New Rx (N) Chapter 2. Filling a New Prescription

Transcription

1 Section A : The Rx System User Guide Chapter 2 New Rx (N) This chapter guides you through the process of filling a new prescription. See Chapter 3 for instructions on how to refill a prescription. Filling a New Prescription From the MASTER MENU, select (A) Rx Menu > (N) New Rx to enter a new prescription. Then follow these steps: 1. When prompted, enter the patient s last name and first name. 2. The PATIENT SEARCH window opens. Search for the appropriate name and address, and enter the line number of that patient. 2-1

2 Health Business Systems, an SXC Company User Guide Note: If there is only one patient in the list, you need only hit <Enter> to select that individual. If there is no *** End of List *** flag at the bottom of the window, the list is more than one page long. Hit <Enter> to scroll forward one page at a time. 3. If the PATIENT COMMENTS window opens, read the notes entered previously about this patient. Then hit <Enter> to close the window and continue. 4. The patient s details appear in the NEW RX screen. 2-2

3 Section A: The Rx System New Rx (N) 5. If the Mini Profile feature is enabled, the six most recently dispensed prescriptions are listed in the MINI PROFILE window. Do one of the following: a. If there is a similar prescription in the MINI PROFILE window, duplicate it and edit its contents to produce the new prescription. (This procedure is described on the next page.) b. If there is no similar prescription, hit <Enter> to close the window. Then follow the standard prompts to create a new prescription from scratch. (This procedure is also explained on the next page.) If the Mini Profile feature is not enabled, you must follow the standard prompts to create a new prescription from scratch, as shown on the next page. To Duplicate an Existing Prescription 1. In the MINI PROFILE window, enter <N#>, where # is the line number of the prescription to be duplicated. The new prescription appears on the screen, with the cursor positioned on Line #9 at the Rfl field. Enter the number of refills. 2. Select the appropriate DAW (Dispense as Written) code. (See Table 2-1, DAW Options, on page 2-11.) 3. Make any other necessary changes to fields such as Days (the days supply), Dr (the physician), and Instr (the instructions). (See pages 2-8 and 2-12.) 4. Enter <L> to print a label and bill the prescription. To Create a New Prescription from Scratch 1. At the Drg prompt, enter the full drug name, or just part of the name. Note: You may optionally enter one of the following pieces of information, instead: A few characters of the drug name followed by a comma and the drug strength, such as <CORT,1> for Cortisone 1% cream The system-assigned drug number The National Drug Code (NDC), which follows this pattern: ##### #### ## Include the dashes. You need not include any preceding zeros, however. 2-3

4 Health Business Systems, an SXC Company User Guide 2. The system searches the database, and it responds to what you entered in one of the following ways: a. If you entered a number or a unique drug name that is on file, the system automatically retrieves the drug. Proceed to Step 3. b. If there are no drug name matches, the system assumes that this is a new drug, and it automatically opens the QUICK DRUG ENTRY window. Add the drug to the database by completing the fields listed in this window. (See Table 2-6 on page 2-22 for field descriptions.) When the cursor returns to the command line of the QUICK DRUG ENTRY window, hit <Enter> to save your work, close the window, and return to the NEW RX screen. Then proceed to Step 3. c. If you entered a portion of a name shared by several drugs on file, the system lists all of them in the DRUG SEARCH window. Search for the right drug. If the list spans two or more pages, enter <M> to scroll forward. If you locate the appropriate drug in the DRUG SEARCH window, type its line number and hit <Enter>. The system retrieves the drug. Proceed to Step

