I recently started as a pharmacy technician and I can not understand how to enter insurance information into RX CONNECT. I search for the BIN and a long list of insurance options show up. It seems no matter which option I choose, there is a third party reject. Can anyone help me better understand? I feel like I see many different insurance cards and some you can enter the letters on the card and some you do not need the letters. SO CONFUSED.
HELP CVS PHARMACY TECHS
- Thread starter storm214
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Ah, the joy of insurance. I don't know the definite answer, but you can sometimes narrow it down to a couple pages by matching up the helpdesk number on the card. Sometimes if you're lucky, the card will have the name of the PBM on it. From there I just take a stab at whatever looks right. But yes, when you type in some BIN numbers, it will pull up 13 pages. There needs to be a more efficient way to bill third parties. The credit card industry doesn't have this issue.
Okay, my pharmacist made a list of about 8 condor codes but when I enter in the code, I still sometimes have a list to choose from. What should I look for on the insurance card to narrow it down farther? Also, when do I know when to use letters and when not to? Maybe my problem is I am entering something incorrectly. We are a busy store so someone usually just fixes it for me so I never know what I am doing wrong.
You can type BIN and PCN if that helps (BIN, PCN). It can narrow it down some depending on the insurance. Most insurances just match the name (Caremark, Aetna, Cigna, UHC, BCBS, Medco/ExpressScripts). PDP is Medicare. If there are multiple options for an insurance with the same name which one normally doesn't really matter (at least not in my experience), unless it says something like MO or WC (there's a bunch of listings for Aetna and Cigna, but I just pick one). So normally just go for the 'plain one'. I personally don't know any condor codes except UHC and just type in the BIN and don't have a problem picking the insurance for 99% of cards by just matching the name (there is of course the occasional weird one).
Assume you don't put the first three letters in if it just starts with letters (ex-ZGP#########). I think that's mostly BCBS? but I normally just recognize the card. Otherwise letters are normally in (if it's 1 letter, W######## or has letters in the middle).
As far as what else you could be entering wrong or if it's something else, I wouldn't really know without seeing the actual rejection.
Assume you don't put the first three letters in if it just starts with letters (ex-ZGP#########). I think that's mostly BCBS? but I normally just recognize the card. Otherwise letters are normally in (if it's 1 letter, W######## or has letters in the middle).
As far as what else you could be entering wrong or if it's something else, I wouldn't really know without seeing the actual rejection.
Once you enter the BIN, look for the insurance that has the same PCN. In many cases multiple insurances will have the same BIN and PCN, in which case you either look for the one that has the same company name as on the card or guess. Once you gain some experience you will just know which one to pick.
With Caremark cards, in the list of cards sometimes one will come up with the name "CAREMARK BN12345" or whatever. In this case, just choose the card with the correct BIN number listed in the name of the insurance.
The letters are used for medical billing and not prescription billing on some cards. I usually enter the letters every time and only take them off if it rejects it.
With Caremark cards, in the list of cards sometimes one will come up with the name "CAREMARK BN12345" or whatever. In this case, just choose the card with the correct BIN number listed in the name of the insurance.
The letters are used for medical billing and not prescription billing on some cards. I usually enter the letters every time and only take them off if it rejects it.
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they have certain codes for every insurance company. write them down and that will make your list shorter
Hi storm214,
As a fellow cvs tech, I can give you a few hints to find the right insurance. When a customer presents his or her insurance card, I immediately look for the RxBin number. Then I look for the PCN number. When you type in the Bin, insurances with the same bin will show up in alphabetical order. If you still don't see the one you're looking for, you can look on the back of the card, and usually there's information about pharmacy benefits.
Here are the common RxBin's that I have memorized.
1. 003858 - Express Scripts (ignore the first 3 letters in the ID, start with the first numerical digit)
2. 610502 - Aetna (Type ID exactly as it shows on the card)
3. 600428 - Blue Shield (ignore the first 3 letters in the ID, start with the 4th digit. Sometimes it's a number, and sometimes it's the letter "J")
4. 610053 - Anthem Blue Cross (ignore the first 3 letters, start with the first numerical digit in the ID number)
5. 610014 - Medco Express Scripts
6. 004336 - Health Net (ID number always start with the letter "R") and Caremark
7. 610279 - OptumRx and United Health Care
Hope this helps you! As you spend more time at Drop-Off, you'll become more familiar with insurances.
As a fellow cvs tech, I can give you a few hints to find the right insurance. When a customer presents his or her insurance card, I immediately look for the RxBin number. Then I look for the PCN number. When you type in the Bin, insurances with the same bin will show up in alphabetical order. If you still don't see the one you're looking for, you can look on the back of the card, and usually there's information about pharmacy benefits.
Here are the common RxBin's that I have memorized.
1. 003858 - Express Scripts (ignore the first 3 letters in the ID, start with the first numerical digit)
2. 610502 - Aetna (Type ID exactly as it shows on the card)
3. 600428 - Blue Shield (ignore the first 3 letters in the ID, start with the 4th digit. Sometimes it's a number, and sometimes it's the letter "J")
4. 610053 - Anthem Blue Cross (ignore the first 3 letters, start with the first numerical digit in the ID number)
5. 610014 - Medco Express Scripts
6. 004336 - Health Net (ID number always start with the letter "R") and Caremark
7. 610279 - OptumRx and United Health Care
Hope this helps you! As you spend more time at Drop-Off, you'll become more familiar with insurances.
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Honestly I feel that condor codes aren't important. I select an insurance with the same name and Bin as the card and the rest takes care of itself.
