Wrong dual-eligible IDs slow Rx claims

February 13, 2006

Forty percent of claims submitted to Anthem under WellPoint's POS system for Part D dual eligibles have "junk" in the cardholder ID field, said a company spokeswoman during a CMS conference call. Since incorrect data slow down claims processing, Anthem instituted hard edits in the cardholder ID field to reject claims back to pharmacies that do not use the correct format for Medicare numbers.

Wrong dual-eligible IDs slow Rx claims

Forty percent of claims submitted to Anthem under WellPoint's POS system for Part D dual eligibles have "junk" in the cardholder ID field, said a company spokeswoman during a CMS conference call. Since incorrect data slow down claims processing, Anthem instituted hard edits in the cardholder ID field to reject claims back to pharmacies that do not use the correct format for Medicare numbers. Anthem had updated its payer sheet for the WellPoint POS system, which can be accessed by going to http://www.anthemprescription.com/ and clicking on Online Services for Providers.

To see more Hot off the Press news articles, click here http://www.drugtopics.com/Hot+off+the+Press.