5 Section A: The Rx System New Rx (N) If the right drug is not listed in the DRUG SEARCH window, do one of the following: Hit <Esc> to open the QUICK DRUG ENTRY window. Add the drug to the database by completing the fields listed in this window. (See Table 2-6 on page 2-22 for field descriptions.) When the cursor returns to the command line of the window, hit <Enter> to save your work and return to the NEW RX screen. Then proceed to Step 3. Hit <Esc> twice to cancel this search. When the Drg prompt reappears, choose a different drug, as described in Step If there is a potential adverse drug interaction with any previously filled drug(s), a DRUG INTERACTIONS window opens to display a numbered list of interaction alerts. Each line item includes the following three fields: Severity Level 3 for Severe, 2 for Moderate, 1 for Minor, or 0 for None Onset Speed Documentation Delayed or Rapid Contains one of the following entries: Established, Probably, Suspected, Possible, or Doubtful. Type <M#> to view a detailed explanation of any item. Hit <Enter> to scroll through the text one page at a time. Enter <RE> to return to the numbered list. After examining the information, do one of the following: Hit <Esc> to cancel filling this drug. Then select a different one, as described in Step

6 Health Business Systems, an SXC Company User Guide Hit <Enter> to continue filling this drug. If the Documentation software module is enabled on your system, a DOCUMENTATION UPDATE window opens. In this window, enter authorized RPh and Tch initials. Then document the reason for dispensing the drug. At the end of each text line, hit <Enter> to create a new, blank line. When you are finished typing, hit <Enter> twice to save your notes and close the window. 4. If the selected drug is a brand name, the system displays a numbered list of each available generic equivalent. To compare the price of the brand name to that of the generic(s), enter <Q##>, where ## is a specific quantity. The system calculates and displays the brand-name and generic drug prices. Hit <Enter> at the command line to retain the brand name, or enter the line number of a listed generic drug to perform a substitution. 2-6

7 Section A: The Rx System New Rx (N) 5. At this point, you might see some of the following pop-up windows, which contain alert messages from the Medi-Span database: a. Allergy Alert. The patient is allergic to the drug or one of its components. Do one of the following: Hit <Esc> to reject this drug. Return to Step 1 and select another one. Hit <Enter> to continue. In the DOCUMENTATION UPDATE window, supply authorized RPh and Tch initials and record the reason for filling this prescription. Hit <Enter> twice to save your notes and close the window. b. MAC Warning. The patient s third party has established a Maximum Allowable Cost (MAC) for this drug. The system will calculate the price using this MAC cost unless you set DAW to <1> in Step 7 (see page 2-11). c. Drug Check. One or more active prescriptions for the same drug are on file. A pop-up window lists all of them. d. Duplicate Therapy. Another medication in the patient s active prescription history serves the same purpose or produces the same effect. This alert prevents harmful duplications in therapy, such as multiple blood-thinning products. Respond in either of these ways: Hit <Esc> to reject this drug. Return to Step 1 and select another one. Hit <Enter> to continue. In the DOCUMENTATION UPDATE window, supply authorized RPh and Tch initials and record the reason for filling this prescription. Hit <Enter> twice to save your notes and close the window. To discontinue a drug that is a duplicate therapy, enter <DC> followed by one of the listed Rx # s in the window. Hit <Enter> to close the window. e. Drug-Disease Monitoring. If the drug is associated with one or more diseases, a pop-up window lists each disease. To add one to the patient s DISEASE HISTORY profile, enter its line number or manually enter an IDC9 (International Classification of Diseases, 9th Revision) code. 2-7

8 Health Business Systems, an SXC Company User Guide 6. In the NEW RX screen, the cursor positions itself at the beginning of Line #8. Complete data entry for the following fields: QtyW Ph Days The quantity written (the amount prescribed by the physician). This amount is based on the unit of measurement (Each for pills, GM for grams, L for liters, etc.) established in the DRUG INQUIRY screen in the UM field. Note: If an * appears next to the drug name (the Drg field, on Line #7), the drug is dispensed in unit packages. In such a case, enter into QtyW the number of packages, not the metric quantity. Following QtyW is the QtyD field, which shows the actual quantity to be dispensed. The system automatically inserts the contents of QtyW into QtyD (If necessary, you can change QtyD later on using the <8> command.) How did the doctor authorize the prescription? In a pop-up window, arrow down to Written, Phoned In, Electronic, Faxed, or Written (Nursing Home). Note: Today s date is automatically inserted into the Dt field. The days supply. To calculate this value, divide QtyD by the quantity that the patient is to take each day. 2-8

