In this era of digitalization, where the use of technology is becoming common. The practices to keep a check on the payments are also adapting. For this action, numerous kinds of codes are used in form of alphabets or digits specifically in debits, credits, and even insurance cards. In order to read the debit or credit card is easier to compare with an insurance card. This is because there are almost three kinds of codes written at the top. These codes are named Rx PCN, Rx BIN, and Rx GRP. For understanding the concept of all these terms, this blog will define first Rx PCN, then Rx BIN, and Rx GRP. Thus, the present site makes it easier to read your own insurance card.
What is PCN on Insurance Card?
The 8-characters of alphabets or numeric values used for the pharmaceutical transaction is PCN. PCN is the abbreviation for Processor Control Number. The use of this code in simple language is defined as finding out which processor will deal with the claim of the user. It also identifies the route of pharmaceutical transactions and finds out the connection with the insurance claims that cover the prescription of the user.
For the distinction between plans, benefits, and business needs, unique PCNs are assigned by processors. With this unique identification property, PCN is not required for the registry. The terms, rules, and conditions of the card are defined by NCPDP Pharmacy ID and Combination Card Implementation Guide. Only the members of NCPDP have the right to access this information which means that only specific entities are allowed to perform this action.
When There is a Need to Show PCN Insurance Card?
Now that we have defined what is PCN on insurance card we are going to discuss when we need to show it. Generally, the member ID of the user needs to show to the doctor or the pharmacist. But in some cases, there is a need of showing the PCN of the insurance card to the health care giver. Here the user finds the cases:
- The situation in which the user avails of any other private insurance services besides allowed ones.
- The case in which the user visits the healthcare besides of permitted network.
- By ordering the medicine through online sources.
- The condition in which the user transfers the prescriptions to another pharmacy through the approval of Rx transfer.
Important Terms - What is PCN on Insurance Card
What is Rx BIN Number?
The six-digit number mentioned on the health insurance card of a user is termed an Rx Bin Number. It is abbreviated as the prescription bank identification number. As the name indicates, this number is beneficial for the identification of insurance providers. Thus, it provides an easy route for the pharmacists as they scan the name of the insurance company for reimbursement of the medical claims.
In terms of the credit card industry, the word BIN is used. But, in January 2017, this number is replaced by IIN (Issuer Identification Number). Also, the length of digits changed from 6-digits to 8-digits. This conversion is approved in the light of the International Organization for Standardization / International Electrotechnical Commission (ISO/IEC). The significant advantage of IIN is that it is the unique number assigned after paid registration. This unique characteristic makes the lives of pharmacists easier to work efficiently.
When there is a Need to Show Rx BIN Number?
The situations in which the Rx BIN number does need to show, are discussed here:
- To claim health plans for the processing of pharmacy claims electronically.
- The condition in which a new member has to fill new or refill the old prescription.
- For issuing a new ID card on behalf of the user’s Rx System.
- For identification of the insurance provider as well as the name of the bank.
What is an Rx Grp Number?
Rx Group number is defined as the prescription group number. It is used for determining the prescription benefits of pharmacists. A unique set of 6-digit string alphabets are used to identify the category of insurance plan availed by the user. Pharmacists further do manipulate this number to check the entire list of drugs included in the user’s insurance coverage.
When there is a Need to Show Rx Grp Number?
There is a list of situations in which a user needs to show the Rx Grp number. The best possible cases are defined here as:
- During filling the prescription at the pharmacy.
- In case of filling a new medication form based on authorization.
- While ordering the medicines via using online services.
- During the submission of reimbursement of claims.
- For scheduling private medical appointments other than insurance coverage.
- In the case of visiting the emergency room of any hospital other than insurance coverage.
- If the user avails the services from a third person, in this situation, the user has to claim with Rx Group number
Other Information on a User’s Insurance Card
The significant information about the claim can collect through PCN Insurance Card only. But other than PCN, Rx BIN, and Rx Grp, a user is also able to find other important data. These are plan name, plan type (three types of plans, HMO, POS, and PPO), name of the member, member ID, and membership number.
How to Read PCN Insurance Card
- There is a list of entire information on the card. Such as the name of the user or patient who is able to avail of the current card.
- The policy number is mentioned on the card.
- Group Plan is mentioned on the card.
- Contact details are written for the insurance business.
- Hospital of coverage is mentioned.
- The total amount of coverage is written on the card, as well as the issuance date and expired date.
- PCN, Rx BIN, Rx Grp numbers, member ID, membership card number, plan group, and types, all information is typed in the card.
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