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 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, 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.
WG16 Property and Casualty/Workers' Compensation 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 open and active participation by Work Group members in educating policy makers on issues pertinent to the delivery of pharmacy care/services for Workers’ Compensation/Property and Casualty patients.
- Support outreach efforts through sponsoring presentations by policy makers/regulators and/or industry experts at work group meetings.
- Develop electronic claim solutions for current and future needs, within the Workers’ Compensation/Property and Casualty industries, not addressed in the NCPDP Telecommunication Standard Implementation Guide.
- Promote a national standard for pharmacy billing and reporting to Property and Casualty/Workers’ Compensation policy makers and stakeholders.
- Seek and promote solutions between stakeholders that may currently lack visibility and/or understanding about pharmacy fulfillment and billing processes as it pertains to Workers’ Compensation/Property and Casualty.
- Educate policy makers on the use of the NCPDP real-time Telecommunication Standard.
- Modify the existing Workers’ Compensation/Property and Casualty Universal Claim Forms and Reference Guide and NCPDP electronic standards, as needed, for the Workers’ Compensation/Property and Casualty industries.
- Review and analyze current NCPDP standards which impact the Workers’ Compensation/Property and Casualty industries and develop action plans or modify NCPDP Standards to meet the needs of the Workers’ Compensation/Property and Casualty industries.
- Collaborate with other NCPDP work groups and the International Association of Industrial Accident Boards and Commissions (IAIABC) as needed.
- Monitor WG16 task groups to ensure they are tracking scope, goals, and deliverables. Disband task groups that have completed their work.
- Support the MC Maintenance and Control Education Legislation-and Regulation Task Group when new legislation is being introduced regarding issues relevant to the work group.
- Review Data Element Request Forms (DERFs) and adjudicate ballots pertaining to standards for which this work group is responsible.
- Analyze, develop and execute Webinar opportunities for WG16 in coordination with Educational Programs Advisors Group.
WG16 Property and Casualty/Workers' Compensation Scope
- Work Group 16 Property and Casualty/Workers' Compensation will ascertain, monitor and analyze regulatory requirements to develop and recommend correlating fields to be supported in the Telecommunication Standard format; evaluate, and maintain a Property and Casualty/Workers’ Compensation standard paper claim form; proactively promote and educate pharmacy industry stakeholders and regulatory policy makers on the form and format standards found in Property and Casualty/Workers’ Compensation. This includes but is not limited to uniform billing, state reporting policies and the overall delivery of pharmacy services/care.