The following information is provided only to help our customers become SIG-IS certified as a non-90% rule pharmacy using our Point of Sale or Pharmacy Cash Register software. Though we strive to keep this information as accurate as possible, we highly recommend customers read the entirety of the merchant form before starting to fill it out to help them understand what to do. As always, our support team is available to help if needed.
To access the TPS Client Merchant Form do the following:
- Go to www.sig-is.org and enter your login information under the Member Login box on the right.
- Click TPS Client Merchant Form in the Announcements area.
Fill out the form as best suited for your pharmacy. Below are a couple pieces of information to help you fill it out. This information is primarily for single-location pharmacies; most of the information will also apply to multi-location pharmacies.
- Double check the Merchant / Pharmacy Information is still accurate.
- Double check the Contact Information is still accurate.
- MCC (DE / Field 18) – select Drug Stores and Pharmacies (5912)
- IIAS Processing Support – check At All POS Terminals / Lanes if you will be using our POS or PCR software at all possible checkout locations
- Third Party Servicer – select Foundation Systems, Inc.
- Products – select FSI Credit Card Payment Application
- Acquirer / Acquirer Processor – select either US Bank National Association – Elavon or Heartland Payment Systems, Inc. depending on which processor you have an account with
- DBA / MCC – List all ‘Doing Business As’ names with the corresponding MCC, usually 5912 (Drug Stores and Pharmacies).
- FSA / HRA Card BIN Loading Responsibility and Frequency
- Does the TPS Software automatically load the FSA / HRA Card BIN List? Yes
- How often does it update this file? Monthly (this is done via our regular software updates)
- Responsibilities for QHP Flags in Merchant’s Inventory
- Will you have any responsibility for QHP Flags in your inventory? Yes
- Please Describe – check all that apply but do not check Private Label
- How often is this file updated? – Determined by a software setting you can change but usually Monthly
- I will use the SIGIS Eligibility Product List for Establishing QHP Flags? Yes
- Will you have any responsibility for QHP Flags in your inventory? Yes
- Qualified Heathcare Product (QHP) Item Exception Process
- Have you setup a process to review items that should be included…? Yes
- Merchant will perform the following – check all that apply
- Have you setup a process to review items that should be included…? Yes
- Retention of Healthcare Product Detail for IIAS Transactions – In-House / Retailer Retention
- IIAS Transaction Retention – Store Truncated Card Number
- Store Training – a description involving training by our support team and/or materials found online
- Merchant Implementation
- Select TBD option if you have no firm date of when you wish to begin accepting FSA / HSA cards
- Enter in a date, usually within the next 10-15 business days, of when you wish to begin accepting FSA / HSA cards
- DOUBLE CHECK EVERYTHING IS CORRECT! ONCE SUBMITTED, YOU CANNOT FIX ANY MISTAKES UNLESS YOUR APPLICATION IS REJECTED!
The application will be sent to us for our review. If no problems are found, we accept it and it is then sent on to your selected payment card processor for their approval. The contacts provided in the form will receive notifications for acceptance or rejection done by us or by your payment card processor.