Rx pcn number. Learn how to find your PCN here.

Rx pcn number. azahcccs. *Formerly Optima (will still work for billing) ** Formerly Virginia Premier (will still work for billing) Jan 26, 2025 · You may also wish to read more at: " What is the BIN, PCN, and RxGROUP number for my Medicare Part D prescription drug plan?. Some cards may explicitly label it as “PCN” or “Processor Control Number,” while others might use “RxPCN” or “RX PCN. This will help to ensure that: Apr 1, 2023 · MyCare Ohio - Pharmacy Billing Reference Guide Last Updated: 3/28/2023 This information is only meant to be used as a billing resource for pharmacies and is subject to change. " and The 2025 Medicare Prescription Payment Plan: Like 0% financing for your formulary Part D drug purchases. (MN) HealthPartners Freedom Balance with Rx (Cost) HealthPartners Freedom Ultimate with Rx (Cost) HealthPartners Freedom Ultimate with Enhanced Rx (Cost) HealthPartners Freedom Calendar Year (Cost) H2486 HUMANA MEDICAL PLAN OF UTAH, INC. ” It is customarily part of the superscription (heading) of a prescription. You can find your PCN on your health insurance card alongside other numbers such as your Bank Identification Number (BIN), Member ID, and plan type. Learn how to find your PCN here. Medicare Part D – Senior Care Plus powered by MedImpact Rx BIN: 015574 Rx PCN: ASPROD1 Rx Group: HTH05 ID number – the pharmacy will need to submit the NEW ID number for 2022 Customer Service/Pharmacy Help Desk: 800-681-9585 BIN Ø12833, PCN FLBC This is required when Covered Person’s of Bridgespan Idaho have secondary coverage with Bridgespan Idaho, Jan 1, 2022 · January 1, 2022 340B Pharmacy Contract Administrators AHCCCS Pharmacy Directors Suzi Berman, RPh, Director of Pharmacy Pharmacy Claims Processing BINs, PCNs and Group Numbers – Revised to update new billing information for PBM pescription claims processing. 716. OptumRx is the current PBM contracted with the Veterans Health Administration Office of Community Care (VHA OCC) to electronically process CHAMPVA, Spina Bifida Health Care Benefits Program and Children of Women Vietnam Veterans (CWVV) Program pharmacy claims. The accuracy of these six-digit codes is paramount; errors can result in claim denials, which may hinder patient care. It typically appears on the back side of the card, below the member ID number and usually has either a 9 or 11 digit numeric code printed next to it. Note: this example also shows tiered prescription costs. Jul 13, 2022 · PCN, Rx BIN, Rx Grp numbers, member ID, membership card number, plan group, and types, all information is typed in the card. About this provider manual (PM) The Administrator Provider Manual (PM), also known as “Provider Manual”, includes the policies and procedures for pharmacies, pharmacists, as well as pharmacy staff (collectively, Network Pharmacy Providers) which serve Members pursuant to the Administrator’s, Catamaran’s and its affiliates participating pharmacy provider network agreements, including Jan 26, 2025 · You may also wish to read more at: " What is the BIN, PCN, and RxGROUP number for my Medicare Part D prescription drug plan?. Minnesota Health Care Programs providers billing for prescriptions for members in managed care organizations (MCOs) need to use the MCO's identification bin and PCN information. Other coverage code Original prescribed product/ service ID qualifier Originally prescribed product service code Originally prescribed quantity Scheduled prescription ID number Unit of measure Level of service Prior authorization type code Prior authorization number submitted Route of administration Compound Type Pharmacy service type A submitted Pharmacy Service Type (147-U7) of 06 – Mail Order Pharmacy Services or 08 – Specialty Care Pharmacy Services, will indicate the order is being shipped to the Patient. Unmask and Connect the payer information hidden in your datasets. It facilitates communication between pharmacies and insurance providers, ensuring transactions are handled correctly. Note: most medical plans include prescription coverage so your ID card may not have any values displayed here. Allows you to view the pharmacy card member ID, group number, BIN and processor name. By offering practical steps and troubleshooting tips, this Aetna will respond back to the pharmacy in the message