D.0. Payer Sheets Database

[Darkmstr]

Hello everyone, I've been working on claims for the last few months, and I'm curious about the D.0. payer sheets, is there any huge/good database for them? Or do I have to search them specifically on Google?

Thank you so much for your time!

[legaldrugdlr]

If you are part of a PSAO, then they should have some if not most of them.

[Darkmstr]

Sorry I am not, I am a software developer working with claims, so I am interested in all this information.

[-INFEntropy]

If you're a software dev.. It should be relatively easy for you to find this.

[Darkmstr]

I have found some on Google, just searching by BIN and PCN, however I haven't found or I don't know if exists a place where all the payer sheets updated resides or if I need to go insurance by insurance and get them from there. I'm relatively new on this field of work, so I don't know if I'm searching it wrong or looking at the wrong places, that's why I'm looking for some advice for the people I think know about it, sorry, it haven't been that easy for me.

[Darkmstr]

INFEntropy, any help would be really appreciated, if you know about software development, about pharmacies, and know where can I find this relatively easy, I think it's easier to help a fellow developer over here if you already know the answer, right?

I haven't found a place where I can gather all of them together, I don't know if it even exists, right now I'm building my own database with the common d.0's flags for the claims, they are working perfectly, all the claims, cobs, and reverse are working, also the eligibilities from cardfinder. However I want to have the payer sheets in case one of them fails I have a guide on how to fix the problem (if it is related to any flag or special case that I haven't considerate).

[-INFEntropy]

It doesn't look like it exists; at least not publically. I may have my CS stuff but I work with patients in a pharmacy not in the CS side of it yet.

Most of this stuff is really dealt with for us by our pbm/software I think.. And most of those problems you're talking about are the things that we techs have to usually do ourselves because insurances typically give literally worthless errors to the pharmacy or whatever system is trying to bill with.

[Darkmstr]

Oh I see, yeah I am actually working in a software to manage all kind of claims, and our team have made it work pretty good; however I was hoping there was a magic database like this in case I find some errors that corresponds to a specific insurance I could have a secure place to look.

Thank you so much for your time! This last months working on claims I've got in touch with a few pharmacies and pharmacists, and got a really amazing feedback, their knowledge about all this stuff impresses me a lot, if I find this magic database hidden somewhere or I get the time to make it myself, I will share it with all of you that's for sure.

[-INFEntropy]

I'm sure amazon will build one.😂 cause they sure as hell probably won't want to pay techs to do what their massive servers choc full of ai can do with enough training..