Tricare NDC Edits

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Emily Wilkinson

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Feb 9, 2012, 11:13:06 AM2/9/12
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Is anyone else having issues with Tricare rejecting claims for NDC
codes not being 12 digits? The standard NDC is 11 digits.
We use SSI as our billing vendor and Tricare is not rejecting all
claims for NDC not being 12 digits, but Tricare states the issue is
with SSI not with them. I am inclined to feel it is with Tricare.

Just wondering if anyone else has experience this issue and where you
are getting with it.

Thanks!
Emily Wilkinson

Cohen, Dolores

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Feb 9, 2012, 12:15:10 PM2/9/12
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Emily,

We have not received rejections for NDC edits from Tricare, but we
haven't had any claims reach Tricare since 1/17/12. 5010 conversion was
fine until that day, then nothing is getting through. We use Relay
Health and are still waiting for a reason these claims aren't getting
through.
You should be able to tell who the NDC edit is coming from by the
reports?

Dolores

Thanks!
Emily Wilkinson

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Holmes, Beatrice

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Feb 9, 2012, 2:53:35 PM2/9/12
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Dolores,

There is a problem between Tricare and Relay Health as far as the data
exchange for 5010. They are aware of this and have been working to get
it resolved but as of today, there is no resolution.

Hope this is helpful.

Beatrice Holmes
Sr. Application Manager
AtlantiCare Regional Medical Center
609-484-6411
Ext 46411

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