Skip to main content

Drug Plans — Screen Catalog

Six windows in the drugplan library, plus one related screen in clmutils. Menus: m_drugplan_member_maint, m_drugplan_plan_maint, m_drugplan_report_transfer, m_drugplan_selection, m_drugplan_other_maint.

w_drugplan_member_maint — "HOMER - Prescription Plan Member Maintenance"​

MDI sheet (w_sheet), menu m_drugplan_member_maint. The workhorse screen for staging member transfer records. Source: drugplan/w_drugplan_member_maint.

  • Opened from: enrollment maintenance after a Drugs election change (enroll/w_enrollment_maintenance, wf_request_prescription_tsfr; also enroll/w_quick_enroll_main), receiving group id, subscriber SSN, plan type and drug election effective date; or standalone (defaults to PCS).
  • Controls: plan-type radio group ("PCS", "RX Claim Drug", "RX Benefits", "EXP", "RESTAT"); Social Security # edit mask; Member ID edit mask (added 05/02/2008); Coverage Active Date; read-only plan info fields (Plan ID / Client ID, Carrier, Named Dep, Group ID, Coverage Code, Level); dw_members edit grid (DataObject swaps per type: d_drugplan_pcs_member_edit, d_drugplan_pcs_std_member_edit, d_drugplan_pcs_rxb_member_edit, d_drugplan_exp_member_edit, d_drugplan_restat_member_edit); dw_transfer_file listing existing staged rows (d_drugplan_pcs_trans_members, d_drugplan_pcs_std_trans_members, d_drugplan_pcs_rxb_trans_members, d_drugplan_exp_trans_members, d_drugplan_restat_trans_members); a mode label ("Member Add Mode" / "Member Edit Mode").
  • Menu actions: m_drugplan_member_maint provides a Retrieve Members toolbar item and an Edit action (ue_edit_member); the companion m_drugplan_selection menu offers Add Member / Edit Member / Delete Member toolbar actions delegating to window events (drugplan/m_drugplan_member_maint, drugplan/m_drugplan_selection).
  • Behavior: retrieve validates SSN/member id and coverage date, loads plan info (uf_get_drug_plan_info), then either lists existing staged rows or auto-builds add rows for subscriber + eligible dependents; per-type dropdowns (PCS action codes from codes PCSAction via dddw_pcs_action_codes; PCS dep codes computed from the plan's age limits in wf_populate_pcs_dep_codes; EXP dependent-coverage codes dddw_exp_dep_coverage_codes, remarks dddw_drugplan_exp_remarks). Save inserts into the vendor staging table with duplicate-batch detection and overwrite prompt. Business rules DRG-3..DRG-8, DRG-11..DRG-21 (see index).

w_drugplan_report_transfer — "HOMER- Prescription Plan Reports and Tranfers"​

MDI sheet, menu m_drugplan_report_transfer. Reports staged rows and writes the PBM transfer files. Source: drugplan/w_drugplan_report_transfer.

  • Controls: "Drug plan type" drop-down (d_drugplan_list over dddw_drugplan_list, values from codes code_key = 'DRUGXFER'); full-window census report dw_report (per type: d_drugplan_pcs_report, d_drugplan_exp_report, d_drugplan_restat_report, d_drugplan_pcs_std_report, d_drugplan_pcs_rxb_report). Hidden developer controls (dw_2..dw_5, cb_1 "RXB" full-file button, row-count labels) are set invisible at open.
  • Events: ue_retrieve (populate report, "Zero Rows" message when the staging table is empty); ue_create_transfer (warns that exported rows are deleted, then dispatches by type — PCS → ue_create_pcs_transfer, EXP → ue_create_exp_transfer, RESTAT → ue_create_restat_transfer, RX_CLAIM → ue_create_pcs_std_transfer_cvs, RXB → ue_create_pcs_std_transfer_rxb); dead legacy events ue_create_pcs_transfer_old, ue_create_pcs_transfer_old_20100128, ue_create_pcs_std_transfer.
  • Behavior: each export event snapshots the staging table, prompts for the output file (paths from HOMER.INI pcs_path/exp_path/restat_path), writes the fixed-width file (layouts in the index page), then deletes staged rows and commits. Rules DRG-9, DRG-10, DRG-22; layouts per vendor.

w_drugplan_plan_maint — "HOMER - Prescription Plan Maintenance"​

Popup (w_popup), not resizable. Maintains drug_plan_exts per plan type. Source: drugplan/w_drugplan_plan_maint.