9 Section A: The Rx System New Rx (N) Note: To print May Refill (PRN Dispense) on the label, enter <99> into the Rfl field. Rfl Dr Note: If the Calculate Days Supply feature is enabled on your system, the cursor skips over Days. Then, after you enter the prescription instructions, the system automatically calculates Days using the QtyD value and the Sig codes in the Instr (Instructions) field. In order for this feature to work, the default dosage information for the drug, which includes fields such as Sig Def, Form, Units, and UM, must have been entered completely in DRUG INQUIRY. (See page 7-4.) Additionally, the Sig codes used in the instructions, such as <QD>, <BID>, and <TID>, must be fully defined in SIG FILE MAINTENANCE. (See page 6 of Section B, File Maintenance System. ) The number of refills allowed. For no refills, enter <0> or hit <Enter> to leave the field blank. If the number of refills entered exceeds the maximum number authorized by the third party, the system will reject the entry and display the reason why. Note: For Class II controlled substances (narcotics), the system automatically bypasses the Rfl field. For Class III through Class V controlled substances, it allows up to five refills. Select a doctor in one of the following ways: a. If the patient has a default physician, such as a primary care or family doctor, his or her name should appear near the bottom of the screen. Hit <Enter> to select the default physician. b. Enter one of the following items: D/ followed by the doctor s Drug Enforcement Agency DEA number S/ followed by the doctor s state license number The system-assigned doctor number Any search code that the pharmacy assigned to the doctor in the DOCTOR INQUIRY screen. (This search code is optional. See page 8-3.) c. Type the doctor s full last name and hit <Enter>. The system responds in one of two ways: If no doctor with that name is on file, the QUICK DOCTOR ENTRY window opens automatically. Supply basic information about the doctor. In the Med Restricted field, enter <Y> if he or she is restricted from serving Medicaid patients. 2-9

10 Health Business Systems, an SXC Company User Guide If at least one doctor with that name is on file, the DOCTOR SEARCH window opens. Hit <Enter> to scroll one page at a time through the list. If you find the right doctor, enter the line number in which he or she appears. If the doctor is not listed, enter <N> to open the QUICK DOCTOR ENTRY window. Supply basic information about the doctor. Note: The system automatically inserts the patient s primary third-party code into the Bill field. Remove this code for cash transactions. Rlt Cpy Establish the relationship between the patient and the cardholder. Enter <M> (member) if the patient is the cardholder. Other valid entries include <H> for husband, <W> for wife, <S> for son, <D> for daughter, and <O> for other. Note: The system automatically calculates the price and inserts it into the Prc field. The portion of the total price that the third party requires the patient to pay Note: If the patient has a secondary insurance provider to cover some or all of the copayment, its coverage code appears to the right of the Cpy field. RPh Tch The initials of the pharmacist The initials of the technician 2-10

11 Section A: The Rx System New Rx (N) 7. When the cursor reaches the DAW field, a menu pops up. Enter the number of one of the options shown in Table 2-1. Table 2-1: DAW Options Note: Hitting <Enter> also selects (0) No DAW. Option Description 0 No DAW The physician did NOT write Dispense As Written in the prescription. The pharmacy has permission to dispense a generic drug. 1 Physician DAW The physician wrote Dispense As Written in the prescription. Do not substitute a generic drug for the brand name. If the third party approves the brand name, the patient is NOT required to pay the price difference between the brand name and the generic drug. 2 Patient DAW The patient has chosen the brand name. If the third party covers only the generic drug, the patient must pay the price difference. 3 RPh DAW The pharmacist has chosen to dispense the brand name. 4 No Generic Available There is no known generic drug. 5 Brand Dispensed The price of the brand name is lower than that of a generic drug. Therefore, dispense the brand name. 6 Branded Generic A generic drug is being sold as if it were a brand name. 7 Substitution Not Allowed Federal or state regulations do not permit substitution of a generic drug. 8 Generic Not Available A generic drug exists, but it is currently unavailable from its distributor. 9 Extra Documents Required Other conditions apply. 2-11

