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Discussion in 'Pre-Pharmacy' started by Oink, Aug 8, 2013.
This is not the case in FL. Techs can take refills over the phone and initiate refill requests, provided no changes.
I guess that helps Florida's drug problems
SO.. do I write the name of the person I'm speaking with, number of refills, time, date, my initials -> hang up and then show it to the pharmacist?
Ask the pharmacist. My techs just scan the printed refill request with that info on it as the hard copy.
I think you might mean doctor calls = a verbal order/rx. In some states, a tech can accept additional refills to an existing rx...but...
If the doctor is calling in a *verbal* Rx/order, then you pass the phone call to the pharmacist (some pharmacists allow you to take down their name, DOB, office # and doctor name/DEA/NPI but NOT the drug and sig...ask your pharmacist. it comes in handy when he/she is busy)
I'm in california and state laws may differ. If a nurse, med asst or doctor is authorizing more refills for an existing medication with no change in strength, sig or authorizing prescriber and it's NOT a control, then you can add the # of refills and type the caller's name and position (RN, MA, MD, etc)
---if they want to add refills to a control (C3 to C5), then you ask them to talk to the pharmacist to give a verbal order or fax a legit rx..whatever is a legit RX is dependent on the state.
--Another thing that pops up in some computer systems is if the rx is about to expire, then you pass it to the pharmacist for a verbal
And Oink, it's always best to ask your pharmacist what he or she wants because some people differ. Pharmacists have rules for controls mainly so ask them about their procedures for handling those.
I did not consider other states, my bad. In ohio only interns/pharmacists. However, here in Ohio we really don't use doctor calls that often, they usually just e-prescribe everything.
Hey guys! I have a few questions myself:
1. How do you do partial fills?
2. Let's say that something doesn't get covered for insurance and you need to request a new insurance card for them to see if it can go through. I know almost nothing about how to do this, so can someone kind of tell me how, step by step?
3. Let's say they're going on an out of country vacation a few days earlier than when they can get the meds, and the drug is non- controlled. Can you just process in a refill, and then how will it go through insurance? Or does it still not in this case?
4. If another CVS calls in to transfer a prescription, how do you deal with this? Also, how do you request to transfer a prescription?
5. If someone is in the donut hole, what can you advise them to do at that point?
6. I forget what it's called, but in the prescription when you are given that sheet of paper that an elderly person has to sign (and you have to sign as a witness and stuff), how do you afterwards process this through the cvs system?
(Sorry, also struggling at the job, and I work weekend shifts, so everyone is too busy to help me train)
1. Edit or fill the prescription. Press O (think for out of stock). Then I believe the choice is 2 (partial fill). You should be able to figure the rest out from there (basically fill out how many you are giving them and what time they are picking it up and stuff).
2. If you get a rejection saying that the insurance is expired ("coverage terminated BLAH"), or something like "non-match cardholder Id", you can ask to see their current insurance card. If they are not there, I call and let them know we need the insurance card. At my store, we prefer to not take it over the phone if possible because some people really suck at finding the numbers you need and some cards are confusing. You need 4 things: BIN, PCN, ID, Group. As you get better, you can do it with just a few of these things. Normally, the card has the name of the insurance provider (Express Scripts, Medco, etc.). Sometimes, the pharmacy provider is on the back of the card. Use that name to pick between all the things that pop up with different BINs. Sometimes you will have to guess, but you'll learn it as you go. Ask if you need help.
3. If leaving on vacation, sometimes insurance allows for early refills for vacation. In QT in the rejection, go to that rx, hit A (don't remember what this stands for, but basically lets you put in override codes), hit 10 (something like override codes). Numbers will be listed with reasons. The only one I remember is 2 (for other) and 5 (for therapy change). There should be a number for lost RX and vacation supply. Not all plans allow vacation supplies. You may have to call the insurance and see if they can put in an override for you. Caremark's favorite new phrase is, "the patient can always pay cash (without insurance)". At least if it's not a control. If they are not going out of the country, you can try to see if there is a CVS where they are going and they can transfer it there (again depending on whether or not it's a control, state laws vary on controls).
