Get National Council For Prescription Drug Programs Batch ... - Wps

This guide provides essential instructions for completing the National Council For Prescription Drug Programs Batch Standard form online. Following these steps will help ensure that your submission is accurate and compliant with the necessary standards.

Follow the steps to complete the National Council For Prescription Drug Programs Batch Standard form.

1. Click ‘Get Form’ button to obtain the form and open it in your preferred format.
2. Begin by entering your submitter identification number (Sender ID) in the designated field. Ensure that it is authorized for electronic claim submission to avoid rejection.
3. Fill out the Receiver ID (880-K7) based on TRICARE guidelines. Use 'REG06' for TRICARE Region 6, 'REG11' for TRICARE Region 11, or 'FORGN' for overseas submissions.
4. Select the transaction type you are submitting. Remember that WPS-TRICARE accepts only one transaction type per file (Billing transaction B1 or Eligibility transaction E1).
5. In the Service Provider ID field, specify the Service Provider ID Qualifier '07' followed by the Pharmacy NCPDP number.
6. Complete the Patient Segment, ensuring to fill out all required fields: Date of Birth, Patient Gender Code, Patient First Name, Patient Last Name, Patient Street Address, Patient City, Patient State, and Patient Zip Code.
7. In the Insurance Segment, provide the Cardholder First Name and Last Name, as well as the Patient Relationship Code.
8. For the claim billing transaction (B1), specify the Product Service ID in the Claim Segment using one of the accepted code sets: National Drug Code (NDC), CPT4, CPT5 (when approved), or HCPCS.
9. Input the Quantity Dispensed in the Claim Segment. Note that units must not exceed '9999', and only the whole number will be considered, ignoring any decimal positions.
10. If applicable, provide up to four iterations of COB/Other Payment information in the COB/Other Payments Segment. Data beyond four iterations will be disregarded.
11. Complete the Pricing Segment by entering the required Ingredient Cost (409) and Gross Amount Due (430) fields. Ensure these fields are not left blank.
12. If using a Compound Segment, include no more than ten iterations of the compound ingredient component, as any additional iterations will be ignored.
13. Finally, review all information for accuracy, then save your changes, download a copy, or print the completed form as needed.

Ensure your submission is compliant by filling out the document correctly online.