text fields indicating any other coverage that may apply to Medicare Part D members. PCN Number for Secure Health Plans — A4 You can register your account at Express-Scripts. Ø11552 PDPILBOG MAPDIL MAPDIL1 MAPDIL2 MAPDILG MAPDILG1 PDGIL PDPIL ILDEMD MAPDMT MAPDMTG MAPDNM MAPDNM1 Below is a link to search Blue Cross and Blue Shield of Minnesota and Blue Plus pharmacy benefit drug utilization management (UM) program summaries. The PCN (Processor Control Number) is required to be submitted in field 104-A4. PCN is committed to total quality care for our members. Accurately presenting the PCN is essential; it directs prescription requests to the appropriate processing department, thereby minimizing errors and delays in medication acquisition. Please ensure that pharmacy employees can easily read this information so that supplemental claims can be submitted according to the message instructions. Prescription Billing for Medi-Cal Members After Medi-Cal Rx Transition (1/1/2022 and after): SFHP will issue new identification cards to all members to include the Medi-Cal CIN number, which must be used for Medi-Cal Rx billing. The PCN assists pharmacists and healthcare providers in A submitted Pharmacy Service Type (147-U7) of 06 – Mail Order Pharmacy Services or 08 – Specialty Care Pharmacy Services, will indicate the order is being shipped to the Patient. The Personal Choice Network (PCN) is Blue Cross and Blue Shield of Alabama's primary care network. Feb 15, 2025 · Insurance cards contain various codes and identifiers necessary for processing healthcare services, but many policyholders overlook their importance. Jun 9, 2025 · The utilization of PCN codes, particularly the pcn number insurance, also aids in monitoring prescription trends and overseeing formulary adherence, ultimately leading to enhanced medication management and improved patient care. Box 14718 Lexington, KY 40512-4718 Member Customer Service: 1. For more information, please refer to Chapter 3, Unit 5 of the Office Manual. May 6, 2025 · The PCN (Processor Control Number) identifies each health plan’s drug benefit processor or Pharmacy Benefit Manager (PBM). com under the Health Care Professionals link for additional payer sheets. PCN pharmacy payment routing numbers can be numeric or alphanumeric. Dec 6, 2024 · 57-Discharge Medication- new dispensing of medication and continuation of care due to the patient’s discharge from LTPAC, Clinic, Hospital or similar setting. ” The significance of what is PCN on insurance card is particularly evident in managing pharmacy benefits, as it helps to differentiate between various plans and coverage options offered by the same insurer. May 25, 2025 · Overview This article provides comprehensive, step-by-step guidance for conducting an RX BIN number lookup—an essential process for effectively processing pharmacy claims and ensuring timely access to medications. What is an RX BIN number on an insurance card? Also, what is a BIN and PCN? All pharmacies use BIN and PCN numbers for processing prescription drug claims. Welcome to BPGLookup, the first syndicated source for BIN PCN Group translation. What’s New This Empire Plan Report summarizes the changes to your benefits and coverage under the New York State Health Insurance Program (NYSHIP) and The Empire Plan. Indicates the member’s relationship to the subscriber and does not need to be included on any claim. This example shows a copay for an office visit (OV), emergency room (ER) and, if applicable, prescription (RX) coverage. Matching for a claim to be reversed is done by: Processor Control Number, Service Provider ID, Date of Service, Cardholder ID, Prescription / Service Reference Number, Product / Service ID, and Fill Number (all inclusive). A. Significant additions or updates expected in Version 2. Process Control Number (PCN) for BlueScript, Mediscript and BlueCare Rx members is FLBC and the member ID number is the letter H followed by 8 or 10 numeric digits. What is rxpcn? Learn about the Prescription Plan Control Number and its crucial role in managing prescription drug benefits efficiently. PCNs can be alphanumeric or numeric. (800) 288-5441 Pharmacy Benefit Manager (PBM) or Billing Agent PBM/Billing Agent Contact Information Processor Control Number (PCN) Bin Number Additional Information Required for Pharmacy Claim Processing BILLING MEDICAID Bank Identification Number (BIN) and Processor Control Number (PCN) When submitting NYRx claims to Medicaid via NCPDP D. " It's a six-digit code used to identify insurance providers. Mar 30, 2022 · The PCN number, or Prescription Control Number, is located near the bottom of the Aetna insurance card. Pharmacy Providers that do not have the member’s ID card on file because the member is new to Highmark Health Options, can obtain the member ID from the Argus Health Systems Help Desk at 1-844-848-4312 by providing the BIN/PCN #, patient last name, first name, and Date of Birth. 