by Lori | Sep 15, 2010 | Medicare payment basics
NCPDP 5.1 ERROR CODES Error Code Explanation Ø1 M/I Bin Ø2 M/I Version Number Ø3 M/I Transaction Code Ø4 M/I Processor Control Number Ø5 M/I Pharmacy Number Ø6 M/I Group Number Ø7 M/I Cardholder ID Number Ø8 M/I Person Code Ø9 M/I Birth Date 1C M/I Smoker/Non-Smoker...
by Lori | Sep 15, 2010 | Medicare payment basics
NCPDP 5.1 ERROR CODES Error Code Explanation AA Patient Spenddown Not Met AB Date Written Is After Date Filled AC Product Not Covered Non-Participating Manufacturer AD Billing Provider Not Eligible To Bill This Claim Type AE QMB (Qualified Medicare Beneficiary)-Bill...
by Lori | Sep 14, 2010 | Medicare payment basics
NCPDP PROVIDER ID AND NPI APPLICATION
by Lori | Sep 14, 2010 | Medicare payment basics
NCPDP Standardizes Electronic Claims for Pharmacy In 1989, NCPDP developed the “real time” Telecommunication Standard v1.0 By HIPAA Final Rule in 2000, 98% of all “third party” prescription drug claims processed using v3.x. HIPAA required v5.1. Transactions...
by Lori | Sep 14, 2010 | Medicare payment basics
Administration of Complex Drug Benefit Designs NCPDP Tiered Copay Proliferation of Prescription Drug Plans Drug Utilization Review – movement to perform concurrent reviews and not just reports. How to Administer Drug Benefit Limitations & Formularies? Industry...