Optumrx bin number 2021 Running the Report This report is part of the F7 Report / Rx by Customer Program. . Each health plan can use one or more Rx BINs; for example Jul 1, 2021 · For the most current list of covered medications or if you have questions: Call the number on your member ID card. We apologize for this inconvenience. All CoverRx phone and fax numbers will be transferred at COB (5:30 PM CT) on 12/31/2019. com NCPDP Version D. The newest being Version 4. Aug 27, 2021 · Pharmacies require an Rx Bin number along with a PCN (Processor Control Number) and Group ID to process prescription transactions accurately. com takes just a few minutes. Mar 22, 2021 · MyCare Ohio - Pharmacy Billing Reference Guide Last Updated: 3/22/2021 This information is only meant to be used as a billing resource for pharmacies and is subject to change. Does OptumRx have provider educators for me to contact? Sep 1, 2025 · Prescription drug lists and drug formulary information. To eliminate issues with members who Bin Number: 610593 Processor Control Number: VA Group number: * Please use the beneficiary's Social Security Number (SSN) for the NCPDP Cardholder ID (3Ø2-C2). 1 communications standard. 0 Payer Sheet COMMERCIAL … professionals. OptumRx provides safe, easy and cost-efective ways for you to get the medication you need. Often the Rx system is separate from the Carrier’s medical system, so it typically takes another 24-48 OptumRx is your plan’s pharmacy care services administrator. Optum Rx is an independent company that provides pharmacy services on behalf of our health plans. The NCPDP Processor ID Number (BIN) is a six-digit number that health plans can use to process electronic pharmacy claims if they do not use pharmacy benefit cards with a magnetic stripe. In those cases, members will need to talk to their doctors to get new prescriptions sent to OptumRx on Jan. Information may vary in appearance or location on the card due to employer, Benefit Plan Sponsors or Administrator requirements, however, ID cards display essentially the same information (e. ProAct BIN: 017366 PCN: 9999. Jan 1, 2021 · This unique number identifies you as a participant in the Michaels prescription drug program with OptumRx. com Website: https://professionals. For a seamless transition to OptumRx, please review the information below. If you are having a medical crisis, please call 911 or contact your local emergency assistance service immediately. Pricing and Coverage Tool Online search by plan and drug name. These programs include: Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) - CHAMPVA is the VA's health benefit program for dependents of permanently and totally disabled Veterans, survivors of Veterans who died from service-connected conditions Search your plan’s formulary to determine coverage and additional details This document outlines the processing instructions for OptumRx External commercial business. Apr 27, 2021 · What is the Rx Bin number for Blue Shield of California? Drug formulary, policy and forms What does PCN and bin mean? Rev. Providers should work directly with the applicable Managed Care Plan for any other use, questions, or assistance. Jan 1, 2025 · Last Updated: 12/23/2024 This information is only meant to be used as a billing resource for pharmacies and is subject to change. 1, 2023, for It will also help you ask your doctor or pharmacist the right questions about your medication needs. FlexScripts/ProAct BIN: 018141 PCN: 9999. Sep 1, 2024 · Learn more about tracking your medication orders, returning a prescription, how to check your order status and more. Prescription drug lists are updated frequently. PPO Preferred Provider Organization Prescription Drug List A list of medication covered by your plan. To set up a HealthSafe ID, enter your health plan number. Privacy Search your plan’s formulary to determine coverage and additional details Find our 24/7 customer support phone number and contact information for physicians, Optum Rx Medicare members and Optum Specialty Pharmacy patients. The CoverRx RxBIN is 001553, and the CoverRx RxPCN is CVRX. Community Health BIN: 610613 PCN: 2417. Health insurance cards in the U. 7. azahcccs. 