3. EPMO Open Source Coordination Office Redaction File Detail Report

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3.1 Files compared

#	Location	File	Last Modified
1	MCCF EDI TAS BPS PSO PSX Bundle.zip\MCCF EDI TAS BPS PSO PSX Bundle	bps_1_um_r0617.doc	Tue Jul 18 13:58:28 2017 UTC
2	MCCF EDI TAS BPS PSO PSX Bundle.zip\MCCF EDI TAS BPS PSO PSX Bundle	bps_1_um_r0617.doc	Wed Sep 6 13:45:08 2017 UTC

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	1	ELECTRONIC CLAIMS MA NAGEMENT E NGINE (ECM E)
	2	Version 1. 0
	3	USER MANUA L
	4	Ju ly 2017
	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 Writer07 /2017 Updated fo r BPS122
	9	Update Tit le page da te, modifi cation to Change Vie w action, change aut o-reverse parameter and auto-r eversal bu lletinDana BennettDe Ann Kelly0 6/2016Upda ted Title Page to cu rrent OI&T standards .
	10	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/
	11	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.)
	12	Contents
	13	11
	14	Introducti on
	15
	16
	17	32
	18	Orientatio n
	19
	20
	21	32.1 Worki ng with th e ECME Use r Manual
	22
	23
	24	42.2 Obtai ning Onlin e Help
	25
	26
	27	52.3 Findi ng Related Manuals
	28
	29
	30	73
	31	ECME Menu Structures
	32
	33
	34	83.1 The C omplete EC ME Menu St ructure
	35
	36
	37	103.2 ECME User Scre en
	38
	39
	40	103.3 ECME Pharmacy COB Menu S tructure
	41
	42
	43	103.4 Phar macy ECME Manager Me nu Structu re
	44
	45
	46	103.5 Phar macy Elect ronic Clai ms Reports Menu Stru cture
	47
	48
	49	124
	50	Accessing the ECME M ain Menu
	51
	52
	53	145
	54	Accessing the ECME U ser Screen
	55
	56
	57	195.1 Chan ge View
	58
	59
	60	275.2 Sort List
	61
	62
	63	295.3 Reve rse Payabl e Claim
	64
	65
	66	325.4 Resu bmit Claim
	67
	68
	69	355.5 Clos e Claim
	70
	71
	72	385.5.1 Va riations t o the Clos e claim pr ocess.
	73
	74
	75	405.5.2 Sp ecial Note s regardin g secondar y claims
	76
	77
	78	405.6 Add/ View Comme nts
	79
	80
	81	425.7 Furt her Resear ch Screen
	82
	83
	84	435.7.1 In surance De tails
	85
	86
	87	445.7.2 Vi ew Eligibi lity
	88
	89
	90	455.7.3 Vi ew Prescri ption
	91
	92
	93	475.7.4 Ad d/View Com ments
	94
	95
	96	475.7.5 Cl aims Track ing
	97
	98
	99	495.7.6 Th ird Party Inquiry
	100
	101
	102	505.7.7 On Hold Copa y Listing
	103
	104
	105	515.7.8 Re lease Copa y
	106
	107
	108	535.7.9 IB (Integrat ed Billing ) Events R eport
	109
	110
	111	575.7.10 G roup Plan Menu
	112
	113
	114	585.7.11 E ligibility Inquiry O ption
	115
	116
	117	605.8 Prin t Claim Lo g (hidden action)
	118
	119
	120	635.09 Sen d to Workl ist
	121
	122
	123	665.10 Reo pen Closed Claims (h idden acti on)
	124
	125
	126	685.11 Res ubmit with Edits (hi dden actio n)
	127
	128
	129	725.12 OP ECC Reject Informati on (hidden action)
	130
	131
	132	735.13 Re submit Cla im Without Reversal (hidden ac tion)
	133
	134
	135	755.14 Op en/Close N on Billabl e Entry (h idden acti on)
	136
	137
	138	765.15 Dis play Updat e (hidden action)
	139
	140
	141	785.16 Exi t (from EC ME User Sc reen)
	142
	143
	144	796.
	145	Accessing the ECME P harmacy CO B Menu
	146
	147
	148	796.1 Pote ntial Seco ndary Rx C laims Repo rt
	149
	150
	151	816.2 Pote ntial Clai ms Report for Dual E ligible
	152
	153
	154	836.3 Proc ess Second ary/TRICAR E Rx to EC ME
	155
	156
	157	846.3.1
	158	Submitting Secondary Claims
	159
	160
	161	856.3.2
	162	Submitting Primary C laims for TRICARE an d Dual Eli gibility P atients
	163
	164
	165	877
	166	Accessing the Pharma cy ECME Ma nager Menu
	167
	168
	169	877.1 ECME Transacti on Mainten ance Optio ns
	170
	171
	172	887.1.1 Vi ew/Unstran d Submissi ons Not Co mpleted
	173
	174
	175	907.1.2 RE OPEN a CLO SED ECME C laim
	176
	177
	178	917.2 Phar macy ECME Setup Menu
	179
	180
	181	927.2.1 Ed it Basic E CME Parame ters
	182
	183
	184	947.2.2 Ed it ECME Ph armacy Dat a
	185
	186
	187	977.2.3 Re gister Pha rmacy with Austin In formation Technology Center
	188
	189
	190	1007.3 Sta tistics Sc reen
	191
	192
	193	1027.3.1 U pdate Cont inuously
	194
	195
	196	1037.3.2 D isplay Upd ate
	197
	198
	199	1037.3.3 Z ero (clear ) Statisti cs
	200
	201
	202	1057.3.4 E xiting the Statistic s Screen
	203
	204
	205	1078
	206	Accessing the Pharma cy Electro nic Claims Reports
	207
	208
	209	1088.1 Cla im Results and Statu s
	210
	211
	212	1108.1.1 P ayable Cla ims Report
	213
	214
	215	1168.1.2 R ejected Cl aims Repor t
	216
	217
	218	1228.1.3 C MOP/ECME A ctivity Re port
	219
	220
	221	1248.1.4 R eversal Cl aims Repor t
	222
	223
	224	1288.1.5 C laims Subm itted, Not Yet Relea sed
	225
	226
	227	1298.1.6 R ecent Tran sactions
	228
	229
	230	1348.1.7 T otals by D ate
	231
	232
	233	1358.1.8 C losed Clai ms Report
	234
	235
	236	1388.1.9 N on-Billabl e Status R eport
	237
	238
	239	1468.1.10 Spending A ccount Rep ort
	240
	241
	242	1528.2 Oth er Reports
	243
	244
	245	1528.2.1 E CME Claims -Response Inquiry Op tion
	246
	247
	248	1558.2.2 P ayer Sheet Detail Re port Optio n
	249
	250
	251	1608.2.3 E CME Setup – Pharmaci es Report
	252
	253
	254	1628.2.4 T urn-around time stat istics
	255
	256
	257	1638.2.5 V iew ePharm acy Rx
	258
	259
	260	1748.2.6 O PECC Produ ctivity Re port
	261
	262
	263	1819
	264	BPS Nightl y Backgrou nd Job
	265
	266
	267	18310
	268	Glossary
	269
	270
	271	19911
	272	Acronyms
	273
	274
	275	20112
	276	Index
	277
	278
	279
	280
	281	1
	282	Introducti on XE "In troduction "
	283	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:
	284	Allows pha rmacy clai ms process ing staff to submit, resubmit, and rever se electro nic claims ;
	285	Provides r eports for end users and manag ement on c laims stat us, transa ction hist ory, and s ystem conf iguration standings;
	286	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.
	287	Allows Eli gibility I nquiry and Verificat ion transa ctions for verificat ion of val id patient pharmacy insurance.
	288	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.
	289	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.
	290	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.
	291	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.
	292	The ECME U ser Manual consists of the fol lowing sec tions.
	293	ECME Intro duction: Outlines t he history , use, and intent of the ECME software.
	294	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.
	295	ECME Menu Structures : Lists t he complet e ECME men u structur e. It also lists the ECME User , Manager, and Repor ts menus.
	296	Accessing the ECME M enu: Desc ribes how to gain ac cess to th e ECME mai n Menu.
	297	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.
	298	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.
	299	Accessing the Pharma cy ECME Ma nager Menu : Describ es electro nic claims managemen t features that requ ire manage ment level decisions .
	300	Accessing the Pharma cy Electro nic Claims Reports: Describes the repor ts generat ed by ECME .
	301	ECME Backg round Jobs : Describ es the tas ks perform ed by the Nightly Ba ckground J ob.
	302	Glossary: Defines c ommon ECME -related t erms.
	303	Acronyms: Lists ECM E-related acronyms.
	304	Index: Li sts subjec ts, option s, and men us alphabe tically.
	305	2
	306	Orientatio n XE "Orie ntation"
	307	2.1 Workin g with the ECME User Manual
	308	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.
	309	The ECME U ser Manual uses the following methods to enhance r eadability .
	310	Menu optio ns and scr een action s are ital icized.
	311	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.
	312	Screen pro mpts are d enoted wit h quotatio n marks ar ound them.
	313	Example: The “Selec t Action:” prompt wi ll display next.
	314	Variable n ames, form al name of options, field and file names , and secu rity keys are comple tely upper case.
	315	Example: The BPS US ER key.
	316	Screen cap tures/dial ogues are shaded and shown in a non-prop ortional f ont.
	317	User respo nses to on line promp ts are in boldface t ype.
	318	Example:
	319	Select Pha rmacy ECME User Menu Option: R PT
	320	<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.
	321	Example:
	322	Select Pha rmacy ECME Manager M enu Option : ?<Enter>
	323	The follow ing symbol s alert yo u to speci al informa tion.
	324	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.
	325	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"
	326	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.
	327	To retriev e Online H elp in any VistA cha racter-bas ed product :
	328	Enter a si ngle quest ion mark ( ?) at a fi eld/prompt to obtain a brief d escription :
	329	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.
	330	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.
	331	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.
	332	Enter thre e question marks (?? ?) at a fi eld/prompt to invoke any addit ional Help text stor ed in Help Frames.
	333	2.3 Findin g Related Manuals XE "Related Manuals"
	334	To learn m ore about the ECME V . 1.0 soft ware, plea se consult the follo wing:
	335	Electronic Claims Ma nagement E ngine (ECM E) V. 1.0 Technical Manual/Sec urity Guid e
	336	All ECME V . 1.0 docu mentation can be fou nd at the VistA Docu mentation Library at http:// DNS\pm/h a pe/ipt_501 0/EDI_Port foli o / TAS%20Inte rim%20Repo sitory/MCC F%20TAS%20 Sche d u l e.zip .
	337	VHA-orient ed HIPAA ( Health Ins urance Por tability a nd Account ability Ac t) informa tion can b e found at http:// DNS . .
	338	(This page included for two-si ded copyin g.)
	339	3
	340	ECME Menu Structures XE "ECME Menu Struc tures"
	341	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.
	342	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.
	343	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.
	344	Table 3-1: List of U sers with Suggested ECME Menus and Secur ity Keys
	345	Type of Us er*ECME Me nuECME Sec urity Keys OPECCAll E CME Menus
	346	ECME Ma in Menu
	347	ECME Us er Screen
	348	ECME Ph armacy COB
	349	Pharmac y ECME Man ager Menu
	350	Pharmac y Electron ic Claims Reports B PSMENU
	351	BPS USER
	352	BPS MANA GER
	353	BPS REPO RTSPharmac ist, Pharm acy Techni cian ECM E Main Men u
	354	ECME Us er Screen
	355	Pharmac y Electron ic Claims Reports B PSMENU
	356	BPS USER
	357	BPS REPO RTSePharma cy Site Ma nager and back-up ECME Main Menu
	358	ECME Us er Screen
	359	Pharmac y ECME Man ager Menu
	360	Pharmac y Electron ic Claims Reports B PSMENU
	361	BPS USER
	362	BPS MANA GER
	363	BPS MAST ER
	364	BPS REPO RTSADPAC
	365	(Autom ated Data
	366	Proce ssing Appl ication
	367	Coord inator) ECME Main Menu
	368	ECME Ph armacy COB
	369	Pharmac y ECME Man ager Menu
	370	Pharmac y Electron ic Claims Reports B PSMENU
	371	BPS MANA GER
	372	(BPS MA STER is al so
	373	requir ed to acce ss certain
	374	MGR me nu options )
	375	BPS REPO RTSIRMS
	376	(Inform ation Reso urces
	377	Manage ment Servi ce)ECME Ma in Menu
	378	Pharmac y ECME Man ager Menu
	379	Pharmac y Electron ic Claims ReportsBPS MENU
	380	BPS MANA GER
	381	(BPS MA STER is al so
	382	requir ed to acce ss certain
	383	MGR me nu options )
	384	BPS REPO RTSOPECC S upervisorP harmacy El ectronic C laims Repo rtsBPS SUP ERVISOR
	385	BPS REPORT S3.1 The C omplete EC ME Menu St ructure XE "ECME Men u Options"
	386	The comple te list of ECME menu options i s shown be low. The O PECC needs to access all ECME options.
	387	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
	388	ECME User Screen
	389	COB
	390	ECME Pharm acy COB .. .
	391	SEC
	392	Potential Secondary Rx Claims Report
	393	TRI
	394	Potential Claims Rep ort for Du al Eligibl e
	395	PRO
	396	Process Se condary/TR ICARE Rx t o ECME
	397	MGR
	398	Pharmacy E CME Manage r Menu . .
	399	MNT
	400	ECME trans action mai ntenance o ptions …
	401
	402	UNS
	403	View/Unstr and Submis sions Not Completed
	404
	405	ROC
	406	Re Open CL OSED Claim
	407	SET
	408	Pharmacy E CME Setup Menu ...
	409
	410	BAS
	411	Edit Basic ECME Para meters
	412
	413	PHAR
	414	Edit ECME Pharmacy D ata
	415
	416	REG
	417	Register P harmacy wi th Austin Informatio n Technolog y Center
	418	STAT
	419	Statistics Screen
	420	RPT
	421	Pharmacy E lectronic Claims Rep orts . .
	422
	423	CLA
	424	Claim Resu lts and St atus . .
	425
	426
	427	PAY
	428	Payable Cl aims Repor t
	429
	430
	431	REJ
	432	Rejected C laims Repo rt
	433
	434
	435	ECMP
	436	CMOP/ECME Activity R eport
	437
	438
	439	REV
	440	Reversal C laims Repo rt
	441
	442
	443	NYR
	444	Claims Sub mitted, No t Yet Rele ased
	445
	446
	447	REC
	448	Recent Tra nsactions
	449
	450
	451	DAY
	452	Totals by Date
	453
	454
	455	CLO
	456	Closed Cla ims Report
	457
	458
	459	NBS
	460	Non-Billab le Status Report
	461
	462
	463	SPA
	464	Spending A ccount Rep ort
	465
	466	OTH
	467	Other Repo rts . .
	468
	469
	470	CRI
	471	ECME Claim s-Response Inquiry
	472
	473
	474	PAY
	475	Payer Shee t Detail R eport
	476
	477
	478	PHAR
	479	ECME Setup - Pharmac ies Report
	480
	481
	482	TAT
	483	Turn-aroun d time sta tistics
	484
	485
	486	VER
	487	View ePhar macy Rx
	488
	489
	490	OPR
	491	OPECC Prod uctivity R eport
	492	3.2 ECME U ser Screen XE "Pharm acy ECME U ser Screen "
	493	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.
	494	You must h old the BP S MENU and BPS USER keys to vi ew the ECM E User Scr een option .U
	495	ECME User Screen
	496	3.3 ECME P harmacy CO B Menu Str ucture
	497	The ECME P harmacy CO B Menu opt ion struct ure is lis ted below. OPECCs mu st be able to access this menu .
	498	You must h old the BP SMENU keys to view t he ECME Ph armacy COB option. C OB
	499	ECME Pharm acy COB . .
	500	SEC Pot ential Sec ondary Rx Claims Rep ort
	501
	502	TRI Po tential Cl aims Repor t for Dual Eligible
	503
	504	PRO Pro cess Secon dary/TRICA RE Rx to E CME
	505	3.4 Pharma cy ECME Ma nager Menu Structure " Pharmacy ECME Mana ger Menu O ptions"
	506	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.
	507	You must h old the BP SMENU and BPS MANAGE R keys to view the P harmacy EC ME Manager Menu opti on.MGR
	508	Pharmacy E CME Manage r Menu . .
	509	MNT
	510	ECME trans action mai ntenance o ptions …
	511
	512	UNS
	513	View/Unstr and Submis sions Not Completed
	514
	515	ROC
	516	Re Open CL OSED Claim
	517	SET
	518	Pharmacy E CME Setup Menu ...
	519
	520	BAS
	521	Edit Basic ECME Para meters
	522
	523	PHAR
	524	Edit ECME Pharmacy D ata
	525
	526	REG
	527	Register P harmacy wi th Austin Automation Center
	528	STAT
	529	Statistics Screen
	530	3.5 Pharma cy Electro nic Claims Reports M enu Struct ure XE " P harmacy El ectronic C laims Repo rts Menu S tructure"
	531	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.
	532	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
	533	Pharmacy E lectronic Claims Rep orts . .
	534
	535	CLA
	536	Claim Resu lts and St atus . .
	537
	538
	539	PAY
	540	Payable Cl aims Repor t
	541
	542
	543	REJ
	544	Rejected C laims Repo rt
	545
	546
	547	ECMP
	548	CMOP/ECME Activity R eport
	549
	550
	551	REV
	552	Reversal C lams Repor t
	553
	554
	555	NYR
	556	Claims Sub mitted, No t Yet Rele ased
	557
	558
	559	REC
	560	Recent Tra nsactions
	561
	562
	563	DAY
	564	Totals by Date
	565
	566
	567	CLO
	568	Closed Cla ims Report
	569
	570
	571	NBS
	572	Non-Billab le Status Report
	573	SPA Spe nding Acco unt Report
	574
	575	OTH
	576	Other Repo rts . .
	577
	578
	579	CRI
	580	ECME Claim s-Response Inquiry
	581
	582
	583	PAY
	584	Payer Shee t Detail R eport
	585
	586
	587	PHAR
	588	ECME Setup - Pharmac ies Report
	589
	590
	591	TAT
	592	Turn-aroun d time sta tistics
	593
	594
	595	VER
	596	View ePhar macy Rx
	597
	598
	599	OPR
	600	OPECC Prod uctivity R eport
	601	4
	602	Accessing the ECME M ain Menu XE "ECME M ain Menu"
	603	The Electr onic Claim s Manageme nt Engine Main Menu option is usually ac cessed thr ough the C ore Applic ations Men u.
	604	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
	605	Select Cor e Applicat ions Optio n: ?
	606	Laboratory ...
	607	PIMS MAS MANAGE R ...
	608	Mental Hea lth ...
	609	Military R etirees .. .
	610	Patient Da ta Log
	611	Informatio n Manageme nt Systems (SWIMS) . ..
	612	Voluntary Services' Menu ...
	613	AR Finance AR Manager M enu ...
	614	BPS ECME ...
	615	EN Engineerin g Main Men u ...
	616	FEE Fee Basis Main Menu ...
	617	HL7 HL7 Main M enu ...
	618	IB Integrated Billing M aster Menu ...
	619	NS Nursing Sy stem Manag er's Menu ...
	620	PSO Outpatient Pharmacy Manager .. .
	621	VOL Voluntary Service Ma ster Menu ...
	622	Select Cor e Applicat ions Optio n: BPS EC ME
	623	(This page included for two-si ded copyin g.)
	624	5
	625	Accessing the ECME U ser Screen XE "ECME User Scre en"
	626	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 .
	627	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.
	628	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.
	629	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
	630	*** ****** ****** ****** ****** **
	631	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	632	* XXXXX V AMC *
	633	* Main M enu *
	634	*** ****** ****** ****** ****** **
	635	U ECME User Screen
	636	COB ECME Pharm acy COB .. .
	637	MGR Pharmacy E CME Manage r Menu ...
	638	RPT Pharmacy E lectronic Claims Rep orts ...
	639	Select ECM E Option: U ECME Us er Screen
	640	Please wai t...
	641	Example 5- 2: Displa ying the E CME User S creen Opti on
	642	PHARMACY E CME Jul 03, 20 10@14:55:0 1 Page : 1 of 30
	643	SELECTED D IVISION(S) : ALL
	644	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	645	Sorted b y: Transac tion date by default
	646	# PATIEN T/DRUG/COM MENTS IN SURANCE/ND C/DOS/RX#/ ECME# STATUS /LOC/TYP/R XINF
	647	1 ECMEPa tient,FIVE (XXXX) I BINSUR1/ VET Pb: 0 Rj:1 AcR v:3 RjRv:0
	648	1.1 CO LCHICINE 0 .6MG 0007 4-3781-01 06/24 1012 97$ 1/ 0000000016 53 M RT DS/N
	649	10/1 9/10 - Cla rification Code 8 su bmitted.
	650	(OPP USER,TWO)
	651	p-Re versal acc epted
	652	Enter ?? f or more ac tions
	653	CV Change View REV Reverse Pa yable Clai m FR Furt her Resear ch
	654	SO Sort L ist RES Resubmit C laim VER View ePharmacy Rx
	655	CMT Add/Vi ew Comment s CLO Close Clai m WRK Send to Workli st
	656	Select Act ion: Next Screen//
	657	This secti on diagram s and desc ribes the different elements o f your ECM E User Scr een.
	658	Dia gram 5-1: ECME User Screen Ar eas
	659
	660
	661
	662
	663
	664
	665	The table below desc ribes the four areas of the EC ME User Sc reen.
	666	Table 5-1: Descript ion of ECM E User Scr een Areas
	667	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 /
	668	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
	669	ECMEPatien t,FIVE (X XXX) IBINS UR1/ VET Pb:0 Rj:1 AcRv:3 Rj Rv:0
	670	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:
	671	Pb = Payab le
	672	Rj = Rejec ted
	673	AcRv = Rev ersal Acce pted
	674	RjRv = R eversal Re jected
	675	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).
	676	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
	677	LOC /BillT YPE /RXSta tus /Rele ase Status
	678	M/ RT/ DS /N
	679	These show for each claim:
	680	Drug Name
	681	NDC (Natio nal Drug C ode)
	682	Date of Se rvice
	683	Rx#
	684	$ Patient Copay (if applicable )
	685	Refill#
	686	ECME#
	687	Fill Locat ion
	688	C = Consol idated Mai l Outpatie nt Pharmac y (CMOP)
	689	M = LO CAL MAIL
	690	W = WI NDOW FILL
	691	Bill Type
	692	BB = B ackbill
	693	P2 = PRO option
	694	RS = Res ubmission
	695	RT = Rea l Time Fil l
	696	RX Status
	697	AC = Acti ve
	698	NV = Non-v erified
	699	HL = Hold
	700	SU = Suspe nd
	701	EX = Expir ed
	702	DS = Disco ntinued
	703	DL = Delet ed
	704	?? = Unkno wn
	705	Release St atus
	706	N = Rx NOT Released
	707	R = Rx Rel eased
	708	Coordinati on of Bene fits Indic ator
	709	p- primary claim
	710	s- seconda ry claim
	711	s-Payable (p-Payable )
	712	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. Pay er Returne d Response sThe Payer Returned Response i nformation is displa yed beneat h the user -input com ments or b eneath the patient i nformation line, if no comment s were ent ered. Each response will begin on a sepa rate line.
	713	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 with addit ional line s of descr iptive err or message s), Payabl e, Reversa l Accepted , Reversal Rejected, Stranded, Stranded reversal, Captured, Duplicate, Other, Ca ncelled, C orrupt, Un known stat us and In Progress. If a claim is closed , “Closed” is added to the sta tus, e.g., “Reversal accepted/ Closed”.Me ssage Wind owThis sec tion displ ays a plus (+) sign, minus (-) sign or i nformation al text (i .e., Enter ?? for mo re actions ). The plu s and minu s signs, e ntered at the action prompt, a re used to jump forw ard or bac k a screen .Action Ar eaA list o f Claims D ata Entry options is available to you as described in Sectio n 5 of thi s manual. A double q uestion ma rk (??) ma y be enter ed at the "Select Ac tion" prom pt for a l ist of all List Mana ger option s availabl e.An optio n chosen a t the pati ent inform ation leve l is perfo rmed on al l claim it ems for th at patient .The ECME User Scree n also dis plays non- billable e ntries in addition t o billable 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.
	714	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).
	715	Example 5- 2: List of all ECME User Scree n Actions
	716	+ Enter ?? f or more ac tions
	717	CV Change View REV Reverse Pa yable Clai m FR Furt her Resear ch
	718	SO Sort L ist RES Resubmit C laim VER View ePharmacy Rx
	719	CMT Add/Vi ew Comment s CLO Close Clai m WRK Send to Workli st
	720	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.
	721	Example 5- 3: Display ing List M anager Act ions by En tering “?? ”
	722	Select Act ion: Next Screen// ? ?
	723	The follow ing action s are also available :
	724	+ Next Screen
	725	- Previ ous Screen
	726	UP Up a Line
	727	DN Down a Line
	728	> Shift View to R ight
	729	< Shift View to L eft
	730	FS First Screen
	731	LS Last Screen
	732	GO Go to Page
	733	RD Re Di splay Scre en
	734	PS Print Screen
	735	PL Print List
	736	SL Searc h List
	737	ADPL Auto Display(On /Off)
	738	Q
	739	Quit
	740	Press RETU RN to cont inue or '^ ' to exit:
	741	ROC Reope n Closed C laims
	742	OCN Open/ Close Non Billable E ntry
	743	DV Print Developer Claim Log
	744	REJ OPECC Reject In formation
	745	RER Resub mit Claim w/o Revers al
	746	EX Exit
	747	LOG Print Claim Log
	748	RED Resub mit Claim w/EDITS
	749	UD Displ ay Update
	750	Enter RETU RN to cont inue or '^ ' to exit:
	751	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).
	752	5.1 Change View XE " Change Vi ew"
	753	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.
	754	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”.
	755	(This page included for two-si ded copyin g.)
	756	Example 5. 1-1: Acce ssing the Change Vie w Action
	757	PHARMACY E CME Apr 26, 20 06@11:44:4 5 Page : 1 of 2
	758	SELECTED D IVISION(S) : ALL
	759	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	760	Sor ted by: Pa tient Name
	761	# PATIEN T/DRUG/COM MENTS INSURANC E/NDC/RX#/ ECME# LOC/TYP RXINF
	762	6 ECMEpa tient,Two (XXXX) W EBMD TE/ VET Pb:1 Rj:0 AcRv:0 RjR v:1
	763	6.1 FU ROSEMIDE 1 0MG/M 006 41-2312-25 04/18 100 004065$ 0 /000000504 691 W RT A C/R
	764	p-Pa yable
	765	6.2 CH OLESTYRAMI NE 4G 000 87-0580-01 04/19 100 004066$ 0 /000000504 692 W RT A C/R
	766	p-Re versal rej ected
	767	NN:T ransaction Rejected At Switch Or Interme diary
	768	NC16 -The clear inghouse d id not rep ly in time .
	769	7 ECMEpa tient,One (XXXX) W EBMD TE/ VET ALL payabl e
	770	7.1 AL BUTEROL IN HALER 555 55-4444-22 04/26 100 003744$ 0 /000000504 304 W RT A C/R
	771	p-Pa yable
	772	7.2 AC ETYLCYSTEI NE 20 000 87-0570-09 04/21 100 004054$ 0 /000000504 677 W RT A C/N
	773	p-Pa yable
	774	8 ECMEpa tient,Thre e (XXXX) W EBMD TE/ VET ALL payabl e
	775	+ Enter ?? f or more ac tions
	776	The screen has been updated on APR 26,20 06@14:50:4 7. Press " Q" to quit .
	777	CV Change View REV Reverse Pa yable Clai m FR Furt her Resear ch
	778	SO Sort L ist RES Resubmit C laim VER View ePharmacy Rx
	779	CMT Add/Vi ew Comment s CLO Close Clai m WRK Send to Workli st
	780	Select Act ion: Next Screen//CV Change Vi ew
	781	(This page included for two-si ded copyin g.)
	782	View data by divisio n(s) or al l division s.
	783	Example 5. 1-2: Sele cting View s by Divis ion
	784	Selec t one of t he followi ng:
	785	D DIVISION
	786	A ALL
	787	Select Cer tain Pharm acy (D)ivi sions or ( A)LL: A// DIVISION
	788	Selected :
	789	Select ECM E Pharmacy Division( s): BAY PI NES
	790	BAY PINES
	791	View data by Eligibi lity Type of the cla im.
	792	Example 5. 1-3: Sele cting View s by Eligi bility Typ e
	793	Selec t one of t he followi ng:
	794	V VETERAN
	795	T TRICARE
	796	C CHAMPVA
	797	A ALL
	798	Select Cer tain Eligi bility Typ e or (A)ll : A// LL
	799	View data for one EC ME user or all users . The ECME user is d efined as the person who last processed/ finished/r esubmitted , etc., th e prescrip tion fill.
	800	Example 5. 1-4: Sele cting View s from Ent ries by On e User
	801	Selec t one of t he followi ng:
	802	U ONE USER
	803	A ALL Disp lay One EC ME (U)ser or (A)LL: A// U ONE USER
	804	Select Use r: USER
	805	1 E CMEuser,On e UO PHARMA CIST
	806	2 E CMEuser,Tw o UTW PHARMA CIST
	807	3 E CMEuser,Th ree UTH PHARMA CIST
	808	CHOOSE 1-3 : 1 ECMEu ser,One UO PHARMA CIST
	809	View data from one p atient or all patien ts.
	810	Example 5. 1-5: Sele cting View s from Ent ries for O ne Patient
	811	Se lect one o f the foll owing:
	812	P ONE PATIEN T
	813	A ALL
	814	Display On e (P)atien t or (A)LL : A// P O NE PATIENT
	815	Select Pat ient: ECME patient,ON E// ECME
	816	1 ECM Epatient,O ne 1-1-65 666443333 NO NSC VET ERAN
	817	2 ECM Epatient,T wo 1-1-65 666443444 NO NSC VET ERAN
	818	3 ECM Epatient,T hree 1-1-68 666773333 YES SC VET ERAN
	819	ENTER '^' TO STOP, O R
	820	CHOOSE 1-3 : 2 ECMEp atient,Two 1- 1-65 66 6443444 NO NSC VETER AN
	821	Enrollmen t Priority : GROUP 8g Categor y: NOT ENR OLLED End Date: 08/ 01/2005
	822	View data about one prescripti on or all prescripti ons.
	823	Example 5. 1-6: Sele cting View s from Ent ries for O ne Prescri ption
	824	Se lect one o f the foll owing:
	825	R ONE RX
	826	A ALL
	827	Display On e (R)x or (A)LL: A// R ONE RX
	828	Select RX: 123456
	829	Choose dat a for a pe riod of da ys or hour s.
	830	Example 5. 1-7: Sele cting View s by Timef rame of th e Default of Days
	831	Selec t one of t he followi ng:
	832	D DAYS
	833	H HOURS
	834	Activity T imeframe ( H)ours or (D)ays: D/ / <Enter> AYS
	835	Enter a nu mber for t he timefra me value f or the num ber of day s, or numb er of hour s, to view .
	836	Example 5. 1-8: Sele cting View s by Timef rame Numbe r of Days or Hours
	837	Activity T imeframe V alue: (1-9 99): 40// 10
	838	Choose whi ch types o f claims w ill displa y on the U ser Screen .
	839	Example 5. 1-9: Sele cting Type s of Claim s
	840	Selec t one of t he followi ng:
	841	O OPEN CLAIM S
	842	C CLOSED CLA IMS
	843	A ALL
	844	Select Ope n/Closed o r All Clai ms: A// <E nter> LL
	845	Choose whi ch types o f non-bill able entri es will di splay on t he User Sc reen.
	846	Example 5. 1-10: Sel ecting Typ es of Entr ies
	847	Selec t one of t he followi ng:
	848	O Open Non-B illable En tries
	849	C Closed Non -Billable Entries
	850	A ALL
	851	Please note this question only appli es to
	852	TRICAR E or CHAMP VA Non-Bil lable Entr ies.
	853	Display (O )pen or (C )losed or (A)ll Non- Billable E ntries: A/ /
	854	Choose whi ch types o f payer re quests wil l display on the Use r Screen.
	855	Example 5. 1-11: Sel ecting Typ es of Requ ests
	856	Selec t one of t he followi ng:
	857	B BILLING RE QUESTS
	858	R REVERSALS
	859	A ALL
	860	Select Sub mission Ty pe: A// <E nter> LL
	861	View rejec ted claims , payable claims or all claims .
	862	Example 5. 1-12: Sel ecting Vie ws of Clai m Status
	863	Selec t one of t he followi ng:
	864	R REJECTS
	865	P PAYABLES
	866	U UNSTRANDED
	867	A ALL
	868	Display (R )ejects or (P)ayable s or (U)ns tranded or (A)LL: R/ / R REJE CTS
	869	View relea sed claims , non-rele ased claim s or all c laims.
	870	Example 5. 1-13: Sel ecting Vie ws of Rele ased Claim s
	871	Selec t one of t he followi ng:
	872	R RELEASED
	873	N NON-RELEAS ED
	874	A ALL
	875	Display (R )eleased R xs or (N)o n-Released Rxs or (A )LL: A// R ELEASED
	876	View CMOP, Mail, Win dow or all claims.
	877	Example 5. 1-14: Sel ecting Vie ws of CMOP Claims
	878	Selec t one of t he followi ng:
	879	C CMOP
	880	M MAIL
	881	W WINDOW
	882	A ALL
	883	Display (C )MOP or (M )ail or (W )indow or (A)LL: A// CMOP
	884	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.
	885	Example 5. 1-15: Sel ecting Vie ws of Bill Types
	886	Select one of the fo llowing:
	887	R REALTIME
	888	B BACKBILLS
	889	P PRO OPTION
	890	S RESUBMISSI ON
	891	A ALL
	892	Display (R )ealTime F ills or (B )ackbills or (P)RO O ption or ( A)LL: A// REALTIME
	893	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.
	894	Example 5. 1-16: Sel ecting Vie ws of One Reject Cod e
	895	Selec t one of t he followi ng:
	896	R REJECT COD E
	897	A ALL
	898	Display Sp ecific (R) eject Code or (A)LL: A// REJEC T CODE
	899	Select Rej ect Code: 29 M /I Number Refills Au thorized
	900	View data for a spec ific insur ance compa ny or all insurance companies.
	901	Example 5. 1-17: Sel ecting Vie ws by a Sp ecific Ins urance Com pany
	902	Selec t one of t he followi ng:
	903	I SPECIFIC I NSURANCES( S)
	904	A ALL
	905	Select Cer tain (I)NS URANCE or (A)LL): I/ / <Enter> SPECIFIC INSURANCES (S)
	906	Selected : OPINSUR2
	907	Select INS URANCE: DE VELOPMENT INS 123 HERE S TREET SAN FR ANCISCO
	908	CALIFORN IA Y
	909	Selected : DEVELOPM ENT INS
	910	OPINSUR2
	911	Select INS URANCE: OP INSUR2 25 INS WAY BIRM ALABAMA Y
	912	Selec t one of t he followi ng:
	913	Y YES
	914	N NO
	915	Delete OPI NSUR2 from your list ?: NO// y YES
	916	Selected : DEVELOPM ENT INS
	917	Select INS URANCE:
	918	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.
	919	Example 5. 1-18: Ent ering “Y” to Save Se lections a s User’s P referred V iew
	920	DO YOU WAN T TO SAVE THIS VIEW AS YOUR PR EFERRED VI EW (Y/N)?: YES
	921	Updating s creen...
	922	Once your view has b een change d and no l onger matc hes your p referred v iew, the C hange View action wi ll allow y ou to reve rt back to your pref erred view .
	923	Example 5. 1-19: Ent ering “Y” to Save Se lections a s User’s P referred V iew
	924	Restore yo ur Preferr ed View an d exit Cha nge View ( Y/N)? Y//
	925	Updating s creen...
	926	5.2 Sort L ist XE " S ort List"
	927	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.
	928	Sort Order (Defaults );
	929	T
	930	Transactio n Date/Tim e
	931
	932
	933	(descendin g)
	934	D
	935	Division
	936
	937
	938
	939	(ascending )
	940	I
	941	Insurance Company
	942
	943
	944	(ascending )
	945	C
	946	Reject Cod e
	947
	948
	949
	950	(ascending )
	951	P
	952	Patient Na me
	953
	954
	955
	956	(ascending )
	957	N
	958	Drug Name
	959
	960
	961
	962	(ascending )
	963
	964	B
	965	Bill Type [BB/P2/RT]
	966
	967
	968	(ascending )
	969	L
	970	Fill Locat ion
	971
	972
	973
	974	(ascending )
	975	R
	976	Released/N on-Release
	977
	978
	979	(ascending )
	980	A
	981	Active/Dis continued Rx
	982
	983	(ascending )
	984	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.
	985	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”.
	986	Example 5. 2-1: Acce ssing the Sort List Option
	987	PHARMACY E CME Apr 30, 20 05@09:10:1 8 Page: 1 of 2
	988	SELECTED D IVISION(S) : ALL
	989	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	990	Sor ted by: Pa tient Name
	991	# PATIEN T/DRUG/COM MENTS INSURANC E/NDC/RX#/ ECME# LOC /TYP RXINF
	992	6 ECMEpa tient,Two (XXXX) WEB MD / 89% Pb: 5 Rj:0 AcR v:0 RjRv:0
	993	6.1 FU ROSEMIDE 1 0MG/M 006 41-2312-25 04/21 100 004065$ 0 /000000504 691 W RT A C/R
	994	p-Pa yable
	995	6.2 CH OLESTYRAMI NE 4G 000 87-0580-01 04/21 100 004066$ 0 /000000504 692 W RT A C/R
	996	p-Re versal rej ected
	997	NN:T ransaction Rejected At Switch Or Interme diary
	998	NC16 -The clear inghouse d id not rep ly in time .
	999	7 ECMEpa tient,One (XXXX) WEBMD TE/ VET ALL payab le
	1000	+ Enter ?? f or more ac tions
	1001	CV Change View REV Reverse Pa yable Clai m FR Furt her Resear ch
	1002	SO Sort L ist RES Resubmit C laim VER View ePharmacy Rx
	1003	CMT Add/Vi ew Comment s CLO Close Clai m WRK Send to Workli st
	1004	Select Act ion: Next Screen//SO Sort Li st
	1005	Example 5. 2-2: Choo sing Patie nt as the User’s Sor t Preferen ce
	1006	Selec t one of t he followi ng:
	1007	T TRANSACTIO N DATE
	1008	D DIVISION
	1009	I INSURANCE
	1010	C REJECT COD E
	1011	P PATIENT NA ME
	1012	N DRUG NAME
	1013	B BILL TYPE (BB/P2/RT)
	1014	L FILL LOCAT ION
	1015	R RELEASED/N ON-RELEASE D
	1016	A ACTIVE/DIS CONTINUED
	1017	ENTER SORT TYPE: P// PATIENT N AME
	1018	Example 5. 2-3: Choo sing User’ s Sort Pre ference as the Prefe rred View
	1019	Selec t one of t he followi ng:
	1020	Y YES
	1021	N NO
	1022	DO YOU WAN T TO SAVE THIS VIEW AS YOUR PR EFERRED VI EW (Y/N)?: YES
	1023	Updating s creen...
	1024	5.3 Revers e Payable Claim XE " Reverse P ayable Cla im"
	1025	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.
	1026	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. ”
	1027	Access the action by entering REV at the “Select A ction:” pr ompt on th e ECME Use r Screen.
	1028	Example 5. 3-1: Acce ssing and Executing the Revers e Payable Claim Acti on
	1029	PHARMACY E CME Aug 10, 20 05@10:31:2 2 Page: 1 8 of 42
	1030	SELECTED D IVISION(S) : ALL
	1031	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	1032	Sor ted by: Pa tient Name
	1033	+# PATIEN T/DRUG/COM MENTS INSURANC E/NDC/RX#/ ECME# LOC /TYP RXINF
	1034	7 ECMEpa tient,One (XXXX) WE BMD TE/ VET A LL payable
	1035	7.1 AL BUTEROL IN HALER 555 55-4444-22 08/08 100 003744$ 0 /000000504 304 W RT A C/R
	1036	p-Pa yable
	1037	7.2 AC ETYLCYSTEI NE 20 000 87-0570-09 08/01 100 004054$ 0 /000000504 677 W RT A C/N
	1038	p-Pa yable
	1039	+ Enter ?? f or more ac tions
	1040	CV Change View REV Reverse Pa yable Clai m FR Furt her Resear ch
	1041	SO Sort L ist RES Resubmit C laim VER View ePharmacy Rx
	1042	CMT Add/Vi ew Comment s CLO Close Clai m WRK Send to Workli st
	1043	Select Act ion: Next Screen// R EV Rever se Payable Claim
	1044	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.
	1045	Example 5. 3-2: Ente ring the L ine Item f or a Claim with a Pa yable Seco ndary Clai m
	1046	1.12 FLU RAZEPAM 15 MG C 00140 -0065-14 0 3/04 10232 2$ 2/00000 0113596 W RT AC/R
	1047	cannot be Reversed i f the seco ndary clai m is payab le.
	1048	Please rev erse the s econdary c laim first .
	1049	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.
	1050	Example 5. 3-3: Ente ring the L ine Item f or the Cla im Reversa l Request
	1051	Enter the line numb ers for th e Payable claim(s) t o be Rever sed.
	1052	Select: 7 .1
	1053	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.
	1054	Example 5. 3-4: Typi ng Text fo r Required Reversal Reason
	1055	You've cho sen to REV ERSE the f ollowing p rescriptio n for ECME patient,Si x
	1056	7.1 AL BUTEROL IN HALER 555 55-4444-22 02/28 100 003744$ 0 /000000504 304 W RT A C/R
	1057	Enter REQU IRED REVER SAL REASON : RX IS FO R SC CONDI TION
	1058	This respo nse must h ave at lea st 0 chara cters and no more
	1059	than 60 ch aracters a nd must no t contain embedded u parrow
	1060	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.
	1061	Example 5. 3-5: Ente ring “Y” t o Continue Claim Rev ersal Requ est
	1062	Enter REQU IRED REVER SAL REASON : Drug is only billa ble throug h CMOP
	1063	Are you su re?(Y/N)? YES
	1064	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.
	1065	Example 5. 3-6: Ente ring “Y” t o Mark the Claim as Non-billab le
	1066	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
	1067	Select CLA IMS TRACKI NG NON-BIL LABLE REAS ONS NAME: ??
	1068	Choose from:
	1069	1 NOT INSURED
	1070	2 SC T REATMENT
	1071	3 AGEN T ORANGE
	1072	4 IONI ZING RADIA TION
	1073	5 SOUT HWEST ASIA
	1074	7 COVE RAGE CANCE LED
	1075	10 INVA LID PRESCR IPTION ENT RY
	1076	12 PRES CRIPTION D ELETED
	1077	13 PRES CRIPTION N OT RELEASE D
	1078	14 DRUG NOT BILLA BLE
	1079	21 MILI TARY SEXUA L TRAUMA
	1080	29 HEAD /NECK CANC ER
	1081	30 COMB AT VETERAN
	1082	33 90 D AY RX FILL NOT COVER ED
	1083	34 NOT A CONTRACT ED PROVIDE R
	1084	35 INVAL ID MULTIPL ES PER DAY SUPP
	1085	36 REFI LL TOO SOO N
	1086	37 INVA LID NDC FR OM CMOP
	1087	38 PRO JECT 112/S HAD
	1088	39 NON COVERED D RUG PER PL AN
	1089	40 FIL ING TIMEFR AME NOT ME T
	1090	61 NO PHARMACY C OVERAGE
	1091	85 NPI /TAXONOMY ISSUES
	1092	86 RX DUR REJECT
	1093	87 RX PRIOR AUTH NOT OBTAI NED
	1094	88 RX MEDICARE P ART D
	1095	89 RX DISCOUNT C ARD
	1096	91 DAT E OF BIRTH MISMATCH
	1097	999 OTH ER
	1098	Select CLA IMS TRACKI NG NON-BIL LABLE REAS ONS NAME: 2 SC TREA TMENT
	1099	Comment : RX IS FOR SC CONDIT ION
	1100	Are you su re (Y/N)? YES
	1101	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.
	1102	The system submits a claim rev ersal requ est to the payer for each sele cted claim .
	1103	Example 5. 3-7: Clai m Reversal Request i s Submitte d
	1104	Processing Primary c laim...
	1105	Claim Stat us:
	1106	Reversing. ..
	1107	IN PROGRES S-Building the trans action
	1108	IN PROGRES S-Transmit ting
	1109	IN PROGRES S-Parsing response
	1110	E REVERSAL ACCEPTED
	1111	Reversal A ccepted
	1112	1 claim re versal sub mitted.
	1113	Enter RETU RN to cont inue or '^ ' to exit:
	1114	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.
	1115	Example 5. 3-8: Acce pted Payab le Claim R eversal Re quest
	1116	PHARMACY E CME Aug 10, 20 05@10:31:2 2 Page: 1 8 of 42
	1117	SELECTED D IVISION(S) : ALL
	1118	Transmitte d by ALL u sers Activity Date Rang e: within the past X X day(s)
	1119	Sor ted by: Pa tient Name
	1120	+# PATIEN T/DRUG/COM MENTS INSURANC E/NDC/RX#/ ECME# LOC /TYP RXINF
	1121	7 ECMEPa tient,Six (XXXX) WE BMD TE/ VET A LL payable
	1122	7.1 AL BUTEROL IN HALER 555 55-4444-22 02/28 100 003744$ 0 /000000504 304 W RT D S/R
	1123	p-Re versal Acc epted
	1124	5.4 Resubm it Claim X E " Resubm it Claim"
	1125	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:
	1126	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.
	1127	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.
	1128	The Resubm it action is accesse d by enter ing RES at the “Sele ct Action: ” prompt o n the ECME User Scre en.
	1129	Example 5. 6-1: Acces sing and E xecuting t he Resubmi t Claim Ac tion
	1130	PHARMACY E CME Jul 22, 20 08@14:41:5 5 Page : 1 of 29
	1131	SELECTED D IVISION(S) : ALL
	1132	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	1133	Sorted by: Transa ction Date
	1134	# PATIEN T/DRUG/COM MENTS IN SURANCE/ND C/DOS/RX#/ ECME# LOC/TYP R XINF
	1135	1 ECMEpa tient,One (XXXX) OP INSUR1/ VE T Pb:2 Rj: 4 AcRv:4 R jRv:0
	1136	1.1 RE SERPINE 0. 1MG S 000 83-0035-40 07/19 100 598$ 1 /000000000 520 W RT A C/N
	1137	p-In progress- Waiting t o start
	1138	1.2 LI DOCAINE 0. 5% W/ 001 86-0140-01 07/19 100 704$ 1 /000000000 623 W RT A C/N
	1139	p-In progress- Transmitt ing
	1140	1.3 IM IPRAMINE 2 5MG T 007 79-0588-30 07/19 100 820$ 1 /000000000 740 W RT * */N
	1141	p-Re jected
	1142	07:M /I Cardhol der ID
	1143	1.4 FL URAZEPAM 1 5MG C 007 81-2806-05 07/18 100 948$ 0 /000000000 870 W RT * */N
	1144	p-Re jected
	1145	07:M /I Cardhol der ID
	1146	1.5 DA CARBAZINE 100MG 000 26-8151-10 07/21 100 958$ 2 /000000000 880 W RT * */N
	1147	p-Re versal acc epted
	1148	+ Enter ?? f or more ac tions
	1149	CV Change View REV Reverse Pa yable Clai m FR Furt her Resear ch
	1150	SO Sort L ist RES Resubmit C laim VER View ePharmacy Rx
	1151	CMT Add/Vi ew Comment s CLO Close Clai m WRK Send to Workli st
	1152	Select Act ion: Next Screen// r es Resub mit Claim
	1153	You are pr ompted for the line item(s) of the claim to be res ubmitted.
	1154	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
	1155	Enter the line numbe rs for the claim(s) to be resu bmitted.
	1156	Select ite m(s): 1.5
	1157	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.
