Title: RE: Tiered Pharmacy
I had same thoughts as Roy, below, - per the HIPAA TCS rules currently out for public comment (comment period ends 6/30), the NCPDP standards are the ones to use for eligibility (therefor benefit?) responses to retail pharmacy queries.  BUT, the 271 remains relevant for, say, doc offices querying for benefits on behalf of their patients.
 
Do hospitals ever have a need for pharmacy co-pay information?  If so, that would be the 270/271, right?
 
Cynthia Korman
 
----- Original Message -----
Sent: Wednesday, June 12, 2002 1:26 PM
Subject: RE: Tiered Pharmacy

Do you plan on communicating with community pharmacy using the 270/271?  I have spoken to a number of chain pharmacies and was told they will be implementing the NCPDP Version 5.1... NOT the 270/271.  Thanks!!!

-----Original Message-----
From: September, Sean A B230 [mailto:[EMAIL PROTECTED]]
Sent: Wednesday, June 12, 2002 7:22 AM
To: '[EMAIL PROTECTED]'
Subject: Tiered Pharmacy


Hello, I am currently working on the 270/271 HIPAA transaction set. I am
attempting to display/map tiered pharmacy copayments/coinsurance amounts.
For example:

*       Generic                 $5.00  
*       Preferred               $10.00 
*       Non-preferred   $15.00

The Service Type Codes (EB03) available are:
*       88 = Pharmacy
*       91 = Brand Name Prescription Drug
*       92 = Generic Prescription Drug
        and for Mail order:
*       90 = Mail Order Prescription Drug.


I am finding it difficult to accommodate for the tiered pharmacy
copayments/coinsurance. Is anyone else experiencing this dilemma and is
there a solution?

Your suggestions and assistance is appreciated.

        Sean A. September      
        E-mail  [EMAIL PROTECTED] <mailto:[EMAIL PROTECTED]>


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