Medicaid pcn number. 855-425-3247 (STAR/Hidalgo) El Paso First Premier . MEMBER ID NUMBER YKU12345678 PCP: PHONE: OFFICE VISIT: SPECIALIST EMERGENCY ROOM: LAST NAME, FIRST NAME $0 $0 $0 EFFECTIVE DATE BC/BS PLAN CODE ISSUER (80840) RxBIN 016499 RxPCN DSNPPRI RxGrp RXHRZN RxID 12345678 CMS-H8298-001 01/01/2017 S 280/780 Member Services: Pharmacy Services: Prior Authorization: Medicaid Pharmacy . Medicare-Medicaid dual eligible 015581 03200000 Medicaid plans 610649 03190000 . RW . • BIN Number – 610084 1. Their phone number and website will be listed on your health plan ID card. These are all of the BIN/PCN/Group The Center for Medicaid and CHIP Services (CMCS) is committed to partnering with states, as well as providers, families, and other stakeholders to support effective, innovative, and high quality health coverage programs. Image. Oklahoma City, OK 73105 health care services to Medicaid and PeachCare for Kids Program Member ID Required BIN PCN Group Processor/Helpdesk # Amerigroup Member or Medicaid ID 003858 MA WKJA Express Scripts/ 1-844-367-6112 CareSource Member or Medicaid ID 004336 MCAIDADV RX0835 CVS Caremark/ 1-844-441-8024 Peach 2 • Group Numbers MDMEDICAID – Medicaid MADAP – AIDS Administration (MADAP) MDKDP – Kidney Disease Program (KDP) MDBCCDT – Breast and Cervical Cancer Diagnosis and Treatment (BCCDT) • BIN Number – 610084 1. gov. com under the Health Professional Services link for additional payer sheets regarding the following: If you're a provider, call our Provider Hotline at 800-686-1516. Medicaid pharmacy authorizations. Pharmacy. • The Nevada Medicaid Pharmacy card will list the recipient’s ID number, name and date of birth. 4345 N Lincoln Blvd. 0 Ver The Centers for Medicare & Medicaid Services (CMS) released a compilation of the BIN and PCN values for each 2024 Medicare Part D plan sponsor. Rx PCN 610494 ACUVA 4900 phone: No Copays 0501 (717)851-6816 UnitedHealthcare Community Plan of Virainia - FAMIS Administered by The NY Medicaid BIN number is BIN 004740. Following are billing instructions for the Molina Healthcare Medicaid Plans: BIN: 004336, PCN: ADV GRP: RX0546, RX6422, RX6423 When submitting the quantity of tests, the quantity should be reflective of the number of individual tests. Government Site for Medicaid and CHIP Services | Medicaid. What’s Covered? Priority Partners members get all of the A Medicaid member’s client identification number (CIN) can be found on their managed care Your (1) Member ID number, (2) Rx BIN, (3) PCN, and (4) Group ID (or Rx Pharmacies should bill NYRx using the Client Identification Number (CIN), which Bank Identification Number (BIN) and Processor Control Number (PCN): For submitting FFS You can use your 10-digit National Provider Identifier (NPI) number to see if you need to submit data to MIPS. (MMA) will assume administrative operation of the Pharmacy Benefits Management (PBM) on behalf of the State of Nevada Department of Health and Human 104-A4 Processor Control Number (PCN) 683377 M NEW! Insurance Segment 301-C1 GROUP ID NVMEDICAID R NEW! Please note in the Payer PCN Group Number; Fee-For-Service: 600760: N/A: N/A: AmeriHealth Caritas Pennsylvania: 019595: 01940000: N/A: AmeriHealth Community Health Choices 004336: MCAIDADV: RX3892 Highmark Wholecare (Medicaid Primary) 004336 MCAIDADV RX2338 Highmark Wholecare (Medicaid Secondary to Medicare) 012114 MCAIDADV RX2338 If you do not have your gray CONNECT card, you can either give the pharmacy your client identification number or your Social Security Number and date of birth. a doctor. What Is a Medicaid Provider Number? Whether you're a physician or you have your own clinic, you want to 1-866-480-1086 , TTY 711 (Medicare/Medicaid plans) Preferred Care Network welcomes new Number 190, December 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 Medicaid Only PBM BIN PCN Group Pharmacy Help Desk Commonwealth Care Alliance Navitus 610602 MCD MHO (855) 673-6504 Senior Whole Health CVS PLAN BIN PCN GROUP HELPLINE Fee for Service 010900 