April 2010
Medication Cost Integration launched
We realize that a choice of medications can be driven by the member's out-of-pocket cost rather than the most effective option. Therefore, we have launched a new product, Medication Cost Integration (MCI) (PDF), in which all medications are covered under a single medication benefit. The member's out-of-pocket is tied to the cost effectiveness of equally beneficial medications rather than whether that medication is an injectable or oral medication.
Submit National Drug Codes (NDCs)
In order to support this product and assist our members and your patients in managing the increasing cost of medications, we are strongly encouraging all providers to submit NDCs on all of their claims.
With the NDCs, we are able to:
- Be more transparent about the cost of medication options
- Continue to develop products that support making the best drug choices for a patient
- Ensure that we apply the member's benefit correctly in accordance with the actual drug used
For electronic professional or institutional transactions, please follow the guidelines below:
Find out where to include this information on paper claims.
Current claims history indicates that over 50% of our contracted providers are already submitting NDCs on their claims. While this is not a mandatory field at this point, we will be researching the impact on having the NDC consistently included on claims.
We thank you for providing this information.