0000005422 00000 n The ISO/IEC 7812 IIN is a number used throughout electronic routing. that insure or administer group HMO, dental HMO, and other products or services in your state). Hb```?@(AEs,Pp IG1~D&t Medicare Advantage plans that include prescription drug coverage (MAPDs) are considered Medicare Part D plans and members with higher incomes may be subject to the Medicare Part D Income Related Monthly Adjustment Amount (IRMAA), just as members in stand-alone Part D plans. 0000009323 00000 n BIN number See above M Pages 1 and 2 for BIN/PCN : 102-A2 : Version/Release number D.0 M : 103-A3 : Transaction code B1, B3 M : 104-A4 : Processor control number : M . 0000006674 00000 n startxref 0 Honestly, whenever I see BIN 610014 I know it's PAID. 0000000975 00000 n The IIN structure is defined within the international standard ISO/IEC 7812-1,Identification cards - Identification of issuers - Part 1: Numbering system. Providers who do not contract with the plan are not required to see you except in an emergency. 0000002851 00000 n 0000019138 00000 n Region BIN PCN/ Group Help Desk Fiserv Health Plans Innoviant National 610127 01960000 877-559-2955 Fishing Partnership Health Plan MedImpact MA 003585 Grp 35026 800-788-2949 FlexScripts WHI/WHP TX/FL 603286 01410000, GP 513274 800/207-2568 FLRx FLRx National 610475 See Card 585-327-7530 Some health plans decided to use magnetic stripe cards, some did not. 0000002069 00000 n ngRH);HRsZ.>@qTi-(0Q\{*`*5&he%fJ`B49Pe(h\#70 #8:(7Q)7mW:R,ATp$&Oz5$;X\MV&N2Z%s6GzMC"C&tcz=8j 11'H[/).R(k9FMfFU%g^|Vk&q/=~CC#Pe[?0gYvnF&9,g8iVIF;>v.fcIt(W=7YKF%ej>-T7WvR"B>]D.by%z"lhhnP7 jP6@{6Ap+t fzWGD\N|@wLL5 0000001081 00000 n PCN: Varies by plan - refer to ID card. BIN/PCN/Group Numbers for ACOs, MCOs and PCC Plan The three tables below shows the correct combinations effective March 1, 2018, for pharmacies to use when submitting MassHealth ACO/MCO/FFS pharmacy claims. 0000001602 00000 n JE?/=lx3Gi8>lp9.lHAT1m~&jcLTj}~`R$/#`Wret"XZ7;Dkts465e,sTXzI#Ve6\E`(&E^DXox._ C!ka7 0000000016 00000 n })(); Chart of 2021 BIN and PCN values for each Medicare Part D prescription drug plan Part 5 of 5 (H8634 through S9701). }|a3M3J=/`zy[X >]!/c 5'{ Xri endstream endobj 73 0 obj 336 endobj 47 0 obj << /Type /Page /Parent 42 0 R /Resources 48 0 R /Contents 56 0 R /MediaBox [ 0 0 612 792 ] /CropBox [ 0 0 612 792 ] /Rotate 0 >> endobj 48 0 obj << /ProcSet [ /PDF /Text /ImageC ] /Font << /TT2 53 0 R /TT4 52 0 R /TT6 51 0 R /TT8 57 0 R /TT10 60 0 R /TT12 61 0 R >> /XObject << /Im1 63 0 R >> /ExtGState << /GS1 66 0 R >> /ColorSpace << /Cs6 55 0 R >> >> endobj 49 0 obj << /Type /FontDescriptor /Ascent 891 /CapHeight 0 /Descent -216 /Flags 34 /FontBBox [ -568 -307 2000 1007 ] /FontName /FHGHLD+TimesNewRoman /ItalicAngle 0 /StemV 0 /FontFile2 67 0 R >> endobj 50 0 obj << /Type /FontDescriptor /Ascent 891 /CapHeight 0 /Descent -216 /Flags 34 /FontBBox [ -558 -307 2000 1026 ] /FontName /FHGHND+TimesNewRoman,Bold /ItalicAngle 0 /StemV 133 /FontFile2 68 0 R >> endobj 51 0 obj << /Type /Font /Subtype /TrueType /FirstChar 32 /LastChar 32 /Widths [ 250 ] /Encoding /WinAnsiEncoding /BaseFont /FHGHND+TimesNewRoman,Bold /FontDescriptor 50 0 R >> endobj 52 0 obj << /Type /Font /Subtype /TrueType /FirstChar 32 /LastChar 49 /Widths [ 250 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 500 ] /Encoding /WinAnsiEncoding /BaseFont /FHGHLD+TimesNewRoman /FontDescriptor 49 0 R >> endobj 53 0 obj << /Type /Font /Subtype /TrueType /FirstChar 32 /LastChar 119 /Widths [ 352 0 0 0 0 0 0 0 0 0 0 0 364 0 364 454 636 636 0 0 636 0 0 636 0 0 0 0 0 0 0 0 0 0 0 0 771 0 575 0 751 421 455 0 557 843 748 0 603 0 0 684 0 0 0 0 0 0 0 0 0 0 0 0 0 601 0 521 623 596 0 0 633 274 0 592 274 973 633 607 623 0 427 521 394 633 592 818 ] /Encoding /WinAnsiEncoding /BaseFont /FHGHKH+Verdana /FontDescriptor 54 0 R >> endobj 54 0 obj << /Type /FontDescriptor /Ascent 1005 /CapHeight 0 /Descent -209 /Flags 32 /FontBBox [ -50 -207 1447 1000 ] /FontName /FHGHKH+Verdana /ItalicAngle 0 /StemV 96 /FontFile2 65 0 R >> endobj 55 0 obj [ /ICCBased 64 0 R ] endobj 56 0 obj << /Length 1929 /Filter /FlateDecode >> stream Have them call the phone number on the back of their Cigna ID card. 0000002463 00000 n 0000100252 00000 n This includes accounts for Grandfathered members. The PCN is defined by the PBM/processor as this identifier is unique to their business needs. We are not compensated for Medicare plan enrollments. It is important to understand the difference between the ISO/IEC 7812 IIN and NCPDP Processor ID Number (BIN) before applying for a Processor ID Number (BIN). The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins. ;;_XKkMUsZWPTdyRWp :{j dac{U|U|Y1~x^_$^4M}]Y>qP7CuH2xzR7bX" w-@yt 1;|hq=Z2C:n{g` 610014 800-824-0898 Integrated Prescription Management (IPM) 014658 877-860-8846 LDI Integrated Pharmacy Services 800010 800-652-9550 Magellan Health Services (Includes: Kentucky Passport) 015053, 016523 800-790-1631 McKesson Specialty 610524 800-657-7613 *Independently Contracted. 0000009977 00000 n BIN: 610014 PCN: COPAY Reimbursement is Based on the Other Payer Patient Paid (COPAY ONLY) Plan Name/Group Name: MEDICARE PART D AS PAYER BIN: 610014 PCN: MEDDPRIME Plan Name/Group Name: SECONDARY to MEDICARE BIN: 610031 PCN: MEDDCOBSEG PART D COBSEG OTHER PAYER PRIMARY Plan Name/Group Name: SECONDARY to MEDICARE BIN: 610031 PCN: MEDDCOPAY 0000003516 00000 n %PDF-1.6 % BIN Number 610014 610014 003858 600428 PCN Number Per card, cannot be 0s 06330000Per card, cannot be 0s A4 . If you join a Medicare MSA Plan, you can also join any separate (stand-alone) Medicare Part D prescription drug plan. The Centers for Medicare & Medicaid Services (CMS) released a compilation of the BIN and PCN values for each 2021 Medicare Part D plan sponsor. At home, across the country, and around the worldthe power of Blue is with you. ;nq*DEhw x~iW}W7#WrL/F6geO6UNHZMS u|Z)/ZE,PK3G}E,8-1|_bF6? %PDF-1.4 % Ut JJ`&PXIIaAAq0. BIN: 610014 PCN: MEDDPRIME Group: RXINN03 Phone: 1-800-416-3628 Accredo Specialty Pharmacy Phone: 1-800-803-2523 . The BIN/IIN field will either be filled with the ISO/IEC 7812 IIN or the NCPDP Processor BIN, depending on which one the health plan has obtained. 0000013525 00000 n 0000009374 00000 n Y fz Y!t|n^JFR0=eS(72H;F^2Myb hIaR:6Y\VO%\":l`v-?y-D[WsF'L"6[C(# )j$\R3 !krl[lp3#u40T534k0ElJQzsC0GKi;}c-Bd9(pU!8;wj0~8@^DUt1Th~;rB] qySULJk(!T&*BTEo0k 6Q4c)![8U/^:y} International Organization for Standardization / International Electrotechnical Commission, (ISO/IEC) Joint Technical Committee (JTC) 1, Contact NCPDP Provider Services Department at 480.734.2870 or. All calls are toll-free. 800-922-1557 Mercy Care LTC 610591 ADV RX8805 CVS- Caremark 855-548-5646 Arizona Complete Health (formerly Health Net & Cenpatico) 004336. The Bank Identification Number (BIN) is a term commonly used in the credit card industry. 