Pharmacy Billing (NCPDP)
Injury

NCPDP Injury Page Explained

Last update
September 24, 2023

The Injury Page displays information about a patient’s injury, including mandated claim information and associated contacts such as adjustors, attorneys, PTP, etc.

You can manage injury information with these functions:

From the ‘Patient Page,’ click on the Patient’s injury

A. To edit injury information, click ‘Edit Injury’

B. To delete an Injury, click ‘Delete’

C. To download a Facesheet, click ‘Facesheet’

D. To add a new Bill for the Injury, click ‘Add’ under ‘Bills’

E. To view existing Bills for the Injury, click ‘View’ under ‘Bills’

F. To create a new RFA, click ‘Add’ under ‘RFAs’

G. To view existing RFAs, click ‘View’ under ‘RFAs’

H. To add an Injury Note, click ‘Add’ under ‘Injury Notes’

I. To view existing ‘Injury Notes’ for the Injury, click ‘View’ under ‘Injury Notes’

J. To upload documents to an Injury, click ‘Add’ under ‘Injury Documents’

K. To view existing ‘Injury Documents’ for the Injury, click ‘View’ under ‘Injury Documents’

L. To create a Paper Second Review, click ‘Add’ under ‘Paper SBRs’

M. To view existing ‘Paper SBRs’ for the Injury, click ‘View’ under ‘Paper SBRs’

N. To view claims administrator information, click ‘Profile’

O. To view Injury History, click ‘History’

P. To add contact information, click ‘Add’

From the ‘Patient Page,’ click on the Patient’s injury

A. To edit injury information, click ‘Edit Injury’

Update, add or change injury information at any time. For more information, see the Help Article: Edit / View Injury.

B. To delete an Injury, click ‘Delete’

Injuries with submitted Bills cannot be deleted. For more information, see the Help Article: Delete Injury / Patient.

C. To download a Facesheet, click ‘Facesheet’

This will open in a new tab on your browser, where you can download and print a PDF with patient, injury, and contact information.

D. To add a new Bill for the Injury, click ‘Add’ under ‘Bills’

For more information, see the Help Articles: NCPDP Add Bill Dispensed Product and NCPDP Add Bill Compound Product.

E. To view existing Bills for the Injury, click ‘View’ under ‘Bills’

This takes you to the List of Bills associated with the Injury where you can also add new bills.

F. To create a new RFA, click ‘Add’ under ‘RFAs’

Create and track Requests for Authorization (RFAs) for each Injury. To view existing RFAs for the Injury, click View under RFAs. For more information, see the Help Article: Add / Send RFA.

G. To view existing RFAs, click ‘View’ under ‘RFAs’

This takes you to the list of RFAs associated with the Injury where you can also add new RFAs.

H. To add an Injury Note, click ‘Add’ under ‘Injury Notes’

Use Injury Notes to retain important information about the Injury. For more information, see the Help Article: Add / View Injury Notes.

Injury Notes appear on all Bill Histories for all Bills (including future Bills) associated with the Injury.

I. To view existing ‘Injury Notes’ for the Injury, click ‘View’ under ‘Injury Notes’

This takes you to the list of Injury Notes associated with the Injury where you can also add new Injury Notes.

J. To upload documents to an Injury, click ‘Add’ under ‘Injury Documents’

Store Injury Documents such as Settlement Hearing Notifications or Declarations of Readiness for organized, easy access later. For more information, see the Help Article: Add / Edit / Delete Injury Documents.

K. To view existing ‘Injury Documents’ for the Injury, click ‘View’ under ‘Injury Documents’

This takes you to the list of Injury Documents associated with the Injury where you can also add new Injury Documents.

L. To create a Paper Second Review, click ‘Add’ under ‘Paper SBRs’

Appealing improper reimbursements from before you joined daisyBill is easy. Click ‘Paper SBRs’ to create and submit paper requests for Second Review (SBRs) for bills not originally submitted with daisyBill. For more information, see the Help Article: Create Paper SBRs - NCPDP.

Do not create paper SBRs for Bills originally submitted from daisyBill.

M. To view existing ‘Paper SBRs’ for the Injury, click ‘View’ under ‘Paper SBRs’

This takes you to the list of Paper SBRs associated with the Injury where you can also add new Paper SBRs.

N. To view claims administrator information, click ‘Profile’

The Claims Administrator Profile displays:

  • Bill review companies associated with the claims administrator and contact information
  • Request for Authorization Information
  • Claim number patterns for the claims administrator

For more information, see the Help Article: Claims Administrator Profile.

O. To view Injury History, click ‘History’

History displays the complete history of the creation and edits to the patient’s Injury.

P. To add contact information, click ‘Add’

Contacts are organized by their role for easy reference. For more information, see the Help Article: Add / Edit / Delete Contacts.

You’re all set!

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