RxLogic PBM Application Update
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Update Type |
Minor |
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Update Description |
This version update includes stabilization and performance items and various bug fixes. Added Features:
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Existing Feature Behavior Changes |
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Version Number |
1.18.5.2 |
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Production Release Date |
7/14/2026 |
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UAT Release Date |
6/29/2026 |
New Features
The New Features section of the Release Notes is dedicated to work items that are new functionality that were not in previous versions of the application. If you have additional questions on any of the new functionalities, please reach out to your RxLogic CSM.
Claim Tab
Adjudication
Option to Calculate SFS on Rejected Transaction (33595) – A new Global Default, Adjudication – Calculate SFS on Rejections, was added. When set to True and active within its effective date range, the State Fee Schedule (SFS) Calculations will still calculate and all associated pricing when the Transaction would otherwise reject. Transactions that occur prior to the lookup of key information such as Pharmacy, Drug, and Member will still not perform this calculation.
Please Note: Plans already using the Capture All Rejects for Non Compounds will calculate the SFS regardless of the Global Default setting.
Paid Claim Lookup
Hide Buy Side Related Fields (33116 / 33117) – A new “Custom-Control-Global: HideBuySidePricing” app area was added. When added to a user, visible information on the Paid Claim Lookup is reduced.
The following elements on Paid Claim results grid and related export are hidden:
On the Paid Claim Detail screen, the following is changed:
The following fields are hidden on the View Compound Details screen:
Transaction Details
Hide Buy Side Related Fields (33118) – A new “Custom-Control-Global: HideBuySidePricing” app area was added. When added to a user, they are no longer able to see the following information on the Transaction Detail results grid and related export:
On the Detail Page, the following changes are made:
The following fields are hidden on the View Compound Details screen:
Claim Activity
Hide Buy Side Related Fields (33134) – A new “Custom-Control-Global: HideBuySidePricing” app area was added. When added to a user, their view is changed by:
Claim Processing
Hide Buy Side Related Fields (33135) – A new “Custom-Control-Global: HideBuySidePricing” app area was added. When added to a user, the Claim Processing screen will be altered by:
The following fields are hidden on the View Compound Details screen:
Member Tab
MPA Manager
Add "Only Apply to Test Claims" to Search Grid, Color Coding, and Export (32045) – Better indicators of if an MPA only applies to a test transaction were added. The “Only Apply to Test Claims” setting is now a selectable column for the grid, and MPAs with it turned on are now highlighted in yellow. The “Only Apply to Test Claims” field is also available in exports when included in the selected grid columns.
Member Search
Show MPAs - Add Color Coding for Test MPAs (32047) - Color coding was added on the Show MPAs screen for MPAs with the “Only Apply to Test Claims” setting enabled. These records now show with a light-yellow highlight. This change was applied to all locations of the Show MPAs screen.
Hide Buy Side Related Fields on Claim History Screen (33134) – A new “Custom-Control-Global: HideBuySidePricing” app area was added. When added to a user, they are no longer able to see the Pharmacy Paid and Patient Paid field on the Claim History screen. Additionally, the Show Accumulator option is hidden in this location.
Both the Regular and WC exports were updated to remove the Patient Pay, Group Id, Plan Id, and Member ID fields. The Regular export Total Pay field was also removed.
This update applies to all locations where the Claim History screen can be accessed.
Plan Design Tab
Carrier Manager
Alternate Pay To Name in Payment Information (32285 / 32532) – A new “Alternate Pay To Name” field was added to the Payment Information section of the Carrier record. When the Billing Entity for the Carrier is set with the “Use Carrier as Pay To” option, the Carrier’s information is used to set the Pay To related information. In this case, the Alternate Pay To Name is used in place of the Carrier’s Name for the Pay To Name if populated, otherwise the Carrier’s Name is used.
Rules & Calculators Tab
SDC Manager
Multiple SDC Support (31795) – Adjudication now supports applying multiple Special Deductibles and Caps (SDCs) to a single transaction. When a transaction qualifies for more than one SDC, each is evaluated and accumulated independently. When multiple SDCs are met on a single transaction, the final copay is determined by the last evaluated SDC in the processing sequence. Up to three SDCs can be processed per transaction with any additional SDCs beyond the first three ignored and noted in the transaction rules.
Files and Jobs Tab
Application Wide Batch Processing
General Enhancement to Batch Jobs
Version 1.18.5 introduces an upgrade to the platform across the Batch Jobs executed from the Job Manager, as well as Batch Processing jobs utilized in the Payables and Receivables modules. This upgrade provides long‑term support, improved performance, and enhanced security ensuring these functions remain modern, stable, and scalable.
RxLogic has been preparing this upgrade behind the scenes and has completed extensive testing to ensure a smooth transition. Our goal is for this update to be largely invisible to clients, while quietly strengthening the foundation that supports your day‑to‑day operations and future enhancements.