12 Health Business Systems, an SXC Company User Guide 8. At the Instr field, enter the instructions using a combination of Sig codes and plain text separated by the forward slash (/) character. Table 2-2 shows the most commonly used codes. Table 2-2: Commonly Used Sig Codes Note: To add new Sig codes without leaving the N EW R X screen, enter <SIG> at the command line. In the S IG F ILE MAINTENANCE window, supply the required information. 0T Take 1/2 tablet. 1T Take one tablet. +T Take 1 or 2 tablets. 1C Take one capsule. 1F Chew one tablet. 1G Instill one drop. 1D Dissolve one tablet. 1I Inhale one puff. 1L Take one teaspoonful. +L Take 1-2 teaspoonfuls. 1M Use one spray. 1N Use one drop. 1P Apply one patch. 1S Insert one suppository. 1V Insert one applicator vaginally. A Apply B, U Use J Inject P Apply (a patch) R Rinse mouth W Wash X Insert AD In the right ear AS In the left ear AU In both ears OD In the right eye OS In the left eye OU In both eyes PO By mouth SL Under the tongue AMPM AC BID HS PC In the morning and the evening Before meals Twice daily At bedtime After meals PRN When necessary QD Daily Q6-8 Every six to eight hours Q12 Every twelve hours QID Four times a day TID Three times a day UD As directed X5 For five days Note: In DRUG INQUIRY, each drug is assigned a Sig Def, which represents the dosage form. This code is usually <T> (take one tablet), <C> (take one capsule), <L> (take one teaspoonful), or <A> (apply cream, ointment, or lotion). See page 7-4 for a complete list of codes. Both <T> and <1T> mean <Take one tablet>. The same rule applies to <C>, <L>, and other codes. If the Rx System s Calculate Days Supply feature is enabled, the Sig Def is automatically inserted into the beginning of the prescription instructions to mean <Take one tablet>, <Take one capsule>, etc. Therefore, you need not manually type that code in the Instructions field. If the doctor wrote <take one tablet four times daily> and the Sig Def for the drug is <T>, just enter <QID> (four times daily) for the coded instructions. However, if the doctor wrote <take two tablets four times daily>, enter <2QID>. Enter a comma into the first position to eliminate <Take one tablet> or <Take one capsule> completely. Use the forward slash character ( / ) to separate individual Sig codes. Enter free text anywhere, but use a forward slash to separate the text from codes that are on either side of it. 2-12

13 Section A: The Rx System New Rx (N) Examples of Prescription Instructions Sig Def Doctor s Instructions Coded Instructions F Chew 1 tablet before meals in the morning and evening. AC / AMPM L T Take 2 teaspoonfuls 3 times a day after meals for 10 days. Take 1 tablet daily for stomach ulcers. 2TID / PC / X10 QD / FOR STOMACH ULCERS A Use as directed on package.,ud / ON PACKAGE If, according to the Medi-Span database, the dosage is either too high or too low for a person of this age and sex, or if the prescribed length of treatment is too short or too long, a DOSE-CHECK alert window appears. Contact the physician to find out what to do. Based on his or her advice, proceed in one of the following ways: Hit <Esc> to reject this drug. Return to Step 1 and select another one. Hit <Enter> to continue. In the DOCUMENTATION UPDATE window, supply RPh and Tch initials and record the reason for filling this prescription. Hit <Enter> twice to save your notes and close the window. After the cursor returns to the NEW RX screen command line, make any necessary changes to the quantity dispensed and the instructions. 9. The system can store and display on-screen instructions of any length. You can print up to four lines of text on a standard prescription label. If you need additional print space, continue the instructions on one or more auxiliary labels, each of which holds up to eight lines of text. Your pharmacy can store commonly-used auxiliary label instructions in the Rx System. This approach eliminates the need to enter the same directions over and over again. 2-13

