Frequently Asked Questions (Independent Pharmacies)

What is the NCPDP Provider ID?

The NCPDP Provider Identification number (NCPDP Provider ID) formerly known as the NABP number, was
developed over 25 years ago to provide pharmacies with a unique, national identifier that would assist
pharmacies in their interactions with pharmacy payers and claims processors. The NCPDP Provider ID is a
seven-digit numbering system that is assigned to every licensed pharmacy and qualified Non-Pharmacy
Dispensing Sites (NPDS) in the United States.

Why is NCPDP Online important to my business?

NCPDP has maintained accurate information about your pharmacy for over 25 years. Maintaining information
about your pharmacy is vital to proper reimbursement by many third party plans because your NCPDP
Provider ID is used to identify your pharmacy.

Now you can keep your pharmacy information up-to-date online at www.NCPDPonline.org. It is faster than the
existing paper process, but still has all the same validation and verification checks. Only YOU can make sure
your pharmacy information is up-to-date.

And with your authority, NCPDP can act as your Electronic File Interchange Organization (EFIO). This means
that NCPDP will automatically submit changes you make to your pharmacy record to the Centers for Medicare
and Medicaid Services (CMS) National Plan and Provider Enumeration System (NPPES). NCPDP
automatically ensures NCPDP Online (NCPDP Provider ID) and CMS NPPES (NPI Number) are in synch.
Note: Federal law requires the NPPES database be updated within thirty (30) days of any provider information
change.

In addition, did you know CMS requires that all Medicare Part D plans send pharmacy drug event data from
claims to CMS? CMS verifies data on your pharmacy against the NCPDP Online database.

Why do I need an NCPDP Provider ID if I have an NPI Number?

Even though pharmacies now use the National Provider Identifier (NPI) number to bill, it is critical that
pharmacies maintain their NCPDP Provider ID pharmacy records. The NCPDP Provider ID is used by MANY
payers and third party contracting entities to identify pharmacies. In addition, the data maintained in the
NCPDP Provider ID pharmacy record assists payers and third party contracting entities in “crosswalking”
between the NPI and NCPDP Provider ID.

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What software do I need to use the NCPDP Online web site?

The NCPDP Online web site works best in Microsoft Windows Explorer 6.0 or higher. If you are not using
Microsoft Windows Explorer, you may experience some issues with the site. You can download the latest
version of Microsoft Windows Explorer from the Microsoft web site (www.microsoft.com) free of charge at.

Most documents on the NCPDP Online web site, such as the User Guide and Quick Reference Sheet, are
available as Adobe PDF files. This helps maintain formatting of the documents and shrinks the size of the
documents to make them easier to download. If you do not have Adobe Reader installed on your computer,
you can download it free of charge from the Adobe web site (www.adobe.com).

Sometimes, when I update a pharmacy record, it asks me for a PIN. What data
fields require me to enter a PIN for updates?
Your user name and password should always be kept to yourself, but while logged onto NCPDPonline.org, you
may walk away from your computer. So a PIN has been added for additional security during a user session.

Data fields that require a PIN authentication for updates include:

• Pharmacy DBA Name

• Pharmacy Legal Name
• Store Open/Effective Date
• Store Close Date
• NPI Number
• NPI Confirmation
• Federal Tax ID
• Federal Tax ID Documentation
• State Tax ID
• Class Designation
• Taxonomy Code(s)
• Pharmacy Authorized Official
• Relationships and Payment Centers

Note: When you are creating a new NCPDP Provider ID, you will always be asked to enter a PIN.

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The link to “Update” a pharmacy profile doesn’t work on the NCPDP Provider ID
tab, what am I doing wrong? I have noticed there are other links on the site that
don’t work too.
There are parts of the site that require your Internet browser to accept pop-ups. For example, when you click
the “Update” link to update your pharmacy profile – a pop-up will appear presenting you with options on what
you wish to update, i.e. pharmacy profile, pharmacy relationships and EFIO permissions.

