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  1. FHIR Specification Feedback
  2. FHIR-35181

accommodate pharmacy benefit information

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    • Icon: Change Request Change Request
    • Resolution: Persuasive with Modification
    • Icon: Highest Highest
    • US CARIN Digital Insurance Card (DIC) (FHIR)
    • current
    • Payer/Provider Information Exchange
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    • 2.4
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      The existing sentence says the following:

      "This IG is not intended to replace use of any existing standards for pharmacy insurance cards, i.e. NCPDP standards, and is being provided to augment existing physical insurance cards where pharmacy benefits may need to be included with other coverage."

      The sentence will be changed to following:

      "Prescription benefit information is addressed in this implementation guide, but it does not replace pharmacy-specific benefit card standards, i.e. NCPDP standards, and is being provided to augment existing physical insurance cards where pharmacy benefits may need to be included with other coverage"

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      The existing sentence says the following: "This IG is not intended to replace use of any existing standards for pharmacy insurance cards, i.e. NCPDP standards, and is being provided to augment existing physical insurance cards where pharmacy benefits may need to be included with other coverage." The sentence will be changed to following: "Prescription benefit information is addressed in this implementation guide, but it does not replace pharmacy-specific benefit card standards, i.e. NCPDP standards, and is being provided to augment existing physical insurance cards where pharmacy benefits may need to be included with other coverage"
    • Mark Roberts/Cille Kissel: 11-0-1
    • Clarification
    • Non-substantive

    Description

      While it is true that some patients may have separate cards for pharmacy benefits, many major medical insurers include PBM info (Rx BIN and RxPCN) on the primary insurance card. This guide should accommodate this pharmacy benefit information, as combination cards are quite common throughout the industry. While I realize BIN/PCN are included later in the guide. This statement "This IG is not intended to replace use of any existing standards for pharmacy insurance cards, i.e. NCPDP standards, and is being provided to augment existing physical insurance cards where pharmacy benefits may need to be included with other coverage" should be more clear that prescription benefit info is addressed in this guide, but it does not replace pharmacy-specific benefit card standards.

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            Unassigned Unassigned
            celine_lefebvre Celine Lefebvre
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              Updated:
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