Bin 610014 pcn medicaid

bin 610014 pcn medicaid This notice is to remind providers that the Illinois Department of Healthcare and Family Services has adjusted the implementation date and time for the new Pharmacy Benefit Management System (PBMS). CDPHP (800) 388-2994. 004336 MCAIDADV RX5435 Molina coordination of benefits (COB) members 013089 COMESEGADV Group per Molina plans listed below Molina: MOLINA WA - AHFAM/IMC Aug 01, 2020 · The Centers for Medicare & Medicaid Services (CMS) released a compilation of the BIN and PCN values for each 2021 Medicare Part D plan sponsor. Keep your KHC Client ID ready when calling. LOYAL. O. 1Ø1-A1 BIN NUMBER Multiple M BIN’s listed in General Information Section 1Ø2-A2 VERSION/RELEASE NUMBER DØ M 1Ø3-A3 TRANSACTION CODE B1 M 1Ø4-A4 PROCESSOR CONTROL NUMBER Multiple M PCN’s listed in General Information Section 1Ø9-A9 TRANSACTION COUNT Ø1-Ø4 M Up to 4 transactions per B1 transmissions accepted PBM BINs Help Desk 4D Management Systems, Inc. Please note, the data below is Part 5 of 5 (H8634 - S9701) with links to Parts 1 through 4. AHCCCS Health Plans BIN PCN Group Number PBM Phone Number AHCCCS FFS 001553 AZM OptumRx 855-577-6310 AHCCCS FFS – Secondary to Commercial 001553 AZM OptumRx 855-577-6310 AHCCCS FFS – Dual Eligibles for Covered OTC Prescriptions 001553 AZM OptumRx 855-577-6310 United Healthcare Community Plan (Acute, CRS, DD, LTC) 610494 4100 ACUAZ OptumRx . 092220 v44 800. 1Ø2 -A2 VERSION/RELEASE NUMBER DØ M 1Ø3 -A3 TRANSACTION CODE B1 M 1Ø4 -A4 PROCESSOR CONTROL NUMBER Enter “WIPARTD” for SeniorCare , Wisconsin Chronic Disease Program (WCDP ), and AIDS/HIV Drug Assistance Program (ADAP) member s that are also enrolled in a Medicare Bank Identification Number (BIN) 016820 001553 Plan Type Medicaid Processor Control Number (PCN) P086016820 TNM New Member ID Yes Submitted Group (Group) . You can also directly call Express Scripts Pharmacy Help Desk at 1. If Commercial claims are submitted for groups that have transitioned with the old BIN or PCN, claims will reject with NCPDP Reject Code 01 (M/I BIN) and 04 (M/I Processor Control Number). The items highlighted in the payer Payer/Carrier BIN/PCN Date Available Vendor Certification ID North Carolina Medicaid 601312 Current Oklahoma Medicaid 010579 12/28/2011 Omnisys All 1/1/2012 522024 Oregon Medicaid 014203 1/1/2012 PA Pace 002286 Current PAN00032 Passport Advantage 012353/03650000 Current 601DN30Y Passport Health Plan 101-A1 BIN NUMBER See Values in General Information M 102-A2 VERSION/RELEASE NUMBER D0 M 103-A3 TRANSACTION CODE B1, B3 M 104-A4 PROCESSOR CONTROL NUMBER See PCN under general information M 109-A9 TRANSACTION COUNT 1-4 M 202-B2 SERVICE PROVIDER ID QUALIFIER 01 M 201-B1 SERVICE PROVIDER ID NPI M Medicaid Primary Billing Medicaid as Secondary Payer Billing Other Payer Patient Responsibility (OPPR) To prevent point of service disruption, the RxGroup must be submitted on all claims and reversals. plan id PAID, bin 610014, add 001 at the end AND . • Leading zeroes in the NCPDP Processor BIN are significant. 