United States Health Information Knowledgebase

 

Telecommunication


Name:Telecommunication
Type:Model View
Definition:Telecommunication Standard / Implementation Guide Version 5 Release 1 September 1999 This version of the standard has been developed recognizing the growing use of direct electronic submission and adjudication of transactions in an on-line, real-time environment. It is the next logical step in an evolutionary process marked by the following key events: Submission of paper claims using claim forms unique to each carrier or administrator. Development of a Universal Claim Form by NCPDP (1980). Submission of claims via magnetic tape and diskette using a format unique to each carrier or administrator (1984). Direct electronic submission and adjudication of claims in an on-line, real-time environment using processor-specific formats (1988). Development of a telecommunication standard format (Version 1 Release 0) by NCPDP (1989). Development of an enhanced telecommunication standard format (Version 3.2) by NCPDP (1992). Development of on-line, real-time compound claim submission within the telecommunication standard format (Version 3.3) by NCPDP (1996). Development of prior authorization transaction sets within the telecommunication standard format (Version 3.4) by NCPDP (1996) Usage of a common transaction format brings advantages to participants in the pharmacy industry. There are significant advantages to both the Originator of the claim and the Processor of the transaction by adopting this version of the standard, such as: Common syntax and dictionary Adaptability Reduced system development expense Reduced equipment requirements Reduced errors This version of the standard facilitates a specific type of business communication among diverse parties within the third party environment. To do this successfully, it must accomplish the following goals: Support the needs of a wide base of potential users. Maximize use of existing relevant standards wherever possible. Be flexible enough to change as needs and technology change. Be unambiguous. Be easy to implement by carriers and vendors.
Registration Authority:National Council for Prescription Drug Programs
Status:Recorded
Administrative Attributes
Responsible Organization:National Council for Prescription Drug Programs
Submitting Organization:National Council for Prescription Drug Programs
Steward Organization:National Council for Prescription Drug Programs
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Relationship Organization Item
utilizes NCPDP Accumulated Deductible Amount   
utilizes NCPDP Additional Message Information   
utilizes NCPDP Alternate ID   
utilizes NCPDP Amount Applied To Periodic Deductible   
utilizes NCPDP Amount Attributed To Product Selection   
utilizes NCPDP Amount Attributed To Sales Tax   
utilizes NCPDP Amount Exceeding Periodic Benefit Maximum   
utilizes NCPDP Amount Of Copay/ Coinsurance   
utilizes NCPDP Approved Message Code   
utilizes NCPDP Approved Message Code Count   
utilizes NCPDP Associated Prescription/ Service Date   
utilizes NCPDP Associated Prescription/ Service Reference Number   
utilizes NCPDP Authorization Number   
utilizes NCPDP Authorized Representative City Address   
utilizes NCPDP Authorized Representative First Name   
utilizes NCPDP Authorized Representative Last Name   
utilizes NCPDP Authorized Representative State/Province Address   
utilizes NCPDP Authorized Representative Street Address   
utilizes NCPDP Authorized Representative Zip/Postal Zone   
utilizes NCPDP Basis Of Calculation-Copay   
utilizes NCPDP Basis Of Calculation-Dispensing Fee   
utilizes NCPDP Basis Of Calculation-Flat Sales Tax   
utilizes NCPDP Basis Of Calculation-Percentage Sales Tax   
utilizes NCPDP Basis Of Cost Determination   
utilizes NCPDP Basis Of Reimbursement Determination   
utilizes NCPDP Basis Of Request   
utilizes NCPDP BIN Number   
utilizes NCPDP Cardholder First Name   
utilizes NCPDP Cardholder ID   
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Relationship Organization Item
is a sub view of NCPDP Data Dictionary Compare these items   
is a sub view of NCPDP NCPDP High Level Outline Graphic Compare these items   
is the parent view of NCPDP REQUEST CLAIM SEGMENT Compare these items   
is the parent view of NCPDP REQUEST CLINICAL SEGMENT Compare these items   
is the parent view of NCPDP REQUEST COMPOUND SEGMENT Compare these items   
is the parent view of NCPDP REQUEST COORDINATION OF BENEFITS/OTHER PAYMENT SEGMENT Compare these items   
is the parent view of NCPDP REQUEST COUPON SEGMENT Compare these items   
is the parent view of NCPDP REQUEST DUR/PPS SEGMENT Compare these items   
is the parent view of NCPDP REQUEST INSURANCE SEGMENT Compare these items   
is the parent view of NCPDP REQUEST PATIENT SEGMENT Compare these items   
is the parent view of NCPDP REQUEST PHARMACY PROVIDER SEGMENT Compare these items   
is the parent view of NCPDP REQUEST PRESCRIBER SEGMENT Compare these items   
is the parent view of NCPDP REQUEST PRICING SEGMENT Compare these items   
is the parent view of NCPDP REQUEST PRIOR AUTHORIZATION SEGMENT Compare these items   
is the parent view of NCPDP REQUEST TRANSACTION HEADER SEGMENT Compare these items   
is the parent view of NCPDP REQUEST WORKER´S COMPENSATION SEGMENT Compare these items   
is the parent view of NCPDP RESPONSE CLAIM SEGMENT Compare these items   
is the parent view of NCPDP RESPONSE DUR/PPS SEGMENT Compare these items   
is the parent view of NCPDP RESPONSE HEADER SEGMENT Compare these items   
is the parent view of NCPDP RESPONSE INSURANCE SEGMENT Compare these items   
is the parent view of NCPDP RESPONSE MESSAGE SEGMENT Compare these items   
is the parent view of NCPDP RESPONSE PRICING SEGMENT Compare these items   
is the parent view of NCPDP RESPONSE PRIOR AUTHORIZATION SEGMENT Compare these items   
is the parent view of NCPDP RESPONSE STATUS SEGMENT Compare these items   
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