	1158	Example 5. 4-3: Resu bmitting a Closed Cl aim
	1159	You've cho sen to RES UBMIT the following prescripti on
	1160	1.2 AM ITRIPTYLIN E HCL 006 03-2212-32 10/11 205 6098 0 /000001616 051 M RT D S/N
	1161	Are you su re?(Y/N)? y YES
	1162	>> Cannot Resubmit
	1163	1.2 AM ITRIPTYLIN E HCL 006 03-2212-32 10/11 205 6098 0 /000001616 051 M RT D S/N
	1164	because t he claim i s Closed. Reopen the claim and try again .
	1165	0 claims h ave been r esubmitted .
	1166	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.
	1167	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.
	1168	Example 5. 4-4: Enter ing the Li ne Item fo r a Claim that has a Payable S econdary C laim
	1169	The claim:
	1170	1.12 FLU RAZEPAM 15 MG C 00140 -0065-14 0 3/04 10232 2$ 2/00000 0113596 W RT AC/R
	1171	cannot be Resubmitte d if the s econdary c laim is pa yable.
	1172	Please rev erse the s econdary c laim first .
	1173	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.
	1174	Example 5. 4-5: Enter ing “Y” to Continue Claim Resu bmission R equest
	1175	You've cho sen to RES UBMIT the following prescripti on for ECM Epatient,O ne
	1176	100MG 000 26-8151-10 06/26 100 958$ 2 /000000000 880 W RT * */N
	1177	Are you su re?(Y/N)? y YES
	1178	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.
	1179	Example 5. 4-6: Ente ring “Y” t o Place Mu ltiple Sub missions i n the Queu e
	1180	The claim is in prog ress. The request wi ll be sche duled and processed after
	1181	the previo us request (s) are co mpleted. P lease be a ware that the result of
	1182	the resubm it depends on the pa yer's resp onse to th e prior in complete r equests.
	1183	Do you wan t to proce ed?(Y/N)? y YES
	1184	The claim resubmissi on request is submit ted and th e progress is displa yed.
	1185	Example 5. 4-7: Disp laying a S uccessfull y Resubmit ted Claim
	1186	Claim Stat us:
	1187	IN PROGRES S-Waiting to start
	1188	IN PROGRES S-Building the claim
	1189	IN PROGRES S-Transmit ting
	1190	E PAYABLE
	1191	Veteran Pr escription 100958 su ccessfully submitted to ECME f or claim g eneration.
	1192	1 claim ha s been res ubmitted.
	1193	Enter RETU RN to cont inue or '^ ' to exit: <ENTER>
	1194	Updating s creen for resubmitte d claims.. .
	1195	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.
	1196	Example 5. 4-8: Displ aying the Claim Stat us after a Resubmiss ion
	1197	PHARMACY E CME Jul 12, 20 08@14:42:4 6 Page : 1 of 29
	1198	SELECTED D IVISION(S) : ALL
	1199	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	1200	Sorted by: Transa ction Date
	1201	# PATIEN T/DRUG/COM MENTS IN SURANCE/ND C/DOS/RX#/ ECME# LOC/TYP R XINF
	1202	1 ECMEpa tient,One (XXXX) OP INSUR1/ VE T Pb:2 Rj: 4 AcRv:4 R jRv:0
	1203	1.1 RE SERPINE 0. 1MG S 000 83-0035-40 07/09 100 598$ 1 /000000000 520 W RT A C/N
	1204	p-In progress- Waiting t o start
	1205	1.2 LI DOCAINE 0. 5% W/ 001 86-0140-01 07/09 100 704$ 1 /000000000 623 W RT A C/N
	1206	p-In progress- Waiting t o start
	1207	1.3 IM IPRAMINE 2 5MG T 007 79-0588-30 07/09 100 820$ 1 /000000000 740 W RT * */N
	1208	p-Re jected
	1209	07:M /I Cardhol der ID
	1210	1.4 FL URAZEPAM 1 5MG C 007 81-2806-05 07/08 100 948$ 0 /000000000 870 W RT * */N
	1211	p-Re jected
	1212	07:M /I Cardhol der ID
	1213	1.5 DA CARBAZINE 100MG 000 26-8151-10 07/06 100 958$ 2 /000000000 880 W RS * */N
	1214	p-Pa yable
	1215	+ Enter ?? f or more ac tions
	1216	CV Change View REV Reverse Pa yable Clai m FR Furt her Resear ch
	1217	SO Sort L ist RES Resubmit C laim VER View ePharmacy Rx
	1218	CMT Add/Vi ew Comment s CLO Close Clai m WRK Send to Workli st
	1219	Select Act ion: Next Screen//
	1220	5.5 Close Claim XE " Close Cla im"
	1221	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” .
	1222	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.”
	1223	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.
	1224	PHARMACY E CME Jul 15, 20 14@18:43:0 2 Page: 1 of 1
	1225	SELECTED D IVISION(S) : GENERIC CITY
	1226	Transmitte d by Trans mitter, Pe rson Ac tivity Dat e Range: w ithin the past 365 d ay(s)
	1227	Sorted b y: Transac tion date by default
	1228	# PATIEN T/DRUG/COM MENTS IN SURANCE/ND C/DOS/RX#/ ECME# STATUS/LOC /TYP/RXINF
	1229	1
	1230	1.1 AB ACAVIR SUL FATE 0017 3066101 07 /15 ###### #0/00000## #7412 M RT SU/N
	1231	07/1 5/14 - IGN ORED - tes t of cmop
	1232	p-Re jected
	1233	NN:T ransaction Rejected At Switch Or Interme diary
	1234	NC16 -The clear inghouse d id not rep ly in time .
	1235	Enter ?? f or more ac tions
	1236	CV Change View REV Reverse Pa yable Clai m FR Furt her Resear ch
	1237	SO Sort L ist RES Resubmit C laim VER View ePharmacy Rx
	1238	CMT Add/Vi ew Comment s CLO Close Clai m WRK Send to Workli st
	1239	Select Act ion: Quit/ /CLO
	1240	Enter the line numbe rs for the claim(s) to be clos ed.
	1241	Select ite m(s): 1.1
	1242	You've cho sen to clo se the fol lowing pre scription( s) for
	1243	Oppatient, ONE :
	1244	1.1 AB ACAVIR SUL FATE 0017 3066101 07 /15 ###### #0/00000## #7412 M RT SU/N
	1245	NN:T ransaction Rejected At Switch Or Interme diary
	1246	NC16 -The clear inghouse d id not rep ly in time .
	1247	ALL Select ed Rxs wil l be CLOSE D using th e same inf ormation g athered in the
	1248	following prompts.
	1249	Are you su re?(Y/N)? y YES
	1250	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.
	1251	PHARMACY E CME Jul 15, 20 14@18:43:0 2 Page: 1 of 1
	1252	SELECTED D IVISION(S) : GENERIC CITY
	1253	Transmitte d by Trans mitter, Pe rson Ac tivity Dat e Range: w ithin the past 365 d ay(s)
	1254	Sorted b y: Transac tion date by default
	1255	# PATIEN T/DRUG/COM MENTS IN SURANCE/ND C/DOS/RX#/ ECME# STATUS/LOC /TYP/RXINF
	1256	1
	1257	1.1 AB ACAVIR SUL FATE 0017 3066101 07 /15 ###### #0/00000## #7412 M RT SU/N
	1258	07/1 5/14 - IGN ORED - tes t of cmop
	1259	p-Re jected
	1260	NN:T ransaction Rejected At Switch Or Interme diary
	1261	NC16 -The clear inghouse d id not rep ly in time .
	1262	Enter ?? f or more ac tions
	1263	CU Contin uous Updat e REV Reverse Pa yable Clai m FR Furt her Resear ch
	1264	UD Displa y Update RES Resubmit C laim LOG Prin t Claim Lo g
	1265	CV Change View CLO Close Clai m WRK Send to Workli st
	1266	SO Sort L ist CMT Add/View C omments EX Exit
	1267	Select Act ion: Quit/ /
	1268	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.
	1269	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.
	1270	Example 5. 5-1: Enter ing a Pres cription L ine Item t o Close On e Rejected Claim
	1271	PHARMACY E CME Aug 02, 20 05@12:19 Page: 1 of 7 0
	1272	SELECTED D IVISION(S) : ALL
	1273	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	1274	Sor ted by: Pa tient Name
	1275	# PATIEN T/DRUG/COM MENTS INSURANC E/NDC/RX#/ ECME# LOC/TYP RXINF
	1276	7 ECMEpa tient,Two (XXXX) WEB MD / VET Pb :3 Rj:1 Ac Rv:0 RjRv: 0
	1277	7.1 DE SIPRAMINE 25MG T 000 68-0011-10 08/02 100 003962$ 0 /000000504 559 W RT * */N
	1278	p-Re jected
	1279	07:M /I Cardhol der ID Num ber
	1280	22:M /I Dispens e As Writt en(DAW)/Pr oduct Sele ction Code
	1281	34:M /I Submiss ion Clarif ication Co de
	1282	7.2 CO DEINE SULF ATE 30 000 02-1010-02 08/02 100 82$ 0 /000000504 561 W RT E X/N
	1283	p-Re jected
	1284	07:M /I Cardhol der ID Num ber
	1285	23:M /I Ingredi ent Cost S ubmitted
	1286	8 ECMEpat ient,Two (XXXX) WEB MD / VET AL L payable
	1287	8.1 TE STOSTERONE ENTH. 000 03-0328-40 07/30 90 9238$ 0/00000110 5472 M RT AC/N
	1288	p-Pa yable
	1289	+ Enter ?? f or more ac tions
	1290	CV Change View REV Reverse Pa yable Clai m FR Furt her Resear ch
	1291	SO Sort L ist RES Resubmit C laim VER View ePharmacy Rx
	1292	CMT Add/Vi ew Comment s CLO Close Clai m WRK Send to Workli st
	1293	Select Lin e Item(s): Next Scre en// CLO Close Cla im
	1294	Enter the line numbe rs for the claim(s) to be clos ed.
	1295	Select Lin e Item(s): 7.1
	1296	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.
	1297	Example 5. 5-2: Ente ring “Y” t o Continue Close Cla im Request
	1298	You've cho sen to clo se the fol lowing pre scription( s) for
	1299	ECMEpatien t,Two:
	1300	7.1 DE SIPRAMINE 25MG T 000 68-0011-10 03/20 100 003962$ 0 /000000504 559 W RT * */N
	1301	07:M /I Cardhol der ID Num ber
	1302	22:M /I Dispens e As Writt en(DAW)/Pr oduct Sele ction Code
	1303	34:M /I Submiss ion Clarif ication Co de
	1304	ALL Select ed Rxs wil l be CLOSE D using th e same inf ormation g athered in the follo wing promp ts.
	1305	Are you su re?(Y/N)? YES
	1306	You are pr ompted for a non-bil lable reas on code.
	1307	Example 5. 5-3: List ing Non-Bi llable Rea son Codes
	1308	PHARMACY E CME Aug 12, 20 05@12:19 Pa ge: 1 o f 70
	1309	Select CLA IMS TRACKI NG NON-BIL LABLE REAS ONS NAME: ??
	1310	Choose from:
	1311	1 NOT INSURED
	1312	2 SC T REATMENT
	1313	3 AGEN T ORANGE
	1314	4 IONI ZING RADIA TION
	1315	5 SOUT HWEST ASIA
	1316	7 COVE RAGE CANCE LED
	1317	10 INVA LID PRESCR IPTION ENT RY
	1318	12 PRES CRIPTION D ELETED
	1319	13 PRES CRIPTION N OT RELEASE D
	1320	14 DRUG NOT BILLA BLE
	1321	21 MILI TARY SEXUA L TRAUMA
	1322	29 HEAD /NECK CANC ER
	1323	30 COMB AT VETERAN
	1324	33 90 D AY RX FILL NOT COVER ED
	1325	34 NOT A CONTRACT ED PROVIDE R
	1326	35 INVA LID MULTIP LES PER DA Y SUPP
	1327	36 REFI LL TOO SOO N
	1328	37 INVA LID NDC FR OM CMOP
	1329	38 PROJ ECT 112/SH AD
	1330	39 NON COVERED DR UG PER PLA N
	1331	40 FILI NG TIMEFRA ME NOT MET
	1332	61 NO P HARMACY CO VERAGE
	1333	85 NPI/ TAXONOMY I SSUES
	1334	86 RX D UR REJECT
	1335	87 RX P RIOR AUTH NOT OBTAIN ED
	1336	88 RX M EDICARE PA RT D
	1337	89 RX D ISCOUNT CA RD
	1338	91 DATE OF BIRTH MISMATCH
	1339	999 OTHE R
	1340	Select CLA IMS TRACKI NG NON-BIL LABLE REAS ONS NAME: 61 NO PHA RMACY COVE RAGE
	1341	You are p rompted fo r a commen t (explana tion), and again whe ther you w ant to con tinue.
	1342	Example 5. 5-4: Ente ring a Com ment and A nswering ‘ Are You Su re?’ Quest ion
	1343	Comment : ECME Rejec t: Insuran ce does no t cover Rx s
	1344	Are you su re?(Y/N)? YES
	1345	Closing Cl aim VA2006 =1712884=0 00010=0006 693...OK
	1346	1 claim ha s been clo sed.
	1347	Enter RETU RN to cont inue or '^ ' to exit: <Enter>
	1348	Updating s creen for closed cla ims...
	1349	5.5.1 Vari ations to the Close claim proc ess. XE " Variation s to the C lose claim process"
	1350	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”.
	1351	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.
	1352	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.
	1353	Example 5. 5.1-1: Cl osing a Pr escription
	1354	You've cho sen to clo se the fol lowing pre scription( s) for
	1355	ECMEPatien t,FIVE :
	1356	4.1 CO LCHICINE 0 .6MG 0007 4378101 06 /24 101297 $ 1/00 0000001653 M RT DS/N
	1357	ALL Select ed Rxs wil l be CLOSE D using th e same inf ormation g athered in the
	1358	following prompts.
	1359	Are you su re?(Y/N)? YES
	1360	Select CLA IMS TRACKI NG NON-BIL LABLE REAS ONS NAME: OTHER
	1361	Selec t one of t he followi ng:
	1362	N NON-BILLAB LE
	1363	D DROP TO PA PER
	1364	Treat as ( N)on-Billa ble Episod e or (D)ro p Bill to Paper?: NO N-BILLABLE
	1365	Comment : Insurance does not cover Rxs
	1366	Release Pa tient CoPa y(Y/N)? YE S
	1367	Are you su re?(Y/N)? NO
	1368	Example 5. 5.1-2: En tering Non -Billable Episode fo r Reason C ode 31
	1369	Select CLA IMS TRACKI NG NON-BIL LABLE REAS ONS NAME: 31 90 DAY RX FILL N OT COVERED
	1370	Selec t one of t he followi ng:
	1371	N NON-BILLA BLE
	1372	D DROP TO P APER
	1373	Treat as ( N)on-Billa ble Episod e or (D)ro p Bill to Paper?: Se lect: N No n-billable
	1374	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 (^ ).
	1375	Example 5. 5.1-3: En tering a C omment
	1376	Comment : ECME Rejec t: Plan do es not cov er 90-day fills
	1377	You can e nter Y or N to choos e to conti nue the cl ose claim request or not.
	1378	Example 5. 5.1-4: Ent ering “Y” to Continu e Close Cl aim Reques t
	1379	Are you su re?(Y/N)? Y YES
	1380	If the Rx# display i s followed by a “$”, the ECME user is gi ven the fo llowing pr ompt to an swer wheth er the pat ient copay can be re leased als o or not. If you sel ect Y, the patient c opay bill will be au tomaticall y removed from hold status for ALL selec ted claims .
	1381	Example 5. 5.1-5: Rel easing Pat ient Copay
	1382	Release Pa tient CoPa y(Y/N)? Y YES
	1383	When the c laim is su ccessfully closed, t he display shows tha t the tran saction we nt through “OK” and states tha t the clai m was clos ed.
	1384	Example 5. 5.1-6: Di splaying S ystem Clos ing the Cl aim
	1385	Closing Cl aim VA2005 -1111111-1 23456-0000 501...OK
	1386	1 claim ha s been clo sed.
	1387	Enter RET URN to con tinue or ' ^' to exit :/ <Enter>
	1388	Updating s creen for closed cla ims...
	1389	The closed claim tra nsaction m ay no long er be disp layed with the patie nt’s other prescript ion line i tems depen ding on th e filters set in Cha nge View. The system will noti fy Integra ted Billin g of the c losed clai m so that Claims Tra cking can be updated .
	1390	Example 5. 5.1-7: Clo sed Item i s No Longe r Displaye d
	1391	PHARMACY E CME Aug 12, 20 05@13:13:1 5 Page : 1 of 69
	1392	SELECTED D IVISION(S) : ALL
	1393	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	1394	Sor ted by: Pa tient Name
	1395	# PATIEN T/DRUG/COM MENTS INSURANC E/NDC/RX#/ ECME# LOC/TYP RXINF
	1396	7 ECMEpa tient,Two (XXXX) WEB MD / VET P b:3 Rj:1 A cRv:0 RjRv :0
	1397	7.1 CO DEINE SULF ATE 30 000 02-1010-02 08/03 100 82$ 0 /000000504 561 W RT E X/N
	1398	p-Re jected
	1399	07:M /I Cardhol der ID Num ber
	1400	23:M /I Ingredi ent Cost S ubmitted
	1401	8 ECMEpat ient, Thre e (XXXX ) WEBMD / VET A LL payable
	1402	8.1 TE STOSTERONE ENTH. 000 03-0328-40 08/03 90 9238$ 0/00000110 5472 M RT AC/N
	1403	p-Pa yable
	1404	9 ECMEpat ient,22 (XXXX) WE BMD / VET A LL payable
	1405	9.1 HY DROCODONE 5/ACET 557 78-8998-88 08/12 909 254$ 1 /000001105 496 C RT A C/N
	1406	+ Enter ?? f or more ac tions
	1407	5.5.2 Spec ial Notes regarding secondary claims XE " Variati ons to the Close cla im process "
	1408	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.
	1409	Example 5. 5.2-1: Sec ondary Ins urance Not ification
	1410	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.
	1411	Patient: EC MEpatient, One
	1412	Date of se rvice: JU N 29, 2010
	1413	Insurance: EC MEInsuranc e,One
	1414	Group numb er: 10 001
	1415	BISOPROL OL 2.5MG/ 51285-004 7-02 06/29 2055810$ 0/00000 1615758 W RT AC/R
	1416	Do you wan t to print the infor mation (ab ove) conce rning addi tional ins urance?
	1417	(Y/N)? n NO
	1418	5.6 Add/Vi ew Comment s XE " Add /View Comm ents"
	1419	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.
	1420	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 .
	1421	Example 5. 6-1: Enter ing a Pres cription L ine Item t o Add a Co mment
	1422	PHARMACY E CME Jul 02, 20 05@22:19 Page: 1 of 7 0
	1423	SELECTED D IVISION(S) : ALL
	1424	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	1425	Sor ted by: Pa tient Name
	1426	# PATIEN T/DRUG/COM MENTS INSURANC E/NDC/RX#/ ECME# LOC/TYP RXINF
	1427	1 ECMEpa tient,Two (XXXX) WEB MD / VET Pb :3 Rj:1 Ac Rv:0 RjRv: 0
	1428	1.1 TA MOXIFEN CI TRATE 000 93-0784-86 07/01 909 392$ 0 /000001105 634 W ** D S/R
	1429	p-Re jected
	1430	NN:T ransaction Rejected At Switch Or Interme diary
	1431	NC40 -Request f rom an unk nown site. Registrat ion is req uired
	1432	1.2 DE SIPRAMINE HCL 25 000 68-0011-10 07/01 909 393$ 0 /000001105 635 W ** A C/R
	1433	p-Pa yable
	1434	1.3 DI AZEPAM 5MG /ML IN 001 40-1933-06 07/01 909 394$ 0 /000001105 636 W ** A C/N
	1435	p-Pa yable
	1436	+ Enter ?? f or more ac tions
	1437	CV Change View REV Reverse Pa yable Clai m FR Furt her Resear ch
	1438	SO Sort L ist RES Resubmit C laim VER View ePharmacy Rx
	1439	CMT Add/Vi ew Comment s CLO Close Clai m WRK Send to Workli st
	1440	Select Act ion: Next Screen// C MT Add/V iew Commen ts
	1441	Enter the line numbe r for whic h you wish to Add/Vi ew comment s.
	1442	Select: 1. 2
	1443	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
	1444	Example 5. 6-2: Displ aying the Prescripti on Line It em to Add a Comment or Quit
	1445	O Add OP ECC Commen t EX Exit
	1446	P Add Ph armacy/OPE CC Comment
	1447	Select act ion: Next Screen// O Add OPE CC Comment
	1448	Enter the line numbe r for whic h you wish to Add co mments.
	1449	Select ite m: 12.1//
	1450	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.
	1451	Example 5. 6-3: Addin g a commen t to a Pre scription Line Item
	1452	Enter Comm ent: This shows a te st comment line for a prescrip tion line item.
	1453	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.
	1454	Example 5. 6-4: Displ aying the Added Comm ent and Pr ompting fo r Another
	1455	ADD/VIEW C OMMENTS Jul 02, 20 05@22:19 Page: 1 of 1
	1456	PHARMACY E CME
	1457	SELECTED D IVISION(S) : ALL
	1458	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	1459	# PATIEN T/DRUG/COM MENTS INSURANC E/NDC/RX#/ ECME# LOC/TYP RXINF
	1460	1.1 DE SIPRAMINE HCL 25 000 68-0011-10 07/01 909 393$ 0 /000001105 635 W ** A C/R
	1461	08/1 5/05 - Thi s shows a test comme nt line fo r a prescr iption lin e item.
	1462	(LAS T,FIRST NA ME)
	1463	p-Payable
	1464	07/ 11/15 (Pha rm) - TEST COMMENT F OR PHARMAC Y/OPECC CO MMENT
	1465	(LAS T,FIRST NA ME)
	1466	p-P ayable
	1467	Enter ?? f or more ac tions
	1468	O Add OP ECC Commen t EX Exit
	1469	P Add Ph armacy/OPE CC Comment
	1470
	1471	Select act ion: Next Screen//
	1472	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”.
	1473	5.7 Furthe r Research Screen XE " Further Research Screen"
	1474	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.
	1475	Enter FR a t the “Sel ect Action :” prompt on the ECM E User Scr een.
	1476	Example 5. 7-1: Acces sing the F urther Res earch Acti on
	1477	PHARMACY E CME July 26, 2 005@11:31: 22 Page: 18 of 42
	1478	SELECTED D IVISION(S) : ALL
	1479	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	1480	Sor ted by: Pa tient Name
	1481	+# PATIEN T/DRUG/COM MENTS INSURANC E/NDC/RX#/ ECME# LOC /TYP RXINF
	1482	16 ECMEpa tient,One (XXXX ) WEBMD / VE T ALL pay able
	1483	16.1 ET ANERCEPT 2 5MG/VI 584 06-0425-34 07/22 909 504$ 0 /000001105 747 M RT A C/N
	1484	p-Pa yable
	1485	16.2 ET ANERCEPT 2 5MG/VI 584 06-0425-34 07/22 909 504$ 1 /000001105 747 M RT A C/N
	1486	p-Pa yable
	1487	16.3 DI VALPROEX 1 25MG T 000 74-6212-13 07/22 909 505$ 0 /000001105 748 M RT A C/N
	1488	p-Pa yable
	1489	16.4 CO LLAGENASE OINT 504 84-0527-30 07/22 909 506$ 0 /000001105 749 M RT A C/N
	1490	p-Pa yable
	1491	16.5 NA FCILLIN 1 GM. IN 002 09-6950-22 07/22 909 507$ 0 /000001105 750 M RT A C/N
	1492	p-Pa yable
	1493	+ Enter ?? for more actions
	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// F R Further Research
	1498	The system re-displa ys the ECM E User Scr een with m ultiple ne w “Researc h” options .
	1499	Example 5. 7-2: Displ aying Mult iple Furth er Researc h Menu Opt ions
	1500	FURTHER RE SEARCH SCR EEN Nov 03, 20 10@15:27:5 4 Page: 1 of 30
	1501	SELECTED D IVISION(S) : ALL
	1502	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	1503	Sorted b y: Transac tion date by default
	1504	# PATIEN T/DRUG/COM MENTS IN SURANCE/ND C/DOS/RX#/ ECME# S TATUS/LOC/ TYP/RXINF
	1505	1 ECMEPa tient,SIX (XXXX) OPI NSUR2/2055 557898 VET Pb:10 Rj:2 AcRv :0 RjRv:1
	1506	1.1 SI METHICONE 40MG 0258 7542934 10 /06 110033 5$ 0/00 0000003119 W RT AC/R
	1507	p-Re jected
	1508	85:C laim Not P rocessed
	1509	NN:T ransaction Rejected At Switch Or Interme diary
	1510	02:M /I Version /Release N umber
	1511	EV11 7-D0 IS IN VALID VERS ION NUMBER
	1512	1.2 TR IAMTERENE 50MG, 0048 4359030 10 /26 110033 6$ 0/00 0000003120 W RT DS/R
	1513	p-Re versal Oth er
	1514	1.3 AM YL NITRITE 0.3M 0022 3700212 10 /27 110033 7$ 0/00 0000003122 W RT DS/R
	1515	p-Re versal Oth er
	1516	1.4 TR IAMTERENE 50MG, 0048 4359030 10 /27 110033 9$ 0/00 0000003124 W RT AC/R
	1517	p-Pa yable
	1518	+ Enter ?? f or more ac tions
	1519	INS Insur ance detai ls CT Claims Tr acking EVNT IB Events Rep ort
	1520	VE View Eligibilit y TPJI Third Par ty Inquiry GRPL Gro up Plan Me nu
	1521	VP View Prescripti on OH On Hold C opay List EX Exi t
	1522	CMT Add/V iew Commen ts RH Release C opay
	1523	Select act ion:Next S creen//
	1524	5.7.1 Insu rance Deta ils XE "In surance De tails"
	1525	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.
	1526	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.
	1527	Example 5. 7.1-1: Acc essing Ins urance Det ails Optio n
	1528	FURTHER RE SEARCH SCR EEN Nov 03, 20 10@15:27:5 4 Page: 1 of 30
	1529	SELECTED D IVISION(S) : ALL
	1530	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	1531	Sorted b y: Transac tion date by default
	1532	# PATIEN T/DRUG/COM MENTS IN SURANCE/ND C/DOS/RX#/ ECME# S TATUS/LOC/ TYP/RXINF
	1533	1 ECMEPa tient,SIX (XXXX) OPI NSUR2/2055 557898 VET Pb:10 Rj:2 AcRv :0 RjRv:1
	1534	1.1 SI METHICONE 40MG 0258 7542934 10 /06 110033 5$ 0/00 0000003119 W RT AC/R
	1535	p-Re jected
	1536	85:C laim Not P rocessed
	1537	NN:T ransaction Rejected At Switch Or Interme diary
	1538	02:M /I Version /Release N umber
	1539	EV11 7-D0 IS IN VALID VERS ION NUMBER
	1540	1.2 TR IAMTERENE 50MG, 0048 4359030 10 /26 110033 6$ 0/00 0000003120 W RT DS/R
	1541	p-Re versal Oth er
	1542	1.3 AM YL NITRITE 0.3M 0022 3700212 10 /27 110033 7$ 0/00 0000003122 W RT DS/R
	1543	p-Re versal Oth er
	1544	1.4 TR IAMTERENE 50MG, 0048 4359030 10 /27 110033 9$ 0/00 0000003124 W RT AC/R
	1545	p-Pa yable
	1546	+ Enter ?? f or more ac tions
	1547	INS Insur ance detai ls CT Claims Tr acking EVNT IB Events Rep ort
	1548	VE View Eligibilit y TPJI Third Par ty Inquiry GRPL Gro up Plan Me nu
	1549	VP View Prescripti on OH On Hold C opay List EX Exi t
	1550	CMT Add/V iew Commen ts RH Release C opay
	1551	Select act ion:Next S creen// IN S Insuran ce details
	1552	Please sel ect a SING LE Patient Line item for viewi ng Insuran ce
	1553	Select ite m: 1.4
	1554	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.
	1555	Example 5. 7.1-2: Di splaying I nsurance D etails Act ions
	1556	Patient In surance In formation Aug 09, 20 06@12:56:4 9 Page: 1 of 1
	1557	Insurance Management for Patie nt: ECMEpa tient,One 0000
	1558	Insura nce Co. Ty pe of Poli cy Group Ho lder Eff ect. Expir es
	1559	1 WEBMD PRESCRIPT ION 10 000 SELF 01/01/00
	1560	Enter ?? f or more ac tions >>>
	1561	VP View P olicy Info BU Benefits U sed EX Exit
	1562	AB Annual Benefits INS View Insur ance Co.
	1563	Select Act ion:Quit// QUIT
	1564	5.7.2 View Eligibili ty XE " Vi ew Eligibi lity"
	1565	The View E ligibility action al lows you t o view the Patient E ligibility Screen.
	1566	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 .
	1567	Example 5. 7.2-1: Acc essing Vie w Eligibil ity Option
	1568	FURTHER RE SEARCH SCR EEN Nov 03, 20 10@15:27:5 4 Page: 1 of 30
	1569	SELECTED D IVISION(S) : ALL
	1570	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	1571	Sorted b y: Transac tion date by default
	1572	# PATIEN T/DRUG/COM MENTS IN SURANCE/ND C/DOS/RX#/ ECME# S TATUS/LOC/ TYP/RXINF
	1573	1 ECMEPa tient,SIX (XXXX) OPI NSUR2/2055 557898 VET Pb:10 Rj:2 AcRv :0 RjRv:1
	1574	1.1 SI METHICONE 40MG 0258 7542934 10 /06 110033 5$ 0/00 0000003119 W RT AC/R
	1575	p-Re jected
	1576	85:C laim Not P rocessed
	1577	NN:T ransaction Rejected At Switch Or Interme diary
	1578	02:M /I Version /Release N umber
	1579	EV11 7-D0 IS IN VALID VERS ION NUMBER
	1580	1.2 TR IAMTERENE 50MG, 0048 4359030 10 /26 110033 6$ 0/00 0000003120 W RT DS/R
	1581	p-Re versal Oth er
	1582	1.3 AM YL NITRITE 0.3M 0022 3700212 10 /27 110033 7$ 0/00 0000003122 W RT DS/R
	1583	p-Re versal Oth er
	1584	1.4 TR IAMTERENE 50MG, 0048 4359030 10 /27 110033 9$ 0/00 0000003124 W RT AC/R
	1585	p-Pa yable
	1586	+ Enter ?? f or more ac tions
	1587	INS Insur ance detai ls CT Claims Tr acking EVNT IB Events Rep ort
	1588	VE View Eligibilit y TPJI Third Par ty Inquiry GRPL Gro up Plan Me nu
	1589	VP View Prescripti on OH On Hold C opay List EX Exi t
	1590	CMT Add/V iew Commen ts RH Release C opay
	1591	Select act ion:Next S creen// VE View El igibility
	1592	Please sel ect a SING LE Patient Line item for viewi ng Eligibi lity
	1593	Select ite m: 1.4
	1594	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.
	1595	Example 5. 7.2-2: Di splaying V iew Eligib ility Opti ons.
	1596	Patient El igibility Aug 15, 20 05@11:14:1 2 Page: 1 of 1
	1597	ECMEPat ient,Six 5959 DOB: 01/02/66
	1598	Means T est: YES Ins ured: Yes
	1599	Date of T est: 07/29 /05 A/O Expo sure:
	1600	Co-pay E xemption T est: Rad. Expo sure:
	1601	Date of T est:
	1602	Patient ha s agreed t o pay dedu ctible
	1603	Prima ry Elig. C ode: NSC
	1604	Serv ice Connec ted: No
	1605	Rated Disabilit ies: None
	1606	Enter ?? f or more ac tions
	1607	EX Exit
	1608	Select Act ion: Quit/ /
	1609	5.7.3 View Prescript ion XE " V iew Prescr iption"
	1610	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.
	1611	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.
	1612	Example 5. 7.3-1: Acc essing Vie w Prescrip tion Actio n
	1613	FURTHER RE SEARCH SCR EEN Nov 03, 20 10@15:27:5 4 Page: 1 of 30
	1614	SELECTED D IVISION(S) : ALL
	1615	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	1616	Sorted b y: Transac tion date by default
	1617	# PATIEN T/DRUG/COM MENTS IN SURANCE/ND C/DOS/RX#/ ECME# S TATUS/LOC/ TYP/RXINF
	1618	1 ECMEPa tient,SIX (XXXX) OPI NSUR2/2055 557898 VET Pb:10 Rj:2 AcRv :0 RjRv:1
	1619	1.1 SI METHICONE 40MG 0258 7542934 10 /06 110033 5$ 0/00 0000003119 W RT AC/R
	1620	p-Re jected
	1621	85:C laim Not P rocessed
	1622	NN:T ransaction Rejected At Switch Or Interme diary
	1623	02:M /I Version /Release N umber
	1624	EV11 7-D0 IS IN VALID VERS ION NUMBER
	1625	1.2 TR IAMTERENE 50MG, 0048 4359030 10 /26 110033 6$ 0/00 0000003120 W RT DS/R
	1626	p-Re versal Oth er
	1627	1.3 AM YL NITRITE 0.3M 0022 3700212 10 /27 110033 7$ 0/00 0000003122 W RT DS/R
	1628	p-Re versal Oth er
	1629	1.4 TR IAMTERENE 50MG, 0048 4359030 10 /27 110033 9$ 0/00 0000003124 W RT AC/R
	1630	p-Pa yable
	1631	+ Enter ?? f or more ac tions
	1632	INS Insur ance detai ls CT Claims Tr acking EVNT IB Events Rep ort
	1633	VE View Eligibilit y TPJI Third Par ty Inquiry GRPL Gro up Plan Me nu
	1634	VP View Prescripti on OH On Hold C opay List EX Exi t
	1635	CMT Add/V iew Commen ts RH Release C opay
	1636	Select act ion:Next S creen// VP View Pr escription
	1637	Please sel ect a SING LE Rx Line item for viewing a Prescripti on
	1638	Select ite m: 1.4
	1639	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 .
	1640	Example 5. 7.3-2: Di splaying V iew Prescr iption Opt ions.
	1641	Rx Activit y Log Nov 03, 20 XX@15:27:5 4 Page: 1 of 5
	1642	ECMEPatie nt,Six
	1643	PID: XXX X Ht(cm): _______ ( ______)
	1644	DOB: MAY X,XXXX (X X) Wt(kg): _ ______ (__ ____)
	1645	Rx # : XXXXXX$
	1646	Orde rable Item : TRIAMTER ENE 50MG
	1647	CMOP Drug : TRIAMTER ENE 50MG T AB
	1648	*Dosage : 50MG
	1649	Verb : TAKE
	1650	Disp ense Units : 1
	1651	Noun : TABLET
	1652	*Route : ORAL
	1653	*Schedule : 2X
	1654	Patient In structions
	1655	SIG : TAKE ONE TABLET BY MOUTH 2X
	1656	Pati ent Status : OPT NSC
	1657	Issue Date : 10/07/XX Fil l Date: 10 /07/XX
	1658	Last Fill Date : 10/07/XX (Window)
	1659	Last Re lease Date : Lot #:
	1660	Expires : 10/08/XX MFG:
	1661	D ays Supply : 90 QTY (TAB) : 11
	1662	# of Refills : 3 Rem aining: 3
	1663	Provider : OPINSUR2
	1664	Routing: W indow
	1665	Copies : 1
	1666	Method of Pickup :
	1667	Clinic : Not on F ile
	1668	Division : XXXXXXXX XX
	1669	Pharmacist :
	1670	Patient Counseling : NO
	1671	Remarks :
	1672	F inished By : PSOuser, Two
	1673	Entry B y: PSOuser ,Two Entry Date: 10/ 6/XX 11:45 :57
	1674	Original F ill Releas ed: Routing: W indow
	1675	Refill Log :
	1676	# Log Dat e Refill Date Qty Routi ng Lot # Phar macist
	1677	========== ========== ========== ========== ========== ========== ========== =========
	1678	There are NO Refills For this Prescripti on
	1679	Partial Fi lls:
	1680	# Log Da te Date Qty Routing Lot # Pharm acist
	1681	========== ========== ========== ========== ========== ========== ========== =========
	1682	There are NO Partial s for this Prescript ion
	1683	Activity L og:
	1684	# Date Reas on Rx Ref Init iator Of A ctivity
	1685	========== ========== ========== ========== ========== ========== ========== =========
	1686	1 08/03/ XX EDIT ORIGINAL PSOu ser,Two
	1687	Comments: FILL DATE (3050801),
	1688	Copay Acti vity Log:
	1689	# Date Reas on Rx Ref Initiato r Of Activ ity
	1690	========== ========== ========== ========== ========== ========== ========== =========
	1691	There's NO Copay act ivity to r eport
	1692	Label Log:
	1693	# Date Rx R ef Printed By
	1694	========== ========== ========== ========== ========== ========== ========== =========
	1695	1 08/01/ XX ORIG INAL PSOuser, Three
	1696	Comments: From RX nu mber XXXXX X
	1697	2 08/03/ 05 ORIG INAL PSOuser, Three
	1698	Comments: From RX nu mber XXXXX X (Reprint )
	1699	Rx Activit y Log Nov 03, 20 10@15:27:5 4 Page: 5 of 5
	1700	ECMEPatie nt,Six
	1701	PID: XXX X Ht(cm) : _______ (______)
	1702	DOB: JAN X, XXXX ( XX) Wt(kg): _______ (_ _____)+
	1703	ECME Log:
	1704	# Date Rx R ef Initiator Of Activi ty
	1705	========== ========== ========== ========== ========== ========== ========== =========
	1706	1 5/22/0 6@19:00:24 ORIGIN AL PSOuser,Th ree
	1707	Comments: Submitted to ECME:CM OP TRANSMI SSION(NDC: 00049-3980 -60)
	1708	2 7/6/06 @19:01:04 REFILL 1 PSOuser,Th ree
	1709	Comments: Submitted to ECME:CM OP TRANSMI SSION(NDC: 00049-3980 -60)
	1710	3 7/7/06 @14:39:19 REFILL 1 PSOuser,Th ree
	1711	Comments: Submitted to ECME:RE JECT WORKL IST-DUR OV ERRIDE COD ES(DD/M0/1 B)-E
	1712	PAYABLE-p MEDCO
	1713	ECME REJEC T Log:
	1714	# Date/Ti me Rcvd Rx Ref Reject Ty pe STA TUS Da te/Time Re solved
	1715	========== ========== ========== ========== ========== ========== ========== =========
	1716	1 7/6/06@ 19:02:08 REFILL 1 DUR RES OLVED 7/ 7/06@14:39 :19
	1717	Comments: AUTOMATICA LLY CLOSED (CLAIM RE -SUBMITTED )
	1718	Enter ?? f or more ac tions
	1719	Selec t Action:Q uit//
	1720	5.7.4 Add/ View Comme nts XE " A dd/View Co mments"
	1721	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.
	1722	5.7.5 Clai ms Trackin g XE "Clai ms Trackin g"
	1723	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.
	1724	Enter the CT action and then e nter a sin gle prescr iption lin e item to track a cl aim.
	1725	Example 5. 7.5-1: Acc essing Cla ims Tracki ng Option
	1726	FURTHER RE SEARCH SCR EEN Nov 03, 20 10@15:27:5 4 Page: 1 of 30
	1727	SELECTED D IVISION(S) : ALL
	1728	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 1 day(s)
	1729	Sorted b y: Transac tion date by default
	1730	# PATIEN T/DRUG/COM MENTS IN SURANCE/ND C/DOS/RX#/ ECME# S TATUS/LOC/ TYP/RXINF
	1731	1 ECMEPa tient,SIX (XXXX) OPI NSUR2/2055 557898 VET Pb:10 Rj:2 AcRv :0 RjRv:1
	1732	1.1 SI METHICONE 40MG 0258 7542934 10 /06 110033 5$ 0/00 0000003119 W RT AC/R
	1733	p-Re jected
	1734	85:C laim Not P rocessed
	1735	NN:T ransaction Rejected At Switch Or Interme diary
	1736	02:M /I Version /Release N umber
	1737	EV11 7-D0 IS IN VALID VERS ION NUMBER
	1738	1.2 TR IAMTERENE 50MG, 0048 4359030 10 /06 110033 6$ 0/00 0000003120 W RT DS/R
	1739	p-Re versal Oth er
	1740	1.3 AM YL NITRITE 0.3M 0022 3700212 10 /07 110033 7$ 0/00 0000003122 W RT DS/R
	1741	p-Re versal Oth er
	1742	1.4 TR IAMTERENE 50MG, 0048 4359030 10 /07 110033 9$ 0/00 0000003124 W RT AC/R
	1743	p-Pa yable
	1744	+ Enter ?? f or more ac tions
	1745	INS Insur ance detai ls CT Claims Tr acking EVNT IB Events Rep ort
	1746	VE View Eligibilit y TPJI Third Par ty Inquiry GRPL Gro up Plan Me nu
	1747	VP View Prescripti on OH On Hold C opay List EX Exi t
	1748	CMT Add/V iew Commen ts RH Release C opay
	1749	Select act ion:Next S creen// C T Claims Tracking
	1750	Please sel ect a SING LE Rx Line item when accessing Claims Tr acking.
	1751	Select ite m: 1.1.... ...
	1752	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.
	1753	Example 5. 7.5-2: Di splaying C laims Trac king Optio ns
	1754	CLAIMS TRA CKING EDIT Nov 03, 20 10@15:27:5 4 Page: 1 of 3
	1755	Expanded C laims Trac king Info for: ECME Patient, T wo ROI:
	1756	For: PRESC RIPTION RE FILL on 11 /04/05
	1757	+
	1758	Visit Type: PRE SCRIPTION REFILL Author ization #:
	1759	Prescript ion #: XXX XXXX No . Days App roved: 0
	1760	Fill Date: Nov 04, 2005 Second Opinion R equired:
	1761	Drug: ALL OPURINOL 3 00MG, 30'S Second Opinion O btained:
	1762	Qua ntity: 1
	1763	Days S upply: 1 Review In formation
	1764	2 NDC#: 510 79-0206-20 Insuranc e Claim: Y ES
	1765	Phys ician: ECM EProvider, Two Follow- up Type:
	1766	Random Sample:
	1767	Special Co ndition:
	1768	Local A ddition:
	1769	Ins. R eviewer:
	1770	Hospital R eviewer:
	1771	Billing Informatio n
	1772	+ Enter ?? f or more ac tions
	1773	BI Billin g Info Edi t TA Treatment Auth. EX Exit
	1774	RI Review Info SE Submit Cla im to ECME
	1775	Select Act ion:Next S creen// <E nter>
	1776	CLAIMS TRA CKING EDIT Nov 03, 20 10@15:27:5 4 Page: 2 of 3
	1777	Expanded C laims Trac king Info for: ECMEp atient,Two ROI:
	1778	For: PRESC RIPTION RE FILL on 11 /04/05
	1779	+
	1780	Episo de Billabl e: NO Total Cha rges: $ 0
	1781	Non-Bill able Reaso n: PRESCRI PTION NOT REL Estima ted Recv ( Pri): $
	1782	Nex t Bill Dat e: Estima ted Recv ( Sec): $
	1783	Work. Com p/OWCP/Tor t: Estima ted Recv ( ter): $
	1784	I nitial Bil l: Mean s Test Cha rges: $
	1785	Bill Statu s: Amount Paid: $ 0
	1786	Hospital Reviews E ntered
	1787	Insuranc e Reviews Entered
	1788	Service Connected Conditions :
	1789	Service C onnected: NO
	1790	+ Enter ?? f or more ac tions
	1791	BI Billin g Info Edi t TA Treatment Auth. EX Exit
	1792	RI Review Info SE Submit Cla im to ECME
	1793	Select Act ion:Next S creen//<En ter>
	1794	CLAIMS TRA CKING EDIT Nov 03, 20 10@15:27:5 4 Page: 3 of 3
	1795	Expanded C laims Trac king Info for: ECMEp atient,Two ROI:
	1796	For: PRESC RIPTION RE FILL on 11 /04/05
	1797	+
	1798	NONE STAT ED
	1799	Enter ?? f or more ac tions
	1800	BI Billin g Info Edi t TA Treatment Auth. EX Exit
	1801	RI Review Info SE Submit Cla im to ECME
	1802	Select Act ion:Quit//
	1803	5.7.6 Thir d Party In quiry XE " Third Par ty Inquiry "
	1804	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 .
	1805	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.
	1806	Example 5. 7.6-1: Acc essing Thi rd Party ( Joint) Inq uiry Optio n
	1807	FURTHER RE SEARCH SCR EEN Nov 03, 20 10@15:27:5 4 Page: 1 of 30
	1808	SELECTED D IVISION(S) : ALL
	1809	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	1810	Sorted b y: Transac tion date by default
	1811	# PATIEN T/DRUG/COM MENTS IN SURANCE/ND C/DOS/RX#/ ECME# S TATUS/LOC/ TYP/RXINF
	1812	1 ECMEPa tient,SIX (XXXX) OPI NSUR2/2055 557898 VET Pb:10 Rj:2 AcRv :0 RjRv:1
	1813	1.1 SI METHICONE 40MG 0258 7542934 10 /06 110033 5$ 0/00 0000003119 W RT AC/R
	1814	p-Re jected
	1815	85:C laim Not P rocessed
	1816	NN:T ransaction Rejected At Switch Or Interme diary
	1817	02:M /I Version /Release N umber
	1818	EV11 7-D0 IS IN VALID VERS ION NUMBER
	1819	1.2 TR IAMTERENE 50MG, 0048 4359030 10 /26 110033 6$ 0/00 0000003120 W RT DS/R
	1820	p-Re versal Oth er
	1821	1.3 AM YL NITRITE 0.3M 0022 3700212 10 /27 110033 7$ 0/00 0000003122 W RT DS/R
	1822	p-Re versal Oth er
	1823	1.4 TR IAMTERENE 50MG, 0048 4359030 10 /27 110033 9$ 0/00 0000003124 W RT AC/R
	1824	p-Pa yable
	1825	+ Enter ?? f or more ac tions
	1826	INS Insur ance detai ls CT Claims Tr acking EVNT IB Events Rep ort
	1827	VE View Eligibilit y TPJI Third Par ty Inquiry GRPL Gro up Plan Me nu
	1828	VP View Prescripti on OH On Hold C opay List EX Exi t
	1829	CMT Add/V iew Commen ts RH Release C opay
	1830	Select act ion:Next S creen// T PJI Thir d Party In quiry
	1831	Please sel ect a SING LE Patient Line item when acce ssing TPJI
	1832	Select ite m:
	1833	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.
