The Supplemental Payer Routing BIN/PCN table is used by switches to determine which transactions are routed to the TrOOP Facilitator and to identify, transmit and process B transactions through the coordination of benefits (COB) process. The TrOOP Facilitator uses these transactions to attempt to generate N transactions, which are used by Part D plans to adjust beneficiaries’ TrOOP balances. Prior to January 1, 2012, the Coordination of Benefits Contractor (COBC) created the BIN/PCN table and provided it to The Transaction Facilitator, for distribution to the switches.
In order to better meet CMS coordination of benefits requirements, CMS transferred the ownership and management of the list of BIN-PCNs to The Transaction Facilitator effective 1-1-2012. Under the direction of CMS personnel, The Transaction Facilitator’s control and maintenance of the list of BIN-PCNs is anticipated to result in a higher rate of compliance and quicker response time for updates to new or revised BIN-PCNs related to supplemental payers. By utilizing specific criteria The Transaction Facilitator will be able to determine, through CMS eligibility records, which BIN-PCNs are supplemental to Part D, allowing the switches to B transactions that may potentially result in Ns.
The Transaction Facilitator maintains a list that represents payers that are supplemental to Part D. This list is derived based on the following criteria:
The Transaction Facilitator and CMS reserve the right to remove any BIN/PCN for which low N transaction/eligibility match rates cannot be resolved.