Current mood:

aggravated

I Told You So (Pharmacists as Whipping Boys)

Long-time fans %^) may recall my rantings about National Provider Numbers in posts such as this one. Well, I predicted that a year later, I'd be saying "I told you so".

I told you so.

Neighborhood Health in MA is now requiring that the prescriber be identified in a pharmacy claim (from a MassHealth [Medicaid] patient) by NPI number, not (like every other health insurance) by DEA number. Now, the NCPDP, the standards bureau for pharmacy claims processing, has developed a bright, shiny new field for NPI numbers, and our software has implemented that field.

Problem is, if the DEA field is populated at all, the claim will bounce. We have a substantial number of patients with this insurance scenario. And now, for every such claim, we have to:

• Process the claim and let it reject.
  
• Obtain the prescriber's NPI number.
  
• Remove the prescriber's DEA number from their record and write it down.
  
• Enter the NPI number.
  
• Re-process the claim.
  
• Re-enter the DEA number into the prescriber's record.
  

I haven't yet had a NHP/MH claim for a controlled substance, which will require the
simultaneous submission of the mutually incompatible DEA and NPI numbers.

Someone got paid for implementing this. Someone is buying a Beemer and putting his kid through
Yale on the money he got for this. And the money came from my taxes.