3 Filing Client PA Appeals 7 6. Will Your Insurance Pay schedule Your Prescription Drugs Here's reply BIN # PCN # FSNCVTY 610014 Not Applicable Member ID# First Script will provide Member upon verification of eligibility EMPLOYEE: First Script is valid only for medications prescribed for your work-related injury. com 6 336-8C Facility ID O 3Ø1-C1 Group ID R 3Ø3-C3 Person Code Ø1 R ALL (with noted exceptions) Number (PCN) Bin Number Additional Information Required for Pharmacy Claim Processing For eligibility information, plan policy and coverage questions For billing issues, claim processing questions and assistance with claim edits Affinity Health Plan (866) 247-5678 CVS Caremark (800) 364-6331 ADV 004336 Group: RX4212 Mar 20, 2017 · Provider Notice Issued 03/20/2017. BIN 61ØØ14 PCN MEDICAID Payer Confidential Information 61ØØ14 ØØ3858 MEDDPRIME A4 (or as assigned by Express Scripts) L a MEDCO Medicare Legacy Express Scripts Plan Values Table Plan Name L a ME-DCO Commercial e header, detail and trailer. 5 Processing Control Number (PCN) 5 4. 0 M 1Ø3-A3 Transaction Code B1=Billing M 1Ø4-A4 Processor Control Number As indicated above 1=One Occurrence 2=Two Occurrences 3=Three Occurrences M 1Ø9-A9 Transaction Count RxBIN 610014 RxGRP BCBSMRX1 XXXXXXXXX Group Number 01/2018 Issued Except for emergency care, you may be liable for a copayment if you receive services from a Blue non-network provider. PCN #: NOT APPLICABLE. 4 Bank Identification Number (BIN) 5 3. Elixir Payer Sheet D. Aug 01, 2020 · The Centers for Medicare & Medicaid Services (CMS) released a compilation of the BIN and PCN values for each 2021 Medicare Part D plan sponsor. Your patient will need a prescription for an over-the-counter drug to be covered by AlohaCare. Thank you. Oct 30, 2013 · BIN: 610014 (this is the unique identifier for the PBM or claims processor) PCN: The processor control number. Humana Drug might also called formulary lists the most widely prescribed drugs. You or your group health insurer are financially responsible for any other prescriptions. MC21 CORPORATION Bin Number ** 010868 Processor Control Number ** clie Varies according to nt Group Number ariesacc ording t client Pharmacy ID Number (Qualifier 01) ** Claim Billing and Response payer sheet (BIN 017522, PCN HH, effective 01/18/2021) Reversal payer sheet (BIN 017522, PCN HH, effective 08/13/2020) Is an innovative Pharmacy Benefit Manager that focuses on providing custom and tailored pharmacy benefit management services to its clients. Prior Authorization 7 5. Coronavirus Disease 2019 (COVID-19) causes respiratory illness in people and can spread from person to person. Aug 26, 2021 · AlohaCare covers all medically necessary Medicare Part D medications. Medicaid as Secondary Payer Billing Other Payer Patient Responsibility (OPPR) Medicaid as Secondary Payer Billing Other Payer Amount Paid (OPAP) To prevent point of service disruption, the RxGroup must be submitted on all claims and reversals. Member ID #: First Script will provide Member ID # upon verification of eligibility. Alaska Blue Cross 610014 800-922-1557 Alaska Medicaid 009661 P013009661 800-884-3238 Alaska Teamsters 400004 DPS 800-233-8065 RE: Unique BIN/PCN for Medicare Part D Effective: 6/27/12 The Centers for Medicare and Medicaid Services (CMS) has indicated that a unique Medicare Part D BIN/PCN combination must be utilized in network pharmacy electronic claim transactions. 