14 Health Business Systems, an SXC Company User Guide To Create an Auxiliary Label a. At the end of the standard prescription instructions field, enter /* followed by a unique 1-3 alphanumeric character sequence (e.g., /*LBL). These characters appear only on the screen. They inform others that the instructions continue on a separate label. Hit <Enter> to return to the command line of the screen. b. Enter <AL> to open the AUXILIARY LABEL window. Complete the instructions, hitting <Enter> to create each new line that you need. c. When you are finished typing the message, hit <Enter> repeatedly until the cursor passes Line #8. A command line will appear at the bottom of the window. If necessary, use the <#> command to correct any typing errors. d. To save the instructions, enter <W###>, where W stands for Write and ### is the same letter sequence that you entered at the end of the standard prescription instructions. e. To print one or more copies of the auxiliary label, enter <L> or <L#>. f. To close the AUXILIARY LABEL window, hit <Esc>. To Retrieve an Auxiliary Label a. To retrieve a label whose code is already appended to the instructions, simply enter <AL> at the NEW RX (or REFILL) screen command line. To retrieve any other label, enter <AL> to open the AUXILIARY LABEL window. On the topmost line of the window, where the cursor is positioned by default, enter <G###>, where G stands for Get and ### is the Auxiliary Label code. The system will load the instructions into the AUXILIARY LABEL window. b. If necessary, edit the instructions using the <#> command. Save your changes with the <W###> command, where ### is the Auxiliary Label code. c. To print one or more copies of the auxiliary label, enter <L> or <L#>. d. To close the AUXILIARY LABEL window, hit <Esc>. 2-14

15 Section A: The Rx System New Rx (N) Note: You can optionally configure NEW RX to open the PRIOR AUTHORIZA- TION window automatically for certain drugs and third parties. 10. If your pharmacy uses the standard three-part label, you can optionally print a short special message (26-characters or less) in the lower section of the label. Enter <SM> at the NEW RX screen command line. In the Spc Msg field, which appears below Instr (Instructions), supply the extra information. 11. If the prescription requires a prior authorization number, enter <PA> to open the PRIOR AUTHORIZATION/CLAIM REF. NO. window. Populate the fields in this window. See Table 2-3 for an definition of each field. Table 2-3: PRIOR AUTHORIZATION Window Fields Field Primary Claim Ref. No. Secondary Claim Ref. No. Instructions A 10-digit confirmation number sent electronically by the primary third party AFTER it has paid the claim. The Rx System automatically enters the number into this field. A 10-digit confirmation number sent electronically by the secondary third party AFTER it has paid the claim. The Rx System automatically enters the number into this field. 2-15

16 Health Business Systems, an SXC Company User Guide Table 2-3: PRIOR AUTHORIZATION Window Fields (Continued) Note: Unless PA Begin Date and PA End Date are filled in, the authorization applies only to the current fill. Field Prior Auth Code Prior Auth No. PA Begin Date PA End Date PA Switch P/S/B Intermediary Prior Auth Code Intermediary Prior Auth No. Visit Code Instructions A prior authorization code identifying the type of authorization obtained. In a pop-up selection window, arrow down to one of these codes: 0 Not specified 1 Prior authorization 2 Med cert 3 EPSDT (Medicaid s Early and Periodic Screening, Diagnostic, and Treatment service) 4 Exempt from copay 5 Exempt from Rx limit 6 Family plan 7 AFDC (the Administration for Children and Families Aid to Families with Dependant Children program.) 8 Recipient pregnant 9 Miscellaneous R Returns A number that the third party issues to authorize the prescription The start-of-authorization date. Use the format <MMDDYY>. The end-of-authorization date. Use the format <MMDDYY>. Use the Prior Auth No. for <P> the primary third party, <S> the secondary, or <B> both. Use this field to indicate whether a secondary, intermediary authorization code is required. In the selection window provided, arrow down to one of these choices 0 Not Specified. No intermediary authorization number is required. 1 Intermediary Prior Authorization. An intermediary authorization number is required. Enter the number into the next field. 99 Other Override. Select this option only when directed to do so by the third party. If you entered either <1> or <99> into Intermediary Prior Auth Code, then supply the code here. An optional field. The third party establishes when and how to use it. 12. If the Medi-Span database contains one or more warnings about this drug, you will see them listed in the WARNING LABEL DATABASE window. To suppress warning messages, hit <Enter>. To print one of them, enter its line number. Depending on how your system is configured, the warning message might be appended to the instructions on the standard label, or it might print on a separate label. 2-16

