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Visual Pharmacy Software

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1. j Pending Filed OnHold Patient Prescrier E Written 2 7 2008 v Hem Dispensed 2 7 2008 y Quantity Quantity Discard fe i Dispense Refills m E Wisirinaion COUMADIN 1 0 Written Sg Y LA Days DAW 0 No Product Selection Indice Lot Instruction Pm X Pcs D Copa Origin 1 Written Delivery Type 7 Next Page Sort by Date Entered Fill Orders QA From 1 31 2008 Clear All Implode Fi Help lp ESC Exit l RPH ABA Tech ABA Queues Orders entered into the Queue can be retried and moved to the Prescription entry screen where you can edit fill and transmit the prescription There are six queues as follows 2 Order Queue As new prescriptions come in rather than entering the order in the Prescription entry by a senior Technician or Pharmacist screen you can have a junior Technician enter the prescription as an order and even scan the prescription The prescription will be put in the Order queue and the senior Technician or Pharmacist can retrieve it from the queue and complete the fill after checking the information entered to the hardcopy prescription displayed 3 Rx On Hold Prescription can be placed on hold by entering a zero in the dispense quantity once the prescription is saved it will be put on the Rx On Hold queue You can later retrieve the prescription from the Rx On Hold queue to to fil
2. Do not display interactions with severity level B E 3 Do not allow to fill Rx with severity level i EE 3 lt Select All Unselect All Users Record Profile of John Doe General m Delivery tt o If the User 1s a Delivery person Driver to generate a Delivery list automatically for this Driver enter the Route or Zip Codes they deliver to Delivery List by Route Zipcode A delivery list will be generated matching the Driver with the Patient s Route or Zip Code Add Zipcode 7 of 16 Find New Delete Save Name The name of the user allowed to access specified functions in the system Rx Label Initials The initials that will be recorded on every prescription the user creates and any activity they do Street The users street address City The users City name State The users State code Zip The users zip code Phone The users phone number Phone2 An alternate phone number for the user Type The type of user determines how they will sign on to the pharmacy software For example an Administrator or Pharmacist can have subordinates where as a Technician Driver or General User cannot Copyright AbacusRx Inc Page 78 of 100 License The type of certification or license Used when transmitting claims to Third Party and its printed on some reports and R
3. AbacusRx Inc Page 91 of 100 DAW P No DAW Instructions Physician specified 2 Em id Patient specified 3 Pharmacist specified 4 Ml No generic available Rx Denial Override Not Specified No override hil mme Vacation supply 5 4 Lost prescription Therapy change e Medically necessary Not Specified EAC Basis of Cost Local Warehouse Acquisition Cost Person Code General use member 12 dependent DER Drug Grant Adjustment l Nursing Home Copyright AbacusRx Inc Page 92 of 100 E AAA Appendix A Glossary Drug Allergy Codes Thiazides Sulfonamides Sulfonylureas Bumetanide Furosemide Carbonic Anhydrase Inhibitors Isoniazid Niacin Ethionamide Pyrazinamide Copyright O AbacusRx Inc Page 93 of 100 Gold Salts Haloperidol Appendix B Glossary A LSD Heroin Marijuana Research only DEA 2 Morphine Meperidine Amphetamines etc Most abused Aspirin Codeine etc Less abused Valium etc Potential abuse Controlled Sale by pharmacy only Copyright AbacusRx Inc Page 94 of 100 CERT CODES listed on the Florida Negative Formulary Prenatal vitamins and contraceptives such as foams gels and condoms Use Cert Code 04 for brand name oral contraceptives Note Do not collect a copayment Amphetamines or other anti obesity drugs are prescribed for a diagnosis or therapy other than weight control ex narcolepsy hyper
4. RaNo Datewriten_ Reminder Author 50000061 34772013 10 45 3 7 2013 MZ MZ On Ax 50000061 the doctor s name was changed from H amp SBUN RENE 50000061 3 7 2013 10 45 3 7 2003 Mz Mz X OnRx 50000061 the drug NDC was changed from 12280018030 to 007 3 5 2013 16 52 Dn Ax 5048 the payment plan was changed from to RH on 3 5 2013 5047 3 5 2013 10 40 3 5 2013 ABA Rx 5047 was transfered to blah blah on 3 5 2013 at 10 39 by ABA ABA 5041 3 5 201311 32 3 5 2013 ABA A Rx5041 was transfered to cvs on 3 5 2013 at 11 32 by ABA ABA with r A note can be 5035 3 5 201311 33 3 5 2013 ABA A Rx5035 was transfered to cv on 3 5 2013 at 11 33 by ABA ABA with r T 5028 3 5 2013 11 36 3 5 2013 ABA A Rx 5028 was transfered to cvs on 3 5 2013 at 11 34 by ABA ABA with r modified by 50000037 3 5 2013 12 10 3 5 2003 ABA A OnRx50000037 the payment plan was changed from RH to C on 3 572 s 8000125 3 5 20131210 3 5 2013 ABA A On Rx 8000125 the payment plan was changed from RH to T on 3 5 20 selecting the note 3033 3 5 2013 12 10 3 5 2013 ABAZA On As 9093 the payment plan was changed from RH to T on 3 5 2013 with the left 5048 3 5 2013 16 54 3 5 2003 ABA OnRx5048 the dispense QTY was changed from 60 to 0 on 3 5 2013 5000001 4 3 5 2013 12 10 3 5 2013 ABAZA On Rx 50000014 the payment plan was ch
5. Show Rs with no refills lett Only patients in facility Only patients with a category of Only prescription with a category of Date to use as the Ax filled date 252013 Auto Refill Use Batch Created C Only refill As checked as Auto Refill You may request to cycle fill refill prescriptions based on the following criterion g Create a New Batch a Batch is a group of Rx claims that have been selected to be processed at the same time Once the batch is created you be revert back to it at any time Most of the time you will want to create a new Batch you will only need to work with a created batch if something is still pending on a previous batch h From and to fill date the date the prescription was filled i From refill due date the date the prescription will be ready for refill j Show refill Rx if within days from due date generally claims can be adjudicated within three days from the refill due date and can also be used if refilling in advance k Show Rx with no refills left extracts Rx that have no refill remaining useful to double check Rx or request additional authorized refills from prescriber l Only patients in facility Generally used to refill all the prescriptions for a given facility m Only patients in room further limits refills to only a certain area of the facility Copyright AbacusRx Inc Page 59
6. Billing Status PD Rx was paidincash Category Number of labels Remaining Rx Quantity Discontinue Rx on x TETUR Prior Auth MC Number Click Prior af Script Rx Order Numb Aut C DEN a eScript Ax Order Number Sp Number to Horan get the E DAW 0 No Product Selection Indicated E Intermediary Ax Serial Number f ea Authorization Document X Ley reason S creen ARET Copyright AbacusRx Inc Page 10 of 100 Override Prior Authorization Issue an Rx number on a new Rx you can request that an Rx number not be assigned to the Rx Auto refill if checked the prescription will be automatically refilled by the Cycle fill function Rx number override here you can assign or change the number of the prescription number Number of labels This is the number of Rx labels you want for the Rx in question Remaining Rx Quantity this is the unit quantity remaining on the entire prescription Discontinue Rx on this is the date the Rx will be discontinue and no further refill may be dispensed Prior Authorization MC this number is used to override some medication claim rejection A prior authorization code is generally issued by the Insurance carrier or processor o Intermediary Authorization Click on Prior Auth MC Number to get the Intermediary Authorization Screen Intermediaries may require providers to enter values in these fields in order to circu
7. Medicaid ID Type Medigap ID To edit select the Unlimited list of Pavment plan R Move Up Down i i atient pavment y p Card Number Relation Personal Code E ligibilit Datel Holder PlanT vpeDleg P P J and click the PCSIPCS H3830200 8390030205 m Jo o Single Pay methods Up arrow pasHEA PB inte Payer Insurance multi payers coupons A R Cash etc History a Orly active Find Hew Save Cancel Select INSURANCE Here you will define the patient s Insurance coverage Coupons and any other plan that the patient is allowed to bill Rx to You can enter multiple coverage to bill the insurance claim primary secondary amp tertiary and the system will automatically bill according to the order or allow patient to be billed On Account Accounts Receivable On the top side of the screen is the Patient Plan new entry edit form here you can enter new or edit patients insurance plans or check the information on a coverage To enter a new plan just type the insurance name or code in the Payment Plan field then fill the rest of the screen when finish press the down arrow on the middle of the screen then Save To Edit a plan highlight the payment plan you wish to edit by right clicking from the list at the bottom of the screen click on the up arrow make the changes then click Save The definition of the fields follows l Payment Plan Enter the name
8. Street the Carrier s street address City the Carrier s address city name State the Carrier s address State name Zip the Carrier s zip code Enrollment the Carriers phone number to enroll the send electronic claims Help Desk the Carriers phone number to help questions Status Indicates if the Carrier is Active can send claims to them or not Balance The amount authorized by the Carrier that has not been paid Open Credit The amount on credit or not posted Fax the Carriers fax number eMail the Carriers eMail address A Payment Plan Record 1 of 1 payment plans PayPlan Description o SoS P PCS PCS Comments PCS Special Instructions Lid ie EZ sare cerea Seea COMMENTS a Comments general notes for informational purpose b Special instructions the notes entered in this field will be displayed every time the payment plan is selected while filling a prescription This is use to alert you to special requirement of the Carrier Copyright AbacusRx Inc Page 39 of 100 Payment Plan E Payment Plan Record 1 of 1 payment plans PayPlan Description gt PCS PCS You can set the Pricing based on the Item or Item Group if you change the Price gt Table used to calculate price to 0 Comments Pricing Rules General Description Place a zero under Price Table to use the Price t
9. f Basis of Request This field is used to explain the reason for the request 1e Medication exception Plan requirement or Increase plan limitation g Prior Authorization Number Assigned This is the prior authorization number assigned by the carrier h Medical Certification The Certification number assigned by the carrier Representative Smoker Pregnant Vitals Alert Deceased History Only active Find New Save Cancel Select Copyright AbacusRx Inc Page 27 of 100 VITALS Here you can record patient s vitals This is transmitted to the insurance HCFA j Smoker this indicator is transmitted to the insurance k Pregnant indicator is transmitted to the insurance l Vitals Alert If checked you are requesting to be alerted at prescription entry if patient s vitals have been entered m Deceased If a date is entered you will be alerted that the patient has deceased upon Rx entry SMITH JOHN ID 2583 Only Active F1 Patient File 1 of 1 patients LastName FirstName Middle Name P SMITH JOHN Medicare 4515564612 Type of Plan 1 Medicare Payment Plan to bill pcs Prior Auth Insured Name JOHN SMITH Other Insurance No Street 7701 Sw 120TH ST City MIAMI State FL Zip Code 331 56 Phone 305 555 2255 DOB 06 12 1980 Sex Male Status M Married Employed Yes S Employer RADIANT CORP EY
10. j Taxable If checked tax will be charged if the Payment Plan used to bill is set to bill tax Price change history every price change is recorded and can be viewed by clicking on the circle next to the price Copyright AbacusRx Inc Page 35 of 100 ZZ A am 1 A A A AA A a A ME mE M A AAA A EM E al e Drug Record On Hand will be J Description Maruf Form Pkg Size Type Class OnHand TF B B F 280 automatically P ZANTAC 150MG EFFERDOSE TAB GLAxO PHAR manage by the system History Quantity on Hand 280 Supplier Amerisource Summary Minimum Inventory Level 180 Order Code ig Maximum Inventory Level 1360 Last Sold 11 6 2008 After the Invento Drug Expires 3 17 2006 Period To Date Sold 30 is entered with drug Lot Number AE 338T Unit Dose 1 Not Unit D expiry date and lot Days Expires After Mixing Unit of Measure i Shelf A number The system 0 EA Each A will dispense using FIFO Location Miami Only display active drugs Find New Delete Save Cancel Select INVENTORY The system maintains a perpetual inventory items are entered as they are received and inventory is deducted or adjusted as the item is dispensed modified or void a Quantity on Hand This is the total unit quantity currently in inventory b Minimum Inventory Level is the minimum allowable level before you are notifi
11. k the Modify button Note An asterisk next to the Rx B Unbilled red Rx and D indicates the Rx has been Bl On Hold From the Patients History the field at the Ax was transfered B DC e dee Image indicates that prescription images exist If no image exist to scan a prescription from the Patient History screen click on Rx image or press the F12 key d ty Total Days Plan Status Origin _ Image Disposition C LLEN 30 169 30 130 J ESI Reiect written No Rejected LLEN 20 28 56 5 ESI Reject Written No tad Shoy ve Rx insfer Woid Details Ax image F F3 F3 F12 Lar um ent Scanning a prescription from the Rx Order Entry screen works similar to the prescription entry screen Orders hl ane Copyright AbacusRx Inc Page 76 of 100 Visual Pharmacu Plus Software User s Manual Users UselD P ABACUS david carpenter GISELA SOSA JAQUELINE FERNAND Juan Madiedo MARLENE PEREIRA Juan Madiedo MARLENE PEREIRA General JABACUS Rx Label Initials ABA 8000 SW 117 Ave PH G MaM State FL Zp 33083 3052200400 Phone 2 o Administrator v License 02 State License v Find New Delete Save Cancel SECURITY Users are pharmacist technicians authorized to use the program at your Pharmacy Different sections of the program or fun
12. For example QD WPRN will concatenate two Sig codes QD and PRN to form Take one tablet daily as needed for pain or enter QD PRN in the Sig field Also you can set the system to automatically default to the last Sig used on the last drug see Configuration Preferences 4 The Payment Plan Plan indicates how the prescription claim will be paid ie Insurance Cash A R etc The default patient s payment plan will be displayed you can change it but if you need to create a new patient plan you must first enter the plan information in the patient profile Copyright AbacusRx Inc Page 4 of 100 Visual Pharmacu Plus Software User s Manual Han You can On a new Rx If the default Payment click on the patient s Plan is not correct you the word default can select from another Plan to Payment Plan payment form the edit will be patient is allowed or has displayed defined in its profile The Price is automatically calculated You can based on the Payment Plan and the click on the Price Table will describe later word Price associated with the Payment Plan or to see the the Item breakdown The Rx price dispensing fee discounts tax and total price are automatically calculated based on your formula to calculate the Rx price you can override the calculated price at anytime or click Price to see the break down The Rx number is assigned upon save Eo Pharmacy Plus
13. If the claim is not covered you may be asked by the insurance carrier to enter a code in this field This may occur if the patient is covered but the patient is not defined or active on the carrier file Copyright AbacusRx Inc Page 24 of 100 v Eligibility Check Click on the icon to request all the carriers and coverage information associated with the patient usually applies to Medicare part D patients All the carriers are automatically created in the insurance segment of the patient information along with Group Card BIN and PCN numbers Eligibility checking provides a way for the pharmacy to determine which prescription drug plan PDP the patient has signed up for Although it is the patients responsibility to enroll in a PDP that best suits their needs there is a possibility that the patient will not remember which plan they chose To further complicate this situation groups of patients will be auto enrolled in PDPs Some patients will not receive their PDP cards before getting their prescriptions filled for the first time Use the Eligibility Check to find out what plan the customer is eligible for w Home Plan Code identifying the Blue Cross or Blue Shield plan ID which indicates where the member s coverage has been designated Usually where the member lives or purchased their coverage x Medicaid ID The 10 digit Medicaid ID y Medigap ID Patient ID assigned by the Medigap Insurer Fel Patient File SMITH JO
14. Claim Reference 13920304039 Mame HHI 100 Provider Submitted Pay to Pro Street 9292 PAYEE AVENUE Fh 841 885 4512 Generic Equivalent Product City SARASOTA State FL Zip 32412 ID Cancel Phone 305 266 1611 Contact WE Copyright O AbacusRx Inc Page 17 of 100 Visual Pharmacu Plus Software User s Manual Workers compensation claims can either be transmitted on line or printed on claim forms However this type of claim requires you to enter more information as follows Employer The employer of the injured patient Street The street address of the employer City The city of the employer s address St The state of the employer s address Zip The zip code of the employer s address Injury The reference date of injury Claim Ref A description as to the type of injury 1 e back injury neck injury etc Emp Phone The employers phone number Carrier name The of the injured patient Street The street address of the employer City The city of the employer s address St The state of the employer s address Zip The zip code of the employer s address CarrierID A field identifying the workers comp insurance co usually provided in the insurance card form if not provided leave blank Emp SSN The social security number of the patient employee Bill to The name and address of the insurance workers compensation company you are billing
15. Dispense fee You can define up to nine levels for calculating a Dispense Fee the levels are based on the price calculated above and can either be a percent of the calculated price of a flat fee A fixed value in dollars and cents to be added to the price calculated to this point it will only apply if the price or quantity is within the applicable break point Recalculate based on Table If you enter a Table Pricing Table and the calculated price falls in Break On then a different Price Table will be used to calculate the Rx price All calculations done to this point are ignored Additional Pricing Copyright AbacusRx Inc Page 43 of 100 Percent Mark up dn after pricing a percent used to subtract or add to the figure calculated after pricing and fees have been calculated The minimum total price is The minimum price to charge if the calculated price is less than the amount specified here than the amount specified will be used as the total price The amount will be used if the total price calculated is below this amount Set total Rx price to cost if the calculated price is less than cost if the calculated total price is less than the cost of the item then the total price will be set to the cost of the item if this field is checked Co payment The Co Payment deducible is the amount the patient is required to pay under the plan either a flat amount or a percentage of the total This is only an estimate and is
16. Get Data Filled Description NDC Qty Days Total Auth tt Ref 1 5 2008 ZANTAC 150MG EFFERD 173042702 30 0 1176 2008 A amp D BARRIER OINTMEN 8333338701 30 0 1 6 2008 ACCUTANE 10MG CAPSU 4015549 30 0 1 6 2008 A amp D BARRIER OINTMEN 833333870 30 0 1 1 2008 PAXILT10MG TABLET 29321013 30 0 12 31 2004PAXIL 20MG TABLET 29321121 30 0 12731 2007 PAXIL 10MG TABLET 29321013 300 12 29 2007 ACCUTANE 20MG CAPSU 4016949 30 0 A 19 99 2007 Paxil 2NMG TARIET 129321121 3nn Kc T Rx Detail General Mere Patient Smith John ID 0820 Refils Remaining Units Drug ZANTAC 150MG EFFERDOSE TAB Directions TAKE 1 TABLET TWICE A DAY Doctor ALEGY ALLEN EE ee L State License MED0384987 DEA AA1343724 Pay Plan Status paz Filled 1 6 2008 Origin CoPay 0 00 Total 111 75 Click the text box of either Auth or Auth Amt to see claims detail 1 of 236 As s Edit Ax Picture Rix Label Cancel Once the prescription has been displayed you will be able to 1 Re print a Rx label 2 Print or view the prescription history of a patient 3 View voided or Archive prescriptions Rx that have been purged from the system by your request 4 View only prescriptions rejected by an Insurance Medicaid 5 View only prescriptions on hold i e Rx that have a dispense quantity DQty of 0 not dispensed 6 View the last 500 Rx done
17. Institutions Insurance Carriers or PBM s Payment You will be able to Invoice enter Accounts Receivables transaction A R Co payments Post payments against items paid mail Statements and view transaction history Mame ACCOUNT RECEIVABLE Payment Plan Code BIN PLN Type Account Receiv Dewar Se If want to track patients with House Accounts Accounts Receivables you must first establish an Account Receivable payment plan then charge the claims to that plan IIscount View Statement alance 0 00 Statement Wes pedit Limit A H Co Pay Yes If the patients claim will be submitted to the insurance and the co payment will be billed to the patient Accounts Receivables set the A R Co Pay flag in the Patients record to Yes Copyright AbacusRx Inc Page 51 of 100 ARE PART D 61001 Price AHJCoPay By clicking on the Copay field name while entering an Rx you can individually set the Co Payment to an A R Copayment Once a A R Payment plan has been established or A R Copay has been set and prescriptions have been entered You will be able to post A R payments against A R amounts Patient payment entry If you bill patients for Items purchased or insurance co payments enter payments received from the patient on the following form X Posting Payment Adjustment From Patient Payment is from e Patient C Company Enter amount then press enter key Patient P
18. JIT Dispense Fee 0 00 6 25 5 75 1 50 0 00 0 00 0 00 0 00 0 00 Recalculate based on Table fo r lo r 10 110 fo r r Find New Delete Save Cancel Select The price table is where you defined how the Rx price is to be calculated The Price table is later attached to either the Payment plan or the Drug You begin by defining the base price 1 e AWP WAC MAC Acquisition Cost or Retail price then you specify the Markup you wish to apply to the base price before adding fees then you establish the fee structure 1 e if the base price the markup is less than 10 00 add a dispensing fee of 6 25 then you define any other markup after adding the fees and lastly on the Additional Pricing tab you define how the co payment if applicable is to be calculated and the Minimum price An Rx price can be automatically calculated by the computer base on your predetermine criterion A price calculation criterion can be set at the Payment Plan or Drug level For example you may want to have the computer calculate the Rx price of a given Payment Plan based on the AWP plus a 20 mark up plus a 6 25 dispensing fee and you may want certain drugs to be calculated based with different formula A formula can be used to calculate the price of the prescription when either a Payment Plan or a Drug is selected In our example above we created a formula that will calculate the price of the prescr
19. Overutilization Over utilization alerts occur when a prescription is refilled before 75 of the previously filled prescription s days supply has elapsed Copyright AbacusRx Inc Page 14 of 100 2 Underutilization Underutilization alerts occur when patients have waited to refill their maintenance medications beyond the specified days supply of the previously fill 3 Excessive daily dose Excessive daily dose alerts occur when the calculated milligrams per day of a drug exceeds the recommended daily dosage 4 Insufficient daily dose This type of underutilization occurs when the calculated milligrams per day of a drug are less than the lowest recommended dosage 5 Therapeutic duplication Therapeutic duplication alerts occur when a drug is filled within a specified time period that is identical to or is in the same therapeutic class as a previously filled drug The prospective DUR system searches previously paid claims within the previous six weeks from all participating pharmacies for this problem type 6 Drug to drug interactions Drug interaction alerts occur when a drug is filled that may interact with a previously filled drug within the previous six weeks from any participating pharmacy Only the most clinically significant drug interactions have been chosen from the prospective DUR system 7 Drug age contraindication Drug age contraindication alerts occur when a drug is dispensed that is not recommended for us in the age group of
20. PRESCRIPTION TMACGE sones dos de do datada 75 NUS CES EEUU TI SECURIT A o A ra RE MARC o Et is M ero dM edP Ue e MAS DUE Lettre dont eode ded 77 Sore PR 79 ARG OPS KEHRT 80 Dale PRES CRIPMOM LOS tds lo cs adidas einen loli idoneidad 80 Controlled Dras Reportando dmca cdo ERR 80 Patent RS Storia 80 DING SCALUS REPO a a a a a tesque dia 81 POS Recone liano REPO cC T 81 Insurance Clant Repo te Tr mE 81 AAA A 81 A P 81 le deter adi Reminders T M lattes saute tccaituaa sone a O a 81 Prescription REPO ci Er 81 SN Rc x T t 81 Payments Received REPO o ce 81 Copyright O AbacusRx Inc Page 3 of 100 Refil Resister Report ioci visti ii 81 Medicaid DER RE e lur DU D sta Ree D DC IE LO tate 81 Potential MENS e e M DAMM IM CIIM ELM MEDICI LM MEDICUS 81 Medical HC EN T500 BOR My iiit dixistis des 81 Universal Chit FOr iarna aa A A e c Mei CIA ELM DAMES eL D Me Dec DE 81 Worker s COmpSPOLbi D zonis co in a UH Ind DM MEN O OS 81 Statements to Pates sai 82 Druss Prescmbed Dy Docta a A A A a ia 82 Drus Utilizan Reportan E E anand ann nae 82 Patient RECAE oa o oa 82 Prescription Labels ui E E an 82 POS Adjudication do ia E A E in 82 Nursing Home Wied sheets MAR ie 82 IN rsmie Home Conipany LS a e alado 82 Nursing Home Rx Puled Delivery lista ein 82 INUESIN GS Home statements an ii ii did 82 Nursing Home Account Inal Balan a ai alii 82 Physical Inye
21. Prescriber ALAGNA MARK Phone 813 862 8548 Item ZANTAC 150 MG EFFERDOSE TAB 00173 0427 Written 6 5 2012 Date Filled 6 5 2012 Qty Dispensed 30 Refills 2 Instruction TAKE ONE DAILYIM Payment Plan CASH Auth mt 0 00 Observations Drug Image ley SPREE Drug Interaction No Monogr Number Unable to check Duplicated Therapy No Monogr Number Unable to check fe Dosage Check No Monogr Number Unable to check z Checked Close Ck Drug The above form will allow you to verify the prescription prior to dispensing to the patient Once checked the initials of the user signed on will be stored as the verifier As a safety feature you can verify the prescription by scanning the prescription number from the Rx label and the prescription information hard copy image and image of the item will be displayed You can also optionally scan the NDC as another verification step if correct the prescription is said to be checked and the initials of the checker will be stored for later review Suppliers suppliers are the distributors of drug items Suppliers are used in the Drug records as primary source for purchasing Name imerso Street 345 NW 45 Street City HIALEAH v State FL y Zip 33014 Contact Orlando tt S Phone 3052121211 Ext Alt Phone 305 222 1111 Ext 222 FAX 3059222222 D Mame Street ity State gt 5 Amerisource 345 NW 45 Street HIALEAH
