Claims, V eteran/TRI CARE/CHAMP VA/All Eli gibility, Excel disp lay format and devic e selectio n.
	4130	Example 8. 1.4-2: Add itional Pr ompts for the Revers al Claims Report Opt ion
	4131	START WITH TRANSACTI ON DATE: T -1// T-30
	4132	GO TO TR ANSACTION DATE: T// <Enter>
	4133	Selec t one of t he followi ng:
	4134	R RELEASED
	4135	N NOT RELEAS ED
	4136	A ALL
	4137	Include Rx s - (R)ELE ASED or (N )OT RELEAS ED or (A)L L: RELEASE D// ALL
	4138	Selec t one of t he followi ng:
	4139	R AutoRevers ed
	4140	A ALL
	4141	Include Au to(R)evers ed or (A)L L: ALL// < Enter>
	4142	Selec t one of t he followi ng:
	4143	C Accepted
	4144	R Rejected
	4145	A ALL
	4146	Include A( C)cepted o r (R)eject ed or (A)L L: Rejecte d// ALL
	4147	Selec t one of t he followi ng:
	4148	V VETERAN
	4149	T TRICARE
	4150	C CHAMPVA
	4151	A ALL
	4152	Include Ce rtain Elig ibility Ty pe or (A)l l: V// ALL
	4153	Data field s VA Ingre dient Cost , VA Dispe nsing Fee, Ingredien t Cost Pai d, Dispens ing Fee Pa id and Pat ient Respo nsibility (INS) will only be i ncluded wh en the rep ort is cap tured for an Excel d ocument. All additi onal data fields may not be pr esent for all report s.
	4154	Do you wan t to captu re report data for a n Excel do cument? NO // <Enter>
	4155	WARNING - THIS REPOR T REQUIRES THAT A DE VICE WITH 132 COLUMN WIDTH BE USED.
	4156	IT WILL NO T DISPLAY CORRECTLY USING 80 C OLUMN WIDT H DEVICES
	4157	DEVICE: HO ME// <Ente r> IP net work
	4158	Please wai t...
	4159	Example 8. 1.4-3: Rev ersal Clai ms Report
	4160	ECME REVER SED CLAIMS DETAIL RE PORT Prin t Date: AP R 17, 2009 @14:17:15 Page: 1
	4161	DIVISION(S ): ALL Fill Locat ions: C,M, W Fill ty pe: RT,BB, RS
	4162	Insurance: ALL ALL R eversals ALL R eturned St atus Dru gs/Classes : ALL
	4163	Eligibilit y: ALL
	4164	ALL PRESCR IPTIONS BY TRANSACTI ON DATE: F rom 03/18/ 09 through 04/17/09
	4165	========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== =========
	4166	PATIENT NA ME Pt.ID EL IG RX# REF/ECME # D ATE $ BILLED $INS RES PONSE $COLLECT
	4167	DRUG NDC RX INFO COB
	4168	RELE ASED ON REVERSAL METHOD/RE TURN STATU S/REASON
	4169	========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== =========
	4170	DIVISION: YYYYYYYY
	4171	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------
	4172	COB INSURA NCE
	4173	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------
	4174	ECMEPATIEN T,ONE (XXXX) TRI 102445$ 0/000001 13725 03/20/ 09 21.88 40. 00 0.00
	4175	OXYTOC IN 10 UNIT INJ 00071-416 0-03 W RT AC /R s
	4176	03/1 8/09 REGULAR/ ACCEPTED/2
	4177	-------- -- --- ------- ----- -----
	4178	SUBTOTALS for INS:CO B INSURANC E 21.88 40. 00 0.00
	4179	COUNT 1 1 1
	4180	MEAN 21.88 40. 00 0.00
	4181	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------
	4182	ECME INSUR ANCE
	4183	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------
	4184	ECMEPATIEN T,TWO (XXXX) VET 102446$ 0/000001 13727 03/20/ 09 11.00 40.00 0.00
	4185	DACARB AZINE 100M G INJ 00 026-8151-1 0 W RT DS /R s
	4186	03/2 0/09 REGULAR/ ACCEPTED/R EVERSING P RIMARY CLA IM
	4187	--------- - ---- ------ ------- ---
	4188	SUBTOTALS for INS:EC ME INSURAN CE 11.00 40. 00 0.00
	4189	COUNT 1 1 1
	4190	MEAN 11.00 40. 00 0.00
	4191	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------
	4192	ECME1 INSU RANCE
	4193	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------
	4194	ECMEPATIEN T,TWO (XXXX) VET 102422$ 1/000001 13698 03/20/0 9 0.00 68.3 2 0.00
	4195	GENTAM ICIN OPHTH ALMIC OINT . 00719-70 58-61 W RT DS /N p
	4196	REGULAR/ ACCEPTED/R X DISCONTI NUED
	4197	ECMEPATIEN T,ONE (XXXX) TRI 102435$ 0/000001 13713 04/06/0 9 0.00 40.0 0 0.00
	4198	METHOX AMINE 10MG /CC INJ 00081-0957 -10 W RT AC /N p
	4199	REGULAR/ ACCEPTED/ RX DISCONT INUED
	4200	--------- - ---- ------ ------- ---
	4201	SUBTOTALS for INS:EC ME1 INSURA NCE 0.00 108. 32 0.00
	4202	COUNT 2 2 2
	4203	MEAN 0.00 54. 16 0.00
	4204	--------- - ---- ------ ------- ---
	4205	SUBTOTALS for DIV:YY YYYYYY 32.88 188. 32 0.00
	4206	COUNT 4 4 4
	4207	MEAN 8.22 47. 08 0.00
	4208	--------- - ---- ------ ------- ---
	4209	GRAND TOTA LS 32.88 188. 32 0.00
	4210	COUNT 4 4 4
	4211	MEAN 8.22 47 .08 0.00
	4212	8.1.5 Clai ms Submitt ed, Not Ye t Released XE "Clai ms Submitt ed, Not Ye t Released "
	4213	The Claims Submitted , Not Yet Released o ption list s all pres cription c laims that have been successfu lly submit ted to the payer, ha ve been re turned PAY ABLE but t he prescri ptions hav e not been released.
	4214	You must h old the BP SMENU and BPS REPORT S keys to view the C laims Subm itted, Not Yet Relea sed Report option. A ccess the report by entering N YR at the “Select Cl aim Result s and Stat us Option: ” prompt o n the Clai m Results and Status option sc reen.
	4215	Example 8. 1.5-1: Acc essing Cla ims Submit ted, Not Y et Release d Option
	4216	*** ****** ****** ****** ****** **
	4217	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	4218	* XXXXX V AMC *
	4219	* Cla im Results and Statu s *
	4220	*** ****** ****** ****** ****** **
	4221	PAY Payable Cl aims Repor t
	4222	REJ Rejected C laims Repo rt
	4223	ECMP CMOP/ECME Activity R eport
	4224	REV Reversal C laims Repo rt
	4225	NYR Claims Sub mitted, No t Yet Rele ased
	4226	REC Recent Tra nsactions
	4227	DAY Totals by Date
	4228	CLO Closed Cla ims Report
	4229
	4230	NBS Non-Billab le Status Report
	4231	SPA Spending A ccount Rep ort
	4232	Select Cla im Results and Statu s Option: NYR Claim s Submitte d, Not Yet Released
	4233	After you have made selections from the “ALL REPOR TS” prompt s, you wil l be given the follo wing promp ts for dat e range, E xcel displ ay format and device selection .
	4234	Example 8. 1.5-2: Add itional pr ompts to C laims Subm itted, Not Yet Relea sed Option
	4235
	4236	START WITH TRANSACTI ON DATE: T -1// T
	4237	GO TO TR ANSACTION DATE: T// T
	4238	Data field s VA Ingre dient Cost , VA Dispe nsing Fee, Ingredien t Cost Pai d, Dispens ing Fee Pa id and Pat ient Respo nsibility (INS) will only be i ncluded wh en the rep ort is cap tured for an Excel d ocument. All additi onal data fields may not be pr esent for all report s.
	4239	Do you wan t to captu re report data for a n Excel do cument? NO // <Enter>
	4240	WARNING - THIS REPOR T REQUIRES THAT A DE VICE WITH 132 COLUMN WIDTH BE USED.
	4241	IT WILL NO T DISPLAY CORRECTLY USING 80 C OLUMN WIDT H DEVICES
	4242	DEVICE: HO ME// <Ente r> IP net work
	4243	Example 8. 1.5-3: Cla ims Submit ted, Not Y et Release d Report
	4244	ECME SUBMI T,NOT RELE ASED CLAIM S DETAIL R EPORT Prin t Date: SE P 23, 2005 @15:01:21 Page: 1
	4245	DIVISION(S ): ALL Fi ll Locatio ns: C,M,W Fill type: RT,BB,RS
	4246	Insurance: ALL Drugs/Clas ses: ALL
	4247	PRESCRIPTI ONS (NOT R ELEASED) B Y TRANSACT ION DATE: From 09/23 /05 throug h 09/23/05
	4248	========== ========== ========== ========== ========== ========== ========== ========== ========
	4249	PATIENT NA ME Pt. ID RX# REF/ECM E# DATE $BILLED $INS RESPONSE
	4250	DRUG RX INF O COB
	4251	========== ========== ========== ========== ========== ========== ========== ========== ========
	4252	DIVISION: ZZZZZZZ
	4253	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- --------
	4254	WEBMD
	4255	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- --------
	4256	ECMEpatien t,One (XX XX) 909716 $ 0/00000 1105959 0 9/23/05 45.0 0 40.00
	4257	PROTAM INE SULFAT E 5ML INJ W RT AC/N p
	4258	---- ------ -- --------
	4259	SUBTOTALS for INS:WE BMD 45.00 40.00
	4260	COUNT 1 1
	4261	MEAN 45.00 40.00
	4262	---- ------ -- --------
	4263	SUBTOTALS for DIV:ZZ ZZZZZ 4 5.00 40.00
	4264	COUNT 1 1
	4265	MEAN 45.00 40.00
	4266	GRAND TOTA LS 45.00 40.00
	4267	COUNT 1 1
	4268	MEAN 45.00 40.00
	4269	8.1.6 Rece nt Transac tions XE " Recent Tr ansactions "
	4270	The Recent Transacti ons option lists cla ims that h ave been s uccessfull y transmit ted to the payer. Th ese claims include s ubmissions , reversal s and resu bmissions. Closed Cl aims will NOT show u p on this report sin ce this re port displ ays activi ty between ECME and the payer only.
	4271	You must h old the BP SMENU and BPS REPORT S keys to view the R ecent Tran sactions R eport opti on. Access the repor t by enter ing REC at the “Sele ct Claim R esults and Status Op tion:” pro mpt on the Claim Res ults and S tatus opti on screen.
	4272	Example 8. 1.6-1: Rec ent Transa ctions Opt ion
	4273	*** ****** ****** ****** ****** **
	4274	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	4275	* XXXXX V AMC *
	4276	* Cla im Results and Statu s *
	4277	*** ****** ****** ****** ****** **
	4278	PAY Payable Cl aims Repor t
	4279	REJ Rejected C laims Repo rt
	4280	ECMP CMOP/ECME Activity R eport
	4281	REV Reversal C laims Repo rt
	4282	NYR Claims Sub mitted, No t Yet Rele ased
	4283	REC Recent Tra nsactions
	4284	DAY Totals by Date
	4285	CLO Closed Cla ims Report
	4286	NBS Non-Billab le Status Report
	4287	SPA Spending A ccount Rep ort
	4288	Select Cla im Results and Statu s Option: REC Recen t Transact ions
	4289	After you have made selections from the “ALL REPOR TS” prompt s, you wil l be given the follo wing promp ts for dat e range, R eleased/No t Released /All Claim s, Excel d isplay for mat and de vice selec tion.
	4290	Example 8. 1.6-2: Add itional pr ompts aske d by the R ecent Tran sactions O ption
	4291	START WITH TRANSACTI ON DATE: T -1// T
	4292	GO TO TR ANSACTION DATE: T// T
	4293	Selec t one of t he followi ng:
	4294	R RELEASED
	4295	N NOT RELEAS ED
	4296	A ALL
	4297	Include Rx s - (R)ELE ASED or (N )OT RELEAS ED or (A)L L: RELEASE D// ALL
	4298	Do you wan t to captu re report data for a n Excel do cument? NO // <Enter>
	4299	WARNING - THIS REPOR T REQUIRES THAT A DE VICE WITH 132 COLUMN WIDTH BE USED.
	4300	IT WILL NO T DISPLAY CORRECTLY USING 80 C OLUMN WIDT H DEVICES
	4301	DEVICE: HO ME// <Ente r> IP netw ork
	4302	Please wai t...
	4303	(This page included for two-si ded copyin g.)
	4304	Example 8. 1.6-3: Rec ent Transa ctions Rep ort
	4305	ECME RECEN T TRANSACT IONS DETAI L REPORT P rint Date: NOV 03, 2 010@17:10: 39 Page: 1
	4306	DIVISION(S ): ALL Fill Lo cations: C ,M,W Fill type: RT,B B,RS
	4307	Insurance: ALL Dru gs/Classes : ALL
	4308	PRESCRIPTI ONS BY TRA NSACTION D ATE: From 10/04/10 t hrough 11/ 03/10
	4309	========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ==
	4310	PATIENT NA ME Pt. ID RX# REF /ECME# COMPL ETED TRANS T YPE PAYER RESP ONSE COB
	4311	DRUG NDC RX INFO I NSURANCE ELAP TIM E IN SECON DS
	4312	========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ==
	4313	DIVISION: XXXXXXXX
	4314	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- --
	4315	ECMEPATIEN T,THREE ( XXXX) 102 128$ 1 /000000002 509 10/04/10 02:52PM SUBMIT E REJECT ED p
	4316	DIAZEP AM 10MG S. T. 00 555-0164-0 4 M RT EX/N RE J OPI NSUR1 9
	4317	ECMEPATIEN T,THREE ( XXXX) 110 0249$ 1 / 10/ 06/10 11:2 9AM SUBMI T E UNSTRA NDED p
	4318	GENTAM ICIN OPHTH ALMIC O 00 719-7058-6 1 W RT AC/N OPI NSUR1 502339
	4319	ECMEPATIEN T,SIX ( XXXX) 110 0341$ 0 /000000003 126 10/ 07/10 12:0 6AM SUBMI T E REJECT ED p
	4320	DOXEPI N 25MG CAP 00 839-7221-0 6 W RT AC/R RE J OPI NSUR2 7
	4321	ECMEPATIEN T,SIX ( XXXX) 110 0342$ 0 /000000003 127 10/ 07/10 01:5 9PM SUBMI T E PAYABL E p
	4322	CORTIC OTROPIN 40 UNIT HP 00 053-1330-0 1 W RT AC/R OPI NSUR2 4
	4323	ECMEPATIEN T,SIX ( XXXX) 110 0336$ 0 /000000003 120 10/ 07/10 03:0 5PM REVER SAL E REVERS AL OTHER p
	4324	TRIAMT ERENE 50MG , HCTZ 00 484-3590-3 0 W RT DS/R OPI NSUR2 3
	4325	ECMEPATIEN T,ONE ( XXXX) 100 952$ 0 /000000000 874 10/07/10 05:29PM SUBMIT E UNSTRA NDED p
	4326	MEDROX YPROGESTRO NE 10MG 00 009-0050-0 2 W RT DS/N OPI NSUR1 76220585
	4327	ECMEPATIEN T,ONE ( XXXX) 100 933$ 0 /000000000 853 10/07/10 07:45PM SUBMIT E REJECT ED p
	4328	DOXEPI N 25MG CAP 00 839-7221-0 6 M RT DS/N RE J OPI NSUR1 7
	4329	ECMEPATIEN T,ONE ( XXXX) 101 814$ 0 /000000002 181 10/08/10 04:11PM REVERSAL E REVERS AL UNSTRAN DED p
	4330	IMIPRA MINE 25MG TAB 00 779-0588-3 0 W RT DS/N OPI NSUR1 57199104
	4331	ECMEPATIEN T,ONE ( XXXX) 100 954$ 0 /000000000 876 10/08/10 04:16PM SUBMIT E UNSTRA NDED p
	4332	DOXEPI N 25MG CAP 00 839-7221-0 6 M RT DS/N OPI NSUR1 76194694
	4333	ECMEPATIEN T,ONE ( XXXX) 100 991$ 0 /000000000 915 10/08/10 04:16PM SUBMIT E UNSTRA NDED p
	4334	BACLOF EN 10MG TA BS 00 023-4534-6 7 W RT DS/N OPI NSUR1 75772098
	4335	ECMEPATIEN T,ONE ( XXXX) 101 860$ 0 /000000002 228 10/08/10 04:16PM SUBMIT E UNSTRA NDED p
	4336	IMIPRA MINE 25MG TAB 00 779-0588-3 0 W RT EX/N OPI NSUR1 57199347
	4337	ECMEPATIEN T,ONE ( XXXX) 101 861$ 0 /000000002 229 10/08/10 04:16PM SUBMIT E UNSTRA NDED p
	4338	CHLORA L HYDRATE 500MG C 00 003-0626-5 1 W RT DS/N OPI NSUR1 57199249
	4339	ECMEPATIEN T,ONE ( XXXX) 101 959$ 0 /000000002 331 10/08/10 04:16PM SUBMIT E UNSTRA NDED p
	4340	LIDOCA INE 2% 50M L INJ M 00 186-0240-0 2 W RT DS/N OPI NSUR1 51602609
	4341	ECMEPATIEN T,THREE ( XXXX) 102 225$ 0 /000000002 607 10/08/10 04:16PM SUBMIT E UNSTRA NDED p
	4342	BIPERI DEN 2MG TA B 00 044-0120-0 4 M RT DS/N OPI NSUR1 46160110
	4343	(This page included for two-si ded copyin g.)
	4344	8.1.7 Tota ls by Date XE " Tot als by Dat e"
	4345	The Totals by Date o ption tota ls the dai ly ECME ac tivity cla ims that h ave been s uccessfull y transmit ted to the payer, ha ve been re turned PAY ABLE or RE JECTED but have not been REVER SED.
	4346	You must h old the BP SMENU and BPS REPORT S keys to view the T otals by D ay Report option. Ac cess the r eport by e ntering DA Y at the “ Select Cla im Results and Statu s Option:” prompt on the Claim Results a nd Status option scr een.
	4347	Example 8. 1.7-1: Tot als by Dat e Option
	4348	*** ****** ****** ****** ****** **
	4349	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	4350	* XXXXX V AMC *
	4351	* Cla im Results and Statu s *
	4352	*** ****** ****** ****** ****** **
	4353	PAY Payable Cl aims Repor t
	4354	REJ Rejected C laims Repo rt
	4355	ECMP CMOP/ECME Activity R eport
	4356	REV Reversal C laims Repo rt
	4357	NYR Claims Sub mitted, No t Yet Rele ased
	4358	REC Recent Tra nsactions
	4359	DAY Totals by Date
	4360	CLO Closed Cla ims Report
	4361	NBS Non-Billab le Status Report
	4362	SPA Spending A ccount Rep ort
	4363	Select Cla im Results and Statu s Option: DAY Total s by Date
	4364	After you have made selections from the “ALL REPOR TS” prompt s, you wil l be given the follo wing promp ts for dat e range, R eleased/No t Released /All Claim s, Excel d isplay for mat and de vice selec tion.
	4365	Example 8. 1.7-2: Add itional pr ompts aske d by the T otals by D ay Option
	4366	START WITH TRANSACTI ON DATE: T -1// T-30
	4367	GO TO TR ANSACTION DATE: T// <Enter>
	4368	Selec t one of t he followi ng:
	4369	R RELEASED
	4370	N NOT RELEAS ED
	4371	A ALL
	4372	Include Rx s - (R)ELE ASED or (N )OT RELEAS ED or (A)L L: RELEASE D// ALL
	4373	Do you wan t to captu re report data for a n Excel do cument? NO // <Enter>
	4374	WARNING - THIS REPOR T REQUIRES THAT A DE VICE WITH 132 COLUMN WIDTH BE USED.
	4375	IT WILL NO T DISPLAY CORRECTLY USING 80 C OLUMN WIDT H DEVICES
	4376	DEVICE: HO ME// <Ente r> IP netw ork
	4377	Please wai t...
	4378	Example 8. 1.7-3: Tot als by Dat e Report ( Compacted to fit int o document )
	4379	ECME TOTAL S DETAIL R EPORT Print D ate: SEP 2 3, 2005@15 :18:52 Pa ge: 1
	4380	DIVISION(S ): ALL Fil l Location s: C,M,W F ill type: RT,BB,RS
	4381	Insurance: DEVELOPME NT INS, OP INSUR1 D rugs/Class es: ALL
	4382	ALL PRESCR IPTIONS BY TRANSACTI ON DATE: F rom 09/23/ 05 through 09/23/05
	4383	========== ========== ========== ========== ========== ========== ========== ========== ======
	4384	AMOUNT RETURNE D RETURNE D AMO UNT
	4385	DATE #CLAIMS SUBMITTED REJECTE D PAYABL E TO RECE IVE DIFF ERENCE
	4386	========== ========== ========== ========== ========== ========== ========== ========== ======
	4387	DIVISION: ZZZZZZZ
	4388	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ------
	4389	09/23/05 2 90.00 45.0 0 45.0 0 40 .00 5.00
	4390	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ------
	4391	TOTALS 2 90.00 45.0 0 45.0 0 40 .00 5.00
	4392	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ------
	4393	GRAND TOTA LS 2 90.00 45.0 0 45.0 0 40 .00 5.00
	4394	Press RETU RN to cont inue:
	4395	8.1.8 Clos ed Claims Report XE " Closed C laims Repo rt"
	4396	The Closed Claims Re port optio n lists cl aims that have been successful ly transmi tted to th e payer, h ave been r eturned RE JECTED and have been CLOSED us ing the Cl ose Claim action wit hin the EC ME User Sc reen. The Excel disp lay format of the re port displ ays the Am ount Bille d and the Amount Bil led is onl y on the E xcel displ ay format.
