IIAS System Update

We continue to see a very positive overall response to the IIAS technology. Since December 1, 2007, we have seen over 500,000 IIAS formatted transactions. Of those transactions, roughly 97% have been successfully authorized. As we have communicated, we have seen some issues with the overall IIAS technology since going live. This email is aimed at providing an update to some of the known issues we are experiencing.

On January 22, 2008 we will be releasing an update to BPS to address the identified IIAS system issues. The changes being made are outlined below:

  • Currently BPS does not display IIAS transaction information when Healthcare Eligible Total (HET) equals $0. This does not mean that the transaction is not coming from a valid IIAS Merchant, only that the amount eligible is $0. BPS will be updated to show IIAS transaction information even when HET = $0.
  • In some cases BPS is displaying a ‘LOW FUNDS’ error for IIAS transactions that are declined due to the fact that the HET = $0. The BPS will be updated to distinguish transactions actually denied due to low funds versus IIAS related declines.
  • Currently, the process that automates removal of the non-medical MTC codes from active or future plans does not include MTC 5300. This is because 5300 is not one of the BPS default MTC codes. However most Administrators chose to manually add this code into plans when Wal-Mart/Sam’s club rolled out their real-time solution in early 2007. BPS will be updated to include 5300 as one of the non-medical MTCs being removed via the automated process. Additionally, we will remove this code from any current plan for which the non-medical MTCs have already been removed via our automated process. If you would like 5300 to be included in any plan that this process will impact, you must manually add it back to the Plan MTCs. The complete list of affected plans is available in the IIAS User Guide. This process will take place during our night-time update on January 22, 2008.

Below are some additional IIAS issue updates that you should be aware of:

  • We have received additional information from Wal-Mart regarding the previously reported issue limited to a specific terminal within each store pharmacy. Attached is the official communication from Wal-Mart with an update.
  • Safeway has determined that the large number of transaction denials is due to a training issue with how Pharmacists were keying in some IIAS transactions at their stores. The result was that in some cases custom prescriptions were being keyed using a generic SKU not flagged as eligible and therefore the HET was coming across as $0. They have confirmed that they are working to address this.
  • Administrators have been challenged in identifying which merchants can authorize RX only amounts and which cannot. SIGIS has indicated that they will add this information to their merchant list.
  • The SIGIS website has the most recent list of eligible merchants (www.sig-is.org). The merchant listing and status updates are made daily so we recommend you check this site often for updates. Those indicated as LIVE are sending IIAS transactions. Some Merchants have an implementation date range. This indicates that their implementation is rolling and may take a period of time to fully complete across all locations. You will also note that the document contains the last update date.
  • Currently all LIVE IIAS merchants are SIGIS certified. There are many reasons why a transaction may decline at the point-of-sale. However, none of these denials are due to the merchant not being certified. If you believe that a transaction declined due to the lack of an IIAS system in place at any given merchant, please refer to the SIGIS Merchant list on-line to check if they are LIVE. If the merchant is LIVE the transaction is declining for another reason.
  • Please keep in mind that in order to start receiving IIAS transactions you must make a request through your CDM to enable IIAS functionality. Once enabled, you will need to roll-out the functionality to current plans using the automated process. Your CDM can help you with these steps.

We are continuing to research issues as they are reported. It is important to note that IIAS issues may not be the only reason for a transaction denial. When reporting a transaction denial to BPS, please include as much information as possible. If possible, please try to obtain a receipt from a participant if another form of payment was ultimately used to complete the transaction. This will help us work through the various channels to arrive at a resolution.

Source: Healthcare Payment Solutions Group