General CVS Pharmacy Questions

[animalsasleaders]

Hi all! I've been working at CVS Pharmacy for about a month now, and today was my first day of pharmacy school. I know there's a lot to being a tech (not to mention a pharmacist), and overall, I just want to be good at my job and have a good understanding of all things pharmacy before I move on to being an intern.

I know we've all been there-- that point where you feel like you are bad at your job. It's a terrible feeling. The modules from CVS are helpful to a certain point, but there are many questions I still have.

1. How do you calculate when a patient can pick up their next Controlled med, when it won't be too soon to fill? EX: When they drop off a prescription for Oxycodone, the Pharamacist always checks in their profile and says "okay, they're good". Is it 30 days between each fill or something similar?

2. Does placing a prescription on Hold change anything about it? Is it "immune" to becoming expired or something of the like? Or is it just a way of saying this prescrip is active.. but not being filled?

3. This is one I've struggled with: When do you call the insurance/doctor for the patient vs. when do you tell the patient to call them? If there's an issue with the insurance (i.e. wrong name on file) or the doctor's taking too long with a Prior Auth, should I tell the patient to call, or is it my Job to call?

4. Insurances can tell what meds a patient has had filled. That's why it will reject too soon if it was filled at another pharmacy, and isn't physically in RXConnect. But, let's say patient gets Oxy 5mg filled on the 1st. Can they then get Oxy 7.5mg the next day? So I guess I'm asking: does the insurance discriminate by the medication itself, including it's dose, or do the say only 1 Oxy script per x days no matter the dose?

5. Can literally anyone pick up someone's prescrip? I've picked up my girlfriend's prescription at her request before. But, as long as you know a person's name and DOB, can't you pick those up as well? Idk, it just doesn't seem as secure as you would expect.

6. How do you guys calculate days supply for eye drops when typing a script? I would consider myself to be very good at math, but everytime I think I'm doing it right, I'm not.

7. Do you have any helpful tips or pneumonics that you use often (for anything) to help you in the job?

Thank you so much, for answering even one of these questions. It will really help alleviate some anxiety on my part.

If anyone else has questions they would like to ask, please post them below!

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[Mounjaro]

2) No, it's not immune to becoming expired, however it is active. It just won't be filled until the patient requests it. Sometimes we put prescriptions on hold because it doesn't go through the insurance, so we call them in order to make sure that they get it resolved.

3) For prior authorizations, we typically tell the patient to call the doctor. In some cases we have called the doctors ourselves as a reminder that the patient has a prior authorization that needs to be looked into. Same thing with insurance, we tell the patients to give them a call (if we gave the insurance companies a call ourselves, we wouldn't be able to fill scripts on time, lowering our scores). If it's slow we can manage calling the insurance company for them.

4) The insurance relies upon the quantity of the oxy which was filled. So, let's say a patient gets 30 oxy 5mg on the 1st. They wouldn't be able to get oxy 7.5 the next day (insurance would definitely reject seeing as only a certain amount is covered at a time) due to the quantity. Thus, the patient would not be able to get that oxy 7.5 filled AT ALL until the previous prescription's day supply runs out. We've had this happen before. Likewise, the same can happen with clonidine,etc.

5) If it's a control, the person must have the patient's ID. We've had a woman who had been receiving norco and her son came to pick them up with her ID (without her knowing, suspected drug abuse). In this case, she called us and said she is to be the only one to pick up her scripts. At the CVS I worked at, we cracked down mostly on control substances, everything else anyone (family members, etc.) could pick up for them.

6) Most eye drops are around a 7-30 day supply, someone may have more information about this. We're not as precise and typically put them in at 7, 15, and 30 day increments (whichever goes through the insurance).

7) I feel hands-on experience is the best way for me to learn, especially at CVS. Work at a busy store and get throw into the action. The store I worked at was filling around 2,000 a week. You'll practically be forced to step up your game.

 

[gwarm01]

That's a lot of questions for your first day! The answers will probably vary from state to state, store to store. I would just ask your fellow techs or the pharmacist whenever these things come up and consider it part of your training. Just don't ask all of them at once or you'll get smacked in the face.

 

[animalsasleaders]

That's a lot of questions for your first day! The answers will probably vary from state to state, store to store. I would just ask your fellow techs or the pharmacist whenever these things come up and consider it part of your training. Just don't ask all of them at once or you'll get smacked in the face.

Haha, yes. I've been taking notes of some of the more complicated things to remember, and have definitely been asking questions. It's just a job that has endless information it seems and everyone I've talked to has told me it will take 6 months to a year before I feel like I know most everything!
Thanks so much for the reply

 

[animalsasleaders]

2) No, it's not immune to becoming expired, however it is active. It just won't be filled until the patient requests it. Sometimes we put prescriptions on hold because it doesn't go through the insurance, so we call them in order to make sure that they get it resolved.

3) For prior authorizations, we typically tell the patient to call the doctor. In some cases we have called the doctors ourselves as a reminder that the patient has a prior authorization that needs to be looked into. Same thing with insurance, we tell the patients to give them a call (if we gave the insurance companies a call ourselves, we wouldn't be able to fill scripts on time, lowering our scores). If it's slow we can manage calling the insurance company for them.