22. the sales volume amount and profit for a given period of time Sales by Drug This report is used to summarize by drug the sales volume amount and profit for a given period of time It can also print an entire years activity summarized by month and can be sorted by drug name highest dollars billed highest paid highest cost highest profit or highest volume Rx Refill Reminders This report is used to remind patients to come to your store for up coming refills There are 3 types of output 1 a list of customers with phone numbers and drugs of up coming refills 2 labels of patients with refills due 3 preprinted mailing forms to remind patients of refills Prescription Report This report is used to list prescription done during a period of time in detailed or as a summary Rx Transferred This report list all prescriptions transferred into or out of your store in a given period Payments Received Report This report list all payments received in a given period Refill Register Report This report list all prescription refilled in a given period Optionally you can specify to list the original prescription Medicaid DER Request This report will print on Medicaid s DER from DER 1003 to order call 800 289 7799 and it is used to request an exception to the prescription limit of 6 per month Potential Medicaid Sales This report is similar to the Refill reminder Report above however it was designed specially for Medicaid patie
23. 7 Sort the prescription s displayed by the drug date or Rx number 8 View the prescription s with replies on transmissions to Insurance Medicaid 9 View or print the hard copy prescription 10 Edit a prescription You begin entering your selection criterion on the top of the screen Once you have entered a patient or an Rx number you will be given the following options Rx label will print a prescription label of the Rx highlighted Rx picture view the hard copy prescription if available Edit will move the prescription to the prescription screen where you can make a change Field definition Rx number The number assigned to the Rx A prescription number is always suffixed with a hyphen and a reference number The reference number indicates that it is an original Rx 0 or a number indicating the refill Date The date the Rx was filled dispensed to the patient Description The name of the drug or compound dispensed DQty The quantity that was dispensed to the patient Total The total price of the Rx includes the ingredient cost dispensing fees and discounts Auth Ref The authorization number given by the insurance company when the claim has been adjudicated Days The number of days supply dispensed to the patient Plan The payment plan code defines the carrier Insurance company Medicaid etc being billed Status The billing disposition of the prescription 1 e Billed or N
24. 9 diagnosis code on the electronic CMN if the physician indicated a narrative diagnosis on the hard copy CMN No The CMN completion instructions on the back of the CMN instruct the physician to provide ICD 9 codes If there is a narrative diagnosis the instructions have not been followed Suppliers who transmit CMNs electronically cannot provide Copyright AbacusRx Inc Page 73 of 100 information that is not on the CMN 22 If a patient has Fee for Service FFS Medicare enters a Medicare HMO and then goes back to FFS is a CMN required If a beneficiary is in a Medicare HMO for 60 days a new CMN is required as a break in need has occurred If the beneficiary is in the Medicare HMO for less than 60 days a new CMN is not required as FFS Medicare will pick up from the last payment 23 What does the KX modifier indicate The KX modifier indicates the presence of documentation as defined by local medical review policy in the beneficiary record file 24 What are the three methods of delivery The three methods of delivery are Delivery direct to the patient Delivery via shipping service 1 e U S Postal Service FedEx UPS etc and Delivery to a skilled nursing facility 25 How long must a supplier retain beneficiary medical records for claims filed to Medicare Per the Program Integrity Manual records should be maintained for seven years OTC SERVICE Over The Counter items or a Service can be billed by entering the
25. E nun Access Internet via proxy server Email Address Jorlando abacusrx com SMTP Server smtp abacusrs com Enter the server s name here User Name lorlando aba Password mm BD Electronic Price and Drug Update Manual Send claims to er Data Path DAPHA RelayHeallhiNDC C Direct exchange Data Path CAPHA3N C Emdeon File exchange Session s Configuration eScript User Name 1 eScript Password 3052200400 Create a new Rx when refills are authorized Modules Save Cancel Copyright AbacusRx Inc Page 85 of 100 Visual Pharmacu Plus Software User s Manual SU Preferences EN Communication Report Type Form Printer Copies Tray Prescription Labels option 8BLC Laser Rx label on legal form for Calif v HPLased w i 15 Auto Delivery Sheet Invoice Invoice HPLases wi 15 Auto y M V Labels VAV label Pint rame v acuson e oji fiS Ato y Shipping Maiinglabels SShppinglabes w DYMO Labelwiter 400 1 15 Auto y Physician Orders Med Sheet PO Physician Order form AdobePDF i 15 Auto y Reports N HPLased i 15 Auto Statements P Statementsonrepotpape x Po li tuto Universal Claim Form F Pre printed form Po fit 15 Auto y Worker s Compensation Form F Pre printed form Po fit 15 Auto vr HCFA Form F Pre printed form Page setting Po i f5 uto y New Rx Barcode Py Physician Rx 304 Rx on Letter Paper 4x print na
26. Emal MEJSGADLCUM Auto refills Click here to Cel i Diver KA SE E 305 555 5545 Ws x HIPAA signatures and acknowledgement Documents print a Auto Refill Authorization form Import Pic Take Pic Diagnosis Type a Diagnosis Description or Code to find Find New Delete Save Cancel The Patient screen displayed above will be displayed when modifying or creating a new patient the screen is broken down in to 9 sections 1 GENERAL this is where the core patient demographics are stored as displayed above Most of the fields are self explanatory a Patient a unique number used by the system to identify the patient can be automatically or manually assigned b HIPAA Specifies the date that the patient was last counseled on HIPAA c Language Is used to denote the language of th Sig and Drug information on the Rx label d Category is a free form field you define mainly used to classify a patient for reporting purposes e Generic If checked the patient has elected to accept a Generic drug f Safety Cap If checked the patient wants all drug containers with a Safety cap g Active This field is used to limit the patient displayed when you type a patient s name In Configuration Preferences you can specify to list only active patients h Auto refill If checked the patient has elected
27. FL r E Foxmyer London m3 McKensson 123 Great Street NEW YORK NY k lt 1 of 3 gt New Delete Save Cancel Copyright AbacusRx Inc Page 46 of 100 Visual Pharmacu Plus Software User s Manual MANUFACTURES Manufactures or Laboratory are used by the Drug record as a reference to the origin creator of the item At times you may need to return medication back to the Manufactures instructions may be stored to indicate the policy and how to return medications 12904 IW Icd 2ITIELI Vi Ic quc sucu uU LL dil iltuicbcduur m 3M PROF HEALTH General ID Labora PHAR Male UNIPAK RETURN Street BFI PHARMACEUTICAL SERVICES Email City CONYERS v State GA Zip 30207 Contact o Phone 800 423 5146 Alt Phone 800 777 6565 Fax a Med Auth No Noo Comment RETURN GOODS DEPT Record 1 of 2241 Find New Delete Save Cancel Select Instructions The Instruction tab contains information on how to return drugs back to a distributor or the manufacture All Drugs these are the instruction to return a non controlled substance to the laboratory Class 2 these are the instruction to return a controlled II substance to the laboratory Class 3 to 5 these are the instruction to return a controlled III V substance to the laboratory SIG The system uses Sig codes to as a short hand for the drug directions The objective 1s to reduc
28. Item from the Rx fill screen a Compound icon will appear so that you can specify the ingredients Item record Description BACLOFEN 5MG ML ORALS Form RAL HDC 00000 0900 11 Package Size 1 000 Make sure to select Compound as the Item Type Type Compound Aw F 25 00 Product IF Fe Equivalent List If the Item type is a Compound a button called Compound will display Click on Compound from the Rx fill screen to enter the Ingredients Prescription Entry screen Aem BACLOFEN 5MG ML ORAL SUS EN ta View a list of Compounds you can select from Compound screen Compound Double click to retrieve AMOXICILLIN 500 MG TABL Compound Name BACLOFEN 5MG ML ORAL SUSPENSIO a e Compound IV M AMOXICILLIN 500 MG TABL List of Route of Administration 54471 007 Buccal route Argus Test 4a ASHLEY CREAM ATENOL HHUYTR PO ATENOL HHUYTR POY ATENOLOL 100 MG TABLE Atlantic Pharmacy Timolol BACLOFEN 10 MG TABLET BACLOFEN 5MG ML ORAL Compound Type 99 Other Dosage form 07 Liquid Dispensing unit 3 Milliliter Pte 11 Buccal E Compound Ingredients Description lngredient NumberfNDC UM Quantity Cost Modifier Bass BACLOFEN 10 MG TABLET 832102400 15000 8237 1009851 BACLOFEN POWDER 3 GLYCERIN BP sot 200 2580 100951 th next to the SIMPLE SYRUP NF 90023 B0000 6 000 10088
29. Modifier Medicare HCPCS Modifiers Employer Patient place of employment Robotic cell to work with Automatic Dispensing System or Robotic systems HOA Hour Of Administration or passing times for the Facility Copyright AbacusRx Inc Page 87 of 100 Backup This function is used to backup your Pharmacy software data E Back Up Database Current Database fou are about ta make a backup of your Visual Pharmacy Plus database Backup compresses the data into a compact file that is smaller than your database Use Restore to later uncompresses your backup Mame Pham mdb Location C Program Filess amp bacus Visual Pharmacy Plus Back Up Current Database As Back Up button To back up to a removable storage media put the disk in the drive before clicking Back Up S Fill in the database name and location for backup and then press Mame FhamB ackLlp zip Location C Program Filess amp bacus Visual Pharmacy PlussBackUp Thu Change Click Change to select a database name and location ro back up your database to Back Up Restore Cancel The backup function will allow you to backup as often as you like or create a differential backup a backup stored in a day of the week folder so you will get a Monday Tuesday Wednesday Folders created with the entire database stored in each day of the week on the backup media Make sure you have sufficient space available in the backup media Drug Cost update Th
30. Resident s pay type PVT MEDICARE MEDICAID Diet Enteral Feedings Dietary Liberties on special occasions YES NO Rehabilitation Potentia GOOD FAIR POOR NONE LTD PT ST OT Evaluation Treatment Special needs NO CODE DNR SEIZURES PACEMAKER ETC other Side rails up when in bed YES NO Laboratory orders Laboratory due dates Vital signs amp weight monthly unless contraind Copyright AbacusRx Inc Page 66 of 100 Crush meds prior to administration YES NO Ambulation INDEPEN CANE WALKER WHEELCHAIR GERICHAIR OTHER With assistance frequency AD LIB SPECIFIC RESTORATIVE NURSING APPLIANCES EXERCISES Restraint Check every 30 minutes release every 2 hours for a period of 10 30 minutes Type circle VEST WRIST GERICHAIR MITTEN LAP OTHER Frequency i e HOURS DAYTIME ETC Purpose i e SAFETY PREVENT FALL ETC Treatments ANCILLARY ORDERS Resident notified of their patient rights YES NO if no give reason May leave facility on pass YES NO If yes with medication YES NO Capable of utilizing cosmetics at bedside YES NO Resident notified of their condition YES NO lfno give reason Oral medications may be given with food unless otherwise specified by the physician Resident free from communicable diseases including TB YES NO Orders reviewed and approved for 30 31 days Resident care plan reviewed and or renewed Dis
31. active physicians If checked when the prescribers name is entered only active prescribers with like names will be displayed DI ee I a Aa A a y Uus u Oc Copyright AbacusRx Inc Page 33 of 100 Visual Pharmacu Plus Software User s Manual DRUG Item The system comes with over 100 000 Items already linked with prices these items are used to fill prescriptions To modify the drug or item from the Rx fill screen click on the Item field identifier E Drug Record E Description SMart Form Pkg Size Ss Type Class OnHand TF 60 B F H R General Description NDC Type AWP Equivalent Active ZANTACTSOMG EFFERDOSE Fom TABLET EFFERVESCENT e 00173 0427 02 Package Size 0 Brand y DEA Class 0 Nocontol vr 161 96 Product F Federalledgen Mi Location Miami Only display active drugs Find New Delete Save Cancel Select GENERAL Information on the drug l 2 3 4 d 7 8 9 10 11 12 Description the name of the Item or drug along with the strength Form here you specify the form the drug comes in NDC the drug products code Package size this is the package size the drug comes in and of how the drug is distributed This field is important when calculating the unit price For example if you are dispensing 30 tables of a drug with a AWP of 150 00 and the drugs Package size is 1
32. contain up to four occurrences of claim service data Depending upon the particular claim submission request the Processor must provide one of the following general types of responses Captured This occurs when the Processor acknowledges receipt of the claim but is not making any judgment regarding eligibility of the patient or payment for the claim at this time Duplicate of Captured This occurs when the Processor has previously received the request and processed the transaction but the response did not return to the Originator The Duplicate response contains the same information as returned in the Captured original response Paid This occurs when the Processor captures and processes the claim and returns to the Originator the dollar amounts allowed under the terms of the plan The Paid response is not used in payer to payer transactions Duplicate of Paid This occurs when the Processor has previously received the request and processed the transaction but the response did not return to the Originator The Duplicate response contains the same information as returned in the Paid original response The Duplicate of Paid response is not used in payer to payer transactions Rejected This occurs when the Processor has encountered an error in the transaction or processing SERVICE BILLING PROFESSIONAL PHARMACY SERVICE Billings may be for professional services rendered Services may be correlated with a dispensing event or may be separate
33. detailed information about the Rx Rx notes or a view print a Monograph Rx Picture This will display the hard copy prescription if it was scanned 0 Show only active Rx If checked only prescriptions still in use by the patient will be displayed if the fill date days supply is greater than today s date 11 Location OPTIONAL If you have multiple locations you can view the patient history at the other locations Eu Field definition Rx number the number assigned to the Rx A prescription number is always suffixed with a hyphen and a reference number The reference number indicates that it is an original Rx 0 or a number indicating the refill the number of refills since the original A letter after the reference number has the following meaning Rx Number a E signifies an Expired Rx b T signifies that the Rx was transferred c signifies that the Rx has refills or quantities available for refill Refill the total number of authorized refills Date the date the Rx was filled dispensed to the patient Description the name of the drug or compound dispensed Doctor the prescribing physician dQty the quantity that was dispensed to the patient Total The total price of the Rx includes the ingredient cost dispensing fees and discounts Days The number of days supply dispensed to the patient Plan The payment plan code defines the carrier Insurance company M
34. exits the screen SELECT Selects the patient displayed and assigns it to the prescription Tr erga th oe ao Patient Rx History F5 A patient history or profile can be viewed while in the patient screen or in the prescription entry screen once the patient has been displayed by clicking on the History icon All the prescriptions dispense to the patient will be displayed 1 AR J JL IEIUNII nu riui ASES F CE ESA SES a Dn BS Rx history of Patient John Smith ID 10820 Location 01 Miami EE To retrieve a Ax highlight the desired Agfa and click the Modify or the Copy button Note An asterisk next to the Ax number indicates refill pending E indicates that Rx has expired and D Indicates the Ax has been discontinued T means transfered FE Number Refil Date Description Doctor dt Total Days Plan Status Origin ENE ZANTAC 150MG EFFERDOMARK ANDREV30 8098 15 C PD Written Show only active Ax Modify Move Authorize Transter Vol Details Hx Picture Once displayed you can sort the list of prescriptions by the drug name date or the Rx number by clicking on the field name there will be a few functions available to you shown above at the bottom of the screen as follows 1 Modify Moves all the highlighted Rx to the prescription form so that you can edit them 2 Copy Make a copy of the Rx this is a time safer when dispensing a new Rx similar to o
35. if different Copyright AbacusRx Inc Page 40 of 100 Visual Pharmacu Plus Software User s Manual E Payment Plan Record 1 of 1 payment plans Description Imesipeket nEn Apply the following rules z ue Prescriber license to transrnit Maximum Rx claims per transmission Plan ID 7 Rules for this Pharmacy ID NPI m fi 2345578310 O Do not display warming on Rx with zero total price Software certification O Do not send Copay as other AMT to 2 and 3INS O Send main NDC on a compound O Do not transmit other payments COB Medicaid Indicator Do not transmit Diagnosis Vitals O Transmit Rph License Send only CV S Caremark protocol lt Ee iew Det sono _cenet seed State License 08 Medicaid amp gency Number Provider Accept Assignment RULES a NCPDP version number this is the communication protocol version of the standard that is used to communicate with the carriers and switching companies b Maximum Rx claims per transmission This tells the software how many prescriptions to transmit at once The maximum prescriptions currently allowed by the communication protocol standard is four however some insurance carriers limit a maximum of one Rx c Pharmacy ID NPI NCPDP This field is used to override for this Carrier the Pharmacy identifier If not specified the Pharmacy ID entered in Preferences will be used d Software certification Some carriers processors and swi
36. in one of the plan if he wishes To cover the second possibility you need to send an El transaction to check the patient eligibility for Medicare Part A or B If the patient is eligible for either Part A or B he is most probably one of those patients who were dropped in the process of auto enrolling Here is what you need to do to send a Medicare A B El transaction Copyright AbacusRx Inc Page 9 of 100 Manual Next make sure in the patient record you have the following required information this is minimum information needed to check patient eligibility for Medicare Part A B 1 PATIENT FIRST NAME 2 PATIENT LAST NAME 3 PATIENT SEX 4 PATIENT DATE OF BIRTH 5 PATIENT ZIP 6 PATIENT SSN or at least the last 4 digits To resolve eligibility issues please contact CMS at 800 MEDICARE 800 633 4227 There is no need for a duplicate response due to the nature of the Predetermination of Benefits transaction Each submission of the transaction is processed with the response reflective of current information Extended prescription entry screen If needed you may enter additional information about the prescription by clicking the icon on the left side AN Prescription next page of JOHN SMITH ID 2583 Ticket No 1009819 Prior Authorize Payer COB verride7Prior Authorization Notes DUR Coupon Other Charges v Issue an Rx numbet Auto refill Rx Number override
37. initial claim was entered incorrectly you should submit a reversal transaction and then resubmit a new corrected claim Be sure not to change any information prior to the Reversal The difference between the original claim and the replacement claim is added to or deducted from the payment amount on your next Remittance Voucher Most carriers have a time limit for transmitting Reversals usually 3 months but may be as little as a few days Note If in the Payment Plan record the field called Type is Cash or Accounts Receivables when you save a claim you will not be asked Transmit claim PREDETERMINATION OF BENEFITS INFORMATION FIELDS REQUIRED FOR ELIGIBILITY CHECKING 1 Patients Name Last Name First Name Zip code can be Specify Eligibility Provider Notes Here you can get the patient s new insurance information the previous insurance data will be saved under the patient s notes Under Setup you can specify to get only Medicare part D insurance data Only General Insurance data or both optional DOB Date of Birth Last four digits of the Social Security Number in the Card Number Patient Info PatientID Eligibility Date 4 22622013 History Setup Copyright AbacusRx Inc Page 8 of 100 The Predetermination of Benefits inquiry transaction is used by the Originator to request the following 1 To determine if the patient is eligible for prescription
38. remaining refills or remaining quantities A refill must have the same Rx number and is uniquely identified by it s suffix a and a number identifying the refill number a zero identifies the original prescription one identifies the first refill etc Governing agencies and insurance companies impose restrictions on when and for how long a prescription can be refilled Some of the most common restrictions are 1 A prescription is only valid for a period of one year or less default or as defined in Preferences 2 A prescription for a controlled substance will expire in less than one year default or as defined in Preferences 3 Some drugs may have a cap on the number of refills On a refill practically all of the information is already filled including any price adjustments since the last fill However you can always change any information Once you are done entering prescriptions refills click on the Save icon to save and print your work To refill more than one script hold down the CTRL and left click the mouse to select Note Original is the date of the original Rx Refilled is the date of the last refill Last Price is the price changed on the last refill Refills Left is the number or Refills Remaining a in this column represents unit quantities pending Expirations of controlled and non controlled substance can be modified under Preferences Copyright AbacusRx Inc Page 32 of 100
39. scan the Items barcode Copyright AbacusRx Inc Page 3 of 100 If you entered a Drug name you will get a list of all the drugs with a similar name use the up down arrow keys or the mouse to highlight the desired drug then double click to select fem ZANTAC 150 MG EFFERDOSE 2 Substitute You can Type the Medication or Items Click here to locate the click on name here You may enter a partial Item by other fields 1 e the word name or a partial name and the product code NDC etc Sig to edit strength with a coma in between or the NDC or scan the Item Click here or press F7 to select another equivalent Item Generic Note If you enter a Drug for a new Rx that the patient has active refills pending the system will optionally alert and locate the refill for you 1f this option in selected in the Configuration Preferences If you enter a branded drug the Substitute icon will appear next to the item if you enter a Compound the Compound icon will appear to allow you to enter or verify the ingredients You can request to see all substitutes of the drug entered by clicking on the Substitute icon or pressing the F7 key The substitute list contains inventory on hand quantity and comparables as a percent of savings against the drug you had originally selected 3 Next you will enter the prescribe quantity quantity written the quantity dispensed the number of refills the Sig code and or enter the directions of th
40. specify all the carriers List claims billed from To Retrieve all claims regardless of date Reconciliation Filter Automatically post payments to open claims Continue Cancel Next you will be show the above screen In this screen you will limit the Prescriptions that will be displayed to post the payment as follows 1 List all Plans paid on the check If it s a single insurance than only one need to be specified otherwise specify all the carriers generally administered by the PBM or at least all the carriers paid on the EOB or Statement 2 List claims billed from This would be the EOB or Statement date range generally the date the claim was billed to the carrier This is used to limit the prescriptions by the date 3 Retrieve all claims regardless of date use this if you want to retrieve all the claims billed to the carriers listed above regardless of the date billed 4 Automatically post payments to open claims use this if you want the system to automatically post the payment to the claims with an open balance starting with the first found We do not recommend the use of this tool as this may not allow you to correctly reconcile with the EOB or Statement as not every claim posted will match the same amount paid on the EOB or Statement Copyright AbacusRx Inc Page 54 of 100 Visual Pharmacy Plus Software User s Manual s Posting Payment Adjustment From Company Payme
41. tamente ais 38 Paen LAR ea adictas 40 WHATES A diLelh eU 40 LINKING A PRICE TABLE TO A PAYMENT PLAN csessseeeeeeeeene e nennen eene nnn n nnnnenss esses sees essen enint ense sess sees esse serene nennen ns 40 018 O 4 PO CUME NT e wM E 4 PRICING TABL e 42 o 43 e O NN RR A O des aueunenesceescussatizcantdeas 44 INVENTOR YE NDA e P 45 A RR Circa e 46 o E E X 46 MANUFACTURE P He 47 Copyright O AbacusRx Inc Page 2 of 100 A O O m 48 NA Het COJE noran dice te sem Pt mea Lats Mei MM CI MI MI M Me 48 LANNS SS a n et oM RI CMM ICA LM MINA MA te 48 MTC OCS SIGS MR MD EE NAE 48 SEARS ME MAII IM MM LM M MIA MM MAT MM MID CUM 49 DELIVER Y sa M 50 PICKUP pe E a eae 50 Account Recervables Payments entry A caesa de cs uisus sos ond cha epa A el vd entes nanos RU RUE 51 Patient payment ent na iaa 252 A R BilltoTocation and C0 Payments A E a in 52 Company Payme
42. the file ipi Medicaid 835 5010 Nov 2011 sample Desktop File name AETNA_081711 y Y My Network Files of type I aces Open as read only 3 Select the Payment Plan name on file that corresponds to the Insurance Company or PBM that sent it Click Ok to process the file Copyright AbacusRx Inc Page 56 of 100 Visual Pharmacu Plus Software User s Manual m Specify a Payment Plan The payor is SE TNA For the reconsilation specify the plan ID correspanding to this payor Select the payer from the Payment Plan on file pes Check Amt Cleared Amt Remaining Check 1 ReHt 6059188 2057 68 10 92 8 60 0 00 1 check Total Amt 3057 68 10 92 3068 60 83s 84 A Payments Reconciliation 1 pay sid Drees IET File SP PREGCREPTI POSITIS TREO IET Pare ET GB MEM DEVIS IP DTT Flea P AUAA 423 MAPOD ADO 0D MOB Primary maaa 1575 10634 000 NOE Perg mivan f 7a nn DOOPSES Primary DERE 5520 14 00 MIAE Primary wara 1 Y 14500 006 DUCETI 4 Prem n a i 128 52 OO UE Prag nran F Vtt TOF 000 1000151 Primer E po dor nnn DOCTI S2 Primary wiran A 257 1457 000 DOO P mer PA DAMAS ECT DOC Par IP ORO 120 MOT AO O DOCET Persae E sino nno ODE Preig e 3 357 000 DOCE Pricey pm 3 3 as un EE 02 4602 11 28 DCE Presa nanan 1 BO 2m DUCECH2 Primas naan E apo pur ae CECE Pray nyana 1280 Bar 000 OCR Primer inven 012 ur Or too DOOM Heer PA Uhr 1 1007 000 DOE Pac TI