	1834	Example 5. 7.6-2: Di splaying T hird Party (Joint) I nquiry Opt ions.
	1835	Third Part y Active B ills Nov 03, 20 10@15:27:5 4 Page: 1 of 1
	1836	ECMEPatien t,SIX (XXX X)NSC
	1837	Bill # From To MT? Type Stat Rate Insure r Orig Am t Curr Amt
	1838	1 K400K9C e 06/15/0 5 06/15/05 YES OP A REIM IN WEBMD 45.00 45.00
	1839	2 K400K9D e 06/15/0 5 06/15/05 YES OP A REIM IN WEBMD 45.00 45.00
	1840	…
	1841	\|r Referre d \|* MT on Hold \|+ M ulti Carri ers \|
	1842	CI Claim Informatio n IL Inactive B ills PI Pati ent Insura nce
	1843	CP Change Patient HS Health Sum mary EL Pati ent Eligib ility
	1844	Select Act ion: Quit/ /
	1845	5.7.7 On H old Copay Listing XE " On-Hold Copay Lis ting"
	1846	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.
	1847	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.
	1848	Example 5. 7.7-1: Acc essing On Hold Copay Listing O ption
	1849	FURTHER RE SEARCH SCR EEN Nov 03, 20 10@15:27:5 4 Page: 1 of 30
	1850	SELECTED D IVISION(S) : ALL
	1851	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	1852	Sorted b y: Transac tion date by default
	1853	# PATIEN T/DRUG/COM MENTS IN SURANCE/ND C/DOS/RX#/ ECME# S TATUS/LOC/ TYP/RXINF
	1854	1 ECMEPa tient,SIX (XXXX) OPI NSUR2/2055 557898 VET Pb:10 Rj:2 AcRv :0 RjRv:1
	1855	1.1 SI METHICONE 40MG 0258 7542934 10 /26 110033 5$ 0/00 0000003119 W RT AC/R
	1856	p-Re jected
	1857	85:C laim Not P rocessed
	1858	NN:T ransaction Rejected At Switch Or Interme diary
	1859	02:M /I Version /Release N umber
	1860	EV11 7-D0 IS IN VALID VERS ION NUMBER
	1861	1.2 TR IAMTERENE 50MG, 0048 4359030 10 /26 110033 6$ 0/00 0000003120 W RT DS/R
	1862	p-Re versal Oth er
	1863	1.3 AM YL NITRITE 0.3M 0022 3700212 10 /27 110033 7$ 0/00 0000003122 W RT DS/R
	1864	p-Re versal Oth er
	1865	1.4 TR IAMTERENE 50MG, 0048 4359030 10 /27 110033 9$ 0/00 0000003124 W RT AC/R
	1866	p-Pa yable
	1867	+ Enter ?? f or more ac tions
	1868	INS Insur ance detai ls CT Claims Tr acking EVNT IB Events Rep ort
	1869	VE View Eligibilit y TPJI Third Par ty Inquiry GRPL Gro up Plan Me nu
	1870	VP View Prescripti on OH On Hold C opay List EX Exi t
	1871	CMT Add/V iew Commen ts RH Release C opay
	1872	Select act ion:Next S creen// O H On Hol d Copay Li sting
	1873	Please sel ect a SING LE Patient Line item when acce ssing On H old Copay Listing
	1874	Select ite m: 1
	1875	You are pr ompted for a start a nd end dat e for the report.
	1876	Example 5. 7.7-2: Ent ering On H old Copay Report Sta rt and End Dates
	1877	Start with DATE: T-3 (AUG 14, 2005)
	1878	Go to DATE: T (AUG 17, 2 005)
	1879	You are pr ompted to choose whe ther to in clude Phar macy Co-pa y charges or not.
	1880	Example 5. 7.7-3: En tering “Y” to Includ e Pharmacy Co-pay Ch arges on R eport
	1881	Include Ph armacy Co- pay charge s on this report? NO // YES
	1882	*** Margin width of this outpu t is 132 * **
	1883	* This o utput shou ld be queu ed *
	1884	DEVICE: HO ME// 132 PRINTER
	1885	Print the report at 132 charac ters.
	1886	Example 5. 9.7-4: Pr inted On H old Copay Listing Re port
	1887	List of al l HELD bil ls for EC MEPatient, SIX (XXXX) AUG 8,200 6 PAGE 1
	1888	PATIENT CH ARGES C ORRESPONDI NG THIRD P ARTY BILLS
	1889	========== ========== ========== ========== ========== ========== ========== =======\|\|= ========== ========== ========== =========
	1890	From/ Date AR IB \|\| AR
	1891	Action ID Type Bill# Fill Dt to AR Charge Status Status\|\| Bill# Cla ssf($Typ) ST Charg e % Paid
	1892	========== ========== ========== ========== ========== ========== ========== =======\|\|= ========== ========== ========== =========
	1893	'* ' = outpt visit on s ame day as Rx fill d ate \|\|
	1894	========== ========== ========== ========== ========== ========== ========== =======\|\|= ========== ========== ========== =========
	1895	5002877 NSC R X Rx #: 100003994 ECME # 0 0000123457 9 \|\|
	1896	12/30/0 5 8.00 ON HOLD\|\|
	1897	Enter RETU RN to cont inue or '^ ' to exit:
	1898	5.7.8 Rele ase Copay XE " Relea se Copay"
	1899	This actio n accesses the Relea se Charges 'On Hold' option, l ocated on the On Hol d Menu (wh ich is loc ated on th e Automate d Means Te st Billing Menu) in the Integr ated Billi ng softwar e. If you select a s ingle Rx L ine item, the system defaults the to the REF# of t he selecte d Rx.
	1900	Enter RH t o access t he Release Copay opt ion. You m ay select a single P atient lin e item or a single R x line ite m.
	1901	Example 5. 7.8-1: Acc essing Rel ease Copay Option
	1902	FURTHER RE SEARCH SCR EEN Nov 03, 20 10@15:27:5 4 Page: 1 of 30
	1903	SELECTED D IVISION(S) : ALL
	1904	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	1905	Sorted b y: Transac tion date by default
	1906	# PATIEN T/DRUG/COM MENTS IN SURANCE/ND C/DOS/RX#/ ECME# S TATUS/LOC/ TYP/RXINF
	1907	1 ECMEPa tient,SIX (XXXX) OPI NSUR2/2055 557898 VET Pb:10 Rj:2 AcRv :0 RjRv:1
	1908	1.1 SI METHICONE 40MG 0258 7542934 10 /06 110033 5$ 0/00 0000003119 W RT AC/R
	1909	p-Re jected
	1910	85:C laim Not P rocessed
	1911	NN:T ransaction Rejected At Switch Or Interme diary
	1912	02:M /I Version /Release N umber
	1913	EV11 7-D0 IS IN VALID VERS ION NUMBER
	1914	1.2 TR IAMTERENE 50MG, 0048 4359030 10 /26 110033 6$ 0/00 0000003120 W RT DS/R
	1915	p-Re versal Oth er
	1916	1.3 AM YL NITRITE 0.3M 0022 3700212 10 /27 110033 7$ 0/00 0000003122 W RT DS/R
	1917	p-Re versal Oth er
	1918	1.4 TR IAMTERENE 50MG, 0048 4359030 10 /27 110033 9$ 0/00 0000003124 W RT AC/R
	1919	p-Pa yable
	1920	+ Enter ?? f or more ac tions
	1921	INS Insur ance detai ls CT Claims Tr acking EVNT IB Events Rep ort
	1922	VE View Eligibilit y TPJI Third Par ty Inquiry GRPL Gro up Plan Me nu
	1923	VP View Prescripti on OH On Hold C opay List EX Exi t
	1924	CMT Add/V iew Commen ts RH Release C opay
	1925	Select act ion:Next S creen// RH Relea se Copay
	1926	Please sel ect a SING LE Patient Line item or a SING LE Rx Line item when accessing
	1927	Release C opay from Hold.
	1928	Select ite m: 9
	1929	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.
	1930	Example 5. 7.8-2: Lis ting On Ho ld Copay C harges for Release C opay Optio n
	1931	ECMEPatien t,,SIX Pt ID: 000-00 -0000
	1932	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------
	1933	The follow ing IB Act ions for t his patien t are ON H OLD:
	1934	========== ========== ========== ========== ========== ========== ========== ==========
	1935	REF Act ion ID Bi ll Type Bill # Fr/Fl Dt To/Rls Dt Charge
	1936	========== ========== ========== ========== ========== ========== ========== ==========
	1937	1 000 596570 Rx #: 909708 08/01/05 08/01/05 21.00
	1938	EC ME #: 0000 00000000
	1939	2 000 596574 Rx #: 909693 08/01/05 08/01/05 21.00
	1940	EC ME #: 0000 00000000
	1941	3 000 596575 Rx #: 909694 08/01/05 08/01/05 21.00
	1942	EC ME #: 0000 00000000
	1943	4 000 596580 Rx #: 909728 08/01/05 08/01/05 21.00
	1944	EC ME #: 0000 00000000
	1945	5 000 596581 Rx #: 909703 08/01/05 08/01/05 21.00
	1946	EC ME #: 0000 00000000
	1947	6 000 596601 Rx #: 909698 08/01/05 08/03/05 21.00
	1948	EC ME #: 0000 00000000
	1949	Select IB Actions (R EF #) to r elease (or '^' to ex it): 2
	1950	OK to pass this char ge to Acco unts Recei vable? YES
	1951	Passing ch arges to A ccounts Re ceivable.. .
	1952	========== ========== ========== ========== ========== ========== ========== ==========
	1953	REF Act ion ID Bi ll Type Bill # Fr/Fl Dt To/Rls Dt Charge
	1954	========== ========== ========== ========== ========== ========== ========== ==========
	1955	2 000 596574 Rx #: 909693 K400KDC 08/01/05 08/01/05 21.00
	1956	EC ME #: 0000 00000000
	1957	The charge listed ab ove has be en passed to Account s Receivab le.
	1958	Enter RETU RN to cont inue or '^ ' to exit:
	1959	5.7.9 IB ( Integrated Billing) Events Rep ort XE " I B (Integra ted Billin g) Events Report"
	1960	The “EVNT” action al lows you t o access t he IB e-Ph armacy Men u Option, ECME Billi ng Events Report.
	1961	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.
	1962	Example 5. 7.9-1: Acc essing IB Events Rep ort Option
	1963	FURTHER RE SEARCH SCR EEN Nov 03, 20 10@15:27:5 4 Page: 1 of 30
	1964	SELECTED D IVISION(S) : ALL
	1965	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	1966	Sorted b y: Transac tion date by default
	1967	# PATIEN T/DRUG/COM MENTS IN SURANCE/ND C/DOS/RX#/ ECME# S TATUS/LOC/ TYP/RXINF
	1968	1 ECMEPa tient,,SIX (XXXX) OP INSUR2/205 5557898 VET Pb:1 0 Rj:2 AcR v:0 RjRv:1
	1969	1.1 SI METHICONE 40MG 0258 7542934 10 /06 110033 5$ 0/00 0000003119 W RT AC/R
	1970	p-Re jected
	1971	85:C laim Not P rocessed
	1972	NN:T ransaction Rejected At Switch Or Interme diary
	1973	02:M /I Version /Release N umber
	1974	EV11 7-D0 IS IN VALID VERS ION NUMBER
	1975	1.2 TR IAMTERENE 50MG, 0048 4359030 10 /26 110033 6$ 0/00 0000003120 W RT DS/R
	1976	p-Re versal Oth er
	1977	1.3 AM YL NITRITE 0.3M 0022 3700212 10 /27 110033 7$ 0/00 0000003122 W RT DS/R
	1978	p-Re versal Oth er
	1979	1.4 TR IAMTERENE 50MG, 0048 4359030 10 /27 110033 9$ 0/00 0000003124 W RT AC/R
	1980	p-Pa yable
	1981	+ Enter ?? f or more ac tions
	1982	INS Insur ance detai ls CT Claims Tr acking EVNT IB Events Rep ort
	1983	VE View Eligibilit y TPJI Third Par ty Inquiry GRPL Gro up Plan Me nu
	1984	VP View Prescripti on OH On Hold C opay List EX Exi t
	1985	CMT Add/V iew Commen ts RH Release C opay
	1986	Select act ion:Next S creen// EVNT IB Ev ents Repor t
	1987	Please sel ect a SING LE Patient Line item or a SING LE Rx Line item when accessing
	1988	The IB Ev ents Repor t.
	1989	Select ite m: 2
	1990	You are p rompted fo r a start and end da te for thi s report.
	1991	Example 5. 7.9-2: Ent ering Date s to Inclu de in IB E vents Repo rt Listing
	1992	START WITH DATE: TOD AY//T-60 (JUN 23, 2 005)
	1993	GO TO DATE : TODAY//T (AUG 22, 2005)
	1994	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.
	1995	Example 5. 7.9-3: Cho osing Defa ult ‘All’ for Types of Events for IB Eve nts Report
	1996	Selec t one of t he followi ng:
	1997	M MAIL
	1998	W WINDOW
	1999	C CMOP
	2000	A ALL
	2001	(M)AIL, (W )INDOW, (C )CMOP, (A) LL: ALL// <Enter> ALL
	2002	You are pr ompted to select S ( SUMMARY RE PORT) or D (DETAILED REPORT) a nd a print device.
	2003	Example 5. 7.9-4: Sel ecting Sum mary Type for IB Eve nts Report
	2004	S SUMMARY RE PORT
	2005	D DETAILED R EPORT
	2006	(S)UMMARY REPORT, (D )ETAILED R EPORT: SUM MARY REPOR T// <Ente r> SUMMARY REPORT
	2007	DEVICE: HO ME//
	2008	PAGE 1
	2009	BILLI NG ECME EV ENTS ON 06 /23/05 TO 08/22/05 (SUMMARY)
	2010	RX# FILL DAT E PA TIENT NAME DRUG
	2011	========== ========== ========== ========== ========== ========== ========== ==========
	2012	1 909693 0 08/0 1/05 EC MEPatient, SIX EPOETI N ALFA,REC OMB 20,000 UNT/
	2013	FINI SH 08/0 1/05 11:32 a Status:E CME Billab le
	2014	SUBM IT 08/0 1/05 11:34 a Status:O K
	2015	REVE RSAL 08/0 1/05 3:19p Status:E CME Claim reversed, no Bill to cancel
	2016	FINI SH 08/0 1/05 3:20p Status:E CME Billab le
	2017	SUBM IT 08/0 1/05 3:20p Status:O K
	2018	RELE ASE 08/0 1/05 3:20p Status:O K
	2019	---------- ---------- ---------- ---------- ---------- ---------- ---------- ----------
	2020	2 909694 0 08/0 1/05 EC MEPatient, Seven CYCL OPHOSPHAMI DE 1000MG INJ
	2021	FINI SH 08/0 1/05 11:44 a Status:E CME Billab le
	2022	SUBM IT 08/0 1/05 11:45 a Status:O K
	2023	REVE RSAL 08/0 1/05 3:37p Status:E CME Claim reversed, no Bill to cancel
	2024	FINI SH 08/0 1/05 3:38p Status:E CME Billab le
	2025	SUBM IT 08/0 1/05 3:38p Status:O K
	2026	RELE ASE 08/0 1/05 3:38p Status:O K
	2027	BILL ING 08/0 1/05 3:38p Status:B ill# K400K BC created
	2028	REVE RSAL 08/0 5/05 3:09p Status:B ill# K400K BC cancell ed
	2029	Press RETU RN to cont inue, '^' to exit:
	2030	Example 5. 7.9-5: Sel ecting a D etailed Ty pe for IB Events Rep ort
	2031	S SUMMARY RE PORT
	2032	D DETAILED R EPORT
	2033	(S)UMMARY REPORT, (D )ETAILED R EPORT: SUM MARY REPOR T// DETAIL ED REPORT
	2034	DEVICE: HO ME//
	2035	PAGE 1
	2036	BILLING EC ME EVENTS ON 07/06/1 1 TO 09/04 /11 (DETAI LED) for X XXXXX VAMC DIVISIO
	2037	RX# FILL DAT E PA TIENT NAME DRUG
	2038	========== ========== ========== ========== ========== ========== ========== ==========
	2039	1 205478 9 0 06/0 8/11 EC MEPATIENT, SIX C LONAZEPAM 1MG TAB
	2040	FINI SH 08/1 0/11 6:35p Status:E CME Billab le
	2041	ELIGIBILIT Y:
	2042	DRUG:CLONA ZEPAM 1MG TAB
	2043	NDC:57664- 0274-08, B ILLED QTY: 30, COST:. 024, DEA:4 CPR
	2044	PLAN: INS URANCE: WE BMD COB: S
	2045	BIN:123456 , PCN:1123 456789, PA YER SHEET B1:WBTESTB 1
	2046	PAYER SHEE T B2:WBTES TB2, PAYER SHEET B3: WBTESTB1
	2047	DISPENSING FEE:11.40 , BASIS OF COST DETE RM:COST CA LCULATIONS
	2048	COST:12.12 , GROSS AM T DUE:12.1 2, ADMIN F EE:0.00
	2049	USER:ECMEu ser,Two
	2050	SUBM IT 08/1 0/11 6:35p Status:O K
	2051	ECME#:0000 01614656, FILL DATE :06/08/11, RELEASE DATE:06/08 /11
	2052	PAYER RESP ONSE: PAYA BLE
	2053	PLAN:, INS URANCE: WE BMD
	2054	USER:ECMEu ser,Three
	2055	BILL ING 08/1 0/11 6:35p Status:B ill K10004 V created with ERROR s
	2056	Press RETU RN to cont inue, '^' to exit:
	2057	PAGE 2
	2058	BILLING EC ME EVENTS ON 07/06/1 1 TO 09/04 /11 (DETAI LED) for X XXXXX VAMC DIVISIO
	2059	RX# FILL DAT E PA TIENT NAME DRUG
	2060	========== ========== ========== ========== ========== ========== ========== ==========
	2061	ERROR DESC RIPTION: C annot esta blish rece ivable in AR (second ary ins).
	2062	ECME#:0000 01614656, FILL DATE :06/08/11, RELEASE DATE:06/08 /11
	2063	DRUG:CLONA ZEPAM 1MG TAB
	2064	NDC:57664- 0274-08, B ILLED QTY: 30, DAYS S UPPLY:30
	2065	BILLED:12. 12, PAID:6 8.32
	2066	PLAN:, INS URANCE: WE BMD
	2067	USER:ECMEu ser,One
	2068	REVE RSAL 08/1 1/11 1:18p Status:
	2069	ECME#:0000 01614656, FILL DATE :06/08/11, RELEASE DATE:06/08 /11
	2070	PAYER RESP ONSE: ACCE PTED
	2071	PLAN:, INS URANCE: WE BMD
	2072	USER:ECMEu ser,Two
	2073	REVERSAL R EASON:TST
	2074	FINI SH 08/1 1/11 1:20p Status:E CME Billab le
	2075	ELIGIBILIT Y:
	2076	DRUG:CLONA ZEPAM 1MG TAB
	2077	NDC:57664- 0274-08, B ILLED QTY: 30, COST:. 024, DEA:4 CPR
	2078	Press RETU RN to cont inue, '^' to exit:
	2079	PAGE 3
	2080	BILLING EC ME EVENTS ON 07/06/1 1 TO 09/04 /11 (DETAI LED) for DNS ENNE VAMC DIVISIO
	2081	RX# FILL DAT E PA TIENT NAME DRUG
	2082	========== ========== ========== ========== ========== ========== ========== ==========
	2083	PLAN: INS URANCE: WE BMD COB: S
	2084	BIN:123456 , PCN:1123 456789, PA YER SHEET B1:WBTESTB 1
	2085	PAYER SHEE T B2:WBTES TB2, PAYER SHEET B3: WBTESTB1
	2086	DISPENSING FEE:11.40 , BASIS OF COST DETE RM:COST CA LCULATIONS
	2087	COST:12.12 , GROSS AM T DUE:12.1 2, ADMIN F EE:0.00
	2088	USER:ECMEu ser,Two
	2089	SUBM IT 08/1 1/11 1:20p Status:O K
	2090	ECME#:0000 01614656, FILL DATE :06/08/11, RELEASE DATE:06/08 /11
	2091	PAYER RESP ONSE: REJE CTED
	2092	PLAN:, INS URANCE: WE BMD
	2093	USER:ECMEu ser,One
	2094	---------- ---------- ---------- ---------- ---------- ---------- ---------- ----------
	2095	2 205480 3 0 05/0 6/11 EC MEPATIENT, SIX L IDOCAINE 0 .5% (5MG/M L) 50ML M
	2096	FINI SH 08/1 0/11 6:07p Status:E CME Billab le
	2097	ELIGIBILIT Y:
	2098	DRUG:LIDOC AINE 0.5% (5MG/ML) 5 0ML MDV
	2099	NDC:00409- 4278-01, B ILLED QTY: 30, COST:1 .486, DEA: 6P
	2100	Press RETU RN to cont inue, '^' to exit:
	2101	5.7.10 Gro up Plan Me nu XE "Gro up Plan Me nu"
	2102	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).
	2103	Enter GRP L to acces s the Grou p Plan Men u option.
	2104	Example 5. 7.10-1: Ac cessing Gr oup Plan M enu
	2105	FURTHER RE SEARCH SCR EEN Nov 03, 20 10@15:27:5 4 Page: 1 of 30
	2106	SELECTED D IVISION(S) : ALL
	2107	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	2108	Sorted b y: Transac tion date by default
	2109	# PATIEN T/DRUG/COM MENTS IN SURANCE/ND C/DOS/RX#/ ECME# S TATUS/LOC/ TYP/RXINF
	2110	1 ECMEPa tient,,SIX (XXXX) OP INSUR2/205 5557898 VET Pb:1 0 Rj:2 AcR v:0 RjRv:1
	2111	1.1 SI METHICONE 40MG 0258 7542934 10 /26 110033 5$ 0/00 0000003119 W RT AC/R
	2112	p-Re jected
	2113	85:C laim Not P rocessed
	2114	NN:T ransaction Rejected At Switch Or Interme diary
	2115	02:M /I Version /Release N umber
	2116	EV11 7-D0 IS IN VALID VERS ION NUMBER
	2117	1.2 TR IAMTERENE 50MG, 0048 4359030 10 /26 110033 6$ 0/00 0000003120 W RT DS/R
	2118	p-Re versal Oth er
	2119	1.3 AM YL NITRITE 0.3M 0022 3700212 10 /27 110033 7$ 0/00 0000003122 W RT DS/R
	2120	p-Re versal Oth er
	2121	1.4 TR IAMTERENE 50MG, 0048 4359030 10 /27 110033 9$ 0/00 0000003124 W RT AC/R
	2122	p-Pa yable
	2123	+ Enter ?? f or more ac tions
	2124	INS Insur ance detai ls CT Claims Tr acking EVNT IB Events Rep ort
	2125	VE View Eligibilit y TPJI Third Par ty Inquiry GRPL Gro up Plan Me nu
	2126	VP View Prescripti on OH On Hold C opay List EX Exi t
	2127	CMT Add/V iew Commen ts RH Release C opay
	2128	Select act ion:Next S creen// GRPL Gr oup Plan M enu
	2129	- -- Group P lan Menu - --
	2130	EPLA Edit PLAN APPLI CATION Sub file
	2131	MGP Match Group Pla n to a Pha rmacy Plan
	2132	MMGP Match Multiple Group Plan s to a Pha rmacy Plan
	2133	Select Ite m(s):
	2134	5.7.11 Eli gibility I nquiry Opt ion XE " V iew Prescr iption"
	2135	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.
	2136	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 .
	2137	You can ed it the Rel ationship Code, Pers on Code, a nd Insuran ce Effecti ve Date.
	2138	Example 5. 7.11-1: Ac cessing El igibility Inquiry Op tion
	2139	FURTHER RE SEARCH SCR EEN Nov 03, 20 10@15:27:5 4 Page: 1 of 30
	2140	SELECTED D IVISION(S) : ALL
	2141	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	2142	Sorted b y: Transac tion date by default
	2143	# PATIEN T/DRUG/COM MENTS IN SURANCE/ND C/DOS/RX#/ ECME# S TATUS/LOC/ TYP/RXINF
	2144	1 ECMEPa tient,,SIX (XXXX) OP INSUR2/205 5557898 VET Pb:1 0 Rj:2 AcR v:0 RjRv:1
	2145	1.1 SI METHICONE 40MG 0258 7542934 10 /06 110033 5$ 0/00 0000003119 W RT AC/R
	2146	p-Re jected
	2147	85:C laim Not P rocessed
	2148	NN:T ransaction Rejected At Switch Or Interme diary
	2149	02:M /I Version /Release N umber
	2150	EV11 7-D0 IS IN VALID VERS ION NUMBER
	2151	1.2 TR IAMTERENE 50MG, 0048 4359030 10 /26 110033 6$ 0/00 0000003120 W RT DS/R
	2152	p-Re versal Oth er
	2153	1.3 AM YL NITRITE 0.3M 0022 3700212 10 /27 110033 7$ 0/00 0000003122 W RT DS/R
	2154	p-Re versal Oth er
	2155	1.4 TR IAMTERENE 50MG, 0048 4359030 10 /27 110033 9$ 0/00 0000003124 W RT AC/R
	2156	p-Pa yable
	2157	+ Enter ?? f or more ac tions
	2158	INS Insur ance detai ls CT Claims Tr acking EVNT IB Events Rep ort
	2159	VE View Eligibilit y TPJI Third Par ty Inquiry GRPL Gro up Plan Me nu
	2160	VP View Prescripti on OH On Hold C opay List EX Exi t
	2161	CMT Add/V iew Commen ts RH Release C opay
	2162	Select act ion:Next S creen// EL IG ELIG
	2163	Enter the line numbe r for the claim to b e submitte d for Elig ibility Ve rification
	2164	Select ite m: 1.1
	2165
	2166
	2167	You've cho sen to VER IFY Eligib ility of t he followi ng prescri ption for ECMEPATIEN T,
	2168	SIX
	2169	1.1 SI METHICONE 40MG 0258 7542934 10 /26 110033 5$ 0/00 0000003119 W RT AC/R
	2170	Are you su re?(Y/N)? YES
	2171	Relationsh ip Code: 1 // CARDHOLDER
	2172	Person Cod e: 01//
	2173	Effective Date: 10/ 06/2010// 11/3/2010
	2174
	2175	Are you su re?(Y/N)? YES
	2176
	2177	Not submit table: Eli gibility P ayer Sheet Not Found .
	2178
	2179	Enter RETU RN to cont inue or '^ ' to exit:
	2180	When you e nter QUIT, the syste m will ret urn you to the Furth er Researc h Screen.
	2181	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 .
	2182	Example 5. 7.11-2: En tering the EXIT Acti on from Fu rther Rese arch Scree n
	2183	FURTHER RE SEARCH SCR EEN Nov 03, 20 10@15:27:5 4 Page: 1 of 30
	2184	SELECTED D IVISION(S) : ALL
	2185	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	2186	Sorted b y: Transac tion date by default
	2187	# PATIEN T/DRUG/COM MENTS IN SURANCE/ND C/DOS/RX#/ ECME# S TATUS/LOC/ TYP/RXINF
	2188	1 ECMEPa tient,,SIX (XXXX) OP INSUR2/205 5557898 VET Pb:1 0 Rj:2 AcR v:0 RjRv:1
	2189	1.1 SI METHICONE 40MG 0258 7542934 10 /06 110033 5$ 0/00 0000003119 W RT AC/R
	2190	p-Re jected
	2191	85:C laim Not P rocessed
	2192	NN:T ransaction Rejected At Switch Or Interme diary
	2193	02:M /I Version /Release N umber
	2194	EV11 7-D0 IS IN VALID VERS ION NUMBER
	2195	1.2 TR IAMTERENE 50MG, 0048 4359030 10 /26 110033 6$ 0/00 0000003120 W RT DS/R
	2196	p-Re versal Oth er
	2197	1.3 AM YL NITRITE 0.3M 0022 3700212 10 /27 110033 7$ 0/00 0000003122 W RT DS/R
	2198	p-Re versal Oth er
	2199	1.4 TR IAMTERENE 50MG, 0048 4359030 10 /27 110033 9$ 0/00 0000003124 W RT AC/R
	2200	p-Pa yable
	2201	+ Enter ?? f or more ac tions
	2202	INS Insur ance detai ls CT Claims Tr acking EVNT IB Events Rep ort
	2203	VE View Eligibilit y TPJI Third Par ty Inquiry GRPL Gro up Plan Me nu
	2204	VP View Prescripti on OH On Hold C opay List EX Exi t
	2205	CMT Add/V iew Commen ts RH Release C opay
	2206	Select act ion:Next S creen// E X Exit
	2207	5.8 Print Claim Log (hidden ac tion) XE " Print Cla im Log"
	2208	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.
	2209	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.
	2210	Example 5. 10-1: Acc essing the Print Cla im Log Opt ion
	2211	PHARMACY E CME Aug 12, 20 05@02:40:3 4 Page: 1 of 81
	2212	SELECTED D IVISION(S) : ALL
	2213	Transmitte d by ALL u sers Activity Date Rang e: within the past 3 0 day(s)
	2214	Sor ted by: Pa tient Name
	2215	# PATIEN T/DRUG/COM MENTS INSURANC E/NDC/RX#/ ECME# LOC /TYP RXINF
	2216	1 ECMEPa tient,,SIX (XXXX) OP INSUR2/205 5557898 VET Pb:1 0 Rj:2 AcR v:0 RjRv:1
	2217	1.1 SI METHICONE 40MG 0258 7542934 10 /06 110033 5$ 0/00 0000003119 W RT AC/R
	2218	p-Re jected
	2219	85:C laim Not P rocessed
	2220	NN:T ransaction Rejected At Switch Or Interme diary
	2221	02:M /I Version /Release N umber
	2222	EV11 7-D0 IS IN VALID VERS ION NUMBER
	2223	1.2 TR IAMTERENE 50MG, 0048 4359030 10 /06 110033 6$ 0/00 0000003120 W RT DS/R
	2224	p-Re versal Oth er
	2225	1.3 AM YL NITRITE 0.3M 0022 3700212 10 /07 110033 7$ 0/00 0000003122 W RT DS/R
	2226	p-Re versal Oth er
	2227	1.4 TR IAMTERENE 50MG, 0048 4359030 10 /07 110033 9$ 0/00 0000003124 W RT AC/R
	2228	p-Pa yable
	2229	+ Enter ?? f or more ac tions
	2230	CV Change View REV Reverse Pa yable Clai m FR Furt her Resear ch
	2231	SO Sort L ist RES Resubmit C laim VER View ePharmacy Rx
	2232	CMT Add/Vi ew Comment s CLO Close Clai m WRK Send to Workli st
	2233	Select Act ion: Next Screen// L OG Print Claim Log
	2234	Enter the line numbe r for whic h you wish to print claim logs .
	2235	Select ite m: 5.1
	2236	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>) .
	2237	Example 5. 8-2: Disp laying Cla im Log Dat a for a Se lected Pre scription Line Item
	2238	PHARMACY E CME A ug 22, 200 5@13:58:50 Page: 1 of 7
	2239	Claim Log informatio n
	2240	Pharmacy E CME Log
	2241	Rx #: 9093 93/0 EC ME#: 00000 1105635
	2242	Drug: AMOX ICILLIN 25 0MG CAP
	2243	Pat ient: ECME patient,On e (0000) S ex: M DOB: J AN 1, 1954 (57)
	2244	Submi tted: JUN 15,2005@15 :19:11
	2245	By: ECME user,One
	2246	VA Cla im #: VA20 05=1234567 893=123456 =0000502
	2247	+ Enter ?? f or more ac tions
	2248	PR Print Data EX Exit
	2249	Select act ion:Next S creen// <E nter>
	2250	PHARMACY E CME Sep 11, 20 05@11:36:1 4 Page: 2 of 7
	2251	Claim Log informatio n
	2252	+
	2253	Transactio n Informat ion (#661) ---------- ---------- ---------- ---------- ---------
	2254	Created on : JUN 15,2 005@16:25: 48
	2255	Submitted By: ECMEUS ER,FOUR
	2256	Transactio n Type: RE QUEST
	2257	Date of Se rvice: 06/ 15/2005
	2258	NDC Code: 00068-0011 -10
	2259	NCPDP Qty: 60 ( )
	2260	Days Suppl y: 30
	2261	Division : ALBANY IS C
	2262	NPI#: 4000 000016
	2263	ECME Pharm acy: XXXXX XXXX
	2264	Billed Qty : 90 (EA) Unit Co st: .752 Gross A mt Due: 79 .08
	2265	Ingredient Cost: 67. 68 Dispe nsing Fee: 11.40
	2266	U&C Charge : 79.08 A dmin Fee: 0.00
	2267	Insurance Name: WEBM D
	2268	Rx Coordin ation of B enefits: P RIMARY
	2269	BIN: 12345 6
	2270	PCN: 11234 56789
	2271	Group ID: WEBMDTEST
	2272	Cardholder ID:
	2273	Patient Re lationship Code: CAR DHOLDER
	2274	Cardholder First Nam e: One
	2275	Cardholder Last Name : ECMEpati ent
	2276	+ Enter ?? f or more ac tions
	2277	PR Print Data EX Exit
	2278	Select act ion:Next S creen// <E nter>
	2279	PHARMACY E CME Sep 11, 20 05@11:39:0 7 Page: 3 of 7
	2280	Claim Log informatio n
	2281	+
	2282	Plan ID: 8 729
	2283	Payer Shee t IEN: WBT ESTB1
	2284	B2 Payer S heet IEN: WBTESTB2
	2285	B3 Rebill Payer Shee t: WBTESTB 1
	2286	Certify Mo de:
	2287	Cert IEN:
	2288	+ Enter ?? f or more ac tions
	2289	PR Print Data EX Exit
	2290	Select act ion:Next S creen// <E nter>
	2291	PHARMACY E CME Sep 11, 20 05@11:39:5 1 Page: 4 of 7
	2292	Claim Log informatio n
	2293	+
	2294	Response I nformation (#661)--- ---------- ---------- ---------- ---------- ---------
	2295	Response R eceived: J UN 15,2005 @16:25:49
	2296	Date of Se rvice: 06/ 15/2005
	2297	Transactio n Response Status: P aid
	2298	Total Amou nt Paid: $ 40.00
	2299	Ingredient Cost Paid : $48.00 Dispensin g Fee Paid : $1.00
	2300	Patient Re sp (INS): ($9.00)
	2301	Reject cod e(s):
	2302	Payer Mess age:
	2303	Payer Addi tional Mes sage:
	2304	Reason for Service C ode: AD
	2305	DUR Text: AMOXICILLI N 250MG CA P
	2306	DUR Additi onal Text: The text would disp lay here
	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@11:39:5 1 Page: 5 of 7
	2311	Claim Log informatio n
	2312	+
	2313	Transactio n Informat ion (#659) ---------- ---------- ---------- ---------- ---------
	2314	Created on : JUN 15,2 005@15:07: 34
	2315	Transactio n Type: RE QUEST
	2316	Date of Se rvice: 06/ 15/2005
	2317	NDC Code: 00068-0011 -10
	2318	NCPDP Qty: 60 ( )
	2319	Days Suppl y: 30
	2320	Division : ALBANY IS C
	2321	NPI#: 4000 000016
	2322	ECME Pharm acy: BAY P INES
	2323	Billed Qty : 90 (EA) Unit C ost: .752 Gross Amt Due: 7 9.08
	2324	Ingredient Cost: 67. 68 Dispe nsing Fee: 11.40
	2325	U&C Charge : 79.08 A dmin Fee: 0.00
	2326	Insurance Name: WEBM D
	2327	Rx Coordin ation of B enefits: P RIMARY
	2328	BIN: 12345 6
	2329	PCN: 11234 56789
	2330	Group ID: WEBMDTEST
	2331	Cardholder ID:
	2332	Patient Re lationship Code: CAR DHOLDER
	2333	Cardholder First Nam e: One
	2334	Cardholder Last Name : ECMEpati ent
	2335	+ Enter ?? for more a ctions
	2336	PR Print Data EX Exit
	2337	Select act ion:Next S creen// <E nter>
	2338	PHARMACY E CME Sep 11, 20 05@11:42:4 1 Page: 6 of 7
	2339	Claim Log informatio n
	2340	+
	2341	Plan ID: 8 729
	2342	Payer Shee t IEN: WBT ESTB1
	2343	B2 Payer S heet IEN: WBTESTB2
	2344	B3 Rebill Payer Shee t: WBTESTB 1
	2345	Certify Mo de:
	2346	Cert IEN:
	2347	+ Enter ?? f or more ac tions
	2348	PR Print Data EX Exit
	2349	Select act ion:Next S creen// <E nter>
	2350	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.
	2351	PHARMACY E CME Sep 11, 20 05@11:43:0 1 Page: 7 of 7
	2352	Claim Log informatio n
	2353	+
	2354	Response I nformation (#659)--- ---------- ---------- ---------- ---------- ---------
	2355	Response R eceived: J UN 15,2005 @15:18:30
	2356	Date of Se rvice: 06/ 15/2005
	2357	Transactio n Response Status: R ejected
	2358	Total Amou nt Paid: $ 0
	2359	Ingredient Cost Paid : Dispe nsing Fee Paid:
	2360	Patient Re sp (INS):
	2361	Reject cod e(s):
	2362	NN:Transa ction Reje cted At Sw itch Or In termediary
	2363	Payer Mess age: NC40- Request fr om an unkn own site. Registrat ion is req uired
	2364	Payer Addi tional Mes sage:
	2365	Reason for Service C ode: AD
	2366	DUR Text: AMOXICILLI N 250MG CA P
	2367	DUR Additi onal Text: The text would disp lay here
	2368	Enter ?? f or more ac tions
	2369	PR Print Data EX Exit
	2370	Select act ion:Quit// <Enter> QUIT
	2371	5.09 Send to Worklis t XE " Se nd to Work list"
	2372	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.
	2373	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”.
	2374	Enter WRK at the Sel ect Action prompt, a nd a singl e line ite m for the claim you wish to se nd.
	2375	Example 5. 09-1: Acc essing the Send to W orklist Op tion, and Entering a Line Item .
	2376	PHARMACY E CME Jul 03, 20 08@12:04:0 2 Page: 1 of 41
	2377	SELECTED D IVISION(S) : ALL
	2378	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	2379	Sorted b y: Transac tion date by default
	2380	# PATIEN T/DRUG/COM MENTS IN SURANCE/ND C/DOS/RX#/ ECME# LOC/ TYP RXINF
	2381	1 ECMEpa tient,One (XXXX) NON TRIC/ V ET Pb:0 Rj :6 AcRv:3 RjRv:2
	2382	1.1 AL BUTEROL 0. 5% IN 503 83-0741-20 07/03 205 4905$ 1 /000001614 782 W RT * */R
	2383	p-Re jected
	2384	07:M /I Cardhol der ID
	2385	1.2 JA PANESE ENC EPHAL 492 81-0680-30 06/27 205 5040$ 0 /000001614 918 W RT * */N
	2386	p-In progress- Parsing r esponse
	2387	1.3 JA PANESE ENC EPHAL 492 81-0680-30 07/03 205 5040$ 1 /000001614 918 W RT D IS/N
	2388	p-In progress- Parsing r esponse
	2389	1.4 OL ANZAPINE 1 0MG T 000 02-4117-30 06/29 205 5048$ 0 /000001614 926 W RT D IS/N
	2390	p-In progress- Parsing r esponse
	2391	1.5 OL ANZAPINE 1 0MG T 000 02-4117-30 06/29 205 5049$ 0 /000001614 927 W RT * */N
	2392	p-Re versal acc epted/Clos ed
	2393	1.6 OL ANZAPINE 1 0MG T 000 02-4117-30 07/03 205 5049$ 1 /000001614 927 W RT A C/N
	2394	+ Enter ?? f or more ac tions
	2395	CV Change View REV Reverse Pa yable Clai m FR Furt her Resear ch
	2396	SO Sort L ist RES Resubmit C laim VER View ePharmacy Rx
	2397	CMT Add/Vi ew Comment s CLO Close Clai m WRK Send to Workli st
	2398	Select Act ion: Next Screen// w rk Send to Worklis t
	2399	Enter the line numbe rs for the claim(s) to send to the Pharm acy Workli st.
	2400	Select ite m(s): 1.1
	2401	You've cho sen to sen d to Pharm acy Work L ist the fo llowing:
	2402	1.1 AL BUTEROL 0. 5% IN 503 83-0741-20 06/03 205 4905$ 1 /000001614 782 W RT * */R
	2403	Comment fo r Pharmacy : Needs t o be resol ved in Pha rmacy.
	2404	Eligible c laim(s) wi ll be sent to the Ph armacy Wor klist...
	2405	Are you su re?(Y/N)? y YES
	2406	1.1 AL BUTEROL 0. 5% IN 503 83-0741-20 07/03 205 4905$ 1 /000001614 782 W RT * */R
	2407	has been s ent to the Pharmacy Work List.
	2408	Enter RETU RN to cont inue or '^ ' to exit:
	2409	Updating s creen...
	2410	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.
	2411	Example 5. 09-2: The Updated U ser Screen
	2412	PHARMACY E CME Jul 03, 20 08@12:04:4 8 Page: 1 of 41
	2413	SELECTED D IVISION(S) : ALL
	2414	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	2415	Sorted b y: Transac tion date by default
	2416	# PATIEN T/DRUG/COM MENTS IN SURANCE/ND C/DOS/RX#/ ECME# LOC/ TYP RXINF
	2417	1 ECMEpa tient,One (XXXX) NON TRIC/ V ET Pb:0 Rj :6 AcRv:3 RjRv:2
	2418	1.1 AL BUTEROL 0. 5% IN 503 83-0741-20 06/03 205 4905$ 1 /000001614 782 W RT * */R
	2419	07/2 3/08 - Sen t to Pharm acy: Needs to be res olved in P harmacy.
	2420	(ECM EUSER,FOUR )
	2421	p-Re jected
	2422	07:M /I Cardhol der ID
	2423	1.2 JA PANESE ENC EPHAL 492 81-0680-30 06/27 205 5040$ 0 /000001614 918 W RT * */N
	2424	p-In progress- Parsing r esponse
	2425	1.3 JA PANESE ENC EPHAL 492 81-0680-30 07/03 205 5040$ 1 /000001614 918 W RT D S/N
	2426	p-In progress- Parsing r esponse
	2427	1.4 OL ANZAPINE 1 0MG T 000 02-4117-30 06/29 205 5048$ 0 /000001614 926 W RT D S/N
	2428	p-In progress- Parsing r esponse
	2429	1.5 OL ANZAPINE 1 0MG T 000 02-4117-30 06/29 205 5049$ 0 /000001614 927 W RT * */N
	2430	+ Enter ?? f or more ac tions
	2431	CV Change View REV Reverse Pa yable Clai m FR Furt her Resear ch
	2432	SO Sort L ist RES Resubmit C laim VER View ePharmacy Rx
	2433	CMT Add/Vi ew Comment s CLO Close Clai m WRK Send to Workli st
	2434	Select Act ion: Next Screen//
	2435	If an inva lid claim is selecte d, other m essages ma y appear.
	2436	Example 5. 09-3: Sel ected Clai m Already on the Pha rmacy Work list
	2437	1.15 TAZAROTENE 0.1% T 0 0023-0042- 03 07/15 2 055208$ 0/0000016 15107 W RT AC/N
	2438	07/1 5/08 - Sen t to Pharm acy:testin g
	2439	+ Enter ?? f or more ac tions
	2440	CV Change View REV Reverse Pa yable Clai m FR Furt her Resear ch
	2441	SO Sort L ist RES Resubmit C laim VER View ePharmacy Rx
	2442	CMT Add/Vi ew Comment s CLO Close Clai m WRK Send to Workli st
	2443	Select Act ion: Next Screen// w rk Send to Worklis t
	2444	Enter the line numbe rs for the claim(s) to send to the Pharm acy Workli st.
	2445	Select ite m(s): 1.15
	2446	You've cho sen to sen d to Pharm acy Work L ist the fo llowing:
	2447	1.15 TA ZAROTENE 0 .1% T 000 23-0042-03 07/15 205 5208$ 0 /000001615 107 W RT A C/N
	2448	was ALREAD Y sent to the Pharma cy Work Li st.
	2449	Enter the line numbe rs for the claim(s) to send to the Pharm acy Workli st.
	2450	Select ite m(s):
	2451	Example 5. 09-4: Sel ected Clai m Doesn’t Have an El igible Rej ect Code
	2452	Enter the line numbe rs for the claim(s) to send to the Pharm acy Workli st.
	2453	Select ite m(s):
	2454	You've cho sen to sen d to Pharm acy Work L ist the fo llowing:
	2455	1.11 ALLOP URINOL 100 MG 00364- 0632-02 02 /18 788538 $ 0/00 0001459640 W RT AC/N
	2456	doesn't ha ve eligibl e reject c ode to be sent to th e Pharmacy Work List .
	2457	Example 5. 09-5: Sel ected Clai m Has Not Been Rejec ted
	2458	Enter the line numbe rs for the claim(s) to send to the Pharm acy Workli st.
	2459	Select ite m(s):
	2460	You've cho sen to sen d to Pharm acy Work L ist the fo llowing:
	2461	1.11 ACARB OSE 25MG T AB 00026- 2863-51 03 /03 788628 $ 0/00 0001459751 W RT DS/N
	2462	was not re jected and cannot be sent to t he Pharmac y Work Lis t.
	2463	Example 5. 09-6: Sel ected Clai m is Close d
	2464	1.22 ERYT HRITYL TET RAN 00223 -0916-01 0 4/03 10202 8$ 3/0 0000000240 3 W RT DL/ N
	2465	04/0 6/09 - RX DELETED
	2466	(ECM Eemployee, One)
	2467	p-Re jected/Clo sed
	2468	88:D UR Reject Error
	2469	1.23 ME THANTHELIN E 50M 000 14-1501-31 03/13 102 029$ 0 /000000002 404 W RT A C/N
	2470	p-Re jected
	2471	79:R efill Too Soon
	2472	+--------- Enter ?? f or more ac tions----- ---------- ---------- ---------- ----------
	2473	CV Change View REV Reverse Pa yable Clai m FR Furt her Resear ch
	2474	SO Sort L ist RES Resubmit C laim VER View ePharmacy Rx
	2475	CMT Add/Vi ew Comment s CLO Close Clai m WRK Send to Workli st
	2476	Select Act ion: Next Screen// W RK Send to Worklis t
	2477	Enter the line numbe rs for the claim(s) to send to the Pharm acy Workli st.
	2478	Select ite m(s): 1.22
	2479	You've cho sen to sen d to Pharm acy Work L ist the fo llowing:
	2480	1.22 ER YTHRITYL T ETRAN 002 23-0916-01 04/03 102 028$ 3 /000000002 403 W RT D E/N
	2481	is closed and cannot be sent t o the Phar macy Work List.
	2482	Enter the line numbe rs for the claim(s) to send to the Pharm acy Workli st.
	2483	Select ite m(s):
	2484	5.10 Reope n Closed C laims (hid den action ) XE " Reo pen Closed Claims (h idden opti on)"
	2485	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.
