Work Group 1 Telecommunication develops and maintains standards and guidelines to accommodate the collection, transmission, and processing of information that may be exchanged electronically or in written formats. The information exchanged may be used for, but is not strictly limited to, such purposes as administering and certifying eligibility, establishing prior authorization for products and services, pharmacy claim billing, payment determination, denial of compensation with explanations, drug use review, determination of benefits and the exchange of adjudicated data between business associates.
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,package size 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 adjudicate 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.
- Support task groups of other Work Groups that may impact or utilize the Telecommunication Standard and other WG1 standards to ensure harmonization and interoperability across electronic data exchanges.
- Support the advancement of the appropriate version of the Telecommunication Standard as the next HIPAA adopted version.
- Create a joint task group with WG16 to modify the UCF forms
- Collaborate with WG45 Documents Revision Task Group to ensure alignment with external standards
- Provide assistance to the Strategic National Implementation Process (SNIP) Committee
- Support Maintenance & Control Task Groups with goals and objectives impacting the Telecommunication Standard
- 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 information that may be exchanged electronically or in written formats. The information exchanged may be used for, but is not strictly limited to, such purposes as administering and certifying eligibility, establishing prior authorization for products and services, pharmacy claim billing, payment determination, denial of compensation with explanations, drug use review, determination of benefits and the exchange of adjudicated data between business associates.