Data related to an individual’s insurance coverage for health care.

Data Element

Information from the submission form

Payer Identifier
Description
The identifier defining a payer entity.

Comment

NCPDP Comments

NCPDP recommends adding the use of Group Number with Issuer Identification Number (IIN) and Processor Control Number (PCN) when applicable for retail pharmacy claims.  This combination of identifiers is commonly used in billions of transactions annually.

There is no national…

There is no national standard for this, nor is there a national definition of payer.  The industry has struggled with this and has been unable to come to consensus; suggest removing this element.

Prime Therapeutics Comments on USCDI draft V3

Prime Therapeutics LLC (Prime) helps people get the medicine they need to feel better and live well. Prime provides total drug management solutions for health plans, employers, and government programs including Medicare and Medicaid. We serve nearly 33 million people and are collectively owned by 19 Blue Cross and Blue Shield Plans, subsidiaries or affiliates of those plans.  Prime Therapeutics requests adding the Issuer Identification Number (IIN), Processor Control Number (PCN), and Group ID as identifiers commonly used in billions of pharmacy industry information exchange transactions each year.  

NCPDP Comments on USCDI draft V3

NCPDP recommends the use of Group Number with Issuer Identification Number (IIN) and Processor Control Number (PCN) in addition to NAIC.

NCPDP Comment

NCPDP recommends the use of Group Number with Issuer Identification Number (IIN) and Processor Control Number (PCN) in addition to NAIC.

payer identifier

The CDC Division for Heart Disease and Stroke Prevention and the Million Hearts® 2022 Hearts national initiative (co-led by and the Centers for Medicare & Medicaid Services) uses this data as it is available for monitoring and evaluation to prevent 1 million heart attacks and strokes in 5 years. Furthermore, the CDC plans to leverage this data further in the future for surveillance and epidemiology studies if advanced through policy and available from EHRs. The Multi-state EHR-based Network for Disease Surveillance (MENDS) pilot will use electronic health record (EHR) data collected in clinical settings leading to a real-time, chronic disease surveillance model to plan and evaluate short-term outcomes of policies and program interventions.This field is for general comments on this specific data element. To submit new USCDI data classes and/or data elements, please use the USCDI ONDEC system: https://healthit.gov/ONDEC

USCDI_Version_2_Draft_Template for Comments_DHDSP_MENDS_04.15.2021_2.docx

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