	4397	You must h old the BP SMENU and BPS REPORT S keys to view the C losed Clai ms Report option. Ac cess the r eport by e ntering CL O at the “ Select Cla im Results and Statu s Option:” prompt on the Claim Results a nd Status option scr een.
	4398	Example 8. 1.8-1: Acc essing the Closed Cl aims Repor t Option
	4399	*** ****** ****** ****** ****** **
	4400	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	4401	* XXXXX V AMC *
	4402	* Cla im Results and Statu s *
	4403	*** ****** ****** ****** ****** **
	4404	PAY Payable Cl aims Repor t
	4405	REJ Rejected C laims Repo rt
	4406	ECMP CMOP/ECME Activity R eport
	4407	REV Reversal C laims Repo rt
	4408	NYR Claims Sub mitted, No t Yet Rele ased
	4409	REC Recent Tra nsactions
	4410	DAY Totals by Date
	4411	CLO Closed Cla ims Report
	4412	NBS Non-Billab le Status Report
	4413	SPA Spending A ccount Rep ort
	4414	Select Cla im Results and Statu s Option: CLO Close d Claims R eport
	4415	After you have made selections from the “ALL REPOR TS” prompt s, you wil l be given the follo wing promp ts for dat e range, R eleased/No t Released /All claim s, All/Spe cific Clos e Claim Re ason, Vete ran/TRICAR E/CHAMPVA/ All Eligib ility, Exc el display format an d device s election.
	4416	Example 8. 1.8-2: Sel ecting Spe cific Clos e Claim Re ason Optio n
	4417	START WITH CLOSE DAT E: T-1// T -50
	4418	GO TO CL OSE DATE: T// <Enter >
	4419	Selec t one of t he followi ng:
	4420	R RELEASED
	4421	N NOT RELEAS ED
	4422	A ALL
	4423	Include Rx s - (R)ELE ASED or (N )OT RELEAS ED or (A)L L: RELEASE D// ALL
	4424	Select one of th e followin g:
	4425	S Specific C lose Claim Reason
	4426	A ALL
	4427	Include (S )pecific C lose Claim Reason or (A)LL: AL L// <Enter >
	4428	Selec t one of t he followi ng:
	4429	V VETERAN
	4430	T TRICARE
	4431	C CHAMPVA
	4432	A ALL
	4433	Include Ce rtain Elig ibility Ty pe or (A)l l: V// ALL
	4434	Do you wan t to captu re report data for a n Excel do cument? NO // <Enter>
	4435	WARNING - THIS REPOR T REQUIRES THAT A DE VICE WITH 132 COLUMN WIDTH BE USED.
	4436	IT WILL NO T DISPLAY CORRECTLY USING 80 C OLUMN WIDT H DEVICES
	4437	DEVICE: HO ME// <Ente r> IP netw ork
	4438	Please wai t...
	4439	Example 8. 1.8-2: Clo sed Claims Report
	4440	ECME CLOSE D CLAIMS D ETAIL REPO RT P rint Date: APR 17, 2 009@14:21: 22 Page: 1
	4441	DIVISION(S ): ALL Fill Lo cations: C ,M,W Fill type: RT, BB,RS
	4442	Insurance: ALL Close Rea son: ALL Drugs/ Classes: A LL
	4443	Eligibilit y: ALL
	4444	RELEASED P RESCRIPTIO NS BY CLOS E DATE: Fr om 03/18/0 9 through 04/17/09
	4445	========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ==
	4446	PATIENT NA ME Pt.ID ELIG RX# REF/EC ME# RX I NFO DRUG NDC
	4447	CARDHOL D.ID GROUP ID CLOSE DAT E/TIME C LOSED BY CLO SE REASON
	4448	COB
	4449	========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ==
	4450	DIVISION: YYYYYYYY
	4451	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- --
	4452	ECME1 INSU RANCE
	4453	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- --
	4454	ECMEPATIEN T,TWO (XXXX) T RI 102446 $ 0/00000 00113727 W RT D S/R DACAR BAZINE 100 MG INJ 00 026-8151-1 0
	4455	1234098 7 10001 03/20/09 03:55PM E CMEUSER,ON E IN VALID NDC FROM CMOP
	4456	p
	4457	Claim ID: VA2009=500 0000021=00 0010=00054 94
	4458	54:Non-M atched Pro duct/Servi ce ID Numb er
	4459	SUBTOTALS for INS: E CMEUSER,ON E
	4460	ECMEPAT ,ONE 1
	4461	-----
	4462	CLOSED CLA IMS SUBTOT AL 1
	4463	SUBTOTALS for DIV:YY YYYYYY
	4464	ECMEUSE R,ONE 1
	4465	-----
	4466	CLOSED CLA IMS SUBTOT AL 1
	4467	GRAND TOTA LS (ALL DI VISIONS) B Y BILLER
	4468	ECMEUSE R,ONE 1
	4469	-----
	4470	CLOSED CLA IMS GRAND TOTAL 1
	4471	8.1.9 Non- Billable S tatus Repo rt XE " No n-Billable Status Re port"
	4472	The ECME R eports men u includes a Non-Bil lable Stat us Report for ECME R xs. This r eport prov ides users with a to ol to easi ly identif y prescrip tions that the ePhar macy softw are determ ines are n ot being b illed (e.g ., OTC pro ducts, no insurance on file or not activ e). The re port ensur es that pr escription s are bill ed for TRI CARE and/o r CHAMPVA patients i n a timely manner.
	4473	You must h old the BP SMENU and BPS REPORT S keys to view the N on-Billabl e Status R eport opti on. Access the repor t by enter ing NBS at the “Sele ct Claim R esults and Status Op tion:” pro mpt on the Claim Res ults and S tatus opti on screen.
	4474	Example 8. 1.9-1: Acc essing the Non-Billa ble Status Report Op tion
	4475	*** ****** ****** ****** ****** **
	4476	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	4477	* XXXXX V AMC *
	4478	* Cla im Results and Statu s *
	4479	*** ****** ****** ****** ****** **
	4480	PAY Payable Cl aims Repor t
	4481	REJ Rejected C laims Repo rt
	4482	ECMP CMOP/ECME Activity R eport
	4483	REV Reversal C laims Repo rt
	4484	NYR Claims Sub mitted, No t Yet Rele ased
	4485	REC Recent Tra nsactions
	4486	DAY Totals by Date
	4487	CLO Closed Cla ims Report
	4488	NBS Non-Billab le Status Report
	4489	SPA Spending A ccount Rep ort
	4490	Select Cla im Results and Statu s Option: NBS Non-B illable St atus Repor t
	4491	After you have made selections from the “ALL REPOR TS” prompt s, you wil l be given a series of prompts as shown below:
	4492	Example 8. 1.9-2: Sel ecting Non -Billable Status Rep ort option
	4493	Selec t one of t he followi ng:
	4494	D DIVISION
	4495	A ALL
	4496	Select Cer tain Pharm acy (D)ivi sions or ( A)LL: DIVI SION
	4497	Select ECM E Pharmacy Division( s): GEN ERIC PHARM ACY
	4498	Selected :
	4499	GENERIC PH ARMACY
	4500	Select ECM E Pharmacy Division( s):
	4501	Selec t one of t he followi ng:
	4502	S Summary
	4503	D Detail
	4504	Display (S )ummary or (D)etail Format: De tail//
	4505	Selec t one of t he followi ng:
	4506	I SPECIFIC I NSURANCE(S )
	4507	A ALL
	4508	Select Cer tain (I)NS URANCE or (A)LL): A/ / LL
	4509	Selec t one of t he followi ng:
	4510	C CMOP
	4511	M Mail
	4512	W Window
	4513	A ALL
	4514	Display (C )MOP or (M )ail or (W )indow or (A)LL: ALL //
	4515	Selec t one of t he followi ng:
	4516	D Drug
	4517	C Drug Class
	4518	A ALL
	4519	Display Sp ecific (D) rug or Dru g (C)lass or (A)LL: ALL//
	4520	START WITH TRANSACTI ON DATE: T -1// T-10 (MAY 29, 2015)
	4521	GO TO TRAN SACTION DA TE: T// T (JUN 08, 2015)
	4522	Selec t one of t he followi ng:
	4523	R RELEASED
	4524	N NOT RELEAS ED
	4525
	4526	A
	4527
	4528	ALL
	4529	Include Rx s - (R)ELE ASED or (N )OT RELEAS ED or (A)L L: ALL//
	4530	R Most Recen t
	4531	A ALL
	4532	Select Mos t (R)ecent or (A)ll: MOST RECE NT//
	4533	Selec t one of t he followi ng:
	4534	E ELIGIBILIT Y
	4535	A ALL
	4536	Select Cer tain (E)li gibilities or (A)LL: ALL//
	4537	Selec t one of t he followi ng:
	4538	S NON-BILLAB LE STATUS
	4539	A ALL
	4540	Select Cer tain Non-B illable (S )tatus or (A)ll: ALL //
	4541	Do you wan t to captu re report data for a n Excel do cument? NO //
	4542	WARNING - THIS REPOR T REQUIRES THAT A DE VICE WITH 132 COLUMN WIDTH BE USED.
	4543	IT WILL NO T DISPLAY CORRECTLY USING 80 C OLUMN WIDT H DEVICES
	4544	DEVICE: HO ME// HOM E (CRT) Right Ma rgin: 80// 132
	4545	Please wai t...
	4546	Example 8. 1.9-3: Non -Billable Status Rep ort
	4547	ECME RXs W ITH Non-Bi llable STA TUS REPORT
	4548
	4549
	4550	Print Date : Sept 26, 2014@11:4 1:54 Page : 1
	4551	DIVISION(S ): GENERIC Fill Locat ions: C,M, W
	4552	Insurance: ALL D rugs/Class es: ALL
	4553	Eligibilit ies: ALL
	4554	NON-BILLAB LE STATUS: ALL
	4555	ALL PRESCR IPTIONS BY TRANSACTI ON DATE: F rom 2/22/0 9 through 09/23/14
	4556	========== ========== ========== ========== ========== ========== ========== ========== ========== =======
	4557	PATIENT NA ME Pt. ID ELIG RX# REF DATE $DRUG COST
	4558	DRUG NDC REL EASED ON RX INFO NON-B ILLABLE ST ATUS
	4559	========== ========== ========== ========== ========== ========== ========== ========== ========== =======
	4560	DIVISION: GENERIC DI VISION
	4561	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- -------
	4562	GENERIC IN S
	4563	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- -------
	4564	ECMEpatien t,One (XX XX) TRI ######$ 2 04/15/ 09 5 1.00
	4565	AMITRI PTYLINE 10 MG TAB 00182-10 18-10 04/ 15/09 W AC/R Plan not active , local
	4566	ECMEpatien t, Three (XX XX) VET ######$ 0 03/10/ 09 5 1.00
	4567	METHAD ONE 10MG T AB 000054-8 554-2 03/ 10/09 W EX/N Plan not linked to Payer
	4568	------ ----
	4569	SUBTOTALS for INS:GE NERIC INS
	4570	102.00
	4571	COUNT
	4572	2
	4573	MEAN
	4574	51.00
	4575	Press RETU RN to cont inue
	4576	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- -------
	4577	GENERIC IN SURANCE 2
	4578	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- -------
	4579	ECMEpatien t, Two (XX XX) VET 100574$ 0 03/05/ 09 5 1.00
	4580	NEODEC ADRON OPHT MALIC SOL. 00006-76 39-03 03/ 05/08 W AC/R Plan n ot found
	4581	ECMEpatien t, Two (XX XX) VET 100575$ 0 03/05/ 09 5 1.00
	4582	PENTAE RYTHRITOL 10MG TAB 00725-20 64-10 03/ 05/08 W AC/R Plan D eactivated
	4583	...
	4584	SUBTOTALS for INS:GE NERIC INSU RANCE 2 214 2.00
	4585	COUNT 42
	4586	MEAN 5 1.00
	4587	------ ----
	4588	SUBTOTALS for DIV:GE NERIC DIVI SION 224 4.00
	4589	COUNT 44
	4590	MEAN 5 1.00
	4591	------ ----
	4592	GRAND TOTA LS 224 4.00
	4593	COUNT 44
	4594	MEAN 5 1.00
	4595	Press RETU RN to cont inue:
	4596	(This page included for two-si ded copyin g.
	4597	8.1.10 Spe nding Acco unt Report XE " Spen ding Accou nt Report"
	4598	The Spendi ng Account Report op tion lists the balan ce from th e patient’ s spending account a fter the s pecific tr ansaction was applie d, the amo unt from t he health plan-funde d assistan ce account that was applied to the Patie nt Pay Amo unt and th e various amounts st ill to be collected from the p atient.
	4599	Access the report by entering SPA at the “Select C laim Resul ts and Sta tus Option :” prompt on the Cla im Results and Statu s option s creen.
	4600	Example 8. 1.10-1: Ac cessing th e Spending Account R eport Opti on
	4601	*** ****** ****** ****** ****** **
	4602	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	4603	* XXXXX V AMC *
	4604	* Cla im Results and Statu s *
	4605	*** ****** ****** ****** ****** **
	4606	PAY Payable Cl aims Repor t
	4607	REJ Rejected C laims Repo rt
	4608	ECMP CMOP/ECME Activity R eport
	4609	REV Reversal C laims Repo rt
	4610	NYR Claims Sub mitted, No t Yet Rele ased
	4611	REC Recent Tra nsactions
	4612	DAY Totals by Date
	4613	CLO Closed Cla ims Report
	4614	NBS Non-Billab le Status Report
	4615	SPA Spending A ccount Rep ort
	4616	Select Cla im Results and Statu s Option: SPA Spe nding Acco unt Report
	4617	Example 8. 1.10-2: Se lecting Sp ending Acc ount Repor t Option
	4618	Selec t one of t he followi ng:
	4619	D DIVISION
	4620	A ALL
	4621	Select Cer tain Pharm acy (D)ivi sions or ( A)LL: DIVI SION
	4622	Select ECM E Pharmacy Division( s): XXXXXX X
	4623	Selected :
	4624	XXXXXXXX
	4625	Select ECM E Pharmacy Division( s): YYYYYY Y CBOC X XX
	4626	Selected :
	4627	XXXXXXXX
	4628	XXXXX
	4629	Select ECM E Pharmacy Division( s):
	4630	Selec t one of t he followi ng:
	4631	S Summary
	4632	D Detail
	4633	Display (S )ummary or (D)etail Format: De tail//
	4634	Selec t one of t he followi ng:
	4635	I SPECIFIC I NSURANCE(S )
	4636	A ALL
	4637	Select Cer tain (I)NS URANCE or (A)LL): A/ / ALL
	4638	Selec t one of t he followi ng:
	4639	C CMOP
	4640	M Mail
	4641	W Window
	4642	A ALL
	4643	Display (C )MOP or (M )ail or (W )indow or (A)LL: ALL //
	4644	Selec t one of t he followi ng:
	4645	R Real Time Fills
	4646	B Backbill
	4647	S ReSubmissi on
	4648	A ALL
	4649	Display (R )ealTime, (B)ackbill s, (P)RO O ption, Re( S)ubmissio n or (A)LL : A//
	4650	Selec t one of t he followi ng:
	4651	D Drug
	4652	C Drug Class
	4653	A ALL
	4654	Display Sp ecific (D) rug or Dru g (C)lass or (A)LL: ALL//
	4655	START WITH TRANSACTI ON DATE: T -1//
	4656	GO TO TR ANSACTION DATE: T//
	4657	Selec t one of t he followi ng:
	4658	R RELEASED
	4659	N NOT RELEAS ED
	4660	A ALL
	4661	Include R xs - (R)EL EASED or ( N)OT RELEA SED or (A) LL: RELEAS ED//
	4662	Selec t one of t he followi ng:
	4663	S Specific R eject Code
	4664	A ALL
	4665	Include ( S)pecific Reject Cod e or (A)LL : ALL//
	4666	Do you wan t to captu re report data for a n Excel do cument? NO //
	4667	WARNING - THIS REPOR T REQUIRES THAT A DE VICE WITH 132 COLUMN WIDTH BE USED.
	4668	IT WILL NO T DISPLAY CORRECTLY USING 80 C OLUMN WIDT H DEVICES
	4669	DEVICE: HO ME//
	4670	Please wai t...
	4671	Example 8. 1.10-3: Sp ending Acc ount Repor t – Summar y
	4672	ECME SPEND ING ACCOUN T REPORT S UMMARY REP ORT P rint Date: DEC 02, 2 011@16:51: 34 Page: 1
	4673	DIVISION(S ): ALL F ill Locati ons: C,M,W Fill typ e: RT,BB,P 2,RS
	4674	Insurance: ALL Dru gs/Classes : ALL
	4675	ALL PRESCR IPTIONS BY TRANSACTI ON DATE: F rom 06/05/ 11 through 12/02/11
	4676	========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ==
	4677	PATIENT NA ME Pt. ID RX# REF /ECME# DA TE $BILLED $IN S RESPONSE $COLLE CT
	4678	DRUG RX INFO INS GR OUP# I NS GROUP N AME BILL#
	4679	$PROVI DER NETWOR K $BRAND DRUG $N ON-PREF FO RM $BRA ND NON-PRE F FORM $COVERAGE GAP $HEA LTH ASST $SPEND AC CT REMAINI NG
	4680	========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ==
	4681	DIVISION: XXXXXX
	4682	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- --
	4683	-- -------- ---------- -------- --
	4684	SUBTOTALS for INS:EP HARM INSUR ANCE 12.00 999999.99 0. 00
	4685	0.00 0 .00 0.00 0.00 0.0 0 0.00 12.3 0
	4686	COUNT 1 1 1
	4687	1 1 1 1 1 1 1
	4688	MEAN 12.00 999999.99 0. 00
	4689	0.00 0 .00 0.00 0.00 0.0 0 0.00 12.3 0
	4690	-- -------- ---------- -------- --
	4691	SUBTOTALS for INS:EX PRESS SCRI PTS 9 99999.99 999999.99 0. 00
	4692	0.00 0 .00 0.00 0.00 0.0 0 0.00 15.4 1
	4693	COUNT 1 1 1
	4694	1 1 1 1 1 1 1
	4695	MEAN 9 99999.99 999999.99 0. 00
	4696	0.00 0 .00 0.00 0.00 0.0 0 0.00 15.4 1
	4697	-- -------- ---------- -------- --
	4698	SUBTOTALS for DIV:XX XXXX 10 00011.99 1999999.98 0. 00
	4699	0.00 0 .00 0.00 0.00 0.0 0 0.00 27.7 1
	4700	COUNT 2 2 2
	4701	2 2 2 2 2 2 2
	4702	MEAN 5 00006.00 999999.99 0. 00
	4703	0.00 0 .00 0.00 0.00 0.0 0 0.00 13.8 6
	4704	-- -------- ---------- -------- --
	4705	GRAND TOTA LS 10 00011.99 1999999.98 0. 00
	4706	0.00 0 .00 0.00 0.00 0.0 0 0.00 27.7 1
	4707	COUNT 2 2 2
	4708	2 2 2 2 2 2 2
	4709	MEAN 5 00006.00 999999.99 0. 00
	4710	0.00 0 .00 0.00 0.00 0.0 0 0.00 13.8 6
	4711	Press RETU RN to cont inue:
	4712	Example 8. 1.10-4: Sp ending Acc ount Repor t – Detail
	4713	ECME SPEND ING ACCOUN T REPORT D ETAIL REPO RT P rint Date: DEC 02, 2 011@17:16: 36 Page: 1
	4714	DIVISION(S ): ALL F ill Locati ons: C,M,W Fill typ e: RT,BB,P 2,RS
	4715	Insurance: ALL Dru gs/Classes : ALL
	4716	ALL PRESCR IPTIONS BY TRANSACTI ON DATE: F rom 06/05/ 11 through 12/02/11
	4717	========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ==
	4718	PATIENT NA ME Pt. ID RX# REF /ECME# DA TE $BILLED $IN S RESPONSE $COLLE CT
	4719	DRUG RX INFO INS GR OUP# I NS GROUP N AME BILL#
	4720	$PROVI DER NETWOR K $BRAND DRUG $N ON-PREF FO RM $BRA ND NON-PRE F FORM $COVERAGE GAP $HEA LTH ASST $SPEND AC CT REMAINI NG
	4721	========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ==
	4722	DIVISION: XXXXXX
	4723	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- --
	4724	EPHARM INS URANCE
	4725	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- --
	4726	OPCOB,ONEC NF (16 6P) 27193 07 0/4 316136 08 /24/11 12.00 999999.99 0. 00
	4727	ATENOLOL 25MG TAB W P2 EX/R T00010 E PHARM INSU RANCE K1000F7
	4728	0.00 0.00 0. 00 0.00 0.00 0.00 12.30
	4729	Claim ID: VA2011=405 0000015=00 0010=00010 47
	4730	-- -------- ---------- -------- --
	4731	SUBTOTALS for INS:EP HARM INSUR ANCE 12.00 999999.99 0. 00
	4732	0.00 0 .00 0.00 0.00 0.0 0 0.00 12.3 0
	4733	COUNT 1 1 1
	4734	1 1 1 1 1 1 1
	4735	MEAN 12.00 999999.99 0. 00
	4736	0.00 0 .00 0.00 0.00 0.0 0 0.00 12.3 0
	4737	EXPRESS SC RIPTS
	4738	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- --
	4739	OPCOB,ONEC NF (16 6P) 27193 07 0/4 316136 08 /24/11 9 99999.99 999999.99 0. 00
	4740	ATENOLOL 25MG TAB W P2 EX/R T10000 0 E XPRESS SCR IPTS K1000F6
	4741	0.00 0.00 0. 00 0.00 0.00 0.00 15.41
	4742	Claim ID: VA2011=405 0000015=00 0010=00010 46
	4743	-- -------- ---------- -------- --
	4744	SUBTOTALS for INS:EX PRESS SCRI PTS 9 99999.99 999999.99 0. 00
	4745	0.00 0 .00 0.00 0.00 0.0 0 0.00 15.4 1
	4746	COUNT 1 1 1
	4747	1 1 1 1 1 1 1
	4748	MEAN 9 99999.99 999999.99 0. 00
	4749	0.00 0 .00 0.00 0.00 0.0 0 0.00 15.4 1
	4750	-- -------- ---------- -------- --
	4751	SUBTOTALS for DIV:XX XXXX 10 00011.99 1999999.98 0. 00
	4752	0.00 0 .00 0.00 0.00 0.0 0 0.00 27.7 1
	4753	COUNT 2 2 2
	4754	2 2 2 2 2 2 2
	4755	MEAN 5 00006.00 999999.99 0. 00
	4756	0.00 0 .00 0.00 0.00 0.0 0 0.00 13.8 6
	4757	-- -------- ---------- -------- --
	4758	GRAND TOTA LS 10 00011.99 1999999.98 0. 00
	4759	0.00 0 .00 0.00 0.00 0.0 0 0.00 27.7 1
	4760	COUNT 2 2 2
	4761	2 2 2 2 2 2 2
	4762	MEAN 5 00006.00 999999.99 0. 00
	4763	0.00 0 .00 0.00 0.00 0.0 0 0.00 13.8 6
	4764	Press RETU RN to cont inue:
	4765	8.2 Other Reports XE " Other R eports"