4. If a CVS is calling to transfer, it is on hold or the first fill. This means you must print the RX and fax it to the pharmacy. I ask for the RX number, repeat it to make sure I'm right, and the store number. You can pull the hardcopy (find it in the stack), or print it. To print it, go to M2 (some kind of maintenance?), then 4 (prescription maintenance), then I think 3 (print hardcopy). Don't memorize the numbers, just read. Then type in the RX number and the hardcopy prints. You type 1-800-700-**** (****=store number) to fax or call any CVS. If you want to look up the fax number there is a key on the keyboard that says store info. Then type in the store number you want (add a leading 0, store numbers should be 5 numbers for most things except when faxing/calling). To transfer from another CVS, you simply do it centrally. Got to the patient's profile and act like you're filling a normal RX, unless it is the first fill (you're backing it out of another pharmacy) or on hold. Then you must call the pharmacy in question and get them to send you the hardcopy.
5. Nothing to do about other people's insurance
6. I think you're talking about the Part B sign off sheet. It has a barcode in the upper right hand corner. You scan that (from the main menu), and then scan the sheet. Your store should have a place these are filed.
I hope I wasn't too confusing or overwhelming. Do NOT try to memorize numbers or menus. Most things can be figured out just by reading the options as long as you know where to go.
I like this advice. I know I am guilty of memorizing numbers and menus and don't even look at the screens as I fly through them, but this is after years of doing the same repetitive tasks, lol. If you can read you can do ~95% of the stuff RxConnect will let you do without issue. The other 5% you learn through experience. OP, there is seriously no reason to let yourself get overwhelmed. For example, at production (QP) if you scan the label one of the options in the menu bar is "Partial Fill (O)" or something similar. From there you just follow the prompts. Keep it simple, yo.
Hi guys, Can you please help me with those questions, I really appreciate if you can help me please
1) What's exactly the status of the Medication is on patient's profile is "On-hold", "Scheduled", "RTS"? Can you explain for me please. I have a tons of patients who are supposed to get for ex: 3 medication, but when I type on register, it just shows 2 Med in the WB, and the other med is "on hold" or "scheduled" or "RTS". What should I do when the status like that? Can you explain for me the Scheduled Drug and Non-Scheduled Drug, how to process those different status?
2) I really don't understand my pharmacist in charge. I don't have the schedule for next week yet and I'm waiting for him to call me anytime. I just worked last week for few days and that's the first week in CVS, then when I called him, he said when he will call me back, but he won't. Is it normally like that in pharmacy that new technician don't have stable schedule? or just because I'm new so they are challenging me? or what? I really don't get it???
3) The pharmacist in duty, he gave me a ton of work on PCQ and he said I supposed to call like 30 calls to patients, but I can't. Too much people at Pick-up and I just can handle like 10 calls, and I worked only a few hours on that's day. Does in Pharmacist in charge's eyes, I'm a bad technician who doesn't finish and keep the job? He said when time is over, I can go home. But I have a bad feeling that they are challenging me? Do I need to stay late, Punch out the time to work, and finish the rest 20 calls. He said he doesn't want people work overtime.
Please help me, I'm really in the middle of nowhere and this is my first pharm. tech job.
1) On-Hold means that the prescriptions was stored in the computer. It has never been filled (or was filled once and returned to stock because it had not been picked up for 2 weeks). Normally, a prescription is On-Hold because: 1. the patient requested it, 2. it was too soon to fill when we got the rx, 3. it has been returned to stock because it was not picked up for 2 weeks. If you normally look at the date it was put on-hold you can make an educated guess, but for you at this point it is probably better to ask another more experienced technician. Do not guess.
Scheduled normally means it is part of ReadyFill (this automatically refills prescriptions 3 days early for patients enrolled). Sometimes it means a rx was too soon at the time an the insurance allowed us to schedule it for the day when insurance would pay for it. Normally, I look at the time the same rx was filled (or one with the same drug and same directions). Look at how long ago that was and calculate if they should be close to out. Insurance will normally pay a week or so ahead of time. If it is a control, most pharmacies will only fill it 3 days early (this depends on the pharmacy but my DM is cracking down on this). It may be best to ask a more experienced tech again (there can be a lot of things an experienced technician can guess from just looking at dates and statuses of prescriptions).
RTS means returned-to-stock. Normally, this means the rx was not picked up for 2 weeks, so we returned it. There are other times where the patient may have asked for it to be returned.
2) Completely depends upon the culture of the store. Some stores work new techs a lot at times when another tech can 'watch' them. Some stores do not have the hours for this and only work the new tech when they couldn't get someone else. Some stores do other stuff.
3) Never work without getting paid. Your pharmacist can actually get fired for asking/knowing letting you to do that Sometimes you only do what you can do.
You just need to focus on learning as much as you can, staying SUPER nice and professional to customers, and try to pay attention to your training. Remain fun to work with, you're going to be asking A LOT questions and that's normal. Try not to ask the same thing more than 3 times (me and most of the techs I work with agree 3 is the limit ). Especially try not to ask the same thing in the same day. Luckily, summer is coming up and that is a better time to train people because it is slower.
