Nexxsys provides assistance with entering drug plans into the patient file. Press the help button for more information on how to enter a plan when in the patient’s 3rd Party tabs. This will also provide a phone number for contacting the plan. For further information regarding error messages, refer to the individual payors.
The following is the Nexxsys codes for each payor:
- Assure/Telus: AS
- Green Shield: GS
- Claim Secure: CS
- ESI/Eclips: EP
- Ontario Drug Benefit/ODB: DB
- Trillium: TR
- Nexgen: NG
- Intrim Federal Health Program: IF
- Indian Affairs/Non-insured Health Benefits/NIHB: IA
Multiple Plans
Often patient are covered by more than one drug plan.
– Patient is Over 65yrs and has private insurance.
ODB is always the first plan (#1). Enter the private drug plan as a secondary plan. All adjudication should go first to ODB then private insurance unless the prescription is not covered by ODB.
– Patient has own plan and spouse plan.
The patient’w own plan is the primary plan and the spouse’s will be the secondary. For children, the parent who’s birth date is earlier (i.e the older parent) will be the primary payor.
– Payer assistant cards
These card are entered exactly like a separate payor. The should be the last payor adjudicated to.
– More than 2 plans.
In some occasions, patients will have 3 plans. Some Payor (i.e Green Shield) will not adjudicate if they are entered as a 3rd payor. If you run into problems, call the payor to check if adjudication is possible. If not, patient will have to pay and submit the receipt manually.
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