	4766	The Other Reports op tion allow s you to a ccess list s of elect ronic clai ms formats and NCPDP V. D0 fie lds.
	4767	Access the Other Rep orts optio n by enter ing OTH at the “Sele ct Pharmac y Electron ic Claims Reports Op tion:” pro mpt on the Pharmacy Electronic Claims Re ports opti on screen.
	4768	Example 8. 2-1: Acces sing the O ther Repor ts Option
	4769	*** ****** ****** ****** ****** **
	4770	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	4771	* XXXX X *
	4772	* Pharmacy Electroni c Claims R eports *
	4773	*** ****** ****** ****** ****** **
	4774	CLA Claim Resu lts and St atus ...
	4775	OTH Other Repo rts ...
	4776	Select Pha rmacy Elec tronic Cla ims Report s Option: OTH Other Reports
	4777	Example 8. 2-2: Displ aying Othe r Reports Options
	4778	*** ****** ****** ****** ****** **
	4779	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	4780	* XXXX X *
	4781	* Other Re ports *
	4782	*** ****** ****** ****** ****** **
	4783	CRI ECME Claim s-Response Inquiry
	4784	PAY Payer Shee t Detail R eport
	4785	PHAR ECME Setup - Pharmac ies Report
	4786	TAT Turn-aroun d time sta tistics
	4787	VER View ePhar macy Rx
	4788	OPR OPECC Prod uctivity R eport
	4789	Select Oth er Reports Option:
	4790	8.2.1 ECME Claims-Re sponse Inq uiry Optio n XE " ECM E Claims-R esponse In quiry"
	4791	The ECME C laims-Resp onse Inqui ry option allows the user to e nter a VA Claim ID a nd see the transacti on data, t he claim d ata sent t o the thir d-party pa yer and th e response data that was retur ned. This option may assist th e sites an d/or the V istA Maint enance Pro ject (VMP) team in d etermining the cause of a reje ct that is received from a pay er.
	4792	Access the ECME Clai ms-Respons e Inquiry option by entering C RI at the “Select Ot her Report s Option:” prompt on the Pharm acy Electr onic Claim s Reports, Other Rep orts optio n screen.
	4793	Example 8. 2.1-1: Acc essing the ECME Clai ms-Respons e Inquiry Option
	4794	*** ****** ****** ****** ****** **
	4795	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	4796	* XXXX X *
	4797	* Other Re ports *
	4798	*** ****** ****** ****** ****** **
	4799	CRI ECME Claim s-Response Inquiry
	4800	PAY Payer Shee t Detail R eport
	4801	PHAR ECME Setup - Pharmac ies Report
	4802	TAT Turn-aroun d time sta tistics
	4803	VER View ePhar macy Rx
	4804	OPR OPECC Prod uctivity R eport
	4805	Select Oth er Reports Option: C RI ECME C laims-Resp onse Inqui ry
	4806	Example 8. 2.1-2: ECM E Claims-R esponse In quiry Opti on
	4807	Select VA Claim ID: VA2009=500 0000021=10 5220=00055 24 VA2009 =500000002 1=105220=0
	4808	005524
	4809	Note: This report co ntains thr ee separat e sections - transac tion data, claims
	4810	data , and resp onse data. There wi ll be a pa ge break/f orm feed a fter
	4811	each section r egardless of the pag e length s pecified i n the devi ce input.
	4812	DEVICE: HO ME// <Ente r> UCX/T ELNET R ight Margi n: 80// < Enter>
	4813	ECME Claim s-Response Inquiry R eport Pr int Date: 04/17/09
	4814	VA CLAIM I D: VA2009= 5000000021 =105220=00 05524
	4815	BPS TRANSA CTION/BPS LOG OF TRA NSACTION D ATA:
	4816	ENTRY#: 11 3414.00042 STATUS: 99
	4817	PHARMACY : PHARM1 PRESCRIPTI ON #: 1021 79
	4818	RXI-INTE RNAL (c): 113414
	4819	PLAN NAM E: COB INS URANCE PHARMACY P LAN ID: VA 105220
	4820	CLAIM IE N (c): 552 4 RESPONSE I EN (c): 53 69
	4821	Press RETU RN to cont inue, '^' to exit:
	4822	BPS CLAIMS FILE DATA :
	4823	CLAIM ID: VA2009=500 0000021=10 5220=00055 24
	4824	ELECTRON IC PAYER: MNMEDB1 TRANSMIT F LAG: YES ( POINT OF S ALE)
	4825	TRANSMIT TED ON: AP R 17,2009@ 14:54:27 CREATED ON : APR 17,2 009@14:54: 27
	4826	TRANSACT ION: 11341 4.00042 PATIENT NA ME: ECMEpa tient,One
	4827	GROUP IN SURANCE PL AN: COB IN SURANCE BIN NUMBER : 610459
	4828	VERSION RELEASE NU MBER: D0 TRANSACTIO N CODE: B1
	4829	PROCESSO R CONTROL NUMBER: MH CP TRANSACTIO N COUNT: 1
	4830	SOFTWARE VENDER CE RT ID: SERVICE PR OVIDER ID: 500000002 1
	4831	SERVICE PROVIDER I D QUAL: 01 GROUP ID: C19977
	4832	CARDHOLD ER ID: C2X XXXXX PERSON COD E: C301
	4833	DATE OF BIRTH: C4X XXXXXXX PATIENT GE NDER CODE: MALE
	4834	PATIENT RELATIONSH IP CODE: C ARDHOLDER
	4835	PLACE OF SERVICE: C700 ELIGIBILIT Y CLARIFIC ATION CODE : C90
	4836	PATIENT FIRST NAME : CAONE PATIENT LA ST NAME: C BECMEPATIE NT
	4837	CARDHOLD ER FIRST N AME: CCONE
	4838	CARDHOLD ER LAST NA ME: CDECME PATIENT
	4839	HOME PLA N: CE36
	4840	PATIENT STREET ADD RESS: CM13 DFG
	4841	PATIENT CITY ADDRE SS: CNXXXX XXXX
	4842	PATIENT STATE PROV ADDRESS: COXX PATIENT ZI P POSTAL Z ONE: CPXXX XX
	4843	PATIENT PHONE NUMB ER: CQXXXX XXXXX PATIENT ID QUALIFIER : CX01
	4844	PATIENT ID: CYXXXX XXXX EMPLOYER I D: CZ
	4845	SMOKER I NDICATOR: 1C PREGNANCY INDICATOR: 2C
	4846	FACILITY ID: 8C
	4847	MEDICATION ORDER: 1 MEDICATION NAME: BET AZOLE 50MG /ML INJ
	4848	PRESCRIP TION NUMBE R: 102179 OTHER COVE RAGE CODE: C800
	4849	ALTERNAT E ID: CW00 0000000000 00000000
	4850	COB OTHER PAYMENT CO UNTER: 4C1 OTHER PAYE R COVERAGE TYPE: 5C0 1
	4851	OTHER PA YER ID QUA LIFIER: 6C 03 OTHER PAYE R ID: 7C12 3456
	4852	OTHER PA YER DATE: APR 14,200 9 OTHER PAYE R AMOUNT P AID COUNT: HB1
	4853	OTHER PA YER REJECT COUNT: 5E 00
	4854	OTHER PAYE R AMT PAID QUALIFIER : HC08 OTHER PAYE R AMOUNT P AID: DV004 00{
	4855	DATE OF SE RVICE: APR 14,2009 PR ESCRIPTION REFERENCE NUMBER: D 20113414
	4856	FILL NUM BER: D304 DAYS SUPPL Y: D5001
	4857	COMPOUND CODE: D61
	4858	PRODUCT SERVICE ID : D7000021 43916
	4859	DISPENSE AS WRITTE N: D80 INGREDIENT COST SUBM ITTED: D90 000510{
	4860	PRESCRIB ER ID: DBX XXXXXXXX DISPENSING FEE SUBMI TTED: DC00 000000
	4861	DATE PRE SCRIPTION WRITTEN: D E20090112
	4862	NUMBER O F REFILLS AUTHORIZED : DF05 LEVEL OF S ERVICE: DI 00
	4863	PRESCRIP TION ORIGI N CODE: DJ 1 SUBMISSION CLARIFICA TION CODE: DK00
	4864	BASIS OF COST DETE RMINATION: DN07 USUAL AND CUSTOMARY CHARGE: DQ 0000510{
	4865	SPECIAL PACKAGING INDICATOR: DT0 GROSS AMOU NT DUE: DU 0000510{
	4866	PRESCRIB ER LAST NA ME: ECMEPR ESCRIBER
	4867	OTHER PA YER AMOUNT : DV00400{
	4868	PATIENT PAID AMOUN T SUBMITTE D: DX00000 00{
	4869	PRODUCT SERVICE ID QUALIFIER : E103 QUANTITY D ISPENSED: E700000010 00
	4870	ORIGINAL LY PRESCRI BED QUANTI TY: EB0000 001000
	4871	SCHEDULE D RX ID NU MBER: EK00 0000000000
	4872	PRESCRIP TION SERVI CE REFEREN CE: EM1 QUANTITY P RESCRIBED: ET0000001 000
	4873	PRIOR AU THORIZATIO N TYPE COD E: EU00
	4874	PRIOR AU THORIZATIO N SUBMITTE D: EV00000 000000
	4875	INTERMED IARY AUTH TYPE ID: E W00
	4876	INTERMED IARY AUTHO RIZATION I D: EX
	4877	PRESCRIB ER ID QUAL IFIER: EZ0 1 PRESCRIBER LOCATION CODE: 1E
	4878	PC PROVI DER LOCATI ON CODE: H 5036 PC PROVIDE R LAST NAM E: 4EECMEP ROVIDER
	4879	PROFESSI ONAL FEE S UBMITTED: BE00000000
	4880	FLAT SAL ES TAX SUB MITTED: HA 00000000
	4881	PERCENTA GE SALES T AX SUBMITT ED: GE0000 000{
	4882	PERCENTA GE SALES T AX RATE: H E0000000 PERCENTAGE SALES TAX BASIS: JE
	4883	PRESCRIB ER PHONE N UMBER: PMX XXXXXXXXX
	4884	DATE OF SERVICE: 2 0090414 PLAN ID: F OECME INS
	4885	RAW DATA SENT:
	4886	61045951B 1MHCP 101500000 0021 2 0090414
	4887	AM01CX01C YXXXXXXXXX C41960010 1C51CAONEC BECMEPATIE NT CM13
	4888	DFG CNX XXXXXXX C OXXCPXXXXX CQXXXX XXXXXXC700
	4889	CZ 1C 2C
	4890	AM04C2234 234CCONECD ECMEPATIEN T CE36 FOECME INS C908C C1997 7
	4891	C301 C61
	4892	AM07EM1D2 0113414E10 3D70000214 3916 E7000000 1000D304D5 001D61D80D E20090112D
	4893	F05DJ1DK00 ET00000010 00C800DT0E B000000100 0CW0000000 0000000000 000EK00000 0000000DI0
	4894	0EU00EV000 00000000EW 00EX
	4895	AM02
	4896	AM03EZ01D BXXXXXXXXX X 1E ECMEPRESC RIBER H50364 EECMEPROVI DER
	4897	AM054C15C 016C037C12 3456 E8 20090414HB 1DV00400{
	4898	AM11D9000 0510{DC000 00000BE000 00000DX000 0000{HA000 00000GE000 0000{HE000 0000JE DQ
	4899	0000510{DU 0000510{DN 07
	4900	Press RETU RN to cont inue, '^' to exit:
	4901	BPS RESPON SE FILE DA TA:
	4902	BPS CLAIM: VA2009=50 00000021=1 05220=0005 524
	4903	DATE RES PONSE RECE IVED: APR 17, 2009@1 4:54:30
	4904	VERSION RELEASE NU MBER: D0 TRANSACTIO N CODE: B1
	4905	TRANSACT ION COUNT: 1 SERVICE PR OVIDER ID: XXXXXXXXX X
	4906	SERVICE PROVIDER I D QUALIFIE R: 01 DATE OF SE RVICE: APR 14,2009
	4907	RESPONSE STATUS: R EJECTED
	4908	MESSAGE: EV161-MAN DATORY FIE LD HC MISS ING IN SEG 05
	4909	MEDICATION ORDER: 1 TRANSACTIO N RESPONSE STATUS: R EJECTED
	4910	PRESCRIP TION RESPO NSE STATUS : REJECTED CLAIM
	4911	REJECT C OUNT: 04
	4912	REJECT COD E: 85 (Cla im Not Pro cessed)
	4913	REJECT COD E: NN (Tra nsaction R ejected At Switch Or Intermedi ary
	4914	REJECT COD E: R8 (Syn tax Error)
	4915	REJECT COD E: HC (M/I Other Pay er Amount Paid Quali fier)
	4916	REJECT COD E: 79 (REF ILL TOO SO ON)
	4917	NEXT AVA IL FILL DA TE: APR 20 ,2009
	4918	RAW DATA RECEIVED:
	4919	VA2009=XX XXXXXXXX=1 05220=000x xxxxxB11R0 1XXXXXXXXX X
	4920	20090414\ X1E\\X1C\A M20\X1C\F4 EV161-MAND ATORY FIEL D HC MISSI NG IN SEG
	4921	05\X1D\\X 1E\\X1C\AM 21\X1C\ANR \X1C\FA04\ X1C\FB85\X 1C\FBNN\X1 C\FBR8\X1C \FBHC
	4922	Press RETU RN to cont inue:
	4923	8.2.2 Paye r Sheet De tail Repor t Option X E " Payer Sheet Deta il"
	4924	The Payer Sheet Deta il Report option all ows you to list the informatio n on payer sheets us ed for ele ctronic cl aims. Paye r sheets a re templat es defined by each p ayer used to create NCPDP tran smissions. The sheet s indicate which fie lds to sen d in the t ransmissio ns, as wel l as the a cceptable values tha t may appe ar in the fields. Yo u may also express c onditions for when p articular values are to be use d.
	4925	Access the Payer She et Detail Report opt ion by ent ering PAY at the “Se lect Other Reports O ption:” pr ompt on th e Pharmacy Electroni c Claims R eports, Ot her Report s option s creen.