	2486	Enter ROC at the “Se lect Actio n:” prompt to access the optio n, and sel ect a line item.
	2487	Example 5. 10-1: Acc essing the Reopen Cl osed Claim s Option
	2488	PHARMACY E CME Mar 27, 20 09@16:26:5 0 Page: 1 of 41
	2489	SELECTED D IVISION(S) : ALL
	2490	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	2491	Sorted b y: Transac tion date by default
	2492	-#--PATIEN T/DRUG/COM MENTS IN SURANCE/ND C/DOS/RX#/ ECME# LOC/ TYP RXINF
	2493	1 ECMEpa tient,One (XXXX) OP INSUR2/205 5557898 VET ALL pa yable
	2494	1.1 DO XEPIN 25MG CAP 008 39-7221-06 03/27 102 105$ 0 /000000002 484 W BB A C/R
	2495	p-Pa yable
	2496	1.2 ME THAZOLAMID E 50M 000 05-5470-23 03/27 102 106$ 0 /000000002 485 W BB A C/R
	2497	p-Pa yable
	2498	2 ECMEpa tient,Two (XXXX) OP INSUR1/ VET Pb:53 Rj:28 AcRv :21 RjRv:6
	2499	2.1 ME DROXYPROGE STRON 000 09-0050-02 06/20 101 171$ 0 /000000001 521 W RT D S/N
	2500	06/2 0/08 - Cla rification Code 99 s ubmitted.
	2501	(ECM Euser,One)
	2502	p-Re versal acc epted
	2503	2.2 RE SERPINE 0. 1MG S 985 21-4587-02 03/26 101 237A$ 0 /000000001 695 C RT D S/R
	2504	p- R ejected/Cl osed
	2505	2.3 FU ROSEMIDE 1 0MG/M 510 79-0935-20 03/21 101 646$ 0 /000000002 014 W RT D S/N
	2506	+--------- Enter ?? f or more ac tions----- ---------- ---------- ---------- ----------
	2507	CV Change View REV Reverse Pa yable Clai m FR Furt her Resear ch
	2508	SO Sort L ist RES Resubmit C laim VER View ePharmacy Rx
	2509	CMT Add/Vi ew Comment s CLO Close Clai m WRK Send to Workli st
	2510	Select Act ion: Next Screen// R OC ROC
	2511	Enter the line numbe r for the claim you want to re open.
	2512	Select ite m(s): 2.2
	2513	You've cho sen to reo pen the fo llowing pr escription s(s) for
	2514	ECMEpatien t,One:
	2515	2.2 RE SERPINE 0. 1MG S 985 21-4587-02 03/26 101 237A$ 0 /000000001 695 C RT DS/R
	2516	All Select ed Rxs wil l be reope ned using the same i nformation gathered in the
	2517	following prompts.
	2518	Are you su re?(Y/N)? YES
	2519	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.
	2520	Example 5. 10-2: Ente ring Text Comment fo r Reopened Closed Cl aim
	2521	REOPEN COM MENTS: Cla im reopene d for new refill
	2522	ARE YOU SU RE YOU WAN T TO RE-OP EN THIS CL AIM? (Y/N) ? No// YES
	2523	ReOpening Claim: VA2 009=400000 0016=10522 0=0005843 ... OK
	2524	1 claim ha s been reo pened.
	2525	Enter RETU RN to cont inue or '^ ' to exit: <Enter>
	2526	Once the c laim has b een succes sfully reo pened, the screen is updated a nd re-disp layed.
	2527	Example 5. 10-3: The User Scree n is Updat ed and Re- Displayed
	2528	Updating s creen for reopened c laims...
	2529	PHARMACY E CME Mar 27, 20 09@16:28:3 2 Page: 1 of 41
	2530	SELECTED D IVISION(S) : ALL
	2531	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	2532	Sorted b y: Transac tion date by default
	2533	-#--PATIEN T/DRUG/COM MENTS IN SURANCE/ND C/DOS/RX#/ ECME# LOC/ TYP RXINF
	2534	1 ECMEpa tient,One (XXXX) OP INSUR2/205 5557898 VET ALL pa yable
	2535	1.1 DO XEPIN 25MG CAP 008 39-7221-06 03/27 102 105$ 0 /000000002 484 W BB A C/R
	2536	p-Pa yable
	2537	1.2 ME THAZOLAMID E 50M 000 05-5470-23 03/27 102 106$ 0 /000000002 485 W BB A C/R
	2538	p-Pa yable
	2539	2 ECMEpa tient,Two (XXXX) OP INSUR1/ VET Pb:53 Rj:28 AcRv :21 RjRv:6
	2540	2.1 ME DROXYPROGE STRON 000 09-0050-02 03/20 101 171$ 0 /000000001 521 W RT D S/N
	2541	06/2 0/08 - Cla rification Code 99 s ubmitted.
	2542	(ECM Euser,One)
	2543	p-Re versal acc epted
	2544	2.2 RE SERPINE 0. 1MG S 985 21-4587-02 03/26 101 237A$ 0 /000000001 695 C RT D S/R
	2545	p-Re jected
	2546	2.3 FU ROSEMIDE 1 0MG/M 510 79-0935-20 03/21 101 646$ 0 /000000002 014 W RT D S/N
	2547	CV Change View REV Reverse Pa yable Clai m FR Furt her Resear ch
	2548	SO Sort L ist RES Resubmit C laim VER View ePharmacy Rx
	2549	CMT Add/Vi ew Comment s CLO Close Clai m WRK Send to Workli st
	2550	Select Act ion: Next Screen//
	2551	5.11 Resub mit with E dits (hidd en action) XE " Resu bmit with Edits (hid den option )"
	2552	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, Date of Service, Patient Re sidence Co de, Pharma cy Service Type Code and/or De lay Reason Code. (Th e Date of Service pr ompt is on ly asked i f the pres cription h as been re leased.) If the cla im selecte d is for s econdary i nsurance, the Coordi nation of Benefits i nformation can also be edited.
	2553	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.
	2554
	2555	0 Not Sp ecified
	2556
	2557	1 Cardho lder
	2558
	2559	2 Spouse
	2560
	2561	3 Child
	2562
	2563	4 Other
	2564	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 .
	2565	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.”
	2566	Enter RED at the “Se lect Actio n:” prompt to choose the presc ription li ne to resu bmit.
	2567	Example 5. 11-1: Acc essing the Resubmit with Edits Option
	2568	PHARMACY E CME Aug 12, 20 11@02:40:3 4 Page: 1 of 81
	2569	SELECTED D IVISION(S) : ALL
	2570	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	2571	Sor ted by: Pa tient Name
	2572	# PATIEN T/DRUG/COM MENTS INSURANC E/NDC/RX#/ ECME# LOC /TYP RXINF
	2573	5 ECMEpa tient,Two (XXXX) WE BMD / VET AL L payable
	2574	5.1 LE UCOVORIN 5 MG/ML 007 03-5140-01 08/12 109 58860$ 0 /000009378 798 W RT A C/N
	2575	p-Re versal rej ected
	2576	6 ECMEpa tient,One (XXXX) WEB MD / VET Pb: 3 Rj:1 AcR v:1 RjRv:0
	2577	6.1 GR ANULEX SPR AY 4O 005 14-0001-01 08/12 109 58847 0 /000009378 705 W RT A C/R
	2578	p-Pa yable
	2579	6.2 AC ARBOSE 100 MG TA 000 26-2862-51 08/12 525 36284 1 /000009378 782 W RT D S/N
	2580	03/2 0/06 - RX DISCONTINU ED
	2581	p-Re jected
	2582	08:M /I Person Code
	2583	+ Enter ?? f or more ac tions
	2584	CV Change View REV Reverse Pa yable Clai m FR Furt her Resear ch
	2585	SO Sort L ist RES Resubmit C laim VER View ePharmacy Rx
	2586	CMT Add/Vi ew Comment s CLO Close Clai m WRK Send to Workli st
	2587	Select Act ion: Quit/ / RED RE D
	2588	Enter the line numbe r for the claim to b e submitte d.
	2589	Example 5. 11-2: Ent ering the Line Item for the Cl aim Resubm ission Req uest
	2590	Enter the line numbe r for the claim to b e resubmit ted:
	2591	Select ite m: 6.2
	2592	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.
	2593	Example 5. 11-3: Ente ring the L ine Item f or a Claim that has a Payable Secondary Claim
	2594	The claim:
	2595	1.12 FLU RAZEPAM 15 MG C 00140 -0065-14 0 3/04 10232 2$ 2/00000 0113596 W RT AC/R
	2596	cannot be Resubmitte d if the s econdary c laim is pa yable.
	2597	Please rev erse the s econdary c laim first .
	2598	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.
	2599	Example 5. 11-4: Ente ring Yes t o “Are You Sure” Pro mpt
	2600	You've cho sen to RES UBMIT the following prescripti on for ECM Epatient, One
	2601	1.2 LI DOCAINE 0. 5% W/ 001 86-0140-01 07/09 100 704$ 1 /000000000 623 W RT A C/N
	2602	ARE YOU SU RE? (Y/N)? No// YES
	2603	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, Date of Se rvice, Pat ient Resid ence Code, Pharmacy Service Ty pe Code an d/or Delay Reason Co de.
	2604	Example 5. 11-5: Edit ing Prompt s
	2605	Pharmacy R elationshi p Code: <E nter>
	2606	Pharmacy P erson Code : 23
	2607	Prior Auth orization Number: 00 000000000/ /
	2608	Prior Auth orization Type Code: 0// NOT SPEC IFIED
	2609	Submission Clarifica tion Code 1: 5// THERAP Y CHANGE
	2610	Submission Clarifica tion Code 2:
	2611
	2612	Select one of the fo llowing:
	2613	1. 01/19/2 010 Curre nt Date of Service
	2614	2. 01/19/2 010 Fill Date
	2615	3. 01/20/2 010 Relea se Date
	2616	Date of Se rvice: 1// 2 01/19/2 010 Fill D ate
	2617	Patient Re sidence Co de: 1// HOME
	2618	Pharmacy S ervice Typ e Code: 1/ / R ETAIL
	2619	Delay Reas on Code:
	2620	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.
	2621	Example 5. 11-6: Ente ring the s econdary c laim infor mation wit h payment informatio n
	2622	Data for S econdary C laim
	2623	---------- ---------- ----
	2624	Insurance: ECME INS URANCE2 COB: SECON DARY
	2625	Rate Type: REIMBURS ABLE INS.
	2626	Other Cove rage Code: 02 (OTHE R COVERAGE EXISTS - PAYMENT CO LLECTED)
	2627	Other Paye r Coverage Type: 01 (PRIMARY)
	2628	Other Paye r ID Quali fier: 03 (BANK INFO RMATION NU MBER (BIN) )
	2629	Other Paye r ID: 123 456
	2630	Other Paye r Date: J un 28, 201 0
	2631	Other Paye r Paid Qua lifier: 0 8 (SUM OF ALL REIMBU RSEMENT)
	2632	Other Paye r Amount P aid: 40.0 0
	2633	Do you wan t to edit this Secon dary Claim Informati on (Y/N)? N// y YES
	2634	Insura nce CO B Subscri ber ID Gro up Ho lder Eff ective Ex pires
	2635	====== ======= == == ======= ====== === ======= == ====== === ======= == ========
	2636	1 ECME I NSURAN PRI 12340987 T-GR OUP1 PAT IENT 10/2 0/2006 06/ 00/2011
	2637	2 ECME I NSURAN SEC D-GR OUP1 PAT IENT 07/0 9/2006 06/ 00/2011
	2638	SECONDARY INSURANCE POLICY: 2/ / ECME I NSURANCE1 (SECONDARY ) - D-GROU P1
	2639	SELECT RAT E TYPE: RE IMBURSABLE INS.// Who's Re sponsible: INSURER
	2640	OTHER COVE RAGE CODE: 02// O THER COVER AGE EXISTS - PAYMENT COLLECTED
	2641	OTHER PAYE R ID: 1234 56//
	2642	OTHER PAYE R DATE: J un 28, 201 0//
	2643	Edit Paid Amounts or Reject Co des (PAID AMOUNTS/RE JECT CODES ): PAID A MOUNTS//
	2644	OTHER PAYE R AMOUNT P AID QUALIF IER: 08// SUM OF ALL REIMBU RSEMENT
	2645	OTHER PAYE R AMOUNT P AID: (0-9 99999): 40 .00//
	2646	Example 5. 11-7: Ente ring the s econdary c laim infor mation wit h reject i nformation
	2647	Data for S econdary C laim
	2648	---------- ---------- ----
	2649	Insurance: DAVE INS URANCE COB: SECON DARY
	2650	Rate Type: REIMBURS ABLE INS.
	2651	Other Cove rage Code: 03 (OTHE R COVERAGE EXISTS - THIS CLAIM NOT COVER ED)
	2652	Other Paye r Coverage Type: 01 (PRIMARY)
	2653	Other Paye r ID Quali fier: 03 (BANK INFO RMATION NU MBER (BIN) )
	2654	Other Paye r ID: 610 459
	2655	Other Paye r Date: A ug 16, 201 0
	2656	Other Paye r Reject C ode: 34:M /I Submiss ion Clarif ication Co de
	2657	Other Paye r Reject C ode: 07:M /I Cardhol der ID
	2658	Other Paye r Reject C ode: JE:M /I Percent age Sales Tax Basis Submitted
	2659	Do you wan t to edit this Secon dary Claim Informati on (Y/N)? N// y YES
	2660	Insura nce CO B Subscri ber ID Gro up Ho lder Eff ective Ex pires
	2661	====== ======= == == ======= ====== === ======= == ====== === ======= == ========
	2662	1 DAVE I NSURANC SE C SI32432 D-G ROUP1 PA TIENT 05/ 09/2007
	2663	SECONDARY INSURANCE POLICY: 1/ / DAVE I NSURANCE ( SECONDARY) - D-GROUP 1
	2664	SELECT RAT E TYPE: RE IMBURSABLE INS.// Who's Re sponsible: INSURER
	2665	OTHER COVE RAGE CODE: 03// O THER COVER AGE EXISTS - THIS CL AIM NOT CO VERED
	2666	OTHER PAYE R ID: 6104 59//
	2667	OTHER PAYE R DATE: A ug 16, 201 0//
	2668	Edit Paid Amounts or Reject Co des (PAID AMOUNTS/RE JECT CODES ): REJECT CODES//
	2669	OTHER PAYE R REJECT C ODE: 34// M/I Submissio n Clarific ation Code
	2670	OTHER PAYE R REJECT C ODE: 07// M/I Cardholde r ID
	2671	OTHER PAYE R REJECT C ODE: JE// M/I Percentag e Sales Ta x Basis Su bmitted
	2672	OTHER PAYE R REJECT C ODE:
	2673	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.
	2674	Example 5. 11-8: Answ ering “Is the Claim Correct?” Prompt
	2675	IS THIS CL AIM CORREC T?(Y/N)? Y // ES
	2676	SUBMIT CLA IM TO ECME INSURANCE 1 ?(Y/N)? Y// ES
	2677	Veteran Pr escription 103689 su ccessfully submitted to ECME f or claim g eneration.
	2678	Example 5. 11-9: Answ ering “Are you sure? ” Prompt
	2679	Are you su re?(Y/N)? YES
	2680	Veteran Pr escription 100003433 A successf ully submi tted to EC ME for cla im generat ion.
	2681	Claim Stat us:
	2682	IN PROGRES S-Waiting to start
	2683
	2684	IN PROGRES S-Waiting for packet build
	2685	IN PROGRES S-Packet b eing built
	2686	IN PROGRES S-Transmit ting
	2687	E PAYABLE
	2688	Veteran Pr escription 100003433 A successf ully submi tted to EC ME for cla im generat ion.
	2689	1 claim ha s been res ubmitted.
	2690	Enter RETU RN to cont inue or '^ ' to exit: <Enter>
	2691	Updating s creen for resubmitte d claim...
	2692	5.12 OPEC C Reject I nformation (hidden a ction)
	2693	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.
	2694	Access the action by entering REJ at the “Select A ction:” pr ompt on th e ECME Use r Screen.
	2695	Example 5. 12-1: Acc essing and Executing the OPECC Reject In formation Action
	2696	PHARMACY E CME Aug 10, 20 05@10:31:2 2 Page: 1 8 of 42
	2697	SELECTED D IVISION(S) : ALL
	2698	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	2699	Sor ted by: Pa tient Name
	2700	+# PATIEN T/DRUG/COM MENTS INSURANC E/NDC/RX#/ ECME# LOC /TYP RXINF
	2701	7 ECMEpa tient,One (XXXX) WE BMD TE/ VET A LL payable
	2702	7.1 PR EDNISONE 1 MG TA 0024 2074475 09 /16 100803 0/00 0000111872 W RS AC/N
	2703	09/1 0/15 – The comment g oes here.
	2704	(USE R, ONE)
	2705	p-Re jected
	2706	79:R efill Too Soon
	2707	+ Enter ?? f or more ac tions
	2708	CV Change View REV Reverse Pa yable Clai m FR Furt her Resear ch
	2709	SO Sort L ist RES Resubmit C laim VER View ePharmacy Rx
	2710	CMT Add/Vi ew Comment s CLO Close Clai m WRK Send to Workli st
	2711	Select Act ion: Next Screen// R EJ REJ OPECC Reje ct Informa tion
	2712	You will s ee the fol lowing mes sage, if y ou attempt to select a claim w hen there is no reje ction.
	2713	Example 5. 12-2: Ent ering the Line Item for a Clai m with no rejection
	2714	This claim is not a valid sele ction for the OPECC Reject Inf ormation s creen.
	2715	This scree n is for e ither reje cted claim s or non-b illable cl aims.
	2716	Enter RETU RN to cont inue or '^ ' to exit:
	2717	You are p rompted fo r the line item of t he rejecte d claim or non-billa ble prescr iption ent ry.
	2718	Example 5. 12-3: Ent ering the Line Item for the OP ECC Reject Informati on Action
	2719	Select Act ion: Next Screen// R EJ REJ OPECC Reje ct Informa tion
	2720	Select ite m: 7.1
	2721	The OPECC Reject Inf ormation S creen disp lays.
	2722	Example 5. 12-4: OPE CC Reject Informatio n Screen D isplay
	2723	OPECC Reje ct Informa tion Oct 28, 20 15@14:45:4 2 Page: 1 of 3
	2724	Division : XXXXXX N PI: 111009 9999 NCP DP: 531000 0XX TAX I D: XX-XXXX XXX
	2725	Patient : PATIENT,O NE(XXXP) Sex: M DOB: JUL X X,19XX(XX)
	2726	Rx# : 100XXX/0 ECME #: 0000001 11872 Da te of Serv ice: Sep 1 6, 2015
	2727	Drug : PREDNISON E 1MG TAB NDC C ode: 00242 -0744-75
	2728	REJECT Inf ormation ( Veteran) RESUBMISSI ON
	2729	Current EC ME Status: E REJECTE D
	2730	Rejects re ceived fro m Payer on 09/16/201 5 5:26:39 pm.
	2731	Code De scription
	2732	79 - Re fill Too S oon
	2733	Next Avail Fill: 10/ 31/2015
	2734	Payer Mess age : EMD 1000: CLA IM PAID
	2735	Payer Addl Msg : EMD 1000: CLA IM PAID RX :00000010X XXFILL:201 5-09-16
	2736	BIN :610144 PC N:TEST
	2737	OPECC COMM ENTS
	2738	- 09/10/15 5:17 pm – First com ment for O PECC scree n (USER,ON E)
	2739	PHARMACIST COMMENTS
	2740	- 05/12/15 8:23 am – Second co mment for Pharmacist (USER,TWO )
	2741	INSURANCE Informatio n
	2742	Insurance : VET CNF
	2743	Contact : 333 -444-5555
	2744	BIN : 610 144
	2745	PCN : TES T
	2746	Group Numb er : 246
	2747	Cardholder ID : 123 4567890
	2748	Effective Date : 01/ 25/2015
	2749	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.
	2750	Example 5. 12-5: Act ions Avail able from the OPECC Reject Inf ormation S creen
	2751	+ Enter ?? f or more ac tions
	2752	VW View R x VER View E CME Rx MP Med Pr ofile PI Pat In fo
	2753	Select: Ne xt Screen/ /
	2754	5.13 Resu bmit Claim Without R eversal (h idden acti on) XE " R esubmit Cl aim"
	2755	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..
	2756	The action is access ed by ente ring RER a t the “Sel ect Action :” prompt on the ECM E User Scr een.
	2757	Example 5. 13-1: Acce ssing and Executing the Resubm it Claim W /O Reversa l Action
	2758	Select Act ion: Next Screen// R ER RER Resubmit C laim w/o R eversal
	2759	You are pr ompted for the line item(s) of the claim to be res ubmitted.
	2760	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
	2761	Note: This actio n will res ubmit clai ms without performin g a revers al.
	2762	This actio n should b e used in instances where the payer show s the
	2763	claim was reversed a nd VistA s hows a pay able claim . This act ion will
	2764	NOT submit a reversa l regardle ss of the current Vi stA claim status.
	2765	Enter the line numbe rs for the claim(s) to be resu bmitted w/ o reversal .
	2766	Select ite m(s):
	2767	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.
	2768	Example 5. 13-5: Ente ring “Y” t o Continue Claim Res ubmission Request
	2769	You've cho sen to RES UBMIT W/O REVERSAL t he followi ng Rx for PATIENT,TW O
	2770	1.4 PR EDNISONE 1 MG TA 0024 2074475 10 /28 100XXX 0/00 0000112XXX W RT AC/N
	2771	Are you su re?(Y/N)? YES
	2772	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.
	2773	Example 5. 13-6: Ent ering “Y” to Place M ultiple Su bmissions in the Que ue
	2774	The claim is in prog ress. The request wi ll be sche duled and processed after
	2775	the previo us request (s) are co mpleted. P lease be a ware that the result of
	2776	the resubm it depends on the pa yer's resp onse to th e prior in complete r equests.
	2777	Do you wan t to proce ed?(Y/N)? y YES
	2778	The claim resubmissi on request is submit ted and th e progress is displa yed.
	2779	Example 5. 13-7: Dis playing a Successful ly Resubmi tted Claim
	2780	Claim Stat us:
	2781	IN PROGRES S-Waiting to start
	2782	IN PROGRES S-Building the claim
	2783	IN PROGRES S-Transmit ting
	2784	E PAYABLE
	2785	Veteran Pr escription 100958 su ccessfully submitted to ECME f or claim g eneration.
	2786	1 claim ha s been res ubmitted.
	2787	Enter RETU RN to cont inue or '^ ' to exit: <ENTER>
	2788	Updating s creen for resubmitte d claims.. .
	2789	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 .
	2790	Example 5. 13-8: Disp laying the Claim Sta tus after a Resubmis sion
	2791	PHARMACY E CME Oct 28, 20 15@16:29:3 2 Page: 2 of 52
	2792	SELECTED D IVISION(S) : ALL
	2793	Transmitte d by ALL u sers Activity Date Rang e: within the past 9 99 day(s)
	2794	Sorted b y: Transac tion date by default
	2795	+# PATIEN T/DRUG/COM MENTS IN SURANCE/ND C/DOS/RX#/ ECME# STATUS/LOC /TYP/RXINF
	2796	1.4 PR EDNISONE 1 MG TA 0024 2074475 10 /28 100XXX 0/00 0000112XXX W RS AC/N
	2797	p-Pa yable
	2798	5.14 Open /Close Non Billable Entry (hid den action )
	2799	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.
	2800	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.
	2801	The action is access ed by ente ring OCN a t the “Sel ect Action :” prompt on the ECM E User Scr een.
	2802	Example 5. 14-1: Acce ssing and Executing the Open/C lose Non B illable En try Action
	2803	Select Act ion: Next Screen// O CN OCN Open/Close Non-Billa ble Entry
	2804	You are pr ompted for the line item(s) of the claim to be ope ned or clo sed.
	2805	Example 5. 14-2: Ente ring the L ine Item f or the Ope n/Close No n Billable Entry
	2806	Enter the line numbe r for the entry to b e opened o r closed.
	2807	Select ite m:
	2808	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 .
	2809	Example 5. 14-5: Answ er Prompts for Open/ Close Non Billable e ntry
	2810	You've cho sen to CLO SE the fol lowing ent ry for
	2811	PATIENT,ON E :
	2812	3.1 MI LK OF MAGN ESIA 0034 9821742 100SSS 0/ W RS EX/N
	2813	p-No n-Billable /Open
	2814	eT:T RICARE-RX NOT BILLAB LE (DRUG N OT BILLABL E)
	2815	The Select ed Entry w ill be CLO SED.
	2816	Comment : Enter a co mment now
	2817	Are you su re? (Y/N)? YES
	2818	Closing En try
	2819	Enter RETU RN to cont inue or '^ ' to exit:
	2820	5.15 Displ ay Update (hidden ac tion) XE " Display U pdate"
	2821	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.
	2822	This hidde n action i s accessed by enteri ng UD at t he “Select Action:” prompt on the ECME User Scree n.
	2823	Example 5. 15-1: Acc essing the Display U pdate Acti on
	2824	PHARMACY E CME Apr 26, 20 06@11:44:4 5 Page : 1 of 2
	2825	SELECTED D IVISION(S) : ALL
	2826	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	2827	Sor ted by: Pa tient Name
	2828	# PATIEN T/DRUG/COM MENTS INSURANC E/NDC/RX#/ ECME# LOC/TYP RXINF
	2829	6 ECMEpa tient,Two (XXXX) WEBMD TE/ VET Pb:1 Rj:0 AcRv:0 Rj Rv:1
	2830	6.1 FU ROSEMIDE 1 0MG/M 006 41-2312-25 04/22 100 004065$ 0 /000000504 691 W RT A C/R
	2831	p-Pa yable
	2832	6.2 CH OLESTYRAMI NE 4G 000 87-0580-01 04/22 100 004066$ 0 /000000504 692 W RT A C/R
	2833	p-Re versal rej ected
	2834	NN:T ransaction Rejected At Switch Or Interme diary
	2835	NC16 -The clear inghouse d id not rep ly in time .
	2836	7 ECMEpa tient,One (XXXX) WEBMD TE/ VET ALL payab le
	2837	7.1 AL BUTEROL IN HALER 555 55-4444-22 04/26 100 003744$ 0 /000000504 304 W RT A C/R
	2838	p-Pa yable
	2839	7.2 AC ETYLCYSTEI NE 20 000 87-0570-09 04/21 100 004054$ 0 /000000504 677 W RT A C/N
	2840	s-Pa yable (p-P ayable)
	2841	8 ECMEpa tient,Thre e (XXXX) WEBMD TE/ VET ALL payab le
	2842	+ Enter ?? f or more ac tions
	2843	The screen has been updated on APR 26,20 06@14:50:4 7. Press " Q" to quit .
	2844	CV Change View REV Reverse Pa yable Clai m FR Furt her Resear ch
	2845	SO Sort L ist RES Resubmit C laim VER View ePharmacy Rx
	2846	CMT Add/Vi ew Comment s CLO Close Clai m WRK Send to Workli st
	2847	Select Act ion: Next Screen// U D Displa y Update
	2848	Updating s creen...
	2849	5.16 Exit (from ECME User Scre en) XE " Exit from ECME User Screen"
	2850	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.
	2851	6.
	2852	Accessing the ECME P harmacy CO B Menu XE "Accessing the ECME Pharmacy C OB Menu"
	2853	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.
	2854	Example 6- 1: Accessi ng the ECM E Pharmacy COB Menu
	2855	*** ****** ****** ****** ****** **
	2856	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	2857	* XXXXXX VAMC *
	2858	* Main M enu *
	2859	*** ****** ****** ****** ****** **
	2860	U ECME User Screen
	2861	COB ECME Pharm acy COB .. .
	2862	MGR Pharmacy E CME Manage r Menu ...
	2863	RPT Pharmacy E lectronic Claims Rep orts ...
	2864	Select ECM E Option: MGR Pharm acy ECME M anager Men u
	2865	Example 6- 2: Display ing the EC ME Pharmac y COB Menu
	2866	*** ****** ****** ****** ****** **
	2867	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	2868	* XXXXXXX VAMC *
	2869	* Phar macy ECME Manager Me nu *
	2870	*** ****** ****** ****** ****** **
	2871	SEC Potential Secondary Rx Claims Report
	2872	TRI Potential Claims Rep ort for Du al Eligibl e
	2873	PRO Process Se condary/TR ICARE Rx t o ECME
	2874	Select ECM E Pharmacy COB Optio n:
	2875	6.1 Potent ial Second ary Rx Cla ims Report XE " Pote ntial Seco ndary Rx C laims Repo rt"
	2876	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:
	2877	A prescrip tion where the secon dary claim is closed in ECME.
	2878	A prescrip tion where the secon dary claim is payabl e in ECME.
	2879	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 .
	2880	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.
	2881	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.
	2882	Example 6. 1-1: Acces sing the P otential S econdary R x Claims R eport
	2883	*** ****** ****** ****** ****** **
	2884	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	2885	* XXXXXX VAMC *
	2886	* Pharmacy Electroni c Claims R eports *
	2887	*** ****** ****** ****** ****** **
	2888	SEC Potential Secondary Rx Claims Report
	2889	TRI Potential Claims Rep ort for Du al Eligibl e
	2890	PRO Process Se condary/TR ICARE Rx t o ECME
	2891	Select ECM E Pharmacy COB Optio n: SEC Po tential Se condary Rx Claims Re port
	2892	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.
	2893	Example 6. 1-2: Gener ating the Potential Secondary Rx Claims Report
	2894	SELECTION CRITERIA
	2895	Selec t one of t he followi ng:
	2896	D DIVISION
	2897	A ALL
	2898	Select Cer tain Pharm acy (D)ivi sions or ( A)LL: ALL
	2899	EARLIEST D ATE: t (A PR 14, 200 9)
	2900	LATEST D ATE: T// < ENTER> (A PR 14, 200 9)
	2901	SORT CRITE RIA
	2902	Primary So rt: (N/P/ S/D): Divi sion// ??
	2903	Enter a co de from th e list to indicate t he Primary sort orde r.
	2904	Selec t one of t he followi ng:
	2905	N Patient Na me
	2906	P Payer
	2907	S Date Of Se rvice
	2908	D Division
	2909	Primary So rt: (N/P/ S/D): Divi sion// <EN TER>
	2910	Secondary Sort: (N/ P/S): <ENT ER>
	2911	DEVICE: HO ME// <ENTE R> UCX/TE LNET Ri ght Margin : 80// <EN TER>
	2912	Collecting Potential Secondary data.
	2913	Enter RETU RN to cont inue or '^ ' to exit: <ENTER>
	2914	========== ========== ========== ========== ========== ========== ========== =========
	2915	Potential Secondary Rx Claims Report 4/14/09 - 4/14/09 Page: 1
	2916	Selected D ivisions: ALL
	2917	Sorted By: Division;
	2918	Bill# RX# Fill Pati ent PatID COB Date Payers
	2919	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------
	2920	Division: XXXXXX
	2921	K9000LG 102179 4 ECME patient,On e 0000 p 4/14/ 09 ECME I NSURANCE1
	2922	t ECME I NSURANCE2
	2923	K0000QD 2055862 0 ECME patient,On e 0000 p 7/13/ 10 ECME I NSURANCE1
	2924	s ECME I NSURANCE2
	2925	- ECME I NSURANCE3
	2926	(P) Rej 2055865 0 ECME patient,On e 0000 p 7/13/ 10 ECME I NSURANCE1
	2927	s ECME I NSURANCE2
	2928	t ECME I NSURANCE3
	2929	(P) Rej 2055866 0 ECME patient,Tw o 4444 p 7/14/1 0 ECME IN SURANCE1
	2930	s ECME I NSURANCE2
	2931	Bill# "(P) Rej" indi cates a re jected/clo sed primar y ECME cla im
	2932	COB "-" in dicates a blank COB field in t he pt. ins . policy
	2933	6.2 XE "Po tential Cl aims Repor t for Dual Eligible" Potentia l Claims R eport for Dual Eligi ble
	2934	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.
	2935	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.
	2936	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.
	2937	Example 6. 2-1: Acces sing the P otential C laims Repo rt for Dua l Eligible
	2938	*** ****** ****** ****** ****** **
	2939	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	2940	* XXXXX V AMC *
	2941	* Pharmacy Electroni c Claims R eports *
	2942	*** ****** ****** ****** ****** **
	2943	SEC Potential Secondary Rx Claims Report
	2944	TRI Potential Claims Rep ort for Du al Eligibl e
	2945	PRO Process Se condary/TR ICARE Rx t o ECME
	2946	Select ECM E Pharmacy COB Optio n: TRI Po tential Cl aims Repor t for Dual Eligible
	2947	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.
	2948	Example 6. 2-2: Gener ating the Potential TRICARE Cl aims Repor t
	2949	Selec t one of t he followi ng:
	2950	D DIVISION
	2951	A ALL
	2952	Select Cer tain Pharm acy (D)ivi sions or ( A)LL: ALL
	2953	Selec t one of t he followi ng:
	2954	T TRICARE
	2955	C CHAMPVA
	2956	A ALL
	2957	Display (T )RICARE or (C)HAMPVA or (A)LL Entries: A // LL
	2958	EARLIEST D ATE: t-10 (APR 06, 2009)
	2959	LATEST D ATE: T// (APR 16, 2009)
	2960	SORT CRITE RIA
	2961	Primary So rt: (N/P/ S/D/E): Di vision//
	2962	Secondary Sort: (N/ P/S/E):
	2963	Tertiary S ort: (N/P /S/E):
	2964	DEVICE: HO ME// ;;999 9 TELNET TERMINAL
	2965	Collecting TRICARE d ata.
	2966	Enter RETU RN to cont inue or '^ ' to exit:
	2967	========== ========== ========== ========== ========== ========== ========== ==========
	2968	Potential TRICARE Rx Claims Re port 8 /1/80 - 7/ 28/14 Page: 1
	2969	Selected D ivisions: ALL
	2970	Selected P atient Eli gibility: ALL
	2971
	2972	Sorted By: Division;
	2973	'*' indica tes the HP ID/OEID fa iled valid ation chec ks
	2974	RX# F ill Date Patient Pat ID COB Eli g Payers H PID/OEID
	2975	---------- ---------- ---------- ---------- ---------- ---------- ---------- ----------
	2976	Division: XXXXX VAMC
	2977	100407 2 9/9/10 OPTRICAR E,ONE 16 0P p TRI C TRICARE- 23 TEST 6 999999999*
	2978	100408 1 9/9/10 OPTRICAR E,ONE 16 0P p TRI C TRICARE- 23 TEST 6 999999999*
	2979	6.3 Proces s Secondar y/TRICARE Rx to ECME XE "Proce ss Seconda ry/Tricare Rx to ECM E"
	2980	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.
	2981	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.
	2982	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.
	2983	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.
	2984	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.
	2985	Example 6. 3-1: Acces sing the P rocess Sec ondary/TRI CARE Rx to ECME opti on
	2986	*** ****** ****** ****** ****** **
	2987	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	2988	* XXXXXX V AMC *
	2989	* Pharmacy Electroni c Claims R eports *
	2990	*** ****** ****** ****** ****** **
	2991	SEC Potential Secondary Rx Claims Report
	2992	TRI Potential Claims Rep ort for Du al Eligibl e
	2993	PRO Process Se condary/TR ICARE Rx t o ECME
	2994	Select ECM E Pharmacy COB Optio n: PRO Pr ocess Seco ndary/TRIC ARE Rx to ECME
	2995	6.3.1
	2996	Submitting Secondary Claims XE "Submitti ng Seconda ry Claims"
	2997
	2998	XE "Submi tting Seco ndary Clai ms"
	2999	The Proces s Secondar y/TRICARE Rx to ECME (PRO) opt ion will p rompt for a Rx#.
	3000	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.
	3001	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.
	3002	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 ).
	3003	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
	3004	Example 6. 3.1-1: Ini tial Promp ts for the Process S econdary/T RICARE Rx to ECME op tion
	3005	Select PRE SCRIPTION RX #: 1003 0 LI DOCAINE 0. 5% W/EPI I NJ MDV
	3006	Patient RX# Dru g Name RX Stat us
	3007	ECMEPatie nt, Two 100 30 L IDOCAINE 0 .5% W/EPI INJ ACTIV E
	3008	DO YOU WAN T TO CONTI NUE?(Y/N)? Y// ES
	3009	RX #10030 has the fo llowing fi lls:
	3010	Fill Date
	3011	==== ==========
	3012	0 07/02/2010
	3013	1 10/12/2010
	3014	SELECT A F ILL TO BIL L: 07/02/2 010
	3015	Select pay er sequenc e for bill ing:
	3016	1 PRIM ARY
	3017	2 SECO NDARY
	3018	SELECT PAY ER SEQUENC E: 2 SECO NDARY
	3019	Drug name NDC Da te RX# RE F# TYPE STATUS
	3020	========== ========== ========== ========== ========== ========== ========== =========
	3021	LIDOCAINE 0. 001860 14001 09 /10 10030$ 0/00 03098 W RT **/R REJECTED
	3022	There is a n existing rejected/ reversed s econdary e -claim(s) for the RX /refill.
	3023	Do you wan t to submi t a new se condary cl aim(Y/N)? N// YES
	3024	DO YOU WIS H TO ADD/E DIT INSURA NCE COMPAN Y DATA FOR THIS PATI ENT?(Y/N)? N// O
	3025	Data for S econdary C laim
	3026	---------- ---------- ----
	3027	Insurance: INSURANC E3 COB: SECONDARY
	3028	Rate Type: REIMBURS ABLE INS.
	3029	Other Cove rage Code: 02 (OTHE R COVERAGE EXISTS - PAYMENT CO LLECTED)
	3030	Other Paye r Coverage Type: 01 (PRIMARY)
	3031	Other Paye r ID Quali fier: 03 (BANK INFO RMATION NU MBER (BIN) )
	3032	Other Paye r ID: 123 456
	3033	Other Paye r Date: O ct 15, 201 0
	3034	Other Paye r Paid Qua lifier: 0 7 (DRUG BE NEFIT)
	3035	Other Paye r Amount P aid: 40.0 0
	3036	Do you wan t to edit this Secon dary Claim Informati on (Y/N)? N// YES
	3037	Insura nce CO B Subscri ber ID Gro up Ho lder Eff ective Ex pires
	3038	====== ======= == == ======= ====== === ======= == ====== === ======= == ========
	3039	1 INSURA NC2 PR I AAA INS . PA TIENT 03/ 10/2010
	3040	2 INSURA N3 SE C 5487357 9430 GR PA TIENT 03/ 26/2010
	3041	SECONDARY INSURANCE POLICY: 2/ / INSURA NCE3 (SECO NDARY) - B RIAN'S GRP
	3042	SELECT RAT E TYPE: RE IMBURSABLE INS.// Who's Re sponsible: INSURER
	3043	OTHER COVE RAGE CODE: 02// O THER COVER AGE EXISTS - PAYMENT COLLECTED
	3044	OTHER PAYE R ID: 1234 56//
	3045	OTHER PAYE R DATE: O ct 15, 201 0//
	3046	Edit Paid Amounts or Reject Co des (PAID AMOUNTS/RE JECT CODES ): PAID A MOUNTS//
	3047	OTHER PAYE R AMOUNT P AID QUALIF IER: 07// DRUG BE NEFIT
	3048	OTHER PAYE R AMOUNT P AID: (0-9 99999): 40 .00//
	3049	OTHER PAYE R AMOUNT P AID QUALIF IER:
	3050	SUBMIT CLA IM TO INSU RANCE3 ?(Y /N)? Y// E S
	3051	Veteran Pr escription 10030 suc cessfully submitted to ECME fo r claim ge neration.
	3052	Processing Secondary claim...
	3053	Claim Stat us:
	3054	IN PROGRES S-Building the claim
	3055	IN PROGRES S-Building the HL7 p acket
	3056	IN PROGRES S-Transmit ting
	3057	E PAYABLE
	3058	6.3.2
	3059	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"
	3060	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.
	3061	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 .
	3062	Example 6. 3.2-1: Pro mpt for th e Process Secondary/ TRICARE Rx to ECME o ption
	3063	Select ECM E Pharmacy COB Optio n: PRO Pr ocess Seco ndary/ TRI CARE Rx to ECME
	3064	Select PRE SCRIPTION RX #: 1030 27 B ETHANECHOL 10MG TAB
	3065	Patient RX# Drug Nam e RX Status
	3066	ECMEpatie nt,One 103027 BETHANEC HOL 10MG T AB ACTIVE
	3067	DO YOU WAN T TO CONTI NUE?(Y/N)? Y// ES
	3068	RX #103027 has the f ollowing f ills:
	3069	Fill Date
	3070	==== ==========
	3071	0 10/27/2009
	3072	SELECT A F ILL TO BIL L: 0 10/2 7/2009
	3073	Select pay er sequenc e for bill ing:
	3074	1 PRIM ARY
	3075	2 SECO NDARY
	3076	SELECT PAY ER SEQUENC E: 1 PRIM ARY
	3077	SELECT RAT E TYPE: ?
	3078	Answer wi th RATE TY PE NUMBER, or NAME
	3079	Do you wa nt the ent ire 17-Ent ry RATE TY PE List? y (Yes)
	3080	Choose from:
	3081	1 CRIM E VICTIM Who's Resp onsible: I NSURER
	3082	2 DENT AL Who's Responsibl e: PATIENT
	3083	3 HUMA NITARIAN Who's Resp onsible: P ATIENT
	3084	4 INTE RAGENCY W ho's Respo nsible: OT HER (INSTI TUTION)
	3085	5 MEAN S TEST Wh o's Respon sible: PAT IENT
	3086	6 MEDI CARE ESRD Who's Res ponsible: OTHER (INS TITUTION)
	3087	7 NO F AULT INS. Who's Res ponsible: INSURER
	3088	8 REIM BURSABLE I NS. Who's Responsib le: INSURE R
	3089	9 SHAR ING AGREEM ENT Who's Responsib le: OTHER (INSTITUTI ON)
	3090	10 TORT FEASOR W ho's Respo nsible: IN SURER
	3091	11 WORK ERS' COMP. Who's Re sponsible: INSURER
	3092	12 CATE GORY C Wh o's Respon sible: PAT IENT
	3093	13 CHAM PVA REIMB. INS. Who 's Respons ible: INSU RER
	3094	14 CHAM PVA Who's Responsib le: INSURE R
	3095	15 TRIC ARE REIMB. INS. Who 's Respons ible: INSU RER
	3096	16 TRIC ARE Who's Responsib le: INSURE R
	3097	17 INEL IGIBLE Wh o's Respon sible: PAT IENT
	3098	SELECT RAT E TYPE: 15 TRICARE REIMB. INS . Who's R esponsible : INSURER
	3099	DO YOU WIS H TO ADD/E DIT INSURA NCE COMPAN Y DATA FOR THIS PATI ENT?(Y/N)? N// NO
	3100	Insuranc e COB Subscrib er ID Grou p Hol der Eff ective Ex pires
	3101	======== ====== === = ======== ===== ==== ====== === ====== === ======= == ========
	3102	EXPRESS SCRIP PRI XXXXXX DODA PAT IENT 12/ 27/2008
	3103	PRIMARY IN SURANCE PO LICY: SH T RICARE (PR IMARY) - T RICARE PLA N
	3104	SUBMIT CLA IM TO SH T RICARE ?(Y /N)? Y// y YES
	3105	TRICARE Pr escription 2055242 s ubmitted t o ECME for claim gen eration.
	3106	7
	3107	Accessing the Pharma cy ECME Ma nager Menu XE "Acces sing Pharm acy ECME M anager Men u"
	3108	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.
	3109	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
	3110	*** ****** ****** ****** ****** **
	3111	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	3112	* XXXXXX VAMC *
	3113	* Main M enu *
	3114	*** ****** ****** ****** ****** **
	3115	U ECME User Screen
	3116	COB ECME Pharm acy COB .. .
	3117	MGR Pharmacy E CME Manage r Menu ...
	3118	RPT Pharmacy E lectronic Claims Rep orts ...
	3119	Select ECM E Option: MGR Pharm acy ECME M anager Men u
	3120	Example 7- 2: Display ing Pharma cy ECME Ma nager Menu Options
	3121	*** ****** ****** ****** ****** **
	3122	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	3123	* XXXXXXX VAMC *
	3124	* Phar macy ECME Manager Me nu *
	3125	*** ****** ****** ****** ****** **
	3126	MNT ECME trans action mai ntenance o ptions ...
	3127	SET Pharmacy E CME Setup Menu ...
	3128	STAT Statistics Screen
	3129	Select Pha rmacy ECME Manager M enu Option :
	3130	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 ”
	3131	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.
	3132	Example 7. 1-1: Acces sing the E CME Transa ction Main tenance Op tions
	3133	*** ****** ****** ****** ****** **
	3134	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	3135	* XXXXX V AMC *
	3136	* Phar macy ECME Manager Me nu *
	3137	*** ****** ****** ****** ****** **
	3138	MNT ECME trans action mai ntenance o ptions ...
	3139	SET Pharmacy E CME Setup Menu ...
	3140	STAT Statistics Screen
	3141	Select Pha rmacy ECME Manager M enu Option : MNT ECM E transact ion mainte nance opti ons
	3142	**** ****** ****** ****** ****** ***
	3143	* Elec tronic Cla ims Manage ment Engin e (ECME) v 1.0 *
	3144	* XXXXX VAMC *
	3145	* B PS MENU MA INTENANCE *
	3146	**** ****** ****** ****** ****** ***
	3147	UNS View/Unstr and Submis sions Not Completed
	3148	ROC Re Open CL OSED Claim
	3149	Select ECM E transact ion mainte nance opti ons Option :
	3150	7.1.1 View /Unstrand Submission s Not Comp leted XE " View/Unstr and Claims ”
	3151	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”.
	3152	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.
	3153	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.
	3154	Example 7. 1.1-1: Acc essing the View/Unst rand Submi ssions Not Completed Option
	3155	UNS View/Unstr and Submis sions Not Completed
	3156	ROC Re Open CL OSED Claim
	3157	Select ECM E transact ion mainte nance opti ons Option : UNS Vie w/Unstrand Submissio ns Not Com pleted
	3158	Please be aware that if there are submis sions appe aring on t he ECME Us er Screen
	3159	with a sta tus of 'In progress - Transmit ting', the n there ma y be a pro blem
	3160	with HL7 o r with sys tem connec tivity wit h the Aust in Automat ion Center (AAC).
	3161	Please con tact your IRM to ver ify that c onnectivit y to the A AC is work ing
	3162	and the HL 7 link BPS NCPDP is processing messages before usi ng this op tion
	3163	to unstran d submissi ons with a status of 'In progr ess - Tran smitting'.
	3164	Do you wan t to conti nue? NO//
	3165	(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.
	3166	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 .
	3167	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.
