Dear Pharmacy, Effective 6/13/2012, pursuant to CMS requirements, Blue Shield of California Medicare claims processed with an invalid Bank Identifier Number (BIN), Processor Control Number (PCN) or member identification number will reject. The correct Medicare member information will be returned with the following reject code(s). NCPDP Error Argus Error Verbiage 04 292 Submitted PCN Not Valid For Member ID 01 294 Submitted BIN Not Valid for Member ID 07 295 Cardholder ID is Invalid
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Medicare: Member ID numbers should be submitted using the eleven-character subscriber identification number beginning after the first three alpha characters. No group number or person code is required for submitting Medicare Part D claims.
MAPD members: BIN 012353 and PCN 01920000 PDP members: BIN 012353 and PCN 03510000 Commercial: Member ID numbers should be submitted using the nine-character subscriber identification number beginning after the first three alpha characters. The member’s date of birth must be submitted in a month, day, year (mm/dd/yyyy) format and the member’s relationship code to the subscriber must also be submitted.
Commercial members: BIN 600428 and PCN 01910000 Please let me know if you have any questions. Danielle Domino Pharmacy Network Coordinator, CPhT, BS Pharmacy Services Blue Shield of California 50 Beale Street San Francisco, CA 94120 Phone: 415-229-5698 Fax: 415-229-6011
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