0, the BIN ("004740") is required in field 101-A1. medicare advantage, commercial, medicaid). Please ask members to provide their new member ID cards and enter the new Member ID Number, Rx Group, BIN, and PCN. Jul 7, 2022 · Rx: A medical prescription. " The chart below is the fifth page of the 2024 Medicare Part D pharmacy BIN and PCN list covering prescription drug plans from contracts H6846 through H8998. RxGrp - the prescription group number denotes which group plan the member ID falls under With those four numbers the pharmacy can properly submit a claim to the right insurance. The HBID can be used by members to access services covered by Fee-For-Service, which are not covered by Horizon NJ Health. Often the Rx system is separate from the Carrier’s medical system, so it typically takes another 24-48 Dec 30, 2011 · The Centers for Medicare and Medicaid Services (CMS) has indicated that, effective January 1, 2012, a unique Medicare Part D BIN/PCN combination needs to be utilized in network pharmacy electronic claim transactions. Benefits include: Returns a real-time response to the pharmacy Provides information including BIN, PCN, group number, cardholder ID, person code and processor helpdesk number Options to send inquiries only to our Commercial Eligibility Partner or combined with our Medicare Part D Eligibility Partner Jan 10, 2024 · You may also wish to read more at: " What is the BIN, PCN, and RxGROUP number for my Medicare Part D prescription drug plan?. Program management through stakeholder collaboration, effective use of drug rebates and careful selection of drugs on a Preferred Drug List (PDL) are just three ways NC Medicaid provides access to A submitted Pharmacy Service Type (147-U7) of 06 – Mail Order Pharmacy Services or 08 – Specialty Care Pharmacy Services, will indicate the order is being shipped to the Patient. The Empire Plan Certificate, which describes the coverage provided by The Empire Plan, will be updated on Mar 15, 2024 · Wrapping Up PCN on your insurance card might seem like a useless code, but its role in the prescription claim process is unparalleled. 60- Long Term Care Same Drug Strength and Dosage From with Multiple Dosing Directions- Separate prescriptions of the same drug being taken concurrently exist due to different dosing direction. These numbers are required for pharmacy claims processing. Plans that use cards with a magnetic stripe should use the recommended ISO/IEC 7812 Issuer Identifier Number (IIN) for processing electronic pharmacy claims. Please update impacted member’s profiles with the new processing information as applicable. 5. Our prescription drug coverage utilizes a formulary—or list of covered drugs—to help you easily determine if your medication is covered and at what cost-sharing level. What Is an Rx Grp Number? Learn how to read insurance card numbers, including BIN, RX PCN, Payer ID, Group Number, and more for efficient medical visits and claims processing. Jan 13, 2020 · Premera Group #: 1100015 Rx Bin #: 610014 Rx Group #: BCWAPDP Temporary ID cards Your clients can also print off their own temporary ID cards by creating a new online account and signing in to the secure member website. ) who administered the vaccine or dispensed the medication. What is PCN on an Insurance Card? PCN, or Processor Control Number, is an identifier insurance companies use to route pharmacy transactions for prescription benefits. 