- Joined
- Sep 13, 2018
- Messages
- 126
- Reaction score
- 21
hey guys,
Got that rejection for a non controlled med. called the office, they said they had this issue and it’s due to the doctor renewing his DEA #. I put in the override for “DEA validated” which is 42 since that’s the only one that works and the insurance company told me to use, although I tried 43-“DEA renewed” but it didn’t work. It’s not a control so what does DEA have to do with it? I called back to get the DEA number and documented on script anyway since the code says dea validated, I figured maybe I need the # even though with the other override of dea renewed it’s probably ok to just document what the office said instead of getting the number.
My question to you folks (especially in chains) is how you ensure you’re not processing cashed out rxs for such prescribers? Let’s say if I was a careless Rph, saw the rejection and didn’t care about the “invalid prescriber” and just went ahead and cashed it out for a few bucks... next month’s rph would probably refill it as is without questioning or doing their own investigation lol I would assume it wasn’t covered that’s why it’s cashed out. Or let’s say tech bills it on my shift, sees the rejection and cashes it out, at an independent i dont get any alert during verification—can you guys at chains? I still think it probably won’t show since you’re verifying a cash med but the software should do a hard stop regardless of whether its thru ins or cash. I wouldnt want to dispense without speaking to someone at the office if the rejection is suggesting anything remotely close to a prescriber not having authority to rx lol.
With erx we might not need to worry as much since it should be authenticated, but written rxs is where it gets tricky. Who has time to be an investigator and see the written rx was cashed out, go back and run thru insurance in order to see the transmission message then realize you need to contact the office lol. If it doesnt tell u during verification i would think its very easy to overlook if last months rph cashed out or if today’s tech converted to a cash rx. Idk if chains let you see transmission messages if lets say its a written rx thats cashed out and ur curious to see why it was cashed out, can you even go back and see it without trying to process thru insurance again? Even if you can see the previous transmission messages, it just seems like a hassle that nobody has time for. Any thoughts?
Got that rejection for a non controlled med. called the office, they said they had this issue and it’s due to the doctor renewing his DEA #. I put in the override for “DEA validated” which is 42 since that’s the only one that works and the insurance company told me to use, although I tried 43-“DEA renewed” but it didn’t work. It’s not a control so what does DEA have to do with it? I called back to get the DEA number and documented on script anyway since the code says dea validated, I figured maybe I need the # even though with the other override of dea renewed it’s probably ok to just document what the office said instead of getting the number.
My question to you folks (especially in chains) is how you ensure you’re not processing cashed out rxs for such prescribers? Let’s say if I was a careless Rph, saw the rejection and didn’t care about the “invalid prescriber” and just went ahead and cashed it out for a few bucks... next month’s rph would probably refill it as is without questioning or doing their own investigation lol I would assume it wasn’t covered that’s why it’s cashed out. Or let’s say tech bills it on my shift, sees the rejection and cashes it out, at an independent i dont get any alert during verification—can you guys at chains? I still think it probably won’t show since you’re verifying a cash med but the software should do a hard stop regardless of whether its thru ins or cash. I wouldnt want to dispense without speaking to someone at the office if the rejection is suggesting anything remotely close to a prescriber not having authority to rx lol.
With erx we might not need to worry as much since it should be authenticated, but written rxs is where it gets tricky. Who has time to be an investigator and see the written rx was cashed out, go back and run thru insurance in order to see the transmission message then realize you need to contact the office lol. If it doesnt tell u during verification i would think its very easy to overlook if last months rph cashed out or if today’s tech converted to a cash rx. Idk if chains let you see transmission messages if lets say its a written rx thats cashed out and ur curious to see why it was cashed out, can you even go back and see it without trying to process thru insurance again? Even if you can see the previous transmission messages, it just seems like a hassle that nobody has time for. Any thoughts?
