Guest guest Posted February 8, 2007 Report Share Posted February 8, 2007 Hey Everybody! Sorry That I have not even been a 'lurker' in the past couple of weeks but I really jusy needed to take some 'time off' from my postings to both Jeanetta and Joe's Groups. After I took my my PCAT, I came doen with some sort of illness that reaked havok with my upper respiratory system, and pretty much put me down. If it was not for the fact that I had to help prepare for yearly inventory... Well, that's a different story. Sometimes you have to 'work through your illness'! As I posted earlier, a Tri-Pak and Medrol got me through it! Jeanetta, I only have experience procesing insurance claims using the Condor System at CVS. As I have posted earler, 'Drop Off' is really the hardest part of the job in Retail. A classroom lesson could help to prepare your students for this. But it seems that Pharmacy chains process claims differently. I will give you (AN EXAMPLE) of my curent BC/BS of Texas insurance card: Subscriber: ES***R M (She still uses her maiden name) Idenification #ZGP887353526 (NOT REALLY OF COURSE! JUST AN EXAMPLE!) Group # 0097004 Coverage Date: 01-01-07 NETWORK: PTXOA ON THE BACK OF THE CARD: RxBin 011552 RxPCN BCTX My 'proper name' is Christian Bowen Oliver. My wife' 'maiden name' is E. Michele . My Step Daughter's name is Felicia M. Cook. But this card covers ALL OF US. At CVS, I use Condor Code 8543 which is what you use ONLY for BC/BS of TEXAS! There are other Condor Codes for other BC/BS insurance cards that you have to 'find' by searching using either the BIN# or the PCN#. As you continue to input a patient's profile, you must be sure to 'make them' male or female, have their 'proper' DOB (WHICH REALLY MIGHT NOT BE THE ACTUAL DAY THAT THEY WERE BORN BUT WHAT THEIR INSURANCE HAS AS THE DOB. I HAVE CALLED THE INS COMPANIES SEVERAL TIMES AND BEEN TOLD THAT I HAVE 'REJECTIONS' BECAUSE THE DOB THAT THEY HAVE ON FILE FOR A PATIENT IS NOT THE SAME THAT I HAVE BEEN TOLD WHEN A CUSTOMER IS STANDING RIGHT IN FRONT OF ME!!!! MAKES FOR AN INTERESTING CONVERSATION!!!) And you also must make sure that you input the proper numbers into your computer system! As I have stated before, with BC/BS cards, NEVER input ANY LETTERS that come before the first numbers. For example: If the card has SSD4656474656, then for the member number you only put 465647656 into the computer as the MEMBER number. On the other hand if the card has something like: 445AGDP011 THEN you input the letters as well.... Seems complicated, but it really is not once you 'learn the ropes'... AND THAT'S JUST BC/BS!!!!! I'd like to see what happens to a 'novice' Tech. when he/she is is trying to 'figure out' how to submit a Medicare Part D plan... Jeanetta, I don't know if I could actually write a 'Lesson Plan' that you could use for your students. But all things considered, especially how much you have helped me to become the professional that I am now: I would be glad to help in any way that I can because pulling stock bottles from the shelf, counting, pouring, labeling, even compounding, is REALLY SIMPLE compared to having to deal with 'DROP- OFF'.... Also a a really neat 'footnote'... I got my Letter of Acceptance today! I guess A & M got my PCAT score before I did! Thank you so much for everything that you have given to me! My customers in the Coastal Bend Region of Texas will benefit from all of the knowlege that you, Joe, and all of the Group members have given to me through all of our discussions over the past two years! Gratius et valoram meastrus intelligenciam! Christian B. Oliver CPhT Quote Link to comment Share on other sites More sharing options...
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