43. then be entered via the payment entry screen or via the POS cash register this will automatically reduce the patients A R balance V Enterlicdale r rd F Bonae m rd i Faxd Rosin Delivered scan the signed Delivery Sheet here Hass p u can track oi wine ha clatus el a dekyang on pickup Rx to Het you can track or vider tha status of a deleesp or pickup Tied Diver C Prlup Dele r deliver E C Pickup Dae 7 Ha C Aleta Deben by HARY Dereeerby MARY Coben Ose agam wins on aw Suns uum Ste Gotas 3 mimm Faune Mireille d Track euni Didier ti B Deveyi Pi DekeeryDse DekeeryPenon S Comments Patient Tracking AES 100 1 OD ESE AL HARY On rita cis PARTO Br J sjean an Debray Shas 57164 Dise a Note An automated version is available on the iPhone iPad for deliveries call us for details Pickup This function is used to indicate that a prescription has been picked up and if a signature pad is available it will ask the receiving party to sign for HIPAA if needed and for receiving the prescription Copyright AbacusRx Inc Page 50 of 100 m Rx for Pick up If a patient has other prescriptions not picked up regardless of their Disposition they will show up here Rs Number 5147 History af gp days Here you see that the Coumadin is complete and waiting to be picked Patent Ss ses EDUAR
44. where it resides Zip The zip code where it resides Phone The telephone number Fax The facsimile telephone number Contact The personal contact at this location Contact Phone The phone number of the contact at this location Ext The phone extension of the contact at this location NPI The facilities provider number for your information not currently used elsewhere in the software Physician The prescriber that normally prescribe medication at this facility Whenever you are filling prescriptions for a patient in the facility this prescriber will be the default Category The facilities category is usually used to limit the reporting views to only a certain category of Facilities HOA default Passing times The usual times medication is administer at the facility This is only the default and can be overridden when the prescription is being filled You can specify up to 5 different times by separating each time with a coma For example 10AM 11AM 2 PM 4PM 10PM Location Type The type of Facility Tote The number of the Tote used for deliveries It is used to validate that the Rx is going to the correct Facility when the driver scans the Rx and the Tote eMail The eMail address of the Facility PRESCRIPTION ENTRY Once you have created a Facility record you begin by assigning patients to the Facility This can be done in the patient file screen or you can assign the patient to the Facility within the Prescription
45. you can use the Move down up icon at the bottom part of the screen to move the prescription to a holding area where you can view or review until all the prescriptions are entered for the same patient You can continue to enter or refill prescriptions for the same patient There is no limit to the number of prescriptions you can enter on this screen If you need to return to a prescription to make a change simply highlight the Rx and click the Move down up icon to place the Rx in prescription fill screen Once saved the prescription will be transmitted to the insurance if applicable and printed When electronically transmitting the claim the claim will be sent to the payment plan selected in the prescription and then to other applicable third party payers as defined in the patient insurance information screen A response is generally received in seconds after transmitting and will be automatically displayed on the screen Drug to Drug Conflicts and Patient Monographs Drug to Drug Interaction You can request to check for drug to drug interactions upon save see Configuration preferences the system will automatically check for you when you request to save the prescription s When checking for drug drug interactions the computer will search the patient s entire active Rx profile and the prescription s currently being dispensed for conflicts allergic reaction and interactions A prescription is considered active based on the dispensed day
46. 00 Then the AWP price per table is 1 50 and the AWP of what your dispensing is 45 00 This field is in the price calculation Type Indicates if the drug is a brand name Generic or other DEA Class This is the DEA classification Drug Schedule of the drug The system uses this code to restrict refills and or Rx expiration date AWP the Average Wholesale Price this price is used by insurance carriers as a base for paying claims but usually paying below the AWP AWP are electronically updated see Updates Product this field is used to indicate whether a drug is Prescription only or OTC Equivalent This is the Brand name of the drug Allow Auto Fill indicator to allow this drug to be used in auto prescription fills Active If checked the drug will be listed when the drug name is entered while in the prescription fill screen if the option is selected in the Configuration preferences this is useful because you will see only the drugs you have Unit of Measure how the item is packaged 1 e Grams Milliliters Each New Click the New button to create a new Item then enter the NDC and drug name then click Save Save After making a change to an existing Item click Save to store it Find To locate an Item by NDC or Description click Find Copyright AbacusRx Inc Page 34 of 100 PRICING This form is contains all the prices and price change history on the drug _ e Dru
47. 25134 1 0384 E 500 The Next Invoice Number The Next Transaction Number V Preferences Modules Save Cancel Communication Ask to print before printing Print Ax that have been rejected in POS Print labels for prescription on hold Print Invoice Delivery Sheet for prescription on hold Issue an Ax Number to prescriptions on hold V List generics when filling a brand drug Y Check pending refills on every new Ax IV Warn me if something is wrong in new Rx V Display message if cannot check below V Check for interactions on save V Check for allergies on save iw Display drug cautions on save V Check for Duplicate Therapy Auto send refill auth request to Prescriber on last refill Enable HIPAA alert on new patients Check for HIPAA date Iv Check for Min Max Dose J Check for Pseudoephedrine Misuse Bill same cash price as original on refill Install security with passwords Keep track of inventory Base inventory on average cost We dispense Medicaid prescriptions We dispense Unit Dose Prescriptions Store the last adjudicated price in FPPUL List only active drugs List only active Physicians w List only active Patients Assign a bar code to new Ax v Display orders pending on the Rx entry Remind me to close inventory period Copyright AbacusRx Inc Modules Save Cancel Page 84 of 100 Visual Pharmacu P
48. 5 COUPONOTHER AMOUNT oriente 16 WORKERS COMPENSA THON T M 17 O AA OOD gees 18 CoOordinaion OF Bene tits CO is rca m 19 A IA HOP 20 DO e BD ic po E PN 21 INV me d Prosi PUOI rito E o E asas cnica 21 Pauententormiattobd Patient toco IDE PM MM DE deudos 23 PURAN LM 24 SIA E T 25 I OL ES C 26 REPRESENTAT C PH 27 LAU VP T 28 Jo LO q 28 NOTE OP On gy 3H E 29 PO e Bii dp 30 Patient o PSOE e H PH 30 Na PPP iecetna sb hana usavencannneses eebeucdesasiaas uncetnauseesaaiced aoaieboetaasaaes 32 PRESCRIBER ornato 33 DRUM isis 34 PRTC TIN E A o O Ue ON 35 INVENTOR Mara edi 36 NMANUBACTURE nal aa 37 COUNSELINO arrasada 38
49. 51 a se peso TS ES peas He Compound name n BACLOFEN 10 MG TAE 15 licked 1S Clicked E GLYCERIN BP 2 E SIMPLE SYRUP NF M 4 Record 3 of 3 e bI Adding DEL ingr Professional Fee 5 00 Mixing MM HMM 4 gt instruction Note 4 Crush tablets to a fine powder 2 Add glycerin to wet the powder and levigate to form a fine paste may need to add some simple syrup 3 Gradually add simple syrup in small amounts levigating well after each addition until a liquid is formed 4 a Cave Clear All Transtar ta a radiata A so sdditinnal cirmmla sunin Fe rina the rar simia dria fram Haa mortar and add ta the aradiista E Copyright AbacusRx Inc Page 12 of 100 Compound s already stored This list is provided when the lookup icon On this screen you can create the details about the compound or IV such as ingredients route of administration mixing instructions fees etc Once the Compound IV has been created it will be saved under the Compound Name Later it can be recall on our next Rx with the same Compound IV Usually compounds and or IV are printed on special 4 x 4 labels see Configuration Preferences e Compound name this is the unique name of the compound all the information entered will be saved under the Compound name for retrieval at a later time Route of Administration how the compound will be administered Compound Type Clarifies the type of compound Dosage form the form the co
50. Accident Type A Auto accident E Date of Injury E 1542012 Delete HCFA History nly active Find New Save Cancel Select Form HCFA 1500 form information This form is intended provide the information required for HCFA 1500 billing This software provides three ways to bill by Paper real time electronically or in batch n Medicare The patient s plan Identifier o Type of Plan The patient s HCFA coverage type select from the combo box p Payment Plan to bill This is the payment plan on file that would have the plan information you would want printed on the HCFA form q Insured Name This is the name of the insured person or card holder if is not the patient r Street Street address of the insured person or card holder s City The address City name of the insured person or card holder t State The address State abbreviation of the insured person or card holder u Zip The address Zip code of the insured person or card holder v Phone The phone number of the insured person or card holder w DOB The Date of Birth of the insured person or card holder x Sex The Gender of the insured person or card holder y Status The marital status of the insured person or card holder z Employed Indicator if the insured person or card holder is employed and the type of employment at this time aa Employer The Company name of the employer of the insured person or card hol
51. Compound or IV can be printed on the Standard Rx Label or on a Compound IV label as shown below you can specified the label in the Configuration Preferences Copyright AbacusRx Inc Page 13 of 100 Seur bruce bribe ROLE Hickory Erro Gia Tad E rd BIIH 1448 F RPABEHTERAL LEE DHL Hard naa Thi Mikii Dr LC bee Bae 54407 Our AAA Bancs Ga 140 Eni Das Dit Com Pou Yogi erai y Total tuner FH mi ceenr Abr AE EE NS ihep d Dera rerpr 8 AM dl ig 4 Mel al ola plinth rp dri ranita Seger Rap He rare edi Dinard Afra CEA RS Epe Lat TENS SA PEST La CALTEm Feira uns peat Haase ad ms dina FACE SLIT J 73 Ey Peron amer rhari 18e pace for Sha preurdited Berii ar Preta 15 Eur Ha DT Can pm besa d A 1 Inport ar ya8curane cet aa Heit Aa age daH Fee ra cnni Drug Expirak TAAL AP Im 5 Combo label with IV Bag Syringe NOTES Drug Utilization Review DUR Prospective Drug Utilization Review DUR encompasses the detection evaluation and counseling components of pre dispensing drug therapy screening The prospective drug utilization review system assists the pharmacist in these functions by addressing many different situations in which potential drug problems may exist DUR performed prior to dispensing helps pharmacist ensure that their patients receive appropriate medications This is accomplished by providing information in the dispensing pharmacist that may have been previously unavailable Prescription next page of
52. DO up but the Paxil has not been billed Filed to the insurance company or has been O 5143 0 4 24 2013 PASIL 10 MG TAB 180 54 Incomplete rejected or not verified Type of deliver amp Pickup C Delivery Mail Return 4 24 2013 COUMADIN 1 MG TABLET 33 58 Weill call The Disposition status indicates where the prescription is in the process Prescriptions can only be picked up if the Disposition is set to Will call If the Rx is not in Will call it will have to be researched maybe the prescription was not billed to the insurance carrier or not verified and the verification step has been specified in the Preferences To change the Disposition to Picked up enter the Rx number or scan the Rx number from the Rx label Select the Rx and click Ok the Disposition will change to Picked up Account Receivables Payments entry The Account Receivables Payment entry form enables the pharmacy manager to reconcile the payment received from patients or third party PBMs against the prescriptions billed to them The user has the option of viewing The status of claims for all Plans a specific insurance company or plan processor which may have multiple plans a specific plan claims submitted for a specific patient or for a range of prescription numbers This software does not replace an accounting system However it has simple accounting functions built in that will allow you to track balances owned by patients
53. Entry screen as shown below Copyright AbacusRx Inc Page 65 of 100 33 Patient File Smith John ID 10820 LastName FirstName Middle Name P Smith John 123 FL 4 sw 34 street MIAMI Facility ANDERSON HEALTH CARE CTR Room 440203 Primary Physician BAADE MELODY NOEL Alternate Physician Admitted 2 5 2008 x Reffered By Location Type O Not specified X NEW To enter a new order select the type of order on the left then write a note in the box on the right EDIT To edit select the type of order then modify the notes SAVE The order is automatically saved as vou exit the notes DELETE To delete a order just uncheck it from the list Standing Orders DIET Retreive From Save as ENTERAL FEEDINGS LABORATORY ORDERS SPECIAL NEEDS MOBILITY NURSING APPLIANCE EXERCI EVALUATION QUESTIONS v tw Join History pr Only active Find New Delete Save Cancel Select Once you have assigned the Facility to the patient you can begin to enter prescriptions the same way you did for regular patients not in a facility NEW PATIENT FORM Some Facility may require a form to be filled out on a new admission you can set the system to automatically print a new admission form see Standing Orders or the facility may use a copy of the form shown below NEW PATIENT INFORMATION Hesident s Name Allergies Resident s D O B Admit to room
54. HN ID 2583 Only Active 1 patients Us Sw 123 STREE MIAN Click here to view a Statement if patient has A R transactions General Insurance Facility Represo Billing Biling ddress Account Information Bill A R To Patient Discount 2 View Statement Name SMITH JOHN Balance 0 00 Statement Yes Street f 2345 Sw 123 STREET Credit Limit Last paid City Mi AMI Last Ax l6 15 2012 Patient assigns benefits State FL Zip Code 331 83 SSN Shipping Address Patient ID hd Directions print ShipTo SMITH DAVID on the Credit Card Deliver Street 8545 Sw 40 STREET Credit Card Number Sheet y Miami w SteterL 2ip 33143 heet Direction Expiration Date TAKE PALMETTO TO BIRD ROAD GO WEST TO 85 AVENUE Card Holder Name History M Only active Find New Save Cancel Select BILLING Here you can define an address to bill for all house account charges Account Receivables a Billing Address this is the address that will print on the invoice and statements b Shipping Address this is the address that will print on all mailing to patient Direction will be printed on the Delivery List for the drive to locate the address Account Information e Discount Discount percent to apply to all Cash or Account Receivable prescriptions e Balance The current patient house account Account Receiv
55. Ins Phone The phone number of the insurance company you are billing Note Once the above information is entered it will be kept along with the patient s record so that you will not have to enter it again Make sure you have set the payment plan as a Workers Compensation plan PAYER COB The Payer tab is used to view responses from electronic claims submitted to the payer If you transmit a multi payer prescription claim you will receive a breakdown of all the payers and the amount they paid on the above screen These fields are automatically pre filled for you Prescription next page of JUAN BURGOS ID 2200 Ticket No 1008306 Override Prior amp uthorization Notes DUR Payer COB o Ote Plan Type Plan Date billed Primary ESI EXPRESS SCRIPTS 10 25 2011 0 00 REJECTED The information you will see on this part of the screen is usually prefilled for you by the m Payments received from other payer Type I Processor Payor Payer ID Amount Date 5 272 Patient Pay ICN Benefit Stage Reject Code Record 1 of 0 Copyright AbacusRx Inc Page 18 of 100 COB Field definition follows l Plan Type Describes how the plan was defined in the patient s record and how the claim was submitted to payers as a Single Payer Primary Payer Secondary Payer Tertiary Payer etc Plan The name of the carri
56. JOHN SMITH ID 2583 Ticket No 1009833 PayerCOB e Respond to a DUR reject by entering Unlimited Notes DUR Service Required The Reject Error Code number of Drug Utiization Review DUR 3 l Professional Service given How you prescription di Cio dud notes Recommendation The result of your intervention Level of Effort Code indicating the level of M 4 Record 1 of 1 effort as determined by the complexity of Notes decision making or resources utilized by a Urosofplion Notes pharmacist to perform a professional service ies x a oo BE Co Agent ID Qualifier Identifies the type D C prescription on December 1 2012 and call physician on changing to Prevac of ID entere d in the Co A g ent fi el d T IE ime T F Done Co Agent Identifies the co existing agent contributing to the DUR event drug or disease conflicting with the prescribed drug or M 4 Notes 1 of 1 prompting pharmacist professional service A Because the prospective DUR system examines claims from all participating pharmacies drugs which interact or are affected by previously dispensed medications can be detected Prospective DUR recognizes that the pharmacist uses his education and professional judgment in all aspects of dispensing Prospective DUR is offered as an informational tool to aid the pharmacist in their professional duties The nine potential therapeutic problems that the prospective DUR system detects are as follows 1
57. PA CEO 3 250 nm DOCK Priest EE i502 112 DEES Prime mg RS 20 DCRI Primary mnan 2 116 60 2370 NESE Pray IPA OLSEN 3 a 7a 188 nena a s 151 376 TE i28 5628 000 parana T i oir ooo ean Mhi x i 000 TEE m o x aw m fi reor bl Fox ned Fours 1 mph be rather cade ci ron anth spo yo ien reu hann s fined hee ins Ui meant thatthe igeboeted dem H not coss py the balance carnal be cleared now e The above are details of each transaction posted to This will be displayed after the posting is complete Copyright AbacusRx Inc Page 57 of 100 Visual Pharmacu Plus Software User s Manual LAIM PAFMENTS ADVICE El al rider s Code ETRY hate 12 10 7017 Tire 08 10 Tree Pee eee ee 22S Pee Tee PAPA FINANCIAL IM ORWATION peni ptpn a in pal athe n ge y 1557 AE in lin k 69 25 aa HE A n ARA APURAR IAEA EbeckfEFT Huber CUSEINS Payer ID FRESCRIPTI PAYEE TDEMTI ICATICHI PERSCE LPT OO XCLUTICOASE 1515 MEDE Gye COSTA Mza CA 52h46 PAYEE IDENTIFICATION n 7 PHYSICIAN CHOICE Federal Tax ID MOT 0N FILE 4539 ORTH PINE JELAMD EA FT LAUDERDALE FL 33351 Line amp 1 PROVIDER SUMMARY g Reference ID 5704398 Facility Code 19 Date a j 11 2012 Claiw Count Z3E Total Charged Amount 11870 CLAIW Fir MET IAFCORMATE t labra irte Dre DOOS Z3 tatupgs Reve real Cha raed raunt 148 23 Heic H Aneumt 4 126 00 aigat Decpay 30 90 Tope ef c liie FRG Reference ID 1222 29497 09052520B CLAIM Ap Jiu Contractual o
58. PRESCRIBER To modify the drug or item click on the Prescriber field To create a prescriber enter the new prescribers name and press enter or click the find icon and click on New Es A T 8 Doctor File ALEGY ALLEN L LastName FirstName Mid NanfStreet Civ State Zip Phone b ALEGY ALLEN 13346 BAYSHORE BL Clear Water FL 34667 7153 General Doctor tt MEOO39687 Last Name ALEGY First Name ALLEN M f Street 113346 BAYSHORE BLVD 330 1 City Clear Water vw State FL xl Zip 34667 7153 Phone 913 343 8568 EXT FAX 727 899 8998 At Phone 727 83434 9 EXT Emi Cell Number f NPI SPI Specialty DEA License 441343724 UPIN D52394 amp Location State License WME00384987 Other ID Active Yes Notes List only active physicians Find New Delete Save Cancel Select A record of the Prescriber is kept to link the prescriber to the prescription and to send license information when billing electronic claims Throughout this manual and in the software prescribers are sometimes referred to as Doctors or Physicians Doctor this is an internal number assigned to the prescriber the number is setup in the Configuration Preferences Last Name the prescribers last name First Name the prescriber s first name MI the prescribers middle initial Street the prescriber s street address Mult
59. RK ALAGNA 30 111 41 30 CA Pad Witten No _ This is the prescription History screen you will see when you click on History or press F5 You can retrieve the prescription by double clicking on the highlighted item Void F3 Yet another way is from the Inquire screen search On the top of the screen select search by Rx number then enter the prescription number and click on Get Data When the prescription is retrieved click on Edit to place the prescription in the prescription screen so you can modify it X Please specify search criterion and then press Get Data Search by Patient Name vl for Any Status v from to Get Data AxNumber Rf Filed Description ty Das Toa Ath ts Al Ax Detail Patient Refills Remaining Units in Depp Doctor State License DEA Pay Plan e Click the text box of either Auth or Auth Amt to see claims detail o Main Edit Ax Image Rx Label Cancel Status Any prescription can be recalled by entering its Rx number If another Rx exists with the same number such as refills or the original you will be given a list of all the refills and asked to select the one you want to change You can also request to modify a group of prescriptions done at the same time for a given patient or you can request a list of the last 50 prescriptions done from which you can select The function of the icon buttons are as foll
60. Version 3 0 321 Your Pharmacy Name Goes Here Location Main T ajaj File Prescriptions Reports Tools Delivery Window 2 nds e EA A lo S Qz i A Patient Prescriber Iter lar Il Verify hy Payment Se a ms a History Pi New Refill Prescription SMITH JOHN 1D 2583 x 3X Picture of ZANTAC 150 MG EFFERDOSE TAB X j Patient Information Patent SMITHJIOHN LA 12345 sw 123 STREET MIAMI FL 33183 l Phone 305 555 2255 Prescriber ALAGNA MARK A a Hen ZANTAC 150 MG EFFERDOSE a Substitute Written 675 2012 gt B2012 ae o ao Refills 3 Quantity Remaining 60 Dispensed g 5 2012 Low Inventory Drug expired on 10 27 2010 Discard 06 05 2013 3 Sg jap A Days 30 0 DAW 0 No Product Selection Ax Expire ERG Lot put IAsirucirm TAKE ONE DAILY Plan CASH ce If you need to you may pre post date gt the prescription by overriding the Origin written Deliver Type 1 Delivery p p y 2 date OTC Service DME Scan Rx Other Ax Fields Clear All H Move down up eal Save len 0 em Number heti Refils Quantity 1 ER Sort by Date Entered Fill Orders From 5 29 2012 Tel 6 5 2012 B Fi Help F2 Plan F3 Del F4 Patient F5 History F amp ReFill F7 Sub F8 Mext Page F9 DME Fi 5ave F11 OTC RPH ABA Tech JD pS EEE OOO lt KEE Copyright O AbacusRx Inc Page 5 of 100 5 Click Save when done Alternately
61. Visual Pharmacu Plus Software User s Manual Visual Pharmacy Software PHARMACY SOFIWARE Users Manual Copyright 2013 Abacus Abacus Rx Inc 8000 S W 117 Avenue Penthouse G Miami Florida 33183 Phone 305 220 0400 www AbacusRx com Copyright AbacusRx Inc Page 1 of 100 Table of Contents TATE OCMC E r 5 ooo BT A o OO T mmm 5 a A Pe PR o uo e PU ata gotescuuneadnlonnccesetentsiuhaseseeceeanes 6 O N ea E ETIE EAEE EEE EASA E EEES AET A AE AE S 6 Ea a EEE O E o o EA EA A oa A 6 Introduction t Me mala Sree Masserie aranea AE EE aE EEEE EAEE Ea EA EEEE NERSE 2 Pe SCT OM e 0 cido a iau aciei Ove PS PE nn Mn PPM oa A 3 Drug to Drug Conflicts and Patient Monographs sartenes drid taria 6 Transman RACIAIS E E nO O e reo E 7 SERVICE BILLING PROFESSIONAL PHARMACY SERVICE oocccccccncnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnninininss 7 Reversal Submission and Processing ia A Iii 8 PREDETERMINATION OF BENEFITS INFORMATION c oooooococncnnnnnnnnnnnnnononnnonnnnnnnnnnnnnnonnonononnnnnn iiia nana 8 Extended prescription entry ECETIA aaa 10 vcio uto AMOO AO peinada 11 OTIO BUD asis orient 12 NOTES Drus Utilization Review DUR Fcio 14 Responding to a Drug Utilization Review DUR oooooonnnnnonnnonononononononononononnnnnnnnnnnnnnnnnnnn nono nn nn eene non n nn nnnnnn non nnnnnnnnnnnnnnnnnnnnnnnnnnnnnnananirennnss 1
62. able balance e Statement If not checked a statement will not be printed for the patient when statements are printed e Credit Limit A warning message will be displayed when a house account Account Receivable balance reaches or exceeds the credit limit Last Rx 1s the date of the last prescription e Last paid is the last amount received as payment e SSN The patient s social security number This identifier can be used to locate a patient on file or via Eligibility Check Credit Card Copyright AbacusRx Inc Page 25 of 100 Visual Pharmacy Plus Software User s Manual e Credit Card Number The patient credit card number used to bill use for reference e Expiration date The date the credit card will expire e Card Holder Name The name of the credit card holder Fel Patient File SMITH JOHN ID 2583 Only Active 1 of 1 patients LastName FirstName Middle Name P SMITH JOHN 12345 SW 123 STREE MIAMI FL Facility Fat GOLDEN AGE INC EY Room 390 Primary Physician Alternate Physician ALAGNA MARK DAWANI MANDANA Admitted B 25 2012 Refer By Place of Service DO Not specified e Patient Residence 3 Nursing Facility NEW To enter a new order select the type of order on the left then write a note in the box on the right EDIT To edit select the type of order then modify the notes S amp VE The order is automatically saved as vou exit the no
63. able used to calculate price for Brand Drugs sgg Ec Group Pricing Price Table defined in the Drug Price table used to calculate price for Generic Drugs ggg By What is the usual Dispensing Fee CN Discount what percent from the total price CNN Plan charges per claim a fee of mz Charge a tax percent of 00 based on pw Flat Tax lz Use patient s default co payment as Rx default No vr LE New Debts save _ corea Select WHAT IS A PRICING TABLE A Pricing Table establishes the formula used when calculating the Items price For example you may want to have two or more separate prices for the same Item drug depending on the Payment Plan Cash vs Insurance The pricing table can be assigned to a Payment Plan an Item or an Item Group LINKING A PRICE TABLE TO A PAYMENT PLAN For additional flexibility the Item price can be calculated using a formula specified in the Pricing Table The Pricing Table number links the payment plan with a Price Table you want to use when the Rx is filled The Price Table contains the pricing strategy formula to calculate the price A different Price Table can be used to calculate Brand drugs different than Generic drugs Note that if you do not enter a price table in the Payment plan then the system will refer to the Item Drug record for a Price table if the Item does not have a Price table number the price cannot be calculated 3 PRICING a Price table used t
