|
Update Type |
Minor |
|
Update Description |
This version update includes stabilization and performance items and various bug fixes. Added Features:
|
|
Version Number |
1.17.6 |
New Development
The New Development section of the Release Notes is dedicated to work items (User Stories, Tasks, etc…) that are new functionality that was not in previous versions of the application. This section has additional information and details that the Bug Fixes section does not have. If you have additional questions on any of the new functionality, please ask your RxLogic Client Manager or check out the User Guide for the new documentation.
Claim Processing
Addition of new Prescriber Information ToolTip (26907) – On the Prescriber tab Prescriber ID field, a new tooltip displaying Prescriber Name or Organization, NPI, Prescriber Phone Number, Prescriber State was added.
Compound Product Id (TE) Field Enhancements (26910) – The Compound Product ID (TE) field on the Compound tab of the Claim Processing screen now includes a Search option and a link to access “Go to Drug Lookup”.
Formulary Manager
Add Show Where Used Button (26927) – A "Show Where Used" button was added to the Formulary Manager. Clicking it opens a pop-up displaying all tabs where the corresponding Formulary is configured, with links to its associated rules.
Member Manager
Improved Timeline Reporting of Changes to Member record (27006) – Improvements were made to the Timeline function to more completely display adds and updates related to the Member, including the following cases:
- Creation of a member
- Changes to demographics of a member
- Creation, deletion, changes of member UDF
- Creation, deletion, changes of Workers Compensation details
- Creation, deletion, changes of Pharmacy Restrictions
- Creation, deletion, changes of Prescriber Restrictions
MPA Manager
Improved Timeline Reporting of Changes to MPA record (22689) – Improvements were made to the Timeline function to more completely display adds and updates on MPAs, including the following cases:
- Creation of a new MPA
- Changes to an existing MPA
- Attachment of a Process Rule to an MPA
- Changing how a Process Rule is attached to an MPA
- Deleting a Process Rule from an MPA
Job Manager
New Validation for Standard Eligibility (25518) – For the error “No Primary Member Exists”, the standard eligibility logic was updated to prevent Dependents with no Primary. The import validation was updated to only load members with 02 (or greater) person codes if a related 01-person code member exists, or if the 01 is also listed on the incoming file. An example of this validation is below.
Claim History Import Job - Perform on System Duplicate Checking Prior To Netting (24799) – The on system duplicate check was moved to occur prior to the use of netting logic. This check now performs the on system duplicate check on the first instance of a transaction key (Pharmacy, Rx, DOS, NDC, Fill Number, Transaction Type). For example, in the left screenshot below, the file started with 3 Paid transactions using the same key, but a Paid transaction for the key already existed on system. As a result, the 3 Paids are errored out. Netting would be performed against the remaining non-errored transactions.
The on system duplicate check is now constrained to the first instance of the key. If a sequence of Paid Paid Reversed Paid were provided on a file, only the initial Paid Paid would be evaluated by this check. The on system duplicate check can still be bypassed by using the Bypass Duplicate Transaction Check option on the job.
Payables manager
Add New Field "Website" To Org. Info (27012 / 27351) – A new field called 'Website’ was added to the Org Info screen in PayRec. This field will be used for future report customization.
MEMBERSUMMary api
Addition of “IncludeInactiveMembers” (26800) – A new parameter of “IncludeInactiveMembers” was added to the MemberSummary API. This parameter is optional, and when on will return members with no active coverage.
New Fields
The following new fields were added as part of this release:
|
Database / Table |
Table |
Field |
Data Type |
Length |
|
Enrollment |
GroupRxLimits |
MaxDollarLimitRejectCode |
varchar |
3 |
|
Payrec |
PayRecOrganizations |
WebsiteUrl |
varchar |
255 |
|
Payrec |
SourceFileDatas |
OPAR |
decimal |
18,2 |
Bug Fixes
The Bug Fixes section of the Release Notes documentation is dedicated to existing functionality of the application that had a defect or system issue that was preventing it from functioning properly. No new functionality should be included in this section, so if you are not sure how a particular screen or area should be working, please refer to the User Guide for additional information.
