• Verify you Drug Record F4 NDC number has 11 digits.
• Contact the insurance to see if the NDC is covered. Prior Authorization may be required. Tip You can verify the Product-Service Code in the transmission details. To access te transmission detail screen double click on the RX FLAG. Example Click on REJECTED sign this will take you the the Payment History Screen which displays the transmission details. Right click on the "A" in the Status Column then click DISPLAY RESPONSE and scroll down to AM07---Claim Segment and location Field 407-D7. This field will confirm the product service code submitted.
• If you are transmitting a COMPOUND Rx and get the rejection 1 or more of the compound ingredients are not covered. You can try to use Clarification Code 8 Process Claim for Approval. But there is no guarantee the Rx will get a PAID response.

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Published in Rejections

Go to Utlilties Click on Un-Delete-RX. check to see what was delete and undelete Rx. go back and fix RX

Published in Rejections

Refer to the settings on the Secondary Billing tab (Delete all the P's)

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Correct Q.Disp (quantiy dispenesd) on rx

Published in Rejections

• Verify you Drug Record F4 NDC number has 11 digits.
• Contact the insurance to see if the NDC is covered. Prior Authorization may be required. Tip You can verify the Product-Service Code in the transmission details. To access te transmission detail screen double click on the RX FLAG. Example Click on REJECTED sign this will take you the the Payment History Screen which displays the transmission details. Right click on the "A" in the Status Column then click DISPLAY RESPONSE and scroll down to AM07---Claim Segment and location Field 407-D7. This field will confirm the product service code submitted.
• If you are transmitting a COMPOUND Rx and get the rejection 1 or more of the compound ingredients are not covered. You can try to use Clarification Code 8 Process Claim for Approval. But there is no guarantee the Rx will get a PAID response.

Published in Rejections

No information available yet…

Published in Rejections

No information available yet…

Published in Rejections

• Re-calculate the pricing of the Rx 1) Change the Bill to from the PLAN NAME to PATIENT then change it back to the plan name. This is re-calculate the rx pricing.
• Verify the Payment History screen (Blue Pricing screen) has "AWP" indicator next to the RX COST amount. If it is not "AWP" you may want o change the P.C. to "I" or "C".

Published in Rejections