1Ø1-A1 BIN Number 610014 M 1Ø2-A2 Version/Release Number 51 M 1Ø3-A3 Transaction Code B1 M 1Ø4-A4 Processor Control Number Anything but Zeros M 1Ø9-A9 Transaction Count 1-4 M 2Ø2-B2 Service Provider ID Qualifier Values 01 (NPI), 07 (NCPDP), or 99 (Medco) M 2Ø1-B1 Service Provider ID NPI #, NCPDP #, MEDCO # M 4Ø1-D1 Date of Service M 610014 MEDDPRIME PCNs: SPBLUE1, SPBLUE2, SPBLUE3. Number (PCN) Bin Number Additional Information Required for Pharmacy Claim Processing For eligibility information, plan policy and coverage questions For billing issues, claim processing questions and assistance with claim edits Affinity Health Plan (866) 247-5678 CVS Caremark (800) 364-6331 ADV 004336 Group: RX4212 Commercial and Medicaid BIN: 610494 PCN: 9999 Community Health BIN: 610613 PCN: 2417 ProAct BIN: 017366 PCN: 9999 FlexScripts/ProAct BIN: 018141 PCN: 9999 United Healthcare Community Plan of Texas BIN: 610494 PCN: 4400 United Healthcare Community Plan of Arizona BIN: 610494 PCN: 4100 MedalistRx BIN: 016580 PCN: <NA> Former Catalyst, informedRx . 0 M 1Ø3-A3 Transaction Code B1=Billing M 1Ø4-A4 Processor Control Number As indicated above M 1Ø9-A9 Transaction Count 1=One Occurrence 2=Two Occurrences 3=Three Occurrences 4=Four Occurrences M (BIN 61ØØ56 only allows TRANS COUNT = 1). 0. The items highlighted in the payer sheet illustrate the updated processing rules. Have them call the phone number on the back of their Cigna ID card. org. 1557 with any problems billing these services. 544-7948 610014; Group: HNRXS. Refer to telephone numbers. Pharmacy providers should ask members for an MCO identification card to verify MCO enrollment in addition to the Medicaid card. 304. The selection following Plan information is listed. Provider COVID-19 Information. Feb 13, 2020 · PLAN BIN PCN GROUP NUMBER Amerigroup 020107 CM WKHA Apple Health Fee-For-Service (FFS) 610706 WAPROD N/A Community Health 003858 A4 CHWA Coordinated Care of Washington, Inc. People of all ages can be infected. NCPDP Data Elements . Pharmacy Help Desk phone number: 800-922-1557. 2. . 6961, ext. All new claims and reversals will go through this BIN number, including reversals of claims previously submitted to FirstHealth Services Corporation. In addition, CMS included the following disclaimer in regards to this data: Provided for your convenience is our billing processing information. for assistance- 800 437-3803. 2 Emergency PA Protocol 7 5. valaent is secondary, VERIFY. The following BIN and PCN combination are required to successfully transmit claims effective January 1, 2007: BIN: 001553 PCN: GAM Dec 31, 2016 · 1Ø1-A1 BIN Number See BIN/PCN table, above M 1Ø2-A2 Version Release Number DØ=Version D. 3 Adjudication Codes 6 5. 2 NCPDP External Code List Version Date: October 2016 BIN: 610014 PCN: MEDDPRIME Plan Name/Group Name BIN: PCN: Plan Name/Group Name: BIN: PCN: Plan Name/Group Name: BIN: PCN: Processor: TelePAID® System Effective as of: 12/08/2011 NCPDP Telecommunication Standard Version/Release #: D. 009265, 610198, 012965 800-837-0581 Applied Underwriters, Inc 13329 877-234-4420 NYS Medicaid Managed Care Plan Contact and Billing Information 2015 . The new implementation date is Sunday, March 26th at 5:00 pm CDT. Payer/Carrier BIN PCN Certification ID Medco All All HJP Express Scripts All All MedImpact All All NV Medicaid 001553 All N/A Prescription Solutions All All Prime Therapeutics All All Argus as per below Adjudicated Marketing 6ØØ428 Ø5Ø8ØØØØ 601DN30Y Bin #: 600471 States: Nationwide Destination: RESTAT Accepting: Claim Adjudication and Claim Reversals Format: NCPDP Version 3A, 3B, 3C, 32V 1. can only secondary bill MEDICAID and TRICARE. What is the Missouri Rx Plan (MORx) BIN/PCN? Where should I send the Medicare Part D coordination of benefits (COB) claims? Use the following BIN/PCN when submitting claims to MORx: 004047/P021011511. We use a Formulary, which is a list of the drugs that we prefer our providers to prescribe. Use BIN Number Ø16929 for ADAP claims. 