| Data Review | Qualification Filters

Overview: 

Qualification Filters are options available to customers allowing them to tailor their data to their specific needs. The Excluded by BIN filter will identify any claims from a designated Payor and prevent those applicable claims from qualifying for 340B.

Field Descriptions

Left side (Available Filters)

• BIN 
  • The BIN number associated with claim
• PCN
  • The PCN associated with claim
• Group Num
  • The group number associated with claim
• Last Used
  • The last date this payor code was received 
• Count
  • How many times the payor code has been received

Right side (Applied Filters)

• Status
  • Blank means the filter is active
  • A red triangle means the filter has been deactivated
• BIN 
  • The BIN being excluded 
• PCN
  • The PCN being excluded 
• Group Num
  • The group number being excluded 
• Exclusion Type
  • States whether the payor is a Medicaid exclusion
• Effective
  • Date the exclusion began
• Terminated
  • Date the exclusion ended
• Added By
  • Name of the user who added the exclusion
• Date Added
  • Date the exclusion was added

Adding a New BIN Exclusion

1. To add a new BIN exclusion, navigate to Data Review > Qualification Filters.
2. In the Filter Options pane on the left side, click the Filter Type drop-down and select Exclude by BIN.
3. Click Refresh Filters to update the panes on the right.
4. Click Add New Filter in the right-hand pane.
5. The Excluded by BINwindow will appear.
   1. Enter the appropriate information in this window
      1. Active - Set to Yes
      2. Exclusion Type:
         • Medicaid
         • Medicare Part B
         • Specific Plan
      3. BIN
      4. PCN
      5. GRP
      6. Effective
      7. Terminated
6. Once all info has been entered, click the green Save Bin button in the top right-hand corner of the window to submit the changes.

Editing an existing filter

1. Right-click on the active filter you would like to edit. Click Edit Filter.
2. The Excluded by Payorwindow will appear. You will be able to adjust the following fields:
   1. Active
   2. Exclusion Type
   3. Payor
   4. Effective
   5. Terminated
3. Once your edits are complete, click the green Save Payor button to finalize your edits.