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Non-contract provider

A provider, facility or pharmacy not contracted with the plan; code NCP when it made the request.

The 'Who made the request?' fields use NCP for requests by a non-contract provider or facility, and in Table 3 by a non-contract provider or pharmacy. Payment determinations on claims from non-contracted providers are tested for timeliness, and their payment appeals involve a Waiver of Liability form.

Source: ODAG protocol, Universe Table 1, Column V, PDF p. 21; Universe Table 3, Column S, PDF p. 33.