64. and unrelated to any particular prescription Professional pharmacy services may include but are not limited to blood pressure monitoring taking a patient history for a new disease or diagnosis referring patients to other health care providers and counseling and education beyond the simple act of describing a medication s use and side effects Notes on DUR PPS Segment on a Service Billing Request The DUR PPS Segment is situational for a Service Billing request It is used when a sender notifies the receiver of information on the appropriate selection to process the Service Billing The DUR PPS information may be sent on the initial submission or alternatively sent after a DUR PPS rejection from a receiver The Segment is mandatory if required under provider payer contract or mandatory on Service Billing where this information is necessary for adjudication of the service REBILL INFORMATION A Rebill transaction is a prescription product or service billing or information submission with an implied reversal of the same Service Reference Number A previously captured or adjudicated claim or service or information reporting is Copyright AbacusRx Inc Page 7 of 100 reversed and then the new claim service or information reporting is processed using a two step procedure Each part of the process works independently of the other Up to four transactions must occur within one transmission ENCOUNTER Encounter transactions are used to report health ca
65. anged from RH to T on 3 572 mouse button 5048 3 5 2013 16 54 3 5 2013 ABA A Rx 5048 O was placed on HOLD by ABA ABA on 3 5 2013 at 16 54 50000058 3 4 2001312 26 3 4 2013 MZ MzZ Rx50000058 was transfered In from ADFDSF on 3 4 2013 at 12 24 by then clicking the 50000058 37472013 12 20 3 4 2013 MZ Mz Rx50000058 was transfered In from ABCDE PHARMACY on 3 4 2013 5042 3 4 2013 10 30 3 4 2013 ABAZA On Ax 5042 the payment plan was changed from C to ICM on 3 4 2013 Edit button 5052 3 4 2013 12 29 3 4 2003 ABA LB Rx5052 1 was placed on HOLD by ABA LB on 3 4 2013 at 12 29 5052 3 4 20312 28 3 4 2013 amp BA LB On Fix 5052 the dispense QTY was changed from 60 to 0 on 3 4 2013 5073 3 12 201315 22 3 12 2013 ABA A Rx 5073 was transfered In from BLANCA NIEVES PHARMA on 3 12 20 Y TT Open C Inactive Done Edit Close Y Reminders only A note is classified as a Reminder if A note can have a status of Open not it has a Reminder date A check completed or Done completed Notes box will display only notes with a can also be Active Pending or Inactive Reminder date closed The user can enter notes at a Prescription record level or at the Patient record level notes are entered on a screen similar to the one below Date Time Once you enter a patient Dr requested to O C all medications except for Maintenance meds 5 5 2012 NE as of July 1 2012 4 30 29 PM or prescr
66. are User s Manual CYCLE FILL The Cycle Fill function generally used by Institutional or closed Pharmacies allows for the automatic refilling of routine medications It has been estimated that approximately 64 70 of all refills in a long term care facility are routinely filled on a weekly monthly etc basis Rather than having the nursing staff continually calling the pharmacy to request these routine refills the system will automatically generate these fills on a regular basis Auto Refill generally used by Retail Pharmacies are Rx that at the time of the original fill are flagged as Auto Refill Thereby each week month etc you instruct the system to refill all Auto Refill prescriptions for a specific time period Billing transactions may be created for a specified date or labels only may be printed for a previous cycle The label date may be different than the billing date allowing for multiple labels to be generated for a particular cycle In addition there is also an option to continue to transmit and adjudicate claims until all claims have been processed Once processed the results of the transmission adjudicated rejected etc may be viewed or printed to aid in the review and correction process w Cycle Fill E r Refill all cycle fill prescriptions found with the following critenian te From refill due date 4 1 2013 to 423042013 Show refill Hs iE within days from due date
67. armacy Name Goes Here National Provider Identifie w 1922364824 Pharmacy Address 8000 Sw 117 Avenue PHG Medicare Provider Number Pharmacy City State Zip Miam FL wy 33183 Provider Accept Assignment Pharmacy Phone ME Passport Code Medicaid Provider Number Pharmacy FAX Numbrer Customer ID 1 Locations Information for this terminal Main This Location Main EDGAR TEST Transfer This Terminal fo RLANDO EM Right clicking this box you can add a logo that will be shown on Ax labels The size of the logo should fit this box Modules Save Cancel New Edit Select Iv Work with multiple inventory based on user sign on Copyright AbacusRx Inc Page 83 of 100 Visual Pharmacu Plus Software Then you will be presented with six screens with features that can be turned on or off The most important entries found on page are The Pharmacy NPI ACPDP number The Medicare Provider number Pharmacy location If you have a chain store module it will list all the stores in your chain User s Manual The above fields allow you to transmit claims to the insurance carriers The rest of the options are self explanatory V Preferences Communication m Global automatic numbers Patient numbers are automatic The next patient is 2587 The Next Physician Number 1 388 m Location specific automatic numbers iw Rx numbers are automatic The next Ax number is 1
68. ated THE ACCURACY OF THESE FORMS EACH MONTH OR CYCLE WILL BE DETERMINED BY THE COMMUNICATION BETWEEN NURSING UNITS AND YOUR PHARMACY ANY DISCHARGES ORDER DIRECTION CHANGES DISCONTINUED ORDERS ROOM CHANGES AND ADMISSIONS MUST BE RELAYED TO THE PHARMACY IN ORDER FOR YOUR FILES TO BE UPDATED DELIVERY SHEETS These can be of great value in documenting receipt of medication by the nursing home Depending on the requirements in you state this could be a tremendous factor during an audit of records by a inspecting agency In addition it can serve as a clincher in convincing families that Momma did get her medication after all The delivery sheets can be prepared on 2 or 3 part paper A signed copy should be returned to the pharmacy and one or two copies retained by the nursing home These copies should be filed permanently Delivery sheets can be printed at the time you filed the order or upon request via the reports menu STATEMENTS Should you desire statements for nursing home patients can be run at any time A separate statement for each patient whose medications are billed to the facility can be prepared if you so desired Since statements are fully descriptive listing date Rx number quantity name of drug and price this is attractive to nursing home administrators as it simplifies their accounting process UTILIZE THIS AS A SALES TOOL DELETING PATIENTS It is advisable to delay the deletion of nursing home patients as it is c
69. billed you will be allowed to enter an adjustment or write off up to the remaining balance on the amount billed m Reconciling Payment Enter below payments or adjustments to apply agains Ax Notice that most third party payers will cala Rc UL Leber generally pay claims below the amount billed Bx 123456 0 PAXIL 10 MG TABLET causing a pending balance due on the claim sited FELIS CoPayment S33 If a third party has paid the amount eise M ae z authorized the GIBT Dee will be e Md ie ds automatically put in the Write Off You 80 will be allowed to change Write Off amount Prev Payments 0 00 Bl at an time Other Insurance Paid 0 00 E M l wiribe DHE 0 00 Balance 364 05 Ok Cancel The above form will be displayed on every posting to allow you to further itemize the posting Most insurance payment will be for the amount Authorized and below the amount billed here you can specify a write off or the balance pending As you post payments to each claim the status will change to PD indicating that a payment was posted to the claim A claim with an open balance will appear on the next reconciliation posting if the claims date falls within the range or if show all claims is selected Copyright AbacusRx Inc Page 55 of 100 Electronic 835 Payment Posting The Electronic 835 Payment Posting is use to automatically post a payment to claims previously authorized for paymen
70. bligati ons Reason Code 9i Adjurtmert Amount 3 2 21 PATIENT a f The above is the original statement received and what was used to post the transactions You can get to this page by clickiing the Read Statement button 5 Your done The posting is now complete 6 In the event you need to reverse delete a posting At any time simply go to the Company Payment Posting screen show below then select Statement Posting PaymentiAdjustment From Company Patel iz hom 1 Potent amp Company Fill all offer fihi lhe pitas eter hip Huang Horme F acddy Al A A o Te Use ma o Opentredt Em Select Statement escrphon Fanen Thank vou Check Amount Auto llene Ho Heeene Audit trail of popmentz ported sf Posting Payment Adjustment From Company Famemiimhem Patent x Deep r7 Fill ali other fields ther quiza suntin ley Miring Horne F icity A Fieervnd Check hom Pon regis A aee JT Date TE Umb ux Dorion PamerbThankgou x Ceckimom J Auto heme ie Rees Payarerd Hunton Tuis rne TEES teen PAC O25 Hi TABLET 500 00 MiS n TAZALATIU SEITE REN EE Lum CARE TES ET 58 74 sensu Fageserz tt D EE META m Seno MADROLSO TABLET Ig 520 4 E TESTA iE 509 Sn El Select the Payment you want to remove TANI DD ze r7 Then click Void Payment Copyright AbacusRx Inc Page 58 of 100 Visual Pharmacy Plus Softw
71. ce these tasks are performed manually by the nursing staff and requires many hours of nursing time each month In addition preparation of these forms and the maintenance Copyright AbacusRx Inc Page 60 of 100 of each patient s medication records by you the pharmacist will result in more accurate chart records in the nursing facility further resulting in fewer pharmacy inspection deficiencies being found by investigating and licensure teams e You have the ability to print delivery sheets to accompany each day s orders by nursing station These delivery sheets can be signed by the receiving nurse and a copy can be retained for documentation of receipt of medication This procedure can be invaluable in proving delivery of medication for Medicaid patients or even private patients on occasion e You have the ability to produce one grand total statement for a nursing facility along with individual patient statements This feature is most desirable for submitting charges to the nursing facility which is responsible for paying a patient s drug account e You have the ability of handling a unit dose operation whether you are pre billing or post billing Multiple labels can be printed or none at all depending on your needs Accurate filling profile records can be printed each month 1f desired e You also have the ability to enter routine orders such as physical therapy nursing care laboratory etc into the patient s profile In addition yo
72. charge potentia GOOD FAIR POOR NONE certify this resident to require nursing care SKILLED INTERMEDIATE INTERMIDIATE ll HOURS OF ADMINISTRATION HOA If you are printing Physician Orders or Medication Administration Records MAR sheets and want the hours of administration to print you must enter them in the HOA field in the prescription entry screen You can define the usual Hours Of Administration for a Nursing Home in the Nursing Home record this default will be displayed in the HOA field of every new prescription You can also limit the times you want to appear in the HOA by specifying the time slots in the Sig file EXAMPLE OF HOA Problem A Nursing Home has the standard HOA of 8am 10am 2pm and 5pm A medication has been prescribed as BID twice a day Solution Enter the standard HOA in the Nursing Home record as the Default HOA Then enter the time slots in the BID slot 1 and 4 This will cause the default HOA for a BID Rx to be 8am and 5pm Copyright AbacusRx Inc Page 67 of 100 This 1S used to know Sig ID Directions in English what time slots to print BID TAKE ONE TABLET BY MOUTH TWICE A DAY on the Med Sheet Quantity Dose 1 Directions in Spanish TOMAR UNA TABLETA POR L4 BOCA DOS VECES AL DIA Doses Day 2 Directions in French Print on Med SheetTime Slot iw 1 2 Directions in Other Languages Find New Delete Save Cancel Select d 4 11 TIP You can also enter o
73. cility the Facility 1f payment is received from a facility or group this will result in reducing the Facilities balance 2 Received Check from Payer then Payment plan of the Insurance billed 3 Date the date the check was received 4 Description a short description of the transaction 5 Auto Itemize to automatically post the check received against as many open claims as possible starting with the first one found and continues until the payment amount has been entirely posted 6 Balance the current balance due 7 Open Credit the current amount on credit over payment 8 Check amount the amount of the check 9 a way to enter fees associated with the payment 10 Reference the check number Copyright AbacusRx Inc Page 53 of 100 Itemized payment entry Enter the date range of the prescriptions you are paying see the Carrier statement EOB for the date range needed to itemize post payment to open claims the computer will pay all Rx within the date specified that have not been completely paid until the payment amount entered is satisfied If entered a negative check amount all paid claims within the date range will be displayed this is used for returns or credits A single PBM Pharmacy Benefit Manager may pay for the claims of multiple insurance carriers on one EOB Explanation Of List all Plans paid on the check PC5 POS B fit H enetits Here you can Add a Pl _Add a Plan
74. coverage 2 To determine if the submitted product is covered 3 To identify the patient financial responsibility at that point in time and 4 To potentially identify clinically relevant information The Originator uses the Processor s response to communicate with the patient and determine if a subsequent prescription claim request is submitted The Originator recognizes that the Processor s response is based upon the following Submitted information in the Predetermination of Benefits inquiry 2 Processor plan parameters 3 Date of Service and 4 Patient s current prescription claim and financial profile at the processor The subsequent submission of the same Predetermination of Benefits Inquiry or a corresponding prescription claim request may result in a different response if any of the identified components i e Submitted Data Processor plan parameters Date of Service or Patient s current prescription and or financial profile change between the period of time between the submission of a Predetermination of Benefits inquiry transaction and the associated Prescription Claim request Conversely the Predetermination of Benefits transaction response is used by the Processor to communicate the following 1 To identify if the patient is eligible for prescription coverage 2 To identify if the submitted product is covered 3 To identify the patient financial responsibility at that point in time and 4 To potentially identify c
75. creen but will list all claims transmitted and replies you can also search by patients name Rx number or any field that will identify the claim you are looking for Nursing Home Med Sheets MAR This form is intended for Nursing Homes that require a Medication Administration Record MAR The MAR sheet can be printed for any period of time and list the medication indication and administration passing times Nursing Home Company List This report will list the Nursing Home patients in that home and the prescription drugs they are currently taking Nursing Home Rx Filled Delivery List This report will list the prescriptions to deliver to patients in a given Nursing Home sorted by the patients room number It can be used as a check list Nursing Home Statements This is generally used for billing nursing homes a statement of account is produce listing drugs filled as well as payments received Nursing Home Account Trial Balance This report is used to spot and manage overdue account It will give you at a glance account aging information as well as current balance due Physical Inventory Sheet This report is generally used to check your actual physical on hand inventory quantities and to make the appropriate adjustments in the computer inventory Refill Requirement Report This report is used to alert you of up coming inventory requirements based on future refills Inventory Received Report This report is used to list the inventory r
76. ctions may be restricted by the use of the security option Whenever a user is created the data is stored in the user file S Users Record NAME UserD Claudia eur in Bim o n John Doe JD Juan C Madiedo 3 Judy Lobo Profile of John Doe General Name JohnDoe Rx Label Initials jo Street 1455 5 Beach Avenue City MIAMI State FL Ze ss Phone 305 555 1212 Phone2 305 555 6555 Type General user y License 02 State License y 9398293 Email Doe2me com Copyright AbacusRx Inc Page 77 of 100 Users Record If security is enabled in the Preferences you can restrict the Users access to functions The User OY Patient will be allowed only in the functions Allow to Add Edit or Delete patient information CU Allow to delete patient scanned document 74 that are checked DI Prescriber Allow to Add Edit or Delete Prescriber information DR 2 04 Drug ltems Allow to Add Edit or Delete Drug Item information DI Allow to delete drug scanned document 75 DI Inventory Allow to change the On Hand quantity without audit DO Allow inventory entry IE Allow to Delete Inventory transactions lt 1 Allow to close the books on the inventory for the month D Y D T Security A 4 Password Password xxx Re type Password x
77. d from the drugs file the price quotation screen or from the Inquiry screen Payment Plan The Payment Plan record is used to store information about an Insurance carrier or other payment methods accepted at your store The Payment Plan describes how the Rx will be paid for example Insurance House Accounts Accounts Receivables Medicaid Medicare or Cash Payment Plan Record 1 of 1 payment plans PayPlan Description 0 0 0 0 ros PCS General EDI 835 EPR Name pcs Payment Plan Code foo BIN 200002 PENH Type Medicae Payer AAN e City De State y Zip Po Enrollment 1800 345 5413 Ext Cotwct Help Desk Status Active v Balance ties Open Credit FO Ed new Dette _ Seve _ caren Select 1 GENERAL a Description The name of the carrier or name to describe the payment method b Payment Plan Code a Short cut code to easily retrieve the carrier C BIN The Bank Identification Number of the carrier used when electronically billing to the carrier d PCN the Processor Control Number used when electronically billing to the carrier e Type This describes the Type of Payment plan as follows e Insurance e Medicare e Medicaid e Accounts Receivables house Account e Cash e Nutritional Medicare Copyright AbacusRx Inc Page 38 of 100 Payer the claim processor if paid by other than the carrier name
78. d or returned entered as a negative number Your Cost Package your actual cost based on the package size Supplier the distributor or manufacture the item was purchase from PO Invoice the sellers distributors invoice number or your reference Purchase Order number Date Received Returned the date the Item was received or returned Lot Number the items manufactures batch identifier lot number Drug Expires the date the drug expires Other Fees other fees that are additional to the cost of the Item delivery shipping etc Shelf Location the Shelf location code where the Item is physically stored in the Pharmacy Note If you are returning or making a correction enter a negative value for the quantity received If you enter the total cost of the package received return the system will automatically calculate the correct avg cost of your inventory and adjust your drug cost accordingly Use the Unit Quantity Adjustment field to adjust your inventory by less than the package size Copyright AbacusRx Inc Page 45 of 100 Visual Pharmacu Plus Software User s Manual CHECK DRUG E a a c3 vw _A Ma a a X Quality Control Medication Verification Type of Check Quality Assurance C Drug Drug Interaction Ax Information Pss Scan Rx number from the Rx label and NDC from the Ax Number 1251 22 Scan Enter NDC container for extra Patient JOHN SMITH DOB 6 12 1990 protection
79. d our extensive edit checks the claims are transmitted and a response is returned in seconds Frequently asked questions regarding Medicare DME part B 1 How does the DMERC define a physician letter when requested to demonstrate medical need A physician s letter must be from the prescribing physician on his her letterhead It describes the specific medical conditions of the patient and documents medical need for the item being prescribed It cannot be a form letter or typed by the supplier for the physician to sign The letter is expected to provide rationale for the items s ordered as well as quantities or frequencies provided to the patient 2 What is the useful lifetime for durable medical equipment and can a patient automatically get a new piece of equipment at the end of the useful lifetime period The useful lifetime for DME is five years A patient is not automatically eligible for a new piece of equipment at the end of the five year period 3 Can a supplier advertise that it provides durable medical equipment prosthetics orthotics and supplies DMEPOS at no cost to Medicare beneficiaries Under the Medicare program the beneficiary is responsible for any unmet deductible amount and applicable coinsurance In addition the supplier is responsible for collecting these amounts from the beneficiary for services rendered It would be misleading to indicate otherwise to Medicare beneficiaries either verbally or in any marketing or advert
80. der bb Accident Type The type of accident the insured person or card holder that led to this claim cc Date of Injury The date the injury occurred Copyright AbacusRx Inc Page 28 of 100 Visual Pharmacu Plus Software User s Manual Fel Patient File SMITH JOHN ID 2583 Only Active 1 of 1 patients LastName FistName Middle Name Dy SMITH fane diede Mane AE A e Representative HCFA Form Note umo Date Active Author AL Dr requested to D C all medications except for Maintenance meds X ABA JD as of July 1 2012 E Print Notes Write a New Note Save Note Audit Trail Join History I nly active Find New Delete Save Cancel Select NOTES Patient notes not electronically transmitted when billing You can enter an unlimited number of notes j Reminder date The note will be displayed in the To Do screen on the date of the reminder and will not go away until it is placed as inactive or done a Note A text description of the issue to be reminded or just as a log b Date Time The date and time the note was entered c Reminder Date The date to remind the user of this Note To be displayed in the Reminder screen d Alert If you want to show the note every time an Rx for the patient is created e Done If checked the tasked is said to be satisfied and will not display in the Reminder active screen f Active If checked the Note or
81. different Response Completed Software if checked will located and display any program update later than your current software version Optional Modules When you order optional modules from Abacus you will receive them electronically if checked you will see a list of modules ordered that can be selected to enhance your software Weekly if checked will locate all drug updates after the last drug update downloaded Full If checked will locate all full data updates available after the last full update downloaded Change drugs NDC if different if checked will update the drugs NDC number if the NDC number changes Adjust retail to AWP change if checked will change the Retail price of the drug by the same percent the AWP was changed TABLES To give the Pharmacy software flexibility by offering selection list we have created a section of tables you can define and maintain on the following fields Compounds this table maintains information on compounds created City These are all the cities in the US it is used when you type a zip code to display the City State these are all the States in the US it is used to display when you type a zip code Patient category you can define categories to group patient for reports or selection Rx category you can define categories to group rx for report or selection Diagnosys general diagnosis on the patient CPT HCPCS Medicare DME CPT codes HCPCS
82. e 72 06 Solution AWP 56 00 20 67 20 Mark up fee of 5 70 56 Dispensing fee of 1 50 72 06 Example 2 The price can be marked up or down from the above base by a percent factor entered in the MarkUp Dn price by field To mark up enter a positive percent or a negative percent to mark down Example If you want the price automatically calculated based on the AWP less 12 select AWP in the Calculate price based on field then enter 12 in the MarkUp Dn Price by field Assuming the AWP is 23 54 for 30 tablets and we are dispensing 30 tables the calculation will be done as follows Price Awp Awp 12 the package size the number of units dispensed 20 71 23 54 23 54 0 12 1 Another example would be a quantity breakpoints instead of price the price would be calculated based on the quantity you dispense Pricing Table record Whenever a price table is created the data 1s stored in the price table file Once stored the price table can be retrieved by the price table number Price table data can be modified directly in the price table file screen A price table determines how the prescription price is calculated The price table works in conjunction with the Payment Plan Once a Payment Plan is selected while entering an Rx the price of the Rx can be calculated using the Payment Plans price table DEFINITION Description A description of the price table logarithm you are creating this is for you
83. e Rx Remaining quantity based on the authorized refills are automatically The Sig code calculated and maintained by the system used for the Item will be remembered the next time Quantity Quant x the dime js ten 30 iens 30 Refills 2o Quantity Remaining 60 selected if Low Inventore Drug expired on 10 21 2010 you choose OD Days 30 0 Warning messages about the item selected DAM 10 No Product Selection Days Supply can be IBStuchan TAKE ONE DAILY automatically You can calculated based on the click on the Sig see Days word Sig to edit calculation An additional message in the same or in another language with Unicode characters can be added by clicking here The Sig instructions as defined in the Sig file will be displayed based on the Patients Language and can be changed or concatenated with other Sig codes i e QD PRN Sig or Signa codes are used as a short hand to keying long Rx directions Directions are stored on file and later retrieved by the Sig code For example Take one tablet daily will be displayed in the patients language when the Sig code QD is entered For unique directions you can omit the Sig code and just enter the directions or you can concatenate Sig codes to combine two or more directions and form a sentence To concatenate Sig codes enter the Sig codes in the Sig line prefixed by a space and a
84. e of amount Cognitive services Drug benefit Coupon and the actual amount adjudicated b Benefit Stage The amount of claim allocated to the Medicare stage Government Programs The previous payer s financial amounts that apply to Medicare Part D beneficiary benefit stages This field is required when the plan is a participant in a Medicare Part D program that requires reporting of benefit stage specific financial amounts a Reject code If the claim was rejected a code indicating the type of rejection Coordination of Benefits COB The software will coordinate benefits with other payers when a member is covered by two or more group health benefit plans Coordination of Benefits COB is the industry standard practice used to share the cost of care between two or more carriers when a member is covered by more than one health benefit plan It is a contractual provision of a majority of health benefit contracts The software complies with federal and state regulations for COB and follows COB guidelines published by the National Association of Insurance Commissioners NAIC Identifying Primary and Secondary Liability The most common rules for determining the order of payment are the Non dependent Dependent Rule Active Inactive Rule and Birthday Rule Non dependent Dependent Rule The first rule governing the order of benefit determination is that the plan covers the individual as an employee member or subscriber before plan bene
