Facilitate Drug Claims Processing with Medicaid Drug Information

For many years, First DataBank has furnished Medicaid drug information for virtually all states that offer Medicaid coverage. This includes information on the various states' formularies, special restrictions and reimbursement rates. This information helps to speed up and simplify payment of Medicaid drug-product claims. Our comprehensive Medicaid drug databases can be easily integrated into your programmable claims‑processing system.

Billing for Medicaid Drug Claims Made Easier

Nationwide, millions of Medicaid claims for drug products are processed every week. Manual procedures used in billing, processing and auditing these claims often result in errors, rejected claims and slow reimbursement. Every rejected claim translates into wasted time and money.

Our Medicaid coverage and pricing information can assist you in the resolution and payment of drug-product claims in your state. These Medicaid databases are used by pharmacies to create and submit third-party claims electronically, and to avoid the expense of continually updating dynamic data. They are also used by system vendors to provide Medicaid data to pharmacy customers.

Comprehensive Medicaid Drug Information

Once integrated into your system, our Medicaid coverage information allows quick access to the following types of information:

• Drug formulary management indicators and billing codes indicating whether a given drug is covered by a particular state's Medicaid program
• Package size and unit-of-measure information for those states using non-metric or restrictive units of measure
• Minimum and maximum dispensing quantities
• Special limitation and/or therapeutic codes for billing purposes
• Special price limitations for some states' programs