4) The insurance relies upon the quantity of the oxy which was filled. So, let's say a patient gets 30 oxy 5mg on the 1st. They wouldn't be able to get oxy 7.5 the next day (insurance would definitely reject seeing as only a certain amount is covered at a time) due to the quantity. Thus, the patient would not be able to get that oxy 7.5 filled AT ALL until the previous prescription's day supply runs out. We've had this happen before. Likewise, the same can happen with clonidine,etc.

5) If it's a control, the person must have the patient's ID. We've had a woman who had been receiving norco and her son came to pick them up with her ID (without her knowing, suspected drug abuse). In this case, she called us and said she is to be the only one to pick up her scripts. At the CVS I worked at, we cracked down mostly on control substances, everything else anyone (family members, etc.) could pick up for them.

6) Most eye drops are around a 7-30 day supply, someone may have more information about this. We're not as precise and typically put them in at 7, 15, and 30 day increments (whichever goes through the insurance).

7) I feel hands-on experience is the best way for me to learn, especially at CVS. Work at a busy store and get throw into the action. The store I worked at was filling around 2,000 a week. You'll practically be forced to step up your game.

Thanks so much for taking the time to answer those! It makes me uncomfortable being at a job where there's so much I don't know. Also, do you by chance have an answer for #1?

 

[Mounjaro]

Oh, to answer question 1) most pharmacists check patients (I think it's called PNP) in order to ensure that they haven't got the prescription filled elsewhere (independents, walmart, etc.). If you check the patient's profile, you should be able to see when they last got their control filled at CVS. Calculating it is the easy part seeing as all you do is look at the script and quantity that is present on your computer screen. For example,"TAKE TWO TABLETS PO TWICE A DAY" and the patient is given a 30 days supply of norco. Thirty (days) divided by four (two tablets twice), that's 7.5 so that was an 8 day supply. It should go through their insurance and be fillable on the ninth day after the script was picked up. Sometimes this can also depend on the insurance. Anyone feel free to clarify if I'm missing anything.

 

[Mounjaro]

I was in the process of it , you'll feel like you're dragging everyone down the first few weeks. However, after two or three months you should be comfortable with the system and how your store works. Good luck!

 

[animalsasleaders]

I was in the process of it , you'll feel like you're dragging everyone down the first few weeks. However, after two or three months you should be comfortable with the system and how your store works. Good luck!

Hey, you're awesome man! Your advice has really helped me. I have work later tonight, so I can't wait to put my new knowledge to work. Thanks again.

 

[gwarm01]

Haha, yes. I've been taking notes of some of the more complicated things to remember, and have definitely been asking questions. It's just a job that has endless information it seems and everyone I've talked to has told me it will take 6 months to a year before I feel like I know most everything!
Thanks so much for the reply

Taking notes is pretty smart. I always do that when I start a new job, and I usually bring the notebook in with me for a few weeks until I start to feel comfortable with the basics. It's been a long time since I worked as a tech, but for my first pharmacist job it was probably about six months before I got really comfortable. I remember being scared every time my partner went to lunch for the longest time. Once an ICU doc called me asking if we could order a new type of blood factor product that I had never heard of, had no idea what the hospital policy was, or who to even contact to figure it out. I did manage to solve the problem before my partner came back, and I think that might have been the day that I started to gain a little confidence. Anyway, good luck and you'll get it!

 

[maria1oh]

For eye drops I use 1 ml = 18-20 drops. So 5 ml bottle has 100 drops. If patient uses 1 drop each eye twice a day that's 4 drops per day so 25 day supply.
Also eye drops come as 2.5 ml bottle size so if it's 1 drop each eye daily that's 25 day supply.

 

[trailerpark]

Walmart has us use 1 ml as 15 drops and I've never had an issue doing that. Allows for a good amount of leeway on the patient as far as refills go.


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[6GodPharm]

Honestly lately i've been having my techs extend day supplys on eye drops and inhalers. These eliminate PCQ calls and people who don't use them regularly. If someone is using it as prescribed (hardly ever) then we just edit the sold rx and run the refill.

 

[Biologynerdforever]

Hey I started working at osco pharmacy as a pharmacy tech and my biggest obstacle is in window because I can't seem
To get days of supply and I heard some
Techs talk about me . I get the out window fill station can anyone help
Please?

 

[animalsasleaders]

Hey I started working at osco pharmacy as a pharmacy tech and my biggest obstacle is in window because I can't seem
To get days of supply and I heard some
Techs talk about me . I get the out window fill station can anyone help
Please?

Do you have an example of the type of days supply problems you're having?

 

[Biologynerdforever]

P

Do you have an example of the type of days supply problems you're having?

in general I am having trouble
To calculate it what's the best
Way to learn it

 

[cakezyum]

How do you guys calculate the otic med drops and the cream/lotion?

 

[txpharmguy]

How do you guys calculate the otic med drops and the cream/lotion?

15 gtts/ml for ear and eye drops. 10 gm/day on topicals