0000005026 00000 n We do not sell leads or share your personal information. The plan deposits Group ID will be ignored by the processor. The IIN structure is defined within the international standard ISO/IEC 7812-1,Identification cards - Identification of issuers - Part 1: Numbering system. Contact the plan provider for additional information. wG4jZG5\s.Wu=]qjLH Share your form with others Send it via email, link, or fax. endstream endobj 2426 0 obj<>/W[1 1 1]/Type/XRef/Index[124 2265]>>stream 24 hours a day/7 days a week or consult, When enrolling in a Medicare Advantage plan, you must continue to pay your. Please note, the data below is Part 5 of 5 (H8634 - S9701) with links to Parts 1 through 4. 4=Four Occurrences. 0000008305 00000 n EmblemHealth (888 . You can also directly call Express Scripts Pharmacy Help Desk at 1.800.922.1557 or visit their Pharmacist Resource Center. A Medicare Advantage Private Fee-for-Service plan (PFFS) is not a Medicare supplement plan. Those that use magnetic stripe cards apply through ANSI for an IIN. TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult. There is no registry of PCNs. The NCPDP Processor BIN, while NCPDP assigns it, is only a number inside the pharmacy industry. What is a Take-Home Drug? var cx = 'partner-pub-9185979746634162:fhatcw-ivsf'; 02. Your Premera provider network: What's 'in' it for you? These numbers commonly begin with "61" as in "610014". MedImpact (Includes: Excellus/ FLRx) Links will appear for the application process. trailer << /Size 74 /Info 43 0 R /Root 46 0 R /Prev 171485 /ID[<37aecaa143068a95479ba03747276abf><049f79498583002e530f12be65619304>] >> startxref 0 %%EOF 46 0 obj << /Type /Catalog /Pages 42 0 R /Metadata 44 0 R /PageLabels 41 0 R >> endobj 72 0 obj << /S 297 /L 404 /Filter /FlateDecode /Length 73 0 R >> stream TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult. 0000028726 00000 n 3456 0 obj <>stream 109-A9 Transaction count 1 to 4 M Up to 4 0000003383 00000 n during the calendar year will owe a portion of the account deposit back to the plan. 'https:' : 'http:') + Box 7012 Downey, CA . 0000032330 00000 n 74 0 obj <> endobj Joined Feb 3, 2010 Messages 2 . 0000001647 00000 n 0000006026 00000 n Medicare evaluates plans based on a 5-Star rating system. endstream endobj 75 0 obj <. 0000016616 00000 n Verify member eligibility and the MCO enrollment . The Cigna name, logo, and other Cigna marks are owned by Cigna Intellectual Property, Inc. LINA and NYLGICNY are not affiliates of Cigna. 0000001856 00000 n 0000046944 00000 n 0000001415 00000 n PBM/processor/plans Payer Sheets are shared with their customers to the pharmacies, dispensing providers, clearinghouses and vendors. | Renew memberhip. Please do not turn the customer away if you receive a rejected claim. Bank identification number (BIN): 600428: Processor control number (PCN): 06210000: Pharmacy directory: Click on : Participating pharmacy: or go to : mibluecrosscomplete.com . 