Job Manager
Job Monitor Emails - Include Environment Level (33669) – Job Monitor emails were updated to include the Environment level as a part of the notification. This helps distinguish Production vs. UAT environments.
Billing & Fee Mgmt Tab
Billing Manager
Add Drug Filters to Retail Tx Admin and Retail Tx Reversal Admin Fees (32970 / 33171 / 32971) – The ability to define drug-specific filters was added to the Retail Tx Admin Fee and Retail Tx Reversal Admin Fee options under Hierarchy Fee Setup. A new optional Drug Filters section is displayed when either of these fee options is selected, allowing specific NDCs and GPIs to be associated with the fee.
These fees are assessed during the processing of a Receivables batch and are not visible on the Billing Cycle Extract file. When assessing the fees, if a transaction applies to a drug specific fee for the Fee Type (Retail Tx Admin Fee), it will not count towards a fee of the same type that does not have a Drug Specific fee. This allows fees to be built where specific drugs receive a specific fee while still having a general fee that applies to all other transactions.
Help & Support
Release History
Added 1.18.4 Release Notes (33524) – Added the Release notes for the 1.18.4 version.
APIs
General
Use Group Effective Date for DOS Option (31559 / 31560 / 31561 / 31562 / 31563) – The following endpoints were updated with a new optional UseGroupEffectiveDateForDOS setting:
When set to True, the UseGroupEffectiveDateForDOS option automatically updates the Date of Service (DOS) on the request to the Effective Date of the Group if the Group’s Effective Date is in the future. This allows for easier use of the APIs for new Groups starting in the future.
Please Note: Future dating of transactions is only allowed on Pricing Requests and Test Claims. While the ClaimSubmit endpoint was updated to include this option, it is only able to submit live transactions currently that will reject for being Post Dated.
TestClaimSubmit
Option to Return Rule Information (33176) – The TestClaimSubmit endpoint was enhanced to include additional information and how the transaction processed. This includes:
TransactionData
Transaction Data API (33638) – A new Transaction Data API endpoint was added to provide access to recent transaction activity. The endpoint supports optional filtering by transaction type and returns up to the 50 most recent transactions based on adjudication date. Results are limited based on the permissions associated with the API key’s user group, and test/imported transactions are automatically excluded. For additional information, please consult the updated API documentation.
Database
New Fields
The following new fields were added as part of this release:
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Database |
Table |
Field |
Data Type |
Length |
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Tx |
Transactions |
SDC2RuleId |
int |
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Tx |
Transactions |
SDC2RuleName |
nvarchar |
128 |
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Tx |
Transactions |
SDC2RuleSource |
tinyint |
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Tx |
Transactions |
SDC2ProcessRuleId |
int |
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Tx |
Transactions |
SDC2ProcessRuleName |
nvarchar |
128 |
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Tx |
Transactions |
SDC3RuleId |
int |
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|
Tx |
Transactions |
SDC3RuleName |
nvarchar |
128 |
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Tx |
Transactions |
SDC3RuleSource |
tinyint |
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|
Tx |
Transactions |
SDC3ProcessRuleId |
int |
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|
Tx |
Transactions |
SDC3ProcessRuleName |
nvarchar |
128 |
Bug Fixes and Minor Enhancements
The Bug Fixes and Minor Enhancements section of the Release Notes documentation is dedicated to existing functionality of the application that had an issue or received a minor update or improvement.
Claim Tab
Adjudication
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Fixed an issue where the State Fee Schedule Dispensing Fee was not populated in the Transactions table when using a Cost List attached to the SFS Cost Calculator. The SFS Dispensing Fee now correctly populates in this configuration. (32832)
Claim Activity
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Updated the Export View option to include the Net Count column if selected in the grid. (33936)
Drug Tab
Drug Lookup
- Fixed a display issue in the Historical Drug Prices box where the termination date for the ACAFUL price would show as 1/1/1970 to 12/31/1969. (32409)
Formulary Manager
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Fixed an issue where the Export was only outputting the top 50 records of the Formulary instead of the full list. (33648)
Member Tab
Member Search
- Fixed an issue where the “Member Benefit Summary” window and the “Accumulator Detail” window were displaying inflated values upon multiple refreshes. (33540)
- Fixed an issue where duplicates for the same Member ID were returned if the Member had two separate Member IDs that shared the same key elements. (33635)
Pharmacy Tab
Payment Center Manager
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Fixed an issue where the Notes could not be used if the Payment Center ID contained alphanumeric characters. (32772)
Rules & Calculators Tab
Process Rules
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Updated the default integration for the Eligibility and Patient Pay Service to include a new OriginalTransmissionId field. This will contain the Transmission ID of the transaction being reversed on a reversal. (33610)
Files and Jobs Tab
File Manager
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Fixed the creation of a new directory to create an empty tmp.txt file. The file was created with data causing File Imports to potentially error. (33628)