85. e that of the patient or the person picking up the prescription as required by the governing body Copyright AbacusRx Inc Page 20 of 100 Visual Pharmacu Plus Software User s Manual DOCUMENTS Here you can scan documents relating to the prescription like CMN Certificate of Medical Necessity and or any other document Y Prescription next page of JOHN SMITH ID 2583 Ticket No 1009819 Override Prior Authorization Notes DUR Coupon Other Charges Worker s Compensation Payer COB Oe New Scan Re Scan mport Bemove Show Larger Picture Modifying a Prescription There are several ways to retrieve a prescription that has been saved to make a correction you can retrieve it from the prescription screen or from the inquire screen search Eo Pharmacy Plus Version 3 0 321 Your Pharmacy Name Goes Here Location Main Terminal ORLANDO Ea fx File Prescriptions Reports Tools Delivery Window Help TIR amp amp ce Y gt QUAN x Rx Patient Prescrber Item Plan Sign On SeXch Report Delivery Payment Resources Reminder Queue Clai New Refill Prescription E Rx Orders EE Patient dL Prescribe Y Pending Filed OnHold Refresh Priority Madin esc pt IVA Fas To retrieve a Prescription by Rx FUR BEZH zl number you can double click the Rx M 4 Number field name and the Rx u number box will open to allow you to To retrieve a Rx by enter the Rx number yo
86. e typing and speed the prescription fill process A Sig code convention has been devised that is easy to remember and a breeze to use It is more comprehensive and can accommodate more variations of Sig instructions than the Latin Sig The Individual Sig codes are used in combination to form the entire Sig sentence You may also use a combination of codes and additional typed text concatenate as will be explained later S SIG File 1 2q12h French ss Dose ty Dose Day 1 1 2qdPRN TOMAR MEDIA TABLE TAKE 1 2 TABLET BY 1 2TE4012H TOMAR MEDIA CUCHZ TAKE 1 2 TEASPOONF 1 2TInAP ITAMAR MFNIA TARI FITAKF 1 2 TARI FT RY Sig ID Directions in English 17281 2h ps 1 2 TABLET BY MOUTH EVERY 12 HOURS Quantity Dose fi Directions in Spanish TOMAR MEDIA TABLETA CADA 12 HORAS Doses Day Directions in French Print on Med SheetT ime Slot iw 1 Directions in Other Languages 2 3 4 Find New Delete Save Cancel Select Copyright O AbacusRx Inc Page 47 of 100 The Sig file contains the instructions on how to administer the medication You may define the Sig in multiple languages the language used will be determined by the language specified in the Patients record a Sig ID this is a unique code you define to easily search for the instruction already on file Once found the correct instruction for the patient s language will be retrieved b Quantity Dose this is quantity per dose
87. easons DATE OF REJECTED FOR WRONG PATIENT RX NUMBER LAST FILL EARLY REFILL NUMBER If the above procedure is followed the review of each patient s drug regimen will be performed on a daily basis and FORWARDED PHYSICIAN S ORDERS can be signed by you as they are printed out This procedure would allow you to spend more time during your regular visit to the facility on studying lab data and diet information on patients and conducting a more thorough inspection of the drug rooms etc CYCLE FILLING Is an optional software that works in conjunction with the pharmacy software to reduce the time it normally takes to refill re occurring prescriptions By displaying and allowing you to select which Rx you want to refill or copy for a given nursing facility It prints a validation report automatically transmits the orders and prints Rx labels and delivery sheets PRESCRIPTION RECORD Medication orders for nursing home patients are entered exactly like orders for outpatients There are however a few things to keep in mind e You must make entries in the HOA Hours of Administration field of the Rx record in the Rx entry screen if you wish to print the hours of administration on your MAR s Copyright AbacusRx Inc Page 63 of 100 e Pay close attention to the Last date on refills Medications are routinely re ordered at times when another full container is in the med room e Keepin mind that sigs on MAR s will normally
88. eceived the date quantities your cost and item information You can also request this report is summary form by month Drug Report This report list your entire drug inventory and can be limited to print only the drugs you carry or have dispensed Patient Report Copyright AbacusRx Inc Page 82 of 100 This report list all patients you have on file and can be limited by the patients category payment plan or a zip code range Patient Labels This report will allow you to print labels for a group of patients Doctor Report This report list all doctors you have on file and can be limited by a zip code range Signa File This report will list all the Signs and indications on your life Payplan Pricing Strategy This report will list all the insurance companies currently in your system and optionally your pricing strategy Interfaces There are many things you can interface with for example IVR Interactive Voice Response Automated Drug Dispenser Rx Scanner Document scanner Signature capture Barcode scanner ePrescription Internet Configuration preferences The configuration preference screen is used to tailor the software at each workstation to your needs There are several features that can be turned on or off at your discretion V Preferences fom O Dear Business IDs General Info Federal ID Pharmacy Service Type 1 Community Retail Pharmacy Ser Terminall ID PCN 0 Pharmacy Name Your Ph
89. ed you will be notified in a similar fashion as the above screen It will display the reason why the interaction was caused along with research references The above check can be done on request or automatically when you save the prescription To have the system automatically check for interactions on save turn on this option within the Configuration Preferences Note In order for conflict to be detected or patient leaflets to be printed a monograph number must exist on the Drug file Copyright AbacusRx Inc Page 6 of 100 Visual Pharmacu Plus Software User s Manual Transmitting Rx Claims You can electronically transmit and have a prescription claim adjudicated by any national insurance carrier over the Internet The entire process of transmitting the claim and receiving a response takes seconds A payable response from a processor indicates that the claim will be paid by the processor and contains the amount authorized and the authorization number and co payment the amount you should collect from the patient among other fields If the claim is rejected you will receive a message indicating the reason for the rejection and any action the needs to be taken Claires far AGLI FRA MASSIF Cisim srsula double click the item of in amp ensi do se deiak aghi click bo reverse a pagable claim Pit Suh Y 40 00 REJECTED Diane Edil Ax Ew Camal Hes vert and recaer 7 Tabe Fomated Test Each claim submission request may
90. ed to reorder c Maximum Inventory Level is the maximum inventory you want to maintain of this item This field is used to establish the reorder amount Maximum Inventory Level Quantity on Hand d Drug Expires This is the expiration of the drug The system can maintain and manage unlimited expiration dates for the same drug along with the quantity of that expiration date However in order to benefit from this function you must dispense the items in expiration date order e Lot Number This is the lot number of the drug The system can maintain and manage unlimited lot numbers for the same drug along with the quantity of that lot number However in order to benefit from this function you must dispense the items in expiration date order f Days Expires After Mixing If a number is entered the expiration date will be determine when the prescription is filled g Supplier This is your main drug Distributor Supplier or Manufacture for this item You can set the default Supplier in the Configuration Preferences h Order code This is the Suppliers internal order code used to order the item i Qty on Order The number of units ordered from the Distributor via Purchase Order j Last Sold This is the date the item was last sold k Period to date Sold This is the quantity sold since the Period to date Sold counters where last initialized a ced Q ne n aj ame rrie c atu y U Vv Du c m Shelf Location This is the inv
91. edicaid etc being billed Status the billing disposition of the prescription Below is a list of valid billing status a PD If the prescription has a Cash payment plan or if the payment has been received for the Rx the status will be set as PD for Paid b P If the prescription has been billed to the insurance and a payable response is received c B If the prescription was billed and no response was received or was billed by report d N If the prescription is not covered by the insurance e X If the prescription is set to be reversed Reverse is used to undo a Rx that was billed and a payable response was received Once the reverse is accepted by the insurance the status will be automatically set to blank f Blank if the prescription has not been billed or is ready to be billed Origin Describes how the prescription was received as follows a Written You receive the original hard copy prescription b Telephone You received the prescription by verbally over the phone c Electronic The prescription was transmitted by the prescriber electronically d Facsimile You received the prescription by fax Image If a Prescription image has been scanned on file Disposition the status of the Rx with regards to its whereabouts a Will Call in the Bin ready for pickup b On Route picked up by the driver now on a delivery route to the patient c Rejected Insurance rejected the claim d Incomplete no
92. elect all the prescription on the list b Clear this will un select all the prescriptions checked c Edit this will allow you to change prescription information on the highlighted prescription d Add New this will allow you to add a new prescription to the list by allowing you to create a prescription without leaving this screen e Print list this will allow you to print the list of prescriptions extracted f Refill Auth Req will allow you to print fax or email a Refill Authorization Request to the Prescriber g Refill this wll refill the selected prescriptions if they are refillable h Transmit this will allow you to transmit all the selected prescriptions to the appropriate carriers i Print this will print a prescription label for all Rx selected and can also print the Invoice or Delivery sheet for all selected Rx based on the form selected in preferences j Exit will leave this screen back to the prescription entry Facility Management Nursing Home module THE ABACUS NURSING HOME MODULE IS CAPABLE OF PERFORMING MANY FUNCTIONS PERTINENT TO NURSING HOME APPLICATIONS For instance you have the ability to produce a forwarded physician s orders medication administration records and other reports on a monthly basis for each nursing facility served These applications alone can cost justify your investment in Nursing Home Module as most nursing facility administrators are willing to pay for this service sin
93. entory location where the item can be found This is printed on the Rx label n History This button will display a detail transaction list of items received o Summary This is a summary of the quantity cost of inventory and retail value by month Copyright AbacusRx Inc Page 36 of 100 Visual Pharmacu Plus Software User s Manual i Drug Records 1 of 1 drugs General Pricing Inventory Manufacturer Counseling Documents Manufacturer GL Ax PHARM Category Class Route of Administration Case Size Strength Potency Unit Code Product Code Obsolete Product Description Location Display only active drugs Find New Delete Save Cancel MANUFACTURE a Manufacture The laboratory that makes the item Useful for returning the item b Category a internal category of the drug for future use c Class an internal classification of the drug for future use d Route of Administration The route of administration is defined as the path by which a drug or other substance enters the body e Case Size How the Item is normally sold by the distributors used to purchase f Strength The drugs strength as a separate field used to locate drug by strength 1 e Paxil 20mg g Potency Unit Code A code used by SureScripts The NCIt Codes are unique strings that begin with a C and are followed by a series of digits assigned by SureScripts See http evs nci nih gov fto1 NCPDP Abo
94. er name and Password are not entered in three attempts the user cannot enter the software If you are using the system for the first time select Abacus as the user and the password password Copyright AbacusRx Inc Page 6 of 100 Visual Pharmacu Plus Software User s Manual Introduction to the main screen mM This part of Prescriptions Ta ne ae en t the screen e gt i7 gt are filled on 3 is THE auk TS list the this part of r3 Jal x functions the form E zin available Cd Tee dE acdProre Notes Ro Nubes Desprer PekupTge Cal Date PeiupDwe Pichap Tine This part of the screen is As prescriptions the queue It displays Rx are entered for the received via Order Entry same patient they Ten sa EG eScripts VR or Fax In are placed here to z addition you can also review request to display prescription not refilled Rejected pending physician approval etc No second mas oun according ho the cater pected nom lay eno s rR The above screen is the initial screen you will see after the sign on screen here you have access to all the functions available in the software The screen is divided in to four sections 1 The top section has a menu and icons to invoke functions 2 The middle left is the Rx form where the Rx is entered or displayed 3 On the right are the Rx queues 4 On the bot
95. er the claims is submitted to Date billed the date the claim was billed to the Payer Status the claims billing status Unbilled Billed Payable Reversed etc Auth Amt The amount authorized promised by the carrier to pay for the Rx claim Authorized a number issued and received from the carrier as a result of authorizing the claim use this number when talking with the carrier regarding the claim T Submission Clarification Code this code is used to override a claim denial by the carrier Some of the reasons are a Vacation supply Lost prescription Therapy change etc 8 Other Coverage Code OCC Identifies if there is other coverage for the claim submitted 9 CoPay The amount identified by the Payer as the Patient s responsibility E a d d us Payment received from other payer field definition 1 Type This indicates whether the payer is the Primary secondary or tertiary i Qualifier 9 Payer ID The Payer ID is composed of two parts the Qualifier which describes the type of payer ID used usually 03 the code for Bin Number and the ID that identifies the Payer Usually the payer ID is the NCPDP BIN number of the Carrier that adjudicated the claim 4 Date The date the payer paid or rejected the claim 5 ICN Medicaid subrogation Internal Control Number A unique claim identification number a Amount The amount is composed of two parts the Qualifier which describes the typ
96. ethods such as discounts or rebates d SWP Suggested Wholesale Price SWP The SWP represents the manufacturer s suggested price for drug products sold by wholesalers to their customers e Direct represents the price reported by a manufacturer at which non wholesalers who may re sell directly or indirectly to retailers purchase drugs from that manufacturer f FUL CMS has developed a list of multiple source drug products with upper price limits for each specific strength and dosage form in its Medicaid Manual The manual establishes ceiling prices for each set of therapeutically equivalent drug products according to the formula in the Medicaid final regulation published July 31 1987 by CMS s parent organization the Department of Health and Human Services HHS The rule s aggregate reimbursement ceiling is set at 150 of the lowest published price for therapeutically equivalent multiple source drug products CMS periodically updates the list of covered drug products g Retail This is your competitive price you establish this price based on your area This price is mostly used to bill Cash or A R prescriptions claims h Your Cost This is the amount you paid for the item This amount can be the cost last entered or the average cost as set up in the Configuration preferences 1 Price Schedule This is the pricing table that will be used to calculate the price of the Rx if no pricing table was entered in the Payment Plan
97. f this is a partial Fill Dispensing status Quantity intended to be dispensed Days supply intended to be dispensed If the NDC number changed Driginally prescribed NDC Originally prescribed quantity Alternate ID OTHER Some carriers require that you document a partial fill a NDC number change or enter any other Rx number used for the prescription in question a Associated Rx number any other Rx number that may be associated with the Rx you are filling For example the Rx number of the original Pharmacy on a transferred prescription or reassigned b Associated date the date the associated Rx was filled c Dispensing status When doing a partial fill some carriers require that you document the partial fill and again when you complete the partial fill In this field you will enter the type partial or complete d Quantity intended to be dispensed this is the total quantity that would have been dispensed if a partial was not done e Days supply intended to be dispensed this is the number of days supply that was originally scheduled to be dispensed before the partial fill f Originally prescribed NDC If the NDC was change from the one originally filled document the original NDC here g Originally prescribed quantity If the NDC was change from the one originally filled The quantity originally prescribed h Alternate ID Person identifier to be used for controlled product reporting Identifier may b
98. fessional fee taxes etc 01 Delivery Cost Note Entering an amount will not guarantee payment U2 Shipping Cost E D3 Postage Cost 1t would be up to the processor 4 U4 4dministrative Cost E Inicentive E Lagnitive Service lr Drug Benefit M9 Compound Prepara Note RelayHealth offers an option via the eVoucherRx Express program For select products eVoucherRx automatically applies paperless electronic coupons supplied by some drug manufacturers towards a patient s out of pocket costs on qualified claims with commercial insurance coverage This savings message is viewable on your Claim Communication Status screen There is a monetary rebate posted against your monthly maintenance fees for each eVoucher you process Relay Health is the administrator of the co pay discounts WORKERS COMPENSATION This form will allow you to collect the information required for a claimant to obtain medication for a work related injury or illness zi Prescription next page of JOHN SMITH 1D 2583 Ticket Na 1009947 Payer COB Oweride Prior Authorization Motes DLIR CouponOther Charges Workers Compensation Employer Carrier Insurance HUMANA HEALTH INSURANCE Employer ABALUS 4 Street 1234 INSLIRANCE DR Street a000 Sw 117 AVE City TAMPA State FL Zip 34302 City MIAMI state FL Zip 33183 Phone 841 555 1545 Contact MARY DOE Carrier ID Il Payee Date of Injury 04 03 2012 zl ID 01 NPI 2938293833
99. fits in which the individual is considered a dependent Active Inactive Rule A policy which covers an individual as an active employee is the primary payer over the policy covering the individual as a retired or laid off employee This rule also applies to dependents covered under two policies Copyright AbacusRx Inc Page 19 of 100 Birthday Rule This is a method used to determine when a plan is primary or secondary for a dependent child when covered by both parents benefit plan The parent whose birthday month and day only falls first in a calendar year is the parent with the primary coverage for the dependent If both parents have the same birthday then the plan that has been in effect the longest pays as primary Magellan follows this birthday rule unless a contract specifically requires otherwise For more information on NAIC rules visit the NAIC web site at http www N AIC org When Medicaid is a payer it is always the payer of last resort Similar rules apply to Medicare subscribers For more information on COB with Medicaid and or Medicare subscribers please refer to the CMS Web site at http www cms hhs gov medicare Y Prescription next page of MASSIEL AGUILERA ID 1309 Ticket No 1002265 D verride Prior Authorization Notes DUR Coupon Other Charges Payer COB Documents Worker s Compensation Documents If Rx number changed Associated Rx number Associated Rx date I
100. g Record Description 1 Manf Form PkaSize Type Class OnHand gt ZANTAC 150MG EFFERDOSE TAB GLAXO PHAR 60 B F 3 General Pricing Inventory Manufacturer Counseling Location Miami Only display active drugs Find New Delete Save Cancel Select wP Histor AWP Q Last wP AMWPFile 3 174 11 10 2005 FTP MAC o 184819 11 10 2008 FTP FPPUL Retail Y our Cost Price Schedule Taxable Note a AWP the Average Wholesale Price this price is used by insurance carriers as a base for paying claims but usually paying below the AWP AWP are electronically updated see Updates b MAC Maximum Allowable Cost MAC States have the flexibility to establish their own payment ceilings for multiple source drugs so long as they do not exceed the federal payment ceiling for Federal Upper Limit FUL drugs Slightly over half the states have taken advantage of this cost containment tool which would enable them to limit their liability with regard to drug pricing c WAC Wholesaler Acquisition Cost WAC the cost reported by a manufacturer at which wholesalers purchase drug products from that manufacturer The WAC does not necessarily represent the actual sales price in any single transaction as any manufacturer may agree to sell its products to one or more wholesalers at a lower price with that wholesaler through the inclusion of any number of m
101. homard Detail D Company ABACUS RX INC NPI Street 8000 S W 117 Avenue PH G City Miami State FL Zip 33183 Phone 305 220 0400 Est Contact Alt Phone 305 996 9066 Email cS abacusrx com Fax 305 220 4900 Category Sw Active Yes Notes A OF SOFTWARE FOR THE PHARMACY Record 1 of 17 Find New Delete Save Cancel Copyright AbacusRx Inc Page 79 of 100 Keports Hundreds of different report variations can be produced for viewing on the screen or printing using the report function Each report can be customized to your particular specifications by using the report selection screen Ld Report Version 1 0 87 Jes File Window Select a type of report amp Report Sample Prescription v Select a report Controlled Drug Report Patient Rix History Rpte 101 Page 1 POS Reconciliation Report Billing Verification Report 6 9 2006 D aily Prescription Log Report 4 15 24 PM Sales Profit Analysis Med Part D Billing Analysis Sorted by Date Filled from 6 9 2005 to 6 9 2006 OnHold No at location Miami Sales by Payment Plan aoe 2 de P Paid or Prescription Report HEEL AeKa Gates Bill 3147 0 1 AXID ceu AARDEMA 439 m m 000 EU ABAMBA PAI N Ax Transferred Notes AUSTIN T t Payments Recieved Report f Gas Bll 3149 0 2 D A CHBAABLE m AARDEMA 16 05 sum 16 05 DIR 1251 ABABA A New Refill Register Report SET inis Medicaid DER Request Insu
102. hone Date 4 2422013 x Description Payment Thank you v Auto ltemize No Audit trail of transactions posted Sn ite filo Desertion Amount Reference 12345 To post a payment Enter the patients name Last First then press enter Proceed to enter the following 1 Date the Date the check was received 2 Description a short free form description of the transaction Next Patient Statement Save Cancel PRE Optionally you may scan the checks received for future reference 3 Itemize select Yes if you want to automatically post the payment against prescriptions entered If this is set to No you must tell the system to which claims should the payment be applied to 4 Amount the amount of the payment or credit 5 Reference check number or reference number Note You can also make negative adjustments by entering a negative amount i e 50 00 The payment history can remain indefinitely and may be viewed at anytime A R Bill to location and Co Payments You can bill invoices and statements to the patient in a Facility or to a Guardian You can specify this option by the Bill A R to field in the Patient Billing tab Copyright AbacusRx Inc Page 52 of 100 Billing Address Bill A A To Facility Name AROCHA HOME street 3810 NW 24D TERRACE City Mim e State FL m Zip Code 33126 Shipping Address ship To AROCHA HOME Ro
103. iles like Physicians Items Sigs and Insurance carriers etc this will save you time by not having to create them Mouse You may use your mouse as with any windows application to move from field to field and to perform various task Simply click on the desired field or option ALT keys Anytime a letter is underlined in a word it denotes that the Alternate key plus the underlined letter will access the function Function Keys Several function keys have been created to quickly perform common tasks Function keys F keys are located at the top of the keyboard Quick Start The following will quickly guide you through entering a prescription and printing an Rx label Logging in Visual Pharmacy Plus Security Primary The person responsible for the prescription filled on this Pharmacist Login computer Pharmacist and determines Location Secondary The person who fills prescriptions under the guidance of a pharmacist Administrators and pharmacists can also login as a secondary User Login Password Save password Primary Abacus E yl Technician Login secondary John Doe pes Bath primary and secondary login required Login Cancel The above sign on screen will be displayed if you have elected sign on security in the Configuration Preferences The Sign On screen allows users to log onto the system using their personalized system profile Each user has a unique user name and password If the proper Us
104. iple prescriber s addresses are supported Alternate Address Multiple prescriber s addresses are supported City the prescriber s city name State the prescribers state abbreviation Zip the prescribers zip code Phone the prescribers phone number Ext the prescriber s extension number Alt Phone an alternate phone number for the prescriber Email the prescribers electronic mail address Cell number the prescriber s cell phone number NPI the prescribers national identifier used by carriers to identify prescribers Electronic claims cannot be billed without the prescribers NPI number 16 SPI this is the prescriber ID that links with a SureScript electronic Rx 17 Specialty This is the prescriber s specialty Only used as information 18 DEA License If the prescriber writes prescriptions for control substance the insurance carrier will require their DEA License number 19 UPIN This identifier was mainly used to bill Medicare claims being phased out 20 Refill Auth Pref the prescriber s preference to receiving a refill request 21 Location if the prescriber has multiple locations this field describes the location 22 State License identifier issued by the state being phased out 23 Other ID a free form identifier used in states or countries that require a special identifier 24 Active indicates if the prescriber can be selected to fill a prescription 25 List only
