Clinical Pharmacist Practitioner
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Transcript Clinical Pharmacist Practitioner
WILLIAM GREEN, R PH, WESTERN MICHIGAN UNIVERSITY
DEBORAH HUBBELL, R PH, UNIVERSITY OF CONNECTICUT
C A R O LY N L A N C O N , R P H , L O U I S I A N A S TAT E U N I V E R S I T Y
L O N C . M U I R , P H A R M D , B O W L I N G G R E E N S TAT E U N I V E R S I T Y
A M Y S AU L S , P H A R M D , U N I V E R S I T Y O F N O R T H C A R O L I N A AT C H A P E L H I L L
Hot Topics: Pharmacy
May 31, 2012
Disclosure
We have NO actual or potential
conflict of interest in relation to this
educational activity or presentation
Objectives
Discuss marketing your college health pharmacy.
Discuss the decision to become a participating
provider in third party prescription insurance
plans.
Discuss how a pharmacy might respond to a
Pharmacy Benefits Management (PBM) audit.
Discuss the impact of EMR on college health
pharmacy.
Why are we here?
To gain a better understanding of who we are as
college health pharmacists and explore what we can
offer to our health centers
Presenters will share their experiences on the topic
areas
Audience is invited to share their experiences also to
expand the knowledge base of everyone in
attendance
Marketing
Pharmacy Services
LON C. MUIR, PHARM.D.
BOWLING GREEN STATE UNIVERSITY
PHARMACY MANAGER
SHS Marketing Committee
Consists of:
Pharmacist, Counseling Center staff member, Administrative
Secretary, and a Marketing Student
Meet Monthly to Bi-monthly
Meeting Agenda Items
Discussion of upcoming campus events
National health awareness campaigns
Promotion of new services
Seasonal products/services
Review of prior minutes
Assess progress and provides a blueprint of tasks to be
accomplished
Outreach Checklist
Simple form used to promote different events
Example:
Promote in Student Union
Send campus wide email
Collaborate with another university dept
Details of the event:
Event planning began in August. Event was promoted in October
using outreaches listed above. This event can be improved for next
year by having more staff present at event.
Marketing Information
Basics
Location, hours, services, payment options
Additional information
Seasonal specials
New staff
New services
Special hours (i.e. breaks)
New products/pricing
Collaboration Opportunities
Academic Affairs departments
Guest speak for health or introductory classes
Greek professional organizations
Guest speak to students who have a common interest in the
public service/health care field
Student Affairs
Learning outcomes
Health and Wellness
Health
Fair
Market in conjunction with Health and Wellness promotions
Collaboration Cont….
Human Resources
Educate new employees to services offered by your pharmacy
to staff members
Open houses, orientations
Marketing Basics
Don’t be wordy
Students don’t read
Always have a visual
Incorporate logo
University approved if applicable
Departmental
Watch out for bright colors
Ease of reading text
Marketing Basics Cont….
Follow set color schemes
Show accreditations
Proof-read
Know your audience
Try to incorporate known figures such as mascots,
university officials
BGSU Pharmacy Website
Handouts/Bag Stuffers
BGSU
University Ad
Campaign
12 ads highlighting staff and
services provided at SHS
Other Marketing Sources
T-shirts
Campus Events- Parade
Email
Sandwich boards
Publications
Campus locations
SHS locations
Bag Stuffers
Website
Departmental
University
Signage
High traffic areas
Union
Sidewalks/chalk
What cool marketing ideas
have you done?
Accepting Third Party
Insurance: Considerations
and Implications
MAY 31, 2012
AMY SAULS, PHARM.D., CPP
CAMPUS HEALTH SERVICES
STUDENT AFFAIRS
THE UNIVERSITY OF NORTH CAROLINA AT
CHAPEL HILL
Campus Health Pharmacy
29,000 students at UNC-Chapel Hill
Serve only students, post-docs, spouses, and
staff of the health center
Average 250 prescriptions/day – school year
Technician staff: 4 FTE
Pharmacist staff: 2.8 FTE + 1 FTE
Pharmacy Director
RX Volume
History of Third Parties at CHP
August 1996 – signed contract with QS1
Family Care
Why?