17 Section A: The Rx System New Rx (N) 13. To add a comment about the prescription, enter <CMT> at the command line. The information you enter will appear on the screen the next time that someone retrieves this prescription record. Note: To profile the prescription (put it on hold without filling it), enter <PO> at the command line. The system assigns a number to the prescription and changes QtyD (the quantity to be dispensed) to zero. Additionally, the PATIENT RX HISTORY screen lists the prescription with the message Profiled Rx. To dispense the prescription later on, unprofile it (remove the on-hold status) by entering <UP> at the PATIENT RX HISTORY or RX INQUIRY screen command line. The system automatically fills in QtyD and changes Dt to the current date. 14. Before billing the patient, you may optionally enter any of the commands described in Table 2-4 on page These commands include <PC> (enter patient comments), <D3> and <10> (view and select a different third-party code), <E3> (add a new thirdparty code), <DG> (enter a diagnosis), and <DW> (enter or change the Date Written). 15. Enter <L> to bill the patient, print a label, submit an electronic claim, and proceed to the next prescription. Note: Table 2-5 on page 2-21 lists additional label printing commands supported in the NEW RX screen. 16. The DATE WRITTEN window opens, allowing you to view and change the date on which the physician wrote the prescription. Initially, Date Written is always the fill date. At the Is This Date Correct (Y/N) prompt, respond <Y> to accept this date, or respond <N> to change it. 17. If the system is configured to process up to four claims at a time, it will ask you if there are any more prescriptions for this patient. To dispense another one, enter <Y>. Otherwise, enter <N>. 2-17

18 Health Business Systems, an SXC Company User Guide 18. If any required information is missing, the system displays an alert at the bottom of the screen and the cursor jumps to the empty data field. If the patient s third-party group number is missing, for example, you will see this message: ** 3rd Party Enter Group ** 19. If the Delivery System is working, and the patient is set up to receive deliveries some or all of the time, a selection window pops up. Arrow down to the correct delivery option (Wait, Pick Up, Delivery, etc.) and hit <Enter> to continue. Note: The Rx System can bill patient charge accounts automatically, as you fill prescriptions. 20. If the patient has a charge account, the Charge Rx? prompt appears. Enter <Y> to charge the patient s bill. 21. If you entered <Y> in Step 17 (if there are more prescriptions), the screen clears and the Drg prompt reappears. Return to Step 1. If you entered <N> in Step 17, (if this was the last prescription), electronic claims submission (ECS) begins. During the transmission, the system displays status information on the screen. 2-18

19 Section A: The Rx System New Rx (N) When the transmission is completed, a CLAIM INFO window opens, displaying one of the following types of messages: Note: To manually open this CLAIM INFO window later on, enter <PD> at the RX INQUIRY screen command line. Claim Paid Claim Rejected Shows the cost basis, dispensing fee, copayment, and Drug Utilization Review (DUR) message(s). Shows the reason for the claim rejection. Correct the appropriate information in the claim and resubmit it. For detailed instructions, see Correcting and Resubmitting Claims on page 5-9. Table 2-4: NEW RX Screen Commands Command Description AQ AR History Inquiry Open the ACCOUNT INQUIRY screen, which displays the patient s charge account transaction history. When prompted, enter the starting date, or hit <Enter> to view all transactions. See page 1-30 for more information. AR AR Account Inquiry Open the AR INFORMATION window, which displays basic charge account details. (See page 1-29.) DB Display BIN Number View the bank identification number of the bill code for the currently selected prescription. CLN Select Clinic Open a list of clinic codes. Select one of them to associate the prescription with a specific clinic. CM Caution Messages Manually insert one or more caution messages into the Instr (Instructions) field. Note: When the Auto Cautions feature is enabled, the system automatically prints caution messages on laser labels. (See page 4-11 of Section J, Store File Maintenance. ) CMT Enter Rx Comments Enter comments about the prescription. They will appear in a special field below Instr. 2-19

