RxLogic Release Notes 1.16.5

Update Type: Minor

Update Description: This version update includes stabilization and performance items and various bug fixes.

Added Features:

Transaction Messages in Database
Claim Submission File Version 2
Payables Wizard Performance Updates

New releases for the following:

Claim
Member
Plan Design
Files and Jobs
Billing & Fee Mgmt
Help & Support
Database

Bug fixes/production hotfixes for the following:

Claim
Drug
Member
Pharmacy
Plan Design
Files & Jobs
Reporting
Billing & Fee Mgmt

New Releases

Claim

Adjudication
- Transaction Response Messages Stored in Database (10715) – Transaction Response Messages are now stored in a new TransactionResponseMessages table, using the Transmission ID to join them to Transactions. F4 messages get their own column whereas FQ messages are combined. Separate FQ messages (not continuations) are delineated by semicolons.
- External Adjudicator – Always Reverse Regardless of Vendor Response (21629) – Clients may now opt to have their UAT level environments set to allow reversal of an externally adjudicated transaction, even if the external adjudicator rejects the request. This setting must be set by RxLogic, and interested clients should contact us.

Member

MPA Manager
- New Location Name Column (22897) – A new column, Location Name, was added to the MPA Manager Search Result grid. The information in this field is pulled from the location field attached to the member record. This field is hidden by default on the grid and can be selected from the column chooser. When selected, Location Name is also included in the Export file.

Member

Hierarchy Detail
- Export Max Records Increase to 5000 (22902) – The max number of records that can be exported was Increased to 5000. As a part of this update, the error message was also updated to "A Maximum of 5000 records can be exported."

Files & Jobs

Job Manager
- Network Rates Import - Add State Code and SOJ Source (22944) – New fields for SOJ Source and State of Jurisdiction were added to the Network Rates Import. These fields are optional, but both are required if present. When both fields are populated, the Process Rule that gets created during this process will have the “Apply only if SOJ is” option turned on with the corresponding State and SOJ Source.
- RxLogic Standard Claim Submission Version 2 (22389) – A new version 2 of the Claim Submission File was created, improving on many aspects of the file. Version 2 is selected via the UseLayoutVersion2 option on the job itself. The legacy format is still supported with this option unchecked.

Supported new fields are:
- For Tagging and Behavior Modification
  - IsHistorical
  - SenderId
  - Keyed
  - SelfPay
  - IsTest
  - IgnoreAccumulators
  - AutoReverse
  - ExemptFromPayables
- New NCPDP Elements
  - Transaction Type
  - OCC
  - Incentive Fee
  - Submission Clarification Code
  - Quantity Prescribed
  - Prior Authorization Number Submitted
  - Diagnosis Code
  - Diagnosis Code Qualifier
  - Other Payer Id
  - Other Payer Id Qualifier
  - Other Payer Date
  - Other Payer-Patient Responsibility Amount
  - Other Payer-Patient Responsibility Amount Qualifier
  - Percentage Sales Tax Amount Submitted
  - Percentage Sales Tax Rate Submitted
  - Percentage Sales Tax Basis Submitted
An updated file spec is available for the new layout.

Billing & Fee Mgmt

Payables Manager
- Combined Claims / Claim Summary - Add Paid Dispensing Fee / Fix Submitted (22693) – On the Combined Claims / Claim Summary report that comes out as a part of the Payables process, the Submitted Dispensing Fee field on the report is now properly populating with the Submitted Dispensing Fee. A new field for Buy Dispensing Fee was added to the end of the report to represent the Dispensing Fee value paid to the Pharmacy.
- Wizard Performance Improvements and Workflow Changes (22982 / 22983 / 23132 / 23135 / 23138 / 23139) – This release includes a series of UI enhancements and backend endpoint changes across the Payables workflow for the purpose of overall performance and stability improvements.
- On Step One of the wizard, data retrieval was updated for the population of the Billing Cycle Start and End Dates to speed the retrieval of this data.

Step Two of the wizard was updated to utilize a new endpoint for data access and brings with it the biggest change in User Experience in that the Step 2 to Step 3 transaction now assigns transactions into a Batch. Previously, this happened on Steps 3 into Step 4. While this is occurring, a pop-up box appears to show the step in the process being performed. The process that assigns Transactions to the Batch was also updated to reduce the runtime of this operation. Once completed, the wizard advances to Step Three.

Step Three now shows transactions assigned into the Batch but otherwise remains the same. The transition of Step Three into Step Four via the Generate Payments button now immediately moves to Step Four allowing visibility into Payments as they are created, as well as Vouchers.

Note: As Step Three now reflects Transactions assigned to a Batch, the Previous button can be used to go back to Step Two, removing the Transactions from the Batch and starting the Transaction selection process over. When clicked, a popup message appears saying " This will return you to Step 2, resetting the Transactions assigned to the Batch. You will be able to re-select the Transactions on Step 2. Continue?". Once the necessary data cleanup is completed, a "Batch successfully reset. Returning to Step 2.” message appears.

Change Monitoring of Job on Step Four (23140) – Step Four of the Payables process shows Payments and Vouchers created during the processing of a Batch. Previously, this step may have indicated all Payments were created prior to the job finishing, and the check that determines job completion was updated to make sure all Payments and Vouchers were created prior to allowing the user to move on to the next step. As a part of this change, a better indication is now given when the processing is complete, but no Payments or Vouchers were created.

Receivables Manager
- Receivables – Step One Update (22982 / 23131 / 23136) – This release includes a series of UI enhancements and backend endpoint changes across the Receivables workflow for the purpose of overall performance and stability improvements. The only user facing changes in the 1.16.5 are an update to Step One of the wizard for data retrieval of the Billing Cycle Start and End Dates.
- Additional changes will be made to Receivables to match the workflow updates in Payables as a part of the next release.

Help & Support

Release History
- Release Notes: Add Notes (23133 / 23134) – Added the 1.16.3 / 1.16.4 Release Notes.

Database

New Fields
- The following new fields were added as part of this release:

Database / Table	Table	Field	Data Type	Length
Tx	TransactionResponseMessages	TransmissionId	uniqueidentifier
Tx	TransactionResponseMessages	F4Message	nvarchar(MAX)
Tx	TransactionResponseMessages	FQMessage	nvarchar(MAX)