	3168	Example 7. 1.1-2: Ent ering Date Range for View/Unst rand Submi ssions Not Completed Option
	3169	FIRST TRAN SACTION DA TE: // T-1 20
	3170	LAST TRANS ACTION DAT E: T// T
	3171	Please wai t...
	3172	Example 7. 1.1-3: Di splaying t he View/Un strand Sub missions N ot Complet ed Actions
	3173	ECME UNSTR AND SUBMIS SIONS Oct 08, 20 10@15:12:0 8 Page: 1 of 1
	3174	Submission s Stranded from 09/2 8/2010 thr ough 10/08 /2010
	3175	Sorted by Transactio n Date
	3176	## Trans DT Patie nt Name ID RX/Fill D OS Ins Co
	3177	* CLA IMS *
	3178	1 10/07/ 2010 ECMEp atient,One 2637 101297/1 06/24/2009 AETNA
	3179	In Pro gress - Do ne
	3180	2 10/07/ 2010 ECMEp atient,One 2637 101320/1 04/27/2009 AETNA
	3181	In Pro gress - Do ne
	3182	3 10/07/ 2010 2637 1100349/0 10/07/201 0 AETNA
	3183	In Pro gress - Pr ocessing r equest
	3184	* REVER SALS *
	3185	4 10/07/ 2010 ECMEp atient,One 2637 101298/1 06/25/2009 AETNA
	3186	In Pro gress - Do ne
	3187	* E LIGIBILITY INQUIRIES *
	3188	5 10/08/ 2010 ECMEp atient,One 2637 10/ 08/2010 AE TNA
	3189	In Pro gress - Pa rsing resp onse
	3190	Enter ?? f or more ac tions >>>
	3191	ALL Unstra nd Current Submissio ns PRT Print Current Su bmissions
	3192	SEL Select Submissio ns to Unst rand EX Exit
	3193	7.1.2 REOP EN a CLOSE D ECME Cla im XE " V ariations to the Clo se claim p rocess"
	3194	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.
	3195	Enter ROC at the “Se lect ECME transactio n maintena nce option s Option:” to access the Re Op en CLOSED Claim opti on.
	3196	Example 7. 1.2-1: Acc essing the Re Open C LOSED Clai m Option
	3197	UNS View/Unstr and Submis sions Not Completed
	3198	ROC Re Open CL OSED Claim
	3199	Select ECM E transact ion mainte nance opti ons Option : ROC Re Open CLOSE D Claim
	3200	You will b e prompted for a pat ient name.
	3201	Example 7. 1.2-2: Ent ering Pati ent Name t o Display Closed Cla ims for th is Option
	3202	Select PATIENT NA ME: ECMEpa tient,One 6 -1-60 6 66006666
	3203	NSC VET ERAN
	3204	You will b e prompted for a dat e range fo r the date s of servi ce of clos ed claims.
	3205	Example 7. 1.2-3: Ent ering Date s of Servi ce for Clo sed Claims Listing
	3206	START W ITH DATE:T ODAY//6/13 /06 (Jun 1 3, 2006)
	3207	GO TO DATE :TODAY//T (JUL 05, 2006)
	3208	Enter Reop en and cho ose the li ne item of the close d claim th at will be reopened.
	3209	Example 7. 1.2-4: Cho osing to R eopen a Cl osed Claim and Selec ting a Lin e Item
	3210	REOPEN CLO SED CLAIM Jul 05, 20 06@15:29:2 1 Page: 1 of 1
	3211	PATIENT: E CMEpatient ,One ( XXXX) Closed cla ims from 0 7/05/06 to 07/05/06
	3212	# DRUG NDC DO S RX# REF/ ECME# LOC RX IN FO
	3213	1 RESER PINE 0.25M G 00083- 0036-45 07 /05 100004 093$ 0/00 0000504727 W RT AC /R
	3214	Enter ?? f or more ac tions
	3215	RE Reopen Claim EX Exit
	3216	Select act ion: Quit/ / R Reop en Claim
	3217	Select ite m: 1
	3218	You are pr ompted to enter a te xt comment , Reopen C omments, a fter claim informati on is disp layed.
	3219	Example 7. 1.2-5: Ent ering Text Comment f or Reopene d Closed C laim
	3220	PATIENT NAME: ECM Epatient,O ne RX#: 100000000 $ 0 DRU G: RESERPI NE 0.25MG
	3221	CLOSED JUL 5,200 6@15:13:42
	3222	ECME#: 000005047 27, DOS: J UL 5,2006, RELEASE D ATE: JUL 5 ,2006@15:1 2:11
	3223	PLAN: HIPPA05 IN SURANCE: M EDCO
	3224	CLOSE REASON: RE FILL TOO S OON
	3225	DROP T O PAPER: N O
	3226	CLOSE USER: ECME user,One
	3227	You have s elected th e CLOSED e lectronic claim list ed above.
	3228	REOPEN COM MENTS: Cla im reopene d for new refill
	3229	Example 7. 1.2-6: Ent ering Yes to “Are Yo u Sure” Pr ompt
	3230	ARE YOU SU RE YOU WAN T TO RE-OP EN THIS CL AIM? (Y/N) ? No// YES
	3231	ReOpening Claim: VA2 006=171288 4=000014=0 006687 ... OK
	3232	1 claim ha s been reo pened.
	3233	Enter RETU RN to cont inue or '^ ' to exit:
	3234	7.2 Pharma cy ECME Se tup Menu X E "Pharmac y ECME Set up Menu”
	3235	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.
	3236	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 .
	3237	Example 7. 2-1: Acces sing the P harmacy EC ME Manager Menu Opti on
	3238	*** ****** ****** ****** ****** **
	3239	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	3240	* XXXX V AMC *
	3241	* Phar macy ECME Manager Me nu *
	3242	*** ****** ****** ****** ****** **
	3243	MNT ECME trans action mai ntenance o ptions ...
	3244	SET Pharmacy E CME Setup Menu ...
	3245	STAT Statistics Screen
	3246	Select Pha rmacy ECME Manager M enu Option : SET Pha rmacy ECME Setup Men u
	3247	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
	3248	*** ****** ****** ****** ****** **
	3249	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	3250	* XXXXXXX VAMC *
	3251	* Pha rmacy ECME Setup Men u *
	3252	*** ****** ****** ****** ****** **
	3253	BAS Edit Basic ECME Para meters
	3254	PHAR Edit ECME Pharmacy D ata
	3255	REG Register P harmacy wi th Austin Informati on Technol ogy Center
	3256	Select Pha rmacy ECME Setup Men u Option:
	3257	7.2.1 Edit Basic ECM E Paramete rs XE "Edi t Basic Ph armacy ECM E Paramete rs”
	3258	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.
	3259	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.
	3260	Example 7. 2.1-1: Acc essing the Edit Basi c ECME Par ameters Op tion
	3261	*** ****** ****** ****** ****** **
	3262	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	3263	* XXXXXX VAMC *
	3264	* Pha rmacy ECME Setup Men u *
	3265	*** ****** ****** ****** ****** **
	3266	BAS Edit Basic ECME Para meters
	3267	PHAR Edit ECME Pharmacy D ata
	3268	REG Register P harmacy wi th Austin Informatio n Technolo gy Center
	3269	Select Pha rmacy ECME Setup Men u Option: BAS Edit Basic ECME Parameter s
	3270	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.
	3271	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.
	3272	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.
	3273	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.
	3274	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
	3275	Select Pha rmacy ECME Setup Men u Option: BAS Edit Basic ECME Parameter s
	3276	Edit Pharm acy ECME c onfigurati on
	3277	ECME timeo ut? (0 to 30 seconds ): 30//
	3278	Insurer As leep Inter val (0 to 29 minutes ): 5//
	3279	Insurer As leep Retri es (0 to 9 9): 3//
	3280	Default El igibility Pharmacy: PHARMACY-1 //
	3281	7.2.2 Edit ECME Phar macy Data XE "Edit E CME Pharma cy Data"
	3282	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.
	3283	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.
	3284	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.
	3285	Example 7. 2.2-1: Acc essing the Edit ECME Pharmacy Data Optio n
	3286	*** ****** ****** ****** ****** **
	3287	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	3288	* XXXXXX VAMC *
	3289	* Pha rmacy ECME Setup Men u *
	3290	*** ****** ****** ****** ****** **
	3291	BAS Edit Basic ECME Para meters
	3292	PHAR Edit ECME Pharmacy D ata
	3293	REG Register P harmacy wi th Austin Informatio n Technolo gy Center
	3294	Select Pha rmacy ECME Manager M enu Option : PHAR Ed it Pharmac y ECME Pha rmacy Data
	3295	Example 7. 2.2-2: Ent ering Edit ECME Phar macy Data Options
	3296	Select BPS PHARMACIE S NAME: XX XXXX VAMC PHARMACY
	3297	NAME: XXXX XX VAMC PH ARMACY
	3298	STATUS: AC TIVE
	3299	NCPDP #: 1 111111
	3300	NPI: 12345 67893
	3301	Select OUT PATIENT SI TE: XXXXXX VAMC PHAR MACY // <E NTER>
	3302	OUTPATIE NT SITE: X XXXXX VAMC PHARMACY // <ENTER>
	3303	Select OUT PATIENT SI TE: <ENTE R>
	3304	CMOP SWITC H: CMOP ON // <ENTER>
	3305	AUTO-REVER SE PARAMET ER: 5 // 5
	3306	DEFAULT DE A #: AG123 45
	3307	The follow ing table describes the Edit E CME Pharma cy Data op tion field s:
	3308	Table 7.2. 2-1: Descr iption of Edit ECME Pharmacy D ata Option Fields
	3309	EntryDescr iptionBPS PHARMACIES NAMEPharm acy in a s pecific VA MC (Depart ment of Ve terans Aff airs Medic al Center) database. The pharm acy user m ay enter a new BPS p harmacy, w hich must be 3-30 al phabetical character s.NAMEDisp lay-only f ield that displays t he full ph armacy nam e entered. NCPDP #A 7 -digit num ber assign ed to the specified pharmacy b y the Nati onal Counc il for Pre scription Drug Progr ams (NCPDP ). It is a lso known as NABP.NP INational Provider I dentifier. A 10-digi t number r equired by the Healt h Insuranc e Portabil ity and Ac countabili ty Act of 1996 (HIPA A) to iden tify indiv idual and organizati onal provi ders, such as outpat ient sites . The NPI has a usag e requirem ent date b eginning M ay 23, 200 8.STATUSTh e status o f the BPS Pharmacy i s either A CTIVE or I NACTIVE. T he STATUS of the pha rmacy may be revised through t he Registe r Pharmacy with Aust in Informa tion Techn ology Cent er option. OUTPATIENT SITESOne or more Ou tpatient S ites (from File 59) may be lin ked with a single BP S Pharmacy entry. Ho wever, an Outpatient Site can only be li nked with a single B PS Pharmac y. All of the sites linked wit h a BPS Ph armacy sho uld have t he same NC PDP number . When an Outpatient Site is l inked to a n active B PS Pharmac y entry, t he ECME sw itch for t hat site i s consider ed ENABLED . If an Ou tpatient S ite is lin ked to an incorrect BPS Pharma cy, it mus t be remov ed from th e incorrec t entry be fore it ca n be linke d to the c orrect ent ry.CMOPON if the tra nsmission of prescri ptions to the CMOP ( Consolidat ed Mail Ou tpatient P harmacy) d ispensing site will automatica lly submit electroni c third pa rty prescr iption cla ims to the insurance payers. S ee note be low for ex planation of claims generated before and after swi tch is tur ned on or off.AUTO-R EVERSE PAR AMETEREnte r numbers from 3 to 10 for the number of days to w ait before ECME reve rses non-r eleased pr escription claims wi th a PAYAB LE payer-r eturned re sponse. 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.
	3310	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.
	3311	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
	3312	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.
	3313	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.
	3314	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
	3315	From: ECME PACKAGE In 'IN' ba sket. Pa ge 1 New
	3316	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------
	3317	Source Pro cess: ECME Pharmacy Registrati on
	3318	ECME Pharm acy Regist ration HL7 Message n ot created .
	3319	PHARMAC Y NAME: TE ST PHARMAC Y 2
	3320	** NPI NUM BER - Miss ing/Invali d
	3321	Enter mess age action (in IN ba sket): Del ete//
	3322	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.
	3323	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.
	3324	Example 7. 2.3-2: Acc essing the Register Pharmacy w ith Austin Informati on Technol ogy Center Option
	3325	*** ****** ****** ****** ****** **
	3326	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	3327	* XXXXX V AMC *
	3328	* Pha rmacy ECME Setup Men u *
	3329	*** ****** ****** ****** ****** **
	3330	BAS Edit Basic ECME Para meters
	3331	PHAR Edit ECME Pharmacy D ata
	3332	REG Register P harmacy wi th Austin Informatio n Technolo gy Center
	3333	Select Pha rmacy ECME Setup Men u Option: REG Regis ter Pharma cy with Au stin Infor mation Tec hnology Ce nter
	3334	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
	3335	E CME Site R egistratio n
	3336	-- PRIMAR Y SITE CON TACT DATA --
	3337	SITE CONTA CT: ECMEUS ER,ONE// < ENTER>
	3338	OFFICE P HONE: XXX- XXX-XXXX// <ENTER>
	3339	EMAIL ADDR ESS: D N S // <ENTER>
	3340	-- ALTERN ATE SITE C ONTACT DAT A --
	3341	ALTERNATE SITE CONTA CT: ECMEUS ER,TWO// < ENTER>
	3342	OFFICE P HONE: XXX- XXX-XXXX// <ENTER>
	3343	EMAIL ADDR ESS: PII //
	3344	Replace < ENTER>
	3345	-- Applica tion Regis tration Va lidation R esults:
	3346	DOMAIN NAME - Req uired - VA LID: XXXXX XXX.XXXXXX -XXX-XXXX. XXX.XX.XXX
	3347	TCP/IP ADDRESS FO R "EPHARM OUT" - Req uired - VA LID: XX.XX X.XXX.XXX
	3348	"EPHARM OUT" PORT NUMBER - Required - VALID: XX XX
	3349	SITE NU MBER - Req uired - VA LID: XXX
	3350	INTERFA CE VERSION - Require d - VALID: 3
	3351	CONTACT NAME - VA LID: ECMEU SER,ONE
	3352	CONTACT ME ANS - VALI D: NET INTERN ET ECMEUSE R.ONE@FORU M. DNS
	3353	ALTERNA TE CONTACT NAME - VA LID: ECMEU SER,TWO
	3354	ALTERNATE CONTACT ME ANS - VALI D: NET INTERN ET PII
	3355	* * Applicat ion Regist ration Dat a VALID **
	3356	Enter RETU RN to cont inue or '^ ' to exit: <ENTER>
	3357	Enter/veri fy Pharmac y Registra tion Data
	3358	Select BPS PHARMACIE S NAME: TE ST PHARMAC Y 3
	3359	--SITE DA TA
	3360	STATUS: IN ACTIVE// < ENTER>
	3361	NCPDP #: X XXXXXX// < ENTER>
	3362	DEFAULT DE A #: XXXXX XXX// <ENT ER>
	3363	SITE ADDRE SS NAME: 1 11 MAIN ST R// <ENTER >
	3364	SITE ADDRE SS 1: 111 MAIN STREE T// <ENTER >
	3365	SITE ADDRE SS 2: <ENT ER>
	3366	SITE CITY: BROOKLYN/ / <ENTER>
	3367	SITE STATE : NEW YORK // <ENTER>
	3368	SITE ZIP C ODE: 11223 // <ENTER>
	3369	REMITTANCE ADDRESS N AME: 1111 TEST STR// <ENTER>
	3370	REMIT ADDR ESS 1: 111 TEST STRE ET// <ENTE R>
	3371	REMIT ADDR ESS 2: <EN TER>
	3372	REMIT CITY : TOPEKA// <ENTER>
	3373	REMIT STAT E: KANSAS/ / <ENTER>
	3374	REMIT ZIP: 66606// < ENTER>
	3375	--PRIMARY CONTACT D ATA
	3376	VA CONTACT : ECMEUSER ,ONE// <EN TER>
	3377	OFFICE P HONE: XXX- XXX-XXXX// <ENTER>
	3378	EMAIL ADDR ESS: D N S
	3379	Replace < ENTER>
	3380	TITLE: O I&T STAFF/ / <ENTER>
	3381	--ALTERNA TE CONTACT DATA
	3382	VA ALTERNA TE CONTACT : ECMEUSER ,THREE L// <ENTER>
	3383	OFFICE P HONE: XXX- XXX-XXXX// <ENTER>
	3384	EMAIL ADDR ESS: PII Replace <E NTER>
	3385	TITLE: O I&T STAFF/ / <ENTER>
	3386	--PHARMAC IST DATA
	3387	VA LEAD PH ARMACIST: ECMEUSER,F OUR// <ENT ER>
	3388	OFFICE P HONE: XXX- XXX-XXXX / / <ENTER>
	3389	EMAIL AD DRESS: <EN TER>
	3390	TITLE: O I&T STAFF/ / <ENTER>
	3391	VA LEAD PH ARMACIST L ICENSE #: XXXXXXX// <ENTER>
	3392	-- Pharmac y Registra tion Valid ation Resu lts --
	3393	PHARMAC Y NAME: TE ST PHARMAC Y 3
	3394	-- Pharmac y Registra tion Data VALID. --
	3395	Enter/veri fy Pharmac y Registra tion Data
	3396	Select BPS PHARMACIE S NAME: <E NTER>
	3397	Applicatio n Registra tion Data is VALID
	3398	Pharmacy R egistratio n Data is:
	3399	VALID for TEST P HARMACY 1 and will b e transmit ted.
	3400	*INVALID for TEST P HARMACY 2 and will N OT be tran smitted.
	3401	VALID for TEST P HARMACY 3 and will b e transmit ted.
	3402	Send Appli cation Reg istration: Y/N ? n NO
	3403	Press RETU RN to cont inue...
	3404	7.3 Statis tics Scree n XE "Stat istics Scr een”
	3405	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.
	3406	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.
	3407	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
	3408	*** ****** ****** ****** ****** **
	3409	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	3410	* XXXXXX VAMC *
	3411	* Phar macy ECME Manager Me nu *
	3412	*** ****** ****** ****** ****** **
	3413	MNT ECME trans action mai ntenance o ptions ...
	3414	SET Pharmacy E CME Setup Menu ...
	3415	STAT Statistics Screen
	3416	Select Pha rmacy ECME Manager M enu Option : STAT Sta tistics Sc reen
	3417	Example 7. 3-2: Stati stics Scre en
	3418	ECME STATI STICS Nov 03, 20 10@16:50:3 0 Page: 1 of 1
	3419	Communicat ions stati stics last cleared o n AUG 18,2 003@16:36: 28
	3420	* CLAIM STATUS * * CLAIM RES ULTS *
	3421	Waiting to start 0 P aid claims 2,93 4
	3422	Building the trans action 0 R ejected cl aims 2,17 1
	3423	Building the claim 0 D ropped to Paper 1 5
	3424	Building the HL7 p acket 1 D uplicate c laims 0
	3425	Preparin g for tran smit 0 C aptured cl aims 0
	3426	Transmit ting 0 A ccepted Re versals 2,06 7
	3427	Parsing response 0 R ejected Re versals 16 6
	3428	Processi ng respons e 0 A ccepted El igibility 7
	3429	R ejected El igibility 4 4
	3430	E rrors 1 4
	3431	Enter ?? f or more ac tions
	3432	UC Updat e continuo usly Z Zero (cle ar) stats
	3433	U1 Displ ay update EX Exit
	3434	Select Act ion:U1//
	3435	This secti on diagram s and desc ribes the different elements o f the Stat istics Scr een.
	3436	Diagram 7. 3-1: Stati stics Opti on Areas
	3437
	3438
	3439
	3440
	3441
	3442
	3443	The table below desc ribes the Statistics Screen op tion areas :
	3444	Table 7.3- 1: Descrip tion of St atistics S creen Opti on
	3445	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”
	3446	The system can updat e the clai ms statist ics every 3 seconds.
	3447	Enter UC to display statistic s that wil l be updat ed every 3 seconds.
	3448	Example 7. 3.1-1: Acc essing Upd ate Contin uously Opt ion
	3449	ECME STATI STICS Nov 03, 20 10@16:50:3 0 Page: 1 of 1
	3450	Communicat ions stati stics last cleared o n AUG 18,2 003@16:36: 28
	3451	* CLAIM STATUS * * CLAIM RES ULTS *
	3452	Waiting to start 0 P aid claims 2,93 4
	3453	Building the trans action 0 R ejected cl aims 2,17 1
	3454	Building the claim 0 D ropped to Paper 1 5
	3455	Building the HL7 p acket 1 D uplicate c laims 0
	3456	Preparin g for tran smit 0 C aptured cl aims 0
	3457	Transmit ting 0 A ccepted Re versals 2,06 7
	3458	Parsing response 0 R ejected Re versals 16 6
	3459	Processi ng respons e 0 A ccepted El igibility 7
	3460	R ejected El igibility 4 4
	3461	E rrors 1 4
	3462	Enter ?? f or more ac tions
	3463	UC Updat e continuo usly Z Zero (cle ar) stats
	3464	U1 Displ ay update EX Exit
	3465	Select Act ion:U1//UC Update co ntinuously
	3466	Press ^ or Q to stop the updat ing. The s ystem will go back t o the Stat istics Scr een.
	3467	Example 7. 3.1-2: Dis playing Cl aims Statu s and Resu lts in Upd ate Contin uously Mod e
	3468	ECME STATI STICS Nov 03, 20 10@16:50:3 0 Page: 1 of 1
	3469	Communicat ions stati stics last cleared o n AUG 18,2 003@16:36: 28
	3470	* CLAIM STATUS * * CLAIM RES ULTS *
	3471	Waiting to start 0 P aid claims 2,93 4
	3472	Building the trans action 0 R ejected cl aims 2,17 1
	3473	Building the claim 0 D ropped to Paper 1 5
	3474	Building the HL7 p acket 1 D uplicate c laims 0
	3475	Preparin g for tran smit 0 C aptured cl aims 0
	3476	Transmit ting 0 A ccepted Re versals 2,06 7
	3477	Parsing response 0 R ejected Re versals 16 6
	3478	Processi ng respons e 0 A ccepted El igibility 7
	3479	R ejected El igibility 4 4
	3480	E rrors 1 4
	3481	In continu ous update mode: pre ss Q to Qu it
	3482	Q Quit
	3483	7.3.2 Disp lay Update XE "Displ ay Update”
	3484	You can up date the s tatistics once every time the option U1 is entered .
	3485	Example 7. 3.2-1: Acc essing Dis play Updat e Option
	3486	ECME STATI STICS Nov 03, 20 10@16:50:3 0 Page: 1 of 1
	3487	Communicat ions stati stics last cleared o n AUG 18,2 003@16:36: 28
	3488	* CLAIM STATUS * * CLAIM RES ULTS *
	3489	Waiting to start 0 P aid claims 2,93 4
	3490	Building the trans action 0 R ejected cl aims 2,17 1
	3491	Building the claim 0 D ropped to Paper 1 5
	3492	Building the HL7 p acket 1 D uplicate c laims 0
	3493	Preparin g for tran smit 0 C aptured cl aims 0
	3494	Transmit ting 0 A ccepted Re versals 2,06 7
	3495	Parsing response 0 R ejected Re versals 16 6
	3496	Processi ng respons e 0 A ccepted El igibility 7
	3497	R ejected El igibility 4 4
	3498	E rrors 1 4
	3499	Enter ?? f or more ac tions
	3500	UC Updat e continuo usly Z Zero (cle ar) stats
	3501	U1 Displ ay update EX Exit
	3502	Select Act ion:U1//U1 Display u pdate
	3503	7.3.3 Zero (clear) S tatistics XE "Zero ( clear) Sta tistics”
	3504	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.
	3505	Enter Z to access th e Zero (cl ear) stats option.
	3506	Example 7. 3.3-1: Acc essing Zer o (clear) stats Opti on
	3507	ECME STATI STICS Nov 03, 20 10@16:50:3 0 Page: 1 of 1
	3508	Communicat ions stati stics last cleared o n AUG 18,2 003@16:36: 28
	3509	* CLAIM STATUS * * CLAIM RES ULTS *
	3510	Waiting to start 0 P aid claims 2,93 4
	3511	Building the trans action 0 R ejected cl aims 2,17 1
	3512	Building the claim 0 D ropped to Paper 1 5
	3513	Building the HL7 p acket 1 D uplicate c laims 0
	3514	Preparin g for tran smit 0 C aptured cl aims 0
	3515	Transmit ting 0 A ccepted Re versals 2,06 7
	3516	Parsing response 0 R ejected Re versals 16 6
	3517	Processi ng respons e 0 A ccepted El igibility 7
	3518	R ejected El igibility 4 4
	3519	E rrors 1 4
	3520	Enter ?? f or more ac tions
	3521	UC Updat e continuo usly Z Zero (cle ar) stats
	3522	U1 Displ ay update EX Exit
	3523	Select Act ion:U1//Z Z (clear ) stats
	3524	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 .
	3525	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
	3526	Selec t one of t he followi ng:
	3527	L Local Copy
	3528	P Permanent Copy
	3529	Delete (L) ocal Copy or (P)erma nent Copy of the sta tistics: L ocal Copy/ / L Local Copy
	3530	When the s ystem asks if you ar e sure, en ter Y to c ontinue or N to stop the delet ion.
	3531	Example 7. 3.3-3: Ent ering Yes to “Are Yo u Sure” Pr ompt
	3532	Are you su re? N// YE S
	3533	Enter Z to access th e Zero (cl ear) stats option.
	3534	Example 7. 3.3-4: Dis playing Ze roed Claim s Statisti cs
	3535	ECME STATI STICS Nov 03, 20 10@16:50:3 0 Page: 1 of 1
	3536	Communicat ions stati stics last cleared o n AUG 18,2 003@16:36: 28
	3537	* CLAIM STATUS * * CLAIM RES ULTS *
	3538	Waiting to start 0 P aid claims 2,93 4
	3539	Building the trans action 0 R ejected cl aims 2,17 1
	3540	Building the claim 0 D ropped to Paper 1 5
	3541	Building the HL7 p acket 1 D uplicate c laims 0
	3542	Preparin g for tran smit 0 C aptured cl aims 0
	3543	Transmit ting 0 A ccepted Re versals 2,06 7
	3544	Parsing response 0 R ejected Re versals 16 6
	3545	Processi ng respons e 0 A ccepted El igibility 7
	3546	R ejected El igibility 4 4
	3547	E rrors 1 4
	3548	Enter ?? for more a ctions
	3549	UC Updat e continuo usly Z Zero (cle ar) stats
	3550	U1 Displ ay update EX Exit
	3551	Select Act ion:U1// Z Zero (c lear) stat s
	3552	Delete (L) ocal Copy or (P)erma nent Copy of the sta tistics: L ocal Copy/ / Local Co py
	3553	Are you su re? N// YE S
	3554	7.3.4 Exit ing the St atistics S creen
	3555	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.
	3556	Example 7. 3.4-1: Acc essing Exi t Option
	3557	ECME STATI STICS Nov 03, 20 10@16:50:3 0 Page: 1 of 1
	3558	Communicat ions stati stics last cleared o n AUG 18,2 003@16:36: 28
	3559	* CLAIM STATUS * * CLAIM RES ULTS *
	3560	Waiting to start 0 P aid claims 2,93 4
	3561	Building the trans action 0 R ejected cl aims 2,17 1
	3562	Building the claim 0 D ropped to Paper 1 5
	3563	Building the HL7 p acket 1 D uplicate c laims 0
	3564	Preparin g for tran smit 0 C aptured cl aims 0
	3565	Transmit ting 0 A ccepted Re versals 2,06 7
	3566	Parsing response 0 R ejected Re versals 16 6
	3567	Processi ng respons e 0 A ccepted El igibility 7
	3568	R ejected El igibility 4 4
	3569	E rrors 1 4
	3570	Enter ?? f or more ac tions
	3571	UC Updat e continuo usly Z Zero (cle ar) stats
	3572	U1 Displ ay update EX Exit
	3573	Select Act ion:U1// E X Exit
	3574	(This page included for two-si ded copyin g.)
	3575	8
	3576	Accessing the Pharma cy Electro nic Claims Reports XE "Pharma cy Electro nic Claims Reports"
	3577	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.
	3578	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.
	3579	Example 8- 1: Accessi ng the Pha rmacy Elec tronic Cla ims Report s Option
	3580	*** ****** ****** ****** ****** **
	3581	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	3582	* XXXXX V AMC *
	3583	* Main M enu *
	3584	*** ****** ****** ****** ****** **
	3585	U ECME User Screen
	3586	COB ECME Pharm acy COB .. .
	3587	MGR Pharmacy E CME Manage r Menu ...
	3588	RPT Pharmacy E lectronic Claims Rep orts ...
	3589	Select ECM E Option: RPT Pharm acy Electr onic Claim s Reports
	3590	Example 8- 2: Display ing Pharma cy Electro nic Claims Reports O ptions
	3591	*** ****** ****** ****** ****** **
	3592	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	3593	* XXXXX V AMC *
	3594	* Pharmacy Electroni c Claims R eports *
	3595	*** ****** ****** ****** ****** **
	3596	CLA Claim Resu lts and St atus ...
	3597	OTH Other Repo rts ...
	3598	Select Pha rmacy Elec tronic Cla ims Report s Option:
	3599	8.1 Claim Results an d Status X E " Claim Results an d Status"
	3600	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.
	3601	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.
	3602	Example 8. 1-1: Acces sing the C laim Resul ts and Sta tus Option
	3603	*** ****** ****** ****** ****** **
	3604	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	3605	* XXXXX VAMC *
	3606	* Pharmacy Electroni c Claims R eports *
	3607	*** ****** ****** ****** ****** **
	3608	CLA Claim Resu lts and St atus ...
	3609	OTH Other Repo rts ...
	3610	Select Pha rmacy Elec tronic Cla ims Report s Option: CLA Claim Results a nd Status
	3611	You have a choice of Claims Re sults and Status rep orts to ch oose from.
	3612	Example 8. 1-2: Displ aying All Claims Res ults and S tatus Opti ons
	3613	*** ****** ****** ****** ****** **
	3614	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	3615	* XXXXXX VAMC *
	3616	* Cla im Results and Statu s *
	3617	*** ****** ****** ****** ****** **
	3618	PAY Payable Cl aims Repor t
	3619	REJ Rejected C laims Repo rt
	3620	ECMP CMOP/ECME Activity R eport
	3621	REV Reversal C laims Repo rt
	3622	NYR Claims Sub mitted, No t Yet Rele ased
	3623	REC Recent Tra nsactions
	3624	DAY Totals by Date
	3625	CLO Closed Cla ims Report
	3626	NBS Non-Billab le Status Report
	3627	SPA Spending A ccount Rep ort
	3628	Select Cla im Results and Statu s Option:
	3629	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.
	3630	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
	3631	Selec t one of t he followi ng:
	3632	D DIVISION
	3633	A ALL
	3634	Select Cer tain Pharm acy (D)ivi sions or ( A)LL: <Ent er> ALL
	3635	Selec t one of t he followi ng:
	3636	S Summary
	3637	D Detail
	3638	Display (S )ummary or (D)etail Format: De tail// Sum mary
	3639	Selec t one of t he followi ng:
	3640	I SPECIFIC I NSURANCE(S )
	3641	A ALL
	3642	Select Cer tain (I)NS URANCE or (A)LL): A/ / I SPECI FIC INSURA NCES(S)
	3643	Select INS URANCE: IB INSUR1 123 ANY WHERE ST HER NDON V IRGINIA
	3644	Y
	3645	Selected :
	3646	IBINSUR1
	3647	Select INS URANCE: DE VELOPMENT INS 123 HERE S TREET SAN FR ANCISCO
	3648	CALIFORN IA Y
	3649	Selected :
	3650	DEVELOPMEN T INS
	3651	IBINSUR1
	3652	Select INS URANCE: <E nter>
	3653	Selec t one of t he followi ng:
	3654	C CMOP
	3655	M Mail
	3656	W Window
	3657	A ALL
	3658	Display (C )MOP or (M )ail or (W )indow or (A)LL: ALL // <Enter> ALL
	3659	Selec t one of t he followi ng:
	3660	R Real Time Fills
	3661	B Backbill
	3662	P PRO Option
	3663	S Resubmissi on
	3664	A ALL
	3665	Display (R )ealTime, (B)ackbill s, (P)RO O ption, Re( S)ubmissio n or (A)LL : A// <Ent er> ALL
	3666	Selec t one of t he followi ng:
	3667	D Drug
	3668	C Drug Class
	3669	A ALL
	3670	Display Sp ecific (D) rug or Dru g (C)lass or (A)LL: ALL// <Ent er> ALL
	3671	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 .
	3672	Example 8. 1-4: Reque sting Repo rt Data in Excel Spr eadsheet F ormat
	3673	Do you wan t to captu re report data for a n Excel do cument? NO // YES
	3674	Befor e continui ng, please set up yo ur termina l to captu re the
	3675	detai l report d ata. On so me termina ls, this c an be done by
	3676	click ing on the 'Tools' m enu above, then clic k on 'Capt ure
	3677	Incom ing Data' to save to Desktop. This repor t may take a
	3678	while to run.
	3679	Note: To avoid undesired wrapping o f the data saved to the
	3680	file, ple ase enter '0;256;999 ' at the ' DEVICE:' p rompt.
	3681	8.1.1 Paya ble Claims Report XE " Payable Claims"
	3682	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.
	3683	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 .
	3684	Example 8. 1.1-1: Acc essing the Payable C laims Repo rt Option
	3685	*** ****** ****** ****** ****** **
	3686	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	3687	* XXXXX V AMC *
	3688	* Cla im Results and Statu s *
	3689	*** ****** ****** ****** ****** **
	3690	PAY Payable Cl aims Repor t
	3691	REJ Rejected C laims Repo rt
	3692	ECMP CMOP/ECME Activity R eport
	3693	REV Reversal C laims Repo rt
	3694	NYR Claims Sub mitted, No t Yet Rele ased
	3695	REC Recent Tra nsactions
	3696	DAY Totals by Date
	3697	CLO Closed Cla ims Report
	3698	NBS Non-Billab le Status Report
	3699	SPA Spending A ccount Rep ort
	3700	Select Cla im Results and Statu s Option: PAY Payab le Claims Report
	3701	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.
	3702	Example 8. 1.1-2: Add itional pr ompts aske d by the P ayable Cla ims Report Option
	3703	START WITH TRANSACTI ON DATE: T -1// T-99
	3704	GO TO TR ANSACTION DATE: T// <Enter>
	3705	Selec t one of t he followi ng:
	3706	R RELEASED
	3707	N NOT RELEAS ED
	3708	A ALL
	3709	Include Rx s - (R)ELE ASED or (N )OT RELEAS ED or (A)L L: RELEASE D// ALL
	3710	Selec t one of t he followi ng:
	3711	V VETERAN
	3712	T TRICARE
	3713	C CHAMPVA
	3714	A ALL
	3715	Include Ce rtain Elig ibility Ty pe or (A)l l: V// ALL
	3716	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.
	3717	Do you wan t to captu re report data for a n Excel do cument? NO // <Enter>
	3718	WARNING - THIS REPOR T REQUIRES THAT A DE VICE WITH 132 COLUMN WIDTH BE USED.
	3719	IT WILL NO T DISPLAY CORRECTLY USING 80 C OLUMN WIDT H DEVICES
	3720	DEVICE: HO ME// <Ente r> IP net work
	3721	Please wai t...
	3722	(This page included for two-si ded copyin g.)
	3723	Example 8. 1.1-3: Pay able Claim s Report
	3724	ECME PAYAB LE CLAIMS DETAIL REP ORT Print Da te: MAY 21 , 2008@11: 41:54 Pag e: 1
	3725	DIVISION(S ): ALL Fi ll Locatio ns: C,M,W Fill type : RT,BB,RS
	3726	Insurance: DEVELOPME NT INS, IB INSUR1 D rugs/Class es: ALL
	3727	Eligibilit y: ALL
	3728	ALL PRESCR IPTIONS BY TRANSACTI ON DATE: F rom 02/12/ 08 through 05/21/08
	3729	========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== =====
	3730	PATIENT NA ME Pt. ID ELIG RX# REF/ECM E# DA TE $B ILLED $ INS RESPON SE $CO LLECT
	3731	DRUG NDC REL EASED ON RX INFO BILL# R X COB
	3732	========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== =====
	3733	DIVISION: PHARMACY-1
	3734	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- -----
	3735	DEVELOPMEN T INS
	3736	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- -----
	3737	ECMEpatien t,One (XX XX) TRI 100222$ 2/000000 111264 04/15/0 8 51 .00 40.00
	3738	AMITRI PTYLINE 10 MG TAB 00182-10 18-10 04/ 15/08 W RT A C/R K8000K9 p
	3739	ECMEpatien t, Three (XX XX) VET 222$ 0/000000 000492 03/1 0/08 51.00 68 .32
	3740	METHAD ONE 10MG T AB W RT E X/N
	3741	-------- -- - ---------
	3742	SUBTOTALS for INS:DE VELOPMENT INS 102. 00 108.32 0.00
	3743	COUNT 2 2 2
	3744	MEAN 51. 00 54.16 0.00
	3745	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- -----
	3746	IBINSUR1
	3747	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- -----
	3748	ECMEpatien t, Two (XX XX) VET 100574$ 0/000000 000484 03/0 5/08 51.00 40 .00
	3749	NEODEC ADRON OPHT MALIC SOL. 00006-76 39-03 03/ 05/08 W RT A C/R K8000H6 p
	3750	ECMEpatien t, Two (XX XX) VET 100575$ 0/000000 000485 03/0 5/08 51.00 40 .00
	3751	PENTAE RYTHRITOL 10MG TAB 00725-20 64-10 03/ 05/08 W RT A C/R K8000H7 p
	3752	...
	3753	SUBTOTALS for INS:IB INSUR1 2142. 00 1652.28 5.00
	3754	COUNT 42 42 42
	3755	MEAN 51. 00 39.34 0.12
	3756	-------- -- --------- ----- -----
	3757	SUBTOTALS for DIV:PH ARMACY-1 2244. 00 1760.60 5.00
	3758	COUNT 44 44 44
	3759	MEAN 51. 00 40.01 0.11
	3760	-------- -- --------- ----- -----
	3761	GRAND TOTA LS 2244. 00 1760.60 5.00
	3762	COUNT 44 44 44
	3763	MEAN 51. 00 40.01 0.11
	3764	Press RETU RN to cont inue:
	3765	(This page included for two-si ded copyin g.)
	3766	8.1.2 Reje cted Claim s Report X E " Payabl e Rejected Claims"
	3767	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.
	3768	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.
	3769	Example 8. 1.2-1: Acc essing the Rejected Claims Rep ort Option
	3770	*** ****** ****** ****** ****** **
	3771	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	3772	* XXXXX V AMC *
	3773	* Cla im Results and Statu s *
	3774	*** ****** ****** ****** ****** **
	3775	PAY Payable Cl aims Repor t
	3776	REJ Rejected C laims Repo rt
	3777	ECMP CMOP/ECME Activity R eport
	3778	REV Reversal C laims Repo rt
	3779	NYR Claims Sub mitted, No t Yet Rele ased
	3780	REC Recent Tra nsactions
	3781	DAY Totals by Date
	3782	CLO Closed Cla ims Report
	3783	NBS Non-Billab le Status Report
	3784	SPA Spending A ccount Rep ort
	3785	Select Cla im Results and Statu s Option: REJ Rejec ted Claims Report
	3786	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.
	3787	Example 8. 1.2-2: Add itional pr ompts aske d by the R ejected Cl aims Repor t Option
	3788	START WITH TRANSACTI ON DATE: T -1// T-30
	3789	GO TO TR ANSACTION DATE: T// <Enter>
	3790	Selec t one of t he followi ng:
	3791	R RELEASED
	3792	N NOT RELEAS ED
	3793	A ALL
	3794	Include Rx s - (R)ELE ASED or (N )OT RELEAS ED or (A)L L: RELEASE D// ALL
	3795	Selec t one of t he followi ng:
	3796	S Specific R eject Code
	3797	A ALL
	3798	Include (S )pecific R eject Code or (A)LL: ALL// <En ter>
	3799	Selec t one of t he followi ng:
	3800	O OPEN
	3801	C CLOSED
	3802	A ALL
	3803	Include (O )pen, (C)l osed, or ( A)ll Claim s: O// ALL
	3804	Selec t one of t he followi ng:
	3805	V VETERAN
	3806	T TRICARE
	3807	C CHAMPVA
	3808	A ALL
	3809	Include Ce rtain Elig ibility Ty pe or (A)l l: V// ALL
	3810	Data field s VA Ingre dient Cost and VA Di spensing F ee will on ly be incl uded when the report is captur ed for an Excel docu ment. All additiona l data fie lds may no t be prese nt for all reports.
	3811	Do you wan t to captu re report data for a n Excel do cument? NO // <Enter>
	3812	WARNING - THIS REPOR T REQUIRES THAT A DE VICE WITH 132 COLUMN WIDTH BE USED.
	3813	IT WILL NO T DISPLAY CORRECTLY USING 80 C OLUMN WIDT H DEVICES
	3814	DEVICE: HO ME// <Ente r> IP net work
	3815	Please wai t...
	3816	Example 8. 1.2-3: Rej ected Clai ms Report
	3817	ECME REJEC TED CLAIMS DETAIL RE PORT Prin t Date: MA Y 21, 2008 @17:20:35 Page: 1
	3818	DIVISION(S ): ALL Fill Locat ions: C,M, W Fill ty pe: RT,BB, RS
	3819	Insurance: IBINSUR1, OPINSUR1 Drugs/ Classes: A LL
	3820	Reject Cod e: ALL Elig ibility: A LL Open/Close d: ALL
	3821	ALL PRESCR IPTIONS BY TRANSACTI ON DATE: F rom 05/01/ 08 through 05/21/08
	3822	========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== =========
	3823	PATIENT NA ME Pt.ID ELIG RX# REF/ ECME# DATE RELEASED O N RX INFO RX COB OPEN/ CLOSED
	3824	CARDHOL D.ID GR OUP ID $B ILLED QT Y NDC# DRUG
	3825	========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== =========
	3826	DIVISION: PHARMACY-1
	3827	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------
	3828	IBINSUR1
	3829	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------
	3830	ECMEPATIEN T,ONE (XXXX) VET 100 888$ 0/00 0000000808 0 5/04/08 0 5/04/08 W RT D S/R s Op en
	3831	123456 55 5 51.00 90 00777 -0877-03 FENOPRO FEN 300MG CAP
	3832	Claim ID: VA2008=400 0000016=00 0010=00018 15
	3833	07:M/I Car dholder ID Number
	3834	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
	3835	123456 55 5 51.00 90 00777 -0877-03 FENOPRO FEN 300MG CAP
	3836	Claim ID: VA2008=400 0000016=00 0010=00018 22
	3837	07:M/I Car dholder ID Number
	3838	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
	3839	123456 55 5 51.00 90 00777 -0877-03 FENOPRO FEN 300MG CAP
	3840	Claim ID: VA2008=400 0000016=00 0010=00018 23
	3841	07:M/I Car dholder ID Number
	3842	--------- -
	3843	SUBTOTALS for INS:IB INSUR1 153.0 0
	3844	COUNT 3
	3845	MEAN 51.0 0
	3846	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------
	3847	OPINSUR1
	3848	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------
	3849	ECMEPATIEN T,TWO (XXXX) VET 100 896$ 0/00 0000000816 0 5/06/08 W RT DS /N p Open
	3850	111 51.00 1 80 0000 3-0626-50 CHLORAL HYDRATE 5 00MG CAP
	3851	Claim ID: VA2008=400 0000016=00 0010=00018 33
	3852	12:M/I Pat ient Locat ion
	3853	ECMEPATIEN T,TWO (XXXX) VET 100 899$ 0/00 0000000819 0 5/06/08 W RT DS /N p Open
	3854	111 51.00 1 80 0014 9-0030-66 DANTROL ENE 25MG C AP
	3855	Claim ID: VA2008=400 0000016=00 0010=00018 34
	3856	75:Prior A uthorizati on Require d
	3857	ECMEPATIEN T,TWO (XXXX) VET 100 901$ 0/00 0000000821 0 5/06/08 W RT DS /N p Open
	3858	111 51.00 9 0 0059 1-5521-04 PHENYLB UTAZONE 10 0MG TAB
	3859	05/06/08 - Prior Aut horization Code (8/3 2432242) s ubmitted.
	3860	Claim ID: VA2008=400 0000016=00 0010=00018 35
	3861	75:Prior A uthorizati on Require d
	3862	ECMEPATIEN T,TWO (XXXX) VET 100 902$ 0/00 0000000822 0 5/06/08 W RT DS /N p Open
	3863	111 51.00 1 80 0002 3-4534-67 BACLOFE N 10MG TAB S
	3864	05/06/08 - Clarifica tion Code 4,3 submit ted.
	3865	Claim ID: VA2008=400 0000016=00 0010=00018 40
	3866	79:Refill Too Soon
	3867	ECMEPATIEN T,TWO (XXXX) VET 100 903$ 0/00 0000000823 0 5/06/08 W RT DS /N s Open
	3868	111 51.00 1 80 0002 3-4534-67 BACLOFE N 10MG TAB S
	3869	05/06/08 - Clarifica tion Code 4,3 submit ted.
	3870	Claim ID: VA2008=400 0000016=00 0010=00018 41
	3871	79:Refill Too Soon
	3872	ECMEPATIEN T,TWO (XXXX) VET 100 906$ 0/00 0000000826 0 5/06/08 M RT DS /N p Open
	3873	111 51.00 1 80 0083 9-7221-06 DOXEPIN 25MG CAP
	3874	05/06/08 - Clarifica tion Code 4,3 submit ted.
	3875	Claim ID: VA2008=400 0000016=00 0010=00018 43
	3876	79:Refill Too Soon
	3877	ECMEPATIEN T,TWO (XXXX) VET 100 907$ 0/00 0000000827 0 5/06/08 M RT AC /N p Open
	3878	111 51.00 1 80 0008 1-0635-35 CHLORAM BUCIL 2MG TAB.
	3879	Claim ID: VA2008=400 0000016=00 0010=00018 45
	3880	79:Refill Too Soon
	3881	ECMEPATIEN T,TWO (XXXX) VET 100 915$ 0/00 0000000835 0 5/07/08 W RT DS /N p Open
	3882	111 51.00 1 80 0002 3-4534-67 BACLOFE N 10MG TAB S
	3883	05/07/08 - DAFASFDAF DASFDASFAS
	3884	Claim ID: VA2008=400 0000016=00 0010=00018 68
	3885	75:Prior A uthorizati on Require d
	3886	ECMEPATIEN T,TWO (XXXX) VET 100 938$ 0/00 0000000858 0 5/08/08 W RT AC /N p Open
	3887	111 51.00 3 0 0002 4-2253-04 STANOZO LOL 2MG
	3888	Claim ID: VA2008=400 0000016=00 0010=00018 92
	3889	75:Prior A uthorizati on Require d
	3890	ECMEPATIEN T,TWO (XXXX) VET 100 939$ 0/00 0000000859 0 5/08/08 W RT DS /N p Open
	3891	111 51.00 1 80 0007 8-0005-10 THIORID AZINE 100M G TAB
	3892	05/08/08 - FDDSFADFA
	3893	Claim ID: VA2008=400 0000016=00 0010=00018 93
	3894	75:Prior A uthorizati on Require d
	3895	ECMEPATIEN T,TWO (XXXX) VET 100 942$ 0/00 0000000862 0 5/08/08 W RT AC /N p Open
	3896	111 51.00 1 80 0002 8-0105-10 TERBUTA LINE 5MG T ABS
	3897	Claim ID: VA2008=400 0000016=00 0010=00018 94
	3898	75:Prior A uthorizati on Require d
	3899	79:Refill Too Soon
	3900	ECMEPATIEN T,TWO (XXXX) VET 100 945$ 0/00 0000000865 0 5/08/08 W RT DS /N p Open
	3901	111 51.00 1 80 0004 5-0412-60 TOLMETI N 200MG TA BS
	3902	Claim ID: VA2008=400 0000016=00 0010=00018 97
	3903	75:Prior A uthorizati on Require d
	3904	79:Refill Too Soon
	3905	ECMEPATIEN T,TWO (XXXX) VET 101 002$ 0/00 0000000926 0 5/14/08 W RT DS /N p Open
	3906	111 51.00 1 80 0002 3-4534-67 BACLOFE N 10MG TAB S
	3907	Claim ID: VA2008=400 0000016=00 0010=00019 89
	3908	64:Claim S ubmitted D oes Not Ma tch Prior Authorizat ion
	3909	ECMEPATIEN T,TWO (XXXX) VET 101 011$ 0/00 0000000935 0 5/14/08 W RT D S/N p Open
	3910	111 51.00 1 80 0078 1-1367-10 BENZTRO PINE 2MG T AB
	3911	Claim ID: VA2008=400 0000016=00 0010=00020 05
	3912	12:M/I Pat ient Locat ion
	3913	Press RETU RN to cont inue, '^' to exit:
	3914	(This page included for two-si ded copyin g.)
