Pharmacy (Part D) Claims Mapping Question

[Boneth Ahaneku]

Hello BCDA Team,

We are seeing a discrepancy in our data between what we would consider the claim processing date for a given claim vs. the actual prescription fill date for that claim.  Is it possible for you all to share which BCDA FHIR elements would be best to use for both of these dates?

Thank you,

Boneth

[Beneficiary Claims Data API (BCDA) Community]

Hi Boneth,

Thanks for your question regarding the prescription fill date and claims processing dates for Part D claims. For the fill date, we recommend that you refer to the service date (Eob.item[N].servicedDate) which contains the date when the prescription was filled. The NCH Weekly Claim Processing Date (Eob.supportingInfo[N].timingDate) is provided for Part A and Part B claims only, and is not available for Part D claims.

Could you share more information to help us better understand how your organization currently or plans to use the processing date for Part D claims? This may help us suggest alternatives already available via BCDA or identify gaps in the data we currently provide.

Thanks,
The BCDA Team

[Boneth Ahaneku]

Hello BCDA Team,

Thank you so much for your reply. Our team is currently attempting to use BCDA pharmacy claims data to try to understand medication adherence within one of our populations. One of the areas we are looking into associated with this analysis is the delta between when patients get prescribed a medication and how soon they pick up from the pharmacy afterwards.

Would these two dates help us get there? Also,  are you saying to tie the part D claim back to the A or B claim via the claim ID in order to obtain the NCH Weekly Claim Processing Date?

Thanks again for your help,

Boneth

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[Beneficiary Claims Data API (BCDA) Community]

Hi Boneth,

Thank you for providing the additional info! BCDA does not have the prescribing date directly available on Part D claims - only the fill date and the payment date. We're taking a look at some options on how you might be able to connect Part D claims to the prescribing event, but don't have a recommendation just yet. We are also still looking for a source for pickup date information, as it is not included in BCDA data. We'll reach out once we have more information to share.

Thanks,
The BCDA Team