What is the "old way" of finding insurence at CVS?

[Aimee19]

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I have always heard that there is another older ways to find insurence in RXnet other than 9999 and zipcide method. They talked about it with no detail and mentioning the steps. Can you please teach each step both for commercial and part D please. Thank you so much.

 

[Dr Wario]

There was an insurance you could add called commercial eligibility check, you would run a claim with that insurance and sometimes it would return a hit with billing information that you would have to manually add (though it mostly only worked with caremark). The current method, while not perfect, seems much more robust.

 

[Mambo#5]

I have always heard that there is another older ways to find insurence in RXnet other than 9999 and zipcide method. They talked about it with no detail and mentioning the steps. Can you please teach each step both for commercial and part D please. Thank you so much.

We used to ask the patient for their insurance card/information and or have them call their insurance.

 

[Old Timer]

There was a condor code you used, put the condor code into the rx and the rejection would show the BIN, PCN, ID, etc. You would print the screen and add the information to the profile. Why in God;'s name would you want to go through all that work? It's like using an abacus instead of a calculator

 

[Sine Cura]

As far as abacus vs calculator, we use the LI NET processing info + MBI for dual eligibles b/c these people are usually illiterate and don't even know their coverage changed (see Aetna Medicare pts) or present a card thinking their new coverage works but it's not active until Feb 1 so we have to find their old coverage, which they don't know about.

 

[dmd20000]

Before I started working at CVS last April I went online and found all info. I could find about insurance using RxConnect. I made a list of the common condor codes for the common insurances so now I just use them only for medicaid. We have many medicaid plans and most of them have the same ID number. I noticed the system will give you the group number sometimes which is good.

 

[RxPreceptor]

Using the commercial eligibility check/9999/EC hotkey is often faster than asking insurance info from patient (highly depends on competency/sense of self responsibility). Caveat being that address needs to be up to date (search based on zip code)....can ask to update address if person is incompetent/lacks responsibility to carry a prescription card