	4926	Example 8. 2.2-1: Acc essing the Payer She et Detail Report Opt ion
	4927	*** ****** ****** ****** ****** **
	4928	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	4929	* XXXXX V AMC *
	4930	* Other Re ports *
	4931	*** ****** ****** ****** ****** **
	4932	CRI ECME Claim s-Response Inquiry
	4933	PAY Payer Shee t Detail R eport
	4934	PHAR ECME Setup - Pharmac ies Report
	4935	TAT Turn-aroun d time sta tistics
	4936	VER View ePhar macy Rx
	4937	OPR OPECC Prod uctivity R eport
	4938	Select Oth er Reports Option: P AY Payer Sheet Deta il Report
	4939	Example 8. 2.2-2: Pay er Sheet D etail Repo rt Option
	4940	Select Pay er Sheet: ABCTEST1
	4941	DEVICE: HO ME// IP network
	4942	Payer Shee t Detail R eport Pri nt Date: 0 9/09/05 Page: 1
	4943	Payer Sh eet Name: ABCTEST1 Version Number: 7
	4944	Status: PRODUCTION NCPDP Version: V ersion D.0
	4945	Seq Field Fie ld Name Proc Mode
	4946	--- ----- --- ------- ---------
	4947	* Trans action Hea der Segmen t *
	4948	1 101-A 1 BIN NUMBER S
	4949	2 102-A 2 VER SION/RELEA SE NUMBER S
	4950	3 103-A 3 TRA NSACTION C ODE S
	4951	5 104-A 4 PRO CESSOR CON TROL NUMBE R S
	4952	17 202-B 2 SER V PROVIDER ID QUALIF IER S
	4953	19 201-B 1 SER VICE PROVI DER ID S
	4954	21 401-D 1 DAT E FILLED S
	4955	Press RETU RN to cont inue, '^' to exit: < Enter>
	4956	Payer Shee t Detail R eport Pri nt Date: 0 9/09/05 Page: 2
	4957	Payer Sh eet Name: ABCTEST1 Version Number: 7
	4958	Seq Field Fie ld Name Proc Mode
	4959	--- ----- --- ------- ---------
	4960	* Trans action Hea der Segmen t *
	4961	22 110-A K SOF TWARE VEND OR/CERT ID S
	4962	* Patient Se gment *
	4963	31 111-A M SEG MENT IDENT IFICATION S
	4964	33 331-C X PAT IENT ID QU ALIFIER S
	4965	35 332-C Y PAT IENT ID S
	4966	36 304-C 4 DAT E OF BIRTH S
	4967	37 305-C 5 SEX CODE S
	4968	39 307-C 7 CUS TOMER LOCA TION S
	4969	40 335-2 C PRE GNANCY IND ICATOR S
	4970	* I nsurance S egment *
	4971	49 111-A M SEG MENT IDENT IFICATION S
	4972	51 302-C 2 CAR DHOLDER ID NUMBER S
	4973	53 301-C 1 GRO UP NUMBER S
	4974	Press RETU RN to cont inue, '^' to exit: < Enter>
	4975	Payer Shee t Detail R eport Pri nt Date: 0 9/09/05 Page: 3
	4976	Payer Sh eet Name: ABCTEST1 Version Number: 7
	4977	Seq Field Fie ld Name Proc Mode
	4978	--- ----- --- ------- ---------
	4979	* I nsurance S egment *
	4980	54 306-C 6 REL ATIONSHIP CODE S
	4981	* Claim Seg ment *
	4982	64 111-A M SEG MENT IDENT IFICATION S
	4983	66 455-E M RX/ SERVICE RE F NUMBER Q UAL S
	4984	69 402-D 2 PRE SCRIPTION NUMBER S
	4985	71 436-E 1 PRO DUCT/SERV ID QUAL S
	4986	73 407-D 7 PRO DUCT/SERVI CE ID S
	4987	75 442-E 7 QUA NTITY DISP ENSED S
	4988	77 403-D 3 NEW /REFILL CO DE S
	4989	78 405-D 5 DAY S SUPPLY S
	4990	79 406-D 6 COM POUND CODE S
	4991	80 408-D 8 OTH ER COVERAG E CODE S
	4992	82 414-D E DAT E PRESCRIP TION WRITT EN S
	4993	85 308-C 8 OTH ER COVERAG E CODE S
	4994	Press RETU RN to cont inue, '^' to exit: < Enter>
	4995	Payer Shee t Detail R eport Pri nt Date: 0 9/09/05 Page: 4
	4996	Payer Sh eet Name: ABCTEST1 Version Number: 7
	4997	Seq Field Fie ld Name Proc Mode
	4998	--- ----- --- ------- ---------
	4999	* Claim Seg ment *
	5000	87 429-D T UNI T DOSE IND ICATOR S
	5001	89 453-E J ORI G PRESCR P ROD/SERV I D QUAL S
	5002	92 445-E A ORI G PRESCRIB ED PROD/SE RV CODE S
	5003	95 446-E B ORI GINALLY PR ESCRIBED Q TY S
	5004	97 418-D I LEV EL OF SERV ICE S
	5005	99 461-E U PRI OR AUTHORI ZATION TYP E CODE S
	5006	102 462-E V PRI OR AUTHORI ZATION NUM SUB S
	5007	106 463-E W INT ERMED AUTH TYPE ID S
	5008	109 464-E X INT ERMEDIARY AUTHORIZAT ION ID S
	5009	112 343-H D DIS PENSING ST ATUS S
	5010	114 344-H F QTY INTENDED TO BE DISP ENSED S
	5011	117 345-H G DAY S SUPPLY I NTEND TO B E DISP S
	5012	* Pharm acy Provid er Segment *
	5013	127 111-A M SEG MENT IDENT IFICATION S
	5014	Press RETU RN to cont inue, '^' to exit: < Enter>
	5015	Payer Shee t Detail R eport Pri nt Date: 0 9/09/05 Page: 5
	5016	Payer Sh eet Name: ABCTEST1 Version Number: 7
	5017	Seq Field Fie ld Name Proc Mode
	5018	--- ----- --- ------- ---------
	5019	* Pharm acy Provid er Segment *
	5020	129 465-E Y PRO VIDER ID Q UALIFIER S
	5021	131 444-E 9 PRO VIDER ID S
	5022	* P rescriber Segment *
	5023	140 111-A M SEG MENT IDENT IFICATION S
	5024	142 466-E Z PRE SCRIBER ID QUALIFIER S
	5025	144 411-D B PRE SCRIBER ID S
	5026	146 427-D R PRE SCRIBER LA ST NAME S
	5027	148 498-P M PRE SCRIBER TE LEPHONE NU MBER S
	5028	150 468-2 E PRI MARY CARE PROV ID QU AL S
	5029	153 421-D L PRI MARY PRESC RIBER S
	5030	155 469-H 5 PRI M CARE PRO V LOCATION CODE S
	5031	158 470-4 E PRI M CARE PRO VIDER LAST NAME S
	5032	Press RETU RN to cont inue, '^' to exit: < Enter>
	5033	Payer Shee t Detail R eport Pri nt Date: 0 9/09/05 Page: 6
	5034	Payer Sh eet Name: ABCTEST1 Version Number: 7
	5035	Seq Field Fie ld Name Proc Mode
	5036	--- ----- --- ------- ---------
	5037	* COB/O ther Payme nts Segmen t *
	5038	168 111-A M SEG MENT IDENT IFICATION S
	5039	170 337-4 C COB /OTHER PAY MENTS COUN TER S
	5040	172 338-5 C OTH ER PAYER C OVERAGE TY PE S
	5041	174 339-6 C OTH ER PAYER I D QUALIFIE R S
	5042	177 340-7 C OTH ER PAYER I D S
	5043	180 443-E 8 Oth er Payer D ate S
	5044	182 341-H B OTH ER PAYER A MOUNT PAID COUNT S
	5045	185 342-H C OTH PYR AMOUN T PAID QUA L. S
	5046	188 431-D V OTH ER PAYOR A MOUNT S
	5047	190 471-5 E OTH ER PAYER R EJECT COUN T S
	5048	192 472-6 E OTH ER PAYER R EJECT CODE S
	5049	* Workers ' Compensa tion Segme nt *
	5050	202 111-A M SEG MENT IDENT IFICATION S
	5051	205 434-D Y DAT E OF INJUR Y S
	5052	Press RETU RN to cont inue, '^' to exit: < Enter>
	5053	Payer Shee t Detail R eport Pri nt Date: 0 9/09/05 Page: 7
	5054	Payer Sh eet Name: ABCTEST1 Version Number: 7
	5055	Seq Field Fie ld Name Proc Mode
	5056	--- ----- --- ------- ---------
	5057	* Workers ' Compensa tion Segme nt *
	5058	* DUR/PPS Se gment *
	5059	213 111-A M SEG MENT IDENT IFICATION S
	5060	215 473-7 E DUR /PPS CODE COUNTER S
	5061	218 439-E 4 DUR CONFLICT CODE S
	5062	220 440-E 5 DUR INTERVENT ION CODE S
	5063	222 441-E 6 DUR OUTCOME C ODE S
	5064	224 474-8 E DUR /PPS LEVEL OF EFFORT S
	5065	227 475-J 9 DUR CO-AGENT ID QUALIFI ER S
	5066	230 476-H 6 DUR CO-AGENT ID S
	5067	* Pricing Se gment *
	5068	240 111-A M SEG MENT IDENT IFICATION S
	5069	242 409-D 9 ING REDIENT CO ST S
	5070	244 412-D C DIS PENSING FE E SUBMITTE D S
	5071	Press RETU RN to cont inue, '^' to exit: < Enter>
	5072	Payer Shee t Detail R eport Pri nt Date: 0 9/09/05 Page: 8
	5073	Payer Sh eet Name: ABCTEST1 Version Number: 7
	5074	Seq Field Fie ld Name Proc Mode
	5075	--- ----- --- ------- ---------
	5076	* Pricing Se gment *
	5077	246 477-B E PRO FESSIONAL SERV FEE S UBMIT S
	5078	249 433-D X PAT IENT PAID AMOUNT S
	5079	252 481-H A FLA T SALES TA X AMOUNT S UBMIT S
	5080	255 482-G E PER CENTAGE SA LES TAX AM T SUB S
	5081	258 484-J E PER CENT SALES TAX BASIS SUB S
	5082	261 426-D Q USU AL & CUSTO MARY CHARG E S
	5083	264 430-D U GRO SS AMOUNT DUE S
	5084	266 423-D N BAS IS OF COST DETERMINA TION S
	5085	* Coupon Se gment *
	5086	275 111-A M SEG MENT IDENT IFICATION S
	5087	277 485-K E COU PON TYPE S
	5088	278 486-M E COU PON NUMBER S
	5089	279 487-N E COU PON VALUE AMOUNT S
	5090	Press RETU RN to cont inue, '^' to exit: < Enter>
	5091	Payer Shee t Detail R eport Pri nt Date: 0 9/09/05 Page: 9
	5092	Payer Sh eet Name: ABCTEST1 Version Number: 7
	5093	Seq Field Fie ld Name Proc Mode
	5094	--- ----- --- ------- ---------
	5095	* Compound S egment *
	5096	288 111-A M SEG MENT IDENT IFICATION S
	5097	290 450-E F Com pound Dose Form Desc Code S
	5098	293 451-E G Com pound Disp ense Unt F orm Ind S
	5099	295 452-E H Com pound Rout e of Admin S
	5100	297 447-E C Com pound Ingr ed Comp Co unt S
	5101	299 488-R E Com pound Prod uct ID Qua lifier S
	5102	301 489-T E Com pound Prod uct ID S
	5103	302 448-E D Com pound Ingr edient Qua ntity S
	5104	304 449-E E Com pound Ingr edient Dru g Cost S
	5105	307 490-U E Com p Ingred B asis Cost Determ S
	5106	Press RETU RN to cont inue:
	5107	8.2.3 ECME Setup – P harmacies Report XE " ECME Set up - Pharm acies"
	5108	This optio n will pro duce a rep ort that d isplays se tup inform ation for each pharm acy config ured for a facility.
	5109	Access the report by entering PHAR at th e “Select Other Repo rts Option :” prompt on the Pha rmacy Elec tronic Cla ims Report s, Other R eports opt ion screen .
	5110	Example 8. 2.3-1: Acc essing ECM E Setup – Pharmacies Report Op tion
	5111	*** ****** ****** ****** ****** **
	5112	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	5113	* XXXXX V AMC *
	5114	* Other Re ports *
	5115	*** ****** ****** ****** ****** **
	5116	CRI ECME Claim s-Response Inquiry
	5117	PAY Payer Shee t Detail R eport
	5118	PHAR ECME Setup - Pharmac ies Report
	5119	TAT Turn-aroun d time sta tistics
	5120	VER View ePhar macy Rx
	5121	OPR OPECC Prod uctivity R eport
	5122	Select Set up (Config uration) R eports Opt ion: PHAR ECME Setup - Pharmac ies Report
	5123	DEVICE: IP network
	5124	Example 8. 2.3-2: ECM E Setup - Pharmacies Report Op tion
	5125	BPS PHARMA CIES LIST SEP 9,2005 07:17 P AGE 1
	5126	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------
	5127	NU MBER: 2
	5128	NAME: XXXX XXXXX NCPDP #: X XXXXXX
	5129	DEFAULT DEA #: AGX XXXX CMOP SWITC H: CMOP ON
	5130	AUTO-REV ERSE PARAM ETER: 0 STATUS: AC TIVE
	5131	SITE ADD RESS 1: 10 1 MAIN STR EET
	5132	SITE CIT Y: XXXXXXX XX SITE STATE : XXXXX
	5133	SITE ZIP CODE: XXX XX SITE ADDRE SS NAME: 1 01 MAIN ST REET
	5134	HOURS OF OPERATION : 24 START DAY RANGE: MON
	5135	END DAY RANGE: MON START HOUR RANGE: 08 00
	5136	END HOUR RANGE: 16 00~TUE NPI: XXXXX XXXXX
	5137	DATE/TIM E OF LAST NPI CHANGE : OCT 10, 2006@15:05 :05
	5138	OUTPATIENT SITE: XXX XXXXXXXXX
	5139	REMITTAN CE ADDRESS NAME: MAI N REMIT ADDR ESS 1: 101 MAIN STRE ET
	5140	REMIT CI TY: XXXXXX XXX REMIT STAT E: XXXXXX
	5141	REMIT ZI P: XXXXX VA CONTACT : CONTACT, ONE
	5142	VA ALTER NATE CONTA CT: CONTAC T,ONE VA LEAD PHAR MACIST: CO NTACT,ONE
	5143	VA LEAD PHARMACIST LICENSE # : XXXXXXXX
	5144	Monday C lose Time: 1600 Tuesday Cl ose Time: 1600
	5145	Wednesda y Close Ti me: 1600 Thursday C lose Time: 1600
	5146	Friday C lose Time: 1600 Saturday C lose Time: 1600
	5147	Monday O pen Time: 0800 Tuesday Op en Time: 0 800
	5148	BPS PHARMA CIES LIST SEP 09, 2005@ 17:17 P AGE 2
	5149	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------
	5150	Wednesda y Open Tim e: 0800 Thursday O pen Time: 0800
	5151	Friday O pen Time: 0800 Saturday O pen Time: 0800
	5152	NU MBER: 3
	5153	NAME: XXXX XXXXXXX NCPDP #: X XXXXXX
	5154	DEFAULT DEA #: AGX XXXX CMOP SWITC H: CMOP ON
	5155	AUTO-REV ERSE PARAM ETER: 2 STATUS: AC TIVE
	5156	SITE ADD RESS 1: 10 1 MAIN AVE
	5157	SITE CIT Y: XXXXXXX XXXX SITE STATE : XXXXXX
	5158	SITE ZIP CODE: XXX XX SITE ADDRE SS NAME: 1 01 MAIN AV E
	5159	HOURS OF OPERATION : 24 START DAY RANGE: MON
	5160	END DAY RANGE: MON START HOUR RANGE: 08 00
	5161	END HOUR RANGE: 16 00~TUE NPI: 00000 00006
	5162	DATE/TIM E OF LAST NPI CHANGE : OCT 10, 2006@15:05 :05
	5163	OUTPATIENT SITE: XXX XXXXXXX VA
	5164	OUTPATIENT SITE: XXX XXXXXX CBO C
	5165	OUTPATIENT SITE: XXX XX VA CBOC
	5166	REMITTAN CE ADDRESS NAME: XXX XXXXXXX XX XXXX
	5167	REMIT AD DRESS 1: 1 01 XXXXXXX XXXXXXXXX
	5168	REMIT CI TY: XXXXXX XXXXX REMIT STAT E: XXXXXXX X
	5169	REMIT ZI P: XXXXX VA CONTACT : CONTACT, ONE
	5170	VA ALTER NATE CONTA CT: CONTAC T,TWO
	5171	VA LEAD PHARMACIST : PHARMACI ST,ONE Monday Cl ose Time: 1600
	5172	Tuesday Close Time : 1600 Wednesday Close Time : 1600
	5173	Thursday Close Tim e: 1600 Friday Clo se Time: 1 600
	5174	BPS PHARMA CIES LIST SEP 09, 2005@ 17:17 P AGE 3
	5175	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------
	5176	Saturday Close Tim e: 1600 Monday Ope n Time: 08 00
	5177	Tuesday Open Time: 0800 Wednesday Open Time: 0800
	5178	Thursday Open Time : 0800 Friday Ope n Time: 08 00
	5179	Saturday Open Time : 0800
	5180	Press ENTE R to conti nue:
	5181	8.2.4 Turn -around ti me statist ics XE " T urn-around time stat istics"
	5182	The Turn-a round time statistic s option s hows the l ength of t ime for cl aims to co mplete, in cluding br eakouts fo r various steps of c laims crea tion. The end of the report ha s the aver age time f or the cla ims displa yed.
	5183	Access the Turn-arou nd time st atistics o ption by e ntering TA T at the “ Select Oth er Reports Option:” prompt on the Pharma cy Electro nic Claims Reports, Other Repo rts option screen.
	5184	Example 8. 2.4-1: Acc essing the Turn-arou nd time st atistics R eport Opti on
	5185	*** ****** ****** ****** ****** **
	5186	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	5187	* XXXXX V AMC *
	5188	* Other Re ports *
	5189	*** ****** ****** ****** ****** **
	5190	CRI ECME Claim s-Response Inquiry
	5191	PAY Payer Shee t Detail R eport
	5192	PHAR ECME Setup - Pharmac ies Report
	5193	TAT Turn-aroun d time sta tistics
	5194	VER View ePhar macy Rx
	5195	OPR OPECC Prod uctivity R eport
	5196	Select Oth er Reports Option: T AT Turn-a round time statistic s
	5197	Example 8. 2.4-2: Dis playing th e Turn-aro und time s tatistics Report
	5198	START WITH DATE: T-1 // <Enter > (SEP 08, 2005)
	5199	GO TO DATE : T// <En ter> (SEP 09, 2005)
	5200	For Prescr iption: 1106378.00 001 (Rx#: 382992)
	5201	Begin 08:19:48
	5202	Gathering informatio n 08:19:52
	5203	Claim ID c reated 08:19:55
	5204	Claim Sent 08:19:56
	5205	Response s tored 08:20:04
	5206	Completed at: 08:20:04
	5207	Turn-aroun d time 16
	5208	For Prescr iption: 1106380.00 001 (Rx#: 382994)
	5209	Begin 08:19:48
	5210	Gathering informatio n 08:19:52
	5211	Claim ID c reated 08:19:55
	5212	Claim Sent 08:20:16
	5213	Response s tored 08:20:18
	5214	Completed at: 08:20:18
	5215	Turn-aroun d time 30
	5216	For Prescr iption: 1106379.00 001 (Rx#: 382993)
	5217	Begin 08:19:48
	5218	Gathering informatio n 08:19:52
	5219	Claim ID c reated 08:19:55
	5220	Claim Sent 08:20:06
	5221	Response s tored 08:20:08
	5222	Completed at: 08:20:08
	5223	Turn-aroun d time 20
	5224	For Prescr iption: 1106384.00 001 (Rx#: 909952)
	5225	Begin 11:27:13
	5226	Gathering informatio n 11:27:15
	5227	Claim ID c reated 11:27:16
	5228	Claim Sent 11:27:17
	5229	Response s tored 11:27:23
	5230	Completed at: 11:27:23
	5231	Turn-aroun d time 10
	5232	For Prescr iption: 1106386.00 001 (Rx#: 909954)
	5233	Begin 11:27:13
	5234	Gathering informatio n 11:27:15
	5235	Claim ID c reated 11:27:17
	5236	Claim Sent 11:27:37
	5237	Response s tored 11:27:39
	5238	Completed at: 11:27:39
	5239	Turn-aroun d time 26
	5240	Average Tu rn-around time: 13
	5241	8.2.5 View ePharmacy Rx
	5242	The View e Pharmacy R x option a llows you to view in formation for one pr escription , combinin g informat ion from O utpatient Pharmacy, Integrated Billing a nd ECME.
	5243	Access the View ePha rmacy Rx o ption by e ntering VE R at the “ Select Oth er Reports Option:” prompt on the Pharma cy Electro nic Claims Reports, Other Repo rts option screen.
	5244	Example 8. 2.5-1: Acc essing the View ePha rmacy Rx R eport Opti on
	5245	*** ****** ****** ****** ****** **
	5246	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	5247	* ALASKA V AHSRO *
	5248	* Other Re ports *
	5249	*** ****** ****** ****** ****** **
	5250	CRI ECME Claim s-Response Inquiry
	5251	PAY Payer Shee t Detail R eport
	5252	PHAR ECME Setup - Pharmac ies Report
	5253	TAT Turn-aroun d time sta tistics
	5254	VER View ePhar macy Rx
	5255	OPR OPECC Prod uctivity R eport
	5256	Select Oth er Reports Option: VER View ePharmacy Rx
	5257	Example 8. 2.5-2: Dis playing th e View ePh armacy Rx Report
	5258	Select Pre scription: 2055346
	5259	ATE NOLOL 25MG TAB
	5260	Patient Rx# Dru g Name Rx Stat us
	5261	ECMEPATIE NT,ONE 20553 46 TAM OXIFEN CIT RATE 10MG TA DISCONT INUED
	5262	OK to cont inue? Yes/ / YES
	5263	Rx# 205534 6 has the following fills:
	5264	Fill# Fill Dat e Rele ase Date
	5265	----- -------- -- ---- --------
	5266	0 01/29/20 09 01/2 9/2009
	5267	1 02/26/20 09 02/2 5/2009
	5268	Select Fil l Number: 1 02/26/20 09 02/2 6/2009
	5269	Selec t one of t he followi ng:
	5270	M Most recen t transact ion for ea ch payer
	5271	A All transa ctions
	5272	There ar e 2 ECME t ransaction s for this Rx/fill.
	5273	1 for th e primary payer, 1 f or the sec ondary pay er.