	3915	8.1.3 CMOP /ECME Acti vity Repor t XE " CMO P/ECME Act ivity Repo rt"
	3916	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
	3917	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.
	3918	Example 8. 1.3-1: Acc essing the CMOP/ECME Activity Report Opt ion
	3919	*** ****** ****** ****** ****** **
	3920	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	3921	* XXXXX V AMC *
	3922	* Cla im Results and Statu s *
	3923	*** ****** ****** ****** ****** **
	3924	PAY Payable Cl aims Repor t
	3925	REJ Rejected C laims Repo rt
	3926	ECMP CMOP/ECME Activity R eport
	3927	REV Reversal C laims Repo rt
	3928	NYR Claims Sub mitted, No t Yet Rele ased
	3929	REC Recent Tra nsactions
	3930	DAY Totals by Date
	3931	CLO Closed Cla ims Report
	3932	NBS Non-Billab le Status Report
	3933	SPA Spending A ccount Rep ort
	3934	Select Cla im Results and Statu s Option: ECMP CMOP /ECME Acti vity Repor t
	3935	ENTER BEGI NNING TRAN SMISSION D ATE: 8/31
	3936	ENTER ENDI NG TRANSMI SSION DATE : 9/1
	3937	SELECTION OF DIVISIO N(S)
	3938	Selec t one of t he followi ng:
	3939	A ALL DIVISI ONS
	3940	S SELECT DIV ISIONS
	3941	Enter resp onse: SELE CT DIVISIO NS
	3942	1 XXXXX XXXXX
	3943	2 YYYYY YYYYY
	3944	3 ZZZZZ ZZZZZ
	3945	Select Div ision(s) : (1-4): 1
	3946	You have s elected:
	3947	1 XXXXX XXXXX
	3948	Is this co rrect? YES // <Enter>
	3949	Do you wan t to captu re report data for a n Excel do cument? NO // <Enter>
	3950	Select Pri nter: HOME ;132;999 IP network
	3951	Example 8. 1.3-2: CMO P/ECME Act ivity Repo rt
	3952	CMOP/ ECME ACTIV ITY REPORT for XXXXX XXXXX
	3953	For AUG 31 ,2005 thr u SEP 1,2 005 Printed: N OV 23,2005 @10:25:49
	3954	========== ========== ========== ========== ========== ========== ========== ========== =========
	3955	TRA NSMISSION: 2671
	3956	STA TUS: TRANS MITTED
	3957	DIV ISION: XXXXX XXXXX
	3958	CMO P SYSTEM: LEAVE NWORTH
	3959	TRA NSMISSION DATE/TIME: AUG 3 1, 2005@16 :17:14
	3960	TOT AL PATIENT S: 3
	3961	TOT AL RXS: 3
	3962	NAME ECME#/ RX#/FL# NDC S ENT NDC RECV D CMOP-STAT
	3963	DRUG INSUR ANCE PAY- STAT BILL # REL-DA TE
	3964	========== ========== ========== ========== ========== ========== ========== ========== =========
	3965	ECMEpatien t,One (XXX X) 000001 106254/909 911$e/0 00000-0158 -23 TRANS MI
	3966	AT ORVASTATIN CALCI WEBMD E PA YAB
	3967	8.1.4 Reve rsal Claim s Report X E " Revers al Claims Report"
	3968	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.
	3969	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.
	3970	Example 8. 1.4-1: Acc essing the Reversal Claims Rep ort Option
	3971	*** ****** ****** ****** ****** **
	3972	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	3973	* XXXXX V AMC *
	3974	* Cla im Results and Statu s *
	3975	*** ****** ****** ****** ****** **
	3976	PAY Payable Cl aims Repor t
	3977	REJ Rejected C laims Repo rt
	3978	ECMP CMOP/ECME Activity R eport
	3979	REV Reversal C laims Repo rt
	3980	NYR Claims Sub mitted, No t Yet Rele ased
	3981	REC Recent Tra nsactions
	3982	DAY Totals by Date
	3983	CLO Closed Cla ims Report
	3984	NBS Non-Billab le Status Report
	3985	SPA Spending A ccount Rep ort
	3986	Select Cla im Results and Statu s Option: REV Rever sal Claims Report
	3987	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.
	3988	Example 8. 1.4-2: Add itional Pr ompts for the Revers al Claims Report Opt ion
	3989	START WITH TRANSACTI ON DATE: T -1// T-30
	3990	GO TO TR ANSACTION DATE: T// <Enter>
	3991	Selec t one of t he followi ng:
	3992	R RELEASED
	3993	N NOT RELEAS ED
	3994	A ALL
	3995	Include Rx s - (R)ELE ASED or (N )OT RELEAS ED or (A)L L: RELEASE D// ALL
	3996	Selec t one of t he followi ng:
	3997	R AutoRevers ed
	3998	A ALL
	3999	Include Au to(R)evers ed or (A)L L: ALL// < Enter>
	4000	Selec t one of t he followi ng:
	4001	C Accepted
	4002	R Rejected
	4003	A ALL
	4004	Include A( C)cepted o r (R)eject ed or (A)L L: Rejecte d// ALL
	4005	Selec t one of t he followi ng:
	4006	V VETERAN
	4007	T TRICARE
	4008	C CHAMPVA
	4009	A ALL
	4010	Include Ce rtain Elig ibility Ty pe or (A)l l: V// ALL
	4011	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.
	4012	Do you wan t to captu re report data for a n Excel do cument? NO // <Enter>
	4013	WARNING - THIS REPOR T REQUIRES THAT A DE VICE WITH 132 COLUMN WIDTH BE USED.
	4014	IT WILL NO T DISPLAY CORRECTLY USING 80 C OLUMN WIDT H DEVICES
	4015	DEVICE: HO ME// <Ente r> IP net work
	4016	Please wai t...
	4017	Example 8. 1.4-3: Rev ersal Clai ms Report
	4018	ECME REVER SED CLAIMS DETAIL RE PORT Prin t Date: AP R 17, 2009 @14:17:15 Page: 1
	4019	DIVISION(S ): ALL Fill Locat ions: C,M, W Fill ty pe: RT,BB, RS
	4020	Insurance: ALL ALL R eversals ALL R eturned St atus Dru gs/Classes : ALL
	4021	Eligibilit y: ALL
	4022	ALL PRESCR IPTIONS BY TRANSACTI ON DATE: F rom 03/18/ 09 through 04/17/09
	4023	========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== =========
	4024	PATIENT NA ME Pt.ID EL IG RX# REF/ECME # D ATE $ BILLED $INS RES PONSE $COLLECT
	4025	DRUG NDC RX INFO RX COB
	4026	RELE ASED ON REVERSAL METHOD/RE TURN STATU S/REASON
	4027	========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== =========
	4028	DIVISION: YYYYYYYY
	4029	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------
	4030	COB INSURA NCE
	4031	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------
	4032	ECMEPATIEN T,ONE (XXXX) TRI 102445$ 0/000001 13725 03/20/ 09 21.88 40. 00 0.00
	4033	OXYTOC IN 10 UNIT INJ 00071-416 0-03 W RT AC /R s
	4034	03/1 8/09 REGULAR/ ACCEPTED/2
	4035	-------- -- --- ------- ----- -----
	4036	SUBTOTALS for INS:CO B INSURANC E 21.88 40. 00 0.00
	4037	COUNT 1 1 1
	4038	MEAN 21.88 40. 00 0.00
	4039	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------
	4040	ECME INSUR ANCE
	4041	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------
	4042	ECMEPATIEN T,TWO (XXXX) VET 102446$ 0/000001 13727 03/20/ 09 11.00 40.00 0.00
	4043	DACARB AZINE 100M G INJ 00 026-8151-1 0 W RT DS /R s
	4044	03/2 0/09 REGULAR/ ACCEPTED/R EVERSING P RIMARY CLA IM
	4045	--------- - ---- ------ ------- ---
	4046	SUBTOTALS for INS:EC ME INSURAN CE 11.00 40. 00 0.00
	4047	COUNT 1 1 1
	4048	MEAN 11.00 40. 00 0.00
	4049	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------
	4050	ECME1 INSU RANCE
	4051	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------
	4052	ECMEPATIEN T,TWO (XXXX) VET 102422$ 1/000001 13698 03/20/0 9 0.00 68.3 2 0.00
	4053	GENTAM ICIN OPHTH ALMIC OINT . 00719-70 58-61 W RT DS /N p
	4054	REGULAR/ ACCEPTED/R X DISCONTI NUED
	4055	ECMEPATIEN T,ONE (XXXX) TRI 102435$ 0/000001 13713 04/06/0 9 0.00 40.0 0 0.00
	4056	METHOX AMINE 10MG /CC INJ 00081-0957 -10 W RT AC /N p
	4057	REGULAR/ ACCEPTED/ RX DISCONT INUED
	4058	--------- - ---- ------ ------- ---
	4059	SUBTOTALS for INS:EC ME1 INSURA NCE 0.00 108. 32 0.00
	4060	COUNT 2 2 2
	4061	MEAN 0.00 54. 16 0.00
	4062	--------- - ---- ------ ------- ---
	4063	SUBTOTALS for DIV:YY YYYYYY 32.88 188. 32 0.00
	4064	COUNT 4 4 4
	4065	MEAN 8.22 47. 08 0.00
	4066	--------- - ---- ------ ------- ---
	4067	GRAND TOTA LS 32.88 188. 32 0.00
	4068	COUNT 4 4 4
	4069	MEAN 8.22 47 .08 0.00
	4070	8.1.5 Clai ms Submitt ed, Not Ye t Released XE "Clai ms Submitt ed, Not Ye t Released "
	4071	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.
	4072	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.
	4073	Example 8. 1.5-1: Acc essing Cla ims Submit ted, Not Y et Release d Option
	4074	*** ****** ****** ****** ****** **
	4075	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	4076	* XXXXX V AMC *
	4077	* Cla im Results and Statu s *
	4078	*** ****** ****** ****** ****** **
	4079	PAY Payable Cl aims Repor t
	4080	REJ Rejected C laims Repo rt
	4081	ECMP CMOP/ECME Activity R eport
	4082	REV Reversal C laims Repo rt
	4083	NYR Claims Sub mitted, No t Yet Rele ased
	4084	REC Recent Tra nsactions
	4085	DAY Totals by Date
	4086	CLO Closed Cla ims Report
	4087
	4088	NBS Non-Billab le Status Report
	4089	SPA Spending A ccount Rep ort
	4090	Select Cla im Results and Statu s Option: NYR Claim s Submitte d, Not Yet Released
	4091	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 .
	4092	Example 8. 1.5-2: Add itional pr ompts to C laims Subm itted, Not Yet Relea sed Option
	4093
	4094	START WITH TRANSACTI ON DATE: T -1// T
	4095	GO TO TR ANSACTION DATE: T// T
	4096	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.
	4097	Do you wan t to captu re report data for a n Excel do cument? NO // <Enter>
	4098	WARNING - THIS REPOR T REQUIRES THAT A DE VICE WITH 132 COLUMN WIDTH BE USED.
	4099	IT WILL NO T DISPLAY CORRECTLY USING 80 C OLUMN WIDT H DEVICES
	4100	DEVICE: HO ME// <Ente r> IP net work
	4101	Example 8. 1.5-3: Cla ims Submit ted, Not Y et Release d Report
	4102	ECME SUBMI T,NOT RELE ASED CLAIM S DETAIL R EPORT Prin t Date: SE P 23, 2005 @15:01:21 Page: 1
	4103	DIVISION(S ): ALL Fi ll Locatio ns: C,M,W Fill type: RT,BB,RS
	4104	Insurance: ALL Drugs/Clas ses: ALL
	4105	PRESCRIPTI ONS (NOT R ELEASED) B Y TRANSACT ION DATE: From 09/23 /05 throug h 09/23/05
	4106	========== ========== ========== ========== ========== ========== ========== ========== ========
	4107	PATIENT NA ME Pt. ID RX# REF/ECM E# DATE $BILLED $INS RESPONSE
	4108	DRUG RX INF O RX COB
	4109	========== ========== ========== ========== ========== ========== ========== ========== ========
	4110	DIVISION: ZZZZZZZ
	4111	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- --------
	4112	WEBMD
	4113	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- --------
	4114	ECMEpatien t,One (XX XX) 909716 $ 0/00000 1105959 0 9/23/05 45.0 0 40.00
	4115	PROTAM INE SULFAT E 5ML INJ W RT AC/N p
	4116	---- ------ -- --------
	4117	SUBTOTALS for INS:WE BMD 45.00 40.00
	4118	COUNT 1 1
	4119	MEAN 45.00 40.00
	4120	---- ------ -- --------
	4121	SUBTOTALS for DIV:ZZ ZZZZZ 4 5.00 40.00
	4122	COUNT 1 1
	4123	MEAN 45.00 40.00
	4124	GRAND TOTA LS 45.00 40.00
	4125	COUNT 1 1
	4126	MEAN 45.00 40.00
	4127	8.1.6 Rece nt Transac tions XE " Recent Tr ansactions "
	4128	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.
	4129	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.
	4130	Example 8. 1.6-1: Rec ent Transa ctions Opt ion
	4131	*** ****** ****** ****** ****** **
	4132	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	4133	* XXXXX V AMC *
	4134	* Cla im Results and Statu s *
	4135	*** ****** ****** ****** ****** **
	4136	PAY Payable Cl aims Repor t
	4137	REJ Rejected C laims Repo rt
	4138	ECMP CMOP/ECME Activity R eport
	4139	REV Reversal C laims Repo rt
	4140	NYR Claims Sub mitted, No t Yet Rele ased
	4141	REC Recent Tra nsactions
	4142	DAY Totals by Date
	4143	CLO Closed Cla ims Report
	4144	NBS Non-Billab le Status Report
	4145	SPA Spending A ccount Rep ort
	4146	Select Cla im Results and Statu s Option: REC Recen t Transact ions
	4147	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.
	4148	Example 8. 1.6-2: Add itional pr ompts aske d by the R ecent Tran sactions O ption
	4149	START WITH TRANSACTI ON DATE: T -1// T
	4150	GO TO TR ANSACTION DATE: T// T
	4151	Selec t one of t he followi ng:
	4152	R RELEASED
	4153	N NOT RELEAS ED
	4154	A ALL
	4155	Include Rx s - (R)ELE ASED or (N )OT RELEAS ED or (A)L L: RELEASE D// ALL
	4156	Do you wan t to captu re report data for a n Excel do cument? NO // <Enter>
	4157	WARNING - THIS REPOR T REQUIRES THAT A DE VICE WITH 132 COLUMN WIDTH BE USED.
	4158	IT WILL NO T DISPLAY CORRECTLY USING 80 C OLUMN WIDT H DEVICES
	4159	DEVICE: HO ME// <Ente r> IP netw ork
	4160	Please wai t...
	4161	(This page included for two-si ded copyin g.)
	4162	Example 8. 1.6-3: Rec ent Transa ctions Rep ort
	4163	ECME RECEN T TRANSACT IONS DETAI L REPORT P rint Date: NOV 03, 2 010@17:10: 39 Page: 1
	4164	DIVISION(S ): ALL Fill Lo cations: C ,M,W Fill type: RT,B B,RS
	4165	Insurance: ALL Dru gs/Classes : ALL
	4166	PRESCRIPTI ONS BY TRA NSACTION D ATE: From 10/04/10 t hrough 11/ 03/10
	4167	========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ==
	4168	PATIENT NA ME Pt. ID RX# REF /ECME# COMPL ETED TRANS T YPE PAYER RESP ONSE RX CO B
	4169	DRUG NDC RX INFO I NSURANCE ELAP TIM E IN SECON DS
	4170	========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ==
	4171	DIVISION: XXXXXXXX
	4172	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- --
	4173	ECMEPATIEN T,THREE ( XXXX) 102 128$ 1 /000000002 509 10/04/10 02:52PM SUBMIT E REJECT ED p
	4174	DIAZEP AM 10MG S. T. 00 555-0164-0 4 M RT EX/N RE J OPI NSUR1 9
	4175	ECMEPATIEN T,THREE ( XXXX) 110 0249$ 1 / 10/ 06/10 11:2 9AM SUBMI T E UNSTRA NDED p
	4176	GENTAM ICIN OPHTH ALMIC O 00 719-7058-6 1 W RT AC/N OPI NSUR1 502339
	4177	ECMEPATIEN T,SIX ( XXXX) 110 0341$ 0 /000000003 126 10/ 07/10 12:0 6AM SUBMI T E REJECT ED p
	4178	DOXEPI N 25MG CAP 00 839-7221-0 6 W RT AC/R RE J OPI NSUR2 7
	4179	ECMEPATIEN T,SIX ( XXXX) 110 0342$ 0 /000000003 127 10/ 07/10 01:5 9PM SUBMI T E PAYABL E p
	4180	CORTIC OTROPIN 40 UNIT HP 00 053-1330-0 1 W RT AC/R OPI NSUR2 4
	4181	ECMEPATIEN T,SIX ( XXXX) 110 0336$ 0 /000000003 120 10/ 07/10 03:0 5PM REVER SAL E REVERS AL OTHER p
	4182	TRIAMT ERENE 50MG , HCTZ 00 484-3590-3 0 W RT DS/R OPI NSUR2 3
	4183	ECMEPATIEN T,ONE ( XXXX) 100 952$ 0 /000000000 874 10/07/10 05:29PM SUBMIT E UNSTRA NDED p
	4184	MEDROX YPROGESTRO NE 10MG 00 009-0050-0 2 W RT DS/N OPI NSUR1 76220585
	4185	ECMEPATIEN T,ONE ( XXXX) 100 933$ 0 /000000000 853 10/07/10 07:45PM SUBMIT E REJECT ED p
	4186	DOXEPI N 25MG CAP 00 839-7221-0 6 M RT DS/N RE J OPI NSUR1 7
	4187	ECMEPATIEN T,ONE ( XXXX) 101 814$ 0 /000000002 181 10/08/10 04:11PM REVERSAL E REVERS AL UNSTRAN DED p
	4188	IMIPRA MINE 25MG TAB 00 779-0588-3 0 W RT DS/N OPI NSUR1 57199104
	4189	ECMEPATIEN T,ONE ( XXXX) 100 954$ 0 /000000000 876 10/08/10 04:16PM SUBMIT E UNSTRA NDED p
	4190	DOXEPI N 25MG CAP 00 839-7221-0 6 M RT DS/N OPI NSUR1 76194694
	4191	ECMEPATIEN T,ONE ( XXXX) 100 991$ 0 /000000000 915 10/08/10 04:16PM SUBMIT E UNSTRA NDED p
	4192	BACLOF EN 10MG TA BS 00 023-4534-6 7 W RT DS/N OPI NSUR1 75772098
	4193	ECMEPATIEN T,ONE ( XXXX) 101 860$ 0 /000000002 228 10/08/10 04:16PM SUBMIT E UNSTRA NDED p
	4194	IMIPRA MINE 25MG TAB 00 779-0588-3 0 W RT EX/N OPI NSUR1 57199347
	4195	ECMEPATIEN T,ONE ( XXXX) 101 861$ 0 /000000002 229 10/08/10 04:16PM SUBMIT E UNSTRA NDED p
	4196	CHLORA L HYDRATE 500MG C 00 003-0626-5 1 W RT DS/N OPI NSUR1 57199249
	4197	ECMEPATIEN T,ONE ( XXXX) 101 959$ 0 /000000002 331 10/08/10 04:16PM SUBMIT E UNSTRA NDED p
	4198	LIDOCA INE 2% 50M L INJ M 00 186-0240-0 2 W RT DS/N OPI NSUR1 51602609
	4199	ECMEPATIEN T,THREE ( XXXX) 102 225$ 0 /000000002 607 10/08/10 04:16PM SUBMIT E UNSTRA NDED p
	4200	BIPERI DEN 2MG TA B 00 044-0120-0 4 M RT DS/N OPI NSUR1 46160110
	4201	(This page included for two-si ded copyin g.)
	4202	8.1.7 Tota ls by Date XE " Tot als by Dat e"
	4203	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.
	4204	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.
	4205	Example 8. 1.7-1: Tot als by Dat e Option
	4206	*** ****** ****** ****** ****** **
	4207	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	4208	* XXXXX V AMC *
	4209	* Cla im Results and Statu s *
	4210	*** ****** ****** ****** ****** **
	4211	PAY Payable Cl aims Repor t
	4212	REJ Rejected C laims Repo rt
	4213	ECMP CMOP/ECME Activity R eport
	4214	REV Reversal C laims Repo rt
	4215	NYR Claims Sub mitted, No t Yet Rele ased
	4216	REC Recent Tra nsactions
	4217	DAY Totals by Date
	4218	CLO Closed Cla ims Report
	4219	NBS Non-Billab le Status Report
	4220	SPA Spending A ccount Rep ort
	4221	Select Cla im Results and Statu s Option: DAY Total s by Date
	4222	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.
	4223	Example 8. 1.7-2: Add itional pr ompts aske d by the T otals by D ay Option
	4224	START WITH TRANSACTI ON DATE: T -1// T-30
	4225	GO TO TR ANSACTION DATE: T// <Enter>
	4226	Selec t one of t he followi ng:
	4227	R RELEASED
	4228	N NOT RELEAS ED
	4229	A ALL
	4230	Include Rx s - (R)ELE ASED or (N )OT RELEAS ED or (A)L L: RELEASE D// ALL
	4231	Do you wan t to captu re report data for a n Excel do cument? NO // <Enter>
	4232	WARNING - THIS REPOR T REQUIRES THAT A DE VICE WITH 132 COLUMN WIDTH BE USED.
	4233	IT WILL NO T DISPLAY CORRECTLY USING 80 C OLUMN WIDT H DEVICES
	4234	DEVICE: HO ME// <Ente r> IP netw ork
	4235	Please wai t...
	4236	Example 8. 1.7-3: Tot als by Dat e Report ( Compacted to fit int o document )
	4237	ECME TOTAL S DETAIL R EPORT Print D ate: SEP 2 3, 2005@15 :18:52 Pa ge: 1
	4238	DIVISION(S ): ALL Fil l Location s: C,M,W F ill type: RT,BB,RS
	4239	Insurance: DEVELOPME NT INS, OP INSUR1 D rugs/Class es: ALL
	4240	ALL PRESCR IPTIONS BY TRANSACTI ON DATE: F rom 09/23/ 05 through 09/23/05
	4241	========== ========== ========== ========== ========== ========== ========== ========== ======
	4242	AMOUNT RETURNE D RETURNE D AMO UNT
	4243	DATE #CLAIMS SUBMITTED REJECTE D PAYABL E TO RECE IVE DIFF ERENCE
	4244	========== ========== ========== ========== ========== ========== ========== ========== ======
	4245	DIVISION: ZZZZZZZ
	4246	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ------
	4247	09/23/05 2 90.00 45.0 0 45.0 0 40 .00 5.00
	4248	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ------
	4249	TOTALS 2 90.00 45.0 0 45.0 0 40 .00 5.00
	4250	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ------
	4251	GRAND TOTA LS 2 90.00 45.0 0 45.0 0 40 .00 5.00
	4252	Press RETU RN to cont inue:
	4253	8.1.8 Clos ed Claims Report XE " Closed C laims Repo rt"
	4254	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.
	4255	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.
	4256	Example 8. 1.8-1: Acc essing the Closed Cl aims Repor t Option
	4257	*** ****** ****** ****** ****** **
	4258	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	4259	* XXXXX V AMC *
	4260	* Cla im Results and Statu s *
	4261	*** ****** ****** ****** ****** **
	4262	PAY Payable Cl aims Repor t
	4263	REJ Rejected C laims Repo rt
	4264	ECMP CMOP/ECME Activity R eport
	4265	REV Reversal C laims Repo rt
	4266	NYR Claims Sub mitted, No t Yet Rele ased
	4267	REC Recent Tra nsactions
	4268	DAY Totals by Date
	4269	CLO Closed Cla ims Report
	4270	NBS Non-Billab le Status Report
	4271	SPA Spending A ccount Rep ort
	4272	Select Cla im Results and Statu s Option: CLO Close d Claims R eport
	4273	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.
	4274	Example 8. 1.8-2: Sel ecting Spe cific Clos e Claim Re ason Optio n
	4275	START WITH CLOSE DAT E: T-1// T -50
	4276	GO TO CL OSE DATE: T// <Enter >
	4277	Selec t one of t he followi ng:
	4278	R RELEASED
	4279	N NOT RELEAS ED
	4280	A ALL
	4281	Include Rx s - (R)ELE ASED or (N )OT RELEAS ED or (A)L L: RELEASE D// ALL
	4282	Select one of th e followin g:
	4283	S Specific C lose Claim Reason
	4284	A ALL
	4285	Include (S )pecific C lose Claim Reason or (A)LL: AL L// <Enter >
	4286	Selec t one of t he followi ng:
	4287	V VETERAN
	4288	T TRICARE
	4289	C CHAMPVA
	4290	A ALL
	4291	Include Ce rtain Elig ibility Ty pe or (A)l l: V// ALL
	4292	Do you wan t to captu re report data for a n Excel do cument? NO // <Enter>
	4293	WARNING - THIS REPOR T REQUIRES THAT A DE VICE WITH 132 COLUMN WIDTH BE USED.
	4294	IT WILL NO T DISPLAY CORRECTLY USING 80 C OLUMN WIDT H DEVICES
	4295	DEVICE: HO ME// <Ente r> IP netw ork
	4296	Please wai t...
	4297	Example 8. 1.8-2: Clo sed Claims Report
	4298	ECME CLOSE D CLAIMS D ETAIL REPO RT P rint Date: APR 17, 2 009@14:21: 22 Page: 1
	4299	DIVISION(S ): ALL Fill Lo cations: C ,M,W Fill type: RT, BB,RS
	4300	Insurance: ALL Close Rea son: ALL Drugs/ Classes: A LL
	4301	Eligibilit y: ALL
	4302	RELEASED P RESCRIPTIO NS BY CLOS E DATE: Fr om 03/18/0 9 through 04/17/09
	4303	========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ==
	4304	PATIENT NA ME Pt.ID ELIG RX# REF/EC ME# RX I NFO DRUG NDC
	4305	CARDHOL D.ID GROUP ID CLOSE DAT E/TIME C LOSED BY CLO SE REASON
	4306	RX COB
	4307	========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ==
	4308	DIVISION: YYYYYYYY
	4309	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- --
	4310	ECME1 INSU RANCE
	4311	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- --
	4312	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
	4313	1234098 7 10001 03/20/09 03:55PM E CMEUSER,ON E IN VALID NDC FROM CMOP
	4314	p
	4315	Claim ID: VA2009=500 0000021=00 0010=00054 94
	4316	54:Non-M atched Pro duct/Servi ce ID Numb er
	4317	SUBTOTALS for INS: E CMEUSER,ON E
	4318	ECMEPAT ,ONE 1
	4319	-----
	4320	CLOSED CLA IMS SUBTOT AL 1
	4321	SUBTOTALS for DIV:YY YYYYYY
	4322	ECMEUSE R,ONE 1
	4323	-----
	4324	CLOSED CLA IMS SUBTOT AL 1
	4325	GRAND TOTA LS (ALL DI VISIONS) B Y BILLER
	4326	ECMEUSE R,ONE 1
	4327	-----
	4328	CLOSED CLA IMS GRAND TOTAL 1
	4329	8.1.9 Non- Billable S tatus Repo rt XE " No n-Billable Status Re port"
	4330	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.
	4331	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.
	4332	Example 8. 1.9-1: Acc essing the Non-Billa ble Status Report Op tion
	4333	*** ****** ****** ****** ****** **
	4334	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	4335	* XXXXX V AMC *
	4336	* Cla im Results and Statu s *
	4337	*** ****** ****** ****** ****** **
	4338	PAY Payable Cl aims Repor t
	4339	REJ Rejected C laims Repo rt
	4340	ECMP CMOP/ECME Activity R eport
	4341	REV Reversal C laims Repo rt
	4342	NYR Claims Sub mitted, No t Yet Rele ased
	4343	REC Recent Tra nsactions
	4344	DAY Totals by Date
	4345	CLO Closed Cla ims Report
	4346	NBS Non-Billab le Status Report
	4347	SPA Spending A ccount Rep ort
	4348	Select Cla im Results and Statu s Option: NBS Non-B illable St atus Repor t
	4349	After you have made selections from the “ALL REPOR TS” prompt s, you wil l be given a series of prompts as shown below:
	4350	Example 8. 1.9-2: Sel ecting Non -Billable Status Rep ort option
	4351	Selec t one of t he followi ng:
	4352	D DIVISION
	4353	A ALL
	4354	Select Cer tain Pharm acy (D)ivi sions or ( A)LL: DIVI SION
	4355	Select ECM E Pharmacy Division( s): GEN ERIC PHARM ACY
	4356	Selected :
	4357	GENERIC PH ARMACY
	4358	Select ECM E Pharmacy Division( s):
	4359	Selec t one of t he followi ng:
	4360	S Summary
	4361	D Detail
	4362	Display (S )ummary or (D)etail Format: De tail//
	4363	Selec t one of t he followi ng:
	4364	I SPECIFIC I NSURANCE(S )
	4365	A ALL
	4366	Select Cer tain (I)NS URANCE or (A)LL): A/ / LL
	4367	Selec t one of t he followi ng:
	4368	C CMOP
	4369	M Mail
	4370	W Window
	4371	A ALL
	4372	Display (C )MOP or (M )ail or (W )indow or (A)LL: ALL //
	4373	Selec t one of t he followi ng:
	4374	D Drug
	4375	C Drug Class
	4376	A ALL
	4377	Display Sp ecific (D) rug or Dru g (C)lass or (A)LL: ALL//
	4378	START WITH TRANSACTI ON DATE: T -1// T-10 (MAY 29, 2015)
	4379	GO TO TRAN SACTION DA TE: T// T (JUN 08, 2015)
	4380	Selec t one of t he followi ng:
	4381	R RELEASED
	4382	N NOT RELEAS ED
	4383
	4384	A
	4385
	4386	ALL
	4387	Include Rx s - (R)ELE ASED or (N )OT RELEAS ED or (A)L L: ALL//
	4388	R Most Recen t
	4389	A ALL
	4390	Select Mos t (R)ecent or (A)ll: MOST RECE NT//
	4391	Selec t one of t he followi ng:
	4392	E ELIGIBILIT Y
	4393	A ALL
	4394	Select Cer tain (E)li gibilities or (A)LL: ALL//
	4395	Selec t one of t he followi ng:
	4396	S NON-BILLAB LE STATUS
	4397	A ALL
	4398	Select Cer tain Non-B illable (S )tatus or (A)ll: ALL //
	4399	Do you wan t to captu re report data for a n Excel do cument? NO //
	4400	WARNING - THIS REPOR T REQUIRES THAT A DE VICE WITH 132 COLUMN WIDTH BE USED.
	4401	IT WILL NO T DISPLAY CORRECTLY USING 80 C OLUMN WIDT H DEVICES
	4402	DEVICE: HO ME// HOM E (CRT) Right Ma rgin: 80// 132
	4403	Please wai t...
	4404	Example 8. 1.9-3: Non -Billable Status Rep ort
	4405	ECME RXs W ITH Non-Bi llable STA TUS REPORT
	4406
	4407
	4408	Print Date : Sept 26, 2014@11:4 1:54 Page : 1
	4409	DIVISION(S ): GENERIC Fill Locat ions: C,M, W
	4410	Insurance: ALL D rugs/Class es: ALL
	4411	Eligibilit ies: ALL
	4412	NON-BILLAB LE STATUS: ALL
	4413	ALL PRESCR IPTIONS BY TRANSACTI ON DATE: F rom 2/22/0 9 through 09/23/14
	4414	========== ========== ========== ========== ========== ========== ========== ========== ========== =======
	4415	PATIENT NA ME Pt. ID ELIG RX# REF DATE $DRUG COST
	4416	DRUG NDC REL EASED ON RX INFO NON-B ILLABLE ST ATUS
	4417	========== ========== ========== ========== ========== ========== ========== ========== ========== =======
	4418	DIVISION: GENERIC DI VISION
	4419	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- -------
	4420	GENERIC IN S
	4421	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- -------
	4422	ECMEpatien t,One (XX XX) TRI ######$ 2 04/15/ 09 5 1.00
	4423	AMITRI PTYLINE 10 MG TAB 00182-10 18-10 04/ 15/09 W AC/R Plan not active , local
	4424	ECMEpatien t, Three (XX XX) VET ######$ 0 03/10/ 09 5 1.00
	4425	METHAD ONE 10MG T AB 000054-8 554-2 03/ 10/09 W EX/N Plan not linked to Payer
	4426	------ ----
	4427	SUBTOTALS for INS:GE NERIC INS
	4428	102.00
	4429	COUNT
	4430	2
	4431	MEAN
	4432	51.00
	4433	Press RETU RN to cont inue
	4434	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- -------
	4435	GENERIC IN SURANCE 2
	4436	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- -------
	4437	ECMEpatien t, Two (XX XX) VET 100574$ 0 03/05/ 09 5 1.00
	4438	NEODEC ADRON OPHT MALIC SOL. 00006-76 39-03 03/ 05/08 W AC/R Plan n ot found
	4439	ECMEpatien t, Two (XX XX) VET 100575$ 0 03/05/ 09 5 1.00
	4440	PENTAE RYTHRITOL 10MG TAB 00725-20 64-10 03/ 05/08 W AC/R Plan D eactivated
	4441	...
	4442	SUBTOTALS for INS:GE NERIC INSU RANCE 2 214 2.00
	4443	COUNT 42
	4444	MEAN 5 1.00
	4445	------ ----
	4446	SUBTOTALS for DIV:GE NERIC DIVI SION 224 4.00
	4447	COUNT 44
	4448	MEAN 5 1.00
	4449	------ ----
	4450	GRAND TOTA LS 224 4.00
	4451	COUNT 44
	4452	MEAN 5 1.00
	4453	Press RETU RN to cont inue:
	4454	(This page included for two-si ded copyin g.
	4455	8.1.10 Spe nding Acco unt Report XE " Spen ding Accou nt Report"
	4456	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.
	4457	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.
	4458	Example 8. 1.10-1: Ac cessing th e Spending Account R eport Opti on
	4459	*** ****** ****** ****** ****** **
	4460	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	4461	* XXXXX V AMC *
	4462	* Cla im Results and Statu s *
	4463	*** ****** ****** ****** ****** **
	4464	PAY Payable Cl aims Repor t
	4465	REJ Rejected C laims Repo rt
	4466	ECMP CMOP/ECME Activity R eport
	4467	REV Reversal C laims Repo rt
	4468	NYR Claims Sub mitted, No t Yet Rele ased
	4469	REC Recent Tra nsactions
	4470	DAY Totals by Date
	4471	CLO Closed Cla ims Report
	4472	NBS Non-Billab le Status Report
	4473	SPA Spending A ccount Rep ort
	4474	Select Cla im Results and Statu s Option: SPA Spe nding Acco unt Report
	4475	Example 8. 1.10-2: Se lecting Sp ending Acc ount Repor t Option
	4476	Selec t one of t he followi ng:
	4477	D DIVISION
	4478	A ALL
	4479	Select Cer tain Pharm acy (D)ivi sions or ( A)LL: DIVI SION
	4480	Select ECM E Pharmacy Division( s): XXXXXX X
	4481	Selected :
	4482	XXXXXXXX
	4483	Select ECM E Pharmacy Division( s): YYYYYY Y CBOC X XX
	4484	Selected :
	4485	XXXXXXXX
	4486	XXXXX
	4487	Select ECM E Pharmacy Division( s):
	4488	Selec t one of t he followi ng:
	4489	S Summary
	4490	D Detail
	4491	Display (S )ummary or (D)etail Format: De tail//
	4492	Selec t one of t he followi ng:
	4493	I SPECIFIC I NSURANCE(S )
	4494	A ALL
	4495	Select Cer tain (I)NS URANCE or (A)LL): A/ / ALL
	4496	Selec t one of t he followi ng:
	4497	C CMOP
	4498	M Mail
	4499	W Window
	4500	A ALL
	4501	Display (C )MOP or (M )ail or (W )indow or (A)LL: ALL //
	4502	Selec t one of t he followi ng:
	4503	R Real Time Fills
	4504	B Backbill
	4505	S ReSubmissi on
	4506	A ALL
	4507	Display (R )ealTime, (B)ackbill s, (P)RO O ption, Re( S)ubmissio n or (A)LL : A//
	4508	Selec t one of t he followi ng:
	4509	D Drug
	4510	C Drug Class
	4511	A ALL
	4512	Display Sp ecific (D) rug or Dru g (C)lass or (A)LL: ALL//
	4513	START WITH TRANSACTI ON DATE: T -1//
	4514	GO TO TR ANSACTION DATE: T//
	4515	Selec t one of t he followi ng:
	4516	R RELEASED
	4517	N NOT RELEAS ED
	4518	A ALL
	4519	Include R xs - (R)EL EASED or ( N)OT RELEA SED or (A) LL: RELEAS ED//
	4520	Selec t one of t he followi ng:
	4521	S Specific R eject Code
	4522	A ALL
	4523	Include ( S)pecific Reject Cod e or (A)LL : ALL//
	4524	Do you wan t to captu re report data for a n Excel do cument? NO //
	4525	WARNING - THIS REPOR T REQUIRES THAT A DE VICE WITH 132 COLUMN WIDTH BE USED.
	4526	IT WILL NO T DISPLAY CORRECTLY USING 80 C OLUMN WIDT H DEVICES
	4527	DEVICE: HO ME//
	4528	Please wai t...
	4529	Example 8. 1.10-3: Sp ending Acc ount Repor t – Summar y
	4530	ECME SPEND ING ACCOUN T REPORT S UMMARY REP ORT P rint Date: DEC 02, 2 011@16:51: 34 Page: 1
	4531	DIVISION(S ): ALL F ill Locati ons: C,M,W Fill typ e: RT,BB,P 2,RS
	4532	Insurance: ALL Dru gs/Classes : ALL
	4533	ALL PRESCR IPTIONS BY TRANSACTI ON DATE: F rom 06/05/ 11 through 12/02/11
	4534	========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ==
	4535	PATIENT NA ME Pt. ID RX# REF /ECME# DA TE $BILLED $IN S RESPONSE $COLLE CT
	4536	DRUG RX INFO INS GR OUP# I NS GROUP N AME BILL#
	4537	$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
	4538	========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ==
	4539	DIVISION: XXXXXX
	4540	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- --
	4541	-- -------- ---------- -------- --
	4542	SUBTOTALS for INS:EP HARM INSUR ANCE 12.00 999999.99 0. 00
	4543	0.00 0 .00 0.00 0.00 0.0 0 0.00 12.3 0
	4544	COUNT 1 1 1
	4545	1 1 1 1 1 1 1
	4546	MEAN 12.00 999999.99 0. 00
	4547	0.00 0 .00 0.00 0.00 0.0 0 0.00 12.3 0
	4548	-- -------- ---------- -------- --
	4549	SUBTOTALS for INS:EX PRESS SCRI PTS 9 99999.99 999999.99 0. 00
	4550	0.00 0 .00 0.00 0.00 0.0 0 0.00 15.4 1
	4551	COUNT 1 1 1
	4552	1 1 1 1 1 1 1
	4553	MEAN 9 99999.99 999999.99 0. 00
	4554	0.00 0 .00 0.00 0.00 0.0 0 0.00 15.4 1
	4555	-- -------- ---------- -------- --
	4556	SUBTOTALS for DIV:XX XXXX 10 00011.99 1999999.98 0. 00
	4557	0.00 0 .00 0.00 0.00 0.0 0 0.00 27.7 1
	4558	COUNT 2 2 2
	4559	2 2 2 2 2 2 2
	4560	MEAN 5 00006.00 999999.99 0. 00
	4561	0.00 0 .00 0.00 0.00 0.0 0 0.00 13.8 6
	4562	-- -------- ---------- -------- --
	4563	GRAND TOTA LS 10 00011.99 1999999.98 0. 00
	4564	0.00 0 .00 0.00 0.00 0.0 0 0.00 27.7 1
	4565	COUNT 2 2 2
	4566	2 2 2 2 2 2 2
	4567	MEAN 5 00006.00 999999.99 0. 00
	4568	0.00 0 .00 0.00 0.00 0.0 0 0.00 13.8 6
	4569	Press RETU RN to cont inue:
	4570	Example 8. 1.10-4: Sp ending Acc ount Repor t – Detail
	4571	ECME SPEND ING ACCOUN T REPORT D ETAIL REPO RT P rint Date: DEC 02, 2 011@17:16: 36 Page: 1
	4572	DIVISION(S ): ALL F ill Locati ons: C,M,W Fill typ e: RT,BB,P 2,RS
	4573	Insurance: ALL Dru gs/Classes : ALL
	4574	ALL PRESCR IPTIONS BY TRANSACTI ON DATE: F rom 06/05/ 11 through 12/02/11
	4575	========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ==
	4576	PATIENT NA ME Pt. ID RX# REF /ECME# DA TE $BILLED $IN S RESPONSE $COLLE CT
	4577	DRUG RX INFO INS GR OUP# I NS GROUP N AME BILL#
	4578	$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
	4579	========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ==
	4580	DIVISION: XXXXXX
	4581	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- --
	4582	EPHARM INS URANCE
	4583	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- --
	4584	OPCOB,ONEC NF (16 6P) 27193 07 0/4 316136 08 /24/11 12.00 999999.99 0. 00
	4585	ATENOLOL 25MG TAB W P2 EX/R T00010 E PHARM INSU RANCE K1000F7
	4586	0.00 0.00 0. 00 0.00 0.00 0.00 12.30
	4587	Claim ID: VA2011=405 0000015=00 0010=00010 47
	4588	-- -------- ---------- -------- --
	4589	SUBTOTALS for INS:EP HARM INSUR ANCE 12.00 999999.99 0. 00
	4590	0.00 0 .00 0.00 0.00 0.0 0 0.00 12.3 0
	4591	COUNT 1 1 1
	4592	1 1 1 1 1 1 1
	4593	MEAN 12.00 999999.99 0. 00
	4594	0.00 0 .00 0.00 0.00 0.0 0 0.00 12.3 0
	4595	EXPRESS SC RIPTS
	4596	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- --
	4597	OPCOB,ONEC NF (16 6P) 27193 07 0/4 316136 08 /24/11 9 99999.99 999999.99 0. 00
	4598	ATENOLOL 25MG TAB W P2 EX/R T10000 0 E XPRESS SCR IPTS K1000F6
	4599	0.00 0.00 0. 00 0.00 0.00 0.00 15.41
	4600	Claim ID: VA2011=405 0000015=00 0010=00010 46
	4601	-- -------- ---------- -------- --
	4602	SUBTOTALS for INS:EX PRESS SCRI PTS 9 99999.99 999999.99 0. 00
	4603	0.00 0 .00 0.00 0.00 0.0 0 0.00 15.4 1
	4604	COUNT 1 1 1
	4605	1 1 1 1 1 1 1
	4606	MEAN 9 99999.99 999999.99 0. 00
	4607	0.00 0 .00 0.00 0.00 0.0 0 0.00 15.4 1
	4608	-- -------- ---------- -------- --
	4609	SUBTOTALS for DIV:XX XXXX 10 00011.99 1999999.98 0. 00
	4610	0.00 0 .00 0.00 0.00 0.0 0 0.00 27.7 1
	4611	COUNT 2 2 2
	4612	2 2 2 2 2 2 2
	4613	MEAN 5 00006.00 999999.99 0. 00
	4614	0.00 0 .00 0.00 0.00 0.0 0 0.00 13.8 6
	4615	-- -------- ---------- -------- --
	4616	GRAND TOTA LS 10 00011.99 1999999.98 0. 00
	4617	0.00 0 .00 0.00 0.00 0.0 0 0.00 27.7 1
	4618	COUNT 2 2 2
	4619	2 2 2 2 2 2 2
	4620	MEAN 5 00006.00 999999.99 0. 00
	4621	0.00 0 .00 0.00 0.00 0.0 0 0.00 13.8 6
	4622	Press RETU RN to cont inue:
	4623	8.2 Other Reports XE " Other R eports"
	4624	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.
	4625	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.
	4626	Example 8. 2-1: Acces sing the O ther Repor ts Option
	4627	*** ****** ****** ****** ****** **
	4628	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	4629	* XXXX X *
	4630	* Pharmacy Electroni c Claims R eports *
	4631	*** ****** ****** ****** ****** **
	4632	CLA Claim Resu lts and St atus ...
	4633	OTH Other Repo rts ...
	4634	Select Pha rmacy Elec tronic Cla ims Report s Option: OTH Other Reports
	4635	Example 8. 2-2: Displ aying Othe r Reports Options
	4636	*** ****** ****** ****** ****** **
	4637	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	4638	* XXXX X *
	4639	* Other Re ports *
	4640	*** ****** ****** ****** ****** **
	4641	CRI ECME Claim s-Response Inquiry
	4642	PAY Payer Shee t Detail R eport
	4643	PHAR ECME Setup - Pharmac ies Report
	4644	TAT Turn-aroun d time sta tistics
	4645	VER View ePhar macy Rx
	4646	OPR OPECC Prod uctivity R eport
	4647	Select Oth er Reports Option:
	4648	8.2.1 ECME Claims-Re sponse Inq uiry Optio n XE " ECM E Claims-R esponse In quiry"
	4649	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.
	4650	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.
	4651	Example 8. 2.1-1: Acc essing the ECME Clai ms-Respons e Inquiry Option
	4652	*** ****** ****** ****** ****** **
	4653	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	4654	* XXXX X *
	4655	* Other Re ports *
	4656	*** ****** ****** ****** ****** **
	4657	CRI ECME Claim s-Response Inquiry
	4658	PAY Payer Shee t Detail R eport
	4659	PHAR ECME Setup - Pharmac ies Report
	4660	TAT Turn-aroun d time sta tistics
	4661	VER View ePhar macy Rx
	4662	OPR OPECC Prod uctivity R eport
	4663	Select Oth er Reports Option: C RI ECME C laims-Resp onse Inqui ry
	4664	Example 8. 2.1-2: ECM E Claims-R esponse In quiry Opti on
	4665	Select VA Claim ID: VA2009=500 0000021=10 5220=00055 24 VA2009 =500000002 1=105220=0
	4666	005524
	4667	Note: This report co ntains thr ee separat e sections - transac tion data, claims
	4668	data , and resp onse data. There wi ll be a pa ge break/f orm feed a fter
	4669	each section r egardless of the pag e length s pecified i n the devi ce input.