20 Health Business Systems, an SXC Company User Guide Table 2-4: NEW RX Screen Commands (Continued) Command Description D Drug Inquiry Open the DRUG INQUIRY screen for the currently selected drug. D3 Display Third Party Open the THIRD PARTY COVERAGE window to view each of the patient s insurance plan codes. To select a different code for the Rx, use the <10> command for the original fill or <12> through <15> for refills. DD Drug Disease Monitoring Open the DRUG DISEASE MONITORING window to add a disease to the patient s profile. DG, DX Diagnosis/ICD9 Code Add a diagnosis and/or ICD9 code to the prescription. DLV Delivery Establish Pick Up, Mail, Delivery, Wait, or On Hold as the default delivery method for the currently selected prescription. DW Enter Date Written View and change the recorded date on which the doctor wrote the prescription. E3 Enter Third Party Add third-party insurance coverage for the patient. Note: The EXTRA CLAIM I NFORMATION window can also be opened from within the RX INQUIRY screen. INF Extra Information Window Open the EXTRA CLAIM INFORMATION window to set DUR Reason for Service, DUR Professional Service, and DUR Result of Service codes before sending a claim. Do this if you expect to receive a rejection to the claim, and you know both the problem and the solution ahead of time. INV Inventory Window In a pop-up window, view and change drug inventory details such as the quantities on hand and on order, the minimum and maximum acceptable stock levels, and the restocking quantity. Enter <V> at the window s command line to view vendor details. LQ Label Quantity This field is for nursing home patients only. If QtyD is set to zero (because the exact dispense quantity will not be determined until later on), enter <LQ> to print some quantity other than zero on the label. M Doctor Inquiry Open the DOCTOR INQUIRY screen to add, view, and modify details about any physician. N Enter New Rx Bill the currently selected prescription and clear the screen to fill another new prescription for the same patient. PC Patient Comments Open the PATIENT COMMENTS window to add, change, or delete comments about the patient. PE Patient Education Print a patient education leaflet for the currently selected prescription. 2-20

21 Section A: The Rx System New Rx (N) Table 2-4: NEW RX Screen Commands (Continued) Command Description PO Profile Only Profile the prescription (put it on hold without filling it.) The system assigns a number to the prescription and changes QtyD (quantity dispensed) to zero. The PATIENT RX HISTORY screen will list the prescription with the message Profiled Rx. To dispense the drug later on, unprofile it (remove the onhold status) by entering <UP> at the PATIENT RX HISTORY or RX INQUIRY screen command line. The system automatically fills in QtyD and changes Dt to the current date. Q Lot Expiration Date Use this command to record the lot number, drug expiration date, and prescription expiration date. R Enter Refill Bill the prescription currently on the screen and open the REFILL screen to dispense another prescription for the same patient. RM Rx Remark Add a remark about the prescription on a special text line. SIG Sig Maintenance Add a new Sig code or edit the details of an existing one without having to leave the NEW RX screen. Note: To print multiple copies of a label with any of these commands, insert a number after L. Examples: L2H, L3, L3R, L4N. Table 2-5: Command L L0 LH LN LP LR S T Billing and Label Printing Commands Description Bill the patient, print a label, and proceed to the next prescription for the same patient. Bill the patient without printing a label, and proceed to the next prescription for the same patient. Bill the patient, print a label, and open the PATIENT RX HISTORY screen. Bill the patient, print a label, and clear the NEW RX screen. Bill the patient, print a label, and open the PATIENT INQUIRY screen. Bill the patient, print a label, and open the REFILL screen. Submit an electronic claim and print a label. Similar to <L>. Also prints a label showing the total charge for the last group of prescriptions filled. 2-21

