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.