claimsecure intervention codes
ClaimSecure For CS drug plans that require 90-day maintenance drug dispensing, short fills can overridden with intervention code MG during the pandemic. It appears that Claimsecure is not permitting early refills for patients in isolation. IP: Internet Protocol. ClaimSecure – COVID-19 Dispensing Frequency (Mar. To bypass the Maintenance Drug providerConnect is a web-based portal for health care providers offered in partnership with the following participating health and … Document rationale. Product Package Size Pseudo-DIN Syringes Con’t UltiCare Insulin Syringe 0.5cc, 30g 100 97799995 UltiCare Insulin Syringe 1.0cc, 29g 100 97799997 Adjudication Response Codes • Standard Canadian Pharmacists Association response codes are attached to a claim when it is returned by PharmaNet, providing information on the status of the claim. The table below details CPhA intervention codes applicable to a DUR. (b) Compound codes: Below is a table of CPhA standard codes for compounded products. Appendix A – Response Codes . Normally Claimsecure requires three month supplies of medication to be dispensed for certain medications. Intervention Codes: Canadian Pharmacists Association (CPhA)‐approved codes that the pharmacist may enter on CBP to override normal adjudication rules when appropriate (e.g., when submitting reversals or overriding a prescription known to be a duplicate). diabetic syringe & pen needle ab, on, nwt, nu, yk pq ns nf, pei, nb bc sk mb bd autoshield pen needle 29gx8mm 97799526 00967408 97799526 97799526 97799526 97799526 97799526 son when an intervention has been conducted. Code Type of Compound 0 topical cream 1 topical ointment 2 external lotion 3 internal use liquid 4 external powder 5 internal powder 6 injection or infusion • UA – Consulted prescriber and filled Rx as written. Examples include: Telus (AHP) has indicated that pharmacies may override “refill too soon” if needed to support patients impacted by COVID-19. Welcome to providerConnect™! • Although the listing below can be used as a guide, pharmacists should refer to the latest version of Commonly used Intervention Codes: Intervention codes - ODB Intervention codes - TELUS Intervention codes - GSC: Prior Authorization Forms TELUS CANADIAN BENEFIT PROVIDERS CLAIMSECURE: Pseudo-DIN List TELUS Pseudo-DIN List and diabetic Pseudo-DIN List 00999997) a valid compound code must be provided as per the CPhA standard (a numeric value between 0 and 9) if the pharmacy is claiming a compounding charge in addition to the normal professional fee. accepts CPhA standard intervention codes. 31, 2020 newsletter) At this unprecedented time, we defer to pharmacists’ professional judgement Procedures for documenting intervention codes as indicated in the claim submission requirements are required (section 8.1 – Claim Submission Requirements – General). • An alternative bill code is used to distinguish between a cardholder and anyone other then the cardholder, for example a spouse card • Another reason to use it is for smart cards to distinguish between the cardholder or spouse drug plan and the smart card AR Account Receivable • There are many AR bill codes XA-X0 and X0-X9 ClaimSecure • Effective March 20, 2020, ClaimSecurehas been reimbursing all maintenance drug claims for a day- ... intervention code “MG – Over-ride, pharmacist judgement” to allow the claim to be processed on-line in real time. Refer to the Compounding section of the Guide for current compound codes. Telus has asked pharmacies to use the following intervention code: Claimsecure (RXP) allows refills at 3/4 the days supply. Intervention / Exception Codes: A claim submission or re-submission may Please use the appropriate code for the corresponding mixture when submitting your prescription.