801 East Jefferson, Phoenix, AZ 85034 • PO Box 25520, Phoenix, AZ 85002 • 602-417-4000 • www. Discover seamless integration and enhanced prescription management. Learn more about what your Rx BIN and other numbers mean on your Medicare Part D or Medicare Advantage plan card. Does anthem still use Express Scripts? REMINDER: NEW PHARMACY BENEFITS MANAGER COMING 4/1/2021 As a reminder, AultCare is transitioning to a new Pharmacy Benefits Manager on April 1, 2021 (OptumRx). OptumRx processes over 4 million pharmacy claims through its nationwide network each year for VHA OCC program beneficiaries. Oct 2, 2024 · Learn more about automatic refills of your medications, managing your prescriptions, how to place an order and shipping options for home delivery. OptumRx Pharmacy Billing and Contact Information 1. At the pharmacy, the pharmacist will use the member ID number on the card and the patient’s date of birth to appropriately link to the OptumRx system for enrollment verification and claim processing. What is OptumRx’s CoverKids BIN and PCN number? The CoverKids RxBIN is 001553, and the CoverKids RxPCN is CKDS. 5/24/2022. Pharmacies may process and dispense pediatric enteral special formula and thickening agents with a valid prescription from the member’s prescriber through MassHealth’s Pharmacy Online Processing System (POPS). If a medication is not listed on your plan’s prescription drug list, check back to see if it has been added. Optum Rx assumed pharmacy benefits management responsibilities for CoverKids CHIP program on January 2, 2021. 1 Access the latest publications, resources, guides and support links that help you serve your patients and manage your business. 1 PHARMACY BENEFITS ADMINISTRATOR (PBA) OptumRx assumed pharmacy benefits management responsibilities for the Division of TennCare (hereafter known as “TennCare”) for the State Medicaid and CoverRx program on January 1, 2020. Is OptumRx a payer? Payer Name: OptumRx Date: 05/01/2021 Commercial and Medicaid BIN: 610494 PCN: 9999 Community Health BIN: 610613 PCN: 2417 ProAct BIN: 017366 PCN: 9999 FlexScripts/ProAct BIN: 018141 PCN: 9999 United Healthcare Community Plan of Indiana BIN: 610494 PCN: 4841 United Healthcare Community Plan of Texas BIN: 610494 PCN: … Order prescriptions, get drug pricing information, pay your bill, locate a pharmacy, manage your health information and more. , Member Name, Subscriber Identification (ID), RxGroup Number (GROUP), Processor Control Number (PCN), Bank Identification Number (BIN), and contact OptumRx NCPDP Version D. Your PBM is Optum Rx. Jan 1, 2020 · BIN: 001553 PCN: TNM All members of TennCare will receive a new member identification (ID) card PHARMACY BIN & PCN NUMBERS The Rx BIN number is a 6-digit number health plans use to process electronic pharmacy claims. For your security, we'll send you a confirmation email and a letter to the name and Search your plan’s formulary to determine coverage and additional details Aug 23, 2023 · Your Rx BIN number is a 6-digit code that identifies the insurance company who provides your Medicare drug plan. Plans that use cards with a magnetic stripe should use the recommended ISO/IEC 7812 Issuer Identifier Number (IIN) for processing electronic pharmacy claims. Find out more. Jan 5, 2023 · Required if Associated Prescription/Service Reference Number (456-EN) is used. The change will take effect on different days depending on membership type. 0 Payer Sheet COMMERCIAL … 1 OptumRx NCPDP Version Payer Sheet COMMERCIAL AND MEDICAID. Are you an employee? Click here to login with your MSID. © 2025 Optum Inc. OptumRx is the current PBM contracted with the Veterans Health Administration Office of Community Care (VHA OCC) to electronically process CHAMPVA, Spina Bifida Health Care Benefits Program and Children of Women Vietnam Veterans (CWVV) Program pharmacy claims. Download PDF Prescriptions by Insurance Bin QuickSCRIP offers the ability filter and print claims by their insurance bin number. Registration at optumrx. Jan 6, 2021 · DETROIT, Jan. Enter your phone number or choose your security questions. Rx PCN: CLAIMCR Additional me: GILBERT cos Find your plan's BINs, PCNs, and RxGroups! Blue Cross Blue Shield of Michigan members, learn about your pharmacy updates with OptumRX, including home delivery, online tools, ID cards and more. The OptumRx Help Desk is available 24 hours per day and 365 days per year. This document provides information on electronic claims processing, specific to NCPDP defined fields and requirements, for OptumRx (formerly Catamaran) Medicare Part D business. The change will occur on Jan. All rights reserved. g. We would like to show you a description here but the site won’t allow us. " and The 2025 Medicare Prescription Payment Plan: Like 0% financing for your formulary Part D drug purchases. Dec 1, 2020 · OptumRx will become the PBM for commercial groups/members at the time they renew their coverage with FCC in 2021 (member numbers/ ID cards starting with 94). We are an Optum® company—a leading provider of integrated health services. When will phone numbers and fax lines be live at OptumRx? All CoverKids phone and fax numbers will be live 1/1/2021. 