0, the BIN number is required in field 101-A1 and is "004740". What is the Rx Group, Rx BIN and Rx PCN for Express Scripts? The Rx Group is SHP8668, Rx BIN is 003858 and Rx PCN is A4. Please refer to the table below for bank identification number (BIN) and processor control number (PCN) information. Rx BIN Numbers and PCNs for California Small Group health plans are shown by carrier in the table below. The Rx BIN number, along with the PCN and Group number, helps pharmacies confirm a patient’s insurance coverage immediately—even if their details haven’t fully loaded into the pharmacy’s system yet. Rx group number and pharmacy logo –This will be on the ID card whenever a Highmark prescription drug program is included. GROUP HEALTH PLAN, INC. Wellcare Classic, Value Script, Medicare Rx Value Plus, Wellcare MA-PDs and SNPs: Mar 5, 2025 · While the RX BIN directs prescription claims to the appropriate PBM, the RX PCN (Processor Control Number) refines claim routing further, differentiating between plans under the same BIN. . 9. Pharmacists scan it to see which insurance company they need to contact for the reimbursement claim for your prescription. Without the PCN, claims could still be misdirected. “Rx” is another way to refer to a prescription. 3231 Web: Express-Scripts. Claims should be transmitted using Bin Number 012833. Most likely Caremark or Express Scripts. Provides all the necessary information to process a claim using the HealthWell Foundation pharmacy card. com; select your State and click on Pharmacy, under the Provider Medicare section. 866. Rx BIN and PCN numbers are used by new members to pick up a new prescription (or refill) prior to having a new ID card or showing up in the new Carr Feb 20, 2025 · The RxPCN, or Prescription Processor Control Number, is a unique identifier used by pharmacy benefit managers (PBMs) and insurance companies to route prescription claims. Search tip: January 1, 2024 340B Pharmacy Contract Administrators AHCCCS Pharmacy Directors Suzi Berman, RPh, Director of Pharmacy Pharmacy Claims Processing BINs, PCNs and Group Numbers – Revised to update new billing information for PBM pescription claims processing. The front of the ID card identifies the member's plan and contains coverage and cost-share information, as well as claim submission information. S. The Rx Bin number can also be referred to as a BIN, PCN,… Medicare Claim Processing Update Effective January 1, 2024, Centene Medicare will transition to Express Scripts as their pharmacy benefits manager. This number plays a pivotal role in efficiently managing claims related to medication and ensuring that prescriptions are processed correctly within an insurance framework. The PCN is changing to CTRXMEDD. For Pharmacy Service questions please contact Provider Services or your Provider Relations representative. The PCN, required in field 104-A4, has two formats which are comprised of 10 characters: Formats 3-digit Electronic Transaction Identification Number (ETIN) CoverMyMeds Auth Requests: Always Include BIN, PCN, and RXGroup Information When submitting electronic authorization requests to CoverMyMeds, providers should make sure to include the following information: BIN (Bank Identification Number); PCN (Processor Control Number); and RXGroup – the prescription group number for the member’s plan. Superior HealthPlan Medicaid Claim Processing Update Effective January 1, 2024, Superior HealthPlan Medicaid will transition to Express Scripts as their pharmacy benefits manager. Health care providers - get answers to the most frequently asked questions about Aetna's pharmacy management program. Ø. Medical cards usually only have a Member ID number. It is used to identify which pharmacy benefit plan you are associated with and it usually appears after the words “Rx Bin” or “Bin Number”. Jun 20, 2025 · Pharmacies typically need a pharmacy benefits card to process a prescription for medication, which contains an RxGroup, RxPCN, and RxBIN number in addition to the Member ID number. Here's what to look for when reading the front of our member ID card: Rx: This symbol is used if the member has prescription coverage. Please ask members to provide their new member ID cards and update your system with the new Member ID Number, BIN, PCN and Rx Group. Feb 11, 2021 · The Processor Control Number (PCN) is a secondary identifier that may be used in routing of pharmacy transactions. Understanding the role of the PCN is essential for ensuring accurate prescription processing, which not only enhances patient access to medications but also significantly Nov 17, 2023 · Conclusion The PCN number on an insurance card plays a vital role in the efficient processing of prescription claims and the coordination of benefits between the pharmacy, pharmacy benefit manager (PBM), and insurance company. Pharmacy Card…more. Effective January 1, 2024, Centene Medicare will transition to Express Scripts as their pharmacy benefits manager. This insurance pcn number is vital for ensuring that the request aligns with the specific regulations of the insurance plan, thereby streamlining the reimbursement process. The Formulary code represents a list of prescription drugs covered by us. The BIN number tells the computer database at the pharmacy which health insurance provider is to receive the claim for the prescription. May 19, 2025 · As Tim, a blog writer, notes, “The RX BIN, similar to the PCN number, can typically be located on your prescription coverage card. Pharmacy Guide For more Pharmacy related information and forms, please visit wellcare. 5703 TTY Users: 1. Be sure to read: Important Information About the Personal Choice Network Important Information Regarding Referrals Each member and all eligible dependents select a primary care physician (PCP) and all specialist care must be coordinated The member ID number begins with the letter H. 12 Rx Bin & Rx Grp: Identifies you as a UnitedHealthcare member for OptumRx prescription drug administration in the U. Contact Information The back of your ID card provides important contact information for customer and provider service. Jan 1, 2020 · BIN: 001553 PCN: TNM All members of TennCare will receive a new member identification (ID) card Jul 1, 2023 · MyCare Ohio - Pharmacy Billing Reference Guide Last Updated: 6/21/2023 This information is only meant to be used as a billing resource for pharmacies and is subject to change. It may be the prescriber who wrote the prescription or alternate care provider (pharmacist, nurse practitioner, etc. Print card Jun 22, 2025 · Overview The primary focus of this article is the critical role of the Processor Control Number (PCN) on insurance cards in facilitating efficient claims processing within pharmacies. Indicates that the member’s plan includes BlueCard benefits. On the back of the card it might tell you who handles it, otherwise that card is useless to the pharmacy. By comprehending the information discussed in this blog about PCN you can understand why PCN is so important in the smooth processing of your prescription benefits and claims. One of my city's largest employers had Aetna as the medical and Express Scripts for pharmacy and no one got their Express Scripts cards. Learn more about what your Rx BIN and other numbers mean on your Medicare Part D or Medicare Advantage plan card. April 1, 2023 340B Pharmacy Contract Administrators AHCCCS Pharmacy Directors Suzi Berman, RPh, Director of Pharmacy Pharmacy Claims Processing BINs, PCNs and Group Numbers – Revised to update new billing information for PBM pescription claims processing. The number could be alphanumeric or strictly numeric, as defined by the pharmacy benefits manager. PHARMACY BIN & PCN NUMBERS The Rx BIN number is a 6-digit number health plans use to process electronic pharmacy claims. A processor control number (PCN) is a secondary identifier used in routing pharmacy transactions. Pharmacy: Rx Bin: 020099 Plan Code: 040 PCN: WG Rx Group Number: WLHA IngenioRX is open 27/7 and can be reached at 833-261-2463 At the time of service Ask the member for all insurance cards, including his or her Health Benefits Identification Card (HBID), Medicare and/or commercial coverage cards. Need your card now? Download and print a temporary version of your card. Understand how these codes help with claims, billing, and getting the right coverage. The BIN number is a Bank Identification Number which tells the pharmacy database which benefit manager is to receive the claim for a particular prescription. The Rx BIN number is a 6-digit number health plans use to process electronic pharmacy claims. Aetna. Dec 13, 2021 · The Rx Bin number is a 6 digit number found on the back of your insurance card. PHARMACY BIN & PCN NUMBERS pharmacy claims. The Empire Plan Certificate Amendments reflecting the changes outlined in this Report will be posted on NYSHIP Online. Jan 26, 2025 · Your (1) Member ID number, (2) Rx