Magazine article Drug Topics

Standardized Software

Magazine article Drug Topics

Standardized Software

Article excerpt

An industrywide standard for transmitting pharmacy claims information has fully arrived in most on-line claims systems used by community pharmacists. Its arrival can be seen as a milestone in the use of on-line computers in community pharmacies, much like the arrival of the computers themselves in nearly every community pharmacy in the United States.

One event that marked the standard's final arrival was a recent call from PCS Health Systems mandating that all pharmacists not yet on the standard had to be on it by Aug. 1 this year for all claims transactions.

The standard, called version 3.2, was developed by the National Council of Prescription Drug Programs and introduced in 1992, explained Lee Ann Stember, executive director of NCPDP. By now, she added, "probably 98% of all the claims that are submitted for pharmacy are on our version 3.2."

What is it? "It's the standard on how claims are submitted electronically. That's how [providers] communicate between the pharmacy and the third-party processor," she pointed out. With the processing standard in place, it becomes possible for all pharmacies to share in the use of other related standards, including one for conducting drug utilization reviews and others for using a variety of other pharmaceutical care programs. …

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