Network Reimbursement IDs
Prime Therapeutics LLC, (“Prime”) provides a Network Reimbursement ID (NRID) on pharmacy claims at point-of-sale. Based on the NRID, the pharmacy can identify the network that adjudicated each claim to help reconcile the pharmacy’s network agreements.
The NRID is transmitted back to pharmacies in the reimbursement ID field (NCPDP field 545-2F) and represents the contractual exhibit from which the claim is adjudicating. The reimbursement ID will be available at point of sale and will not be reflected on the pharmacy’s remittance.
If your pharmacy does not currently receive information in NCPDP field 545-2F, and want to see the reimbursement ID, you will need to work with your claims software vendor to include this.
If the reimbursement ID is for a network contracted and managed by Prime, pharmacies can direct inquires to Prime’s Provider Relations Team at firstname.lastname@example.org. Prime’s pricing appeals process is available on Prime’s website under Pharmacy provider tools (www.primetherapeutics.com/en/resources/pharmacists.html).