Prime will require the Pharmacy NPI on all claims transmissions beginning February 13, 2008
CMS encourages health care providers that have not obtained an NPI to do so immediately and to use their NPIs in all HIPAA transactions beginning May 23, 2007.
PHARMACY NPI REQUIREMENTS
Effective February 13, 2008, Prime will require all electronic claims to be submitted with the Pharmacy NPI number. The Service Provider ID Qualifier (202-B2) must equal 01 and the Service Provider ID must be the Pharmacy NPI number.
Note: Refill prescriptions may require a manual update on your system if the initial prescription was submitted with an NCPDP number.
PRESCRIBER NPI REQUIREMENTS
Prime will continue to accept the Prescriber DEA or the Prescriber NPI after May 23, 2008. However, when available, Prime prefers the Prescriber NPI as the submitted value.
To avoid future disruption of service, Prime strongly recommends that pharmacies submit their Pharmacy NPI number on all electronic claim submissions.
NPI testing is available, click on the NPI Testing link below for testing scenarios.
Reminder, Prime only accepts HIPAA 5.1 electronic claims.
NPI Frequently Asked Questions
NPI Test Scenarios
e-mail address: npi@primetherapeutics.com