0 Payer Sheet COMMERCIAL AND MEDICAID General Information Payer Name: OptumRx Date: 01/01/2025 Former Catalyst, informedRx and HealthTrans BIN: Patients will need to bring their new OptumRx ID card to the pharmacy with them starting January 1, 2021. This can be very useful for tracking your most profitable insurance payers or gathering data for upcoming audits. Search your plan’s formulary to determine coverage and additional details Will my prescriptions be transferred to OptumRx home delivery? If you have existing Express Scripts home delivery prescriptions with valid refills, these will automatically transfer to Optum Home Delivery, the new home delivery, pharmacy. Your Pharmacy group number is MICHAELS. info. The BIN number is 610011 and PCN number IRX. COMMERCIAL and Medicaid BIN: 610494 PCN: 9999. Display Rx BIN numbers, with examples including 610502 for OptumRx and 003858 for Express Scripts, as informed by YourInsurance. Historically claims only required the 9-digit member ID number for processing. Often the Rx system is separate from the Carrier’s medical system, so it typically takes another 24-48 This document provides information on electronic claims processing, specific to NCPDP defined fields and requirements, for OptumRx (formerly Catamaran) non-Medicare Part D business. Date: 10/01/2021 OPTUMRx' Rx Bin: 610279 Rx PCN: 9999 Rx Grp: UHCNICE SignatureValue HMO Office: $20 DOI-0504 ER: $50 2020 OptumRx BIN 610279 Payer Sheet This document provides information on electronic claims processing, specific to NCPDP defined fields and requirements, for OptumRx BIN 610279 business. 6. Scenario 3 - Other Payer Amount Paid, Other Payer-Patient Responsibility Amount, and Benefit Stage Repetitions Present (Government Programs) Transcription of OptumRx NCPDP Version D. Processor Control Number. We were unable to save any information. You are not required to use Optum Home Delivery Pharmacy for a 90-/100-day supply of your maintenance medication. Optum’s Customer Service Toll-Free Number is 855-540-5861. Our commitment is to help you get the most out of your prescription medication benefit. 1 which was published at the being of October 2021. Rx BIN and PCN numbers are used by new members to pick up a new prescription (or refill) prior to having a new ID card or showing up in the new Carrier’s Rx system. 6 days ago · Beneficiary Management Lock-In Program Outpatient Pharmacy Services Standard Plan Benefits Information Effective July 1, 2021, any claims that are submitted to our legacy pharmacy processor, NCTracks, for beneficiaries enrolled in managed care plans will reject with the information necessary to process pharmacy claims for these members. Added DUR/PPS Segments Added missing Pricing Segment in Claim Billing Transaction Name change for plan PWA now CoastalRx Removed COB Scenarios 1 and 3 – not applicable with this payer sheet Added new BIN: 023252 February 2021 Added OrchestraRx cash BINs 018687 and 019934 Most members currently using home delivery will have their prescriptions automatically transferred to OptumRx, our new home delivery pharmacy, as a result of the transition. Oct 1, 2023 · For medications you take regularly, you can also use the Optum Home Delivery Pharmacy. 0 Payer Sheet COMMERCIAL AND MEDICAID Contract Information: Independent Contracting Contact: independent. Need your card now? Download and print a temporary version of your card. It processes all Fee For Service outpatient pharmacy claims on-line through Point of Sale transmission utilizing the NCPDP 5. PHARMACY BIN & PCN NUMBERS The Rx BIN number is a 6-digit number health plans use to process electronic pharmacy claims. OptumRx specializes in the delivery, clinical management and affordability of prescription medications and consumer health products. It also pays enrolled pharmacy providers weekly. Jan 12, 2021 · Blue Cross Blue Shield of Michigan chose OptumRx as its new pharmacy benefit provider, ending a relationship with Express Scripts. MedImpact will continue to serve as the PBM for commercial groups/members until they have renewed in 2021 (member numbers/ID cards starting with 00). Q: Who in my household should have an ID card? A: OptumRx prescription drug cards were mailed to participants and spouses/partners. The ISO/IEC 7812 Registration Authority (the Dec 31, 2023 · Learn about transitioning to OptumRx with Hometown Health's pharmacy services. Our pharmacy benefits are managed by Optum Rx ®. S. This information identifies Michaels prescription drug program with OptumRx. OptumRx assumed pharmacy benefits management responsibilities for CoverKids CHIP program on January 2, 2021. The VETERAN FAMILY MEMBER PROGRAMS (VFMP) payer sheet is listed on the home page. Payer Name: OptumRx Date: 05/01/2021. Controlled substances, expired prescriptions and