Nx Reject Reports for Part D Plan

CMS expects Part D sponsors to successfully coordinate benefits with other payers as indicated the Medicare Prescription Drug Benefit Manual Chapter 14—Coordination of Benefits.

Beginning around the end of the first quarter of 2015, Part D Plans will begin receiving Part D Nx Performance Reports on the 1st and 15th of every month.

Initially plans should use these reports to identify potential processing issues. The industry, through NCPDP WG1 Supplemental Payment Reporting task group, will begin reviewing feedback from the plans/processors to create additional FAQs and determine any report changes that might be necessary.

The first scheduled call to review Plan findings will be April 9th, 2015 at noon EST.

If you are not a member and would like to join the task group, email Margaret Weiker. If you are an NCPDP member, please register for the task group through the NCPDP collaborative site.

Valid and Invalid Reject Codes for Part D Record of Supplemental Payment Nx Transactions

The Valid and Invalid Reject Codes for Part D Record of Supplemental Payment Nx Transactions document, which can also be found under Related Documents, represents a list of reject codes which are recommended as valid (applicable) or invalid (non-applicable) as they apply to processing N transactions generated by the Transaction Facilitator (RelayHealth). There are three tabs in the document:

  1. Overview: identifies the purpose of the document and provides an overview of the other tabs
  2. Valid Rejects: list of recommended reject codes to be returned to the Transaction Facilitator when unable to successfully process an N transaction initiated by the Transaction Facilitator (110-AK Certification ID = TROOP or TROOPBATCH).
  3. Invalid Rejects: list of recommended reject codes that should not be returned to the Transaction Facilitator when unable to successfully process an N transaction initiated by the Transaction Facilitator (110-AK Certification ID = TROOP or TROOPBATCH). Note these reject codes may be valid for Ns from other entities, therefore it is recommended to segregate coding based on 110-AK.

This document has been created through industry collaboration on the NCPDP WG1 Supplemental Payment Reporting Task Group. Questions related to these reject codes can be submitted to NCPDP at Standards@NCPDP.org for discussion on a task group call.

Part D Nx Performance Report Distribution:

The reports are transmitted via secure email. For more information on adding or updating emails that should receive the Part D Nx Performance Reports please see Annual Report Distribution Email Setup and Changes after Annual Submission.