National Drug Codes - UHCprovider.com

National Drug Codes claim submission and inquiry procedures (NDC/ppoONE contracted providers only) PCA-1-21-04504-UHN-WEB_12172021 1 Table of contents Overview of National Drug Code claims .. 1 How to submit NDC 1 Types of NDC claims .. 2 NDC claim requirements .. 2 NDC claim inquiry .. 3 Health plan information .. 4 Overview of National Drug Code claims Some home care service professionals typically, home infusion and/or specialty pharmacy providers must follow specific submission and inquiry procedures for National Drug Code (NDC) claims. These claims may differ from one home care provider to another. Home care providers may also have certain service types for which claims must be submitted, according to the NDC process, but may have other service types for which claims must be submitted by the standard UnitedHealthcare claims submission process.

explanation of benefits (EOB) or provider remittance advice (PRA) As a coordination of benefits (COB) claim (any primary payer; not limited to Medicare) COB submission The paper process2 (by fax), as noted in “How to submit NDC claims” Please submit both the CMS-1500 claim form and the primary carrier’s EOB together. NDC claim requirements

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  Benefits, Claim, Explanation, Explanation of benefits, Of benefits, S eob

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