7914 (after-hours: 1. com. For commercial claims, ESI accepts any value except zeroes. Dec 22, 2020 · BIN: 610014 PCN: MEDDPRIME Group: RXINN03 1-800-416-3628 Accredo Specialty Pharmacy 1-800-803-2523 https://www. Rx Bin: 610014 Rx PCN: COPAY Rx Group: MMODRUG Print Date: XX/XX/XX For Members PRIMARY NETWORK: Aetna Open Choice PPO/NAP OHIO NETWORK: SuperMed PPO VISION: EyeMed 1-877-226-1115 DENTAL: SuperDental 1-800-822-1182 24/7 NURSE LINE: 1-888-912-0636 For Providers Plan Name Bin Number PCN Phone Number . This guide supports Commercial and Medicare Advantage (MA) products. Plan Name Short Plan Processor Bin PCN Name # Name Jan 01, 2021 · Administrative Guide for Commercial, Medicare Advantage and DSNP. 2015 Medicare Contract/Plan and BIN/PCN Combinations BIN/PCN Data Disclaimer The Centers for Medicare & Medicaid Services (CMS) has made a reasonable effort to ensure that the provided data are a true and accurate representation of the data on file at CMS at the time of disclosure. AlohaCare also covers the over-the-counter drugs listed on our Formulary. For questions regarding claims, call 800-222-3986. gov . 3. 922. BIN Number 610014 610014 003858 600428 PCN Number Per card, cannot be 0s 06330000Per card, cannot be 0s A4 Group Number CVTYWVM THPWVMC WFWA . 2 Claim Reversals 6 4. 624. Nov 20, 2019 · Bin#: 610014 RX PCN#: A4 RX Group #: NYSTFRX Pharmacies should call 800. If the retail pharmacy has any concerns, the technician can contact the Pharmacy Services Dept. 621 This Medicaid Patient Is Medicare Eligible 2514 RECIPIENT COVERED BY MEDICARE (A AND B), NO MED D 621 This Medicaid Patient Is Medicare Eligible 2521 RECIPIENT COVERED BY MEDICARE A AND/OR B, NO MED D 621 This Medicaid Patient Is Medicare Eligible 2801 MEDICARE ELIGIBLE, CLIENT MUST ENROLL IN PART D Part D Prescription Drug Plans 2021 Humana. The header and s. Click below for more information from Absolute Total Care: Member COVID-19 Information. Community Plan guides are available on the Community Plan Care Provider Manuals page. 1 Rx BIN number: 610014 Rx PCN number: MEDDPRIME (Medicare Companion Plan participants only) Rx Group number: GBOPRX1 223008686 Medco Direct Claims Medco Prescriptions LLC P. To find a dentist near you, or view dental plans, . Please note, the data below is Part 2 of 5 (H2237 - H3959) with links to Part 1 and Parts 2 through 5. Feb 18, 2020 · BIN: 610014 PCN: MEDDPRIME Group: RXINN03 1-800-416-3628 Accredo Specialty Pharmacy . BIN: 61Ø342 PCN: ROIRX Plan Name/Group Name: Medicaid BIN: 61Ø342 PCN: ROIRX Plan Name/Group Name: New Benefits BIN: 61Ø346 PCN: N/A Plan Name/Group Name: Bridgeport Claims BIN: Ø19272 PCN: ROIBPC Plan Name/Group Name: OneRx BIN: 637639 PCN: ROIRX/ AEØ2 Plan Name/Group Name: MedTrak BIN: Ø14244 PCN: DCAE2/ ROIRX PCN: Processor name and PCN searches are prefix searches. POS Specifications 6 4. Go to The BIN/IIN field will either be filled with the ANSI IIN or the NCPDP Processor BIN, depending on which one the health plan has obtained. First Script is valid only for medications prescribed for your work-related injury. Jan 01, 2021 · BIN 610591 20107 610649 4336 4336 610494 11529 PCN ADV KY 3191501 MCAIDADV MCAIDADV 4040 P022011529 GROUP RX8831 WKVA RX5035 RX8893 ACUKY KY Medicaid PBM CVS Caremark IngenioRx Humana Pharmacy Solutions CVS Caremark CVS Caremark Optum Rx Magellan Kentucky Medicaid Bin/PCN/Group Numbers Effective 1/1/2021 1Ø1-A1 BIN NUMBER 021106 M 1Ø2-A2 VERSION/RELEASE NUMBER DØ M 1Ø3-A3 TRANSACTION CODE B1, B3 M 1Ø4-A4 PROCESSOR CONTROL NUMBER 08053875 M Valid PCN required. 