Group ID definition
Examples of Group ID in a sentence
Retail pharmacies that wish to trigger claim-based crossovers to Medigap when billing in the NCPDP format should enter the Medigap claim-based COBA ID in the 301-C1 (Group ID) portion of the Transmission Insurance Segment in the NCPDP format version D.0. The beneficiary’s Medigap policy number is reported in the 359-2A (Medigap ID) portion of the Insurance Segment of the NCPDP format version D.0. It should be noted that no development for missing or incomplete information will be done by the DME MAC.
In addition to your client statement, you can also find your Group ID online if you’re registered on the secure site at ▇▇▇▇▇▇▇▇▇▇.▇▇▇.
Rx ID and RxBIN are required for coverage type ‘U, W X, or Y.’ DCN, middle initial, termination date, RxPCN, Rx Group ID and person code should be provided if available.
Please resubmit all EDI forms and include the Group PTAN (Group ID) associated with this provider number (PTAN).
That claims documentation must include the following fields: Client FEIN, Carrier ID, Account ID, Group ID, Member ID, Date of Service, NDC, Drug Name, Product Description, Quantity, Total Paid, Member Paid, Plan Paid, Pharmacy Name and Pharmacy Location.
Patient Name Person Responsible for Payment Signature Date Patient name: Date of Birth: Age: Social Security Number: Phone Number: Home street address: Apt: City: State: Zip: Name: Phone: Address: Relationship to you: Date of Birth: Insurance Company: Address: Customer Service Phone: Primary Insured ID#: Group ID#: ▇▇▇▇▇▇▇ ▇.
To access it, visit: ▇▇▇▇▇://▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇▇.▇▇▇ – Once at the site, enter the Group ID: 100105CPPD19 to review the plan.
S1-365 04 The employee coverage will be effective the 366th day following the date of hire/rehire S3-365 05 Page 7 of 11, Part B, July 1, 2010 Group Exec Initials Group Name (Full Legal Name) Sub Group ID Class ID (Date entered will be BCN renewal date.) Requested Effective Date / / Healthy Blue LivingSM Note: HBL products may Healthy Blue LivingSM Prescription Drug Options only be offered at the group's renewal date.
In connection with the obligations of the Company hereunder to register a Holder's Registrable Securities, the Holder shall furnish the Company such information concerning the Holder, the Holder's Registrable Securities, and the terms of the offering of such Registrable Securities by the Holder as the Company may reasonably request in order to comply with the provisions of the Act with respect to the Registration Statement to be filed.
Insurance Name Address Phone ( ) Subscriber Name Subscriber / Group ID # Member ID# I understand that Family to Family (FTF) is an out-of-network practice and its physicians do not accept insurance or Medicare.