Work Group 1 Telecommunication develops and maintains standards and guidelines to accommodate the collection, transmission, and processing of electronic pharmacy claim information, i.e. administering and certifying eligibility, prior authorization, and prescribing drug benefits for traditional, managed care, and government programs; billing; payment determination or denial of compensation with explanations, and concurrent drug use review.
Work Group 2 Product Identification deals with issues relating to the identification of drugs and health related products within NCPDP’s stated mission. Identification consists of how the product is billed (billing units, quantity designations), product identification systems, and any type of descriptive data which serves to uniquely identify a product with the intent to establish standards for product identification such that there is no ambiguity in distinguishing one product from another.
Work Group 7 Manufacturer and Associated Trading Partner Transaction Standards develops, monitors, and maintains standards for the electronic exchange of data amongst manufacturers and trading partners to facilitate business processes. Additionally, the work group promotes implementation and education of the standards.
Work Group 9 Government Programs, in conjunction with Work Group 1 Telecommunication and other Work Groups, as necessary, guides and advises federal and state pharmacy programs and their agents on NCPDP standards. WG9 also supports data processing initiatives, and provides design alternatives for standards, which support government requirements.
Work Group 10 Professional Pharmacy Services supports the pharmacist’s individual and collaborative planning, delivery, documentation and quality assessment of patient care services through the development and distribution of standards, standards-based templates, and implementation guides. These documents/tools in conjunction with the publication of best practices recommendations encourage patient engagement, foster patient safety and support consistent delivery of patient care services to optimize outcomes.
WG10 strives to support pharmacists in utilizing their unique training and expertise to provide patient care services related to the appropriate use of medications. Patient care services are provided in many different practice settings and include activities such as medication therapy management, clinical reconciliation (medication, allergies and problems), patient immunization management, disease state monitoring, adverse drug event reporting and therapy adherence program management. Pharmacists contribute to improving patients’ health by providing patient care services as authorized by license and allowed under their scope of practice and collaborative practice agreements.
WG1 Telecommunication Goals
For a list of acronyms, please see the Acronym Dictionary
- Promote NCPDP membership attendance and active participation in work group meetings and task groups.
- Promote all standards created by this work group including but not limited to the Telecommunication Standard, Audit Standard, Post Adjudication Standard, Prior Authorization Transfer Standard, Prescription Transfer Standard, Benefit Integration Standard, Batch Standard, Subrogation Implementation Guide, Uniform Healthcare Payer Standard and Retiree Drug Subsidy Standard.
- Review Data Element Request Forms (DERFs) and ballots pertaining to standards for which this work group is responsible.
- Promote the use of the other transactions in the Telecommunication Standard for eligibility verification, predetermination of benefits, information reporting, controlled substance reporting, and prior authorizations.
- Continue support of the Universal Claim Form (UCF), Workers’ Compensation/Property and Casualty UCF, and supporting Reference Implementation Guide for enhancements to the Telecommunication Standard.
- Provide Health Insurance Portability and Accountability Act (HIPAA) updates.
- Provide responses to technical questions that may be sent to NCPDP as a result of a Notice of Proposed Rule Making (NPRM) for new transactions or enhancements in HIPAA.
- Review Designated Standards Maintenance Organizations Change Request System (DSMO CRS) requests as needed.
- Support WG9 Government Programs and MC Maintenance and Control Education-Legislation and Regulation Task Group when new legislation is being introduced regarding issues relevant to the work group.
- Support a forum for the discussion of Centers for Medicare and Medicaid Services pharmacy issues, as appropriate to WG1 standards.
- Support a forum for the discussion of Food and Drug Administration Risk Evaluation and Mitigation Strategies issues, as appropriate to WG1 standards.
- Monitor WG1 task groups to ensure they are tracking scope, goals, and deliverables. Disband task groups that have completed their work.
- Continue support for task groups of other Work Groups that may impact or utilize the Telecommunication Standard or other WG1 standards.
- Support the advancement of the Telecommunication Standard vF2 as the next HIPAA adopted version.
- Create a joint task group with WG16 to modify the UCF forms
- Provide assistance to the Strategic National Implementation Process (SNIP) Committee
- Analyze, develop and execute Webinar opportunities for WG1 standards in coordination with Educational Programs Advisors Group.
WG1 Telecommunication Scope
- Work Group 1 Telecommunication develops and maintains standards and guidelines to accommodate the collection, transmission, and processing of electronic pharmacy claim information, i.e. administering and certifying eligibility, prior authorization, and prescribing drug benefits for traditional, managed care, and government programs; billing; payment determination or denial of compensation with explanations, and concurrent drug use review.