You should allow pop-ups for NCPDP Online, which you can do without allowing pop-ups for other web sites.
To do this:

Step 1 – Click on “Tools” at the top of your Microsoft Internet Explorer browser

Step 2 – Select “Pop-Up Blocker”

Step 3 – Select “Pop-Up Blocker Settings”

Step 4 – Enter www.ncpdponline.org in the “Address of Website to Allow” box

Step 5 – Click the “Add” button, then click the “Close” button

If I am creating an additional NCPDP Provider ID for an existing location, do I

need to pay for the second NCPDP Provider ID?
If you choose to create a new NCPDP Provider ID for an existing location, you will be asked to select the
current location from your list of pharmacies. The new pharmacy record will be populated with the data fields
from the pharmacy you selected. If you change any of the following data fields, you will be charged for a new
NCPDP Provider ID:

• Legal Business Name

• Federal Tax ID
• Pharmacy Class/Designation
• Physical Address
• Authorized Official

If none of the above fields are changed, the new NCPDP Provider ID will be assigned at no cost.

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If I pay for a new NCPDP Provider ID online with my credit card, what does
NCPDP do with my credit card information?
At no point does NCPDP have access to your credit card information, and NCPDP does not store your credit
card information in the NCPDP Online database.

NCPDP utilizes one of the largest, secure 3rd party online payment processors (Verisign Payment Services
acquired by PayPal) to process your credit card.

NCPDP receives ONLY a confirmation if your credit card payment is accepted, and a rejection if it is not.

Can I get my own NPI number and still have NCPDP act as my Electronic File
Interchange Organization (EFIO)?
You have the ability to grant NCPDP permission to act as an EFIO for your pharmacy. NCPDP will
communicate your information to the Centers for Medicare and Medicaid Services (CMS) in order to 1) Obtain
a National Provider Identifier (NPI ) for your pharmacy OR 2) If you already have an NPI, to update your
pharmacy information with CMS automatically.

This service has been enhanced by NCPDP for the NCPDP Online web site. Previously, you would simply
check off (Yes/No) that you did or did not want NCPDP to act as an EFIO. With the new NCPDP Online web
site, you can now specify you want NCPDP to act as the EFIO for ADDS and/or for CHANGES. This enables
you to obtain your own NPI number (if you prefer) and still have NCPDP act as the EFIO for CHANGES.

Why do I need to upload my licenses and/or certificates?

Some sections of your NCPDP Provider ID pharmacy record will require a document upload (e.g. state
pharmacy license, pharmacy DEA registration, Federal Tax ID documentation, NPI confirmation, EFIO
Authorization). NCPDP uses the documents you upload to verify the data entered is correct.

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 Frequently Asked Questions (Independent Pharmacies)

How do I upload my licenses and/or certificates?

If you have the document electronically, simply upload it to the corresponding section of your pharmacy record.

If you don’t have the document electronically, a link is provided to print a fax coversheet. Print the coversheet
and fax with the document you wish to upload to NCPDP. Your document will be converted to an electronic file
and associated with your pharmacy record.

Note: There will be times when you update your pharmacy record and you find some edits require the
uploading of documents. Please add the documents if you have them. However, for updating existing
pharmacy records, NCPDP may already have these documents, so you can simply generate the fax cover
sheet and indicate that this information is already on file. NCPDP will search its existing electronic documents
and insert the proper document into your online pharmacy record. If NCPDP cannot find the document, you
will be contacted via your preferred method of communication.

Can I submit data to NCPDP with blank data fields?

It depends on the data field. There are required data fields in the NCPDP Provider ID pharmacy record that
must be completed before submitting to NCPDP. If you have made changes to your pharmacy record, but do
not have all the required data fields complete… not to worry. Simply Pend the pharmacy record. The
pharmacy record will be saved and you can come back later to complete the required data fields.

Data fields that are not required can be completed at any time and submitted to NCPDP.

How long will it take for NCPDP to verify and update information to the live
database?
There are a number of automated checks already built into NCPDP Online to ensure the data you enter is
validated prior to submitting to NCPDP. But it is important that NCPDP verifies “adds” and “updates” to your
NCPDP Provider ID pharmacy records prior to making them live in the database. This will ensure your
pharmacy record does not contain errors that could impact proper reimbursement for your pharmacy. This
verification by NCPDP can take up to five (5) business days.

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Will NCPDP reject any data that is submitted? How will you know your data has
been rejected?
It is a rare occurrence, but there are times when NCPDP will reject data that is submitted to the NCPDP Online
database. NCPDP will work with the pharmacy, during verification, to fix any minor data issues. If it is a major
issue that would cause significant problems for the pharmacy, NCPDP will reject the data and provide an
explanation as to why it was rejected.

If your data is rejected, you will receive an alert and can view the notes provided by NCPDP as to why the data
was rejected. Simply make the corrections to the data and re-submit to NCPDP.

