Certified Payors. How to set a Carrier to NCPDP D.0: QUESTIONS?
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- Harold Osborne
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1 Certified Payors As payers confirm their ability to accept D.0 claims we will be updating the list below with the BIN information and date of availability. Bookmark this page so you can check it frequently. Payer/Carrier 4D d/b/a Medtipster Adjudicated Marketing Alaska AmeriHealth Advantage Anthem Argus Discount Plan Blue Cross Blue Shield Northern Alliance BCBS of Delaware / DN30Y / DN30Y D / DN30Y / DN30Y / DN30Y / DN30Y BSCA / DN30Y BSCA Commercial BSCA Local / DN30Y / DN30Y BSCA PDP / DN30Y Carefirst / DN30Y Carefirst / DN30Y Caremark /17/2011 D Caremark /17/2011 D Caremark /17/2011 D Caremark /17/2011 D Caremark /17/2011 D Caremark /17/2011 D Caremark /17/2011 D Caremark /17/2011 D Caremark /17/2011 D How to set a Carrier to NCPDP D.0: Set the CAM Billing Parameters Format to NCPDP D.0 Set Claim Type Overrides Format to NCPDP D.0 Set CAM Templates for Carrier to NCPDP D.0 (This option is now available on the Pharmaserv Utilities Menu.) HIPAA X Compliance: 835 Health Care Claim Payment/Advice. Pharmaserv Chain Host reconciliation is the only application affected by this change and minor changes to accommodate this are included in our next release, and will be available prior to the 1/1/2012 due date. Express Scripts Compound Rx Processing Note: Pharmacies are required to sign an Express Scripts Compound Claims Contract Exhibit in order to process compound claims starting 1/1/2012. This must be on file at Express Scripts by 12/23/2011 or all compound claims will be rejected. QUESTIONS? If you have any questions regarding the best way to upgrade your system, please call Pharmaserv Customer Support at Caremark /17/2011 D
2 Caremark /17/2011 D Caremark /17/2011 D Great West Commercial Great West TPA International Medicare PDP Part D Pharmacy Services / DN30Y / DN30Y / DN30Y / DN30Y / DN30Y Clarian / DN30Y Connecticut Contra Costa Contra Costa Select Care Envision Rx Options Essence Health Plan Express Scripts Florida FutureScripts PDP Gateway Gateway Geisinger Geisinger Humana (Commercial) / DN30Y / DN30Y , , , , / DN30Y , , , , , , , , , , , D / DN30Y / DN30Y / DN30Y / DN30Y / DN30Y / DN30Y
3 *Humana LI NET / DN30Y *Humana Part D / DN30Y Idaho /12/ D002 Illinois University Health University s Kentucky Kern Health Systems Keystone Mercy Health Plan KMHP Lovelace, Inc. Lovelace Health Systems, Inc /17/ / DN30Y / DN30Y /1/ D / DN30Y / DN30Y / DN30Y / Curent 601DN30Y MDWise / DN30Y Medco , , , , /PRODUR1 UDO Medi-Care First / DN30Y MercyCare Insurance Corporation Michigan Nebraska Neighborhood of Rhode Island / DN30Y /14/ D / DN30Y New Benefits / DN30Y North Carolina New York EPIC D002 New York Magellan D002
4 North Carolina Oklahoma /28/2011 Omnisys All 1/1/ Oregon /1/2012 PA Pace PAN00032 Advantage Physicians Plus Insurance Corporation Solutions Prime Therapeutics / DN30Y / DN30Y / DN30Y / DN30Y ; ; ; ; ; ; Priority Health / DN30Y Priority Medicare & Medicare Plus Priority Medicare Rx Medicare Extra Pharmacy Bridge Program Rhode Island / DN30Y / DN30Y / DN30Y / DN30Y / DN30Y RxEDO / DN30Y Scott & White Senior Care Rx White White HMO White PBM South Carolina / DN30Y / DN30Y / DN30Y / DN30Y D002
5 Select Health / DN30Y State of CA PBM: CDRC DAPO & CDCR DJJPO SXC/American Health Care SXC/Informed RX National SXC/Kroger s Plans SXC/Teamster RX / DN30Y /1/ , , , , , , , , /1/ /1/2012 SXC/Welldyne /1/2012 Tennessee /1/2012 Texas Valley Baptist ASO Valley Baptist HMO / DN30Y / DN30Y VRx / DN30Y Washington DC D002 Washington /1/2012 Wisconsin *Note: Humana Part D and Humana LI Net was BIN for 5.1 claims.
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