Competition from local pharmacies
As of 2010-11 year, insurance mandatory in the UNC
system
Right thing to do – help students navigate health care
system, enable students to get the medications they
need, and enable them to get them from CHP
Contracts
QS1 Family Care – majority of contracts,
enhances negotiating power
Separately negotiate with Medco,
Prescription Solutions, Express Scripts
University Counsel reviews and approves all
contracts
Director of Pharmacy completes annual
Verification Forms
CHP serves as Pharmacy Benefit Manager for
Student Insurance Plans
Typical Contract Terms
[(AWP - x %) + dispensing fee] or usual
and customary, whichever is lowest
For
example,
Brand:
AWP - 17.5% + disp fee of $1.25
Generic: AWP – 25% + disp fee of $1.50
May have different rates for 30 versus 90
day supplies
Credentialing/Verification
NPI and BOP license numbers
Liability insurance certificates
Copy of DEA certificate
Federal Tax ID
Services offered, operating hours
Every 3 months, check applicable state and federal
exclusion lists
FWA training
Insurance Requirements
Fill prescription exactly as written
No substitution of sizes of tubes, etc
Can only fill for the amount prescriber writes on Rx,
even if BOP rules allow for more
Must be able to calculate days’ supply from sig
Keep a printed copy of every prescription, even
electronic prescriptions, for 6 years
Call for travel overrides, early fills, prior
authorizations
Signature Logs
Submission Policies
Current NCPDP HIPAA-compliant format
Appropriate DAW code
Accurate National Provider Identification
(NPI) on all claims
Only for the eligible person for whom the
prescription is written by the prescriber
Submit claims simultaneously with
dispensing
Usual and Customary price
Avoiding Audits
PAAS – Pharmacy Audit Assistance Services
Newsletters
Assistance with audits
Resource for questions regarding insurances
Staff meetings
Best Practices Policy
Provider manuals
Workflow Issues
Technicians must become familiar with the most
common insurance cards
Educate students about cards
Find and clarify insurance information – must call
insurance companies, use websites
Who is going to help with problem insurance issues?
Expect longer wait times
Reconciliation
What Does CHS Pharmacy
Staff Say About Insurance?
“Nothing logical about it”
“One of least understood aspects of health
care”
“Patients can be health literate and insurance
illiterate”
“The cards are not always helpful”
Insurance Cards
BIN
PCN
Group Number
Person Code
Relationship Status
Financial Implications
Average $9 margin per prescription at CHS
Pharmacy
Third Party Loss Report – monthly
Constant vigilance for medications that are being
reimbursed below acquisition
Transmission Fees
Look for other ways to be reimbursed
Vaccines
Medication Therapy Management Services
How to Survive Your Audit
WILLIAM GREEN, RPH
S I N D E C U S E H E A LT H S E R V I C E
WESTERN MICHIGAN UNIVERSITY
D U E T O U N F O R S E E N C I R C U M S TA N C E S ,
B I L L G R E E N I S U N A B L E T O P R E S E N T T O D AY.
HIS SLIDES ARE INCLUDED HERE FOR
I N F O R M AT I O N A L P U R P O S E S .
Impact of EMR on
Pharmacy Services
CAROLYN LANCON, RPH
LOUISIANA STATE UNIVERSITY
Pros
Prescriptions are legible
Less paper and scanning
Pt does not have to keep track of hard copy
Have the ability to see previously prescribed
medications
Pt may not need refill that day
Pros
No manual billing to student’s fee bill
Prescriber in clinic can ask where to send Rx and
suggest using our pharmacy
Students are loaded in computer through the
bursar’s office
No need to gather information about address, DOB, etc
Pros
PATIENT SAFETY
System alerts prescriber of drug-drug interactions
Alerts prescriber to allergies that may prohibit prescribing of
some medications
Reduced potential for medication errors
Pros
Quick access to the physicians has enabled a variety
of improvements
Transmission of quantities
Z-pak = 6 tablets not “1”
Birth control = 28 tablets not “1”
Transmission of sig
Prescribers have created their own “favorites” for medications that
do not have a common sig
Cons
Billing doesn’t always work out right
Connection times out ~once weekly
Where did the Rx go?
Implementation is a little rocky
Give your clinic 6 months – 1 year to be fully trained
our story
We did our HOMEWORK, but…
Our smooth PHARMACY ROUTINE suddenly changed…
We communicated with our providers more than ever…
We communicated with our Pharmacy software vendor
for interface help as well as our EMR vendor…
We became experts on IT issues…
We became FRUSTRATED…BUT OUR PATIENTS
SEEMED PATIENT.
ONE YEAR LATER…
WE ARE TRAINED AND CONFIDENT WITH OUR
WORK FLOW
WE APPRECIATE THE LIMITED AMOUNT OF
DATA ENTRY INVOLVED IN OUR WORK FLOW
WE HAVE FEWER ERRORS IN PATIENT BILLING
WE HAVE LESS PHONE CALLS TO OUR
PROVIDERS REGARDING QUESTIONABLE
DIRECTIONS AND DRUG INTERACTIONS…
WE HUNG IN THERE, KEPT OUR SANITY; DON’T
KNOW OF ANY NEGATIVE WHISPERING ABOUT
THE PHARMACY GIRLS…
AND THE STORY AT LSU CONTINUES….
E-MAIL ME: [email protected]
CALL ME: (225) 578-5651
Thank you!