600428 800-522-7487 Agelity, Inc. Blue Medicare Rx MA-PDs (NC): 015905 PCNs: HMONC, PPONC, HMONCG, PPONCG KHC Drug Claims. Please do not turn the customer away if you receive a rejected claim. Accountable Care Partnership Plans MCO Partner PBM BIN PCN Group BMC HealthNet Plan Community Alliance contains Blue Cross Complete’s BIN (600428), PCN (06210000), member services number, field definitions and other helpful information for pharmacy claim billing and rebilling. (No PCN number required) — 610014 Rx Bin for Secure Health — 003858/PCN A4 PRESCRIPTION COVERAGE. 4542 | elixirsolutions. Number (PCN) Bin Number Additional Information Required for Pharmacy Claim Processing For eligibility information, plan policy and coverage questions For billing issues, claim processing questions and assistance with claim edits Affinity Health Plan (866) 247-5678 CVS Caremark (800) 364-6331 ADV 004336 Group: RX4212 Use BIN Number Ø16929 for ADAP claims. Blue Medicare Rx Enhanced and Standard (NC): 015905 PDPNC NCPARTD. Learn how you can help keep yourself and others healthy. CommunityCare Prescription Drug Plan PDP (OK): 004336 MEDDADV RX2477. 0 NCPDP Data Dictionary Version Date: 07/01/2007 NCPDP External Code List Version Date: 10/01/2009 Jan 01, 2014 · Medicaid Managed Care BIN, PCN, and Group 1/1/2019 through 12/31/2019 (pharmacy services carved out of managed care starting 1/1/2020) BIN 610011, PCN IRX, Group SHNNDMEDI If you have pharmacy questions, you may email them to dhsmed@nd. For KHC drug claims, the BIN is 610084, the PCN is DRTXPRODKH and the Group is KHC. com A nonprofit corporation and independent licensee of the Blue Cross and Blue Shield Association Customer Service: 800-662-6667 TTY/TDD: 800-257-9980 To locate participating providers outside of Michigan: 800 . BIN and PCN Codes. BIN # 610014 PCN # Not Applicable Member ID# First Script will provide Member ID# upon verification of eligibility PharmacyBenefit Program Commonwealth of Virginia Employer Information Card UNIVERSITY OF VIRGINIA Agency Name Agency Code CV207000 Questions? Call First Script Customer Service at 1-800-791-2080 Rx Bin- 610014 Rx PCN- n/a . Feb 22, 2018 · BIN/PCN/Group Numbers for ACOs, MCOs and PCC Plan The three tables below shows the correct combinations effective March 1, 2018, for pharmacies to use when submitting MassHealth ACO/MCO/FFS pharmacy claims. com/oh/plans/mycare/benefits-services/pharmacy/ Molina Healthcare CVS/Caremark Medicare/Medicaid Members BIN: 004336 PCN: MEDDADV Group: RX5060 1-866-693-4620 Medicaid Only Members BIN: 004336 PCN: MCAIDOH Group: RX0867 1-800-364-6331 CVS/Caremark Specialty Pharmacy 1-800-237-2767 2016 Medicare Contract/Plan and BIN/PCN Combinations BIN/PCN Data Disclaimer The Centers for Medicare & Medicaid Services (CMS) has made a reasonable effort to ensure that the provided data are a true and accurate representation of the data on file at CMS at the time of disclosure. Medicare/Medicaid Members BIN: 610097 PCN: 9999 Group: MPDOHCSP Medicaid Only . Jan 01, 2018 · 1Ø1-A1 BIN Number See BIN/PCN table, above M 1Ø2-A2 Version Release Number DØ=Version D. 1 Required Data Elements 6 4. Aetna Better Health of Michigan Members must have their prescriptions filled at a in network pharmacy to have their prescriptions covered at no cost to them. 