0000003547 00000 n Please renew your membership to login. %%EOF The term BIN is synonymous with the ISO/IEC 7812 IIN. RX Bin: 610014 . <<5F4BCB39515F55479546A7F5DAE5B678>]>> 0000007668 00000 n Edit your form online Type text, add images, blackout confidential details, add comments, highlights and more. Providers who do not contract with the plan are not required to see you except in an emergency. When applicable, the Pharmacy Providers should update impacted members profiles with the new processing information. Those who disenroll 0000001717 00000 n 0000004577 00000 n %%EOF 0000007450 00000 n 0000011949 00000 n 0000004799 00000 n 0000001469 00000 n AHCCCS FFS 001553 AZM OptumRx 855-577-6310 . The above chart is the sixth (final) page of the 2022 Medicare Part D pharmacy BIN and PCN list (H9699 - S9701). 11-A1 BIN Number See BIN/PCN table, above M 12-A2 Version Release Number D=Version D.0 M 13-A3 Transaction Code B1=Billing M 14-A4 Processor Control Number As indicated above M 19-A9 Transaction Count 1=One Occurrence 2=Two Occurrences . xref Selecting these links will take you away from Cigna.com to another website, which may be a non-Cigna website. The Privacy Policy has also been updated to better clarify what information we collect and how we use it. cyU>]s#~e{0Bb'Su[4E(/0PS_5]bmE k!Nb%Lx@b,/c7RL Xg29jA8Ruk1 fRBYoD0F9%e=E>e?-"{wQD ?c['l|S_R "qQKMF4B6B] o)/+jtqGOfPN-H ni;9uE%[7 aX4wve.\FPDvY '}Aj(bsgZJLi|]&:{|r2+>p#+Y31D|nGPrtqp\R]oMDl${mI15R/,;$5#]_zK>%,u$xwO@B,UlCt MOkd?X?. What is BIN/PCN and Group number needed to submit a BC/BS FEP prescription drug claim? 0000002330 00000 n We are not affiliated with any Medicare plan, plan carrier, healthcare provider, or insurance company. For more information on your Medicare coverage, please be sure to seek legal, medical, pharmaceutical, or financial advice from a licensed professional or telephone Medicare at 1-800-633-4227. 58 D-MEDCO 610014(`1589) MEDCO MEDICARE PDP 5.1 57 CATALYST RX(`1306) 1/3/2012ps Page 2 3. 0000016527 00000 n 0000002289 00000 n Sign it in a few clicks Draw your signature, type it, upload its image, or use your mobile device as a signature pad. 0000028775 00000 n trailer The Rx BIN # 610014 The PCN is MEDDPRIME The Rx Group number as listed below The member's ID number (format listed below) Note: Medco anticipates members will have their newly issued ID cards, but to assist members and pharmacy in the event that not every member has the new ID card, Medco is supplying Your medical benefits allow you during the calendar year will owe a portion of the account deposit back to the plan. 0000003136 00000 n hb```>>S~1A\pDKu;sH(1mA~>bN %%EOF TTY users should call, 1-800-325-0778; or your state Medicaid Office. xb```b``bl,@0fAgXE#$3V(a (jt m=a(%sdA`i78*Lj7 MN 14000 0000011029 00000 n 03. 0000001448 00000 n gcse.async = true; 0000002073 00000 n Accountable Care Partnership Plans MCO Partner PBM BIN PCN Group BMC HealthNet Plan Community Alliance 0000005387 00000 n Find a 2023 Medicare Advantage Plan (Health and Health w/Rx Plans), Browse Any 2023 Medicare Plan Formulary (or Drug List), Q1Rx Drug-Finder: Compare Drug Cost Across all 2023 Medicare Plans, Find Medicare plans covering your prescriptions, Medicare plan quality and CMS Star Ratings, Understanding Your Explanation of Benefits, IRMAA: Higher premiums for higher incomes, 2023 Medicare Advantage Plans State Overview, 2023 Medicare Advantage Plan Benefit Details, Find a 2023 Medicare Advantage Plan by Drug Costs. 