8263342243 VAMEDICAID 1-800-424-4046 Aetna 610591 ADV RX8837 1-855-270-2365 Anthem 020107 FM WQWA 1-833-207-3120 Molina CCC+ (non-dual) 004336 MCAIDADV RX21EK 1-800-424-4518 Molina CCC+ (dual) RX51BJ Molina Med4 RX21EK Molina FAMIS RX51BD Sentara 003858 MA OHPMDCD* What is the BIN, PCN, and RxGROUP number for my Medicare Part D prescription drug plan? A non-government resource for the Medicare community 1-800-325-0778; or your state Medicaid Office. Enrollment Claims Processor Bin Number PCN Number Group Number NC Medicaid Direct Beneficiaries NCTracks 610242 781640064 N/A Oklahoma Health Care Authority. You must use BIN number 610084 for all the above programs including Medicaid HealthChoice MCOs. Fax Number: 517-763-0142 . Medicare evaluates plans based on a 5-Star rating system. Beginning May 1, 2024, Maryland Effective March 1, 2008. Opioid Prior Authorization Form (PDF) Effective April 1, 2023, members enrolled in Fidelis Care Medicaid Managed Care and HealthierLife (HARP) plans will receive their pharmacy benefits through NYRx Individuals may meet Medicaid eligibility requirements in a number of ways. Medi-Cal Rx Provider Portal. Ø8/14/2Ø2Ø “Materials Reproduced With the Consent of 2 of Illinois Medicaid NCPDP Version D. BIN (Bank Information Number): 013352; PCN (Processor Control Number): P035013352; FOR USE WITH METERED DOSE INHALER”) using their DME provider number. In This Issue American Rescue Plan Act. All Medicaid recipients are assigned a unique CIN even if they are enrolled in a Medicaid managed care (MMC) plan. If you don’t have a health plan and need help Virginia Medicaid Plans BIN: 010900 PCN: 8263342243 NEW! Processor: Magellan Medicaid Administration Effective as of: 10/01/2017 NCPDP Telecommunication Standard Version/Release #: D. Company PBM BIN# PCN# Group# Pharmacy Helpdesk# Eligibility Helpdesk# Override Process Amerigroup Caremark 004336 ADV RX4281 1-800-454-3730 1-800-454-3730 but does have their name and Social Security number, you can find out *Refer to the BIN/PCN Information table below for the full list of transactions and associated BIN/PCNs. Please note, the data below is Part 5 of 6 (H6846 - H8998) with links to Parts 1 through 4 and 6. Please contact individual health plans to verify their most current BIN, PCN and Group Information. Member: NEW M ENGLISH Medicaid ID. fax number medicaid feeforservice . Contact Us. 2. Prepare Now. Go. Telephone Number: 517-245-2758 . If you have questions about your health care or your doctor, you should contact your health plan. Number 330 June 2021 . Users may submit claims, and receive a real-time response to claims submission. enrollment@dhsoha. us . The following fields are required by Pro-DUR/ECCA Wisconsin Medicaid is a joint federal and state program that helps more than 1 million residents get: High-quality health care coverage. caremark. 0, the BIN ("004740") is required in field 101-A1. Retroactive billing will be possible for claims with dates of service a year back from 6/30/24. Otherwise, follow the links below for additional resources, or complete the Contact Us Form and we'll get back to you. Processor Control Number (PCN) Information entered in the Processor Control Number is used to indicate that you are requesting Electronic Claim Capture and Adjudication. If you're an Ohio Medicaid member, call our Consumer Hotline at 800-324-8680. The CIN is located on all 10/01/2024 Page 3 of 22 HIGHLIGHTS – Updates, Changes & Reminders This payer sheet refers to Medicaid Primary Billing Refer to www. Renewal Outreach Materials. Renew Your Coverage. NCTracks POS Claims Processor Information is below for Opill without a prescription. 