Effective April 1, 2018 Capital Health Plan will implement on-line Coordination of Benefits processing. Capital Health Plan Participating Pharmacies have the capability to process on-line claims for Covered Persons of Capital Health Plan who have a primary insurance in addition to Capital Health Plan.

Action Required:

• Participating Pharmacies are required to process claims to the Covered Person’s primary insurance first.

• Secondary claims should be submitted using NCPDP’s Telecommunication Standard Version D.0 Coordination of Benefits Segment, Scenario 1-Other Payer Amount Paid Repetitions Only.

*Please see attached for more information*