	5274	Select Mos t recent t ransaction for each payer or A ll transac tions: M// All trans
	5275	actions
	5276	Compiling data for V iew Prescr iptions .. .
	5277	Compiling data for t he ECME Cl aim Log .. .
	5278	Compiling data for t he ECME Bi lling Even ts Report ...
	5279	Compiling data for t he ECME Cl aims-Respo nse Inquir y (CRI) Re port ...
	5280	Compiling data for V iew Insura nce Polici es ... ... .......... ......
	5281	Compiling the list o f TPJI bil ls ...
	5282	Compiling data for T PJI Claim Informatio n ...
	5283	Compiling data for T PJI AR Acc ount Profi le ...
	5284	Compiling data for T PJI AR Com ment Histo ry ...
	5285	Compiling data for T PJI ECME R x Response ...
	5286	Compiling data for V iew Regist ration Eli gibility S tatus ...
	5287	Compiling data for V iew Regist ration Eli gibility V erificatio n ...
	5288	View Presc ription
	5289	Rx View (D iscontinue d) Feb 08, 2 011@13:59: 27 P age: 1 of 1
	5290	ECMEPATIEN T,ONE
	5291	PID: 666 -87-4529 Ht(cm): _ ______ (__ ____)
	5292	DOB: OCT 18,1963 ( 47) Wt(kg): _ ______ (__ ____)
	5293	+--------- ---------- ---------- ---------- ---------- ---------- ---------- ----------
	5294	Rx # : 2055346$ e (ECME#: 000001615 253)
	5295	Orde rable Item : TAMOXIFE N CITRATE TAB
	5296	CMOP Drug : TAMOXIFE N CITRATE 10MG TAB
	5297	NDC : 00378-01 44-93
	5298	*Dosage : 10MG
	5299	Verb : TAKE
	5300	Disp ense Units : 1
	5301	Noun : TABLET
	5302	*Route : ORAL (BY MOUTH)
	5303	*Schedule : BID
	5304	Patient In structions :
	5305	SIG : TAKE ONE TABLET BY MOUTH TWI CE A DAY
	5306	Pati ent Status : OUTPT NO N-SC
	5307	Issue Date : 01/29/09 Fil l Date: 01 /29/09
	5308	Last Fill Date : 02/26/09 (Mail, Tr ansmitted)
	5309	Last Re lease Date : 02/25/09 Lot #:
	5310	Expires : 01/30/10 MFG:
	5311	D ays Supply : 3 QT Y (TAB): 6 0
	5312	# of Refills : 11 Rem aining: 9
	5313	Provider : ECMEPROV IDER,ONE
	5314	Routing : Window
	5315	Copies : 1
	5316	Method of Pickup :
	5317	Clinic : Not on F ile
	5318	Division: DNS ENNE VAM&R OC (442)
	5319	Pharmacist : ECMEPROV IDER,ONE
	5320	Patient Counseling : NO
	5321	Remarks : New Orde r Created by copying Rx # 2055 345.
	5322	F inished By : ECMEPROV IDER,ONE
	5323	Entry B y: ECMEPRO VIDER,ONE Entry Da te: 01/29/ 09 12:59:3 8
	5324	Original F ill Releas ed: 02/25/ 09 Ro uting: Win dow
	5325	Refill Lo g:
	5326	# Log Dat e Refill Date Qty Routi ng Lot # Phar macist
	5327	========== ========== ========== ========== ========== ========== ========== =========
	5328	1 02/25/ 09 02/25 /09 60 Mail
	5329	Division: 442 Dispensed: 02/25/09 Released : 2/25/09 NDC: 0037 8-0144-91
	5330	2 02/25/ 09 02/26 /09 60 Mail
	5331	Division: 442 Dispensed: 02/26/09 Released :
	5332	Partial Fi lls:
	5333	# Log Da te Date Qty Routing Lot # Pharm acist
	5334	========== ========== ========== ========== ========== ========== ========== =========
	5335	There are NO Partial s for this Prescript ion
	5336	Activity L og:
	5337	# Date Reas on Rx Ref Init iator Of A ctivity
	5338	========== ========== ========== ========== ========== ========== ========== =========
	5339	1 02/25/ 09 SUSP ENSE REFILL 1 ECME PROVIDER,O NE
	5340	Comments: RX Placed on Suspens e for CMOP until 02- 25-09
	5341	2 02/25/ 09 PROC ESSED REFILL 1 ECME PROVIDER,O NE
	5342	Comments: Transmitte d to DALLA S CMOP
	5343	3 02/25/ 09 SUSP ENSE REFILL 2 ECME PROVIDER,O NE
	5344	Comments: RX Placed on Suspens e for CMOP until 02- 26-09
	5345	4 02/25/ 09 SUSP ENSE REFILL 2 ECME PROVIDER,O NE
	5346	Comments: 3/4 of Day s Supply S USPENSE HO LD until 2 /28/09.
	5347	5 03/01/ 09 PROC ESSED REFILL 2 ECME PROVIDER,O NE
	5348	Comments: Transmitte d to DALLA S CMOP
	5349	6 06/11/ 09 DISC ONTINUED REFILL 2 ECME PROVIDER,T WO
	5350	Comments: Discontinu ed During New Prescr iption Ent ry - Dupli cate Drug
	5351	Copay Acti vity Log:
	5352	# Date Reas on Rx Ref Initiato r Of Activ ity
	5353	========== ========== ========== ========== ========== ========== ========== =========
	5354	There's NO Copay act ivity to r eport
	5355	Label Log:
	5356	# Date Rx R ef Printed By
	5357	========== ========== ========== ========== ========== ========== ========== =========
	5358	1 02/25/ 09 ORIG INAL ECMEPROV IDER,ONE
	5359	Comments: From RX nu mber 20553 46
	5360	ECME Log:
	5361	# Date/T ime Rx Ref Initiator Of Activit y
	5362	========== ========== ========== ========== ========== ========== ========== =========
	5363	1 1/29/0 9@12:59:55 ORIGIN AL ECMEPROVID ER,ONE
	5364	Comments: Submitted to ECME:WI NDOW FILL( NDC:00378- 0144-93)-E REJECTED
	5365	2 2/25/0 9@16:49:16 ORIGIN AL ECMEPROVID ER,ONE
	5366	Comments: Submitted to ECME:RE JECT WORKL IST-E PAYA BLE
	5367	3 2/25/0 9@16:51:03 REFILL 1 ECMEPROVID ER,ONE
	5368	Comments: Submitted to ECME:CM OP TRANSMI SSION(NDC: 00378-0144 -91)
	5369	4 3/1/09 @14:00:05 REFILL 2 ECMEPROVID ER,ONE
	5370	Comments: Submitted to ECME:CM OP TRANSMI SSION(NDC: 00378-0144 -91)
	5371	ECME REJEC T Log:
	5372	# Date/Ti me Rcvd Rx Ref Reject Ty pe STA TUS Da te/Time Re solved
	5373	========== ========== ========== ========== ========== ========== ========== =========
	5374	1 1/29/09 @12:59:54 ORIGINAL REFILL TO O SOON RES OLVED 2/ 25/09@16:4 9:04
	5375	Comments: AUTOMATICA LLY CLOSED (CLAIM RE -SUBMITTED )
	5376	CMOP Event Log:
	5377	Date/Time Rx Ref TRN-Order Stat Comment s
	5378	========== ========== ========== ========== ========== ========== ========== =========
	5379	02/25/09@1 656 Ref 1 16346-1 DISP ND C: 0037801 4491
	5380	Carrier: U SPS Pkg ID: P GKID999
	5381	03/01/09@1 403 Ref 2 16360-1 TRAN
	5382	CMOP Lot#/ Expiration Date Log:
	5383	Rx Ref Lot # Expiratio n Date
	5384	========== ========== ========== ========== ========== ========== ========== =========
	5385	Ref 1 A87904 03/22/07
	5386	ECME Claim Log
	5387	PHARMACY E CME Feb 08, 2011@14:0 6:41 Pag e: 1 of 1
	5388	Claim Log informatio n
	5389	---------- ---------- ---------- ---------- ---------- ---------- ---------- ----------
	5390	Pharmacy E CME Log
	5391	VA Rx #: 2055346$ Fill #: 1 ECM E #: 16152 53
	5392	Pati ent Name: ECMEPATIEN T,ONE (452 9)
	5393	Transactio n Number: 1615253.00 011
	5394	Last S ubmitted: FEB 25,200 9@16:51:03
	5395	Last Subm itted By: ECMEPROVID ER,ONE
	5396	Last VA Claim #: VA2009=116 4471991=00 0010=00012 35
	5397	Transmissi on Informa tion (CLAI M REQUEST) (#1236)--- ---------- ---------- ---------
	5398	Created on : FEB 25,2 009@16:51: 04
	5399	VA Claim I D: VA2009= 1164471991 =000010=00 01235
	5400	Submitted By: ECMEPR OVIDER,ONE
	5401	Transactio n Type: RE QUEST
	5402	Date of Se rvice: 02/ 25/2009
	5403	NDC: 00378 -0144-91
	5404	ECME Pharm acy: DNS 9-BOTH NPI & NCPDP
	5405	Days Suppl y: 3
	5406	Qty: 60 Unit Cos t: .928 Total Pr ice: 68.20
	5407	Insurance Name: BLUE MOON INSU RANCE
	5408	Group Name : T-GROUP1
	5409	Rx Coordin ation of B enefits: P RIMARY
	5410	BIN: 12345 6
	5411	PCN: 11234 56789
	5412	NCPDP Vers ion: D.0
	5413	Group ID: 10001
	5414	Cardholder ID:
	5415	Patient Re lationship Code: CAR DHOLDER
	5416	Cardholder First Nam e: ONE
	5417	Cardholder Last Name : OPPATIEN T
	5418	Facility I D Qualifie r:
	5419	Billing Re quest Paye r Sheet: W BTESTB1
	5420	Reversal P ayer Sheet : WBTESTB2
	5421	Response I nformation (CLAIM R EQUEST)(#1 213)------ ---------- ---------- ---------
	5422	Response R eceived: F EB 25,2009 @16:51:10
	5423	Date of Se rvice: 02/ 25/2009
	5424	Transactio n Response Status: P aid
	5425	Total Amou nt Paid: $ 58.20
	5426	Reconcilia tion ID:
	5427	Reject cod e(s):
	5428	Message:
	5429	Additional Message:
	5430	DUR Respon se Info:
	5431	DUR Additi onal Text:
	5432	ECME CRI R EPORT DATA
	5433	ECME Claim s-Response Inquiry R eport Pr int Date: 02/08/11
	5434	VA CLAIM I D: VA2009= 1164471991 =000010=00 01235
	5435	BPS TRANSA CTION/BPS LOG OF TRA NSACTION D ATA:
	5436	ENTRY#: 16 15253.0001 1 STATUS: 99
	5437	PHARMACY: DNS 9-BOTH NPI & NCPDP PRESCRIPTI ON #: 2055 346
	5438	RXI-INTE RNAL (c): 1615253
	5439	PLAN NAM E: BLUE MO ON INSURAN CE PHARMACY P LAN ID: T0 0010
	5440	CLAIM IE N (c): 123 6 RESPONSE I EN (c): 12 13
	5441	BPS CLAIMS FILE DATA :
	5442	CLAIM ID: VA2009=116 4471991=00 0010=00012 35
	5443	ELECTRON IC PAYER: WBTESTB1 TRANSMIT F LAG: YES ( POINT OF S ALE)
	5444	TRANSMIT TED ON: FE B 25,2009@ 16:51:04 CREATED ON : FEB 25,2 009@16:51: 04
	5445	PATIENT NAME: ECME PATIENT,ON E
	5446	GROUP IN SURANCE PL AN: BLUE M OON INSURA NCE
	5447	BIN NUMB ER: 123456 VERSION RE LEASE NUMB ER: D.0
	5448	TRANSACT ION CODE: B1 PROCESSOR CONTROL NU MBER: 1123 456789
	5449	TRANSACT ION COUNT: 1 SOFTWARE V ENDER CERT ID: TATP
	5450	SERVICE PROVIDER I D: 1164471 991 SERVICE PR OVIDER ID QUAL: 01
	5451	GROUP ID : C110001 CARDHOLDER ID: C2
	5452	DATE OF BIRTH: C41 9631018 PATIENT GE NDER CODE: MALE
	5453	PATIENT FIRST NAME : CAONE PATIENT LA ST NAME: C BOPPATIENT
	5454	PATIENT STREET ADD RESS: CM32 OAK STREE T
	5455	PATIENT CITY ADDRE SS: CNBIRM INGHAM
	5456	PATIENT STATE PROV ADDRESS: COAL PATIENT ZI P POSTAL Z ONE: CP352 09
	5457	PATIENT PHONE NUMB ER: CQ2055 559874 PATIENT ID QUALIFIER : CX01
	5458	PATIENT ID: CY6668 74529
	5459	TRANSACTIO N ORDER: 1
	5460	MEDICATI ON NAME: T AMOXIFEN C ITRATE 10M G TAB
	5461	PRESCRIP TION NUMBE R: 2055346 OTHER COVE RAGE CODE: C800
	5462	SUBM CLA RIFICATION CODE COUN T: 1
	5463	SUBMISSION CLRFCTN C ODE CNTR: 1 SUBMISSION CLARIFICA TION CODE: DK02
	5464	DATE OF SERVICE: F EB 25,2009 PRESCRIPTI ON/SERVICE REF NO: D 21615253
	5465	FILL NUM BER: D301 DAYS SUPPL Y: D5003
	5466	COMPOUND CODE: D61
	5467	PRODUCT SERVICE ID : D7003780 14491
	5468	DISPENSE AS WRITTE N: D80 INGREDIENT COST SUBM ITTED: D90 000510{
	5469	PRESCRIB ER ID: DB DISPENSING FEE SUBMI TTED: DC00 000000
	5470	DATE PRE SCRIPTION WRITTEN: D E20090129
	5471	NUMBER O F REFILLS AUTHORIZED : DF11 PRESCRIPTI ON ORIGIN CODE: DJ1
	5472	*SUBMISS ION CLARIF ICATION CO DE: DK02 BASIS OF C OST DETERM INATION: D N07
	5473	USUAL AN D CUSTOMAR Y CHARGE: DQ0000510{
	5474	GROSS AM OUNT DUE: DU0000510{ PRESCRIBER LAST NAME : DROPPROV IDER
	5475	PATIENT PAID AMOUN T SUBMITTE D: DX00000 00{
	5476	PRODUCT SERVICE ID QUALIFIER : E103 QUANTITY D ISPENSED: E700000600 00
	5477	PRESCRIP TION SERVI CE REFEREN CE: EM1 QUANTITY P RESCRIBED: ET0000060 000
	5478	PRESCRIB ER ID QUAL IFIER: EZ0 1 PRESCRIBER LOCATION CODE: 1E
	5479	PC PROVI DER LOCATI ON CODE: H 5001 PC PROVIDE R LAST NAM E: 4EOPPRO VIDER
	5480	PRESCRIB ER PHONE N UMBER: PM0 001234567
	5481	DATE OF SERVICE: 2 0090225
	5482	RAW DATA SENT:
	5483	12345651B 1112345678 9101116447 1991 2 0090225TAT P
	5484	AM01CX01C Y666874529 C41963101 8C51CAONE CB OPPATIENT CM32
	5485	OAK STREET CNB IRMINGHAM C OALCP35209 CQ2055 559874
	5486	AM04C2C11 0001
	5487	AM07EM1D2 1615253E10 3D70037801 4491 E7000006 0000D301D5 003D61D80D E20090129D
	5488	F11DJ1DK02 ET00000600 00C800
	5489	AM02
	5490	AM03EZ01D B 1E DROPPROVI DER H50014EO PPROVIDER
	5491	AM11D9000 0510{DC000 00000DX000 0000{DQ000 0510{DU000 0510{DN07
	5492	BPS RESPON SE FILE DA TA:
	5493	BPS CLAIM: VA2009=11 64471991=0 00010=0001 235
	5494	DATE RES PONSE RECE IVED: FEB 25, 2009@1 6:51:10
	5495	VERSION RELEASE NU MBER: D.0 TRANSACTI ON CODE: B 1
	5496	TRANSACT ION COUNT: 1 SERVICE PR OVIDER ID: 116447199 1
	5497	SERVICE PROVIDER I D QUALIFIE R: 01 DATE OF SE RVICE: FEB 25,2009
	5498	RESPONSE STATUS: A CCEPTED
	5499	TRANSACTIO N ORDER: 1 TRANSACTIO N RESPONSE STATUS: P AID
	5500	PRESCRIP TION REFER ENCE NUMBE R: 1615253
	5501	RX REFER ENCE NUMBE R QUALIFIE R: RX BILL ING
	5502	HEADER R ESPONSE ST ATUS: CLAI M PAYABLE
	5503	AUTHORIZ ATION NUMB ER: WEBMD: PAID PATIENT PA Y AMOUNT: $ 10.00
	5504	INGREDIE NT COST PA ID: $ 55. 70 DISPENSING FEE PAID: $ 12.50
	5505	TOTAL AM OUNT PAID: $ 58.20 INCENTIVE AMOUNT PAI D: $ 1.2 5
	5506	BASIS OF REIMB DET ERMINATION : 08 TAX EXEMPT INDICATOR : NOT TAX EXEMPT
	5507	FLAT SAL ES TAX PAI D: $ 1.0 0 PROFESSION AL SERVICE FEE PAID: $ 4.54
	5508	OTHER AM OUNT PAID COUNT: 1 OTHER PAYE R AMOUNT R ECOGNIZED: $ 0.00
	5509	RAW DATA RECEIVED:
	5510	VA2009=11 64471991=0 00010=0001 23551B11A0 1116447199 1
	5511	20090225\ X1D\\X1E\\ X1C\AM21\X 1C\ANP\X1C \F3WEBMD:
	5512	PAID\X1E\ \X1C\AM22\ X1C\EM1\X1 C\D2161525 3\X1E\\X1C \AM23\X1C\ F50000100{ \X1C\F6000
	5513	0557{\X1C\ F70000125{ \X1C\AV2\X 1C\AW00000 10{\X1C\FL 0000012E\X 1C\J100000 45D\X1C\J2
	5514	1\X1C\J301 \X1C\J4000 0033C\X1C\ J50000000{ \X1C\F9000 0683B\X1C\ FM08
	5515	ECME BILLI NG EVENTS REPORT
	5516	PAGE 1
	5517	BILLI NG ECME EV ENTS (DETA ILED) for ALL DIVISI ONS
	5518	SINGLE PRESCRIPT ION – 2055 346 FILL # 1
	5519	RX# FILL DAT E PA TIENT NAME DRUG
	5520	========== ========== ========== ========== ========== ========== ========== ==========
	5521	1 205534 6 1 02/2 5/09 EC MEPATIENT, ONE TAMOXIFE N CITRATE 10MG TAB
	5522	FINI SH 02/2 5/09 4:51p Status:E CME Billab le
	5523	ELIGIBILIT Y: CV:No
	5524	DRUG:TAMOX IFEN CITRA TE 10MG TA B
	5525	NDC:00378- 0144-91, B ILLED QTY: 60, COST:. 928, DEA:6 PR
	5526	PLAN:T-GRO UP1 INSUR ANCE: BLUE MOON INSU RANCE
	5527	BIN:123456 , PCN:1123 456789, PA YER SHEET B1:WBTESTB 1
	5528	PAYER SHEE T B2:WBTES TB2, PAYER SHEET B3: WBTESTB1
	5529	DISPENSING FEE:0, BA SIS OF COS T DETERM:U SUAL & CUS TOMARY
	5530	COST:68.20 , GROSS AM T DUE:68.2 0, ADMIN F EE:12.50
	5531	USER:POSTM ASTER
	5532	SUBM IT 02/2 5/09 4:51p Status:O K
	5533	ECME#:0000 01615253, FILL DATE :02/25/09
	5534	PAYER RESP ONSE: PAYA BLE
	5535	PLAN:T-GRO UP1, INSUR ANCE: BLUE MOON INSU RANCE
	5536	USER:POSTM ASTER
	5537	RELE ASE 02/2 5/09 4:56p Status:O K
	5538	ECME#:0000 01615253, FILL DATE :02/25/09
	5539	USER:POSTM ASTER
	5540	BILL ING 02/2 5/09 4:56p Status:B ill# K9000 7W created
	5541	ECME#:0000 01615253, FILL DATE :02/25/09, RELEASE DA TE:02/25/0 9
	5542	DRUG:TAMOX IFEN CITRA TE 10MG TA B
	5543	NDC:00378- 0144-91, B ILLED QTY: 60, DAYS S UPPLY:3
	5544	BILLED:68. 20, PAID:5 8.20
	5545	PLAN:T-GRO UP1, INSUR ANCE: BLUE MOON INSU RANCE
	5546	USER:POSTM ASTER
	5547	List of al l bills fo r this Rx (all fills )
	5548	BI LL RX DATE INSURANC E COB PATIE NT
	5549	------ ---------- ---------- ---------- ---------- ---------- ---------- ---------
	5550	1 K9 0007U 205 5346-0 01/29/09 BLUE MOO N INSURANC P ECMEP ATIENT,ONE
	5551	2 K9 0007W 205 5346-1 02/25/09 BLUE MOO N INSURANC P ECMEP ATIENT,ONE
	5552	Medicatio n Profile
	5553	ISSU E LAST REF DAY
	5554	# Rx# DR UG [^] QT Y ST DATE FILL REM SUP
	5555	---------- ---------- ---------- ---------- ---------- ---------- ---------- ----------
	5556	REFILL TOO SOON/ DUR REJECT S (Third P arty) (2 o rders)
	5557	1 299999 9e AM OXAPINE 25 MG TAB 9 0 A 11-3 0-17 11-30 -17 3 90
	5558	2 288888 8e AM OXICILLIN 250/CLAV K 62.5 1 A 12-0 1-17 12-01 -17 3 90
	5559	View Patie nt Insuran ce
	5560	Patient Po licy Infor mation Feb 23, 2011@1 3:24:18 Page: 1 of 1
	5561	Expanded P olicy Info rmation fo r: ECMEPAT IENT,ONE 666-20-458 9
	5562	OPINSUR1 I nsurance C ompany Plan Curre ntly Activ e
	5563	Plan Inf ormation Insur ance Compa ny
	5564	Is Gro up Plan: Y ES Com pany: OPIN SUR1
	5565	Gro up Name: D RUG INS St reet: 32 C ATASTROPHE WAY
	5566	Group Number: 1 11 City/S tate: BIRM INGHAM, AL 35209
	5567	BIN: Billin g Ph:
	5568	PCN: Precer t Ph:
	5569	Type of Plan: P RESCRIPTIO N
	5570	Electron ic Type: C OMMERCIAL
	5571	Plan Fi ling TF:
	5572	ePh armacy Pla n ID: VA10 5220
	5573	ePhar macy Plan Name: MINN ESOTA MEDI CAID
	5574	ePharma cy Natl St atus: ACTI VE
	5575	ePharmac y Local St atus: ACTI VE
	5576	Utilizat ion Review Info Effective Dates & S ource
	5577	Require UR : NO Effec tive Date: 10/12/07
	5578	Requir e Amb Cert : Expira tion Date:
	5579	Requir e Pre-Cert : NO Sourc e of Info: INTERVIEW
	5580	Exclud e Pre-Cond : NO Policy Not Billable: NO
	5581	Benefits Assignable : YES
	5582	Subscrib er Informa tion Subscriber 's Employe r Informat ion
	5583	Whose In surance: V ETERAN E mp Sponsor ed Plan: N o
	5584	Subscrib er Name: E CMEPATIENT ,ONE Employer:
	5585	Relat ionship: S ELF Employment Status:
