Register today for APCI's 2016 Annual Convention and Stockholders' Meeting in Chattanooga, Tenn.!

Beginning Jan. 1, 2016, the Member Identification Number, Bank Identification Number (BIN), Processor Control Number (PCN) and Group (GRP) codes will change for UnitedHealthcare Care Improvement Plus Medicare Part D members. Please submit all UnitedHealthcare Care Improvement Plus Medicare Part D pharmacy claims and include the BIN, PCN and GRP code. This helps ensure the pharmacy claim applies to the correct member account and benefit information. BIN, PCN and GRP information is listed on the front of the UnitedHealthcare Medicare member identification (ID) cards.

OptumRx will assume responsibility for claims processing for members of Packers Sanitation Services, Inc. Please Note:  All plan participants of Packers Sanitation Services, Inc will receive a new member identification (ID) card. Please refer to the sample of the new ID card below.  Prescriptions need to be processed on-line using the Packers Sanitation Services, Inc ID card information.

We want to make you aware that for Medicare Part D claims currently processing on the OptumRx claim adjudication system, you may see transitional benefit messaging returned, on both paid and rejected claims, which are not applicable to why claims have paid or rejected. This is most commonly occurring with claims that are reading Drug Utilization edits in place for the plan sponsors. The claims are paying and rejected appropriately. We are working to get the messaging updated to mitigate confusion. You should see this updated in March 2016.

On April 16, 2015 the Medicare Access and CHIP Authorization Act of 2015 (MACRA) was signed into law. Section 507 of MACRA amends Section 1860D-4(c) of the Social Security Act by requiring that pharmacy claims for covered Part D drugs include an active and valid Type 1 National Provider Identifier (NPI). Beginning January 1, 2016 a Part D sponsor cannot pay a claim that does not include an active and valid prescriber NPI. Effective January 1, 2016 pharmacies must submit claims with an active and valid prescriber NPI – the SCC 49 value will be discontinued. The legislation invalidates the use of Submission Clarification Code (SCC) value 49 "Prescriber does not currently have an Active Type 1 NPI.” Claims without the NPI will reject with reject code 34 - M/I Sbm Clarification Cde If you have questions, please call the OptumRx Help Desk anytime:  UnitedHealthcare Medicare Prescription Drug Plans : 877-889-6481  UnitedHealthcare Medicare Advantage Prescription Drug Plans: 877-889-6510  All other plans: Use Toll-Free-Number on Member’s ID Card Please distribute