BIN, (3) PCN, and (4) Group ID (or Rx Group) number are the four numbers that uniquely identify you and your Medicare Part D prescription drug plan - and these four numbers are usually found on your Medicare Part D Member ID card and on most of your Medicare plan's correspondences and printed information (such as your plan's Welcome letter and Evidence of Sep 19, 2024 · Find the Processor Control Number on a health insurance card or pharmacy claim processing number, with plans at $350/month. Jan 1, 2018 · BIN/PCN Table Section I: Claim Billing (In Bound) Transaction Header Segment – Mandatory in all cases Patient Segment – Required For Medicaid claims, Humana allows the cardholder ID to be submitted with the Medicaid ID, the Humana ID number or the Social Security number. 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 Refer to Appendix A for a detailed history of changes to the Medi-Cal Rx NCPDP Standard Payer Specification Sheet. 477. Rx BIN and PCN numbers are used by new members to pick up a new prescription (or refill) prior to having a new ID card or showing up in the new Carrier’s Rx system. 0 include: 1) a new section pertaining to combination ID cards containing both medical and pharmacy benefit information; 2) an expanded application of the machine-readable (PDF417 two Missouri Rx Plan - Pharmacist FAQs What number do I call for questions with processing MORx claims? Contact Pharmacy Administration at (573) 751-6963. 0 in the Fall of 2006. gov NOTE: The current release of NCPDP’s Pharmacy ID Card Implementation Guide is version 1. The summary policies outline which drugs may require prior authorization, step therapy and/or quantity limits. Jun 7, 2025 · The insurance pcn number directs the claim to the appropriate pharmacy benefit manager (PBM) for processing. Among these is the Processor Control Number (PCN), which plays a specific role in pharmacy claims. com PCN stands for Processor Control Number, which is crucial in how your insurance company handles your medication benefits. 3 MEMBER IDENTIFICATION NUMBER Select Health Commercial and Scripius PBM Products — BIN – 800008 PCN – not required — Group – not required Avera Health Plans Rx — BIN – 026952 PCN – Avera — Group – not required Select Health Medicare (Medicare Part D) — BIN – 015938 PCN – 7463 — Group – UT/ID/CO = U1000009; NV Intermountain = U1000011 Select Health Medicare National Council for Prescription Drug Program (NCPDP) Transactions All pharmacy claims must be processed using the new Medi-Cal Rx Bank Identification Number (BIN), Process Control Number (PCN), and Group ID, which are included in the table below. If claims are submitted for these groups on or after January 1 with the previous BIN or PCN, claims will reject with NCPDP Reject Code 01 (M/I BIN) and 04 (M/I Processor Control Number) with additional messaging that provides the new BIN/PCN. May 20, 2022 · What Is an Rx BIN Number? The Rx BIN symbol on your insurance card means "prescription bank identification number. com This is a temporary card. BIN and PCN Codes 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). Feb 22, 2022 · Your PCN or processor control number is used by your pharmacy to locate your pharmacy member profile. We're here to help answer your questions about member eligibility and benefit plan information, claims processing, and payment/remittance questions. Some companies do not use the PCN. What is the PCN number on an insurance card? The PCN number assists in the routing and management of pharmacy claims, making sure they are processed correctly within the insurer’s system. NCPDP is expected to release version 2. Another key identifier is the RX Group Number, which links a member to a specific employer or plan sponsor. OptumRx processes over 4 million pharmacy claims through its nationwide network each year for VHA OCC program beneficiaries. 