1Ø9-A9 TRANSACTION COUNT 1 M Only 1 transaction for transmissions for Medicare Part D claims. SECTION 2 – Employee. Members are instructed to show both ID cards before receiving health care services. The following is a summary of our new requirements. Browse chapter and supplement titles for specific areas. Beginning June 27, 2012, pharmacies will be required to enter the BIN, PCN and member ID that are unique to Dec 09, 2011 · 3. caresource. Verify member eligibility and the MCO enrollment . Box 14711 Lexington, KY 4052 1 Medical and Hospital Pacifiare SeCcure Horizons (HMEP PacifiCare) 33-0561998 Pacifiare/UHCC-Claims Processing M/S AZ121-0149 BIN #: 610014. Rx Bin 610014 Pcn Peu Agricola Guarnera. NAME ID SHORT NAME PROCESSOR BIN PCN MEDCO MEDICARE PART D/PDP CLAIMS 3065 MDCOMPTD PAID 610014 MEDDPRIME In this case the POS format name is: MEDCO MEDICARE PDP 5. Author: Martha Susan Derocher search with BIN and PCN. RxBIN 610014 RxGRP MiBCNRX XYH888888888 Enrollee ID 9101000021 Issuer (80840) XXXXXXXX Group Number Blue Care Network of Michigan bcbsm. 2Ø2-B2 SERVICE PROVIDER ID QUALIFIER 01 M Only value ’01’ (NPI) accepted. Drug Formulary CareSource. Contact Pharmacy Administration at (573) 751-6963. BIN Number Additional Information . For commercial claims, this is typically used by the pharmacy to identify a PBM or claims processor. Your doctor may make a request by telephone at 1-866-316-3784, via fax 1-855-799-2551, or through CoverMyMeds. You or your group health insurer, are financially responsible for any other prescriptions. 361. Plan ID: Processor BIN: Bottom of Form. Dental SM Blue Vision SM Benefits may be limited; predetermination approval is required for hospitalization and certian services. • BIN Number – 610084 1. com Batch Standard Version: 1. Prescription Blue Preferred, Select, and Premium PDPs (MI): 610014 MEDDPRIME BCNRXPD. You must use BIN number 610084 for all the above programs including Medicaid HealthChoice MCOs. 1557 or visit their Pharmacist Resource . You may go to our website to search for an in-network pharmacy near your . 8591) or email us at pharmacy@healthplan. • Since 8-digit IINs are now being assigned, use the first 6 digits of the IIN as the BIN even if the first digit(s) is a zero. If you have questions or concerns processing claims, you can call 1. 1 Drugs requiring PA 7 5. 639. 800. below with the BIN, PCN and Certification ID for each. In addition to their Minnesota Health Care Programs (MHCP) ID cards, members enrolled in a managed care organization (MCO) also receive ID cards directly from their MCOs. 1Ø2 -A2 VERSION/RELEASE NUMBER DØ M 1Ø3 -A3 TRANSACTION CODE B1 M 1Ø4 -A4 PROCESSOR CONTROL NUMBER Enter “WIPARTD” for SeniorCare , Wisconsin Chronic Disease Program (WCDP ), and AIDS/HIV Drug Assistance Program (ADAP) member s that are also enrolled in a Medicare Effective January 1, 2007 the Georgia FFS Medicaid Pharmacy Program with have a new Pharmacy Benefit Manager. SXC will be taking over all services previously provided by Express Scripts for FFS Medicaid. Managed care pharmacy identification. Dec 09, 2005 · BIN PCN S1566 ELDER HEALTH TEXAS, INC 1-410-864-4400 610014 MEDDPRIME 22 Texas S2770 QCC INS CO D/B/A AMERIHEALTH INS CO 1-800-898-3492 012353 036600000 06 39 Pennsylvania West Virginia S2893 CENTRAL NEW ENGLAND JOINT ENTERPRISE 1-886-755-2776 610575 * 02 07 Connecticut Massachusetts Rhode Island Vermont S3521 EXCELLUS HEALTH PLAN, INC 1-800 . bin 610014 pcn medicaid