10/17/2018

Post date: Oct 17, 2018 3:59:20 PM

• • Staffing Updates

    • Fatima is back. Matt is no longer here. We have a new shipping technician starting on 10/22. Working on 1 more technician.

  • Red "Misc" tab on Framework

    • Please make sure that we are checking to see what the comment is on an order before we finish processing it. A lot of times the comment section will tell you to adjust the price to something other than the default price that Framework populates. There also may be a note that says something is okay per a standing authorization specific to that client/order. If the tab is red, we need to look into it first. Make sure to erase the old notes if they are not needed.

• Coverage Terminated Rejections

  • We need to make sure that we are looking for updated coverage if someone's insurance says that the coverage has been terminated. Check to see if there is another plan on the patient's profile that we need to be billing. If there is not any active insurance already on the profile, make sure that we are running a Medicare D E1 check as well as a Commercial E1 check if needed.

• Issues on Reorders

  • We need to make sure that we are notifying the facility on any issues with reorders. If we have a call back number, that should be our first line of communication to reach the facility. I am seeing a lot of times where we typed up a request from a facility and the "Global Reorder Request" is just being faxed back, even though we have a good callback number on the paperwork. If we try to call and cannot reach them, then we can email/fax a note back; but make sure to document on the paperwork that we tried to call first.

• Refill Request

  • If you create a refill request for a medication, please make sure that you are faxing it to the doctor and completing it.

• Add to Cycle notes

  • Please make sure that when we see something marked with a big "CYCLE MED" stamp, that is hilighted, with a note that says "Please add back on to cycle when refilling" that we are actually checking the cycle fill box when we refill the med. This is being done because the new script that has come in was only written for 1 month and no refills, but we want it to pull on cycle so we are requesting refills from the MD.

  • 407 "Pending Updates"

    • We are no longer saving "Pending Updates" for 407. We need to scrap whatever remaining quantity they have on their old script and update the orders as they come in. This will help with the requests we get to "Request refills on all meds" since the routine meds should be caught in cycle.

• 499 Billing for Group Homes

  • We need to do our due diligence to make sure we have the proper billing information for 499. If we have a social security number for a client, which we should be getting whenever we admit a new person, we can look up their coverage to see if they have any active Medicaid. That said, if we cannot locate any coverage or if something isn't covered, we need to just send the medication out. Make sure to put a note on the billing comment that tells why we are billing GUAR/FACI. Billing will go behind us once they update the insurance and rebill for whatever they can.

• Billing Nebulizer medications

  • After researching who we are supposed to bill on these medications we determined that the proper course of action is to bill Medicare Part D first. If Medicare Part D doesn't cover the product, then we would bill Medicare Part B.

• 2nd exchange letter

  • We are sending out a letter with 2nd exchange that lets the facility know that if something is short filled it needs a new script. It also asks them to make sure they are requesting refills for any non-cycle meds.

  • New Business

    • 214 added 33 new clients that came from another facility. Transition is being handled by Jan Breedlove.

  • Other