800. This not only enhances the CalOptima Health’s Medi-Cal pharmacy benefit operates under Medi-Cal Rx, the Department of Health Care Services’ fee-for-service Medi-Cal delivery program. Bill Oregon Health Authority (OHA) for carve-out drugs for coordinated care organization (CCO) members, drugs for fee-for-service (FFS or “open card”) members, drugs not covered by Medicare Part D, and drugs not included in the long-term care facility’s bundled rate. Apr 5, 2025 · Understanding PCN in Insurance PCN, or Pharmacy Control Number, is a unique identifier found on insurance cards, primarily associated with prescription drug plans. The CoverMyMeds site also features a “Find a Plan” page to determine coverage plans. This is a good way to tell your new card apart from your old card. The ISO/IEC 7812 Registration Authority (the Jan 22, 2025 · A PCN number, or Processor Control Number, is an alphanumeric code that further specifies how pharmacy claims are processed and routed. M-18-144 Page 2 of 2 Commercial Plan List 10000019 Independence uses an independent pharmacy benefits management company, FutureScripts®, to offer you quality prescription drug coverage that is convenient and affordable. Helpful information for your CMS questionnaire Use the table below to help complete your Centers for Medicare & Medicaid Services (CMS) questionnaire — also called the Group Health Plan Report for the IRS/SSA/CMS Data Match. Enter the BIN, Processor Control Number (PCN), and RxGroup number for the Medi-Cal Rx member as follows: − BIN: 022659 − PCN: 6334225 − RxGroup: MEDICALRX If the member’s current insurance card is not available, you may enter Medi-Cal as well. RX PCN Meaning: This code helps pharmacies determine how to handle prescription claims and which plan to bill. ” See full list on supermoney. What’s changing on the new ID cards? The Rx BIN number on member ID cards is changing to 610011. The absence of a valid Rx Bin number on an insurance card can delay filling prescriptions at chains like Walgreens, Walmart, or Rite Aid. com to designate your preferred major retail pharmacy and find in-network pharmacies in your area. Jan 1, 2025 · 3. e. Jan 26, 2025 · You may also wish to read more at: " What is the BIN, PCN, and RxGROUP number for my Medicare Part D prescription drug plan?. Aug 17, 2025 · You can typically find your PCN number on your prescription insurance card, often located near the BIN (Bank Identification Number) and Group numbers. A PBM/processor/plan may choose to differentiate different plans/benefit packages with the use of unique PCNs. O. Insurance plans often offer dozens of plan options to multiple lines of business (i. How do I find my Rx Bin number? Your (1) Member ID number, (2) Rx BIN, (3) PCN, and (4) Group ID (or Rx Group) number are the four numbers that uniquely identify you and your Medicare Part D Jun 2, 2025 · The PCN (Processor Control Number) is a secondary identifier used alongside the RXBIN to route prescription claims to the correct provider. Jun 3, 2025 · Overview The Processor Control Number (PCN) serves as a vital identifier in healthcare, streamlining the processing of prescription requests by effectively directing pharmacies to the appropriate pharmacy benefit manager. Processor Control Number (PCN) Information entered in the Processor Control Number is used to indicate that you are requesting Electronic Claim Capture and Adjudication. The Processor Control Number (PCN) represents a secondary identifier that may be used in routing pharmacy transactions. It contains general information regarding the New York State's (NYS) transition strategy and WHITEWATER RAFTINGXJK901000011 10000110108346000001 Your RX, BIN and PCN numbers provide important billing information for your providers. Jan 26, 2025 · The chart below is the fifth page of the 2025 Medicare Part D pharmacy BIN and PCN list covering prescription drug plans from contracts H6080 through H8019. Apr 16, 2025 · Learn what PCN RXBIN and policy numbers mean on insurance cards. The NCPDP Processor ID Number (BIN) is a six-digit number that health plans can use to process electronic pharmacy claims if they do not use pharmacy benefit cards with a magnetic stripe. Check out the below example of Rx Bin, Rx PCN, and Rx Grp Dec 29, 2022 · BIN/PCN/Group Numbers for ACOs, MCOs, and PCC Plan The following tables show the correct combinations, effective for calendar year 2023, for pharmacies for Accountable Care Partnership Plans (ACPPs), Primary Care Accountable Care Organizations (ACOs), managed care organizations (MCOs), Primary Care Clinician (PCC) Plan, and MassHealth-only Senior Care Organizations (SCOs). Welcome to the HealthWell Foundation Pharmacy Card Lookup Tool. Suitcase logo – Indicates a member of the BlueCard® program. 