Job Manager
- Member Merge – Fixed an issue where merging a member with many transactions caused a failure when attempting to insert a note for the member. The message is now truncated to stay within the max field length. (26802)
- Surescripts Export Jobs - Updated the Surescripts Formulary and Eligibility export jobs to report a successful status upon completion and to capture all expected log output. (26818)
- Standard Eligibility - Fixed an issue where print card requests were being created for coverageType changes when no coveragetype change occurred. (32820)
- Standard Eligibility – Improved performance of the Full file type eligibility with respect to determining the applicable CH Elig coverages. (32373)
- Billing Cycle Export - Fixed an issue where reversing a transaction with a Pay To override without submitting the Pay To Override on the reversal did not correctly populate the associated Pay To details in the billing export. The export will now consistently display the correct Pay To name and related information based on the Pay To ID. (33351)
Reporting Tab
Report Manager
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Fixed an issue where the "By Date" schedule options were not saving properly without a daily schedule already set on the report. (33350)
Billing & Fee Mgmt Tab
Payables Manager
- Fixed an issue where the Released Folder Download button generated an empty ZIP file when downloaded from Step 6 of the Payables Wizard and the Batch ID screen. The downloaded ZIP file now contains the expected released files. (13528)
- Fixed an issue in the Payables Manager where a new adjustment could not be created after viewing an existing applied adjustment as the fields would show as grayed out. (32318)
- Removed a database setting that could result in the starting Check Number being reset on deployment if the Check Number in the database was manually edited previously. This is not common. (33996)
Receivables Manager
- Improved performance of the Step 3 -> Step 4 grouping of transactions to their respective entities. (33478)
- Fixed an issue where invoice totaling on step 4 could fail if using the Per Member Per Day fee and there were no members in the billing entity. (33650)
Invoice Manager
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Updated the selectable Category Codes to just WriteOff and Adjustment types when adding or updating a Writeoff/Adjustment. (33500)
APIs
TestClaimSubmit
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Added new validation to return an error if no RxNumber is provided. Previously, a blank response was returned. The error detail is included in a new Errors attribute on the response. (31388)
HotFixes
The HotFixes section includes both Enhancement and Bug related information applied to an earlier version after the publication of their Release Notes.
Site Wide
- 1.18.4.2 – Added the following reject codes for use in dropdowns across the application:
- AD - Billing Provider Not Eligible To Bill This Claim Type
- 560 - Pharmacy Not Contracted In Retail Network
- 6Z - Provider Not Eligible To Perform Service/Dispense Product
- R6 - Product/Service Not Appropriate For This Location
- 690 - PDMP: Pharmacy Not Contracted
- 8J - Incorrect Product/Service ID For Processor/Payer
(33443)
Claim Tab
Adjudication
- 1.18.3.2 - Fixed an issue where rule trackers would not be captured on all subsequent transactions after a transaction that exceeded the max rule tracker length. These rule trackers are now captured. (33501)
- 1.18.4.2 - Fixed a regression issue that caused a 92 error to occur on groups using Bypass Member Enrollment. (33636)
Paid Claim Lookup
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1.18.3.2 - Fixed an issue where the Paid Claim Export DOS value was one day earlier than the expected DOS displayed in the results grid. (33462)
Rules & Calculators Tab
COB Rule
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1.18.4.2 – Fixed an issue where the CalculatedAmtMinusOPAR formula typically used with OCC 2 would not reduce the Patients remaining copay below the calculated amount when using flat copays. This will now reduce the copay if the Other Payer Amount Paid submitted has already reduced the Total Pay to the pharmacy. (33590)
Cost List
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1.18.4.2 – Fixed an issue where the CalculatedAmtMinusOPAR formula typically used with OCC 2 would not reduce the Patients remaining copay below the calculated amount when using flat copays. This will now reduce the copay if the Other Payer Amount Paid submitted has already reduced the Total Pay to the pharmacy. (33590)
Files and Jobs Tab
Job Manager
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1.18.3.2 – Claim Import – Updated lookups related to Location Code to improve performance. (33634)
Billing & Fee Mgmt Tab
Payables Manager
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1.18.3.2 - Increased the timeout for the excel version of the AP Summary Export and other minor timeout expansions. (33256 / 33602)
Receivables Manager
- 1.18.3.2 - Increased the timeout for the excel version of the AP Summary Export and other minor timeout expansions. (33256 / 33602)
APIs
General
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1.18.3.2 - Fixed an issue that caused CORs Policy to be enforced on Client facing endpoints. (33479)
LocationGroup
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1.18.4.2 – Corrected documentation to indicate GET filters use StartDate and EndDate instead of previously documented StartDateTime and EndDateTime. (33582)
PharmacyRadiusPricing
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1.18.3.2 - Fixed an issue that resulted in a 415 HTTP Response code being returned for URL encoded requests. This fix also applied to the MemberPharmacyRadiusPricing endpoint. (33565 / 34021)
ProcessTransaction
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1.18.3.2 - Fixed an issue that prevented the submission of a null “DateOfBirth”. (33520)