105. iption based on the AWP Average Wholesale Price and we also set breakpoints based on the price calculated the calculated price is compared to the Breakpoint when the price is within the range the price will be further marked up or down based on the formula entered on the same line as follows 1 If the price calculated is below 0 01 no additional mark up or dispensing fee will be added and the total price will be 0 00 2 If the price calculated is between 00 01 and 10 00 then a dispensing fee of 6 25 will be added to the total price 3 Otherwise if the price calculated is between 10 01 and 30 00 then a dispensing fee of 5 75 will be added to the total price 4 Otherwise if the price calculated is between 30 01 and 100 00 then the total price will be marked up by 965 plus a dispensing fee of 1 50 5 Otherwise if the price calculated is between 100 01 and 250 00 then markup the total price by 962 6 Otherwise if the price calculated 1s between 250 01 and 500 00 then the calculated price will be discarded and a new price will be calculated based on pricing table 10 7 Otherwise if the price calculated 1s between 500 01 and 9 999 99 then the calculated price will be the final price and nothing else will be added Copyright AbacusRx Inc Page 42 of 100 For example a drug with an AWP price of 56 00 for a package of 30 tables when 30 tables are dispensed using the above table the calculated price will b
106. iption note with a reminder date you can go at any time to the Reminder screen to display the reminders for a given range Print Mates Write a Mew Mote Save Mote Audit Trail SCANNING A PRESCRIPTION IMAGE A prescription image can be scanned and stored to display at a later date The system supports multiple page prescriptions front and back prescriptions full page prescriptions and color prescriptions Future refills of the same prescription will have a reference to the original scan image Hard copy prescriptions can be scanned upon Prescription Entry screen the Order Entry Copyright AbacusRx Inc Page 75 of 100 Visual Pharmacu Plus Software User s Manual screen or from the Patients history To scan the prescription from the Prescription Entry screen either click the Scan Rx button at the bottom of the screen or double click the prescription image if displayed dnd ACCOUN The green check mark indicates that you will be asked to scan a prescription every time you save a new prescription You can also m request to scan a prescription by SEAE NERE clicking on Scan a prescription wW avec yee aw QUEUE AULAS LADY If a prescription has already been scanned you can either follow the above instruction on scanning or you can double click the prescription Re image to rescan Ea 2019 30 digo cada Fa Feat Anus Acres auia Fau ir esse Isa Cone Soe 2 AD aS
107. is function will update your entire inventory items with the current contract prices cost of the medications from your current distributors You will receive a file from your distributor containing your contract price by FTP internet CD or other media The file is loaded into your inventory by this function This can be done on a daily weekly or monthly schedule as you see fit Copyright AbacusRx Inc Page 88 of 100 Visual Pharmacu Plus Software User s Manual m Drug Cost Update Version 2 0 11 aur Suppliers can provide you with a file af pour contracted cost or you can download it fram the Supplier Ftp site This will update the item File to give you a cost comparable by supplier Get cost update for all Suppliers Supplier File Farmat File Name Browse Recycle Bin The system keep track the information you delete from the file and is design to restore prescriptions or patients that have been voided deleted To access this function click on the Tool menu then click on Restore from Recycle Bin and select what to restore Patient Prescriber Prescription or Drug eg Recycle Bin of all voided prescriptions r Select one and then click a Button E PATIENT INV NBR CUSTID Rx NO REFNO Remove Copyright AbacusRx Inc Page 89 of 100 Appendix A Glossary The Drug Utilization Review DUR Rejections are part of the manage care program These codes where designed t
108. ising material 4 What is a break in service A break in service is a temporary interruption in the use billing of equipment The medical need for the item continues however a new benefit period does not begin 5 How is claim jurisdiction determined Jurisdiction is determined by the state where the beneficiary permanently resides 6 Who should I contact for HCPCS coding questions Please contact the Statistical Analysis Durable Medical Equipment Regional Carrier SADMERC for HCPCS coding questions at 877 735 1326 7 Do I have to have an Assignment of Benefits AOB for each item billed to Medicare Yes an AOB must be obtained for each item billed to Medicare Copyright AbacusRx Inc Page 72 of 100 8 What information can be accessed through Claim Status Inquiry You can access the amounts of the last three payments the dates of the payments and the number of checks for each payment 9 What if a patient does not want a claim filed to Medicare If there is an order you must file a claim on behalf of the beneficiary under the Mandatory Submission of Claims Act 10 Can a supplier opt not to accept assignment on drugs No Section 114 of the Benefits Improvement and Protection Act BIPA of 2000 states that payment for any drug covered under Part B of Medicare may be made only on an assignment related basis 11 Are suppliers allowed to charge a beneficiary for completing or filing a claim on the beneficiary s behalf Supp
109. issue is still open and valid g Author The user that created the note Fel Patient File SMITH JOHN ID 258 3 Only Active LastName FirstName Middle Name D gt SMITH fiai Hide Mans e STTZSSTREE Me REA f General Insurance Tiling Representative HCFA Fom Notes Documents New Scan Re Scan Import Remove Show Larger Picture Join History La Only active Find New Delete Save Cancel Select Copyright AbacusRx Inc Page 29 of 100 Visual Pharmacy Plus Software User s Manual DOCUMENTS Here you can scan documents that pertinent to the patients like Certificates of Medical Necessity CMN or Injury form or any document pertinent to the patient you would like to scan At the bottom of the screen are other icon buttons you may use as follows a COPY F4 Used to make a copy of the patient information generally used to create family members b JOIN F6 Used to combine the prescription from two patients Generally used when the same patient was accidentally created twice with prescriptions HISTORY F Displays the patients prescription history Only Active if checked will display only active patients FIND F5 Locates another patient NEW F2 Clears the screen to allow you to create a new patient DELETE F3 Deletes the patient displayed SAVE F10 Stores the changes entered CANCEL Cancels any change entered and
110. k This book is divided into two sections a quick start that will guide you through the basic functions on how to fill a prescription and a more detailed section that explains all other functions Each unit covers on broad topic units are arranged in order of increasing proficiency The skills you acquire in one unit will be used and developed in subsequent units Copyright notice This manual and software are copyright O materials of Abacus Rx Inc Abacus All rights reserved No part of this manual or ancillary materials may be reproduced stored in a retrieval system or transmitted in any form or by any means electronic mechanical photocopying recording or otherwise without prior written permission of Abacus Rx Inc and the copyright owners All third party product names and services used throughout this book are common law or registered trademarks and service marks of their respective companies Use of another entity s product name or service in this book is for editorial purposes only No such use or the use of any trade name is intended to convey endorsement or other affiliation with this manual or the company Date June 17 2013 Revision 3 1 Copyright AbacusRx Inc Page 5 of 100 T7 1 T1 T CX C4 T T 2 NIT 7 1c11nil DPhny ari PIHI Sntt1Iimiroe lleor e IVinmm 11n visual Fnarmacy Plus S OJUWare User s Manual Initial setup Your system will come preloaded with some f
111. kinesis Drugs that are both medically necessary and used in relation to family planning Use for oral contraceptives Note Do not collect a copayment prescribed for dialysis patient A7 day trial quantity is required to be dispensed and the recipient is otherwise required to pay a copayment This only applies to recipients who have not received the medication previously Note Do not collect a copayment Indicates the recipient is pregnant and age 2 or older and no copayment will be collected Note All other recipient groups who do not require a copayment will be systematically determined Do not use a 07 for these recipients Indicates in house unit dose packaging to enable the claim to be paid at an increased amount STATUS CODES Unbilled B Billed uncollected P Claim Adjudicated Payable E Patient 1s Eligible Claim not sent K Eligible Claim Captured C Claim Captured R Claim rejected X Reverse an Adjudicated Claim PD Claim paid in full all monies collected NA Not Applicable take no action Copyright AbacusRx Inc Page 95 of 100
112. l 4 Rx Not Checked optionally As a safety feature you can verify the prescription filled thru the Ck Drug icon Once a prescription is filled it will be place in the Rx Not Checked queue Later you will scan the prescription number from the Rx label and the prescription information hard copy image and image of the item will be displayed You can also optionally scan the NDC as another verification step if correct the prescription is said to be checked and will be taken out of the queue 5 Rx Claims Rejected All third party claims that have been rejected are displayed in this queue for you to work on at a later me 6 Rx Not Billed AII third party claims that have not been billed are displayed in this queue for you to work on at a later time 7 Rx waiting to be picked up Delivered Will Call prescriptions are displayed in this queue for you to work on at a later time DME MEDICARE DME POS BILLING Our DME module offer independent and chain customers a complete billing solution designed to accommodate the busy environment of Copyright AbacusRx Inc Page 70 of 100 the retail pharmacy We believe that the best solution is one that requires the least amount of interaction between the Pharmacist Patient and the billing service Our solution takes the burden of complicated billing away from the pharmacy and does it at a price that will make Medicare billable products an area that will help boost pharmacies profitabi
113. le that you want to produce the reports from Next you must specify the following 1 Select Display or Print 2 Enter your selection criterion 3 Click Ok to produce the report The following is a list of reports available Daily Prescription Log This report summarizes all the prescription done during the day It is generally produced on a daily basis at the end of the day Controlled Drug Report This report summarizes the controlled II III IV and V drugs done during the day It is a generally produced on a daily basis as required by government agencies Patient Rx History This report also referred to as the IRS report is used to provide a given patient with a list of drugs purchased during a given period of time Copyright AbacusRx Inc Page 80 of 100 Billing Status Report This report is generally used to reconcile with statements issued by insurance companies It can also be used to list the status of POS transmissions or as a guide when you need to report revenues POS Reconciliation Report This report is generally used to reconcile with statements issued by Medicaid It can also be used to list the status of POS transmissions The only difference from the above report is that it is sorted by patients name Insurance Claim Report This report is used for billing insurance companies that are not equipped to handle electronic claim transmissions Sales by Payplan This report is used to summarize by plan
114. liers may not charge the beneficiary for completing or filing a Medicare claim on the beneficiary s behalf 12 What are claim filing requirements for non covered Medicare services Suppliers are required to file claims on behalf of Medicare beneficiaries for non covered Medicare services if the patient requests a formal Medicare determination 13 Where is Medigap information reported on the CMS 1500 claim form Medigap information is listed in Item 9 on the CMS 1500 claim form 14 Can suppliers downcode a DMEPOS item and only bill Medicare for what they think will be covered A supplier must bill Medicare with the HCPCS code for whatever item was provided Only Medicare can downcode the item once medical necessity determination is made 15 On assigned claims what can be collected up front from the beneficiary On assigned claims you can collect payment for any unmet deductibles 2096 co insurance and items statutorily non covered by Medicare Do not indicate amounts collected in Item 29 of the CMS 1500 claim form 16 On assigned claims can the supplier collect payment from the beneficiary above the Medicare allowable Yes if the beneficiary chooses an upgrade item and signs and dates an Advance Beneficiary Notice ABN For further details on ABNSs please refer to Chapter 7 in the Region C DMERC DMEPOS Supplier Manual 17 Can suppliers bill Medicare for delivery and or shipping of DMEPOS items No Per 5105 of the Medicare Carriers Ma
115. linically relevant information that may influence the submission of a corresponding prescription claim request The Processor recognizes that the Originator s inquiry is a what if transaction that may not result in the submission of a corresponding prescription claim request The Predetermination of Benefits transaction does not result in payment or application to the patient s benefit The Predetermination of Benefits transaction is used on claim submission only It is not valid for a service submission Each Predetermination of Benefits submission request may contain up to four occurrences of claim data Depending upon the particular claim submission request the Processor can provide one of the following general types of responses Benefit This occurs when the Processor processes the claim and returns to the Originator a snapshot of the patient s responsibility at this point in time Rejected This occurs when the Processor has encountered an error in the transaction or processing There are two possibilities 1 The patient does not have dual eligibility and did not voluntarily enroll in the Medicare Part D prescription program 2 The patient has dual eligibility and should have been automatically enrolled in one of the plans by CMS but for some reason the patient information was never communicated to the Troop facilitator NDC Obviously there is nothing you can do about the first possibility other than asking the patient to enroll
116. lity The DME screen will allow you to bill for Medicare part B items in real time Medicare DME HCFA SMITH JOHN ID 2583 Labels To Print f Rental Issue an Ax number Patient SMITH JOHN Prescriber AA v Item NEBULIZER w COMPRESSOR Date of Service 4 1264201 7 4 72622012 Place 01 Pharmacy CPT HCPCS 47003 a Modifier Diagnosis 4959 0 A Emergency No Payment Plan PCS PCS Units f Times To Rebill 13 Price 77 99 For 30 Days Length of Med Necessity f an Bases for Messurement D A Days Submission Clarification 7M edically Necessary Prior Authorization Number DAW 10 No Product Selection Indicated Provider Accept Assignment CMN Save Cancel You begin by filling out the prescription screen then click on the DME icon you will receive the above Medicare part B screen Enter the CPT HCPCS and Diagnosis then click Save and you are done Transmit the claim and you will receive a response in seconds similar to an insurance claim Submit your Medicare on line through your pharmacy system just like any other third party Abacus provides a convenient and thorough method for billing Medicare DME and Part B Vaccinations claims point of fill through the Pharmacy Plus Pharmacy software eliminating the need for additional costly software double entry and training Diabetic supplies Ostomy Supplies Inhalation Drugs Supplies Anti Cancer Drugs Immunosuppres
117. lity to the patient CREATING A FACILITY RECORD From the menu select File then select Homes Facility The screen will appear to allow you to create edit or delete a Facility record Copyright AbacusRx Inc Page 64 of 100 Facility Record 5 of 409 facilities racial Phone a gt RE ASSISTED LIVING COMP AF AMERIC 11190 BISCAYNE BOLENORTH MIAMI 33181 305 895 489 ASSISTED LIVING RET HOM 1 132 134NW 17CT MIAMI 305 642 849 ASSISTED LIVING RET HOM 2 2787 89 SW 33AWE Miami 305 446 507 ASSISTED LIVING RET HOM 3 2756 58 SwW 25 TER Miami 305 567 958 AUXANO ACLF 12020 Sw 176 ST Miami 305 251 471 BARBARA RETIREMENT HOME 2 1214 WEST 785T HIALEAH 305 769 186 BAY SHORE CONVALESCENT CTA 16650 w DIXIE HWY NORTH MIAMI BCH 305 945 744 7 b Receivables Name ASSISTED LIVING C Facility jy Tote Street 11190 BISCAYNE BO Location Type 0 Not specified NPL City MaM v State FL v Zip Baa Phone 305 895 4899 Fax 305 893 9454 Contact JOY BIGGE Contact Phone Ext 00 Physician al Category Ps HOA default fl Email 0 Find New Delete Save Cancel Select FIELD DEFINITION Facility A code that uniquely identifies Facility internally by software This code is assigned by you Name The name of the Nursing Home Company or Family group Street The street address City The city where it resides State The state
118. lus Software User s Manual V Preferences Daily Reports Use package size as PQTY when sold in package Default City Put patients Primary Physician on new Ax Default State Iv Put most common drug SIG on new Rx Default Zip Default to last drug expiration date and LOT Default Payment Plan Show opened windows Default Language English X No login needed Default Drug Supplier AmeriSource Only Pharmacist need to login Default Level of Service LOS The first screen is Rx Order Entry Default Origin Default co payment as 4 R Automatic Log Off in min Default delivery fi Delivery Workflow gt Control Substance Expiration Modules Save Cancel V Preferences Daily Reports Multiple Payer transmission option C Transmit with interaction you pick other overage code in this case e Transmit unattendedly to secondary and or tertiary insurances If Primary pays submit unattendedly to Secondary with a Other Coverage Code 2 Other coverage exists payment collected v If Primary rejects submit unattendedly to Secondary with a Other Coverage Code 3 Other coverage exists this claim not cove v If Secondary pays submit unattendedly to Tertiary with a Other Coverage Code f8 Claim is a billing for a copay If Secondary rejects submit unattendedly to Tertiary with a Other Coverage Code 3 Other coverage exists this claim not cove v
119. me v HPLaser 1 15 Auto y C Print Physician Ax on Telephone orders C Print Physician Ax when writing Orders Modules Save Cancel V Preferences Business Newt Number Communication Forms Dally Reports Scanned Image Layout aj Prescription Size 1 Left T Prescription Size 2 Top fo Prescription Size 1 Right 5 86 Bottom l6 Sample layout Test Scanner Scanner Resolution 200 RGB Color Black white Scanner Lexmark Network y Y Enable Image Scanning ScanRx oneatatime all upon save Signature PAD datapath ICA POS data interchange path FAX In path Pe Gut path CABackupiDATA F Save full driver license image Modules Save Cancel Data and Software updates From the tools menu you can select to get the latest software update or install a module recently ordered or the latest data update Copyright O AbacusRx Inc Page 86 of 100 ag Abacus Updator Version 1 0 85 Type le Software f Optional Modules Update frequency le Weekly C Full Cancel Updates scheduled to be performed SureScrpts Prescribers update October 2007 week 4 Data Update October 2007 week 5 Data Update November 007 week 1 Data Update November 007 week 2 Data Update November 007 week 3 Data Update November 007 week 4 Data Update December 007 week 1 Data Update December 007 week 2 Data Update Options W Change drugs NOC if
120. mpound will be dispensed in 1 e Tablets Solution Cream Dispensing unit how the compound will be dispensed 1 e Each Grams Milliliter Description the description of the ingredient The ingredient can be looked up by name or NDC Ingredient number NDC the NDC number of the ingredient UM Unit of Measure as specified on the drug record Quantity the quantity of the ingredient you are mixing Cost the cost of the ingredient Modifier Procedure Modifier Code Identifies special circumstances related to the performance of the service Basis Basis of Cost how the cost was derived Professional Fee a fee that will be added to the Rx associated with mixing the ingredients Note notes on the compound or how to mix ingredients Not all processors accept Compound ingredients some claim processors only want to receive the NDC of the most expensive Ingredient without the other ingredients Still others may require you to send the NDC you created with the Compound name Main NDC To do this you must set the Rules in the Payment Plan to Send the Main NDC on a Compound Payment Plan record Frescriber license to transmit National Provider ID MPI 01 Rulez for this payment plan 3 Do not display warning on Ax with zero total price E Do not send Copay as other AMT to 2 and 31M5 E Send main HDC on a compound O Do not transmit other payments COB Compound IV label The
121. mvent a system edit that could cause a transaction to reject The Intermediary Authorization fields are also used for adjudication status information from a processor to a client to inform the receiving entity what action was taken regarding the encounter by the Managed Care Plan m Prior Authorization Below describe the Prior amp uthorizatian This form is use to further document the Prior Request Type 1 Initial be ii Authorization if needed It Requested Period 10 2 2002 w To m 27202 y is intended for future use Basis of Request ME Medical Exception as a limited number of processors will request this type of information But it s available here if you need it Prior Authorization Supporting Documentation Intermediary Authorization Save Exit eScript Rx Order Number The electronic order number to track and identify prescriptions received via SureScripts DAW Dispense As Written Code indicating whether or not the prescriber s indication regarding generic substitution Rx Serial Number The serial number of the prescription blank form Some states require prescription forms to be Serialized Rx Delay Reason a code to specify the reason that submission of the transactions has been delayed Billing Status a code that indicates the whether a claim has been billed authorized paid or rejected Below are a list of valid billing status o PD Ifthe prescription has a Cash payme
122. ne already on file a copy is made of the prescription assigned a new Rx number and places you in edit mode so that you can make any changes you want or make a change to a prescription currently highlighted 3 Print You can print a prescription label by highlighting an Rx and pressing the F4 key Copyright AbacusRx Inc Page 30 of 100 4 Move Moves the highlighted Rx to a patient you specify This is useful if the Rx was entered under the wrong patient This should only be used when the incorrect patient was entered and a prescription was created You will be allowed to do this only if the prescription has not been transmitted the status is blank unbilled If the prescription was transmitted and payable by the processor insurance co then you must transmit a reversal before the Rx can be moved to the correct patient 5 Authorize You can print a refill authorization request or prior authorization in order to fax to a physician or you can change the number of authorized refills remaining quantity or set a date when the Rx should be discontinued 1 e not to appear in the active refill list 6 Transfer This is used when a prescription is transferred out of your pharmacy or in It will allow you do document the transaction and print a report of the transfer Void This will delete the prescription from the active file the prescription will be moved to the recycle bin Details Request to see more
123. nt cA ns M 53 Hemized payment DIURNO Ep 54 Electronic 835 Payrnent POS O a a 56 CYXCDEBR BILD S d A A UA QA Soo D e udi d pde qut one 59 Bacility NManageiment Nursins Home module ud eb nat Das estu Cr po DE X be Qr pus Tua eee eur al 60 MEDICATION ADMINISTRATION RECORDS AND FORWARDED PHYSICIAN S ORDERS eese 61 DELIVERY SHEETS Tec 62 STATEMENT Solotele 62 DELETING PATTEN Eo rr NER 62 REVIEWING DRUG REGIMENS stato illa oo node epa Se ate pus 62 OYCEB ILL Gusto aa natal pbjes 63 NONE ORDERS a E PEE 64 PRINTING PHYSICIAN ORDERS AR Si alla at 64 HOW TO WORK WITH EACLDEDEDBS aliada a 64 CREATING A PACILITY RECORD aos eel aaa 64 PRE SCRIP TION ENTRA Nica caos MN DUO OL SI 65 NEW PATIENT FPORM denota E 66 HOURS OF ADMINISTRATION HOA serca ii iaa 67 INVOICE S DELIVER Y SHEE ME E e E EE HR 68 SN TLABEL S todos 68 PRINTING MED SHEETORPHYSICIAN ORDERS erorte e e e EE Eee e E EEE E EREE eE 68 SEANDING ORDERS OTHER INS ERUCTUO NS 68 STATEMENT MC MMC ccc EROR A 68 ORDER ENTR de tie 69 OUEUES T o n 70 DME MEDICARE DVMEPOS BILE IN israelita 70 GN EIR VICE E M N 74 REMINDER ogrene a aio as Dd ea 74 SCANNING A
124. nt is from Patient Company Fill all other fields then press enter key Next Payment Nursing Home F acility E Statement Received Check from Payer PCS PCS Balance Date 4 24 2013 Open Credit 4626 00 a Description Payment Thank you Check Amount 400 00 a ave Auto ltemize No Reference 45655 ree fene E ance 73 of prescriptions found Patient DateFiled Price CoPay Paid AuthAmt Adius Write Off Due Status eid Payment O 601400 0 PCS PCS GARCIA 01 29 2010 67 50 20 00 25 00 2500 0 00 0 00 4250 PD O 601566 0 PCS PCS GASOL 05 19 2010 1 11 2000 109 109 0 00 0 00 20 00 PD Electronic 835 O 601587 0 PCS PCS GASOL 05 19 2010 1500 1000 5 00 500 0 00 0 00 10 00 PD Payment Reconciliation Im 12345 0 PCS PCS Garcia G 11 12 2010 164 05 000 S000 12525 S000 0 00 164 05 Payabl L1602614 2 PCS PCS Garcia G 11 12 2010 154 05 0 00 0 00 41 14 0 00 0 00 164 05 Payabl 1123456 0 PCS PCS Garcia G 11 12 2010 154 05 0 00 0 00 12525 0 00 0 00 164 05 Payabl L1602614 2 PCS PCS Garcia G 11 12 2010 164 05 0 00 0 00 41 14 0 00 0 00 164 05 Payabl w lt Find Ax No Total Auth Amt 0 00 Cleared 0 00 Remaining Amt 100 00 Add In the above form you define how the payment will be distributed posted to the individual prescriptions If the amount posted to a claim is less than the amount
125. nt plan or if the payment has been received for the Rx the status will be set as PD for Paid P If the prescription has been billed to the insurance and a payable response is received B If the prescription was billed and no response was received or was billed by report N If the prescription is not covered by the insurance X If the prescription is set to be reversed Reverse is used to undo a Rx that was billed and a payable response was received Once the reverse is accepted by the insurance the status will be automatically set to blank o Blank if the prescription has not been billed or is ready to be billed 0 000 Copyright O AbacusRx Inc Page 11 of 100 Dj E raus User s FIDATE corq ware USer S 1c i3 Dha YMACTI Pli IQ Cy VISUAL Fnarmacy rtis OO Manin Manual Category a user define prescription category generally use to group Rx on reports Message The response from the carrier COMPOUND IV Compounds are medication that has to be made by the pharmacist because it is not available from a manufacturer in the desired strength or containing the ingredients prescribed by Physicians To enter ingredients for a new compound you must first create an Item record of the compound To do this you must go to the Item record and add an Item same as adding a drug Make sure to select Compound in the Type field this will establish the Item as a compound then when you select the