  • Controls: plan-type radio group ("PCS", "RX Claim Drug", "RX Benefits", "EXP", "RESTAT"); Coverage Type (fixed "Drugs"); Coverage Code drop-down with dropdown-search (d_drugplan_coverage_codes over dddw_drug_coverage_codes — coverage codes in drug_plan_exts for the selected plan type); buttons Retrieve Plan, Save, Delete; plan detail dw_plan_maint (d_drugplan_plan_maint: named dep flag, dependent age limits, PCS plan id/carrier/eff date/account, EXP plan id, Restat customer/client ids); "Groups Using Coverage" list (d_drugplan_groups_by_coverage).
  • Behavior: retrieving an unknown coverage code offers to add the plan (ue_add_plan pre-fills coverage type Drugs, code and plan type; RESTAT forces named-dep Y); Save updates and commits with success/failure message; Delete confirms ("changes are saved immediately") then deletes and commits. EXP named-dep-flag change defaults the non-student age to 19 (itemchanged). Rules DRG-1, DRG-2.

w_drugplan_other_maint — "Non-PCS/Express Scripts Drug Plan Maintenance"​

MDI sheet, menu m_drugplan_other_maint. Assigns benefit coverage codes to "other" drug plans (codes table DRUG_PLAN). Source: drugplan/w_drugplan_other_maint.

  • Controls: Drug Plan drop-down (d_drugplan_other_select / dddw_drugplan_other_select), Filter and Show All buttons, display grid d_drugplan_other_maint (drug_plan_exts joined to codes, restricted by user/group security — DRG-25), row-selection and column-header-sort services.
  • Behavior: Add opens w_drugplan_other_add; rows returned are inserted with the chosen plan code and named_dep_flg = 'N'; Save updates drug_plan_exts and commits; Delete removes all selected rows.

w_drugplan_other_add — "Add Plans"​

Response window opened from other-maint Add. Source: drugplan/w_drugplan_other_add.

  • Controls: Group ID entry (validated against groups), Drug Plan drop-down, checklist of the group's coverage codes (d_drugplan_other_add, retrieved by group), Done / Cancel.
  • Behavior: Done returns the checked coverage codes (via datastore d_drugplan_other_pass) to the calling window; requires a drug plan selection and at least one checked row.

w_drugplan_other_save — "Non-PCS/Express Script Drug Plan Enrollment Export"​

Response window; full-population enrollment export for "other" plans. Source: drugplan/w_drugplan_other_save.

  • Controls: Drug Plan drop-down (d_drugplan_other_select), Save, Done.
  • Behavior: only VALUERX is implemented (of_savevaluerx): retrieves every member on a ValueRx plan (d_drugplan_other_members, plan type 'VALUERX'), writes 177-byte records (SSN + dep code + SQL-preformatted remainder) to a *.vrx file defaulted from INI key valuerx_path, incrementing child dependent codes per family; reports the record count. Rules DRG-24.

clmutils/w_caremark_non_claim_record — "Caremark Non Claim Records"​

Related screen in the clmutils library (menu m_moon_in_reprice_menu); the inbound side of the Caremark interface. Source: clmutils/w_caremark_non_claim_record, clmutils/d_caremark_non_claim_record_report.

  • Controls: Number Of Days To Search (default 7), Claim ID filter, Processed Date filter, Status radio (Active = processed_ind 'N' / Complete = 'Y'), Search, Clear; report grid over caremark_edi_table union query (record status Processed / 2 claims found / 1 claim found).
  • Behavior: editable columns are processed_ind, matching_claim_id, affected_claim_id; double-clicking a claim id locks the claim and opens the claim editor; Save updates and commits. Rule DRG-26.
  • m_drugplan_selection: Drug Plan menu with Add Member / Edit Member / Delete Member toolbar items delegating to window events (drugplan/m_drugplan_selection).
  • m_drugplan_member_maint: Retrieve Members toolbar item plus Edit → ue_edit_member (drugplan/m_drugplan_member_maint).
  • m_drugplan_report_transfer: adds a "Member Transfer" menu with "Create Transfer" (toolbar "Create Transfer File" → ue_create_transfer) and a Retrieve toolbar item (drugplan/m_drugplan_report_transfer).
  • m_drugplan_plan_maint, m_drugplan_other_maint: standard frame menus with Save enabled.