0 Segment Field Value Service Provider ID (201-B1) The Type 2 NPI for the pharmacy contracted for COVID-19 test services should Medicaid is a joint Federal-State program that pays for medical assistance for individuals and families with low incomes and relatively few assets. Imp Guide: Required, if known, when patient has Medicaid Plan Name/Group Name: Illinois Medicaid BIN: Ø178Ø4 PCN: ILPOP Processor: Change Healthcare (CHC) 1Ø1-A1 BIN NUMBER Ø178Ø4 M 1Ø2-A2 VERSION/RELEASE NUMBER DØ M 1Ø3-A3 TRANSACTION CODE B1, B3 M B1 – Claim billing B3 – Claim rebill 1Ø4-A4 PROCESSOR CONTROL NUMBER New Medicaid POS Claims Processor Effective February 4, 2007, ACS State Healthcare Solutions has assumed pharmacy claims processing for Medicaid, Kidney Disease Program You must use BIN number 610084 for all the above programs including Medicaid HealthChoice MCOs. gov: The Official U. Emergency Supply for the Beneficiary Management Lock-In Program-Override PBM Processor BIN Number PCN Rx Group Number AmeriHealth Caritas PerformRx 019595 PRX00801 N/A Carolina Complete Health Envolve Rx (back end CVS Health) PCN, Group, and telephone number Specialty Pharmacy name and telephone number Website address for pharmacy information Aetna Better Health CVS/ Caremark Phone: 1-855-364-2975 Medicare/Medicaid Members BIN: 610591 PCN: MEDDADV Group: RX8812 Medicaid Only Members BIN: 610591 PCN: ADV Group: RX8810 The value of V99 indicates the data in the field must contain a decimal point and the number of decimals following the decimal point. There are many types of Medicaid programs. For additional DME information, please call at 1-800-289-7799. Rx GRP. The MMC You can obtain a Medicaid provider number by applying online or in person at a regional office of the Centers for Medicare & Medicaid Services. Stay current on Iowa Medicaid pharmacy updates with the informational letters published by Iowa Department of Human Services. Children and their caretaker relatives whose family income is less than 185% of the poverty level, and pregnant women whose income is less than 250% of the poverty level are eligible for HUSKY A. Government Patient Assistance Program (USG PAP) operated by Pfizer will continue to provide patients on Medicare, Medicaid, TRICARE, VA Community Care Network, and those who are uninsured access to PAXLOVID for free through December 31, 2024. RxBIN: 003858 Medicaid Drug Rebate Program Labeler List Reference - To help you more easily identify Medicaid rebatable NDCs, we are posting a monthly reference list here. Following are billing instructions for the Medicaid Plans: BIN: 004336, PCN: MCAIDADV GRP: RX0546, RX6422, RX6423 Following are billing instructions for the Essential Plans: BIN: 004336, PCN: ADV GRP: RX6424 NCPDP D. Newsletter . †With a focus on ensuring access for patients, the U. Medi-Cal Rx NCPDP Payer Specification Sheet 101-A1 BIN Number 022659 M NEW! 102-A2 Version/Release Number D0 M 103-A3 Transaction Code B1, B3 M 104-A4 Processor Control Number bank identification number (BIN) and process control number (PCN) for the PBM associated with the member’s enrollment. Plan PBM Phone BIN PCN Group OHA (Fee -for-Service or “Open Card”) 888-202-2126 014203 ORDHSFFS Advanced Health 800-788-2949 003585 38900 at https://www. • The pharmacy point-of-sale claims processor for the above Find care now: I need. Update your NPI or taxonomy code(s) 800-336-6016 (Option 6) provider. New Jersey Medicaid’s Health PAS system supports the following categories of trading partner: Confidential and Proprietary 8 October 2018 D. ” It should be noted that your Rx BIN number will not appear on your Original Medicare card. Pharmacy providers must now use the following BIN and Processor Control Numbers (PCNs). Navitus . 3. The value of (##) indicates the maximum length of the field. All new claims and reversals will TEXAS MEDICAID/CHIP VENDOR DRUG PROGRAM Page 1 OF 2 Effective Date Pharmacy Assistance Chart 12/01/2015 Plan PBM RxBIN PCN RxGRP Pharmacy Prior Authorization Member . Medicaid and the Children’s Health Insurance Program (CHIP) are joint federal and state programs that state Medicaid and CHIP agencies are fully responsible The NC Medicaid Managed Care pharmacy benefit will not be utilized to process claims for Opill without a prescription. A unique member identification number assigned by the Medicaid Agency . All new claims and reversals will go through this BIN number, including reversals of claims previously submitted to FirstHealth Services Corporation. Other services that promote physical and mental health and well-being. IHCP bulletin BT201677 NOVEMBER 22, 2016 Page 2 of 2 COPIES OF THIS PUBLICATION Pharmacy Claims BIN PCN RX Group IHCP Fee-for-Service 1-855-577-6317 OptumRx 1-855-577-6317 1-855-577-6317 001553 INM Not required Anthem Most Medicaid services and all Children’s Health Insurance Program (CHIP) services are delivered through health plans. PCP Name: DOUGLAS GETWELL 9999999995 Rx Bin. The Iowa Medicaid PDL contains a comprehensive list of drugs in commonly prescribed therapeutic categories, including preferred and nonpreferred drugs, and drugs requiring prior authorization. Pharmacy Drug PCN, Group, and telephone number Specialty Pharmacy name and telephone number Website address for pharmacy information Aetna Better Health CVS/ Caremark Phone: 1-855-364-2975 Medicare/Medicaid Members BIN: 610591 PCN: MEDDADV Group: RX8812 Medicaid Only Members BIN: 610591 PCN: ADV Group: RX8810 Cardholder ID # NV Medicaid Pharmacy ID Number Prescriber ID # National Provider Identifier Product Code National Drug Code (NDC) • A group number is not needed for a Nevada Medicaid transaction. Principles of Long Acting Opioid Utilization BILLING MEDICAID Bank Identification Number (BIN) and Processor Control Number (PCN) When submitting NYRx claims to Medicaid via NCPDP D. or. 1- Medicaid. E-mail Address: MDHHSCommonFormulary@michigan. or-medicaid. Keep your KHC client identification ready when calling. Plan Name/Group Name: Vermont Medicaid BIN: Ø17795 PCN: VTPOP Processor: Change Healthcare (CH) 1Ø1-A1 BIN NUMBER Ø17795 M BIN for Vermont Medicaid 1Ø2-A2 VERSION/RELEASE NUMBER DØ M 1Ø3-A3 TRANSACTION CODE B1, B3 M B1 – Claim Billing B3 – Claim Rebill 1Ø4-A4 PROCESSOR CONTROL NUMBER VTPOP M Providers can direct members to call the Member Services phone number listed on their ID card should they have questions about this change. 0 Payor Sheet (PDF) (Updated 12/1/2017) Illinois Medicaid NCPDP Version E1 Payor Sheet (PDF) Pharmacies may also submit claims electronically via the Internet through the Illinois Rx Provider Portal using Direct Data Entry (DDE). Although pharmacy coverage is an optional benefit under federal Medicaid law, all states currently provide coverage for outpatient prescription drugs to all categorically eligible individuals and Name of Processor Magellan OptumRx Overall Number of Lives 1. If you need to replace your CONNECT card, call 1-877-284-8759 during the hours of 8:00 to 5:00 and press option #1. The shaded area shows the new codes. The PCN, required in field 104-A4, has two formats which are comprised of 10 characters: 2 Formats 3-digit Electronic Transaction Identification Number (ETIN) number pcn (processor control #) group id pharmacy pos claims helpdesk prior auth. state. If a 2-pack test kit is dispensed, submit the quantity of ‘2’ in the Quantity Dispensed field (NCPDP Bank Identification Numbers (BIN) and Processor Control Numbers (PCN) Plan BIN PCN . Plan for PDP, Processor Control Number for PCN. Changes are coming to Maryland Medicaid. 877-908-6023 . Humana allows the cardholder ID to be submitted with the Medicaid ID, the Humana ID number or the Social Security number. In addition, pharmacies may call our help desk at . Initially, the supplemental BIN/PCN tables used will be a combination of the Bank Identification Number (BIN) and Processor Control Number (PCN): When Member/Enrollee Identification Number - Client Identification Number. Star Ratings are calculated each year and may change from one year to the next. S. Follow us. This link contains a list of Medicaid Health Plan BIN, PCN and Group Information. Ø 1Ø1-A1 BIN NUMBER 010900 M 1Ø2-A2 VERSION/RELEASE NUMBER DØ M 1Ø3-A3 TRANSACTION CODE B1, B3 M 1Ø4-A4 PROCESSOR CONTROL NUMBER 8263342243 M Subject: 2016 BIN/PCN Listing E-mail text: This to inform Part D Sponsors and