Ncpdp Forms Form PDF Details

In the realm of prescription drug programs, the need for standardization and efficient processing of claims has led to the development and use of the National Council for Prescription Drug Programs (NCPDP) Universal Claim Forms. These forms, which are cornerstone assets for pharmacies, healthcare providers, and insurance processors, come in various versions tailored to meet specific needs, including those for workers’ compensation and property and casualty cases. They are available for purchase through CommuniForm, with detailed product information and ordering options found directly on the NCPDP’s official website. Ranging from continuous feed to laser form options, these claim forms support different telecommunications standards, including the widely recognized Version D.0. The introduction of these forms marked a significant stride towards improving the efficiency and reliability of claims processing in the healthcare sector. In addition to the forms themselves, NCPDP and CommuniForm provide critical support documentation, such as the Universal Claim Forms Reference Guide and access to an external code list for completing the forms accurately. These resources are indispensable for entities involved in the manual entry of claims, aiming to streamline operations and enhance the accuracy of data submission. Moreover, CommuniForm extends contractual arrangements, like distribution and licensing agreements, which further facilitate the implementation and use of these vital forms within the healthcare industry’s technological infrastructures.

QuestionAnswer
Form NameNcpdp Forms Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namescommuniform, ncpdp universal claim form pdf, products universal claim forms, purchase universal claim form

Form Preview Example

Purchasing the Universal Claim Forms

Updated 01/2015

Universal Claim Forms Purchase

The National Council for Prescription Drug Programs (NCPDP) Universal Claim Forms are

purchased from CommuniForm. Information is available at http://www.ncpdp.org/Products/Universal-Claim-Forms.

Product

Description

“Previous

Identification

 

identification”, if

 

 

applicable

PUCFCC

"Credit Card" style form

DAH 3-97

PUCF2PT

"Version 5" continuous feed form

DAH 2PT

PUCF1PT

"Version 5" laser form

UCF L1

 

 

 

PUCF-D02PT v1.1

“Version D.0" continuous feed form

 

PUCF-D01PT v1.1

"Version D.0" laser form

 

 

02/2013 NOTE: VERSION 1.1 WILL BE SUNSETTED AS

 

 

V1.2 IS USED

 

 

 

 

PUCF-D02PT v1.2

“Version D.0" continuous feed form

 

PUCF-D01PT v1.2

"Version D.0" laser form

 

 

 

 

WUCF1PT

Workers’ Compensation/Property and Casualty

 

 

"Version 5 and above" laser form

 

Note: The Workers’ Compensation/Property and Casualty Universal Claim Forms were built to support Telecommunication Standard Version 5 and above (including Version D.0).

Other Solutions (Contractual Arrangement)

CommuniForm offers a distribution agreement. CommuniForm offers a licensing agreement for a PDF Template (you must have IT resources for implementation). To discuss, please contact Alex Pallas.

Universal Claim Forms Reference Guide

NCPDP has published the MANUAL CLAIM FORMS REFERENCE GUIDE for pharmacies or other providers who are filling out the “Version D” Universal Claim Form or the Workers’

Compensation/Property and Casualty Universal Claim Forms. This guide is also for use by health plans/processors who are accepting these claim forms. The guide is available via the customer- only web page of CommuniForm, for entities that purchase the form(s). The guide is also available with NCPDP membership. This guide is copyrighted and cannot be reproduced or distributed.

EXTERNAL CODE LIST Data Element Values

The back of the “Version D” Universal Claim Form and the Workers’ Compensation/Property and

Casualty Universal Claim Forms contain common data element values from the NCPDP EXTERNAL CODE LIST document. There is limited real estate to the back of the forms, so the MANUAL CLAIM FORMS REFERENCE GUIDE should be used for more information.

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