prescriptions without refills remaining cannot be transferred. OptumRx NCPDP Version D. 6, 2021 — A new partnership between Blue Cross Blue Shield of Michigan, Blue Care Network and OptumRx will provide members, providers and employers with prescription drug benefit services designed to improve the pharmacy experience, drive better health outcomes and lower costs. Play video Optum Rx online tools Get ready to use your benefits and learn how to use Optum Rx's online tools to make informed decisions about your pharmacy plan and the medications you take. com PBM BINs Help Desk 4D Management Systems, Inc. Jun 11, 2021 · Effective June 1, 2021, when processing claims for Health Alliance Medical Plans, please enter the full 11-digit member number (including the 2-digit person code) for the claim to process as expected. Pharmacies will be paid the lower of the Wholesale Acquisition Dec 13, 2021 · Rx BIN stands for “Bank Identification Number” and acts as a numeric code that tells pharmacies which pharmacy benefit manager (PBM) to bill for a prescription. Often the Rx system is separate from the Carrier’s medical system, so it typically takes another 24-48 OptumRx provides prescription management, pharmacy locator, and health benefit services to help you manage your medications and health information efficiently. This document provides information on electronic claims processing, specific to NCPDP defined fields and requirements, for OptumRx (formerly Catamaran) Medicare Part D business. Information includes specialty pharmacy and health-plan specific details. Jul 1, 2024 · We’ll make the transition easy by helping you find a network pharmacy, learn about coverage and ways to get your medications. Patients may also use their Social Security Number to obtain their medications. Required if the Dispensing Status (343-HD) = “P” (Partial Fill) and there are multiple occurrences of partial fills for this prescription. For the most current list of covered medications or if you have questions: Call the number on your member ID card. 600428 800-522-7487 Agelity, Inc. If you don't have your ID card, enter your Social Security number and ZIP code. A pharmacy eligibility service that checks patient coverage with the nation’s largest Pharmacy Benefit Managers (PBMs) and returns real-time responses. Optum Home Delivery Pharmacy and Optum Rx are affiliates of UnitedHealthcare Insurance Company. contracting@optum. What is OptumRx’s BIN and PCN number? The TennCare RxBIN is 001553, and the TennCare RxPCN is TNM. 1 PHARMACY BENEFITS ADMINISTRATOR (PBA) Optum Rx assumed pharmacy benefits management responsibilities for the Division of TennCare (hereafter known as “TennCare”) for the State Medicaid and CoverRx program on January 1, 2020. Ø. gov OptumRx NCPDP Version D. BIN: PCN: Varies by plan – refer to ID card. 0 Payer Sheet MEDICARE ONLY General Information Payer Name: OptumRx Date: 01/01/2025 Member Services: 1-888-901-4636 Member Services TTY: 1-800-833-6388 or 711 Mail Order: 1-800-245-7979 This document outlines the unique processing instructions for OptumRx Wrap COB BIN 610127 business. Find a network pharmacy For customer support, call your benefit administrator or the phone number on your member ID card, once your plan is effective. The absence of a valid Rx Bin number on an insurance card can delay filling prescriptions at chains like Walgreens, Walmart, or Rite Aid. A guide for network pharmacy providers Review policies and procedures in accordance with participating pharmacy provider network agreements, including: Term definitions Contact information Member identification (ID) cards Processing claims BIN information Medicare product information and guidelines Compliance; fraud, waste and abuse (FWA); general training and audits Pharmacy network Customer Service:1-855-524-0381 Home Delivery: 1-800-788-4863 TDHI (for the hearing impaired): 1-800-498-5428 (24hours a day, 7 days a week) Dec 16, 2021 · This change is effective December 16, 2021, and will remain in effect unless MassHealth provides alternative guidance. Get all the tools to manage your account, learn what medications are covered, understand your medications and update your prescriber details. To get started with Optum Home Delivery Pharmacy, visit optumrx. 