	4670	DEVICE: HO ME// <Ente r> UCX/T ELNET R ight Margi n: 80// < Enter>
	4671	ECME Claim s-Response Inquiry R eport Pr int Date: 04/17/09
	4672	VA CLAIM I D: VA2009= 5000000021 =105220=00 05524
	4673	BPS TRANSA CTION/BPS LOG OF TRA NSACTION D ATA:
	4674	ENTRY#: 11 3414.00042 STATUS: 99
	4675	PHARMACY : PHARM1 PRESCRIPTI ON #: 1021 79
	4676	RXI-INTE RNAL (c): 113414
	4677	PLAN NAM E: COB INS URANCE PHARMACY P LAN ID: VA 105220
	4678	CLAIM IE N (c): 552 4 RESPONSE I EN (c): 53 69
	4679	Press RETU RN to cont inue, '^' to exit:
	4680	BPS CLAIMS FILE DATA :
	4681	CLAIM ID: VA2009=500 0000021=10 5220=00055 24
	4682	ELECTRON IC PAYER: MNMEDB1 TRANSMIT F LAG: YES ( POINT OF S ALE)
	4683	TRANSMIT TED ON: AP R 17,2009@ 14:54:27 CREATED ON : APR 17,2 009@14:54: 27
	4684	TRANSACT ION: 11341 4.00042 PATIENT NA ME: ECMEpa tient,One
	4685	GROUP IN SURANCE PL AN: COB IN SURANCE BIN NUMBER : 610459
	4686	VERSION RELEASE NU MBER: D0 TRANSACTIO N CODE: B1
	4687	PROCESSO R CONTROL NUMBER: MH CP TRANSACTIO N COUNT: 1
	4688	SOFTWARE VENDER CE RT ID: SERVICE PR OVIDER ID: 500000002 1
	4689	SERVICE PROVIDER I D QUAL: 01 GROUP ID: C19977
	4690	CARDHOLD ER ID: C2X XXXXX PERSON COD E: C301
	4691	DATE OF BIRTH: C4X XXXXXXX PATIENT GE NDER CODE: MALE
	4692	PATIENT RELATIONSH IP CODE: C ARDHOLDER
	4693	PLACE OF SERVICE: C700 ELIGIBILIT Y CLARIFIC ATION CODE : C90
	4694	PATIENT FIRST NAME : CAONE PATIENT LA ST NAME: C BECMEPATIE NT
	4695	CARDHOLD ER FIRST N AME: CCONE
	4696	CARDHOLD ER LAST NA ME: CDECME PATIENT
	4697	HOME PLA N: CE36
	4698	PATIENT STREET ADD RESS: CM13 DFG
	4699	PATIENT CITY ADDRE SS: CNXXXX XXXX
	4700	PATIENT STATE PROV ADDRESS: COXX PATIENT ZI P POSTAL Z ONE: CPXXX XX
	4701	PATIENT PHONE NUMB ER: CQXXXX XXXXX PATIENT ID QUALIFIER : CX01
	4702	PATIENT ID: CYXXXX XXXX EMPLOYER I D: CZ
	4703	SMOKER I NDICATOR: 1C PREGNANCY INDICATOR: 2C
	4704	FACILITY ID: 8C
	4705	MEDICATION ORDER: 1 MEDICATION NAME: BET AZOLE 50MG /ML INJ
	4706	PRESCRIP TION NUMBE R: 102179 OTHER COVE RAGE CODE: C800
	4707	ALTERNAT E ID: CW00 0000000000 00000000
	4708	COB OTHER PAYMENT CO UNTER: 4C1 OTHER PAYE R COVERAGE TYPE: 5C0 1
	4709	OTHER PA YER ID QUA LIFIER: 6C 03 OTHER PAYE R ID: 7C12 3456
	4710	OTHER PA YER DATE: APR 14,200 9 OTHER PAYE R AMOUNT P AID COUNT: HB1
	4711	OTHER PA YER REJECT COUNT: 5E 00
	4712	OTHER PAYE R AMT PAID QUALIFIER : HC08 OTHER PAYE R AMOUNT P AID: DV004 00{
	4713	DATE OF SE RVICE: APR 14,2009 PR ESCRIPTION REFERENCE NUMBER: D 20113414
	4714	FILL NUM BER: D304 DAYS SUPPL Y: D5001
	4715	COMPOUND CODE: D61
	4716	PRODUCT SERVICE ID : D7000021 43916
	4717	DISPENSE AS WRITTE N: D80 INGREDIENT COST SUBM ITTED: D90 000510{
	4718	PRESCRIB ER ID: DBX XXXXXXXX DISPENSING FEE SUBMI TTED: DC00 000000
	4719	DATE PRE SCRIPTION WRITTEN: D E20090112
	4720	NUMBER O F REFILLS AUTHORIZED : DF05 LEVEL OF S ERVICE: DI 00
	4721	PRESCRIP TION ORIGI N CODE: DJ 1 SUBMISSION CLARIFICA TION CODE: DK00
	4722	BASIS OF COST DETE RMINATION: DN07 USUAL AND CUSTOMARY CHARGE: DQ 0000510{
	4723	SPECIAL PACKAGING INDICATOR: DT0 GROSS AMOU NT DUE: DU 0000510{
	4724	PRESCRIB ER LAST NA ME: ECMEPR ESCRIBER
	4725	OTHER PA YER AMOUNT : DV00400{
	4726	PATIENT PAID AMOUN T SUBMITTE D: DX00000 00{
	4727	PRODUCT SERVICE ID QUALIFIER : E103 QUANTITY D ISPENSED: E700000010 00
	4728	ORIGINAL LY PRESCRI BED QUANTI TY: EB0000 001000
	4729	SCHEDULE D RX ID NU MBER: EK00 0000000000
	4730	PRESCRIP TION SERVI CE REFEREN CE: EM1 QUANTITY P RESCRIBED: ET0000001 000
	4731	PRIOR AU THORIZATIO N TYPE COD E: EU00
	4732	PRIOR AU THORIZATIO N SUBMITTE D: EV00000 000000
	4733	INTERMED IARY AUTH TYPE ID: E W00
	4734	INTERMED IARY AUTHO RIZATION I D: EX
	4735	PRESCRIB ER ID QUAL IFIER: EZ0 1 PRESCRIBER LOCATION CODE: 1E
	4736	PC PROVI DER LOCATI ON CODE: H 5036 PC PROVIDE R LAST NAM E: 4EECMEP ROVIDER
	4737	PROFESSI ONAL FEE S UBMITTED: BE00000000
	4738	FLAT SAL ES TAX SUB MITTED: HA 00000000
	4739	PERCENTA GE SALES T AX SUBMITT ED: GE0000 000{
	4740	PERCENTA GE SALES T AX RATE: H E0000000 PERCENTAGE SALES TAX BASIS: JE
	4741	PRESCRIB ER PHONE N UMBER: PMX XXXXXXXXX
	4742	DATE OF SERVICE: 2 0090414 PLAN ID: F OECME INS
	4743	RAW DATA SENT:
	4744	61045951B 1MHCP 101500000 0021 2 0090414
	4745	AM01CX01C YXXXXXXXXX C41960010 1C51CAONEC BECMEPATIE NT CM13
	4746	DFG CNX XXXXXXX C OXXCPXXXXX CQXXXX XXXXXXC700
	4747	CZ 1C 2C
	4748	AM04C2234 234CCONECD ECMEPATIEN T CE36 FOECME INS C908C C1997 7
	4749	C301 C61
	4750	AM07EM1D2 0113414E10 3D70000214 3916 E7000000 1000D304D5 001D61D80D E20090112D
	4751	F05DJ1DK00 ET00000010 00C800DT0E B000000100 0CW0000000 0000000000 000EK00000 0000000DI0
	4752	0EU00EV000 00000000EW 00EX
	4753	AM02
	4754	AM03EZ01D BXXXXXXXXX X 1E ECMEPRESC RIBER H50364 EECMEPROVI DER
	4755	AM054C15C 016C037C12 3456 E8 20090414HB 1DV00400{
	4756	AM11D9000 0510{DC000 00000BE000 00000DX000 0000{HA000 00000GE000 0000{HE000 0000JE DQ
	4757	0000510{DU 0000510{DN 07
	4758	Press RETU RN to cont inue, '^' to exit:
	4759	BPS RESPON SE FILE DA TA:
	4760	BPS CLAIM: VA2009=50 00000021=1 05220=0005 524
	4761	DATE RES PONSE RECE IVED: APR 17, 2009@1 4:54:30
	4762	VERSION RELEASE NU MBER: D0 TRANSACTIO N CODE: B1
	4763	TRANSACT ION COUNT: 1 SERVICE PR OVIDER ID: XXXXXXXXX X
	4764	SERVICE PROVIDER I D QUALIFIE R: 01 DATE OF SE RVICE: APR 14,2009
	4765	RESPONSE STATUS: R EJECTED
	4766	MESSAGE: EV161-MAN DATORY FIE LD HC MISS ING IN SEG 05
	4767	MEDICATION ORDER: 1 TRANSACTIO N RESPONSE STATUS: R EJECTED
	4768	PRESCRIP TION RESPO NSE STATUS : REJECTED CLAIM
	4769	REJECT C OUNT: 04
	4770	REJECT COD E: 85 (Cla im Not Pro cessed)
	4771	REJECT COD E: NN (Tra nsaction R ejected At Switch Or Intermedi ary
	4772	REJECT COD E: R8 (Syn tax Error)
	4773	REJECT COD E: HC (M/I Other Pay er Amount Paid Quali fier)
	4774	REJECT COD E: 79 (REF ILL TOO SO ON)
	4775	NEXT AVA IL FILL DA TE: APR 20 ,2009
	4776	RAW DATA RECEIVED:
	4777	VA2009=XX XXXXXXXX=1 05220=000x xxxxxB11R0 1XXXXXXXXX X
	4778	20090414\ X1E\\X1C\A M20\X1C\F4 EV161-MAND ATORY FIEL D HC MISSI NG IN SEG
	4779	05\X1D\\X 1E\\X1C\AM 21\X1C\ANR \X1C\FA04\ X1C\FB85\X 1C\FBNN\X1 C\FBR8\X1C \FBHC
	4780	Press RETU RN to cont inue:
	4781	8.2.2 Paye r Sheet De tail Repor t Option X E " Payer Sheet Deta il"
	4782	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.
	4783	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.
	4784	Example 8. 2.2-1: Acc essing the Payer She et Detail Report Opt ion
	4785	*** ****** ****** ****** ****** **
	4786	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	4787	* XXXXX V AMC *
	4788	* Other Re ports *
	4789	*** ****** ****** ****** ****** **
	4790	CRI ECME Claim s-Response Inquiry
	4791	PAY Payer Shee t Detail R eport
	4792	PHAR ECME Setup - Pharmac ies Report
	4793	TAT Turn-aroun d time sta tistics
	4794	VER View ePhar macy Rx
	4795	OPR OPECC Prod uctivity R eport
	4796	Select Oth er Reports Option: P AY Payer Sheet Deta il Report
	4797	Example 8. 2.2-2: Pay er Sheet D etail Repo rt Option
	4798	Select Pay er Sheet: ABCTEST1
	4799	DEVICE: HO ME// IP network
	4800	Payer Shee t Detail R eport Pri nt Date: 0 9/09/05 Page: 1
	4801	Payer Sh eet Name: ABCTEST1 Version Number: 7
	4802	Status: PRODUCTION NCPDP Version: V ersion D.0
	4803	Seq Field Fie ld Name Proc Mode
	4804	--- ----- --- ------- ---------
	4805	* Trans action Hea der Segmen t *
	4806	1 101-A 1 BIN NUMBER S
	4807	2 102-A 2 VER SION/RELEA SE NUMBER S
	4808	3 103-A 3 TRA NSACTION C ODE S
	4809	5 104-A 4 PRO CESSOR CON TROL NUMBE R S
	4810	17 202-B 2 SER V PROVIDER ID QUALIF IER S
	4811	19 201-B 1 SER VICE PROVI DER ID S
	4812	21 401-D 1 DAT E FILLED S
	4813	Press RETU RN to cont inue, '^' to exit: < Enter>
	4814	Payer Shee t Detail R eport Pri nt Date: 0 9/09/05 Page: 2
	4815	Payer Sh eet Name: ABCTEST1 Version Number: 7
	4816	Seq Field Fie ld Name Proc Mode
	4817	--- ----- --- ------- ---------
	4818	* Trans action Hea der Segmen t *
	4819	22 110-A K SOF TWARE VEND OR/CERT ID S
	4820	* Patient Se gment *
	4821	31 111-A M SEG MENT IDENT IFICATION S
	4822	33 331-C X PAT IENT ID QU ALIFIER S
	4823	35 332-C Y PAT IENT ID S
	4824	36 304-C 4 DAT E OF BIRTH S
	4825	37 305-C 5 SEX CODE S
	4826	39 307-C 7 CUS TOMER LOCA TION S
	4827	40 335-2 C PRE GNANCY IND ICATOR S
	4828	* I nsurance S egment *
	4829	49 111-A M SEG MENT IDENT IFICATION S
	4830	51 302-C 2 CAR DHOLDER ID NUMBER S
	4831	53 301-C 1 GRO UP NUMBER S
	4832	Press RETU RN to cont inue, '^' to exit: < Enter>
	4833	Payer Shee t Detail R eport Pri nt Date: 0 9/09/05 Page: 3
	4834	Payer Sh eet Name: ABCTEST1 Version Number: 7
	4835	Seq Field Fie ld Name Proc Mode
	4836	--- ----- --- ------- ---------
	4837	* I nsurance S egment *
	4838	54 306-C 6 REL ATIONSHIP CODE S
	4839	* Claim Seg ment *
	4840	64 111-A M SEG MENT IDENT IFICATION S
	4841	66 455-E M RX/ SERVICE RE F NUMBER Q UAL S
	4842	69 402-D 2 PRE SCRIPTION NUMBER S
	4843	71 436-E 1 PRO DUCT/SERV ID QUAL S
	4844	73 407-D 7 PRO DUCT/SERVI CE ID S
	4845	75 442-E 7 QUA NTITY DISP ENSED S
	4846	77 403-D 3 NEW /REFILL CO DE S
	4847	78 405-D 5 DAY S SUPPLY S
	4848	79 406-D 6 COM POUND CODE S
	4849	80 408-D 8 OTH ER COVERAG E CODE S
	4850	82 414-D E DAT E PRESCRIP TION WRITT EN S
	4851	85 308-C 8 OTH ER COVERAG E CODE S
	4852	Press RETU RN to cont inue, '^' to exit: < Enter>
	4853	Payer Shee t Detail R eport Pri nt Date: 0 9/09/05 Page: 4
	4854	Payer Sh eet Name: ABCTEST1 Version Number: 7
	4855	Seq Field Fie ld Name Proc Mode
	4856	--- ----- --- ------- ---------
	4857	* Claim Seg ment *
	4858	87 429-D T UNI T DOSE IND ICATOR S
	4859	89 453-E J ORI G PRESCR P ROD/SERV I D QUAL S
	4860	92 445-E A ORI G PRESCRIB ED PROD/SE RV CODE S
	4861	95 446-E B ORI GINALLY PR ESCRIBED Q TY S
	4862	97 418-D I LEV EL OF SERV ICE S
	4863	99 461-E U PRI OR AUTHORI ZATION TYP E CODE S
	4864	102 462-E V PRI OR AUTHORI ZATION NUM SUB S
	4865	106 463-E W INT ERMED AUTH TYPE ID S
	4866	109 464-E X INT ERMEDIARY AUTHORIZAT ION ID S
	4867	112 343-H D DIS PENSING ST ATUS S
	4868	114 344-H F QTY INTENDED TO BE DISP ENSED S
	4869	117 345-H G DAY S SUPPLY I NTEND TO B E DISP S
	4870	* Pharm acy Provid er Segment *
	4871	127 111-A M SEG MENT IDENT IFICATION S
	4872	Press RETU RN to cont inue, '^' to exit: < Enter>
	4873	Payer Shee t Detail R eport Pri nt Date: 0 9/09/05 Page: 5
	4874	Payer Sh eet Name: ABCTEST1 Version Number: 7
	4875	Seq Field Fie ld Name Proc Mode
	4876	--- ----- --- ------- ---------
	4877	* Pharm acy Provid er Segment *
	4878	129 465-E Y PRO VIDER ID Q UALIFIER S
	4879	131 444-E 9 PRO VIDER ID S
	4880	* P rescriber Segment *
	4881	140 111-A M SEG MENT IDENT IFICATION S
	4882	142 466-E Z PRE SCRIBER ID QUALIFIER S
	4883	144 411-D B PRE SCRIBER ID S
	4884	146 427-D R PRE SCRIBER LA ST NAME S
	4885	148 498-P M PRE SCRIBER TE LEPHONE NU MBER S
	4886	150 468-2 E PRI MARY CARE PROV ID QU AL S
	4887	153 421-D L PRI MARY PRESC RIBER S
	4888	155 469-H 5 PRI M CARE PRO V LOCATION CODE S
	4889	158 470-4 E PRI M CARE PRO VIDER LAST NAME S
	4890	Press RETU RN to cont inue, '^' to exit: < Enter>
	4891	Payer Shee t Detail R eport Pri nt Date: 0 9/09/05 Page: 6
	4892	Payer Sh eet Name: ABCTEST1 Version Number: 7
	4893	Seq Field Fie ld Name Proc Mode
	4894	--- ----- --- ------- ---------
	4895	* COB/O ther Payme nts Segmen t *
	4896	168 111-A M SEG MENT IDENT IFICATION S
	4897	170 337-4 C COB /OTHER PAY MENTS COUN TER S
	4898	172 338-5 C OTH ER PAYER C OVERAGE TY PE S
	4899	174 339-6 C OTH ER PAYER I D QUALIFIE R S
	4900	177 340-7 C OTH ER PAYER I D S
	4901	180 443-E 8 Oth er Payer D ate S
	4902	182 341-H B OTH ER PAYER A MOUNT PAID COUNT S
	4903	185 342-H C OTH PYR AMOUN T PAID QUA L. S
	4904	188 431-D V OTH ER PAYOR A MOUNT S
	4905	190 471-5 E OTH ER PAYER R EJECT COUN T S
	4906	192 472-6 E OTH ER PAYER R EJECT CODE S
	4907	* Workers ' Compensa tion Segme nt *
	4908	202 111-A M SEG MENT IDENT IFICATION S
	4909	205 434-D Y DAT E OF INJUR Y S
	4910	Press RETU RN to cont inue, '^' to exit: < Enter>
	4911	Payer Shee t Detail R eport Pri nt Date: 0 9/09/05 Page: 7
	4912	Payer Sh eet Name: ABCTEST1 Version Number: 7
	4913	Seq Field Fie ld Name Proc Mode
	4914	--- ----- --- ------- ---------
	4915	* Workers ' Compensa tion Segme nt *
	4916	* DUR/PPS Se gment *
	4917	213 111-A M SEG MENT IDENT IFICATION S
	4918	215 473-7 E DUR /PPS CODE COUNTER S
	4919	218 439-E 4 DUR CONFLICT CODE S
	4920	220 440-E 5 DUR INTERVENT ION CODE S
	4921	222 441-E 6 DUR OUTCOME C ODE S
	4922	224 474-8 E DUR /PPS LEVEL OF EFFORT S
	4923	227 475-J 9 DUR CO-AGENT ID QUALIFI ER S
	4924	230 476-H 6 DUR CO-AGENT ID S
	4925	* Pricing Se gment *
	4926	240 111-A M SEG MENT IDENT IFICATION S
	4927	242 409-D 9 ING REDIENT CO ST S
	4928	244 412-D C DIS PENSING FE E SUBMITTE D S
	4929	Press RETU RN to cont inue, '^' to exit: < Enter>
	4930	Payer Shee t Detail R eport Pri nt Date: 0 9/09/05 Page: 8
	4931	Payer Sh eet Name: ABCTEST1 Version Number: 7
	4932	Seq Field Fie ld Name Proc Mode
	4933	--- ----- --- ------- ---------
	4934	* Pricing Se gment *
	4935	246 477-B E PRO FESSIONAL SERV FEE S UBMIT S
	4936	249 433-D X PAT IENT PAID AMOUNT S
	4937	252 481-H A FLA T SALES TA X AMOUNT S UBMIT S
	4938	255 482-G E PER CENTAGE SA LES TAX AM T SUB S
	4939	258 484-J E PER CENT SALES TAX BASIS SUB S
	4940	261 426-D Q USU AL & CUSTO MARY CHARG E S
	4941	264 430-D U GRO SS AMOUNT DUE S
	4942	266 423-D N BAS IS OF COST DETERMINA TION S
	4943	* Coupon Se gment *
	4944	275 111-A M SEG MENT IDENT IFICATION S
	4945	277 485-K E COU PON TYPE S
	4946	278 486-M E COU PON NUMBER S
	4947	279 487-N E COU PON VALUE AMOUNT S
	4948	Press RETU RN to cont inue, '^' to exit: < Enter>
	4949	Payer Shee t Detail R eport Pri nt Date: 0 9/09/05 Page: 9
	4950	Payer Sh eet Name: ABCTEST1 Version Number: 7
	4951	Seq Field Fie ld Name Proc Mode
	4952	--- ----- --- ------- ---------
	4953	* Compound S egment *
	4954	288 111-A M SEG MENT IDENT IFICATION S
	4955	290 450-E F Com pound Dose Form Desc Code S
	4956	293 451-E G Com pound Disp ense Unt F orm Ind S
	4957	295 452-E H Com pound Rout e of Admin S
	4958	297 447-E C Com pound Ingr ed Comp Co unt S
	4959	299 488-R E Com pound Prod uct ID Qua lifier S
	4960	301 489-T E Com pound Prod uct ID S
	4961	302 448-E D Com pound Ingr edient Qua ntity S
	4962	304 449-E E Com pound Ingr edient Dru g Cost S
	4963	307 490-U E Com p Ingred B asis Cost Determ S
	4964	Press RETU RN to cont inue:
	4965	8.2.3 ECME Setup – P harmacies Report XE " ECME Set up - Pharm acies"
	4966	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.
	4967	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 .
	4968	Example 8. 2.3-1: Acc essing ECM E Setup – Pharmacies Report Op tion
	4969	*** ****** ****** ****** ****** **
	4970	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	4971	* XXXXX V AMC *
	4972	* Other Re ports *
	4973	*** ****** ****** ****** ****** **
	4974	CRI ECME Claim s-Response Inquiry
	4975	PAY Payer Shee t Detail R eport
	4976	PHAR ECME Setup - Pharmac ies Report
	4977	TAT Turn-aroun d time sta tistics
	4978	VER View ePhar macy Rx
	4979	OPR OPECC Prod uctivity R eport
	4980	Select Set up (Config uration) R eports Opt ion: PHAR ECME Setup - Pharmac ies Report
	4981	DEVICE: IP network
	4982	Example 8. 2.3-2: ECM E Setup - Pharmacies Report Op tion
	4983	BPS PHARMA CIES LIST SEP 9,2005 07:17 P AGE 1
	4984	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------
	4985	NU MBER: 2
	4986	NAME: XXXX XXXXX NCPDP #: X XXXXXX
	4987	DEFAULT DEA #: AGX XXXX CMOP SWITC H: CMOP ON
	4988	AUTO-REV ERSE PARAM ETER: 0 STATUS: AC TIVE
	4989	SITE ADD RESS 1: 10 1 MAIN STR EET
	4990	SITE CIT Y: XXXXXXX XX SITE STATE : XXXXX
	4991	SITE ZIP CODE: XXX XX SITE ADDRE SS NAME: 1 01 MAIN ST REET
	4992	HOURS OF OPERATION : 24 START DAY RANGE: MON
	4993	END DAY RANGE: MON START HOUR RANGE: 08 00
	4994	END HOUR RANGE: 16 00~TUE NPI: XXXXX XXXXX
	4995	DATE/TIM E OF LAST NPI CHANGE : OCT 10, 2006@15:05 :05
	4996	OUTPATIENT SITE: XXX XXXXXXXXX
	4997	REMITTAN CE ADDRESS NAME: MAI N REMIT ADDR ESS 1: 101 MAIN STRE ET
	4998	REMIT CI TY: XXXXXX XXX REMIT STAT E: XXXXXX
	4999	REMIT ZI P: XXXXX VA CONTACT : CONTACT, ONE
	5000	VA ALTER NATE CONTA CT: CONTAC T,ONE VA LEAD PHAR MACIST: CO NTACT,ONE
	5001	VA LEAD PHARMACIST LICENSE # : XXXXXXXX
	5002	Monday C lose Time: 1600 Tuesday Cl ose Time: 1600
	5003	Wednesda y Close Ti me: 1600 Thursday C lose Time: 1600
	5004	Friday C lose Time: 1600 Saturday C lose Time: 1600
	5005	Monday O pen Time: 0800 Tuesday Op en Time: 0 800
	5006	BPS PHARMA CIES LIST SEP 09, 2005@ 17:17 P AGE 2
	5007	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------
	5008	Wednesda y Open Tim e: 0800 Thursday O pen Time: 0800
	5009	Friday O pen Time: 0800 Saturday O pen Time: 0800
	5010	NU MBER: 3
	5011	NAME: XXXX XXXXXXX NCPDP #: X XXXXXX
	5012	DEFAULT DEA #: AGX XXXX CMOP SWITC H: CMOP ON
	5013	AUTO-REV ERSE PARAM ETER: 2 STATUS: AC TIVE
	5014	SITE ADD RESS 1: 10 1 MAIN AVE
	5015	SITE CIT Y: XXXXXXX XXXX SITE STATE : XXXXXX
	5016	SITE ZIP CODE: XXX XX SITE ADDRE SS NAME: 1 01 MAIN AV E
	5017	HOURS OF OPERATION : 24 START DAY RANGE: MON
	5018	END DAY RANGE: MON START HOUR RANGE: 08 00
	5019	END HOUR RANGE: 16 00~TUE NPI: 00000 00006
	5020	DATE/TIM E OF LAST NPI CHANGE : OCT 10, 2006@15:05 :05
	5021	OUTPATIENT SITE: XXX XXXXXXX VA
	5022	OUTPATIENT SITE: XXX XXXXXX CBO C
	5023	OUTPATIENT SITE: XXX XX VA CBOC
	5024	REMITTAN CE ADDRESS NAME: XXX XXXXXXX XX XXXX
	5025	REMIT AD DRESS 1: 1 01 XXXXXXX XXXXXXXXX
	5026	REMIT CI TY: XXXXXX XXXXX REMIT STAT E: XXXXXXX X
	5027	REMIT ZI P: XXXXX VA CONTACT : CONTACT, ONE
	5028	VA ALTER NATE CONTA CT: CONTAC T,TWO
	5029	VA LEAD PHARMACIST : PHARMACI ST,ONE Monday Cl ose Time: 1600
	5030	Tuesday Close Time : 1600 Wednesday Close Time : 1600
	5031	Thursday Close Tim e: 1600 Friday Clo se Time: 1 600
	5032	BPS PHARMA CIES LIST SEP 09, 2005@ 17:17 P AGE 3
	5033	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------
	5034	Saturday Close Tim e: 1600 Monday Ope n Time: 08 00
	5035	Tuesday Open Time: 0800 Wednesday Open Time: 0800
	5036	Thursday Open Time : 0800 Friday Ope n Time: 08 00
	5037	Saturday Open Time : 0800
	5038	Press ENTE R to conti nue:
	5039	8.2.4 Turn -around ti me statist ics XE " T urn-around time stat istics"
	5040	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.
	5041	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.
	5042	Example 8. 2.4-1: Acc essing the Turn-arou nd time st atistics R eport Opti on
	5043	*** ****** ****** ****** ****** **
	5044	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	5045	* XXXXX V AMC *
	5046	* Other Re ports *
	5047	*** ****** ****** ****** ****** **
	5048	CRI ECME Claim s-Response Inquiry
	5049	PAY Payer Shee t Detail R eport
	5050	PHAR ECME Setup - Pharmac ies Report
	5051	TAT Turn-aroun d time sta tistics
	5052	VER View ePhar macy Rx
	5053	OPR OPECC Prod uctivity R eport
	5054	Select Oth er Reports Option: T AT Turn-a round time statistic s
	5055	Example 8. 2.4-2: Dis playing th e Turn-aro und time s tatistics Report
	5056	START WITH DATE: T-1 // <Enter > (SEP 08, 2005)
	5057	GO TO DATE : T// <En ter> (SEP 09, 2005)
	5058	For Prescr iption: 1106378.00 001 (Rx#: 382992)
	5059	Begin 08:19:48
	5060	Gathering informatio n 08:19:52
	5061	Claim ID c reated 08:19:55
	5062	Claim Sent 08:19:56
	5063	Response s tored 08:20:04
	5064	Completed at: 08:20:04
	5065	Turn-aroun d time 16
	5066	For Prescr iption: 1106380.00 001 (Rx#: 382994)
	5067	Begin 08:19:48
	5068	Gathering informatio n 08:19:52
	5069	Claim ID c reated 08:19:55
	5070	Claim Sent 08:20:16
	5071	Response s tored 08:20:18
	5072	Completed at: 08:20:18
	5073	Turn-aroun d time 30
	5074	For Prescr iption: 1106379.00 001 (Rx#: 382993)
	5075	Begin 08:19:48
	5076	Gathering informatio n 08:19:52
	5077	Claim ID c reated 08:19:55
	5078	Claim Sent 08:20:06
	5079	Response s tored 08:20:08
	5080	Completed at: 08:20:08
	5081	Turn-aroun d time 20
	5082	For Prescr iption: 1106384.00 001 (Rx#: 909952)
	5083	Begin 11:27:13
	5084	Gathering informatio n 11:27:15
	5085	Claim ID c reated 11:27:16
	5086	Claim Sent 11:27:17
	5087	Response s tored 11:27:23
	5088	Completed at: 11:27:23
	5089	Turn-aroun d time 10
	5090	For Prescr iption: 1106386.00 001 (Rx#: 909954)
	5091	Begin 11:27:13
	5092	Gathering informatio n 11:27:15
	5093	Claim ID c reated 11:27:17
	5094	Claim Sent 11:27:37
	5095	Response s tored 11:27:39
	5096	Completed at: 11:27:39
	5097	Turn-aroun d time 26
	5098	Average Tu rn-around time: 13
	5099	8.2.5 View ePharmacy Rx
	5100	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.
	5101	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.
	5102	Example 8. 2.5-1: Acc essing the View ePha rmacy Rx R eport Opti on
	5103	*** ****** ****** ****** ****** **
	5104	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	5105	* ALASKA V AHSRO *
	5106	* Other Re ports *
	5107	*** ****** ****** ****** ****** **
	5108	CRI ECME Claim s-Response Inquiry
	5109	PAY Payer Shee t Detail R eport
	5110	PHAR ECME Setup - Pharmac ies Report
	5111	TAT Turn-aroun d time sta tistics
	5112	VER View ePhar macy Rx
	5113	OPR OPECC Prod uctivity R eport
	5114	Select Oth er Reports Option: VER View ePharmacy Rx
	5115	Example 8. 2.5-2: Dis playing th e View ePh armacy Rx Report
	5116	Select Pre scription: 2055346
	5117	ATE NOLOL 25MG TAB
	5118	Patient Rx# Dru g Name Rx Stat us
	5119	ECMEPATIE NT,ONE 20553 46 TAM OXIFEN CIT RATE 10MG TA DISCONT INUED
	5120	OK to cont inue? Yes/ / YES
	5121	Rx# 205534 6 has the following fills:
	5122	Fill# Fill Dat e Rele ase Date
	5123	----- -------- -- ---- --------
	5124	0 01/29/20 09 01/2 9/2009
	5125	1 02/26/20 09 02/2 5/2009
	5126	Select Fil l Number: 1 02/26/20 09 02/2 6/2009
	5127	Selec t one of t he followi ng:
	5128	M Most recen t transact ion for ea ch payer
	5129	A All transa ctions
	5130	There ar e 2 ECME t ransaction s for this Rx/fill.
	5131	1 for th e primary payer, 1 f or the sec ondary pay er.
	5132	Select Mos t recent t ransaction for each payer or A ll transac tions: M// All trans
	5133	actions
	5134	Compiling data for V iew Prescr iptions .. .
	5135	Compiling data for t he ECME Cl aim Log .. .
	5136	Compiling data for t he ECME Bi lling Even ts Report ...
	5137	Compiling data for t he ECME Cl aims-Respo nse Inquir y (CRI) Re port ...
	5138	Compiling data for V iew Insura nce Polici es ... ... .......... ......
	5139	Compiling the list o f TPJI bil ls ...
	5140	Compiling data for T PJI Claim Informatio n ...
	5141	Compiling data for T PJI AR Acc ount Profi le ...
	5142	Compiling data for T PJI AR Com ment Histo ry ...
	5143	Compiling data for T PJI ECME R x Response ...
	5144	Compiling data for V iew Regist ration Eli gibility S tatus ...
	5145	Compiling data for V iew Regist ration Eli gibility V erificatio n ...
	5146	View Presc ription
	5147	Rx View (D iscontinue d) Feb 08, 2 011@13:59: 27 P age: 1 of 1
	5148	ECMEPATIEN T,ONE
	5149	PID: 666 -87-4529 Ht(cm): _ ______ (__ ____)
	5150	DOB: OCT 18,1963 ( 47) Wt(kg): _ ______ (__ ____)
	5151	+--------- ---------- ---------- ---------- ---------- ---------- ---------- ----------
	5152	Rx # : 2055346$ e (ECME#: 000001615 253)
	5153	Orde rable Item : TAMOXIFE N CITRATE TAB
	5154	CMOP Drug : TAMOXIFE N CITRATE 10MG TAB
	5155	NDC : 00378-01 44-93
	5156	*Dosage : 10MG
	5157	Verb : TAKE
	5158	Disp ense Units : 1
	5159	Noun : TABLET
	5160	*Route : ORAL (BY MOUTH)
	5161	*Schedule : BID
	5162	Patient In structions :
	5163	SIG : TAKE ONE TABLET BY MOUTH TWI CE A DAY
	5164	Pati ent Status : OUTPT NO N-SC
	5165	Issue Date : 01/29/09 Fil l Date: 01 /29/09
	5166	Last Fill Date : 02/26/09 (Mail, Tr ansmitted)
	5167	Last Re lease Date : 02/25/09 Lot #:
	5168	Expires : 01/30/10 MFG:
	5169	D ays Supply : 3 QT Y (TAB): 6 0
	5170	# of Refills : 11 Rem aining: 9
	5171	Provider : ECMEPROV IDER,ONE
	5172	Routing : Window
	5173	Copies : 1
	5174	Method of Pickup :
	5175	Clinic : Not on F ile
	5176	Division: DNS ENNE VAM&R OC (442)
	5177	Pharmacist : ECMEPROV IDER,ONE
	5178	Patient Counseling : NO
	5179	Remarks : New Orde r Created by copying Rx # 2055 345.
	5180	F inished By : ECMEPROV IDER,ONE
	5181	Entry B y: ECMEPRO VIDER,ONE Entry Da te: 01/29/ 09 12:59:3 8
	5182	Original F ill Releas ed: 02/25/ 09 Ro uting: Win dow
	5183	Refill Lo g:
	5184	# Log Dat e Refill Date Qty Routi ng Lot # Phar macist
	5185	========== ========== ========== ========== ========== ========== ========== =========
	5186	1 02/25/ 09 02/25 /09 60 Mail
	5187	Division: 442 Dispensed: 02/25/09 Released : 2/25/09 NDC: 0037 8-0144-91
	5188	2 02/25/ 09 02/26 /09 60 Mail
	5189	Division: 442 Dispensed: 02/26/09 Released :
	5190	Partial Fi lls:
	5191	# Log Da te Date Qty Routing Lot # Pharm acist
	5192	========== ========== ========== ========== ========== ========== ========== =========
	5193	There are NO Partial s for this Prescript ion
	5194	Activity L og:
	5195	# Date Reas on Rx Ref Init iator Of A ctivity
	5196	========== ========== ========== ========== ========== ========== ========== =========