Logout
- Resolved a logout error by eliminating an API call attempting to get the latest Transaction time. (27445)
Paid Claim Lookup
- Improved performance of the Paid Claim Lookup and performed load testing was performed against data sets of 500,000 to 1,000,000 transactions. A new message appears on the larger queries to indicate the search is still in progress to discourage users from attempting to retry the search while it is still occurring. (24118 / 27456)
Adjudication
- Fixed an issue where MPA Max Quantity Override for Restriction Rule was not overriding Unit Quantity of Restriction Rules. MPA’s are now compared against Restriction Rule Unit Quantity by the MPA Max Daily Dose. (26883)
- Resolved an issue where a Bill Cost Calculator using a Cost Calculator that uses a Cost List was not appropriately adjusting the dispense fee from the Cost List. In this scenario, the percentage applied to the Cost List via the Cost Calculator attachment was not properly adjusting the sell side dispensing fee. This will now be uniformly applied. This logic has no impact on Dispensing Fees applied directly to the Bill Cost Calculator itself. (27010)
Claim Processing
- Fixed an issue where clicking “Go To Most Recent Transaction” in Claim Processing left the Status box empty on the linked transaction. (27120)
- Fixed a missing parenthesis in the message display related to the Over Max Dollar Limit Reject message. (27534)
Drug Lookup
- Fixed an issue where searching by Drug Name would not accept integer-only queries. (27105)
- Resolved an issue on the Drug Lookup screen where an error of "Please enter a filter parameter before searching" would be displayed after the user performed a search on the NDC or GPI tab and then switched to the Drug Name tab. (27123)
- Resolved an issue in the Claim Activity's Response Tab, Accumulators section, where clicking the “i” icon displayed incorrect maximum benefit amounts if the Group had a plan from a previous year with different maximums. (27179)
Formulary Manager
- Re-instated Auditing of the Formulary import, resolving a prior issue where the process experienced issues on files with larger formulary lists. (27007)
Import Manager
- Resolved an issue where users without read permissions for Import Manager were able to access the Import Manager page. (27446)
Member Search
- Fixed an issue where exporting Member Search results only included the current page instead of all data. (27119)
- Resolved an issue where the maximum benefit limits displayed in both the Member Benefit Summary box and the Show Details section were calculated using the incorrect date when an end date of 12/31/2025 was present alongside another group with an effective date of 1/1/2026 and different benefit amounts. This problem affected only users in the Eastern Time zone. (27113)
- Fixed an issue where the SDC Adjustment amounts were not showing in the View Accumulator view, accessible by clicking on a record on the Accumulator Detail screen. (27352)
Group Manager
- Fixed an issue where changing a group’s plan termination date via the Group Plan TermDate Update window caused the Deductible, OOP, and Benefit Cap value fields on the Plan record to be cleared. These values are now properly retained. (27177).
Plan Manager
- Fixed an issue where tabs within the Plan Manager were not displaying results if a plan was opened, the green back arrow was used to return to the search results, and then another plan was opened. This would result in the Process Rules or Pharmacy Network tabs not displaying any data. (27121)
DUR Manager
- Fixed an issue on how the MED calculation was determined on patches to prevent the value being undercounted when the patch was used over multiple days. (26915)
Rules & Calculator
Process Rules
- Fixed an issue where the Process Rule had a rule for “Reject with Code” that would disappear when a user changed the Rule Type. (27372)
Billing & Fee Mgmt
Payables Manager
- Fixed an issue where output files download button “Released” from the Batch ID screen would not download properly if the name had an apostrophe in the name. (26938)
Production HotFixes
System wide
TIMELINE AUDIT
- 1.17.4 – Removed a prior implementation of code designed to improve timeline performance. A revamped version of this code was included in the 1.17.5 release. (27316 / 27488)
Group Manager
- 1.17.5 – Added a new "Max Dollar Reject Code" option in the Date Driven Options section on the Limits tab of the Group Manager screen. This feature provides a dropdown menu containing the standard reject code list, allowing selection of an alternative reject code to be applied in place of the default code 78. (27452 / 27499)
Cost List
- 1.17.5 - Fixed an issue were dispense fees in nested Cost Lists were not being added to claims. This allows a parent Cost List to have no dispense fee but a nested child cost list to have one and be included in calculations. (27115)
SDC MAnager
- 1.17.5 - Fixed an issue where Lifetime SDC accums were resetting on the benefit year. (27309)
Receivables Manager
- 1.17.5 - Other Payer Amount Recognized was added to the Billing Cycle Extract and Import in Payrec. Invoices for clients using OPAR now subtract this amount from the Ingredient Cost. (27330 / 26937)
Global Defaults
- 1.17.5 - A new global default option, "Compounds - Skip NDC 0 Check," was introduced. When enabled (set to True), this option allows compounds with a nonzero NDC in the Product/Service ID field (D7) to bypass a new validation that rejected compounds submitted with a non-zero value. (27360)