5. JIJ United Health Plan (80840): 911-87726-04 Member ID: 4657645-02 Member: KIMBERLY HARRIS BALUYUT, MICHAEL (951) 371-8805 PCP EFFECTIVE DATE 10/01/2021 PRIME-CARE OF RIVERSIDE 008331 Group Number: 366334 Payer ID 87726 Eff. Jan 26, 2025 · You may also wish to read more at: " What is the BIN, PCN, and RxGROUP number for my Medicare Part D prescription drug plan?. On Jan. com or call 855-524-0380. CLAIM BILLING/CLAIM REBILL TRANSACTION The following lists the segments and fields in a Claim Billing or Claim Rebill Transaction for the NCPDP Telecommunication Standard Implementation Guide Version D. Enter your email address. Optum Rx can help. Dec 21, 2021 · OptumRx® updates their provider manual multiples times each year. Due to security and privacy reasons, OptumRx will not provide a beneficiary's SSN to anyone. Print card We would like to show you a description here but the site won’t allow us. 009265, 610198, 012965 800-837-0581 Applied Underwriters, Inc 13329 877-234-4420 Argus Health Syst The Health Care Authority’s mission is: We ensure that New Mexicans attain their highest level of health by providing whole-person, cost-effective, accessible, and high-quality health care and safety-net services. OptumRx is the Pharmacy Benefit Manager for three programs offered by the VETERAN AND FAMILY MEMBER PROGRAMS (VFMP). Quick reference guide Please use this guide to quickly refer to the information you need to work with our UnitedHealthcare Individual Exchange plans in Texas, also referred to as UnitedHealthcare Individual & Family ACA Marketplace plans. 0 Payer Sheet COMMERCIAL AND MEDICAID Payer Name: OptumRx Date: 05/01/2021 Commercial and Medicaid BIN: 610494 PCN: 9999 Community Health BIN: 610613 PCN: 2417 ProAct BIN: 017366 PCN: 9999 FlexScripts/ProAct BIN: 018141 PCN: 9999 United Healthcare Community Plan of Indiana BIN: 610494 PCN: 4841 PHARMACY BIN & PCN NUMBERS The Rx BIN number is a 6-digit number health plans use to process electronic pharmacy claims. We want to make sure you have the information you need to make the best choice for you. This full 11-digit member number (no dash) can be found on the member ID card. Please give us a few minutes while we fix the error. Choose a username and password. Mar 22, 2021 · Group extended #: 002609 coverage Member Name: GILBERT I VELEZ Rx BIN: 005947 Member Number: through 941096543-01 the MultiPlan-PHCS network. You have received multiple communications regarding this transition throughout the past several months. The Processor Control Number (PCN) is a secondary identifier that may be used in routing of pharmacy transactions. For information or assistance with prescription claims, prior authorization, contracted network pharmacies, or the AHCCCS FFS Drug List, please contact the OptumRx Customer Service Help Desk at (855) 577-6310. 1, 2022, Express Scripts will no longer be BCBS of Michigan’s pharmacy benefit provider for commercial individual and group members. 610182 610593 610679 014681 015839 018643 600471 603286 610140 610527 610619 610604 014872 015756 020768 003650 009951 018704 601577 606464 610171 610548 610621 610704 015814 017267 060646 601683 610011 610173 610560 610652 020149 024045 021049 021916 021825 Oct 1, 2025 · 1. The provider manual for OptumRx ® is publicly available under the Manuals and Guides sections of the Health Care Professionals website. Find a network pharmacy Network pharmacy list (PDF) Extended Day Supply pharmacy list Compound pharmacy locater guide For assistance locating a Specialty Pharmacy in your network, please contact a customer service representative at (855) 828-9834, TTY 711, 24 Nov 11, 2025 · Learn how to register and sign in to your account using HealthSafe ID, how to change your shipping address and how to change your payment information. OptumRx pharmacy network includes access to thousands of retail locations, including national chains, and many community pharmacies. Do I need to register online with OptumRx? No. optumrx. 0 Payer Sheet COMMERCIAL AND MEDICAID Payer Name: OptumRx Date: 05/01/2021 Commercial and Medicaid BIN: 610494 PCN: 9999 Community Health BIN: 610613 PCN: 2417 ProAct BIN: 017366 PCN: 9999 FlexScripts/ProAct BIN: 018141 PCN: 9999 United Healthcare Community Plan of Indiana BIN: 610494 PCN: 4841 Dec 29, 2022 · BIN/PCN/Group Numbers for ACOs, MCOs, and PCC Plan The following tables show the correct combinations, effective for calendar year 2023, for pharmacies for Accountable Care Partnership Plans (ACPPs), Primary Care Accountable Care Organizations (ACOs), managed care organizations (MCOs), Primary Care Clinician (PCC) Plan, and MassHealth-only Senior Care Organizations (SCOs). Be sure to have your Harvard Pilgrim ID number, prescription number (s) and credit card information ready when you call. Dec 21, 2021 · MyCare Ohio - Pharmacy Billing Reference Guide Last Updated: 12/21/2021 This information is only meant to be used as a billing resource for pharmacies and is subject to change. Feb 1, 2023 · OptumRx is the Pharmacy Benefits Manager for the Georgia Medicaid Fee For Service Outpatient Pharmacy Program. wpmid izamyht illi xagrc iae iyhct oachtn eckm zhnwb argrig nrsgym targ odmtfe beyaw wniy