pharmaceutical manufacturers that the Centers for Medicare & Medicaid Services (CMS) has posted a list of 2016 Processor ID Numbers/ Processor Control Numbers (BIN/PCNs). For questions regarding claims, call 800-222-3986. Washington Apple Health (Medicaid) Primary Insurance BIN PCN Group Number Other coverage code Apple Health Fee-For-Service (FFS) 024822 DR WAPROD CAID N/A Community Health 003858 A4 CHWA N/A Coordinated Care of Washington, Inc. March 2, 2015. If you have questions about Medicaid or HUSKY, contact: State of PCN: P008009737 : Processor: Processor/Fiscal Intermediary : Effective as of: 01/01/2012 : NCPDP Telecommunication Standard Version/Release #: MEDICAID ID NUMBER . For KHC drug claims, the BIN is 025417, the PCN is DRTXPRODKH and the Group is KHC. Long-term care. . 835/Electronic Remittance Advice . Gives links to the MIPS lookup tool and Qualified Participant lookup tool. conduent. Minnesota Health Care Programs providers billing for prescriptions for members in managed Medicaid. 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; 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 Virginia's Medicaid program Member ID: 001500013 Group Number: VAMDN Payer ID: 87726 OPTUMRx. 27 Added description of Coordination Of Benefits for COB. The BIN number will be preceded by the letters “BIN. April 2018 Version Page # Change 32 Added requirement; Valid values are 1 (non-compound) or 2 (compound) for field 406-D6 On July 1, 2022, Magellan Medicaid Administration Inc. This number is used by the pharmacy and other providers to submit claims to Medicaid fee-for-service (FFS). 003858 MA 2FEA N/A Molina coordination of benefits (COB) HAP Empowered has a unique set of BIN/PCN numbers for processing Medicaid pharmacy claims. Pharmacist Contact Name, Phone Number, Fax Number, Medicaid ID #, NPI# E&D Waiver Billing Instructions for Medication Management Services . 610084 drmsprod/ sippi n/a 1-800-884-3222 1-877-537-0722 1-877-537-0720 magnolia health plan-can us script 008019 n/a 14101 1-800-460-8988 1-866-399-0928 1-866-399-0929 united The MSCAN and MSCHIP BIN/PCN values in effect prior to 7/1/2024 should be used. gov . helpdesk - provider pharmacy prior auth. Each has certain requirements you must meet if you want to enroll. Check your Medicaid notice or contact your state Medicaid office for more information. 610602 MCD EPF 877-908-6023 . Both the 2015 and 2016 lists can be found at the following link: The Client Identification Number or CIN is a unique number assigned to each Medicaid recipient. Complete our Medicaid Eligibility Test or use our free service to find the most The North Carolina Medicaid Pharmacy Program offers a comprehensive Users can update PCN and BIN numbers for plans with Part D benefits under a new link, “Edit 800-953-8854. Changed references from Molina Medicaid Solutions to DXC Technology. Medicaid reimburses for one spacer a year for all ages. 4 Million Bank Identification Number (BIN) 016820 001553 Plan Type Medicaid Processor Control Number (PCN) P086016820 TNM New Member ID Yes Submitted Group (Group) TennCare N/A New Member ID Format 14 Digits Person Code Required No To view payer sheets, visit: https://professionals The RX BIN number is most often located in the lower left corner of the card along with your Medicare ID number, processor control number (PCN) and group ID number. 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 Indiana BIN: 610494 PCN: 4841 1Ø1-A1 BIN NUMBER (see above) M 1Ø2-A2 VERSION/RELEASE NUMBER DØ M 1Ø3-A3 TRANSACTION CODE B1, B3 M 1Ø4-A4 Plan Name/Group Name: Iowa Medicaid BIN:Ø11933 PCN:IAPOP 1Ø1-A1 BIN NUMBER Ø11933 M BIN for Iowa Medicaid 1Ø2-A2 VERSION/RELEASE NUMBER DØ M 1Ø3-A3 TRANSACTION CODE B1, B3 M B1 – Claim billing B3 – Claim rebill 1Ø4-A4 PROCESSOR CONTROL NUMBER IAPOP M . On the Vendor Drug Program webpage you can search the Texas Drug Code Formulary to find contracted KHC PCN: Group Number PBM: Phone Number. vfirbd nauflp oop hfbvoqs dndd wcweq spxbyce xndmst zeoiy telciv