Insurance Transmission Fields: Difference between revisions
Jump to navigation
Jump to search
No edit summary |
No edit summary |
||
| Line 1: | Line 1: | ||
Quickscrip transmits electronic prescriptions in the new D.0 transmission format | Quickscrip transmits electronic prescriptions in the new D.0 transmission format | ||
as of 2011. | as of 2011. | ||
| Line 10: | Line 9: | ||
101-A1 by an insurance customer support representative) | 101-A1 by an insurance customer support representative) | ||
==Segment ID Field== | |||
The Field AM-111 is the Segment identifier field. This field will apper multiple | The Field AM-111 is the Segment identifier field. This field will apper multiple | ||
times in a transmission, and is used to seperate transmitted data into relevant | times in a transmission, and is used to seperate transmitted data into relevant | ||
groupings. | groupings. | ||
==Transmission Header== | |||
The transmission header contains routing information that your switch uses to | The transmission header contains routing information that your switch uses to | ||
determine where the claim is sent to. | determine where the claim is sent to. | ||
| Line 40: | Line 39: | ||
|} | |} | ||
==Insurance Info== | |||
{| border="1" cellpadding="2" | {| border="1" cellpadding="2" | ||
|- | |- | ||
| Line 73: | Line 72: | ||
|} | |} | ||
==Patient Info== | |||
{| border="1" cellpadding="2" | {| border="1" cellpadding="2" | ||
|- | |- | ||
| Line 83: | Line 82: | ||
|} | |} | ||
==Claim Information== | |||
{| border="1" cellpadding="2" | {| border="1" cellpadding="2" | ||
|- | |- | ||
| Line 93: | Line 92: | ||
|} | |} | ||
==Doctor Information== | |||
{| border="1" cellpadding="2" | {| border="1" cellpadding="2" | ||
|- | |- | ||
| Line 103: | Line 102: | ||
|} | |} | ||
==Pricing Informaction== | |||
In Quickscrip claim transmissions, numberical values end with a letter of the alphabhet | In Quickscrip claim transmissions, numberical values end with a letter of the alphabhet | ||
and do not include a decimal. <br/> | and do not include a decimal. <br/> | ||
| Line 116: | Line 115: | ||
|} | |} | ||
==Coordination of Benefits== | |||
This section typically appears on secondary billing claims. | This section typically appears on secondary billing claims. | ||
{| border="1" cellpadding="2" | {| border="1" cellpadding="2" | ||
| Line 127: | Line 126: | ||
|} | |} | ||
==Workers Comp Information== | |||
Workers comp fields are generated when a '''Date of Injury''' has been set on a claim. | Workers comp fields are generated when a '''Date of Injury''' has been set on a claim. | ||
{| border="1" cellpadding="2" | {| border="1" cellpadding="2" | ||
| Line 138: | Line 137: | ||
|} | |} | ||
==DUR Information== | |||
{| border="1" cellpadding="2" | {| border="1" cellpadding="2" | ||
|- | |- | ||
| Line 148: | Line 147: | ||
|} | |} | ||
==Coupon Information== | |||
{| border="1" cellpadding="2" | {| border="1" cellpadding="2" | ||
|- | |- | ||
| Line 158: | Line 157: | ||
|} | |} | ||
==Compound Drug Information== | |||
{| border="1" cellpadding="2" | {| border="1" cellpadding="2" | ||
|- | |- | ||
| Line 168: | Line 167: | ||
|} | |} | ||
==P/A Request Information== | |||
{| border="1" cellpadding="2" | {| border="1" cellpadding="2" | ||
|- | |- | ||
| Line 178: | Line 177: | ||
|} | |} | ||
==Clinical Information== | |||
{| border="1" cellpadding="2" | {| border="1" cellpadding="2" | ||
|- | |- | ||
| Line 188: | Line 187: | ||
|} | |} | ||
==Additional Documantation Segment== | |||
{| border="1" cellpadding="2" | {| border="1" cellpadding="2" | ||
|- | |- | ||
| Line 199: | Line 198: | ||
==Older Versions== | ==Older Versions== | ||
On rare occasions, an insurance may require a claim be send on an older transmission standard. Please contact Cost Effective Computers for these claims. | On rare occasions, an insurance may require a claim be send on an older transmission standard (RXOL51 or RXO3PI). Please contact Cost Effective Computers for these claims. | ||
Revision as of 18:05, 29 May 2015
Quickscrip transmits electronic prescriptions in the new D.0 transmission format as of 2011.
To see what fields of data are being transmitted, enter T/B at the time of transmission (in RXFILL and Dual Billing EDIT) or Y/B (in the EDIT Screen).
Note: When searching this document by field number, be aware that insurance companies often reverse the numeric code (Thus, field A1-101, may be called 101-A1 by an insurance customer support representative)
Segment ID Field
The Field AM-111 is the Segment identifier field. This field will apper multiple times in a transmission, and is used to seperate transmitted data into relevant groupings.
Transmission Header
The transmission header contains routing information that your switch uses to determine where the claim is sent to.
| Field Name | Description |
| A1-101 | Insurance BIN Number |
| A2-102 | Version Number |
| A3-103 | Transaction Code |
| A4-104 | Processor Control Number |
| A9-109 | Transaction Count |
| B2-202 | Service Provider ID |
| D1-401 | Date of Service |
| AK110 | Software Vendor Certification # |
Insurance Info
| Field Name | Description |
| C2-302 | Cardhoder ID Number |
| CC-312 | Cardholder First Name |
| CD-313 | Cardholder Last Name |
| CE-314 | Home Plan |
| FO-524 | Plan ID |
| C9-309 | Eligibility Clerification Code |
| C1-301 | Group ID |
| C3-303 | Person Code |
| C6-306 | Relationship Code |
| 2D-361 | Provider Accept Assignment |
| G2-997 | Long Term Care Claim Submission |
| 2B-360 | Medicaid Indicator |
| N5-115 | Medicaid ID Number |
Patient Info
| Field Name | Description |
| Placeholder | Placeholder |
Claim Information
| Field Name | Description |
| Placeholder | Placeholder |
Doctor Information
| Field Name | Description |
| Placeholder | Placeholder |
Pricing Informaction
In Quickscrip claim transmissions, numberical values end with a letter of the alphabhet
and do not include a decimal.
Thus 7462E would corrispond to $746.25.
| Field Name | Description |
| Placeholder | Placeholder |
Coordination of Benefits
This section typically appears on secondary billing claims.
| Field Name | Description |
| Placeholder | Placeholder |
Workers Comp Information
Workers comp fields are generated when a Date of Injury has been set on a claim.
| Field Name | Description |
| Placeholder | Placeholder |
DUR Information
| Field Name | Description |
| Placeholder | Placeholder |
Coupon Information
| Field Name | Description |
| Placeholder | Placeholder |
Compound Drug Information
| Field Name | Description |
| Placeholder | Placeholder |
P/A Request Information
| Field Name | Description |
| Placeholder | Placeholder |
Clinical Information
| Field Name | Description |
| Placeholder | Placeholder |
Additional Documantation Segment
| Field Name | Description |
| Placeholder | Placeholder |
Older Versions
On rare occasions, an insurance may require a claim be send on an older transmission standard (RXOL51 or RXO3PI). Please contact Cost Effective Computers for these claims.