0000019287 00000 n 0000000016 00000 n We provide our Q1Medicare.com site for educational purposes and strive to present unbiased and accurate information. U6E6hlhwElgf\0 $M[T=w"RnKPmH~g;~'-W99g/j730ePkxYj7 % "iU|5*hu88mG?K5rS0Q+C@^5k;5o^dM0&s o*e1gq~8F+aNc>CV} ${ *#. %PDF-1.6 % Details. HWr+S&M,N&H MRRgRIsin9ad_%^!c/$I &juN$WfOT^nvZd%w-17/0P}2EdN/[xnEZgcEir7x!%? Rx PCN: N/A 0000002215 00000 n Your membership is expired. Health insurance can seem complicated, especially if you're new to the plan. endstream endobj 249 0 obj <>stream 01. Express Scripts resources for pharmacists. 0000007679 00000 n PCN GROUP : Type Network: Location Help Desk Number: ARGUS 1.1.2015 HealthCare Corp of America /Prescription Corp of America HCA-PCA 340 Basics 600428 06730000 Medicaid: National 1-800-309-1603: ARGUS 1.1.2015 Health Network Dscnt Card 600428: 1HEALTH Commercial: National 1-866-921-7286: ARGUS 1.1.2015 Health Options 600428: 07130000 Commercial . RX Group: UHEALTH . On the ANSI web page, enter "IIN" in the Search box. In approximately 1989 the pharmacy services sector began using electronic processing for pharmacy claims. trailer <<0F6188EC756C624CBAA438B0D92726A7>]>> Individual and family medical and dental insurance plans are insured by Cigna Health and Life Insurance Company (CHLIC), Cigna HealthCare of Arizona, Inc., Cigna HealthCare of Illinois, Inc., Cigna HealthCare of Georgia, Inc., Cigna HealthCare of North Carolina, Inc., Cigna HealthCare of South Carolina, Inc., and Cigna HealthCare of Texas, Inc. Group health insurance and health benefit plans are insured or administered by CHLIC, Connecticut General Life Insurance Company (CGLIC), or their affiliates (see The Medicare Advantage and Medicare Part D prescription drug plan data on our site comes directly from Medicare and is subject to change. All insurance policies and group benefit plans contain exclusions and limitations. 0000003632 00000 n 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. 0000021562 00000 n Rx Information: MEDCO 1-800-842-2038 . For more information on your Medicare coverage, please be sure to seek legal, medical, pharmaceutical, or financial advice from a licensed professional or telephone Medicare at 1-800-633-4227. gcse.type = 'text/javascript'; 0000008854 00000 n 610014 003858 MA . 0000014626 00000 n The benefit information provided is a brief summary, not a complete description of benefits. %PDF-1.3 % (function() { 0000014560 00000 n UMP Plus networks. Plans that use cards with a magnetic stripe should use the recommended ISO/IEC 7812 Issuer Identifier Number (IIN) for processing electronic pharmacy claims. 0000007443 00000 n 0000004285 00000 n 0000007028 00000 n Rx PCN: N/A The TIN for Optimum Choice HMO is: 52-1518174 Group ID Number: 717578 . 0000010641 00000 n You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. 0000011550 00000 n If you have questions or concerns processing claims, you can call 1.800.624.6961, ext. If you are enrolled in a Medicare plan with Part D prescription drug coverage, you may be eligible for financial Extra Help to assist with the payment of your prescription drug premiums and drug purchases. Our Privacy Policy is now easier to read and better organized. 2. Your membership is expired. var s = document.getElementsByTagName('script')[0]; Credit/debit cards that are involved in banking transactions contain a BIN on magnetic stripe. In certain situations, you can. 0000008161 00000 n 0000021734 00000 n Star Ratings are calculated each year and may change from one year to the next. 0000003144 00000 n CO. & UHC INS. Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. 0000007215 00000 n MARTIN'S POINT GENERATIONS ADVANTAGE, INC. BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC. CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK, CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANY, ANTHEM INSURANCE CO. & BCBSMA & BCBSRI & BCBSVT, HAWAII MEDICAL SERVICE ASSOCIATION (HMSA), BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA, 314, 315, 316, 317, 318, 319, 320, 321, 322, 323, 324, 325, 326, 327, 328, 329, 330, 331, 332, 333, 334, 335, 336, 337, 338, 339, 340, 341, 342, 343, 344, 345, 346, 347, 003, 008, 013, 018, 053, 068, 088, 103, 108, 113, 118, 123, 128, 133, 138, 143, 148, 153, 158, 163, 214, 215, 216, 217, 218, 219, 220, 221, 222, 223, 224, 225, 226, 227, 246, 247, 248, 249, 250, 251, 252, 253, 254, 255, 256, 257, 258, 259, 260, 261, 262, 263, 264, 265, 266, 267, 268, 269, 270, 271, 272, 273, 274, 275, 276, 277, 278, 279, 280, 281, 282, 283, 284, 285, 286, 287, 288, 289, 290, 291, 292, 293, 294, 295, 296, 297, 298, 299, 300, 301, 302, 303, 304, 305, 306, 307, 308, 309, 310, 311, 312, 313, 801, 802, 805, 806, MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY, WELLMARK IA & SD, & BCBS MN, MT, NE, ND,& WY, WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION, REGENCE BLUESHIELD OF IDAHO AND REGENCE BC BS UTAH, UNITEDHEALTHCARE INS. trailer 8254 0 obj <> endobj 7914 (after-hours: 1.304.639.8591) or email us at pharmacyservices@healthplan.org. However, it is highly encouraged that the Group ID is submitted for all Part D claims. money from Medicare into the account. DownloadtheNCPDP Payer Sheet Template, more information is available by selecting Resource Topic - "HIPAA". startxref 0000030450 00000 n gcse.src = (document.location.protocol == 'https:' ? To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). 0000006589 00000 n var gcse = document.createElement('script'); One piece of information is the name of the health plan/PBM. 0000033238 00000 n Click here to let us know, CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA, Highmark Blue Cross Blue Shield of Western New York and Highmark Blue Shield of Northeastern New York, BlueCross BlueShield: Empire, Excellus, WNY & NENY, Health Alliance Medicare Prescription Plan, Blue Cross and Blue Shield of North Carolina, Blue Cross and Blue Shield of IL, NM, OK, TX, Blue Cross and Blue Shield of Kansas or Blue KC, Regence BlueShield of Idaho and Regence BC BS Utah, Horizon Blue Cross Blue Shield of New Jersey, 001-012, 014-034, 070, 105, 106, 121-137, 801, 802, 808. Type of GHP: W United HealthCare Optimum Choice claims address: PO Box 740825 Atlanta, GA 30374 Rx Information: MEDCO 1-800-842-2038 . MCAIDADV RX5443. 0000002482 00000 n BANBUHP Express Scripts. Once verified, ANSI will submit the application to the ISO/IEC 7812 Registration Authority for assignment of an IIN. Have them call the phone number on the back of their Cigna ID card. Og%$pB1 o:er1?P_ojKuK3L 9H(! 24 hours a day/7 days a week or consult, When enrolling in a Medicare Advantage plan, you must continue to pay your. '//cse.google.com/cse.js?cx=' + cx;
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