	5586	Pri mary ID: 5 43252 Retireme nt Date:
	5587	Coord. B enefits: P RIMARY C laims to E mployer: N o, Send to Insurance Company
	5588	Primary P rovider: Street:
	5589	Prim Pro v Phone: Cit y/State:
	5590	Phone:
	5591	Insure d Person's Informati on (use Su bscriber U pdate Acti on)
	5592	Ins ured's DOB : 10/18/19 63 Str 1: 1225 OAK L ANE
	5593	Ins ured's Sex : MALE Str 2:
	5594	Insure d's Branch : ARMY City: HOMEWOOD
	5595	Insu red's Rank : St/Zip: AL 35209
	5596	Phone: 2055555555
	5597	Insuranc e Company ID Numbers (use Subs criber Upd ate Action )
	5598	Subscri ber Primar y ID: 5432 52
	5599	Plan Cov erage Limi tations
	5600	Coverag e Effecti ve Date Covered? Limit Comments
	5601	------- - ------- ------- -------- ----- ---------
	5602	INPATIE NT 08/04/2 008 YES
	5603	07/11/2 008 YES
	5604	06/26/2 008 YES
	5605	02/26/2 008 YES
	5606	01/28/2 008 YES
	5607	10/12/2 007 YES
	5608	06/19/2 007 YES
	5609	04/13/2 007 YES
	5610	01/08/2 007 YES
	5611	06/17/2 006 YES
	5612	OUTPATI ENT 08/04/2 008 YES
	5613	07/11/2 008 YES
	5614	06/26/2 008 YES
	5615	02/26/2 008 YES
	5616	01/28/2 008 YES
	5617	10/12/2 007 YES
	5618	08/02/2 007 YES
	5619	06/19/2 007 YES
	5620	04/13/2 007 YES
	5621	01/08/2 007 YES
	5622	06/17/2 006 YES
	5623	PHARMAC Y 03/17/2 009 YES
	5624	08/06/2 008 YES
	5625	08/04/2 008 YES
	5626	07/11/2 008 YES
	5627	06/26/2 008 YES
	5628	DENTAL 08/04/2 008 YES
	5629	07/11/2 008 YES
	5630	06/26/2 008 YES
	5631	02/26/2 008 YES
	5632	01/28/2 008 YES
	5633	10/12/2 007 YES
	5634	08/02/2 007 YES
	5635	06/19/2 007 YES
	5636	04/13/2 007 YES
	5637	01/08/2 007 YES
	5638	06/17/2 006 YES
	5639	MENTAL HEALTH 08/04/2 008 YES
	5640	07/11/2 008 YES
	5641	06/26/2 008 YES
	5642	02/26/2 008 YES
	5643	01/28/2 008 YES
	5644	10/12/2 007 YES
	5645	08/02/2 007 YES
	5646	06/19/2 007 YES
	5647	04/13/2 007 YES
	5648	01/08/2 007 YES
	5649	06/17/2 006 YES
	5650	LONG TE RM CARE BY DEFAULT
	5651	User Inf ormation Insuranc e Contact (last)
	5652	Ent ered By: E LLZEY,LIND A Person C ontacted:
	5653	Ent ered On: 1 0/12/07 Method of Contact: PHONE
	5654	Last Veri fied By: E LLZEY,LIND A Contact 's Phone:
	5655	Last Veri fied On: 0 2/07/08 Call Ref. No.:
	5656	Last Upd ated By: E LLZEY,LIND A Cont act Date: APR 15, 20 09
	5657	Last Upd ated On: 0 4/15/09
	5658	Comment -- Patient Policy
	5659	None
	5660	Comment -- Group P lan
	5661	Personal Riders
	5662	TPJI – Cla im Informa tion
	5663	Claim Info rmation Fe b 08, 2011 @14:36:24 P age: 1 of 1
	5664	K90007We ECMEPATIE NT,ONE O4 529 DOB: 10 /18/63 S ubsc ID:
	5665	TPJI – Cla im Informa tion
	5666	Claim Info rmation Fe b 08, 2011 @14:36:24 P age: 1 of 1
	5667	K90007We ECMEPATIE NT,ONE O4 529 DOB: 10 /18/63 S ubsc ID:
	5668	---------- ---------- ---------- ---------- ---------- ---------- ---------- ----------
	5669	Insuranc e Demograp hics Subscrib er Demogra phics
	5670	Bill P ayer: BLUE MOON INSU RANCE Group N umber: 100 01
	5671	Claim Add ress: 321 MOON DRIVE Group Name: T-G ROUP1
	5672	BIRM INGHAM, AL 35209 Subscrib er ID:
	5673	Claim P hone: Emp loyer: USA ARMY CONS ULTANTS
	5674	Insured's Name: ECM EPATIENT,O NE
	5675	Relatio nship: PAT IENT
	5676	C laim Infor mation
	5677	Bill Typ e: OUTPATI ENT Charge Type:
	5678	Time Fram e: ADMIT T HRU DISCHA RGE Service Dates: 02/ 25/09 - 02 /25/09
	5679	Rate Typ e: REIMBUR SABLE INS. Orig Claim: 68.20
	5680	AR Statu s: ACTIVE Balanc e Due: 10.00
	5681	Sequenc e: PRIMARY
	5682	Purch Sv c: NO
	5683	ECME N o: 1615253
	5684	ECME Ap N o: WEBMD: PAID
	5685	NP I: 1164471 991
	5686	Provider s: NONE
	5687	En tered: 02/ 25/09 by POSTMASTE R
	5688	Autho rized: 02/ 25/09 by POSTMASTE R
	5689	First Pr inted: 02/ 25/09 by POSTMASTE R
	5690	Related Prescripti on Copay I nformation
	5691	<none f ound>
	5692	TPJI – AR Account Pr ofile
	5693	AR Account Profile Feb 08, 2011@1 4:46:24 Page: 1 of 1
	5694	K90007We ECMEPATIE NT,ONE O4 529 DOB: 10 /18/63 S ubsc ID:
	5695	AR Status: ACTIVE Orig Amt: 68.2 0 Bal ance Due: 10.00
	5696	---------- ---------- ---------- ---------- ---------- ---------- ---------- ----------
	5697	02/25/0 9 IB Sta tus: PRINT ED (First) 68.20 10.00
	5698	Total C ollected: 58 .20
	5699	TPJI – AR Comment Hi story
	5700	Comment Hi story Feb 08, 20 11@14:47:1 0 Page: 1 of 1
	5701	K90007We ECMEPATIE NT,ONE O4 529 DOB: 10 /18/63 S ubsc ID:
	5702	AR Status: ACTIVE Orig Amt: 68.2 0 Bal ance Due: 10.00
	5703	No Comment Transacti ons Exist For This A ccount.
	5704	TPJI – ECM E Claim In formation
	5705	ECME Claim Informati on F eb 08, 201 1@14:48:16 Pag e: 1 of 1
	5706	K90007We ECMEPATIE NT,ONE O4 529 DOB: 10 /18/63 S ubsc ID:
	5707	---------- ---------- ---------- ---------- ---------- ---------- ---------- ----------
	5708	ECME N o: 1615253 Pharmacy NPI: 1164 471991
	5709	ECME Ap N o: WEBMD: PAID Provider NPI: No N PI on file
	5710	Rx N o: 2055346 / 1 Fill Date: 02/2 5/09
	5711	Drug Nam e: TAMOXIF EN CITRATE 10MG TAB N DC #: 0037 8-0144-91
	5712	Billed Am t: 68.2 0 COB: Prim ary
	5713	IB Statu s: CANCEL LED (02/25 /09) Reas on: ECME PRESCRIPTI ON REVERSE D
	5714	Payment I nformation
	5715	Expecte d Payment Amount: 58.20
	5716	Ingredie nt Cost Re im Amt: 0.00 Disp ensing Fee Reim Amt: 0.00
	5717	Patient R esponsibil ity Amount s
	5718	Deducti ble: 0 .00 Co insurance: 0.00 Amount of Copay: 0.00
	5719	Coverage Gap: 0 .00 Proc essor Fee: 0.00 Exceed Be nefit Max: 0.00
	5720	Health Plan-funde d Assistan ce Amount: 0.00
	5721	Product S election A mounts
	5722	P rod Sel Am t: 0.0 0 Prod Sel /Non-Pref Formulary: 0.00
	5723	Prod Sel/B rand Drug: 0.00 Prod S el/Brand N on-Pref Fo rmulary: 0.00
	5724	Provider Network Ad j: 0.0 0
	5725	No COB/Ot her Payer Data on fi le in the ECME Respo nse.
	5726	ELIGIBIL ITY STATUS DATA, SCR EEN <7>
	5727	ECMEPATIEN T,ONE; 666 -20-4589 ACTIVE DUT Y
	5728	========== ========== ========== ========== ========== ========== ========== =========
	5729	<1> Patient Ty pe: ACTIVE DUTY Ve teran: YES
	5730	S vc Connect ed: YES SC Pe rcent: 20%
	5731	S C Award Da te: OCT 12 ,2007 Unemplo yable: NO
	5732	P &T: NO
	5733	R ated Incom p.: NO
	5734	Claim Numb er: 432432 22
	5735	Folder Lo c.: ALBUQU ERQUE
	5736	<2> Aid & Attendan ce: NO House bound: NO
	5737	VA Pensi on: NO VA Disab ility: NO
	5738	Total Check Amou nt: NOT AP PLICABLE
	5739	GI Insuran ce: NO A mount: UNA NSWERED
	5740	<3> Prima ry Elig Co de: SC LES S THAN 50%
	5741	Other Elig Code( s): NO ADD ITIONAL EL IGIBILITIE S IDENTIFI ED
	5742	Perio d of Servi ce: PERSIA N GULF WAR
	5743	<3.1> Comb at Vet Eli g.: EXPIRE D End Date : OCT 11, 2009
	5744	<4> Servic e Connecte d Conditio ns as stat ed by appl icant
	5745	------ ---------- ---------- ---------- ---------- -----
	5746	NONE S TATED
	5747	ELIGIBILIT Y VERIFICA TION DATA
	5748	EL IGIBILITY VERIFICATI ON DATA, S CREEN <11>
	5749	ECMEPATIEN T,ONE; 666 -20-4589 ACTIVE DUT Y
	5750	========== ========== ========== ========== ========== ========== ========== =========
	5751	<1> Eligib ility Stat us: NOT VE RIFIED Status D ate: NOT A PPLICABLE
	5752	Statu s Entered By: NOT AP PLICABLE
	5753	Inte rim Respon se: UNANSW ERED (NOT REQUIRED)
	5754	V erif. Meth od: NOT AP PLICABLE
	5755	V erif. Sour ce: NOT AV AILABLE
	5756	<2> Mo ney Verifi ed: NOT VE RIFIED
	5757	<3> Serv ice Verifi ed: NOT VE RIFIED
	5758	<4> Rated Disabiliti es: SC%: 20 EFF. DATE OF C OMBINED SC %:
	5759	Orig Curr
	5760	Rated D isability Extr Eff D t Eff Dt
	5761	NONE STATE D
	5762	Enter ?? f or more ac tions >>>
	5763	VW View Rx CR CRI Rep ort CI TPJI Cl aim Info ER TPJI EC ME Rx
	5764	CL Claim L og IN Insuran ce AP TPJI Ac ct Pro ES Elig St atus
	5765	BE Billing Events LB List of Bills CM TPJI AR Comm EV Elig Ve rif
	5766	MP Med Pro file PR Print R eport(s)
	5767	Select Act ion: Quit/ /
	5768	There are thirteen a ctions at the bottom of the sc reen. Twel ve of thes e actions allow the user to ju mp to any one of the twelve se ctions com prising th e View ePh armacy Rx report. Th e thirteen th action, PR Print Report(s), allows th e user to print one or more se ctions of the report .
	5769	8.2.6 OPEC C Producti vity Repor t XE " OPE CC Product ivity??"
	5770	The OPECC Productivi ty Report option all ows you to track the claims fo r users by transacti on date, w ith the op tion of a summary vi ew, detail view or E xcel downl oad format . If the c laim has b een submit ted multip le times i n the repo rt date ra nge, it wi ll appear on the rep ort only o nce with t he appropr iate count of transa ctions dis played und er the hea der: # of Transacti ons. The status dis played on the report reflects the status of the mo st recent transactio n. A tran saction is anything that resul ts in a cl aim submis sion from the ECME U ser Screen or any ba ck billing claim sub mission fr om Claims Tracking o r the PRO Process Se condary/TR ICARE Rx t o ECME opt ion. An O PECC actio n of open/ close clai m is not c onsidered a transact ion for th e OPECC pr oductivity report.
	5771	You must h old the BP S SUPERVIS OR key to view the O PECC Produ ctivity Re port optio n. Access the OPECC Productivi ty Report option by entering O PR at the “Select Ot her Report s Option:” prompt on the Pharm acy Electr onic Claim s Reports, Other Rep orts optio n screen.
	5772	Example 8. 2.6-1: Acc essing the OPECC Pro ductivity Report Opt ion
	5773	*** ****** ****** ****** ****** **
	5774	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	5775	* ALASKA V AHSRO *
	5776	* Other Re ports *
	5777	*** ****** ****** ****** ****** **
	5778	CRI ECME Claim s-Response Inquiry
	5779	PAY Payer Shee t Detail R eport
	5780	PHAR ECME Setup - Pharmac ies Report
	5781	TAT Turn-aroun d time sta tistics
	5782	VER View ePhar macy Rx
	5783	OPR OPECC Prod uctivity R eport
	5784	Select Oth er Reports Option: VER View ePharmacy Rx
	5785	Example 8.2.6-2: Prompts fo r the OPEC C Producti vity Repor t
	5786	Select Oth er Reports <TEST ACC OUNT> Opti on: OPR O PECC Produ ctivity Re port
	5787	Selec t one of t he followi ng:
	5788	D DIVISION
	5789	A ALL
	5790	Select Cer tain Pharm acy (D)ivi sions or ( A)LL: A// LL
	5791	Selec t one of t he followi ng:
	5792	V VETERAN
	5793	T TRICARE
	5794	C CHAMPVA
	5795	A ALL
	5796	Include Ce rtain Elig ibility Ty pe or (A)l l: A// LL
	5797	Selec t one of t he followi ng:
	5798	U USER
	5799	A ALL
	5800	Display EC ME (U)ser or (A)LL: A// LL
	5801	START WITH TRANSACTI ON DATE: T -1// (OC T 28, 2015 )
	5802	GO TO TR ANSACTION DATE: T// (OCT 29, 2015)
	5803	Selec t one of t he followi ng:
	5804	S Summary
	5805	D Detail
	5806	Display (S )ummary or (D)etail Format: De tail//
	5807	Enter a co de from th e list to indicate t he sort or der.
	5808	Selec t one of t he followi ng:
	5809	D Division
	5810	U User Name
	5811	Sort: (D/ U): User N ame// Divi sion
	5812	Do you wan t to captu re report data for a n Excel do cument? NO //
	5813	WARNING - THIS REPOR T REQUIRES THAT A DE VICE WITH 132 COLUMN WIDTH BE USED.
	5814	IT WILL NO T DISPLAY CORRECTLY USING 80 C OLUMN WIDT H DEVICES
	5815	DEVICE: HO ME//0;132
	5816	Example 8. 2.6-3: Dis play of th e Detailed OPECC Pro ductivity Report
	5817	OPECC PROD UCTIVITY D ETAIL REPO RT Prin t Date: Oc t 29, 2015 @10:15:57 Page: 1
	5818	DIVISION(S ): ALL
	5819	ELIGIBILIT Y: ALL
	5820	USERS: ALL
	5821	ALL PRESCR IPTIONS BY TRANSACTI ON DATE: F rom 9/29/1 5 through 10/29/15
	5822	========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== =========
	5823	# TRA NSACTIONS
	5824	USER STAT US DT RA NGE TOTAL ELIG R X# REF/ECME# DOS TRA NS DATE P AID AMT
	5825	========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== =========
	5826	DIVISION: DIVISION O NE
	5827	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------
	5828	USER,EIGHT REJE CTED 1 1 CVA 1 00888 0/0000001 12004 09/ 29/15 09/ 29/15 6 .62
	5829	USER,EIGHT REJE CTED 1 1 CVA 1 00889 0/0000001 12005 09/ 29/15 09/ 29/15 10 .00
	5830	USER,NINE PAYA BLE 1 1 VET 1 00840G 0/0000001 11960 09/ 30/15 09/ 30/15 10 .00
	5831	USER,NINE REVE RSAL REJEC TED 1 1 VET 1 00845 0/0000001 11942 08/ 25/15 10/ 01/15 10 .00
	5832	USER,NINE REJE CTED 1 1 CVA 1 00895 0/0000001 12012 10/ 01/15 10/ 01/15 7 .43
	5833	USER,NINE REJE CTED 1 1 CVA 1 00895A 0/0000001 12013 10/ 01/15 10/ 01/15 7 .43
	5834	USER,NINE REJE CTED 1 1 CVA 1 00895D 0/0000001 12017 10/ 01/15 10/ 01/15 7 .43
	5835	USER,NINE REJE CTED 1 1 CVA 1 00896 0/0000001 12018 10/ 01/15 10/ 01/15 10 .00
	5836	USER,NINE REJE CTED 1 1 CVA 1 00895F 0/0000001 12020 10/ 01/15 10/ 01/15 7 .43
	5837	USER,NINE REVE RSAL REJEC TED 1 1 VET 1 00840H 0/0000001 12025 10/ 01/15 10/ 01/15 10 .00
	5838	USER,EIGHT REVE RSAL ACCEP TED 1 1 VET 1 00904 0/0000001 12032 10/ 06/15 10/ 06/15 10 .00
	5839	USER,EIGHT REJE CTED 1 1 VET 1 00905 0/0000001 12033 10/ 06/15 10/ 06/15 10 .00
	5840	USER,TWO REVE RSAL ACCEP TED 1 1 TRI 1 00872 0/0000001 11986 09/ 23/15 10/ 08/15 10 .00
	5841	USER,NINE REVE RSAL ACCEP TED 1 1 CVA 1 00896A 0/0000001 12024 10/ 08/15 10/ 08/15 10 .00
	5842	USER,NINE REVE RSAL ACCEP TED 1 1 TRI 1 00917 0/0000001 12046 10/ 14/15 10/ 14/15 10 .00
	5843	USER,NINE REJE CTED 1 1 TRI 1 00917A 0/0000001 12049 10/ 14/15 10/ 14/15 10 .00
	5844	USER,NINE REJE CTED 1 1 TRI 1 00917B 0/0000001 12050 10/ 14/15 10/ 14/15 10 .00
	5845	USER,NINE PAYA BLE 1 1 CVA 1 00881 0/0000001 11997 10/ 15/15 10/ 15/15 5 .23
	5846	USER,FOUR REJE CTED 1 1 TRI 1 00923 0/0000001 12055 10/ 15/15 10/ 15/15
	5847	USER,NINE REVE RSAL REJEC TED 1 1 TRI 1 00922 0/0000001 12054 10/ 15/15 10/ 16/15 10 .00
	5848	USER,FOUR REJE CTED 1 1 TRI 1 00927 0/0000001 12059 10/ 16/15 10/ 16/15
	5849	USER,FOUR REJE CTED 1 1 TRI 1 00929 0/0000001 12061 10/ 16/15 10/ 16/15
	5850	USER,FOUR REJE CTED 1 1 TRI 1 00933 0/0000001 12065 10/ 17/15 10/ 18/15
	5851	USER,FOUR REJE CTED 1 1 TRI 1 00936 0/0000001 12068 10/ 18/15 10/ 18/15
	5852	USER,FOUR REJE CTED 1 1 TRI 1 00832 0/0000001 11902 09/ 25/15 10/ 20/15
	5853	USER,THREE 1 1 TRI 1 00938 0/0000001 12070 10/ 28/15 10/ 28/15 10 .00
	5854	SUBTOTALS FOR DIVISI ON ONE PHA RMACY
	5855	REJE CTED AND N OT REJECTE D AND PAYA BLE
	5856	USER RESO LVED TO PA YABLE ( POSSIBLE B ACK-BILL) TRANS IN DT RANGE AMOUNT PAID
	5857	USER,EIGHT 0 0 4 36.62
	5858	USER,THREE 0 0 1 10.00
	5859	USER,TWO 0 0 1 10.00
	5860	USER,FOUR 0 0 6 0.00
	5861	USER,NINE 2 0 14 124.95
	5862	GRAND TOTA L
	5863	REJE CTED AND N OT REJECTE D AND PAYA BLE
	5864	USER RESO LVED TO PA YABLE ( POSSIBLE B ACK-BILL) TRANS IN DT RANGE AMOUNT PAID
	5865	USER,EIGHT 0 0 4 36.62
	5866	USER,THREE 0 0 1 10.00
	5867	USER,TWO 0 0 1 10.00
	5868	USER,FOUR 0 0 6 0.00
	5869	USER,NINE 2 0 14 124.95
	5870	Example 8. 2.6-4: Dis play of th e Summary OPECC Prod uctivity R eport
	5871	OPECC PROD UCTIVITY S UMMARY REP ORT Prin t Date: Oc t 29, 2015 @10:32:13 Page: 1
	5872	DIVISION(S ): ALL
	5873	ELIGIBILIT Y: ALL
	5874	USERS: ALL
	5875	ALL PRESCR IPTIONS BY TRANSACTI ON DATE: F rom 9/29/1 5 through 10/29/15
	5876	========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== =========
	5877	# TRA NSACTIONS
	5878	USER STAT US DT RA NGE TOTAL ELIG R X# REF/ECME# DOS TRA NS DATE P AID AMT
	5879	========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== =========
	5880	DIVISION: DIVISION O NE
	5881	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------
	5882	SUBTOTALS FOR DIVISI ON ONE PHA RMACY
	5883	REJE CTED AND N OT REJECTE D AND PAYA BLE
	5884	USER RESO LVED TO PA YABLE ( POSSIBLE B ACK-BILL) TRANS IN DT RANGE AMOUNT PAID
	5885	USER,ONE 0 0 4 36.62
	5886	USER,TWO 0 0 1 10.00
	5887	USER,THREE 0 0 1 10.00
	5888	USER,FOUR 0 0 6 0.00
	5889	USER,FIVE 2 0 14 124.95
	5890	GRAND TOTA L
	5891	REJE CTED AND N OT REJECTE D AND PAYA BLE
	5892	USER RESO LVED TO PA YABLE ( POSSIBLE B ACK-BILL) TRANS IN DT RANGE AMOUNT PAID
	5893	USER,ONE 0 0 4 36.62
	5894	USER,TWO 0 0 1 10.00
	5895	USER,THREE 0 0 1 10.00
	5896	USER,FOUR 0 0 6 0.00
	5897	USER,FIVE 2 0 14 124.95
	5898	(This page included for two-si ded copyin g.)
