Prescription Billing and Third-Party Payer Information

This set of flashcards covers key vocabulary and definitions related to prescription billing and third-party payer information based on the lecture notes.

Prescription coverage

Insurance coverage for prescription medication, offered by private or government programs.

Third-party program

Involves the patient, pharmacy, and insurance company or government program for payment coverage of prescriptions.

Processor BIN

A six-digit number assigned to third-party processors for routing pharmacy transaction electronically.

PCN

A secondary alphanumeric identifier used in routing pharmacy claims, defined by the pharmacy benefits manager.

Member ID number

Unique ID number for the primary insurance holder on a plan, shared by family members with different person codes.

Person code

Code identifying which household member is receiving services under an insurance plan.

Rx group number

Identifies the specific insurance plan a member is associated with, often linked to the member's employer.

Prescription discount card

A card offering discounts on prescriptions for uninsured patients or those with high deductible plans.