22 Health Business Systems, an SXC Company User Guide Using the QUICK DRUG ENTRY Window As explained on page 2-4, when filling a new prescription in the NEW RX screen, if you enter a drug name or drug number that is NOT on file, the system opens the QUICK DRUG ENTRY window. This window, which contains a subset of the fields appearing in the DRUG INQUIRY screen, enables you to quickly add a new drug to the database without leaving NEW RX. Table 2-6: QUICK DRUG ENTRY Window Fields Field Description Instructions Note: For compound drugs, enter the NDC # of the highest-cost drug. NDC # The National Drug Code Enter this code in the following format: <##### #### ##> Enter hyphens manually. If necessary, add leading zeros to comply with the digit format. Strength The strength of the drug This value is usually expressed in milligrams or in a percentage. Narc The federal narcotic code Enter one of these codes: 0, 6 Legend drug 2 Narcotic (Class II controlled substance) 3, 4, 5 Controlled substance 7 Over-the-counter drug Form The form in which the drug is manufactured Enter a one- to four-letter code that represents a drug form such as tablet, capsule, liquid, cream or ointment, suppository, inhaler, etc. Sig Def Default Sig code The code that you enter here, such as <T> for take tablet, <L> for take teaspoonful, or <A> for apply, will combine with numerical values and other codes entered into the Instr (Instructions) field of the NEW RX screen to generate instructions for the patient. 2-22

23 Section A: The Rx System New Rx (N) Table 2-6: QUICK DRUG ENTRY Window Fields (Continued) Field Description Instructions Units The dispensing quantity per package (rounded) If Units contains a decimal quantity, round off Units to the next higher whole number. Metric The metric (exact) drug quantity. Third parties require this information. The last three digits that you enter automatically become cents. AWP Average wholesale price HBS updates your pharmacy s average wholesale price information on a weekly basis. AqC The acquisition cost Prc Table The number of the appropriate cash pricing table The default cash pricing table is <001>. Note: A unit package contains multiple doses, but the package cannot be subdivided. A tube of cream or ointment, a bottle of eye drops, and an inhaler are examples of unit packages. U/P Is this drug dispensed in unit packages? Leave blank if drug is not unit packed. Otherwise, enter one of the following codes: 8 Birth control pills, unit packed. Dispense the number of packages technicians enter into the QtyW field of the NEW RX screen. 9 Cream or ointment, unit packed. Dispense the number of packages technicians enter into the QtyW field of the NEW RX screen. Generic Is this a generic drug? Enter <Y> or <N>. Brand Link This field is for generic drugs only. Leave this field blank if the drug is not generic. To price this drug as a percentage of a brand name, enter the system-assigned drug number of the brand name. Comp Grp The categories for which third parties restrict compensation In a pop-up selection window, arrow down to one of these categories: <Blank> Fertility Growth Sti Non-compensable Injectable State Restricted Anorexics Birth Control Diaphragm Insulin Syringe Vitamin Chemo Drug Nicorette Anxiolytic Rogaine Diabetic AZT Antacids Compound 2-23

24 Health Business Systems, an SXC Company User Guide Table 2-6: QUICK DRUG ENTRY Window Fields (Continued) Note: Hitting <Enter> selects <No DAW>. Note: If normal drug prices change by a certain percentage, the system automatically changes special prices by the same percentage. It makes this change when you apply price updates. Field Description Instructions DAW Dispense As Written code. In a pop-up selection window, enter the number of one of these categories: 0 No DAW. The physician did not write Dispense as Written. 1 Physician DAW. The physician did write Dispense as Written. 2 Patient DAW. The patient has chosen the brand name. 3 RPh DAW. The pharmacist has chosen the brand name. 4 No Generic Available. There is no known generic drug. 5 Brand Dispensed. The brand-name price is less than that of the generic. Therefore, dispense the brand name. 6 Branded Generic. A generic drug is being sold as if it were a brand name. 7 Substitution Not Allowed. Federal and/or state regulations don t permit substitution. 8 Generic Not Available. A generic drug exists, but it is currently unavailable from its distributor. 9 Extra Documents Required. Other conditions apply. Spec Prc Special pricing When the cursor reaches this field, a table with two columns (commonly called quantity-price buckets) appears in a pop-up window. Use this table to establish fixed prices for different quantities of a drug. Enter quantity-price combinations with quantity values arranged in ascending order. To close the window, hit <Enter> twice. MAC Prc The maximum allowable cost per unit, in dollars and cents If one or more third parties have established a maximum allowable cost (MAC) for this drug, enter the amount here. The last four digits that you enter become cents. UPC # The universal product code The UPC # appears as a bar code on the drug package. 2-24