Submitting NIHB Claims for Children Under Age One

Non-Insured Health Benefits (NIHB) claims for children under the age of one year must be submitted manually to NIHB. Although prescriptions for these children will be rejected on-line, PharmaClik Rx has the ability to create the manual claim and allow the prescription to be filled.

When an NIHB claims for a child under the age of one year is submitted on-line, the claim will be returned as Rejected, with the rejection code A6 SUBMIT MANUAL CLAIM and the claim response message will indicate CHILD UNDER AGE.

To create a manual claim, do the following:

1. The REJECTED claim is displayed in the Rx Detail Third Party tab.

Note: Press the More Info button to view the claim response message.

2. Press the Fill button.

The prescription becomes Completed and PharmaClik Rx creates an offline claim for the manual NIHB claim. The Patient Pays amount on the receipt indicates $0.00 unless an NIHB deductible has been set in the patient's Third Party tab (the deductible will be indicated instead).

You can press the Abort or Skip TP button in the Rx Detail Third Party tab if you DO NOT want to create a manual claim for the prescription. The patient’s receipt will print with the appropriate Patient Pays amount. This amount should be collected from the patient; the patient can submit his/her own manual claim.