Cvs Change to broken pack insulin pen policy

[Old Timer]

Hey don’t be mad at me that you weren’t making since or being consistent lol

Also how is correct day supply nonsense? Insurance companies will penalize us for not getting it right so I would say it is actually pretty important.

Also how is it like debating angels dancing on the head of a pin? One is a rhetorical question and the other determines if we will get reimbursed or not.

Not inconsistent at all. Vaccines are billed differently. Vaccines, like colonoscopy preps are not recuring prescriptions. Depo-Provera is a recuring order that happens every three months.

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[PharFromNormal]

Not inconsistent at all. Vaccines are billed differently. Vaccines, like colonoscopy preps are not recuring prescriptions. Depo-Provera is a recuring order that happens every three months.

I’d argue the days supply of the colonoscopy prep ends the day of the prep. The medication for the prep does not last the duration of a seperate order which would be that of the colonoscopy itself.

 

[PharFromNormal]

Hey don’t be mad at me that you weren’t making since or being consistent lol

Also how is correct day supply nonsense? Insurance companies will penalize us for not getting it right so I would say it is actually pretty important.

Also how is it like debating angels dancing on the head of a pin? One is a rhetorical question and the other determines if we will get reimbursed or not.

It’s simple follow the rules and get reimbursed. No one said you need to know the rules or that the rules make sense. Also in the case of Walgreens with insulin, you can get reimbursed but you can also be sued to pay for it. Just shut up don’t ask questions. Literally just do what you need to do to get the paid claim. They don’t want us to do that but they do. They’ll reject things when it’s wrong until they don’t and you get slapped with a nine digit penalty. By the way what’s the right day supply for this 5mL bottle of eye drops that has a sig “use for 5 days”

 

[PharFromNormal]

Legit recommendation for ncpdp for next telecom standard: have pharmacy submit quantity and a sig. let the payer use sig parsing and nlp to return what the days supply back to the pharmacy is. That way it can never be wrong. 😉

 

[Deja]

What you wouldn’t want is 2019 flu season shot triggering a warning for 2020 flu season shot. In that sense it is an improvement. As for a flu shot from this flu season triggering a warning for a flu shot this season I would be very surprised if the system didn’t trigger a warning. Not to mention I doubt most insurances would be willing to pay for the same flu shot twice in the same season.

As for an improved DUR system saving time...I mean yeah but in practice it’s the opposite. Fill a script for zestoretic sometime and enjoy the duplicate therapy warning you get.

not sure about flu shots but CVS system definitely flags duplicate therapies... although I still say Rite Aid flags the duplicates the best...

also not sure what you are talking about with zestoretic...

am i missing something lol

 

[Concerned Parent]

Just gonna leave this here

View attachment 313771

Then why are pharmacies still opening the packs of 5 and dispensing individually? In order to save a few dollars per month, these insurance companies are putting diabetics at risk. If the pens were meant to be distributed individually, they would be packaged that way with an individual insert. Opening the sealed box of 5 leaves the product open to the possibility of med errors (many of these pens look very similar), tampering, and contamination. If they want to require dispensing the pens individually, they need to be packaged that way. Tylenol requires a safety seal, but an injectable medication doesn’t?