Final answer:
When a tech receives a rejected claim "NDC Not Covered", it means that the NDC on the claim is not covered by the insurance plan. They should check the formulary to verify if the NDC is included or explore other options.
Step-by-step explanation:
When a tech receives a rejected claim "NDC Not Covered", it means that the National Drug Code (NDC) provided on the claim is not covered by the insurance plan or the specific policy. The NDC is a unique identifier for medications, and insurance companies have a list of drugs that they cover
For example, if a patient's insurance plan does not cover a specific brand of medication, and the NDC on the claim corresponds to that brand, the claim will be rejected with the error message "NDC Not Covered". The rejection will indicate that the insurance company will not pay for the medication
To resolve this issue, the tech should check the formulary or list of covered drugs for the patient's insurance plan and verify if the NDC is included. If it is not covered, the tech can work with the healthcare provider to find an alternative medication or explore other options.