	5899	9
	5900	BPS Nightl y Backgrou nd Job XE "BPS Night ly Backgro und Job"
	5901	The BPS Ni ghtly Back ground Job is schedu led to run daily at the sites during off -hours at intervals defined by the site staff. One of the fu nctions of this job is to iden tify claim s to be re versed and then to a utomatical ly submit the Revers al Request to the pa yer.
	5902	For inpati ent claims reversals , the prog ram will g o through all WINDOW fills for the date 5 days pri or to the current da te (T-5) a nd check t o see if t he patient is a curr ent inpati ent. If so , the reve rsal would be given the reason CURRENT I NPATIENT t o differen tiate betw een non-re leased pre scriptions and inpat ient rever sals.
	5903	The auto-r eversal pr ocess for outpatient claims is dependent on whethe r the site sets the Auto-Rever sal parame ter to any thing but 0 (see Aut o-Reversal parameter in the Ed it ECME Ph armacy Dat a option o n the ECME Setup men u). All no n-released outpatien t prescrip tions that were init ially retu rned as PA YABLE and are not cu rrently RE VERSED and have a da te older t han the nu mber of da ys set in the Auto-R eversal pa rameter wo uld be rev ersed.
	5904	After the BPS Nightl y Backgrou nd Job ide ntifies cl aims to au to-reverse and proce sses the R eversal Re quest, the system se nds a bull etin to th e members of the “BP S OPECC” m ail group listing bo th reversa ls from th e paramete r setting and the in patient cl aims. This mail grou p needs to be create d at the s ite and sh ould inclu de all OPE CC resourc es.
	5905	Example 9. 1-1 Displa ying the A uto-Revers al Bulleti n
	5906	Subj: ECME AUTO-REVE RSAL PROCE SS [#2473 ] 03/05/05 @01:00 29 lines
	5907	From: BPS PACKAGE I n 'IN' bas ket. Pag e 1 New
	5908	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------
	5909	The ECME N ightly Pro cess compl eted auto- reversing e-Pharmacy claims fo r prescrip tions not released w ithin the specified timeframe.
	5910	TOTAL AUTO -REVERSED CLAIMS: 3
	5911	Claims Aut o-Reversed on 03/06/ 05:
	5912	# RX/FI LL STA TUS DATE ELIG PA TIENT BPS PHAR M DRUG NA ME
	5913	---------- ---------- ---------- ---------- ---------- ---------- ---------- --------
	5914	1 908955 /1 W/N R 03/01/0 6 V ECME patient,On e ANC DRUG NAME ONE
	5915	2 909225 /1 W/N R 03/04/0 6 V ECME patient,Tw o ANC DRUG NAME TWO
	5916	3 41581/ 0 W/N R 03/04/0 6 V ECME patient,Th ree ANC DRUG NAME THREE
	5917	(This page included for two-si ded copyin g.)
	5918	10
	5919	Glossary X E "Glossar y"
	5920	Accredited Standards Committee (ASC)
	5921	An organiz ation that has been accredited by Americ an Nationa l Standard s Institut e (ANSI) f or the dev elopment o f American National Standards.
	5922	Administra tive Code Sets
	5923	Code sets that chara cterize a general bu siness sit uation rat her than a medical c ondition o r service.
	5924	Administra tive Simpl ification (A/S)
	5925	Title II, Subtitle F , of HIPAA , which gi ves the De partment O f Health A nd Human S ervices (D HHS) the a uthority t o mandate the use of standards for the e lectronic exchange o f health c are data; to specify what medi cal and ad ministrati ve code se ts should be used wi thin those standards ; to requi re the use of nation al identif ication sy stems for health car e patients , provider s, payers (or plans) , and empl oyers (or sponsors); and to sp ecify the types of m easures re quired to protect th e security and priva cy of pers onally ide ntifiable health car e informat ion.
	5926	American M edical Ass ociation ( AMA)
	5927	A professi onal assoc iation tha t represen ts the voi ce of the American m edical pro fession an d constitu tes the pa rtnership of physici ans and th eir profes sional ass ociations dedicated to promoti ng the art and scien ce of medi cine and t he betterm ent of pub lic health .
	5928	American N ational St andards (A NS)
	5929	Standards developed and approv ed by orga nizations accredited by ANSI.
	5930	American N ational St andards In stitute
	5931	An organiz ation that accredits various
	5932	(ANSI)
	5933	standards- setting co mmittees, and monito rs their c ompliance with the o pen rule-m aking proc ess that t hey must f ollow to q ualify for ANSI accr editation.
	5934	American S ociety for Testing a nd
	5935	A standard s group th at has pub lished gen eral
	5936	Materials (ASTM)
	5937	guidelines for the d evelopment of standa rds, inclu ding those for healt h care ide ntifiers.
	5938	Back Door
	5939	System acc ess via th e roll and scroll, c haracter a nd Mumps b ased VistA applicati on.
	5940	Blue Cross and Blue Shield Ass ociation
	5941	An associa tion that represents the commo n
	5942	(BCBSA)
	5943	interest o f Blue Cro ss and Blu e Shield h ealth plan s. The BCB SA maintai ns the Cla im Adjustm ent Reason Codes cod e set.
	5944	Business M odel
	5945	A model of a busines s organiza tion or pr ocess.
	5946	CHAMPVA Pa tient
	5947	A CHAMPVA patient is a patient that is r eceiving s ervices du e to being eligible for the CH AMPVA heal th benefit s program. His/her C HAMPVA hea lth benefi t program will be bi lled for t he prescri ption.
	5948	Clean Clai m
	5949	An insuran ce claim t hat has no defect, i mpropriety (includin g any lack of any su bstantial documentat ion) or pa rticular c ircumstanc e requirin g special treatment that preve nts timely payment f rom being made.
	5950	Clearingho use
	5951	For health care, an organizati on that
	5952	(or Health Care Clea ringhouse)
	5953	translates health ca re data to or from a standard format.
	5954
	5955	Centers fo r Medicare & Medicai d
	5956	Centers fo r Medicare & Medicai d Services ,
	5957	Services ( CMS)
	5958	formerly H ealth Care Financing Administr ation (HCF A). The ad ministrati on within the Depart ment of He alth and H uman Servi ces (HHS) that is re sponsible for the na tional adm inistratio n of the M edicaid an d Medicare programs.
	5959	CMS-1450
	5960	CMS’s name for the i nstitution al uniform claim for m, or UB-9 2.
	5961	CMS-1500
	5962	CMS’s name for the p rofessiona l uniform claim form . Also kno wn as the UCF-1500.
	5963	Coordinati on of Bene fits (COB)
	5964	A provisio n that is intended t o avoid cl aims payme nt delays and duplic ation of b enefits wh en a perso n is cover ed by two or more pl ans provid ing benefi ts or serv ices for m edical, de ntal or ot her care o r treatmen t.
	5965	Code Set
	5966	Under HIPA A "codes u sed to enc ode data e lements, t ables of t erms, medi cal concep ts, diagno stic codes , or medic al procedu res. A cod e set incl udes the c odes and d escriptors of the co des." [45 CFR 162.10 3]
	5967	Covered En tity
	5968	Under HIPA A, a healt h plan, he althcare c learinghou se or heal th care pr ovider who transmits informati on in elec tronic for m in conne ction with a transac tion cover ed by this subchapte r 160.103 of 45 CFR.
	5969	Current Pr ocedural T erminology
	5970	A procedur e code set maintaine d and copy righted by the AMA a nd that ha s been sel ected for use under HIPAA for non-instit utional an d non-dent al profess ional tran sactions.
	5971	Data Dicti onary (DD)
	5972	A document or system that char acterizes the data c ontent of a system.
	5973	Data Eleme nt
	5974	Under HIPA A, this is "…the sma llest name d unit of informatio n in a tra nsaction." [45 CFR 1 62.103]
	5975	Data Mappi ng
	5976	The proces s of match ing one se t of data elements o r individu al code va lues to th eir closes t equivale nts in ano ther set o f them.
	5977	Data Model
	5978	A conceptu al model o f the info rmation ne eded to su pport a bu siness fun ction or p rocess.
	5979	Data Set
	5980	Under HIPA A, this is "…a seman tically me aningful u nit of inf ormation e xchanged b etween two parties t o a transa ction." [4 5 CFR 162. 103]
	5981	Designated Code Set
	5982	A medical or adminis trative co de set, wh ich DHHS h as designa ted for us e in one o r more of the HIPAA standards.
	5983	Designated Data Cont ent Commit tee
	5984	An organiz ation, whi ch DHHS ha s
	5985	or Designa ted DCC
	5986	designated for overs ight of th e business data cont ent of one or more o f the HIPA A-mandated transacti on standar ds.
	5987	Designated Standard
	5988	A standard that DHHS has desig nated for use under the author ity provid ed by HIPA A.
	5989	Department of Health and Human
	5990	Per the we bsite addr ess provid ed below,
	5991	Services ( DHHS) or ( HHS)
	5992	'The Depar tment Of H ealth And Human Serv ices is th e United S tates gove rnment's p rincipal a gency for protecting the healt h of all A mericans a nd providi ng essenti al human s ervices, e specially for those who are le ast able t o help the mselves.' The websi te is avai lable at < http://www .os.dhhs.g ov/>.
	5993	Electronic Commerce (EComm)
	5994	The exchan ge of busi ness infor mation by electronic means.
	5995	Electronic Data Inte rchange (E DI)
	5996	The transf er of data between d ifferent c ompanies u sing netwo rks, such as the Int ernet. As more and m ore compan ies are co nnected to the Inter net, EDI i s becoming increasin gly import ant as an industry s tandard fo r companie s to buy, sell, and trade info rmation. A NSI has ap proved a s et of EDI standards known as t he X12 sta ndards.
	5997	Finish
	5998	Term used for comple ting order s from Ord er Entry/R esults Rep orting V. 3.0.
	5999	‘Finish’ a Prescript ion
	6000	This proce ss within VistA Outp atient Pha rmacy V. 7 .0 where a pharmacy prescripti on order h as been re viewed by either a p harmacy te chnician o r pharmaci st and is the first step in pr ocessing a prescript ion in Pha rmacy. If performed by a pharm acist with the appro priate sec urity key, the presc ription ca n be ‘Veri fied’ as w ell. See ‘ Verify a P rescriptio n’ for mor e informat ion.
	6001	Flat File
	6002	This term usually re fers to a file that consists o f a series of fixed- length rec ords that include so me sort of record ty pe code.
	6003	Front Door
	6004	System acc ess via th e Delphi, Graphical User Inter face (GUI) based Vis tA applica tion.
	6005	Graphical User Inter face (GUI)
	6006	A graphica l method o f controll ing how a user inter acts with a computer to perfor m various tasks.
	6007	HCFA Commo n Procedur al Coding
	6008	A medical code set t hat identi fies healt h care
	6009	System (HC PCS)
	6010	procedures , equipmen t, and sup plies for claim subm ission pur poses. It is maintai ned by Hea lth Care F inancing A dministrat ion (HCFA) , and has been selec ted for us e in the H IPAA trans actions. H CPCS Level I contain numeric C PT-4 codes , which ar e maintain ed by the AMA. HCPCS Level II contains a lphanumeri c codes us ed to iden tify vario us items a nd service s that are not inclu ded in the CPT-4 cod e set. The se are mai ntained by HCFA, BCB SA, and He alth Insur ance Assoc iation of America (H IAA). HCPC S Level II I contains alphanume ric codes that are a ssigned by Medicaid State agen cies to id entify add itional it ems and se rvices not included in levels I and II. These are usually ca lled "loca l codes”, and must h ave "W", " X", "Y", o r "Z" in t he first p osition. T hey are no t named as HIPAA sta ndard code s. HCPCS P rocedure M odifier Co des can be used with all three levels, w ith the WA -ZY range used for l ocally ass igned proc edure modi fiers.
	6011	Health Car e Clearing house
	6012	Under HIPA A, this is "… a publ ic or priv ate entity that does either of the follo wing: (1) processes or facilit ates the p rocessing of informa tion recei ved from a nother ent ity in a n onstandard format or containin g nonstand ard data c ontent int o standard data elem ents or a standard t ransaction , or (2) r eceives a standard t ransaction from anot her entity and proce sses or fa cilitates the proces sing of [t hat] infor mation int o nonstand ard format or nonsta ndard data content f or a recei ving entit y." [45 CF R 160.103]
	6013	Health Car e Financin g Administ ration
	6014	The DHHS a gency resp onsible fo r Medicare
	6015	(HCFA)
	6016	and parts of Medicai d. HCFA ha s historic ally maint ained the UB-92 inst itutional Electronic Media Cla ims (EMC) format spe cification s, the pro fessional EMC Nation al Standar d Format ( NSF) speci fications, as well a s specific ations for various c ertificati ons and au thorizatio ns used by the Medic are and Me dicaid pro grams. HCF A also mai ntains the HCPCS med ical code set.
	6017	Health Car e Provider
	6018	Under HIPA A, this is "…a provi der of ser vices as d efined in the sectio n 1861(u) of the [So cial Secur ity] Act, 42 USC 139 5x(u), a p rovider of medical o r other he alth servi ces as def ined in se ction 1861 (s) of the Act, 42 U SC 1395(s) , and any other pers on or orga nization w ho furnish es, bills, or is pai d for heal th care in the norma l course o f business ." [45 CFR 160.103]
	6019	Health Inf ormation
	6020	Under HIPA A this is "… any inf ormation, whether or al or reco rded in an y form or medium tha t (a) is c reated or received b y a health care prov ider, heal th plan, p ublic heal th authori ty, employ er, life i nsurer, sc hool or un iversity, or health care clear inghouse; and (b) re lated to t he past, p resent or future phy sical or m ental heal th or cond ition of a n individu al, the pr ovision of health ca re to an i ndividual, or the pa st, presen t or futur e payment for the pr ovision of health ca re to an i ndividual. " [45 CFR 160.103]
	6021	Health Ins urance Ass ociation o f
	6022	An industr y associat ion that r epresents the
	6023	America ( HIAA)
	6024	interests of commerc ial health care insu rers. The HIAA parti cipates in the maint enance of some code sets, incl uding HCPC S Level II codes.
	6025	Health Ins urance Por tability a nd
	6026	A Federal law that m akes a num ber of
	6027	Accountabi lity Act o f 1996 (HI PAA)
	6028	changes th at have th e goal of allowing p ersons to qualify im mediately for compar able healt h insuranc e coverage when they change th eir employ ment relat ionships. Title II, Subtitle F , of HIPAA gives HHS the autho rity to ma ndate the use of sta ndards for the elect ronic exch ange of he alth care data; to s pecify wha t medical and admini strative c ode sets s hould be u sed within those sta ndards; to require t he use of national i dentificat ion system s for heal th care pa tients, pr oviders, p ayers (or plans), an d employer s (or spon sors); and to specif y the type s of measu res requir ed to prot ect the se curity and privacy o f personal ly identif iable heal th care in formation. Also know n as the K ennedy-Kas sebaum Bil l, the Kas sebaum-Ken nedy Bill, K2, or Pu blic Law 1 04-191.
	6029	Health Pla n
	6030	Under HIPA A this is "…an indiv idual or g roup plan that provi des, or pa y the cost of, medic al care”. [45 CFR 16 0.103]
	6031	Healthcare Financial Managemen t
	6032	An organiz ation for the improv ement
	6033	Associatio n (HFMA)
	6034	of the fin ancial man agement of healthcar e-related organizati ons. The H FMA sponso rs some HI PAA educat ional semi nars.
	6035	Health Lev el Seven ( HL7)
	6036	An ANSI-ac credited g roup that defines st andards fo r the cros s-platform exchange of informa tion withi n a health care orga nization. HL7 is res ponsible f or specify ing the Le vel Seven Open Syste m Intercon nection (O SI) standa rds for th e health i ndustry. S ome HL7 st andards wi ll be enca psulated i n the X12 standards used for t ransmittin g claim at tachments.
	6037	HIPAA Data Dictionar y
	6038	A data dic tionary th at defines and cross -
	6039	or HIPAA D D
	6040	references the conte nts of all X12 trans actions in cluded in the HIPAA mandate. I t is maint ained by X 12N/TG3.
	6041	Implementa tion Guide (IG)
	6042	A document explainin g the prop er use of a standard for a spe cific busi ness purpo se. The X1 2N HIPAA I Gs are the primary r eference d ocuments u sed by tho se impleme nting the associated transacti ons, and a re incorpo rated into the HIPAA regulatio ns by refe rence.
	6043	Implementa tion Speci fication
	6044	Under HIPA A, this is "… the sp ecific ins tructions for implem enting a s tandard [4 5 CFR 160. 103]
	6045
	6046	Informatio n Model
	6047	A conceptu al model o f the info rmation ne eded to su pport a bu siness fun ction or p rocess.
	6048	Internatio nal Classi fication o f Diseases
	6049	A medical code set m aintained by the
	6050	(ICD)
	6051	World Heal th Organiz ation (WHO ). The pri mary purpo se of this code set is to clas sify cause s of death . A United States (U S) extensi on of this coding sy stem, main tained by the Nation al Center for Health Statistic s (NCHS) w ithin the Centers fo r Disease Control (C DC), is us ed to iden tify morbi dity facto rs, or dia gnoses. Th e ICD-9-CM (Revision 9 Clinica l Modifica tion) code s have bee n selected for use i n the HIPA A transact ions.
	6052	Internatio nal Standa rds Organi zation
	6053	An organiz ation that coordinat es the
	6054	(ISO) or I nternation al Organiz ation
	6055	developmen t and adop tion of nu merous
	6056	for Standa rdization
	6057	internatio nal standa rds.
	6058	Joint Comm ission on Accreditat ion
	6059	In the fut ure, the J CAHO may p lay a role in
	6060	of Healthc are Organi zations (J CAHO)
	6061	certifying these org anizations complianc e with the HIPAA A/S requireme nts.