	5197	1 02/25/ 09 SUSP ENSE REFILL 1 ECME PROVIDER,O NE
	5198	Comments: RX Placed on Suspens e for CMOP until 02- 25-09
	5199	2 02/25/ 09 PROC ESSED REFILL 1 ECME PROVIDER,O NE
	5200	Comments: Transmitte d to DALLA S CMOP
	5201	3 02/25/ 09 SUSP ENSE REFILL 2 ECME PROVIDER,O NE
	5202	Comments: RX Placed on Suspens e for CMOP until 02- 26-09
	5203	4 02/25/ 09 SUSP ENSE REFILL 2 ECME PROVIDER,O NE
	5204	Comments: 3/4 of Day s Supply S USPENSE HO LD until 2 /28/09.
	5205	5 03/01/ 09 PROC ESSED REFILL 2 ECME PROVIDER,O NE
	5206	Comments: Transmitte d to DALLA S CMOP
	5207	6 06/11/ 09 DISC ONTINUED REFILL 2 ECME PROVIDER,T WO
	5208	Comments: Discontinu ed During New Prescr iption Ent ry - Dupli cate Drug
	5209	Copay Acti vity Log:
	5210	# Date Reas on Rx Ref Initiato r Of Activ ity
	5211	========== ========== ========== ========== ========== ========== ========== =========
	5212	There's NO Copay act ivity to r eport
	5213	Label Log:
	5214	# Date Rx R ef Printed By
	5215	========== ========== ========== ========== ========== ========== ========== =========
	5216	1 02/25/ 09 ORIG INAL ECMEPROV IDER,ONE
	5217	Comments: From RX nu mber 20553 46
	5218	ECME Log:
	5219	# Date/T ime Rx Ref Initiator Of Activit y
	5220	========== ========== ========== ========== ========== ========== ========== =========
	5221	1 1/29/0 9@12:59:55 ORIGIN AL ECMEPROVID ER,ONE
	5222	Comments: Submitted to ECME:WI NDOW FILL( NDC:00378- 0144-93)-E REJECTED
	5223	2 2/25/0 9@16:49:16 ORIGIN AL ECMEPROVID ER,ONE
	5224	Comments: Submitted to ECME:RE JECT WORKL IST-E PAYA BLE
	5225	3 2/25/0 9@16:51:03 REFILL 1 ECMEPROVID ER,ONE
	5226	Comments: Submitted to ECME:CM OP TRANSMI SSION(NDC: 00378-0144 -91)
	5227	4 3/1/09 @14:00:05 REFILL 2 ECMEPROVID ER,ONE
	5228	Comments: Submitted to ECME:CM OP TRANSMI SSION(NDC: 00378-0144 -91)
	5229	ECME REJEC T Log:
	5230	# Date/Ti me Rcvd Rx Ref Reject Ty pe STA TUS Da te/Time Re solved
	5231	========== ========== ========== ========== ========== ========== ========== =========
	5232	1 1/29/09 @12:59:54 ORIGINAL REFILL TO O SOON RES OLVED 2/ 25/09@16:4 9:04
	5233	Comments: AUTOMATICA LLY CLOSED (CLAIM RE -SUBMITTED )
	5234	CMOP Event Log:
	5235	Date/Time Rx Ref TRN-Order Stat Comment s
	5236	========== ========== ========== ========== ========== ========== ========== =========
	5237	02/25/09@1 656 Ref 1 16346-1 DISP ND C: 0037801 4491
	5238	Carrier: U SPS Pkg ID: P GKID999
	5239	03/01/09@1 403 Ref 2 16360-1 TRAN
	5240	CMOP Lot#/ Expiration Date Log:
	5241	Rx Ref Lot # Expiratio n Date
	5242	========== ========== ========== ========== ========== ========== ========== =========
	5243	Ref 1 A87904 03/22/07
	5244	ECME Claim Log
	5245	PHARMACY E CME Feb 08, 2011@14:0 6:41 Pag e: 1 of 1
	5246	Claim Log informatio n
	5247	---------- ---------- ---------- ---------- ---------- ---------- ---------- ----------
	5248	Pharmacy E CME Log
	5249	VA Rx #: 2055346$ Fill #: 1 ECM E #: 16152 53
	5250	Pati ent Name: ECMEPATIEN T,ONE (452 9)
	5251	Transactio n Number: 1615253.00 011
	5252	Last S ubmitted: FEB 25,200 9@16:51:03
	5253	Last Subm itted By: ECMEPROVID ER,ONE
	5254	Last VA Claim #: VA2009=116 4471991=00 0010=00012 35
	5255	Transmissi on Informa tion (CLAI M REQUEST) (#1236)--- ---------- ---------- ---------
	5256	Created on : FEB 25,2 009@16:51: 04
	5257	VA Claim I D: VA2009= 1164471991 =000010=00 01235
	5258	Submitted By: ECMEPR OVIDER,ONE
	5259	Transactio n Type: RE QUEST
	5260	Date of Se rvice: 02/ 25/2009
	5261	NDC: 00378 -0144-91
	5262	ECME Pharm acy: DNS 9-BOTH NPI & NCPDP
	5263	Days Suppl y: 3
	5264	Qty: 60 Unit Cos t: .928 Total Pr ice: 68.20
	5265	Insurance Name: BLUE MOON INSU RANCE
	5266	Group Name : T-GROUP1
	5267	Rx Coordin ation of B enefits: P RIMARY
	5268	BIN: 12345 6
	5269	PCN: 11234 56789
	5270	NCPDP Vers ion: D.0
	5271	Group ID: 10001
	5272	Cardholder ID:
	5273	Patient Re lationship Code: CAR DHOLDER
	5274	Cardholder First Nam e: ONE
	5275	Cardholder Last Name : OPPATIEN T
	5276	Billing Re quest Paye r Sheet: W BTESTB1
	5277	Reversal P ayer Sheet : WBTESTB2
	5278	Response I nformation (CLAIM R EQUEST)(#1 213)------ ---------- ---------- ---------
	5279	Response R eceived: F EB 25,2009 @16:51:10
	5280	Date of Se rvice: 02/ 25/2009
	5281	Transactio n Response Status: P aid
	5282	Total Amou nt Paid: $ 58.20
	5283	Reject cod e(s):
	5284	Message:
	5285	Additional Message:
	5286	DUR Respon se Info:
	5287	DUR Additi onal Text:
	5288	ECME CRI R EPORT DATA
	5289	ECME Claim s-Response Inquiry R eport Pr int Date: 02/08/11
	5290	VA CLAIM I D: VA2009= 1164471991 =000010=00 01235
	5291	BPS TRANSA CTION/BPS LOG OF TRA NSACTION D ATA:
	5292	ENTRY#: 16 15253.0001 1 STATUS: 99
	5293	PHARMACY: DNS 9-BOTH NPI & NCPDP PRESCRIPTI ON #: 2055 346
	5294	RXI-INTE RNAL (c): 1615253
	5295	PLAN NAM E: BLUE MO ON INSURAN CE PHARMACY P LAN ID: T0 0010
	5296	CLAIM IE N (c): 123 6 RESPONSE I EN (c): 12 13
	5297	BPS CLAIMS FILE DATA :
	5298	CLAIM ID: VA2009=116 4471991=00 0010=00012 35
	5299	ELECTRON IC PAYER: WBTESTB1 TRANSMIT F LAG: YES ( POINT OF S ALE)
	5300	TRANSMIT TED ON: FE B 25,2009@ 16:51:04 CREATED ON : FEB 25,2 009@16:51: 04
	5301	PATIENT NAME: ECME PATIENT,ON E
	5302	GROUP IN SURANCE PL AN: BLUE M OON INSURA NCE
	5303	BIN NUMB ER: 123456 VERSION RE LEASE NUMB ER: D.0
	5304	TRANSACT ION CODE: B1 PROCESSOR CONTROL NU MBER: 1123 456789
	5305	TRANSACT ION COUNT: 1 SOFTWARE V ENDER CERT ID: TATP
	5306	SERVICE PROVIDER I D: 1164471 991 SERVICE PR OVIDER ID QUAL: 01
	5307	GROUP ID : C110001 CARDHOLDER ID: C2
	5308	DATE OF BIRTH: C41 9631018 PATIENT GE NDER CODE: MALE
	5309	PATIENT FIRST NAME : CAONE PATIENT LA ST NAME: C BOPPATIENT
	5310	PATIENT STREET ADD RESS: CM32 OAK STREE T
	5311	PATIENT CITY ADDRE SS: CNBIRM INGHAM
	5312	PATIENT STATE PROV ADDRESS: COAL PATIENT ZI P POSTAL Z ONE: CP352 09
	5313	PATIENT PHONE NUMB ER: CQ2055 559874 PATIENT ID QUALIFIER : CX01
	5314	PATIENT ID: CY6668 74529
	5315	TRANSACTIO N ORDER: 1
	5316	MEDICATI ON NAME: T AMOXIFEN C ITRATE 10M G TAB
	5317	PRESCRIP TION NUMBE R: 2055346 OTHER COVE RAGE CODE: C800
	5318	SUBM CLA RIFICATION CODE COUN T: 1
	5319	SUBMISSION CLRFCTN C ODE CNTR: 1 SUBMISSION CLARIFICA TION CODE: DK02
	5320	DATE OF SERVICE: F EB 25,2009 PRESCRIPTI ON/SERVICE REF NO: D 21615253
	5321	FILL NUM BER: D301 DAYS SUPPL Y: D5003
	5322	COMPOUND CODE: D61
	5323	PRODUCT SERVICE ID : D7003780 14491
	5324	DISPENSE AS WRITTE N: D80 INGREDIENT COST SUBM ITTED: D90 000510{
	5325	PRESCRIB ER ID: DB DISPENSING FEE SUBMI TTED: DC00 000000
	5326	DATE PRE SCRIPTION WRITTEN: D E20090129
	5327	NUMBER O F REFILLS AUTHORIZED : DF11 PRESCRIPTI ON ORIGIN CODE: DJ1
	5328	*SUBMISS ION CLARIF ICATION CO DE: DK02 BASIS OF C OST DETERM INATION: D N07
	5329	USUAL AN D CUSTOMAR Y CHARGE: DQ0000510{
	5330	GROSS AM OUNT DUE: DU0000510{ PRESCRIBER LAST NAME : DROPPROV IDER
	5331	PATIENT PAID AMOUN T SUBMITTE D: DX00000 00{
	5332	PRODUCT SERVICE ID QUALIFIER : E103 QUANTITY D ISPENSED: E700000600 00
	5333	PRESCRIP TION SERVI CE REFEREN CE: EM1 QUANTITY P RESCRIBED: ET0000060 000
	5334	PRESCRIB ER ID QUAL IFIER: EZ0 1 PRESCRIBER LOCATION CODE: 1E
	5335	PC PROVI DER LOCATI ON CODE: H 5001 PC PROVIDE R LAST NAM E: 4EOPPRO VIDER
	5336	PRESCRIB ER PHONE N UMBER: PM0 001234567
	5337	DATE OF SERVICE: 2 0090225
	5338	RAW DATA SENT:
	5339	12345651B 1112345678 9101116447 1991 2 0090225TAT P
	5340	AM01CX01C Y666874529 C41963101 8C51CAONE CB OPPATIENT CM32
	5341	OAK STREET CNB IRMINGHAM C OALCP35209 CQ2055 559874
	5342	AM04C2C11 0001
	5343	AM07EM1D2 1615253E10 3D70037801 4491 E7000006 0000D301D5 003D61D80D E20090129D
	5344	F11DJ1DK02 ET00000600 00C800
	5345	AM02
	5346	AM03EZ01D B 1E DROPPROVI DER H50014EO PPROVIDER
	5347	AM11D9000 0510{DC000 00000DX000 0000{DQ000 0510{DU000 0510{DN07
	5348	BPS RESPON SE FILE DA TA:
	5349	BPS CLAIM: VA2009=11 64471991=0 00010=0001 235
	5350	DATE RES PONSE RECE IVED: FEB 25, 2009@1 6:51:10
	5351	VERSION RELEASE NU MBER: D.0 TRANSACTI ON CODE: B 1
	5352	TRANSACT ION COUNT: 1 SERVICE PR OVIDER ID: 116447199 1
	5353	SERVICE PROVIDER I D QUALIFIE R: 01 DATE OF SE RVICE: FEB 25,2009
	5354	RESPONSE STATUS: A CCEPTED
	5355	TRANSACTIO N ORDER: 1 TRANSACTIO N RESPONSE STATUS: P AID
	5356	PRESCRIP TION REFER ENCE NUMBE R: 1615253
	5357	RX REFER ENCE NUMBE R QUALIFIE R: RX BILL ING
	5358	HEADER R ESPONSE ST ATUS: CLAI M PAYABLE
	5359	AUTHORIZ ATION NUMB ER: WEBMD: PAID PATIENT PA Y AMOUNT: $ 10.00
	5360	INGREDIE NT COST PA ID: $ 55. 70 DISPENSING FEE PAID: $ 12.50
	5361	TOTAL AM OUNT PAID: $ 58.20 INCENTIVE AMOUNT PAI D: $ 1.2 5
	5362	BASIS OF REIMB DET ERMINATION : 08 TAX EXEMPT INDICATOR : NOT TAX EXEMPT
	5363	FLAT SAL ES TAX PAI D: $ 1.0 0 PROFESSION AL SERVICE FEE PAID: $ 4.54
	5364	OTHER AM OUNT PAID COUNT: 1 OTHER PAYE R AMOUNT R ECOGNIZED: $ 0.00
	5365	RAW DATA RECEIVED:
	5366	VA2009=11 64471991=0 00010=0001 23551B11A0 1116447199 1
	5367	20090225\ X1D\\X1E\\ X1C\AM21\X 1C\ANP\X1C \F3WEBMD:
	5368	PAID\X1E\ \X1C\AM22\ X1C\EM1\X1 C\D2161525 3\X1E\\X1C \AM23\X1C\ F50000100{ \X1C\F6000
	5369	0557{\X1C\ F70000125{ \X1C\AV2\X 1C\AW00000 10{\X1C\FL 0000012E\X 1C\J100000 45D\X1C\J2
	5370	1\X1C\J301 \X1C\J4000 0033C\X1C\ J50000000{ \X1C\F9000 0683B\X1C\ FM08
	5371	ECME BILLI NG EVENTS REPORT
	5372	PAGE 1
	5373	BILLI NG ECME EV ENTS (DETA ILED) for ALL DIVISI ONS
	5374	SINGLE PRESCRIPT ION – 2055 346 FILL # 1
	5375	RX# FILL DAT E PA TIENT NAME DRUG
	5376	========== ========== ========== ========== ========== ========== ========== ==========
	5377	1 205534 6 1 02/2 5/09 EC MEPATIENT, ONE TAMOXIFE N CITRATE 10MG TAB
	5378	FINI SH 02/2 5/09 4:51p Status:E CME Billab le
	5379	ELIGIBILIT Y: CV:No
	5380	DRUG:TAMOX IFEN CITRA TE 10MG TA B
	5381	NDC:00378- 0144-91, B ILLED QTY: 60, COST:. 928, DEA:6 PR
	5382	PLAN:T-GRO UP1 INSUR ANCE: BLUE MOON INSU RANCE
	5383	BIN:123456 , PCN:1123 456789, PA YER SHEET B1:WBTESTB 1
	5384	PAYER SHEE T B2:WBTES TB2, PAYER SHEET B3: WBTESTB1
	5385	DISPENSING FEE:0, BA SIS OF COS T DETERM:U SUAL & CUS TOMARY
	5386	COST:68.20 , GROSS AM T DUE:68.2 0, ADMIN F EE:12.50
	5387	USER:POSTM ASTER
	5388	SUBM IT 02/2 5/09 4:51p Status:O K
	5389	ECME#:0000 01615253, FILL DATE :02/25/09
	5390	PAYER RESP ONSE: PAYA BLE
	5391	PLAN:T-GRO UP1, INSUR ANCE: BLUE MOON INSU RANCE
	5392	USER:POSTM ASTER
	5393	RELE ASE 02/2 5/09 4:56p Status:O K
	5394	ECME#:0000 01615253, FILL DATE :02/25/09
	5395	USER:POSTM ASTER
	5396	BILL ING 02/2 5/09 4:56p Status:B ill# K9000 7W created
	5397	ECME#:0000 01615253, FILL DATE :02/25/09, RELEASE DA TE:02/25/0 9
	5398	DRUG:TAMOX IFEN CITRA TE 10MG TA B
	5399	NDC:00378- 0144-91, B ILLED QTY: 60, DAYS S UPPLY:3
	5400	BILLED:68. 20, PAID:5 8.20
	5401	PLAN:T-GRO UP1, INSUR ANCE: BLUE MOON INSU RANCE
	5402	USER:POSTM ASTER
	5403	List of al l bills fo r this Rx (all fills )
	5404	BI LL RX DATE INSURANC E COB PATIE NT
	5405	------ ---------- ---------- ---------- ---------- ---------- ---------- ---------
	5406	1 K9 0007U 205 5346-0 01/29/09 BLUE MOO N INSURANC P ECMEP ATIENT,ONE
	5407	2 K9 0007W 205 5346-1 02/25/09 BLUE MOO N INSURANC P ECMEP ATIENT,ONE
	5408	View Patie nt Insuran ce
	5409	Patient Po licy Infor mation Feb 23, 2011@1 3:24:18 Page: 1 of 1
	5410	Expanded P olicy Info rmation fo r: ECMEPAT IENT,ONE 666-20-458 9
	5411	OPINSUR1 I nsurance C ompany Plan Curre ntly Activ e
	5412	Plan Inf ormation Insur ance Compa ny
	5413	Is Gro up Plan: Y ES Com pany: OPIN SUR1
	5414	Gro up Name: D RUG INS St reet: 32 C ATASTROPHE WAY
	5415	Group Number: 1 11 City/S tate: BIRM INGHAM, AL 35209
	5416	BIN: Billin g Ph:
	5417	PCN: Precer t Ph:
	5418	Type of Plan: P RESCRIPTIO N
	5419	Electron ic Type: C OMMERCIAL
	5420	Plan Fi ling TF:
	5421	ePh armacy Pla n ID: VA10 5220
	5422	ePhar macy Plan Name: MINN ESOTA MEDI CAID
	5423	ePharma cy Natl St atus: ACTI VE
	5424	ePharmac y Local St atus: ACTI VE
	5425	Utilizat ion Review Info Effective Dates & S ource
	5426	Require UR : NO Effec tive Date: 10/12/07
	5427	Requir e Amb Cert : Expira tion Date:
	5428	Requir e Pre-Cert : NO Sourc e of Info: INTERVIEW
	5429	Exclud e Pre-Cond : NO Policy Not Billable: NO
	5430	Benefits Assignable : YES
	5431	Subscrib er Informa tion Subscriber 's Employe r Informat ion
	5432	Whose In surance: V ETERAN E mp Sponsor ed Plan: N o
	5433	Subscrib er Name: E CMEPATIENT ,ONE Employer:
	5434	Relat ionship: S ELF Employment Status:
	5435	Pri mary ID: 5 43252 Retireme nt Date:
	5436	Coord. B enefits: P RIMARY C laims to E mployer: N o, Send to Insurance Company
	5437	Primary P rovider: Street:
	5438	Prim Pro v Phone: Cit y/State:
	5439	Phone:
	5440	Insure d Person's Informati on (use Su bscriber U pdate Acti on)
	5441	Ins ured's DOB : 10/18/19 63 Str 1: 1225 OAK L ANE
	5442	Ins ured's Sex : MALE Str 2:
	5443	Insure d's Branch : ARMY City: HOMEWOOD
	5444	Insu red's Rank : St/Zip: AL 35209
	5445	Phone: 2055555555
	5446	Insuranc e Company ID Numbers (use Subs criber Upd ate Action )
	5447	Subscri ber Primar y ID: 5432 52
	5448	Plan Cov erage Limi tations
	5449	Coverag e Effecti ve Date Covered? Limit Comments
	5450	------- - ------- ------- -------- ----- ---------
	5451	INPATIE NT 08/04/2 008 YES
	5452	07/11/2 008 YES
	5453	06/26/2 008 YES
	5454	02/26/2 008 YES
	5455	01/28/2 008 YES
	5456	10/12/2 007 YES
	5457	06/19/2 007 YES
	5458	04/13/2 007 YES
	5459	01/08/2 007 YES
	5460	06/17/2 006 YES
	5461	OUTPATI ENT 08/04/2 008 YES
	5462	07/11/2 008 YES
	5463	06/26/2 008 YES
	5464	02/26/2 008 YES
	5465	01/28/2 008 YES
	5466	10/12/2 007 YES
	5467	08/02/2 007 YES
	5468	06/19/2 007 YES
	5469	04/13/2 007 YES
	5470	01/08/2 007 YES
	5471	06/17/2 006 YES
	5472	PHARMAC Y 03/17/2 009 YES
	5473	08/06/2 008 YES
	5474	08/04/2 008 YES
	5475	07/11/2 008 YES
	5476	06/26/2 008 YES
	5477	DENTAL 08/04/2 008 YES
	5478	07/11/2 008 YES
	5479	06/26/2 008 YES
	5480	02/26/2 008 YES
	5481	01/28/2 008 YES
	5482	10/12/2 007 YES
	5483	08/02/2 007 YES
	5484	06/19/2 007 YES
	5485	04/13/2 007 YES
	5486	01/08/2 007 YES
	5487	06/17/2 006 YES
	5488	MENTAL HEALTH 08/04/2 008 YES
	5489	07/11/2 008 YES
	5490	06/26/2 008 YES
	5491	02/26/2 008 YES
	5492	01/28/2 008 YES
	5493	10/12/2 007 YES
	5494	08/02/2 007 YES
	5495	06/19/2 007 YES
	5496	04/13/2 007 YES
	5497	01/08/2 007 YES
	5498	06/17/2 006 YES
	5499	LONG TE RM CARE BY DEFAULT
	5500	User Inf ormation Insuranc e Contact (last)
	5501	Ent ered By: E LLZEY,LIND A Person C ontacted:
	5502	Ent ered On: 1 0/12/07 Method of Contact: PHONE
	5503	Last Veri fied By: E LLZEY,LIND A Contact 's Phone:
	5504	Last Veri fied On: 0 2/07/08 Call Ref. No.:
	5505	Last Upd ated By: E LLZEY,LIND A Cont act Date: APR 15, 20 09
	5506	Last Upd ated On: 0 4/15/09
	5507	Comment -- Patient Policy
	5508	None
	5509	Comment -- Group P lan
	5510	Personal Riders
	5511	TPJI – Cla im Informa tion
	5512	Claim Info rmation Fe b 08, 2011 @14:36:24 P age: 1 of 1
	5513	K90007We ECMEPATIE NT,ONE O4 529 DOB: 10 /18/63 S ubsc ID:
	5514	TPJI – Cla im Informa tion
	5515	Claim Info rmation Fe b 08, 2011 @14:36:24 P age: 1 of 1
	5516	K90007We ECMEPATIE NT,ONE O4 529 DOB: 10 /18/63 S ubsc ID:
	5517	---------- ---------- ---------- ---------- ---------- ---------- ---------- ----------
	5518	Insuranc e Demograp hics Subscrib er Demogra phics
	5519	Bill P ayer: BLUE MOON INSU RANCE Group N umber: 100 01
	5520	Claim Add ress: 321 MOON DRIVE Group Name: T-G ROUP1
	5521	BIRM INGHAM, AL 35209 Subscrib er ID:
	5522	Claim P hone: Emp loyer: USA ARMY CONS ULTANTS
	5523	Insured's Name: ECM EPATIENT,O NE
	5524	Relatio nship: PAT IENT
	5525	C laim Infor mation
	5526	Bill Typ e: OUTPATI ENT Charge Type:
	5527	Time Fram e: ADMIT T HRU DISCHA RGE Service Dates: 02/ 25/09 - 02 /25/09
	5528	Rate Typ e: REIMBUR SABLE INS. Orig Claim: 68.20
	5529	AR Statu s: ACTIVE Balanc e Due: 10.00
	5530	Sequenc e: PRIMARY
	5531	Purch Sv c: NO
	5532	ECME N o: 1615253
	5533	ECME Ap N o: WEBMD: PAID
	5534	NP I: 1164471 991
	5535	Provider s: NONE
	5536	En tered: 02/ 25/09 by POSTMASTE R
	5537	Autho rized: 02/ 25/09 by POSTMASTE R
	5538	First Pr inted: 02/ 25/09 by POSTMASTE R
	5539	Related Prescripti on Copay I nformation
	5540	<none f ound>
	5541	TPJI – AR Account Pr ofile
	5542	AR Account Profile Feb 08, 2011@1 4:46:24 Page: 1 of 1
	5543	K90007We ECMEPATIE NT,ONE O4 529 DOB: 10 /18/63 S ubsc ID:
	5544	AR Status: ACTIVE Orig Amt: 68.2 0 Bal ance Due: 10.00
	5545	---------- ---------- ---------- ---------- ---------- ---------- ---------- ----------
	5546	02/25/0 9 IB Sta tus: PRINT ED (First) 68.20 10.00
	5547	Total C ollected: 58 .20
	5548	TPJI – AR Comment Hi story
	5549	Comment Hi story Feb 08, 20 11@14:47:1 0 Page: 1 of 1
	5550	K90007We ECMEPATIE NT,ONE O4 529 DOB: 10 /18/63 S ubsc ID:
	5551	AR Status: ACTIVE Orig Amt: 68.2 0 Bal ance Due: 10.00
	5552	No Comment Transacti ons Exist For This A ccount.
	5553	TPJI – ECM E Claim In formation
	5554	ECME Claim Informati on F eb 08, 201 1@14:48:16 Pag e: 1 of 1
	5555	K90007We ECMEPATIE NT,ONE O4 529 DOB: 10 /18/63 S ubsc ID:
	5556	---------- ---------- ---------- ---------- ---------- ---------- ---------- ----------
	5557	ECME N o: 1615253 Pharmacy NPI: 1164 471991
	5558	ECME Ap N o: WEBMD: PAID Provider NPI: No N PI on file
	5559	Rx N o: 2055346 / 1 Fill Date: 02/2 5/09
	5560	Drug Nam e: TAMOXIF EN CITRATE 10MG TAB N DC #: 0037 8-0144-91
	5561	Billed Am t: 68.2 0 COB: Prim ary
	5562	IB Statu s: CANCEL LED (02/25 /09) Reas on: ECME PRESCRIPTI ON REVERSE D
	5563	Payment I nformation
	5564	Expecte d Payment Amount: 58.20
	5565	Ingredie nt Cost Re im Amt: 0.00 Disp ensing Fee Reim Amt: 0.00
	5566	Patient R esponsibil ity Amount s
	5567	Deducti ble: 0 .00 Co insurance: 0.00 Amount of Copay: 0.00
	5568	Coverage Gap: 0 .00 Proc essor Fee: 0.00 Exceed Be nefit Max: 0.00
	5569	Health Plan-funde d Assistan ce Amount: 0.00
	5570	Product S election A mounts
	5571	P rod Sel Am t: 0.0 0 Prod Sel /Non-Pref Formulary: 0.00
	5572	Prod Sel/B rand Drug: 0.00 Prod S el/Brand N on-Pref Fo rmulary: 0.00
	5573	Provider Network Ad j: 0.0 0
	5574	No COB/Ot her Payer Data on fi le in the ECME Respo nse.
	5575	ELIGIBIL ITY STATUS DATA, SCR EEN <7>
	5576	ECMEPATIEN T,ONE; 666 -20-4589 ACTIVE DUT Y
	5577	========== ========== ========== ========== ========== ========== ========== =========
	5578	<1> Patient Ty pe: ACTIVE DUTY Ve teran: YES
	5579	S vc Connect ed: YES SC Pe rcent: 20%
	5580	S C Award Da te: OCT 12 ,2007 Unemplo yable: NO
	5581	P &T: NO
	5582	R ated Incom p.: NO
	5583	Claim Numb er: 432432 22
	5584	Folder Lo c.: ALBUQU ERQUE
	5585	<2> Aid & Attendan ce: NO House bound: NO
	5586	VA Pensi on: NO VA Disab ility: NO
	5587	Total Check Amou nt: NOT AP PLICABLE
	5588	GI Insuran ce: NO A mount: UNA NSWERED
	5589	<3> Prima ry Elig Co de: SC LES S THAN 50%
	5590	Other Elig Code( s): NO ADD ITIONAL EL IGIBILITIE S IDENTIFI ED
	5591	Perio d of Servi ce: PERSIA N GULF WAR
	5592	<3.1> Comb at Vet Eli g.: EXPIRE D End Date : OCT 11, 2009
	5593	<4> Servic e Connecte d Conditio ns as stat ed by appl icant
	5594	------ ---------- ---------- ---------- ---------- -----
	5595	NONE S TATED
	5596	ELIGIBILIT Y VERIFICA TION DATA
	5597	EL IGIBILITY VERIFICATI ON DATA, S CREEN <11>
	5598	ECMEPATIEN T,ONE; 666 -20-4589 ACTIVE DUT Y
	5599	========== ========== ========== ========== ========== ========== ========== =========
	5600	<1> Eligib ility Stat us: NOT VE RIFIED Status D ate: NOT A PPLICABLE
	5601	Statu s Entered By: NOT AP PLICABLE
	5602	Inte rim Respon se: UNANSW ERED (NOT REQUIRED)
	5603	V erif. Meth od: NOT AP PLICABLE
	5604	V erif. Sour ce: NOT AV AILABLE
	5605	<2> Mo ney Verifi ed: NOT VE RIFIED
	5606	<3> Serv ice Verifi ed: NOT VE RIFIED
	5607	<4> Rated Disabiliti es: SC%: 20 EFF. DATE OF C OMBINED SC %:
	5608	Orig Curr
	5609	Rated D isability Extr Eff D t Eff Dt
	5610	NONE STATE D
	5611	8.2.6 OPEC C Producti vity Repor t XE " OPE CC Product ivity??"
	5612	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.
	5613	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.
	5614	Example 8. 2.6-1: Acc essing the OPECC Pro ductivity Report Opt ion
	5615	*** ****** ****** ****** ****** **
	5616	Elec tronic Cla ims Manage ment Engin e (ECME) V 1.0
	5617	* ALASKA V AHSRO *
	5618	* Other Re ports *
	5619	*** ****** ****** ****** ****** **
	5620	CRI ECME Claim s-Response Inquiry
	5621	PAY Payer Shee t Detail R eport
	5622	PHAR ECME Setup - Pharmac ies Report
	5623	TAT Turn-aroun d time sta tistics
	5624	VER View ePhar macy Rx
	5625	OPR OPECC Prod uctivity R eport
	5626	Select Oth er Reports Option: VER View ePharmacy Rx
	5627	Example 8.2.6-2: Prompts fo r the OPEC C Producti vity Repor t
	5628	Select Oth er Reports <TEST ACC OUNT> Opti on: OPR O PECC Produ ctivity Re port
	5629	Selec t one of t he followi ng:
	5630	D DIVISION
	5631	A ALL
	5632	Select Cer tain Pharm acy (D)ivi sions or ( A)LL: A// LL
	5633	Selec t one of t he followi ng:
	5634	V VETERAN
	5635	T TRICARE
	5636	C CHAMPVA
	5637	A ALL
	5638	Include Ce rtain Elig ibility Ty pe or (A)l l: A// LL
	5639	Selec t one of t he followi ng:
	5640	U USER
	5641	A ALL
	5642	Display EC ME (U)ser or (A)LL: A// LL
	5643	START WITH TRANSACTI ON DATE: T -1// (OC T 28, 2015 )
	5644	GO TO TR ANSACTION DATE: T// (OCT 29, 2015)
	5645	Selec t one of t he followi ng:
	5646	S Summary
	5647	D Detail
	5648	Display (S )ummary or (D)etail Format: De tail//
	5649	Enter a co de from th e list to indicate t he sort or der.
	5650	Selec t one of t he followi ng:
	5651	D Division
	5652	U User Name
	5653	Sort: (D/ U): User N ame// Divi sion
	5654	Do you wan t to captu re report data for a n Excel do cument? NO //
	5655	WARNING - THIS REPOR T REQUIRES THAT A DE VICE WITH 132 COLUMN WIDTH BE USED.
	5656	IT WILL NO T DISPLAY CORRECTLY USING 80 C OLUMN WIDT H DEVICES
	5657	DEVICE: HO ME//0;132
	5658	Example 8. 2.6-3: Dis play of th e Detailed OPECC Pro ductivity Report
	5659	OPECC PROD UCTIVITY D ETAIL REPO RT Prin t Date: Oc t 29, 2015 @10:15:57 Page: 1
	5660	DIVISION(S ): ALL
	5661	ELIGIBILIT Y: ALL
	5662	USERS: ALL
	5663	ALL PRESCR IPTIONS BY TRANSACTI ON DATE: F rom 9/29/1 5 through 10/29/15
	5664	========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== =========
	5665	# TRA NSACTIONS
	5666	USER STAT US DT RA NGE TOTAL ELIG R X# REF/ECME# DOS TRA NS DATE P AID AMT
	5667	========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== =========
	5668	DIVISION: DIVISION O NE
	5669	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------
	5670	USER,EIGHT REJE CTED 1 1 CVA 1 00888 0/0000001 12004 09/ 29/15 09/ 29/15 6 .62
	5671	USER,EIGHT REJE CTED 1 1 CVA 1 00889 0/0000001 12005 09/ 29/15 09/ 29/15 10 .00
	5672	USER,NINE PAYA BLE 1 1 VET 1 00840G 0/0000001 11960 09/ 30/15 09/ 30/15 10 .00
	5673	USER,NINE REVE RSAL REJEC TED 1 1 VET 1 00845 0/0000001 11942 08/ 25/15 10/ 01/15 10 .00
	5674	USER,NINE REJE CTED 1 1 CVA 1 00895 0/0000001 12012 10/ 01/15 10/ 01/15 7 .43
	5675	USER,NINE REJE CTED 1 1 CVA 1 00895A 0/0000001 12013 10/ 01/15 10/ 01/15 7 .43
	5676	USER,NINE REJE CTED 1 1 CVA 1 00895D 0/0000001 12017 10/ 01/15 10/ 01/15 7 .43
	5677	USER,NINE REJE CTED 1 1 CVA 1 00896 0/0000001 12018 10/ 01/15 10/ 01/15 10 .00
	5678	USER,NINE REJE CTED 1 1 CVA 1 00895F 0/0000001 12020 10/ 01/15 10/ 01/15 7 .43
	5679	USER,NINE REVE RSAL REJEC TED 1 1 VET 1 00840H 0/0000001 12025 10/ 01/15 10/ 01/15 10 .00
	5680	USER,EIGHT REVE RSAL ACCEP TED 1 1 VET 1 00904 0/0000001 12032 10/ 06/15 10/ 06/15 10 .00
	5681	USER,EIGHT REJE CTED 1 1 VET 1 00905 0/0000001 12033 10/ 06/15 10/ 06/15 10 .00
	5682	USER,TWO REVE RSAL ACCEP TED 1 1 TRI 1 00872 0/0000001 11986 09/ 23/15 10/ 08/15 10 .00
	5683	USER,NINE REVE RSAL ACCEP TED 1 1 CVA 1 00896A 0/0000001 12024 10/ 08/15 10/ 08/15 10 .00
	5684	USER,NINE REVE RSAL ACCEP TED 1 1 TRI 1 00917 0/0000001 12046 10/ 14/15 10/ 14/15 10 .00
	5685	USER,NINE REJE CTED 1 1 TRI 1 00917A 0/0000001 12049 10/ 14/15 10/ 14/15 10 .00
	5686	USER,NINE REJE CTED 1 1 TRI 1 00917B 0/0000001 12050 10/ 14/15 10/ 14/15 10 .00
	5687	USER,NINE PAYA BLE 1 1 CVA 1 00881 0/0000001 11997 10/ 15/15 10/ 15/15 5 .23
	5688	USER,FOUR REJE CTED 1 1 TRI 1 00923 0/0000001 12055 10/ 15/15 10/ 15/15
	5689	USER,NINE REVE RSAL REJEC TED 1 1 TRI 1 00922 0/0000001 12054 10/ 15/15 10/ 16/15 10 .00
	5690	USER,FOUR REJE CTED 1 1 TRI 1 00927 0/0000001 12059 10/ 16/15 10/ 16/15
	5691	USER,FOUR REJE CTED 1 1 TRI 1 00929 0/0000001 12061 10/ 16/15 10/ 16/15
	5692	USER,FOUR REJE CTED 1 1 TRI 1 00933 0/0000001 12065 10/ 17/15 10/ 18/15
	5693	USER,FOUR REJE CTED 1 1 TRI 1 00936 0/0000001 12068 10/ 18/15 10/ 18/15
	5694	USER,FOUR REJE CTED 1 1 TRI 1 00832 0/0000001 11902 09/ 25/15 10/ 20/15
	5695	USER,THREE 1 1 TRI 1 00938 0/0000001 12070 10/ 28/15 10/ 28/15 10 .00
	5696	SUBTOTALS FOR DIVISI ON ONE PHA RMACY
	5697	REJE CTED AND N OT REJECTE D AND PAYA BLE
	5698	USER RESO LVED TO PA YABLE ( POSSIBLE B ACK-BILL) TRANS IN DT RANGE AMOUNT PAID
	5699	USER,EIGHT 0 0 4 36.62
	5700	USER,THREE 0 0 1 10.00
	5701	USER,TWO 0 0 1 10.00
	5702	USER,FOUR 0 0 6 0.00
	5703	USER,NINE 2 0 14 124.95
	5704	GRAND TOTA L
	5705	REJE CTED AND N OT REJECTE D AND PAYA BLE
	5706	USER RESO LVED TO PA YABLE ( POSSIBLE B ACK-BILL) TRANS IN DT RANGE AMOUNT PAID
	5707	USER,EIGHT 0 0 4 36.62
	5708	USER,THREE 0 0 1 10.00
	5709	USER,TWO 0 0 1 10.00
	5710	USER,FOUR 0 0 6 0.00
	5711	USER,NINE 2 0 14 124.95
	5712	Example 8. 2.6-4: Dis play of th e Summary OPECC Prod uctivity R eport
	5713	OPECC PROD UCTIVITY S UMMARY REP ORT Prin t Date: Oc t 29, 2015 @10:32:13 Page: 1
	5714	DIVISION(S ): ALL
	5715	ELIGIBILIT Y: ALL
	5716	USERS: ALL
	5717	ALL PRESCR IPTIONS BY TRANSACTI ON DATE: F rom 9/29/1 5 through 10/29/15
	5718	========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== =========
	5719	# TRA NSACTIONS
	5720	USER STAT US DT RA NGE TOTAL ELIG R X# REF/ECME# DOS TRA NS DATE P AID AMT
	5721	========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== ========== =========
	5722	DIVISION: DIVISION O NE
	5723	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------
	5724	SUBTOTALS FOR DIVISI ON ONE PHA RMACY
	5725	REJE CTED AND N OT REJECTE D AND PAYA BLE
	5726	USER RESO LVED TO PA YABLE ( POSSIBLE B ACK-BILL) TRANS IN DT RANGE AMOUNT PAID
	5727	USER,ONE 0 0 4 36.62
	5728	USER,TWO 0 0 1 10.00
	5729	USER,THREE 0 0 1 10.00
	5730	USER,FOUR 0 0 6 0.00
	5731	USER,FIVE 2 0 14 124.95
	5732	GRAND TOTA L
	5733	REJE CTED AND N OT REJECTE D AND PAYA BLE
	5734	USER RESO LVED TO PA YABLE ( POSSIBLE B ACK-BILL) TRANS IN DT RANGE AMOUNT PAID
	5735	USER,ONE 0 0 4 36.62
	5736	USER,TWO 0 0 1 10.00
	5737	USER,THREE 0 0 1 10.00
	5738	USER,FOUR 0 0 6 0.00
	5739	USER,FIVE 2 0 14 124.95
	5740	(This page included for two-si ded copyin g.)
	5741	9
	5742	BPS Nightl y Backgrou nd Job XE "BPS Night ly Backgro und Job"
	5743	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.
	5744	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.
	5745	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.
	5746	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.
	5747	Example 9. 1-1 Displa ying the A uto-Revers al Bulleti n
	5748	Subj: ECME AUTO-REVE RSAL PROCE SS [#2473 ] 03/05/05 @01:00 29 lines
	5749	From: BPS PACKAGE I n 'IN' bas ket. Pag e 1 New
	5750	---------- ---------- ---------- ---------- ---------- ---------- ---------- ---------
	5751	The ECME N ightly Pro cess compl eted auto- reversing e-Pharmacy claims fo r prescrip tions not released w ithin the specified timeframe.
	5752	TOTAL AUTO -REVERSED CLAIMS: 3
	5753	Claims Aut o-Reversed on 03/06/ 05:
	5754	# RX/FI LL STA TUS DATE ELIG PA TIENT BPS PHAR M DRUG NA ME
	5755	---------- ---------- ---------- ---------- ---------- ---------- ---------- --------
	5756	1 908955 /1 W/NR 03/01/06 V ECMEpatien t,One ANC DRUG NAME ONE
	5757	2 909225 /1 W/NR 03/04/06 V ECMEpatien t,Two ANC DRUG NAME TWO
	5758	3 41581 /0 W/NR 03/04/06 V ECMEpatien t,Three ANC DRUG NAME THREE


	5759	(This page included for two-si ded copyin g.)
	5760	10
	5761	Glossary X E "Glossar y"
	5762	Accredited Standards Committee (ASC)
	5763	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.
	5764	Administra tive Code Sets
	5765	Code sets that chara cterize a general bu siness sit uation rat her than a medical c ondition o r service.
	5766	Administra tive Simpl ification (A/S)
	5767	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.
	5768	American M edical Ass ociation ( AMA)
	5769	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 .
	5770	American N ational St andards (A NS)
	5771	Standards developed and approv ed by orga nizations accredited by ANSI.
	5772	American N ational St andards In stitute
	5773	An organiz ation that accredits various
	5774	(ANSI)
	5775	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.
	5776	American S ociety for Testing a nd
	5777	A standard s group th at has pub lished gen eral
	5778	Materials (ASTM)
	5779	guidelines for the d evelopment of standa rds, inclu ding those for healt h care ide ntifiers.
	5780	Back Door
	5781	System acc ess via th e roll and scroll, c haracter a nd Mumps b ased VistA applicati on.
	5782	Blue Cross and Blue Shield Ass ociation
	5783	An associa tion that represents the commo n
	5784	(BCBSA)
	5785	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.
	5786	Business M odel
	5787	A model of a busines s organiza tion or pr ocess.
	5788	CHAMPVA Pa tient
	5789	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.
	5790	Clean Clai m
	5791	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.
	5792	Clearingho use
	5793	For health care, an organizati on that
	5794	(or Health Care Clea ringhouse)
	5795	translates health ca re data to or from a standard format.
	5796
	5797	Centers fo r Medicare & Medicai d
	5798	Centers fo r Medicare & Medicai d Services ,
	5799	Services ( CMS)
	5800	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.
	5801	CMS-1450
	5802	CMS’s name for the i nstitution al uniform claim for m, or UB-9 2.
	5803	CMS-1500
	5804	CMS’s name for the p rofessiona l uniform claim form . Also kno wn as the UCF-1500.
	5805	Coordinati on of Bene fits (COB)
	5806	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.
	5807	Code Set
	5808	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]
	5809	Covered En tity
	5810	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.
	5811	Current Pr ocedural T erminology
	5812	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.
	5813	Data Dicti onary (DD)
	5814	A document or system that char acterizes the data c ontent of a system.
	5815	Data Eleme nt
	5816	Under HIPA A, this is "…the sma llest name d unit of informatio n in a tra nsaction." [45 CFR 1 62.103]
	5817	Data Mappi ng
	5818	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.
	5819	Data Model
	5820	A conceptu al model o f the info rmation ne eded to su pport a bu siness fun ction or p rocess.
	5821	Data Set
	5822	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]
	5823	Designated Code Set
	5824	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.
	5825	Designated Data Cont ent Commit tee
	5826	An organiz ation, whi ch DHHS ha s
	5827	or Designa ted DCC
	5828	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.
	5829	Designated Standard
	5830	A standard that DHHS has desig nated for use under the author ity provid ed by HIPA A.
	5831	Department of Health and Human
	5832	Per the we bsite addr ess provid ed below,
	5833	Services ( DHHS) or ( HHS)
	5834	'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 websit e is avail able at <h ttp://www. DNS />.
	5835	Electronic Commerce (EComm)
	5836	The exchan ge of busi ness infor mation by electronic means.
	5837	Electronic Data Inte rchange (E DI)
	5838	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.
	5839	Finish
	5840	Term used for comple ting order s from Ord er Entry/R esults Rep orting V. 3.0.
	5841	‘Finish’ a Prescript ion
	5842	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.
	5843	Flat File
	5844	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.
	5845	Front Door
	5846	System acc ess via th e Delphi, Graphical User Inter face (GUI) based Vis tA applica tion.
	5847	Graphical User Inter face (GUI)
	5848	A graphica l method o f controll ing how a user inter acts with a computer to perfor m various tasks.
	5849	HCFA Commo n Procedur al Coding
	5850	A medical code set t hat identi fies healt h care
	5851	System (HC PCS)
	5852	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.
	5853	Health Car e Clearing house
	5854	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]
	5855	Health Car e Financin g Administ ration
	5856	The DHHS a gency resp onsible fo r Medicare
	5857	(HCFA)
	5858	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.
	5859	Health Car e Provider
	5860	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]
	5861	Health Inf ormation
	5862	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]
	5863	Health Ins urance Ass ociation o f
	5864	An industr y associat ion that r epresents the
	5865	America ( HIAA)
	5866	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.
	5867	Health Ins urance Por tability a nd
	5868	A Federal law that m akes a num ber of
	5869	Accountabi lity Act o f 1996 (HI PAA)
	5870	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.
	5871	Health Pla n
	5872	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]
	5873	Healthcare Financial Managemen t
	5874	An organiz ation for the improv ement
	5875	Associatio n (HFMA)
	5876	of the fin ancial man agement of healthcar e-related organizati ons. The H FMA sponso rs some HI PAA educat ional semi nars.
	5877	Health Lev el Seven ( HL7)
	5878	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.
	5879	HIPAA Data Dictionar y
	5880	A data dic tionary th at defines and cross -
	5881	or HIPAA D D
	5882	references the conte nts of all X12 trans actions in cluded in the HIPAA mandate. I t is maint ained by X 12N/TG3.
	5883	Implementa tion Guide (IG)
	5884	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.
	5885	Implementa tion Speci fication
	5886	Under HIPA A, this is "… the sp ecific ins tructions for implem enting a s tandard [4 5 CFR 160. 103]
	5887
	5888	Informatio n Model
	5889	A conceptu al model o f the info rmation ne eded to su pport a bu siness fun ction or p rocess.
	5890	Internatio nal Classi fication o f Diseases
	5891	A medical code set m aintained by the
	5892	(ICD)
	5893	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.
	5894	Internatio nal Standa rds Organi zation
	5895	An organiz ation that coordinat es the
	5896	(ISO) or I nternation al Organiz ation
	5897	developmen t and adop tion of nu merous
	5898	for Standa rdization
	5899	internatio nal standa rds.
	5900	Joint Comm ission on Accreditat ion
	5901	In the fut ure, the J CAHO may p lay a role in
	5902	of Healthc are Organi zations (J CAHO)
	5903	certifying these org anizations complianc e with the HIPAA A/S requireme nts.
	5904	J-Codes
	5905	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.
	5906	Maintain o r Maintena nce
	5907	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]
	5908	Maximum De fined Data Set
	5909	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.
	5910	Medical Co de Sets
	5911	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.
	5912	Memorandum of Unders tanding (M OU)
	5913	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).
	5914	Modify or Modificati on
	5915	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]
	5916	National C enter for Health Sta tistics
	5917	An adminis tration of HHS and C DC that
	5918	(NCHS)
	5919	oversees I CD coding.
	5920	National C ouncil for Prescript ion Drug
	5921	An ANSI-ac credited g roup that maintains
	5922	Programs ( NCPDP)
	5923	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.
	5924	National D rug Code ( NDC)
	5925	A medical code set t hat has be en selecte d for use in the HIP AA transac tions.
	5926	National E mployer ID
	5927	A system f or uniquel y identify ing all sp onsors of health car e benefits .
	5928	National P atient ID
	5929	A system f or uniquel y identify ing all re cipients o f health c are servic es.
	5930	National P ayer ID
	5931	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.
	5932	National P rovider Fi le (NPF)
	5933	The databa se envisio ned for us e in maint aining a n ational pr ovider reg istry.
	5934	National P rovider ID
	5935	A system f or uniquel y identify ing all pr oviders of health ca re service s, supplie s, and equ ipment.
	5936	National P rovider Re gistry
	5937	The organi zation env isioned fo r assignin g the Nati onal Provi der IDs.
	5938	National P rovider Sy stem (NPS)
	5939	The admini strative s ystem envi sioned for supportin g a nation al provide r registry .
	5940	National S tandard Fo rmat (NSF)
	5941	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 .
	5942	National U niform Bil ling Commi ttee
	5943	The commit tee establ ished by t he America n
	5944	(NUBC)
	5945	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.
	5946	NCPDP Batc h Standard
	5947	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.
	5948	NCPDP Tele communicat ion Standa rds
	5949	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.
	5950	Non-Formul ary Drugs
	5951	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.
	5952	Notice of Intent (NO I)
	5953	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.
	5954	Notice of Proposed R ulemaking (NPRM)
	5955	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.
	5956	Office of Management & Budget (OMB)
	5957	A Federal Government agency th at has a m ajor role in reviewi ng propose d Federal regulation s.
	5958	Open Syste m Intercon nection (O SI)
	5959	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 .
	5960	Outpatient Pharmacy Electronic Claims
	5961	This is a designated individua l at each site
	5962	Coordinato r (OPECC)
	5963	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.
	5964	Orderable Item
	5965	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).
	5966	Payer
	5967	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).
	5968	DNS D
	5969	HCFA’s ter m for thei r National Payer ID initiative .
	5970	PBM
	5971	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.
	5972	Placeholde rs
	5973	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.
	5974	Potentiall y Billable Event
	5975	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.
	5976	Profession al Compone nt
	5977	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.
	5978	Provider T axonomy Co des
	5979	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.
	5980	Secretary
	5981	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].
	5982	Segment
	5983	Under HIPA A, this is "…a group of relate d data ele ments in a transacti on”. [45 C FR 162.103 ]
	5984	Service
	5985	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.
	5986	Standard
	5987	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 ]
	5988	Standard S etting Org anization (SSO)
	5989	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]
	5990	Standard T ransaction
	5991	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]
	5992	Statement of Work (S OW)
	5993	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.
	5994	Third Part y Administ rator (TPA )
	5995	An entity that proce sses healt h care cla ims and pe rforms rel ated busin ess functi ons for a health pla n.
	5996	Third (3rd ) Party Cl aims
	5997	Health car e insuranc e claims s ubmitted t o an
	5998	Transactio n
	5999	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 ]
	6000	TRICARE Pa tient
	6001	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.
	6002	UB-92
	6003	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.
	6004	Unstructur ed Data
	6005	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.
	6006	‘Verify’ a Prescript ion
	6007	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.
	6008	Veterans H ealth Info rmation Sy stems
	6009	Acronym fo r Veterans Health In formation
	6010	and Techn ology Arch itecture ( VistA)
	6011	Systems an d Technolo gy Archite cture, the new name for Decent ralized Ho spital Com puter Prog ram (DHCP) .
	6012	Workgroup for Electr onic Data
	6013	A health c are indust ry group t hat lobbie d
	6014	Interchang e (WEDI)
	6015	for HIPAA A/S, and t hat has a formal con sultative role under the HIPAA legislati on.
	6016	(This page included for two-si ded copyin g.)
	6017	11
	6018	Acronyms X E "Acronym s"
	6019	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
	6020	Index
	6021
	6022	A
	6023	Accessing Pharmacy E CME Manage r Menu, 87
	6024	Accessing the ECME P harmacy CO B Menu, 79
	6025	Acronyms, 199
	6026	Add/View C omments, 4 0, 47
	6027	B
	6028	BPS Nightl y Backgrou nd Job, 18 1
	6029	C
	6030	Change Vie w, 19
	6031	Claim Resu lts and St atus, 108
	6032	Claims Sub mitted, No t Yet Rele ased, 128
	6033	Claims Tra cking, 47
	6034	Close Clai m, 35
	6035	Closed Cla ims Report , 135
	6036	CMOP/ECME Activity R eport, 122
	6037	D
	6038	Display Up date, 76
	6039	Display Up date, 103
	6040	E
	6041	ECME Claim s-Response Inquiry, 152
	6042	ECME Main Menu, 12
	6043	ECME Menu Options, 8
	6044	ECME Menu Structures , 7
	6045	ECME Setup - Pharmac ies, 160
	6046	ECME Trans action Mai ntenance O ptions, 87
	6047	ECME User Screen, 14
	6048	Edit Basic Pharmacy ECME Param eters, 92
	6049	Edit ECME Pharmacy D ata, 94
	6050	Exit from ECME User Screen, 78
	6051	F
	6052	Further Re search Scr een, 42
	6053	G
	6054	Glossary, 183
	6055	Group Plan Menu, 57
	6056	I
	6057	IB (Integr ated Billi ng) Events Report, 5 3
	6058	Insurance Details, 4 3
	6059	Introducti on, 1
	6060	N
	6061	Non-Billab le Status Report, 13 8
	6062	O
	6063	On-Hold Co pay Listin g, 50
	6064	Online Hel p, 4
	6065	OPECC Prod uctivity?? , 174
	6066	Orientatio n, 3
	6067	Other Repo rts, 152
	6068	P
	6069	Payable Cl aims, 110
	6070	Payable Re jected Cla ims, 116
	6071	Payer Shee t Detail, 155
	6072	Pharmacy E CME Setup Menu, 91
	6073	Pharmacy E CME User S creen, 10
	6074	Pharmacy E lectronic Claims Rep orts, 107
	6075	Pharmacy E lectronic Claims Rep orts Menu Structure, 10
	6076	Potential Claims Rep ort for Du al Eligibl e, 81
	6077	Potential Secondary Rx Claims Report, 79
	6078	Print Clai m Log, 60
	6079	Process Se condary/Tr icare Rx t o ECME, 83
	6080	R
	6081	Recent Tra nsactions, 129
	6082	Related Ma nuals, 5
	6083	Release Co pay, 51
	6084	Reopen Clo sed Claims (hidden o ption), 66
	6085	Resubmit C laim, 32, 73
	6086	Resubmit w ith Edits (hidden op tion), 68
	6087	Reversal C laims Repo rt, 124
	6088	Reverse Pa yable Clai m, 29
	6089	S
	6090	Send to Wo rklist, 63
	6091	Sort List, 27
	6092	Spending A ccount Rep ort, 146
	6093	Statistics Screen, 1 00
	6094	Submitting Primary C laims for TRICARE an d Dual Eli gibility P atients, 8 5
	6095	Submitting Secondary Claims, 8 4
	6096	T
	6097	Third Part y Inquiry, 49
	6098	Totals by Date, 134
	6099	Turn-aroun d time sta tistics, 1 62
	6100	U
	6101	Update Con tinuously, 102
	6102	V
	6103	Variations to the Cl ose claim process, 3 8, 40, 90
	6104	View Eligi bility, 44
	6105	View Presc ription, 4 5, 58
	6106	View/Unstr and Claims , 88
	6107	Z
	6108	Zero (clea r) Statist ics, 103
	6109
	6110
	6111	PHARMACY E CME Jul 03, 20 10@14:55:0 1 Page : 1 of 30
	6112	SELECTED D IVISION(S) : ALL
	6113	Transmitte d by ALL u sers Activity Date Rang e: within the past 1 0 day(s)
	6114	Sorted b y: Transac tion date by default
	6115
	6116	# PATIEN T/DRUG/COM MENTS IN SURANCE/ND C/FILL/RX# /ECME# STATU S/LOC/TYP/ RXINF
	6117	1 ECMEPa tient,FIVE (XXXX) I BINSUR1/ Vet Pb: 0 Rj:1 AcR v:3 RjRv:0
	6118	1.1 CO LCHICINE 0 .6MG 0007 4-3781-01 06/24 1012 97$ 1/ 0000000016 53 M RT DS/N
	6119	10/1 9/10 - Cla rification Code 8 su bmitted.
	6120	(OPP USER,TWO)
	6121	p-Re versal acc epted
	6122
	6123	Enter ?? f or more ac tions
	6124
	6125
	6126
	6127
	6128	CV Change View REV Reverse Pa yable Clai m FR Furt her Resear ch
	6129	SO Sort L ist RES Resubmit C laim VER View ePharmacy Rx
	6130	CMT Add/Vi ew Comment s CLO Close Clai m WRK Send to Workli st
	6131	Select Act ion: Next Screen//
	6132
	6133
	6134
	6135	Header
	6136	Area
	6137
	6138	Patient/
	6139	Rx
	6140	Area
	6141
	6142	Message
	6143	Window
	6144
	6145
	6146	Action
	6147	Area
	6148
	6149	ECME STATI STICS Nov 03, 2 010@16:50: 30 Page: 1 of 1
	6150	Communicat ions stati stics last cleared o n AUG 18,2 003@16:36: 28
	6151
	6152
	6153	* CLAIM STATUS * * CLAIM RES ULTS *
	6154	Waiting to start 0 P aid claims 2,93 4
	6155	Building the trans action 0 R ejected cl aims 2,17 1
	6156	Building the claim 0 D ropped to Paper 1 5
	6157	Building the HL7 p acket 1 D uplicate c laims 0
	6158	Preparin g for tran smit 0 C aptured cl aims 0
	6159	Transmit ting 0 A ccepted Re versals 2,06 7
	6160	Parsing response 0 R ejected Re versals 16 6
	6161	Processi ng respons e 0 A ccepted El igibility 7
	6162	R ejected El igibility 4 4
	6163	E rrors 1 4
	6164
	6165
	6166
	6167	Enter ?? f or more ac tions
	6168	UC Updat e continuo usly Z Zero (cle ar) stats
	6169	U1 Displ ay update EX Exit
	6170	Select Act ion:U1//
	6171
	6172	Header
	6173	Area
	6174
	6175	Stats
	6176	Area
	6177
	6178	Message Wi ndow
	6179
	6180
	6181	Action
	6182	Area
	6183
	6184