I wish you luck
I really appreciate all your answer. I'm still learning stuff. I have another question.
For ex: the patient come to pick up Rx, then I know 1 Rx is on-hold. Then they ask me why it's on hold. Then on the patient profile, I hit "S", I see it's on hold, and I select the Rx is on-hold. But I don't see anything else. After that, I hit "P", select the same Rx is on-hold, I hit they wait "W15". After that, I see the Rx is on-hold transfer to QP, but the the insurance don't cover that.
Can you teach me another way to see if "the Rx on-hold is not cover by the insurance". Because the way I do, it's transfer from "on-hold" to "QP", and if the patient don't pay for medication, it's my fault to put Rx from on-hold to QP. It wastes everybody time and paper.
Another question is can you teach me how to do this. I don't remember the name of it, but I click QV, then I need to call the doctor office to ask them if we can get any refill for patient.
Thank you very much, I appreciate it.
There is no way to know it wasn't covered by insurance, unless the technician who put it on hold puts it in the sig. Technically, I think they are suppose to call the patient (but as busy as stuff is, this doesn't always happen), so in my store we put a note in the sig like "Take 1 tablet by mouth every day ***Not covered by ins--- $350*** that way whoever looks can just look at the sig and see why it is on hold without running it through or put a note on the bag (if they have other rx's). If your store does not do this, there is no way without running it through.
After running an rx through always hit Adj. Status (which I think is F12). A little window in the lower right hand corner will show up with recent rx's ran through will pop up with a circle that is green or red and the price. Green is good, it went through insurance. Red means it did not go through insurance and you need to go to QT and see why. In the situation you described, somebody fixed the rejection so it would go from QT to QP (it shouldn't without going through insurance). QT is where you will see the actual insurance rejection. You can ask for help here if you are not sure about what these mean.
Our doctor calls are done by the pharmacist (as they are in QV), but basically, you call the doctor and let them know we sent refill requests for this medication and for this patient and have not received a response. If you have to leave a voice mail, remember to leave all the information they would need (DOB, medication, when it was last filled, etc.) I believe afterwards it makes you call the patient. You just let them know, we called the doctor on a refill request and have not heard back yet and have sent it 3 times or had communication errors or whatever the case may be. Do NOT say the medication name or anything in this case (if it's a voice mail).
I hope that answered your questions, I'm a little frazzled today
Honestly, with cases of medications not going through to insurance, I call the patient to see if they have a new card. If they do, I usually bill it to cash (it depends on the drug, maintenance stuff for sure). If it's crazy expensive, I put it back on hold. You can easily put it back on hold if you hit E and then the line number from the QP and then hit H from the edit screen. If it is a refill select DE from that screen instead. It just reverses any claim for a medication someone doesn't want.
And with regards to PCQ, they suck. I have issues completing them most days, don't sweat it.
Wow, you guys are awesome. I appreciate alots. I need to do QV request call, PCQ everyday. Now the pharmacist said they will teach me how to do QT. How hard is it? I saw it and I thought we need to make a call for insurance. I'm getting scared. Lol.
Do you guys need to do the reconstitute for some antibiotic med, can pharm tech do it or it has to be a pharmacist do it. I know that Target, they let the pharm tech do reconstitution?
At target they allow techs to do mixes but cvs in general does not.
QT isn't too hard. You really have to know sig codes for the most part (in regards to prescriptions e-prescribed).
But insurance issues can be a pain. At least some of them are easy to resolve.
QT is typing in electronic prescriptions and faxes sent in from the doctor (and possibly other stores) and also fixing insurance rejections (which may involve calling insurance companies).
For a lot of sig codes (when typing a new prescription), you can type it into the computer separated by a ";" and it will go.
Example: "1t; po; qd; hs;" hit enter and it changes to the written text "Take 1 tablet by mouth every day at bedtime". Some combinations can be typed without the semicolon (I think 1tqd), but I do not know all of those and normally just hit ";" between them all. Makes typing a lot faster.
Insurance issues can be very hard, and you will likely have to ask a lot of questions. I have been working 2 years and still ask questions to my lead tech if I get something really weird who has worked for 15 years (and very rarely she doesn't know the answer either).
My DM just made a point of telling us that techs are not allowed to reconstitute any more like 2 weeks ago (which is funny because some of the technicians have been reconstituting longer than our pharmacist has been an actual pharmacist). We had always been reconstituting until then. You probably should double check with the techs in the store to see what's actually practiced though. It is a CVS policy and not a state law (in Texas at least ).