	6062	J-Codes
	6063	Previously HCPCS Lev el II has contained a set of c odes with a high-ord er value o f "J" to i dentify so me drugs a nd some ot her items. The final HIPAA tra nsactions and code s et rule st ates that any J-code s identify ing drugs will be dr opped from the HCPCS and NDC c odes will be used to identify all drug p roducts.
	6064	Maintain o r Maintena nce
	6065	Under HIPA A, this is "…activit ies necess ary to sup port the u se of a st andard ado pted by th e Secretar y, includi ng technic al correct ions to an implement ation spec ification, and enhan cements or expansion of a code set. This term excl udes the a ctivities related to the adopt ion of a n ew standar d or imple mentation specificat ion, or mo dification to an ado pted stand ard or imp lementatio n specific ation." [4 5 CFR 162. 103]
	6066	Maximum De fined Data Set
	6067	Under HIPA A, this is "… all of the requi red data e lements fo r a partic ular stand ard based on a speci fic implem entation s pecificati on." [45 C FR 162.103 ]. A frame work under HIPAA whe reby an en tity creat ing a tran saction is free to i nclude wha tever data any recei ver might want or ne ed. The re cipient of a maximum data set is free to ignore an y portion of the dat a not need ed to cond uct their part of th e associat ed busines s transact ion, unles s the none ssential d ata is nee ded for co ordination of benefi ts.
	6068	Medical Co de Sets
	6069	Codes that character ize a medi cal condit ion or tre atment. Th e code set s are usua lly mainta ined by pr ofessional societies and publi c health o rganizatio ns.
	6070	Memorandum of Unders tanding (M OU)
	6071	A document providing a general descripti on of the kinds of r esponsibil ities that are to be assumed b y two or m ore partie s in their pursuit o f some goa l(s). More specific informatio n may be p rovided in an associ ated State ment Of Wo rk (SOW).
	6072	Modify or Modificati on
	6073	Under HIPA A, refers to "a chan ge adopted by the Se cretary, t hrough reg ulation, t o a standa rd or an i mplementat ion specif ication." [45 CFR 16 0.102]
	6074	National C enter for Health Sta tistics
	6075	An adminis tration of HHS and C DC that
	6076	(NCHS)
	6077	oversees I CD coding.
	6078	National C ouncil for Prescript ion Drug
	6079	An ANSI-ac credited g roup that maintains
	6080	Programs ( NCPDP)
	6081	a number o f standard formats f or use by the retail pharmacy industry, some of wh ich are in cluded in the HIPAA mandates.
	6082	National D rug Code ( NDC)
	6083	A medical code set t hat has be en selecte d for use in the HIP AA transac tions.
	6084	National E mployer ID
	6085	A system f or uniquel y identify ing all sp onsors of health car e benefits .
	6086	National P atient ID
	6087	A system f or uniquel y identify ing all re cipients o f health c are servic es.
	6088	National P ayer ID
	6089	A system f or uniquel y identify ing all or ganization s that pay s for heal th care se rvices. Al so known a s Health P lan ID or Plan ID.
	6090	National P rovider Fi le (NPF)
	6091	The databa se envisio ned for us e in maint aining a n ational pr ovider reg istry.
	6092	National P rovider ID
	6093	A system f or uniquel y identify ing all pr oviders of health ca re service s, supplie s, and equ ipment.
	6094	National P rovider Re gistry
	6095	The organi zation env isioned fo r assignin g the Nati onal Provi der IDs.
	6096	National P rovider Sy stem (NPS)
	6097	The admini strative s ystem envi sioned for supportin g a nation al provide r registry .
	6098	National S tandard Fo rmat (NSF)
	6099	Genericall y, this ap plies to a ny nationa l standard format, b ut it is o ften used in a more limited wa y to desig nate the P rofessiona l EMC NSF, a 320-byt e flat fil e record f ormat used to submit professio nal claims .
	6100	National U niform Bil ling Commi ttee
	6101	The commit tee establ ished by t he America n
	6102	(NUBC)
	6103	Hospital A ssociation (AHA) to develop a single bil ling form and standa rd data se t that cou ld be used nationwid e by insti tutional p roviders a nd payers for handli ng health care claim s.
	6104	NCPDP Batc h Standard
	6105	An NCPDP s tandard de signed for use by lo w-volume d ispensers of pharmac euticals, such as nu rsing home s. Version 1.0 of th is standar d has been mandated under HIPA A.
	6106	NCPDP Tele communicat ion Standa rds
	6107	An NCPDP s tandard de signed for use by hi gh-volume dispensers of pharma ceuticals, such as r etail phar macies. Ve rsion D0 i s the tran saction st andard und er HIPAA.
	6108	Non-Formul ary Drugs
	6109	The medica tions, whi ch are def ined as co mmercially available drug prod ucts not i ncluded in the VA Na tional For mulary.
	6110	Notice of Intent (NO I)
	6111	A document that desc ribes a su bject area for which the Feder al Governm ent is con sidering d eveloping regulation s. It may describe w hat the go vernment c onsiders t o be the r elevant co nsideratio ns and inv ite commen ts from in terested p arties. Th ese commen ts can the n be used in develop ing a Noti ce of Prop osed Rulem aking (NPR M) or a fi nal regula tion.
	6112	Notice of Proposed R ulemaking (NPRM)
	6113	A document that desc ribes and explains r egulations that the Federal Go vernment p roposes to adopt at some futur e date, an d invites interested parties t o submit c omments re lated to t hem. These comments can then b e used in developing the final rules.
	6114	Office of Management & Budget (OMB)
	6115	A Federal Government agency th at has a m ajor role in reviewi ng propose d Federal regulation s.
	6116	Open Syste m Intercon nection (O SI)
	6117	A multi-la yer ISO da ta communi cations st andard. Le vel Seven of this st andard is industry-s pecific, a nd HL7 is responsibl e for spec ifying the level sev en OSI sta ndards for the healt h industry .
	6118	Outpatient Pharmacy Electronic Claims
	6119	This is a designated individua l at each site
	6120	Coordinato r (OPECC)
	6121	who will b e responsi ble for mo nitoring N CPDP claim s using th e ECME mod ule. The O PECC will resolve cl aim reject ion issues with the appropriat e parties, make data correctio ns, and re submit cla ims.
	6122	Orderable Item
	6123	An Orderab le Item na me and dos age form t hat has no strength attached t o it (e.g. , Acetamin ophen). Th e name wit h a streng th attache d is the D ispense Dr ug name (e .g., Aceta minophen 3 25mg).
	6124	Payer
	6125	In health care, an e ntity that assumes t he risk of paying fo r medical treatments . This can be an uni nsured pat ient, a se lf-insured employer, or a heal th care pl an or Heal th Mainten ance Organ ization (H MO).
	6126	DNS D
	6127	HCFA’s ter m for thei r National Payer ID initiative .
	6128	PBM
	6129	A Pharmacy Benefit M anager (PB M) is a th ird party administra tor of pre scription drug progr ams. They are primar ily respon sible for processing and payin g prescrip tion drug claims.
	6130	Placeholde rs
	6131	Physical a nd/or logi cal data e lements th at are ref erenced an d placed w ithin a da ta structu re that ha ve a data definition but may o r may not currently exist with in the sys tem. The v alue of th ese data e lements ar e not curr ently main tained by the softwa re but are establish ed for fut ure iterat ions of sy stem devel opment rel ated to Bi lling Awar e.
	6132	Potentiall y Billable Event
	6133	A service, which has all requi red data e lements as sociated w ith it. Th ese data e lements ar e collecte d in the V istA Clini cal Applic ation.
	6134	Profession al Compone nt
	6135	Charges fo r physicia n services . Examples include p hysician w ho reads t he Electro cardiogram (EKG) and an Emerge ncy Room p hysician w ho provide s treatmen t.
	6136	Provider T axonomy Co des
	6137	A code set for ident ifying the provider type and a rea of spe cializatio n for all health car e provider s. A given provider can have s everal Pro vider Taxo nomy Codes . The BCBS A maintain s this cod e set.
	6138	Secretary
	6139	Under HIPA A, this re fers to th e Secretar y of the U S Departme nt of Heal th and Hum an Service s or his/h er designa ted repres entatives. [45 CFR 1 60.103].
	6140	Segment
	6141	Under HIPA A, this is "…a group of relate d data ele ments in a transacti on”. [45 C FR 162.103 ]
	6142	Service
	6143	Medical ca re and ite ms such as medical d iagnosis a nd treatme nt, drugs and biolog icals, sup plies, app liances, a nd equipme nt, medica l social s ervices, a nd use of hospital R egional Pr imary Care Hospital (RPCH) or Skilled Nu rsing Faci lity (SNF) facilitie s.
	6144	Standard
	6145	Under HIPA A, this is "… a pres cribed set of rules, condition s, or requ irements d escribing the follow ing inform ation for products, systems, s ervices or practices (1) Class ification of compone nts, (2) S pecificati on of Mate rials, per formance o r operatio ns, (3) De lineation of procedu res. [45 C FR 160.103 ]
	6146	Standard S etting Org anization (SSO)
	6147	Under HIPA A, this is "…an orga nization a ccredited by ANSI th at develop s and main tains stan dards for informatio n transact ions or da ta element s, or any other stan dard that is necessa ry for, or will faci litate the implement ation of t his part." [45 CFR 1 60.103]
	6148	Standard T ransaction
	6149	Under HIPA A, this is "… a tran saction th at complie s with the applicabl e standard adopted u nder this part." [45 CFR 162.1 03]
	6150	Statement of Work (S OW)
	6151	A document describin g the spec ific tasks and metho dologies t hat will b e followed to satisf y the requ irements o f an assoc iated cont ract or MO U.
	6152	Third Part y Administ rator (TPA )
	6153	An entity that proce sses healt h care cla ims and pe rforms rel ated busin ess functi ons for a health pla n.
	6154	Third (3rd ) Party Cl aims
	6155	Health car e insuranc e claims s ubmitted t o an
	6156	Transactio n
	6157	entity for reimburse ment of he alth care bills. Und er HIPAA, this is "… the exchan ge of info rmation be tween two parties to carry out financial or admini strative a ctivities related to health ca re." [45 C FR 160.103 ]
	6158	TRICARE Pa tient
	6159	A TRICARE patient is a patient that is r eceiving s ervices du e to being covered b y TRICARE . His/her TRICARE in surance wi ll be bill ed for the prescript ion.
	6160	UB-92
	6161	A uniform institutio nal claim form devel oped by th e National Uniform B illing Com mittee (NU BC) that h as been in use since 1993.
	6162	Unstructur ed Data
	6163	This term usually re fers to da ta that is represent ed as free -form text , as an im age, etc., where it is not pra ctical to predict ex actly what data will appear wh ere.
	6164	‘Verify’ a Prescript ion
	6165	After a pr escription order has been ‘Fin ished’ the prescript ion must b e ‘Verifie d’ by an a uthorized VistA user , through the admini stration o f the syst em securit y key SOP. This is a critical step in th e process of generat ing an ele ctronic cl aim.
	6166	Veterans H ealth Info rmation Sy stems
	6167	Acronym fo r Veterans Health In formation
	6168	and Techn ology Arch itecture ( VistA)
	6169	Systems an d Technolo gy Archite cture, the new name for Decent ralized Ho spital Com puter Prog ram (DHCP) .
	6170	Workgroup for Electr onic Data
	6171	A health c are indust ry group t hat lobbie d
	6172	Interchang e (WEDI)
	6173	for HIPAA A/S, and t hat has a formal con sultative role under the HIPAA legislati on.
	6174	(This page included for two-si ded copyin g.)
	6175	11
	6176	Acronyms X E "Acronym s"
	6177	AcronymDes criptionAI TC Austin Informatio n Technolo gy CenterA DPACAutoma ted Data P rocessing Applicatio n Coordina torAMAAmer ican Medic al Associa tionANSAme rican Nati onal Stand ardsANSIAm erican Nat ional Stan dards Inst ituteA/SAd ministrati ve Simplif icationASC Accredited Standards Committee ASTMAmeric an Society for Testi ng and Mat erialsBCBS ABlue Cros s and Blue Shield As sociationC DESECME Us er ScreenC MOPConsoli dated Mail Outpatien t Pharmacy CMSCenters for Medic are & Medi caidCOBCoo rdination of Benefit sDDData Di ctionaryDE ADrug Enfo rcement Ad ministrati onDHHSDepa rtment of Health and Human Ser vicesDURDr ug Utiliza tion Revie wECMEElect ronic Clai ms Managem ent Engine ECommElect ronic Comm erceEDIEle ctronic Da ta Interch angeFILEMA NVistA Fil eManGUIGra phical Use r Interfac eHCFAHealt h Care Fin ancing Adm inistratio nHCPCSHCFA Common Pr ocedural C oding Syst emHFMAHeal thcare Fin ancial Man agement As sociationH HSDepartme nt of Heal th and Hum an Service sHIAAHealt h Insuranc e Associat ion of Ame ricaHIPAAH ealth Insu rance Port ability an d Accounta bility Act HL7Health Level Seve nIBIntegra ted Billin gICDIntern ational Cl assificati on of Dise aseICD-9-C MInternati onal Class ification of Disease , 9th revi sion, Clin ical Modif icationICD -9-PCSInte rnational Classifica tion of Di sease, 9th revision, Procedure Coding Sy stemIGImpl ementation GuideIRMS Informatio n Resource s Manageme nt Service ISOInterna tional Sta ndards Org anizationJ CAHOJoint Commission on Accred itation of Healthcar e Organiza tionsAcron ymDescript ionMOUMemo randum of Understand ingNCHSNat ional Cent er for Hea lth Statis ticsNCPDPN ational Co uncil for Prescripti on Drug Pr ogramsNDCN ational Dr ug CodeNDF National D rug FileNO INotice of IntentNPF National P rovider Fi leNPINatio nal Provid er Identif ierNPRMNot ice of Pro posed Rule makingNPSN ational Pr ovider Sys temNSFNati onal Stand ard Format NUBCNation al Uniform Billing C ommitteeOM BOffice of Managemen t and Budg etOPECCOut patient Ph armacy Ele ctronic Cl aims Coord inatorOSIO pen System Interconn ectionOTCO ver the Co unterPOSPo int of Sal eSOWStatem ent of Wor kSSOStanda rd Setting Organizat ionTPAThir d Party Ad ministrati onVADepart ment of Ve terans Aff airsVAMCDe partment o f Veterans Affairs M edical Cen terVHAVete rans Healt h Administ rationVist AVeterans Health Inf ormation S ystems and Technolog y Architec tureWEDIWo rkgroup fo r Electron ic Data In terchange1 2
	6178	Index
	6179
	6180	A
	6181	Accessing Pharmacy E CME Manage r Menu, 87
	6182	Accessing the ECME P harmacy CO B Menu, 79
	6183	Acronyms, 199
	6184	Add/View C omments, 4 0, 47
	6185	B
	6186	BPS Nightl y Backgrou nd Job, 18 1
	6187	C
	6188	Change Vie w, 19
	6189	Claim Resu lts and St atus, 108
	6190	Claims Sub mitted, No t Yet Rele ased, 128
	6191	Claims Tra cking, 47
	6192	Close Clai m, 35
	6193	Closed Cla ims Report , 135
	6194	CMOP/ECME Activity R eport, 122
	6195	D
	6196	Display Up date, 76
	6197	Display Up date, 103
	6198	E
	6199	ECME Claim s-Response Inquiry, 152
	6200	ECME Main Menu, 12
	6201	ECME Menu Options, 8
	6202	ECME Menu Structures , 7
	6203	ECME Setup - Pharmac ies, 160
	6204	ECME Trans action Mai ntenance O ptions, 87
	6205	ECME User Screen, 14
	6206	Edit Basic Pharmacy ECME Param eters, 92
	6207	Edit ECME Pharmacy D ata, 94
	6208	Exit from ECME User Screen, 78
	6209	F
	6210	Further Re search Scr een, 42
	6211	G
	6212	Glossary, 183
	6213	Group Plan Menu, 57
	6214	I
	6215	IB (Integr ated Billi ng) Events Report, 5 3
	6216	Insurance Details, 4 3
	6217	Introducti on, 1
	6218	N
	6219	Non-Billab le Status Report, 13 8
	6220	O
	6221	On-Hold Co pay Listin g, 50
	6222	Online Hel p, 4
	6223	OPECC Prod uctivity?? , 174
	6224	Orientatio n, 3
	6225	Other Repo rts, 152
	6226	P
	6227	Payable Cl aims, 110
	6228	Payable Re jected Cla ims, 116
	6229	Payer Shee t Detail, 155
	6230	Pharmacy E CME Setup Menu, 91
	6231	Pharmacy E CME User S creen, 10
	6232	Pharmacy E lectronic Claims Rep orts, 107
	6233	Pharmacy E lectronic Claims Rep orts Menu Structure, 10
	6234	Potential Claims Rep ort for Du al Eligibl e, 81
	6235	Potential Secondary Rx Claims Report, 79
	6236	Print Clai m Log, 60
	6237	Process Se condary/Tr icare Rx t o ECME, 83
	6238	R
	6239	Recent Tra nsactions, 129
	6240	Related Ma nuals, 5
	6241	Release Co pay, 51
	6242	Reopen Clo sed Claims (hidden o ption), 66
	6243	Resubmit C laim, 32, 73
	6244	Resubmit w ith Edits (hidden op tion), 68
	6245	Reversal C laims Repo rt, 124
	6246	Reverse Pa yable Clai m, 29
	6247	S
	6248	Send to Wo rklist, 63
	6249	Sort List, 27
	6250	Spending A ccount Rep ort, 146
	6251	Statistics Screen, 1 00
	6252	Submitting Primary C laims for TRICARE an d Dual Eli gibility P atients, 8 5
	6253	Submitting Secondary Claims, 8 4
	6254	T
	6255	Third Part y Inquiry, 49
	6256	Totals by Date, 134
	6257	Turn-aroun d time sta tistics, 1 62
	6258	U
	6259	Update Con tinuously, 102
	6260	V
	6261	Variations to the Cl ose claim process, 3 8, 40, 90
	6262	View Eligi bility, 44
	6263	View Presc ription, 4 5, 58
	6264	View/Unstr and Claims , 88
	6265	Z
	6266	Zero (clea r) Statist ics, 103
	6267
	6268
	6269	PHARMACY E CME Jul 03, 20 10@14:55:0 1 Page : 1 of 30
	6270	SELECTED D IVISION(S) : ALL
	6271	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	6272	Sorted b y: Transac tion date by default
	6273
	6274	# PATIEN T/DRUG/COM MENTS IN SURANCE/ND C/FILL/RX# /ECME# STATU S/LOC/TYP/ RXINF
	6275	1 ECMEPa tient,FIVE (XXXX) I BINSUR1/ Vet Pb: 0 Rj:1 AcR v:3 RjRv:0
	6276	1.1 CO LCHICINE 0 .6MG 0007 4-3781-01 06/24 1012 97$ 1/ 0000000016 53 M RT DS/N
	6277	10/1 9/10 - Cla rification Code 8 su bmitted.
	6278	(OPP USER,TWO)
	6279	p-Re versal acc epted
	6280
	6281	Enter ?? f or more ac tions
	6282
	6283
	6284
	6285
	6286	CV Change View REV Reverse Pa yable Clai m FR Furt her Resear ch
	6287	SO Sort L ist RES Resubmit C laim VER View ePharmacy Rx
	6288	CMT Add/Vi ew Comment s CLO Close Clai m WRK Send to Workli st
	6289	Select Act ion: Next Screen//
	6290
	6291
	6292
	6293	Header
	6294	Area
	6295
	6296	Patient/
	6297	Rx
	6298	Area
	6299
	6300	Message
	6301	Window
	6302
	6303
	6304	Action
	6305	Area
	6306
	6307	ECME STATI STICS Nov 03, 2 010@16:50: 30 Page: 1 of 1
	6308	Communicat ions stati stics last cleared o n AUG 18,2 003@16:36: 28
	6309
	6310
	6311	* CLAIM STATUS * * CLAIM RES ULTS *
	6312	Waiting to start 0 P aid claims 2,93 4
	6313	Building the trans action 0 R ejected cl aims 2,17 1
	6314	Building the claim 0 D ropped to Paper 1 5
	6315	Building the HL7 p acket 1 D uplicate c laims 0
	6316	Preparin g for tran smit 0 C aptured cl aims 0
	6317	Transmit ting 0 A ccepted Re versals 2,06 7
	6318	Parsing response 0 R ejected Re versals 16 6
	6319	Processi ng respons e 0 A ccepted El igibility 7
	6320	R ejected El igibility 4 4
	6321	E rrors 1 4
	6322
	6323
	6324
	6325	Enter ?? f or more ac tions
	6326	UC Updat e continuo usly Z Zero (cle ar) stats
	6327	U1 Displ ay update EX Exit
	6328	Select Act ion:U1//
	6329
	6330	Header
	6331	Area
	6332
	6333	Stats
	6334	Area
	6335
	6336	Message Wi ndow
	6337
	6338
	6339	Action
	6340	Area
	6341
	6342