126. nts it list not only refills coming up but the patients remaining Rx limit balance Medical HCFA 1500 FORM This report will print a bill in the HCFA 1500 format HCFA 1500 forms are required To order call MOORE BUSINESS FORMS at 800 634 7341 Universal Claim Form This form is used for billing insurance companies that are not equipped to handle electronic claim transmissions Worker s Comp Form This form is used for billing insurance companies that are not equipped to handle electronic worker s compensation claim transmissions Copyright AbacusRx Inc Page 81 of 100 Statements to Patients This is generally used to bill accounts receivable House account patient s A statement is produce for patient see Accounts Receivables for more information Optionally you can also request to print a patients trial balance Drugs Prescribed by Doctor This report will print all drugs prescribed by a doctor for a given period of time Drug Utilization Report This report list all or a given drugs utilization listing the patient it was given to and indication It can be requested for any given period of time Patient Rx Card This report gives you a snap shot of a prescriptions filled for a patient in a given period It shows amount authorized and status Prescription Labels This option will allow you to print prescription labels within a selection criterion 1 e date range POS Adjudication Log This report can only be viewed on s
127. nual delivery and services are an integral part of a DMEPOS supplier s cost of doing business The cost of delivery and service are typically taken into account by suppliers when determining their customary charges Therefore these costs are already included in the calculation for fee schedules and allowables 18 If a beneficiary has a secondary insurance policy that does not coordinate benefits and pays the supplier more than the co pay is the supplier mandated by law to refund the insurance company Yes When a supplier accepts assignment on a claim filed to Medicare that supplier agrees to accept the Medicare allowable as payment in full Acceptance of payments above and beyond the Medicare allowable is a violation of the Medicare assignment agreement whether the payment is from the beneficiary or an insurer 19 What can suppliers do about other suppliers who routinely tell patients that they will write off the 20 co payment Such activities should be reported to the Benefit Integrity Unit at 877 867 4852 Routinely waiving the 2096 co payment could be perceived as an enticement to gain Medicare business 20 When should a supplier file a hard copy claim versus an electronic media claim Suppliers should file claims electronically whenever possible The only time a claim should be filed hard copy is if required by policy or if the additional documentation does not fit into the electronic narrative record HAO 2 Can a supplier key an ICD
128. o assist the pharmacist arguably with drug conflicts in most cases processors will not adjudicate claims that have a drug conflict so you will need to reply to the rejection in order to have these claims adjudicate using the following codes What was the conflict code This code tells the processor what conflict are you responding to D E Early refill Overuse precaution I Ingredient Duplication L E Tobacco uses precaution Drug actual disease precaution How did you intervene This code tells the processor what you did to resolve the problem PE F MO Low dosage alert Underuse precaution A F Su D High dose alert N H D D R H D D R MN Insufficient duration alert A G R S O SX Patient education instructions P Patient referral Prescriber Consulted TH Therapeutic product interchange What was the result of your intervention This code reports the results Filled as is false positive Copyright AbacusRx Inc Page 90 of 100 Pharmacy Plus software Filled prescription as is Appendix A Glossary Relationship Code 0 Not Specified Spouse Eligibility Override code EligOvr O NotSpecified 6 Significantother_ PA MC Prior Auth Medical Cert Code 0 NotSpecified 3 5 Exemption from Rx Limits 7 Rx Origin Code 0 Not Specified Telephone Prescription Level of Service Copyright
129. o calculate price for Brand Drugs Here we link the Pricing Table the formula for calculating the price to the Payment Plan This Pricing table will be used if the drug is a Brand name drug b Price table used to calculate price for Generic Drugs Here we link the Pricing Table the formula for calculating the price to the Payment Plan This Pricing table will be used if the drug is a Generic and other type ie multi source OTC drug c What is the usual dispensing fee Enter the dispensing fee you want to charge when dispensing with this payment plan d Discount what percent from the total price If the payment plan offers a discount ie Senior Citizen enter it here e Plan charges per claim a fee of If the Carrier charges a fee for each claim you may enter it here This is used in order to correctly post and balance with the carriers EOB Payments e Charge a tax percent of This establishes that when the payment plan is use the items are subject to tax However the item must be set to taxable in order for tax to be charge f based on You can further specify how the tax calculation is to be based on g Flat tax Enter a flat tax to be charge if needed g Use patient s default co payment as Rx default You can specify to default the Rx co payment using the co payment you entered in the patient file this is only used for information as the insurance carrier will override the co payment amount
130. of 100 n Only patients with a category of this is a user defined category to filter only selected patients with the same category as define f Only prescriptions with a category of you can define any category you want it may be used to classify a maintenance Rx so you can request only to refill maintenance Rx a Date to use as the Rx filled date this is the date that will be used as the refill date on the refilled prescriptions b Use Batch created the group of the Rx selected are saved when a batch is created and may be reviewed or modified by using this option c Onlyrefill Rx checked as Auto Refill if checked you will only refill prescriptions checked to auto refill if the refill due date is within the days specified X Cycle Fill from refill due date 4 1 2013 to 4 30 2013 Rx Number Driginal Refilled Description Last Price Plan Refill Left Patient Refilled Transmit R Label Invoice O 3033 11 28 20 3 5 2013 TRAZODONE 100MG 30 30 00 23 47 T 5 Sample Nick O 3054 8 1 2002 3 5 2013 METFORMIN HCL 1 0 30 30 00 60 59 C 1 Sample Nick 3 25 2013 3 25 2013 PAXIL 10 MG TAB W 361 09 richards pharm 3 prescriptions in the list Select All Clear Edit Add New Print List Refill Auth Reg 1 Refill Transmit 3 Print Exit Next you will see the prescriptions that meet the criterion enter in the previous screen Here you can do the following a Select All this will s
131. of Rx into an Rx waiting queue This saves Pharmacist or senior technician time and it provides another verification layer amp Rx Orders New Prescription Refill Y Pending Filed OnHold Pateni Patient washington George Entered by ABA Promise B Prescriber ABAD JORGE A lios Type Pickup y Item COUMADIN 10MG TABLET 56017475 a Date 2 7 2008 Quantity 30 Quantity 30 Refills lo Written 2 7 2008 al Time 10 40 28 PM Written Dispense Sig la QI Days Boo DAW 0 No Product Selection Instruction TAKE ONE A DAY Plan C Cash al Origin 0 Not Specified Ex NA EN Name Pan lem Refils Quantity Physician Dy Washington George C Cah PAXICTOMG TABLET42 30 ABADJORGE A No recored was found according to the criterion specified Save Clear Close _see_ se 2 Fil Orders Qi From 1 73172008 To 27772008 Order Entry Allows a technician to take orders enter prescriptions and scan the hard copy prescription to place in a Queue where it is picked verified and filled by a pharmacist via the prescription entry screen Copyright AbacusRx Inc Page 69 of 100 Visual Pharmacu Plus Software User s Manual QUEUES Pharmacy Plus Version 1 0 587 XP Medical Equipment Pharmacy Location Miami Terminal ORLANDO LAPTOP ES File Prescriptions Reports Tools Archive Pickup Window d
132. ommon for them to be discharged and then readmitted in a few days Also if a patient is discharged around the 1st of the month their Rx s might not be processed until the end of the month A good rule of thumb is to delete only those patients discharged three 3 months ago REVIEWING DRUG REGIMENS As each NEW ORDER is processed for a patient the patient profile should be reviewed checking for allergies overutilization and underutilization of medication If a comment is necessary concerning drug therapy a form similar to this could be utilized and sent to the facility DEAR DIRECTOR OF NURSING A PATIENT IN IS ON THE FOLLOWING MEDICATION S COMMENT Copyright AbacusRx Inc Page 62 of 100 REGULATIONS REQUIRE A FREQUENT REVIEW OF EACH PATIENT S DRUG REGIMEN BY PHARMACISTS SERVICING SKILLED NURSING FACILITIES FOR DRUG UTILIZATION AND INTERACTIONS THE INFORMATION WE ARE PROVIDING DOES NOT NECESSARILY SUGGEST A CHANGE IN ORDERS HOWEVER THE ATTENDING PHYSICIAN SHOULD BE NOTIFIED PLEASE FILE THIS REPORT WITH YOUR MONTHLY CONSULTANT PHARMACIST EVALUATION AND REPORT FORM FOR REVIEW BY SURVEY TEAMS SINCERELY PHARMACIST Should a medication be reordered too early or if a wrong refill number is received a form similar to this or Reject Report could be utilized and sent to the facility TO DIRECTOR OF NURSES DATE The following medications were ordered today We have not filled these orders for the following r
133. on the patient s chart for signature by the physician The nursing staff should review the forms for accuracy checking the following items Are orders correct Are strengths correct Are directions correct Are physician s names correct If a discrepancy exists in the above items it should be reported to the pharmacy for correction If an order is listed that was discontinued earlier it should be reported to the pharmacy and order should be discontinued via the Authorize button on the patient profile history screen Med Sheet s will only print for patients with active orders not discontinued Copyright AbacusRx Inc Page 61 of 100 Should a current order not be listed one of two factors will be responsible 1 The order was erroneously discontinued in the patient s profile 2 The order has not been communicated since you began using the computer This will be the case in many standing prn orders Since forms are printed a few days before they are inserted in charts any new orders changes in orders or D C s must be written in by hand by the nursing staff After the sheets are signed by the physician a facility supplied physician s order sheet should be used for any new orders during the remainder of the month or cycle It is highly recommended that you use a duplicating physician order form for daily orders so that a copy can be returned to the pharmacy In this way any changes etc can be easily communic
134. only print three 3 lines of directions therefore edit your sigs accordingly Be sure to discontinue orders in the profile as the occasion arises Otherwise your MAR s and physician orders will be inaccurate NON DRUG ORDERS Orders such as physical therapy routine statements lab orders etc can be entered through the Patient Order screen These orders can then be printed on several different physician order sheets You can also enter Standing Orders for nursing home patients Whenever a new patient is admitted to the facility you may copy these orders to the new patient s Patient Orders section thereby saving yourself considerable time in making the same repetitive entries PRINTING PHYSICIAN ORDERS MAR s Physician Orders can be printed at any time from the report menu screen Select Med Sheets MAR you can specify how to limit your printing as follows Specify a Rx date range to extract Specify a date to print on the MAR sheet Limit to a specific a nursing home Request whether you want print Treatment Maintenance and PRN medications on its own page Limit to a specific Rx category Limit to a specific nursing facility wing floor or room Limit to a specific patient NN NE RRA All Rx that fit the specified criterion will be printed HOW TO WORK WITH FACILITIES To work with the Nursing Home or Facilities you must first create a record of the Nursing Home or facility Then assign the Faci
135. or PRN medications together For example use the first character of Category for the frequency of the Rx i e M Monthly W Weekly B Bi Weekly and the second character for the type of medication i e T Treatment M Maintenance P PRN STANDING ORDERS OTHER INSTRUCTIONS You can enter orders or instructions that will appear on the upper right side of the Physician Order Sheet These orders are use by various facilities to remind staff nurse of patient activities special needs dietary orders etc The orders are entered in the Patient s record under the Facility tab e OTC ORDERS are OTC products where the NDC number has six digits or less and the type code in the drug file is O These products can be entered and will appear on the med sheet e NON DRUG ORDERS Non drug orders are services procedure adjustments or other than drugs items e DME ORDERS Durable Medical Equipment are generally orders for equipment STATEMENTS A Statement can be printed at any time for selected patients or for all patients in a given Facility A bill to person and address other than the Facility can be specified on Billing tab of the patient information screen Statements can be found under the Reports menu under the financial section Copyright AbacusRx Inc Page 68 of 100 Visual Pharmacu Plus Software User s Manual ORDER ENTRY The Order enter feature is useful for Pharmacies to quickly Rx orders and scan hard copy images
136. or code of a payment plan already stored on file or use the find icon to select m Group Enter the insurance Group number used as specified in the patient s insurance card n Card number Enter the patient s insurance Card number as specified in the patient s insurance card o Relation Enter the relation of the card holder to the patient p Person Code Enter the patient person code as specified in the patient s insurance card q Type If the payment plan is an insurance coverage here you can define how the coverage is to be transmitted as the primary coverage secondary or tertiary i BIN This is the actual insurance identifier this is only applicable when transmitting to multiple insurance carriers and can be automatically entered by the use of Eligibility Check ii PCN t This is the insurance Processor Control Number this is only applicable when transmitting to multiple insurance carriers and can be automatically entered by the use of Eligibility Check r Card Holder If the patient is a member in the insurance coverage here you will enter the actual name of the card holder s Co Payment This field can be used to define the default patient s co payment when the claim is transmitted the insurance will display and override default with the actual co payment t A R Copay If checked the co payment will be on house account Account Receivable and billed to the patient u Eligibility Override Code
137. ot billed to the insurance Copyright AbacusRx Inc Page 49 of 100 ES DELIVERY The Delivery form is used to document and track deliveries and Will Call Rx pickup Delivery flow Rx labels are printed with a Delivery Sheet and assigned to a driver based on the Route Zip code Facility or other attribute 2 The delivery person sets the Disposition Delivery Status to On route and scans the bar code on the Delivery Sheet or the bar code on the prescription label 3 The delivery person puts the scanned prescriptions in the Tote set for delivery and repeats the process with the next prescriptions Once all the prescriptions have been entered the Delivery Report a summary report of the delivery by driver will be printed The Delivery report can be sorted by territory location and address and may contain address directions if entered in the patient screen 4 When the delivery person returns from the route a new Disposition delivery status will be given for each Prescription on route ie Delivered Canceled or On Hold a comment can be entered if necessary and the image of the signed Delivery sheet will be scanned and stored in the patients profile for future reference This process will allow you to maintain the correct Rx Disposition track and answer questions regarding any delivery In addition you will have the signature readably available for inspection 5 The money collected will
138. ows o Edit allows the user to make a change to the prescription o Rx Image to view the prescription hardcopy image o Rx Label to print the prescription label o Payments to view payments received for the Rx displayed Copyright AbacusRx Inc Page 22 of 100 Tip A groups of prescriptions done at the same time for the same patient will have an invoice number Also called a group or ticket number assigned to them and you can use this invoice number to locate the group Patient Information Patient To change any information on the patient currently selected click on the Patient field name The all the patient s information demographics will be displayed Fel Patient File SMITH JOHN ID 2583 Only Active 1 of 1 patients LastName FirstName Middle Name I 112345 SW 123 STREE MIAMI FL Click here to view Click here to Map General a route for delivery Personal text message iis when Rx field Phone Allergies To be asked Type a word to see a related list icense O Ew Join History iv Only active Patient 553 HIPAA x Last Name SMITH First Name JOHN Middle E Language English z Street 112345 SW 123STREET Category e City MIAMI gt State FL v Zip Code 33183 Y Generic Click here to iat Gjssscos DOB pizzrsso Gender Mae y z s Cap establish to send a Wok 3055557784
139. patients name in the prescription screen then click on the OTC Service icon then fill the OTC Service screen and your done 8 OTC Service Patient SmithJohn ltem A amp D BARRIER OINTMENT 83 On hand Quantity 50 Pkg Size 20 Retail Price o AWP fe g Payment Plan C Cah y Date 277 200 Taxable No v Quantity 1 Total 6 30 HOA Category Comments Save Cancel In the OTC Service entry screen you can enter the following fields a HOA Hours of Administration if you are printing the OTC Service for a patient in a Facility that will receive a Med Sheet or Physician Orders b Category A user defined category to group OTC Services c Comments For informational purposes REMINDER The Reminder icon is used as a tickler to view notes entered for a Patient or Prescription that have a reminder date set You can view notes for a specific Patient Prescription or all the notes for the same within a given date range General notes are system generated notes in the future there will be a Add note icon to allow the user to enter a general note Copyright AbacusRx Inc Page 74 of 100 Visual Pharmacu Plus Software User s Manual V Notes Set your criteria then click Search for an y Prescription Reminder from 1 1 2013 y To 3713 2013 Le Get Data to list the notes that meat your criterion Prescription 26 messages
140. r change a HOA on the Rx to skip a time slot on the Med Sheet type a For example if you want 8am to print on slot 1 and 5pm on slot 4 of the Med Sheet type the HOA as 8am 5pm To print 10am in slot 2 and 5pm in slot 4 type the HOA as 10am 5pm INVOICES DELIVERY SHEET An Invoice or Delivery Sheet can be printed for each patient upon saving the prescriptions You should have another printer connected to the computer to avoid changing printer form each time you print an invoice delivery sheet or Rx label Invoices Delivery Sheet is available for batch printing within the Reports SHIPPING LABELS If you mail order a shipping label can be printed upon saving the prescriptions You should have another printer connected to the computer to avoid changing printer form each time you print an invoice delivery sheet shipping label or Rx label Many printers can be defined in the Preferences to print simultaneously PRINTING MED SHEET OR PHYSICIAN ORDERS Once you enter all the Rx for a given Nursing Home Facility you may request to print Med Sheet for all or select patients assigned to the Nursing Home Select Reports from the menu then Nursing Home Company to print the Med Sheet or Physician Orders you will be guided through the selection process by screen prompts The prescriptions on the Physician Orders Med Sheets can be filtered and page break by the Category this way you can print all the Treatment Maintenance
141. r either the NDC or the name of the drug 2 Enter the payment plan and the quantity 3 You will be asked 1f you want to view substitutes answer Yes to show all substitutes The price quotation is based on the definition of your customized price calculation in the Pricing Tables for the payment plan entered Copyright O AbacusRx Inc Page 44 of 100 Visual Pharmacu Plus Software User s Manual INVENTORY ENTRY S Inventory Entry m Instruction Here you can enter quantities received into inventory amp positive number will add to inventory amp negative number will reduce from inventory returns shrinkage or adjustment r Please enter your data Drug COUMADIN 1 MG TABLET NDC 35355054030 On Hand Quantity 0 00 Package Size 90 00 Case Size Retail Price 2 07 AWP Price 2 07 Package Received Returned 5 00 C Units Packages C Your Cost Package 18640 Supplier AmerisourceBergen Corporation P Inveice 96565351 LE e EN Date Received Returned 1 30 2013 Drug E oz m Lot Number 1392039 Other Fees Unit Quantity Adjustment o Shelf Location da ug Rue TT Tr Physical Close Month Reset Save Clear Cancel The above screen depicts the inventory entry adjustment screen From this screen you can enter inventory received to keep a record and to adjust your on hand quantity Package Received Returned the number of Units Packages or Cases receive
142. r future reference Table A unique number assigned by you that identifies the price table This number is then put in the payment plan file or the drug so that it can use the table to calculate a price The calculated price will be base on The price in the drug file that will be used to start the calculation of the final price Percent of Mark up down before pricing A percent to apply towards the base price as defined by the price based on Specify a positive value to increase or a negative value to decrease Break On CALCULATED PRICE UNIT PRICE QU ANTIT Y this is used to differentiate the two types of pricing strategies that can be used to calculate the final price A price structure based on quantity or price can be used to further refined the final price For example if the breakpoint is based on quantity you could setup a different mark up strategy for a quantity of 10 as opposed to a quantity of 50 Likewise if the breakpoint is based on price you could setup additional mark up strategies based on the price calculated to this point Breakpoint Either a quantity or a price range as specified in Break point is Here you can specify up to nine different price or quantity structure that will trigger more calculations to be performed Percent Mark up dn fee a percent used to subtract or add to the figure calculated after pricing it will only apply if the price or quantity is within the applicable break on Dispense Fee
143. rance Claim Report Gaes Bill 3143 0 2 S amp CCORNSTARCH 1 AARDEMA psa snm psa oo WO ABBA A New Expired Rx Report BODY POWD AUSTIN Referral Report pe TEMPLE ERMA 3146 0 1 A D BARRIER 12 Carey Ben 35555 ges pmo ome Fis ABAGBA C PD New OINTMENT Display Print TEMPLE ERMA 3145 0 n Prozac Amg Capstes 90 Aaron Bob qas va gpm DI mo anaba C PD New 01 Miami v TEMPLE ERMA 314 1 D A CHBAGBLE 10 TesfEDPresorber 1121 1121 sum DI 364 ABAGBA C PD New TABLET 4 Tes 10 Yan JEngro 3142 0 2 S amp CCORNSTARCH 1 SCHARGEL 153 qnm snm DIDX 3DID ABA ABA Fo New BODY POWD STEVEN Gates Bll 3143 0 1 D A CHBAABLE in TesfEDPrescrber 1053 qnm sum omy 35641 ARABIA PAI New TABLET 4 Tes Gates 81 3141 0 1 DA CHEMABLE 10 AARDEMA gins3 qum sum Om ai ABA ABA PAI New TABLET AUSTIN Gates 811 3135 0 1 A D BARRIER 12 AARDEMA 250 sum snm DI 155 ABA ABA PAI New OINTMENT AUSTIN Gates 81 3135 0 1 DA CHEMABLE 10 AARDEMA gins3 sum sum DIDX 35641 ABA BA PAI New TABLET AUSTIN Gates Bill 3131 0 2 H 9600 SR TABLETSA W AARDEMA 1570 sum snm Ooms HAS ABAAA pal New AUSTIN Gat 81 31 2 WEF 256 LANCETS 1 AARDEMA 255 aum sum DIE JM ABA ABA PA New AUSTIN Yan Jtagto 3134 0 o ABC Drg 2 BAAB HOLLY 11 10 sum qnm DD 39222 ABABA FO New v lt gt 2 3 2008 4 51 PM 1 Reports are organized by type first select the type of report you want then select the report and the location if applicab
144. re product services from the provider to the payer This guide uses the definition stated in the HIPAA regulations If there is no direct claim because the reimbursement contract is based on a mechanism other than charges or reimbursement rates for specific services the transaction is the transmission of encounter information for the purpose of reporting health care For example a payer and provider have entered into a capitation agreement i e 50 PMPM per member per month On an agreed upon schedule the encounter data will be reconciled with the capitated payments that have been made The encounter data may support adjustment settlement of the amount paid to the provider based on actual experience and products services provided as well as incentives or other contract terms Note To distinguish an encounter from a regular claim you must put 9 Encounters in the Submission Clarification Code 420 DK Reversal Submission and Processing If you need to cancel or void a claim that was billed electronically to a processor you need to transmit a Reversal transaction The reversal transaction is used to back out a previously captured or paid prescription service billing information or controlled substance reporting by first placing an X or Reverse in the claim status field The reversal transaction completely reverses the previously processed claim and appears as a credit on your next Remittance Voucher If the
145. ription next page of orlando alberro ID 1507 Ticket No 1009872 Payer COB verride Prior Authorization Notes DUR Coupon Other Charges Coupon Coupon Type 99 0ther Other amount claimed Coupon Number 193920392 DpD Coupon Value Amount 15 00 A coupon is used to reduce the patient out of pocket prescription cost by either reducing the cost of a CASH prescription or the patient financial responsibility from a Third Party payer who allows coupon usage The coupon processor is the LAST payer The following fields are required to enter a Coupon a Coupon Type a code indicating the type of coupon being used b Coupon number a unique serial number assigned to the prescription coupon Most of the time you will find the number on the actual coupon c Coupon value amount the dollar value of the coupon The following Coupon types are supported by processors 1 Free Product Patient is provided the product at no cost Manufacturer coupons for a Free Product should be submitted as Primary Billing 2 Price Discount Patient s out of pocket cost is reduced by a designated coupon amount e g 5 00 off Please note state or federal regulations may prohibit the use of coupons Copyright AbacusRx Inc Page 16 of 100 l You can use the Other Amount Claimed field to enter Other amount claimed one or more charges that will be considered in addition to the Ingredient cost dispensing fee pro