What if I am setting up a new pharmacy and I do not yet have my pharmacy

license?

If you do not have your pharmacy license, upload a copy of your temporary license/inspection report (a
temporary license/inspection report will be given a 30-day expiration date). Once you receive your pharmacy
license, log back into NCPDP Online and update the pharmacy record with the pharmacy license information
and upload a copy of the pharmacy license.

In my user preferences, I have turned on my email and/or fax alerts. When will I
receive the alert if I choose “daily”? When will I receive the alert if I choose
“weekly”?

Based on the alerts you have chosen, your alerts are consolidated into one email or fax. If you choose “daily”
alerts, the alert is sent to you at approximately 1:00am for the NCPDP Provider ID pharmacy records that
triggered the alert the day before. If you choose “weekly” alerts, the alert is sent to you at approximately
1:00am on Thursday morning.

Under my Tools, I can create and manage payment centers. Can I set up more
than one payment center?

If you have a third party relationship, such as a PSAO (third party contracting group), there may be a payment
center associated with this relationship. But if this is not the case AND you want payments from payers to go
some place other than your pharmacy’s physical or mailing address (e.g., a bank lock box), you can set up and
manage your own payment center. There is no limit to how many payment centers you can create.

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When I create a new user and assign a “Role”, what is the difference between
VIEW, EDIT, APPROVER and ADMIN?

User roles are hierarchical – i.e. the permissions build on each other with more responsibilities as you move
from View to Admin.

A user with VIEW permissions can only view pharmacy information. A user with EDIT permissions can view
and edit pharmacy information, but any edits must be approved by the approver or admin before they are
submitted to NCPDP for verification.

A user with APPROVER permissions can view, edit and approve pharmacy information including submitting
new pharmacy applications to NCPDP. It is important that a user with approver permissions pays special
attention to the “Waiting for Approvals” queue on the NCPDP Provider ID tab.

A user with ADMIN permissions can view, edit and approve pharmacy information and maintains his/her
organization’s user accounts, relationships, parent organizations and payment centers.

I received multiple emails with a different user account for each of my

pharmacies? Can I access all my pharmacies under one user account?

Yes, NCPDP Online allows you to consolidate multiple pharmacies under one user account. Please send the
list of NCPDP Provider IDs for your pharmacies and your contact information to [email protected].
NCPDP will assist you in creating a single user account that has access to all your pharmacies.

I own multiple stores, but I am not sure if I want a chain relationship code for my
pharmacies because I have a PSAO (third party contracting group) relationship
for the pharmacies. Can a pharmacy have both a chain and PSAO relationship?

Yes, NCPDP Online allows you to associate more than one relationship with your pharmacies – but you will be
required to identify one as your primary relationship.

If you wish to create a chain relationship for your pharmacies, please contact [email protected] to
change your “independent” user permissions to “chain” user permissions.

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 Frequently Asked Questions (Independent Pharmacies)

I accidentally linked my Type 1 (personal) NPI to my pharmacy record. Why

won't NCPDP Online allow me to correct it?

If you are not a sole proprietor and your pharmacy has submitted claims with a Type 1 (individual) NPI
attached to an NCPDP ID, you must apply for a new NCPDP ID and NPI. Once the two numbers are linked
they cannot be decoupled. Many industry systems use the NCPDP ID as the crosswalk to your NPI number.
This means that systems regard the number as one and the same. Changing either one of them will lead to
rejected claims and a serious disruption to your business.

Unless you are a Non Pharmacy Dispensing Site (NPDS), NCPDP can apply for a new NPI on your behalf if
you grant EFIO permission while applying for your new NCPDP Provider ID.

Please note that sole proprietors must, by law, apply for a Type 1 (individual) NPI rather than an organizational
NPI. Sole proprietorships are the only Type 1 NPIs maintained in the NCPDP database.

What is an acceptable Federal Tax ID (EIN) document?

NCPDP will not accept a W-9 form, EFTPS Enrollment Form or state issued letter with EIN. If you call the IRS
Business and Specialty Tax Line at (800) 829-4933, the IRS will fax you a confirmation letter within minutes at
no charge.

The following Federal Tax ID documents are accepted:

 Confirmation letter from the IRS with the pharmacy legal business name (LBN) & EIN
 FTD Coupon (Federal Tax Deposit Coupons - Form 8109)
 Payment Voucher (Form 941-V)

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