Hahah, just the other day I spent 35 minutes on the phone with an insurance company trying to get a vacation override (well, they're going back to their home country for a few months). That was a beast to tackle.
Reconstituting is so easy.
Idk why we have to waste the pharmacist's time to do something we could easily do ourselves.
Did your stores get a hydrocodone safe? Or was that just my district? Talk about another extreme wasting.
I believe all of CVS now has a hydrocodone safe, but I could be wrong. My district does also.
LP seems to be making a lot of changes, so I'm sure somebody somewhere messed up and now we all get to suffer for it.
QT is a beast. If at all possible I would ask to practice with QD first. QD will give you practice typing without the hassle of insurance rejections. In the spectrum of technician training insurance is by far the hardest thing to learn.
Thank you very much guys, I appreciate it. Owlegrad, what's QD for?
QD is queue drive through. It is for pre-entry of prescriptions and some insurance fixes. My store doesn't use QD though. It can be good practice. I think you just pick the right patient and type in when they want to pick it up and the number in their order and scan it, but like I said my store does not do pre-entry.
No insurance rejections go to QD. It is just electronic prescriptions and scripts that have been scanned in at drive through and voice mail. It is great for practicing typing without being hassled with all the insurance rejections and other garbage that goes to QT.
Ah, my mistake. I always thought I saw some insurance rejections in there. My store doesn't really use pre-entry, so we all just use QT.
It's definitely better to practice typing before you get into insurance rejections and all that jazz.
I have floated at stores that don't use pre-entry. It makes no sense to me. Is that people enjoy looking around the pharmacy for prescriptions? Enjoy misplacing them? Waiting for them to be typed in before you can see their status in the computer? The pre-scan thing was a nice upgrade from the old system of having a stack of prescriptions at drop off waiting to be typed.
I never really got the whole "fight the system" attitude some people have with regard to workflow. Just use the system in the manner it was designed to be used.
We're just seeing it differently is all. We tended to lose scripts when we did preentry. We haven't lost one now in a really long time. Also, the people who did the preentry at drive through tended to pick the wrong person (don't ask me how), increasing the number of scripts that were typed under the wrong person. They also tended to mess other stuff up. Drive through is normally newer techs is all.
Older techs can type most rxs in just as fast as preentry (obviously some preentry would be much faster) and some techs took like 5 minutes to do 1 preentry and had to keep asking like every time :-/ (this did not help out drive through wait time or satisfaction). The main girl that types likes preentry, it's just that the newer techs haven't been able to do it and drive through successfully.
It's just what works at our store (to avoid filling errors and make sure people actually got through drive through quickly). Does not mean it would work at every store (a 24 hour store probably NEEDS preentry). We never tell floaters they CAN'T preentry (we never mention it at all), I just go and grab the actual hard copy and print the real backtag right after I type it so I can file it right away. I hate going through later and filing all the prescriptions and trying to figure out why some have backtags and some don't and why is everything out of order (though that's another story too T.T).
I know it's defiantly annoying as a floater though that the rules are "not the same" everywhere.
hi, I need help ! I had interview at CVS last week. The pharmacist asked me few simple questions which i answered correctly , than she explained me about the pay that for first few months you will be blah blah and once you become certified tech. than you your pay will be like XXX. she also told me that i need go to different CVS stores for the training and i will be paid for that as well, nothing i will be doing on free.
But after completion of interview she told me that she will inform me once she make decision as she has few more interviews in raw.
Now,, Its been more than two week and i did not heard anything back from her.. I called her few time but got the same answer that she has not made the decision yet. What does that mean?
I want to know that will she inform that they had recruited other tech? or she will keep ignoring my question?>
Now there is another opening at near-by CVS store, i went there asked them if they have opening they can look at my profile as i have already applied online. That other pharmacist asked me my name and other detail, checked on computer and than he told me that my resume is not available for download.
I can not understand what is happening?
Is it that CVS interviews candidates fro only once?
Can i apply to other CVS location, if i am rejected from one CVS?
Please help me.
I need this job .
I never saw this either, maybe once but in my state theyre supposed to be written out both ways so we make sure the script wasnt altered. Are we required not to dispense til we call and verify then? So annoying
lol, i remember my first day. Some intern threw me under the bus and then started yelling at my for not knowing how to do something. Then at the end of the day she asked me how long ive been working there, I answered its my first day, to which she replied, "o....oh..... It seems like you have been here forever....." Not only did i get abuse from the customers but also from that intern. It was really great.