What Is an RxBIN or BIN Number on an Insurance Card?

When filling a prescription, pharmacies require specific details from your insurance to accurately process claims. RxBIN or BIN numbers are central to connecting the pharmacy to the correct insurance provider or pharmacy benefit manager (PBM). These numbers streamline the overall electronic processing of prescription drug claims, ensuring your medication is covered appropriately and at the correct cost.

Understanding BIN and RxBIN

The term BIN, or Bank Identification Number, originated in the banking industry but serves a distinct purpose in healthcare. In the context of prescription drugs, BIN and RxBIN are used interchangeably, referring to a six-digit code found on an insurance card. This number identifies the specific pharmacy benefit manager or insurance company responsible for processing your prescription claim. Each insurance provider uses a unique BIN number for its prescription drug plans, which are included in a national database.

Pharmacies use this code to electronically route your prescription claim to the appropriate payer for real-time adjudication. This ensures the claim reaches the correct entity, allowing for immediate verification of coverage and determination of your out-of-pocket cost. Using the correct BIN helps prevent delays in medication access and ensures patients receive proper coverage and pricing.

Other Essential Pharmacy Identifiers

Beyond the BIN or RxBIN, other identifiers on your prescription insurance card ensure claims are processed efficiently.

Processor Control Number (PCN)

The PCN is a secondary identifier that helps narrow down the specific plan or program within the PBM identified by the BIN. This alphanumeric code acts as a routing code, directing the claim to the correct processing system within the insurance company.

Group Number (RxGRP)

The Group Number identifies the specific employer or organization group under which your insurance coverage is provided. This number links your individual coverage to the broader group plan and its benefits structure.

Member ID

The Member ID, also known as the Subscriber ID or Policy Number, serves as your unique identifier within your insurance plan. This number is specific to you as the policyholder or an individual covered under the plan, allowing providers to verify your coverage.

Locating and Using Your Pharmacy Information

All crucial pharmacy identifiers—the BIN/RxBIN, PCN, Group Number, and Member ID—are typically located on your physical or digital insurance card. They are often found on the front or back, usually under clear labels like “BIN,” “Rx BIN,” “PCN,” “Group #,” or “Member ID.” Some cards may combine medical and pharmacy benefits, while others might provide separate cards for prescription coverage.

When filling a prescription, provide all these numbers to the pharmacist. This complete information allows the pharmacy to accurately submit your claim to the correct insurance provider. If you encounter an issue, such as a missing number or a rejected claim, contact your insurance provider’s member services department for clarification or to obtain the necessary information. Pharmacies can sometimes assist by calling your plan if you only have your Member ID.