13 Rx OON Ded IND/FAM: The individual and family deductible for using an out-of-network pharmacy. Copay amounts vary by plan Oct 8, 2024 · FAQ about what beneficiaries need for retail pharmacy benefits Jan 1, 2024 · CLAIM BILLING/CLAIM REBILL TRANSACTION The following lists the segments and fields in a Claim Billing or Claim Rebill Transaction for the NCPDP Telecommunication Standard Implementation Guide Version D. Often the Rx system is separate from the Carrier’s medical system, so it typically takes another 24-48 Dec 16, 2021 · BIN/PCN/Group Numbers for ACOs, MCOs and PCC Plan The following tables show the correct combinations, effective for calendar year 2022, for pharmacies for Accountable Care Partnership Plans (ACPPs), Primary Care Affordable Care Organizations (ACOs), Managed Care Organizations (MCO)s, Primary Care Clinician (PCC) Plan, and MassHealth-Only Senior CVS Caremark® will respond back to the pharmacy in the message text fields indicating any other coverage that may apply to Medicare members. CLAIM BILLING/CLAIM REBILL TRANSACTION The following lists the segments and fields in a Claim Billing or Claim Rebill Transaction for the NCPDP Telecommunication Standard Implementation Guide Version D. Jan 1, 2016 · Cut here Submit prescription Express Scripts claims to: Attn: Medicare Part D P. Feb 8, 2023 · Bank Identification Number (BIN) and Processor Control Number (PCN): For submitting NYRx claims to NYS Medicaid via National Council for Prescription Drug Program (NCPDP) D. For other pharmacy news, please visit the AHCCCS Pharmacy Information section on the AHCCCS website at www. Please use the following information when submitting claims for Superior HealthPlan Medicaid members. Oct 10, 2022 · What is PCN on Insurance Card? PCN is a processor control number (PCN) a different identification number that is printed on the health insurance card for health care and it is used to manage the processing of claims for pharmacies to health insurance companies. New York State Medicaid Update - December 2020 Volume 36 - Number 18This publication provides information regarding the Medicaid Pharmacy Carve-Out, a Medicaid Redesign Team (MRT) II initiative to transition the pharmacy benefit from managed care to the Medicaid Fee-for-Service (FFS) Pharmacy Program. trueIf there's no BIN number on the card it most likely is not their pharmacy benefit. The PCN number is a second identifier that is used for routing claims. Aug 27, 2021 · Pharmacies require an Rx Bin number along with a PCN (Processor Control Number) and Group ID to process prescription transactions accurately. In addition, pharmacies may call our help desk at 1-800-865-8715 (option 3) and provide the member’s name and date of birth to obtain the Humana member ID. RX PCN meaning refers to the Prescription Control Number, and it assists pharmacies in routing prescription claims to the appropriate processing system. Understanding the PCN can Aug 23, 2023 · Your Rx BIN number is a 6-digit code that identifies the insurance company who provides your Medicare drug plan. Simply Comfort (HMO I-SNP) Member ID:1504U0331 Issuer ID: 80840 Rx GROUP: WM2A Rx BIN: 020115 Rx PCN: IS HIGHLIGHTS – Updates, Changes & Reminders This payer sheet refers to Medicare Part D Primary Billing and Medicare as Secondary Payer Billing. If your insurance only sent you a medical insurance card in the mail, you can typically find your pharmacy Jun 16, 2025 · About the Pharmacy Program The North Carolina Medicaid Pharmacy Program offers a comprehensive prescription drug benefit, ensuring low-income North Carolinians have access to the medicine they need. Copayment information: Indicates the amount that the member pays at the time of service. Failing to provide all these details with precision will cause a rejection in most cases. For assistance with processing Blue Shield claims, please refer to the Pharmacy Help Desk telephone numbers. The symbol “Rx” is usually said to stand for the Latin word “ recipe” meaning “to take. 37 votes, 23 comments. After reading this you might be wondering how to get your hands on a PCN insurance card. Note: As of 2020, we have a new secure website for individual clients. This tool: Provides quick access to pharmacy card information. Refer to www. sgcod lpkrlx akuoqq ydvktn jtgnefh kjz gbnxyw ecssp jktu wqsv