146. rs 1 e Exercise Mon Thur will print on left side of the Physician Orders or Medication Sheet You can customize orders assign a code for them and save them for later use Copyright AbacusRx Inc Page 26 of 100 Visual Pharmacu Plus Software User s Manual fel Patient File SMITH JOHN ID 2583 Only Active 1 of 1 patients m Middle Name FL 12345 SW 123 STREE MIAMI ena Y ame Y Feci Auth Representative Prior amp uthorization First Name fn ree Prior Authorization Number assigned Steep Medical Certification City De State Zip Code A History F nly active Find New Save Cancel Select REPRESENTATIVE Here you can define authorize patient representative describe a Medication exception Plan requirement or request to Increase plan limitation This information is sent to the carrier if the claim is billed electronically a Authorized Representative The patient representative if any Can be also be used to verify when Rx is picked up by someone other than patient b Request Here you can describe a Medication exception Plan requirement or request to Increase plan limitation c Type Here you describe the type of request you are seeking an initial request or getting reauthorization d Requested Period Begin the date you are requesting coverage to begin e Requested Period End the date requested coverage ends
147. rtory Mechita lalalala ad 82 Reni Require mette OLD asiatica aa dei 82 Inventory Received Repo orleans ladran 82 Dro Reporta P 82 Patient Rh CD OL ibe ranas lada bid a riad 82 Pan A sinet ovens seh MU IMMER EMI IMP LRI EERI Ue LEL MEI I EMIL IUD 83 Doctor keria il oi icons 83 UN A rl c PET HTN 83 Payplan Pricine traes llo do OS 83 A de DELL I NU EA LM MEAM MEE MEME EL EM 83 Conticutation Prel NCES ss ETT Tt TO o OO LEER 83 Datasand Software Udala talon 86 TABLE ron 87 A NP TWCCHERERET RORIS RRIC CERTE 88 DUS ST AA CRURDRIC CERERI T 88 GA e TEN D RP A A A a DRIC CRINE TI 89 APPEN a OG SAE An q A O O A A A A 90 The Dror Dtiizatonkevuiew DUR rana uc dao tela 90 Copyright O AbacusRx Inc Page 4 of 100 Introduction This manual will introduce you to all the features of the Abacus Visual Pharmacy Plus Software The manual is design to assist you in adding and editing initial files and provides practice task to ensure your success in using your new system What You Need To Know Before You Begin To ensure your success we recommend that you have a basic understanding of the Windows operating system including basic functionalities and navigational tools Overall Goal Upon completing the exercises in this manual you will have demonstrated the skills you need to begin using your Abacus system How to use this boo
148. s supply of the medication 1 e if the date of the date filled the days supply is greater or equal to today s date then the prescription is considered to be active If a drug conflict has been sited the system will display the drugs that caused the conflict a description in detail of the conflict including the severity of the conflict and information on how to resolve the conflict Drug Drug Interactions Interactions Description ASPIRIN 325 MG Cl MATEO TABLET interacts with Cl MNT T Tg em ri LE d Ee ES Ix Detailed Report MONOGRAPH TITLE Anticoagulants S alicylates SEVERITY LEVEL Z Severe Interaction Acton ls required to reduce the risk of severe adverse interaction MECHANISM OF ACTION Multiple processes are involved 1 Salicylate doses greater than 3 qm daily decrease plasma prothrombin levels 2 Salicylates may also displace anticoagulants from plasma protein binding sites 3 Salicplates impair platelet function resulting in prolonged bleeding time 4 S aliculates may cause gastrointestinal bleeding due to irritation LLIMICAL EFFECTS The concurrent use of anticoagulants and salicylates may result in increased INA values and increase the risk of bleeding A drug conflict check can be performed in two ways upon save or on request from the Tool menu The system will check for Patient Allergies Drug Dosage Prenatal and Geriatric and Drug Conflict Interaction If a conflict is sit
149. s you the DUR error You enter the second code to explain what you did to resolve the DUR The last code explains what was the result of what you did to resolve the problem If checked will Date to remind user of note or event Notes Show note anytime the prescription 1s viewed or modified print the notes on the Rx form Notes Prescription Motes Mew Note Mate Alert Prin Reminder date 12 1 2012 E ERE p prescription on December 1 2012 and call physician on changing to Prevacal Drag k Author Date Time Done Inactive M 4 Notes 1 of 1 nni You can enter an unlimited number of notes lines per prescription However each line is limited to 255 characters The definitions of the fields follow Copyright AbacusRx Inc Page 15 of 100 e Alert If checked will show note anytime the prescription is viewed or modified Print If checked will print the note on the patient education part of the Rx label Reminder date The date to remind the user about the note or event via the To do function Author The Tech Rph initials of the user that wrote the note Created The date the note was created Time The time the note was created Done If checked will remove the note of the pending list in the To do function and will not display or print Inactive If checked the note will not display or print on the Rx label COUPON OTHER AMOUNT V Presc
150. sive Drugs Flu Pneumo Vaccines Rentals Enteral Formula and Equipment Payment assignment e Assignment accepted by pharmacy or patient and payment remitted to pharmacy Corporate office or patient e Coordination of benefits handled whether Medicare is the primary or secondary insurer Other insurance amounts automatically reported to participating secondary insurer Claim edits Our real time edits enforce compliance to HCFA policy significantly reducing costly rejects Copyright AbacusRx Inc Page 71 of 100 Each claim is processed at the point of fill and the complete claim is captured Edits included but are not limited to Product Coverage Doctor DEA NPI UPIN number and demographic verification Patient ID and demographic verification Product NDC HCPCS code coverage and automatic modifier determination MAC price minimum maximum quantity verification Diagnosis code to product verification Coordination of Benefits and patient pharmacy assignment Refill too soon and Min Max Quantity determination Assignment of benefits determined by pharmacy or Third party coordinator Patient annual deductible verification Automatic quantity conversions for inhalation products Non covered items may be submitted when required by state Medicaid ML to MG conversion on inhalation drugs NDC to HCPCS conversion DEA to UPIN conversion Package unit quantity conversion on diabetic supplies etc After your claim has passe
151. t by the PBM You will need to receive an 835 file from the PBM or Insurance companies third party the file contains the check amount and a detail breakdown by claim of the amount paid The automated system will analysis the file locate the claim and post the amount paid to the claim on the Abacus system The Abacus Electronic 835 Payment Posting is equipped to handle a single or multiple check file A detail and summary analysis of posting will be displayed for your review In the event of an accidental double posting the system ignores the later posting In the event of incorrect posting the entire posting may be removed 1 You will need to obtain the 835 posting file from the PBM or Insurance Company N Posting Payment Adjustment From Company Payment it kon 7 Pai Compay Emai ether a letter or number to relieve 4 Facility Begin by clicking al Be 7 E here to select the file to process Nursing Hore T acit Recerend Check from Plan Dan 1 16 2012 Leli Derap Payment T hari yeu Check Amount g r Ardo lere Wo e Reterence r Audet trad of payments posted 2 You will be shown a browser now select the 835 posting file you received from the PBM or Insurance Company Select the file and click Open button Look in Sample Y efgerE3 AETNA_081711 835 amp ARGUS_081711 835 My Recent El CATALYSTRX 081711 835 Documents cms MCKESSON_081711 835 Select
152. t ready to be given to the patient some action is needed 1e verification Copyright AbacusRx Inc Page 31 of 100 Picked Up Rx was picked up by the patient Delivered Rx was delivered to the patient Returned Rx was refused or returned back from a delivery Mailed Rx was shipped to the patient 70029 Refills Pending F6 When an original prescription is created with Authorized Refills the system automatically manages the refills quantity available to the patient by maintaining a count of the total quantity authorized less used By clicking on Refills or pressing F6 we can view and or refill prescriptions or partial quantities remaining Click the prescription to refill select more than one by holding done the Ctrl key Once you have selected all the Rx from the pending refills the Rx information will be summarized Ed Rx refills availble for the Patient Smith John ID 10820 4 r To select a Ax click the small button on the left of a row To select more than one hold down Ctrl key when clicking a Ax e Original Refiled Description Qty Days LastPrce Plan Refill Left plus after the Refill Left indicates a partial refill Refill E A refill is a prescription that has been authorized to have a number of repetitions refills The system creates a refill by copying the information from the original prescription which has either
153. tch companies require the software companies to certify with them This is the certification number received once certification is complete e Prescribers license to transmit Some carriers may require a particular license number from the prescriber to override license usually transmitted select the License type to transmit The Standard Rules or default is the prescribers NPI DOCUMENTS Here you can scan documents relating to the payment plan like Carrier card Documents EDIESSEFR Description Add a description here Remove E CRIA ATA RC IER O asume sd ete nt 4 060 305 4504 r 1 amp in Hhz ASES AA IU E AR gt FE AA mec Meda ane 1 566 805 4588 Foe pen and posi velirmant yurellans WN TT g g o zd 1 866 505 4949 Opan Y am ril 5 pm hasal dire TI Y 1 020n 555 Z28bL eaw Im A p Cem Select Copyright AbacusRx Inc Page 41 of 100 PRICING TABLE dal dd ltd amp Pricing Table AWP price break AWP 0 2 00 AWP 0 3 00 AWP 0 4 00 COST 50 5 00 AWP 0 6 00 General Description AWP price break Table 1 The calculated price will be based on AWP Percent of markup or markdown E Additional Pricing cO OO N CD CH 4 amp wh Break On Percent Mark Price ssl 0 01 110 00 30 00 1100 00 200 00 500 00 e e NM s NM NM NM ON OG
154. tes DELETE To delete a order just uncheck it from the list Retreive From Save as Standing Orders ENTERAL FEEDINGS LABORATORY ORDERS SPECIAL NEEDS MOBILITY NURSING APPLIANCE EXERCI EVALUATION QUESTIONS History F nly active Find New Save Cancel Select FACILITY Information on the facility where the patient is residing b Facility The name of the facility already on file Once a Facility name is entered the patient is flagged as a facility patient and special rules apply c Primary Physician This is the patient s primary physician usually used to print on Physician Orders or Medication Sheet d Admitted The date the patient was admitted to the Facility e Location Type This field is used for electronic carrier billing to inform the carrier of the patient s location f Room This is the room the patient is located in the Facility Some reports can be sorted by the patient s room number The field is freeform and you can specify a floor or wing location as well for example 3 floor west wing amp room 210 can be defined as 3W210 g Alternate Physician This is the patient s alternate physician usually used to print on Physician Orders or Medication Sheet h Referred By Here you can define a reference on a referral the record is saved in the Contact file You can later print a report of all referrals by contact i Standing Orders These are patient directed orde
155. the patient Age alerts can occur when the patient is too old for the given medication is too young for the medication or is not within the normal age range of the medication 8 Drug pregnancy contraindication In drug only environments where diagnosis is not available pregnancy is implied by the use of a prenatal vitamin by a female between the ages of 12 and 45 Drug pregnancy contraindication alerts occur when a drug that is not recommended for use during pregnancy is filled within six week of a prenatal vitamin 9 Excessive quantity Excessive quantity alerts occur when a quantity is billed which is outside of normal dispensing parameters for a given XX days supply Note Days supply information is critical to the edit function of the prospective DUR system Submitting incorrect days supply information in the days supply field can cause false DUR messages or claim denial for that particular claim or for drug claims that are submitted in the future Responding to a Drug Utilization Review DUR Upon transmitting a prescription claim the processor will review the complete patient s history regardless of where the medication was dispensed and will alert you of any conflicts interactions duplications over or under uses At times you will be required by the carrier to respond to a DUR in order to have the claim adjudicated To do this you must go to the Next page of the prescription with a DUR Remember the first code of the DUR tell
156. to have their prescription refill automatically To use the auto refill feature the patient can not be in a facility and you must have access to the Cycle fill screen If checked as a prescription is created it will automatically be set to Auto refill Later you can refill all the Auto Refill Rx via the Cycle fill screen i Allergies Here you can specify all the patient allergies if present the system will check for drug allergy conflicts j Diagnosis Here you can specify all the patient diagnosis k Picture If a camera is attach to the computer you are on you can take a picture of the patient or take it with another camera and import it Copyright AbacusRx Inc Page 23 of 100 Fel Patient File SMITH IOHB ID 2583 Only Active r 1 of 1 patients LastName FirstName Middle Name e SMITH JOHN 12345 SW 123 STREE MIAMI FL 3183 ES Enter or edit insurance info here Notes Documents y below all the payment methods the patient is known to have Eligibility check will al Card Holder Name check if the patient 1S Group amp EN CoPament A R Co Pay No y eligible for benefits and will also retrieve Insurance Payment Plan Card H Eligibility veride Code ON ot specified Eligibility Check h Relation 10 Not Specified Home Plan mmm the patient s insurance information Person 100 Not specified
157. tom a log of prescription entered for the same patient Copyright AbacusRx Inc Page 2 of 100 Prescription Processing From this screen you can enter information about a new patient fill new prescriptions refill active prescriptions display the patients Rx history view notes about the patient or Rx and much more 1 We begin at the Patient prompt Here you will enter the name of the patient in capital or lower case letters only the patients last name only the patients first name prefixed by a or a partial name i e Smi J or the patients number to locate the patient you are dispensing the medication s to If the patient entered is not on file you will be asked if you want to place the new patient on file If you misspelled the name you will have the opportunity to re enter the name at the prompt If you enter a name that 1s on file a list of patient s that match the name entered will be displayed When a patient has been selected information about the patient patient allergies health condition or special comments about them is automatically displayed on the top right side of the screen Fx Patient Prescriber Item Plan Capote sign Un Search Report necs eee Orler E rie Refill Prescription SMITH JOHN ID 2583 Patent Information 2345 Sf 123 STREET mJ FL 331983 S MITH JCOHBIEJ Type the patients name here Last Click here to locate name first name you ma
158. translation of the instructions This number in combination with the Dosage per day is used by the software to calculate the days supply C Dosage Day this is quantity per day translation of the instructions This number in combination with the quantity per dose is used by the software to calculate the days supply d Print on Med sheet Time Slot is used to indicate the time slot on the med sheet or physician order to print the passing times This field is used only if you print Med Sheet or Physician order forms e Other Language sig In cases where you wish the instructions to appear in both English and a foreign language you construct a SIG which contains the instructions in both languages The Other Language area is a special field that will accept foreign icons or characters all you have to do is type the sentence in the Language you need to and when the Sig is selected for a patient with language of Other language the special Sig will be displayed or printed Example shown below BEH L ERBAK B Take 1 three times daily One letter codes There are three different sets of one letter codes A set of codes is used in each of the first three code positions position 1 2 and 3 When combining a one letter code from each of the first three positions the result may look as follows A one letter code in position one usually translates to a verb e g take give apply etc Codes in position two are usually translated to a n
159. u may maintain diet orders diagnosis multi allergies etc All of this information can then be printed on monthly physician order sheets e Inactive orders can be flagged as such remaining in the patient s profile to be reactivated when necessary e Special Drugs such as IV fluids medical supplies even admission kits can be maintained in your drug file inventory and can be dispensed much like a prescription if you have such a need e Patients can be flagged by type such as Medicare Medicaid VA or Private to facilitate proper pricing and billing procedures e Accounts can be created for charging house supplies to each nursing facility e Patients can be deleted from the Patient File whenever they are discharged and all charges are settled e Each patient s drug regimen can be reviewed each time a medication order is dispensed thereby performing the drug regimen review on a daily rather than monthly basis The potential increase in identifying drug drug interactions allergies overutilization or underutilization of medication can greatly enhance your professional service to the facility MEDICATION ADMINISTRATION RECORDS AND FORWARDED PHYSICIAN S ORDERS These should be printed a few days prior to the last of the month to allow time for a review of accuracy They will be printed in either room sequence patient number sequence or patient name sequence and therefore must be sorted before placing
160. u want to other parameters click retrieve on Search then enter your selection criteria To retrieve a Rx by patient name enter and select the patient name then click on History or press F5 for the patient history and select the Rx you want to retrieve see History screen below Tan Price 3 Origin written Delivery Type 1 Delivery DME ScanRx Other Rx Fields Clear All E Move down up 7 Save O ANY 10 No Product Sort by Date Entered Fill Orders QA From 5 29 2012 To 6 5 2012 lt F1 Help ESC Exit RPH ABA Tech JD Copyright AbacusRx Inc Page 21 of 100 Visual Pharmacu Plus Software User s Manual From the prescription screen click on the Rx Number to the top right side of the screen and enter the Rx number to retrieve Another way from the prescription screen is to enter the patients name then click on history and selected it from the patient s prescription history 3 Rx history of Patient JOHN SMITH ID 2583 Location 01 Main Toretieve a Ax highlight the desired Ax s and click the Modify button Note An asterisk next to the Ax BW Unbilled number indicates refill pending E indicates an expired Ax and D indicates the Ax has been B On Hold discontinued T next to Ax Number indicates that the Rx was transfered 125132 0 2 06 05 2012 16 09 ZANTAC 150MGEFFER MA
161. umber or a fraction e g one two one half etc In third position codes translate to a form or a location e g capsule suppository rectally eye ear etc Two letter codes These codes can only be used after a position 1 2 and 3 has been coded Two letter Sig codes usually translate into a frequency a time span a condition etc For example e Code 4h translates to every four hours e Code bm translates to after each loose bowel movement and e Code sb translates to for shortness of breath You can use as many two letter codes as you like to come up with a translated Sig text For example the Sig text Take one tablet three times daily before meals for nasal congestion can be coded as T1T3DACNC Latin Sigs The user may prefer to enter Sig codes in the way a physician writes it Most of the Latin style Sig codes are pre programmed in the Pharmacy System Unicode Sigs The system comes with standard Sigs in English Spanish and French You may add or change a Sig as needed In addition the system also has the capacity to write in any Unicode Symbol character language example Chinese Vietnamese Thai Korean Russian Hebrew Hindi Urdu Marathi Tamil etc Copyright AbacusRx Inc Page 48 of 100 SEARCH This form allows a user to search for a group of prescriptions with a specified attribute 5 Last 500 Rx Search by LastSODORM v for Any Status from vs to Do
162. used only for your information the actual co payment the patient is responsible for will be transmitted back to you when you transmit the claim to the carrier a The patient s co payment is This is the amount the patient is required to pay under the plan set as a default b The patient s co payment is of the total price The co payment will be calculated based on the percentage of the total price c The patient s co payment is based on sliding table the co payment will be calculated based on the co payment calculation found in another pricing table Rx price Quotation This form is used to allow the user to quote prices on any Item and provide a list of comparable Items Generics with price comparison nll Drug Price Quotation Active Drugs Only Data Entry Print Drug 1421 32 0122 02 HALAC COMBO KI Payment Plan I CASH SALE PK Size Dew Quantity H0 AP Monograph Price Ac Edit Quote Quotation List 406 2097 03 PAROXETINE HCL 10 MG TABLET 30 34 30 Generic 406 2052 01 WARFARIN SODIUM 1 MG TABLET 100 1750 0 Generic 29 3210 13 PAXIL 10 MG TABLET 30 19443 725 Brand After you enter the Item to quote you will be asked 1f you would like to see a list of comparable Items You can enter as many items as you need a quote for Later you can print the quote print or view the patient information leaflet for a drug or edit the quote amount To locate the drug you wish to quote 1 Ente
163. ut html h Obsolete Indicates that the Item is listed as obsolete and is not manufactured anymore i Product Code Alternate code used to search for Item j Product Description Alternate item description currently used to print alternate description on select labels 3 Drug Records 1 of 1 drugs General Pricing Inventory Manufacturer Counseling Documents Monograph View Med Guide Browse E Drug Notes Write a New Note Note Save Note This note will print on the patients Rx education leaflet monograph Audit Trail M 4 1of1 L gt gt t Print notes on patient leaflets Location Display only active drugs Find New Delete Save Cancel Copyright AbacusRx Inc Page 37 of 100 COUNSELING Patient Counseling monograph can be viewed or printed on request or automatically for each new prescription a Monograph This number is used to display the Patient Information Leaflet Monograph link substitute drugs and check for drug to drug conflicts and all other conflicts Med Guide The filename of a PDF with the Med Guides information used to view or print when printing the Rx label c Notes Drug notes are used to add to the Patient information leaflet as well as internal information Tip Full page patient counseling leaflets can automatically print for new prescriptions if this option is set in the configuration screen Monographs can also be viewed or printe
164. ute A728 Street 3810 Niw 2MD TERRACE City Miami State FL Zip 331 26 Direction TAKE 826 TO 2 AVE THEN 2 AWE TO 38 5T Company Payment Entry Here you can enter modify or view payments received from an Insurance Carrier Facility or a Family group You begin by selecting Payment Plan you will then be asked to enter the payment amount credits are entered as a negative amount and a reference number check number or a notation the description of the payment as you want it seen on the statement If you want to automatically post the payment entered against open claims answer Yes to Auto Itemize E Posting Payment Adjustment From Company Optionally scan the check Payment is from Patient Company received for your recor ds Fill all other fields then press enter key Nursing Home Facility A Saat Received Check from Payer jPcsPcS W Balance 1228 77 Date 4724203 xl Open Credit 4626 00 Description Payment Thark you v Check Amount 100 00 Auto ltemize No v Reference 45659 Scan Check TA If the insurance carrier is capable of sending an Aee Electronic 835 Payment iacu Reconciliation rather than entering payments you can just process the file See Audit trail of payments posted gee De Reina Deseibion Amount posting Electronic 835 Payment Reconciliation From the above screen enter the following 1 Nursing Home Fa
165. x transfers Email The users email address Notes General notes for informational use Password The password that will allow the user access to the system Re type Password Type the same password here do not copy this will verify that you type the password as intended Do not display interactions with severity level upon checking for drug to drug interactions if the severity level is one of the ones checked a message warning of the interaction will not display for the user Do not allow to fill Rx with severity level upon checking for drug to drug interactions if the severity level is one of the ones checked the user will not be allow to fill the prescription Use Inventory in Location use this to restrict the user to filling prescriptions for a specific location Useful if you have multiple companies Retail Pharmacy and an Institutional Pharmacy and you want to keep the user from entering prescription for one of them Can also be used for many other applications Only fill Rx from Prescriber This is generally used in a clinical or hospital setting Delivery list by Route or Zip Code If the User is a Delivery person Driver to generate a Delivery list automatically for this Driver enter the Route or Zip Codes they deliver to Contacts A database of all your business relations can be kept here this is used to function like a Rolodex Phone 33183 HOTANYS COMP 5468 W 20 AVE HIALEAH 33016
166. y enter the patient by other okon a partial name or just the last name Click here if you have fields i e patient the word a just the first name with a coma previously selected the patient number phone SSN Patient to in fr ont and a list of the last 20 driver license edit patient s previously selected address card number will be displayed for you to ete select You can TIP Another way to find a patient is to enter the patient number or click on the find icon next to the name field there you will be able to find the patient by other identifiers or click on the down arrow symbol to see the last 20 patients selected at this terminal 1 Next we enter the Prescriber by entering the last name first name or a partial name and select it in the same way as the patient or click the down arrow symbol to see the patient s last 20 prescribers MIAMI FL 331983 Preseriber LAGNA MARK zr ae ed ee Click here to locate the Prescriber by other fields 1 e state license number Click here to select from DEA NPI Physician Type the Prescriber s name here the last 20 Prescriber s Auger mo Last name first name you may that have prescribed to the enter a partial name or just the last selected patient name or just the first name with a coma in front You can click on the word Prescriber to edit 2 The Item Drug is next enter a full or partial drug name and strength or NDC or

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