Adding and Authorizing Users

In order to use the BestRx system, first, users must be set-up with appropriate IDs and access rights. Typicallt, this is done with the help of our staff by the owner of the pharmacy or the head pharmacist-in-charge.

First, go to the User menu by going to: Administration:> 1. User Profiles -> A. Add/Update User.

You will come across the Restricted Access screen such as the one in the example below.

As we're setting up users for the first time, simply hit 'Authorize' as the user RPh does not have a password set up.

Select 'Add New User'

Enter the required information; you must enter the ID (typically first name or nickname), First and Last name, RPh or Tech initials depending on the user being entered, New Password and Confirm Password.

• For the state of New York, the Provider ID must be filled out with the pharmacist's individual NPI number.

• For the state of New Jersey, the PIN and Confirm PIN must be entered for Workflow use.

Click "Save & Exit" when done.

Access Rights

At this point, you'll be required to assign proper authorization and access to the user just created. Simply look over the categories, and adjust any and all you wish to give Full Access, Read-Only Access (where specified) or No Access.

Click "Save & Exit" when done assigning Access Rights.

User Preferences

At this time, the user has been created, and they will be able to log into the BestRx program. If they would like, they can also alter individual user preferences according to their habits and likes. Log into the user account in question, then go to: Administration -> 1. User Profiles -> C. User Preferences.

When you are done changing their preferences, simply click "Save & Exit".

Now, the user is fully set-up, and you can begin entering prescriptions. At this time, you can set-up other users as you see fit by logging into the RPH ID or the primary owner/PIC user ID and going through the same steps to create additional user IDs. When you are done adding users, it is very highly recommended that you delete the generic RPH ID as it has no password and full access.

Go back to: Administration -> 1. User Profiles -> A. Add/Update User. Select the RPH user ID from the list.

Click the "Delete" button in the bottom right.

Click "Yes" to delete the user on the confirmation dialogue box.

Performing Medi-Span Update

The Medi-Span update contains essential information for drugs in the system, and, every week, it is updated automatically to assure accurate information in relation to your drug database. This article is meant to guide the user in case the update needs to be done manually.

The Medi-Span information includes details like: allergies, interactions, descriptions, educational messages - both long and short, FDA-approved medication guides for select medications, caution information, auxiliary label information, manufacturer and shape/ID information.

Some of this information is not always included and might be missing. But, most often, any issues related to the information listed above can be fixed by making sure the Medi-Span files are updated, in case they did not do so automatically.

To access the Medi-Span Update screen, click on: Administration -> 4. Medi-Span Update.

To obtain a Medi-Span update, simply click the "Update" button in the bottom, left-hand side of the screen. NOTE : This should be done on your main computer as it will be much faster, and will prevent potential issues that could arise from copying files cross network. When the update has finished downloading, it will process and update all files automatically as shown below.

When you are done, the screen will display a small pop-up in the bottom right; simply click Finish when that appears.

To exit this screen and return to work, click the "Exit" button or press the "Enter" key when the "Exit" button is highlighted.

Performing the Price Update

The price update for drugs in BestRx is provided by a third-party database company; this file updates AWP pricing (average wholesaler price) every Saturday morning.

In BestRx, this prompt appears when logging into the software for the first time after every Saturday. You are given a choice to: perform the update now, be reminded later, or not be reminded until next week.

The price update function can also be accessed at any time by going to: Administration -> 2. Price Update. It is also advised to go in there manually at least once and select options you'd like to have updated when performing the price update.

You can choose to update your AWP, Direct, Fed MAC and OTC Drug prices. Also, you are able to set a flat percentage off AWP for your acquisition cost. However, this will be very inaccurate, as acquisition costs vary from supplier to supplier and drug to drug. It is recommended to adjust your own acquisition pricing and select 'No' in the price update settings for both Brand and Generic acquisition cost updates.

For any reason, if any updates were skipped, there is a function of the price update screen to update multiple weeks sequentially. Go to the price update screen as described above and select the last week you are sure the price update was performed for in the drop-down box. Next press 'F12' on your keyboard, and select "Yes" in the dialogue box that pops up.

The update will take some time as it will be downloading and updating every week one after another. The software will prompt you when it has been completed.

Starting Your First Prescription

From the main screen, make sure "New RX" is chosen. To clear open screens and go back to New Rx mode, simply hit "Esc" on your keyboard or the "Cancel" button in the bottom right when on the main processing screen.

Most likely, your insurance file is empty, and before adding a patient it is a good idea to add their insurance into the system, if it not present. Press "F5" on your keyboard, or click the Insurance F5 button with your mouse.

Search for the insurance plan by typing in the name. Occasionally, you'll need to enter a brand new plan into the system; if that's the case, click the "Add New Plan" radio box. There are a few fields you'll be required to fill out; the Insurance Plan Code, the Insurance Plan name and the BIN number are all necessary. Processor Control Number (PCN) is also often required, but not every insurance company uses it. The Insurance Plan Code is a field for your internal use to quickly identify an insurance. For example, NYM is a name pharmacies in New York often use to describe New York Medicaid, BCBS typically stands for Blue Cross Blue Shield and so forth. Go ahead and fill out the information as provided on the patient's insurance card. When done, click "Save & Exit" in the bottom left.

Tab down to the patient field either by pressing the "Tab" button on your keyboard, or by clicking the field with the mouse cursor. Also, you can press "F3" on your keyboard, or click the Patient F3 button with your mouse. Since this is your first prescription, you'll most likely need to add a patient into the system as well.

The patient file requires that you input the name, date of birth and gender of the patient; however it's always a good idea to input as much information as possible for future use. From the main patient screen, click the "Insurance Plans" or press "F9" on your keyboard to move onto entering this patient's insurance information. Enter the information off the patient's ID in the first available plan; for a new patient it will be Plan 1. Go over the information and make sure it's correct. When done, click "Save Plans".

When done working with the patient click "Save & Exit".

We've made some progress, and it's finally visible on the main prescription screen!

The same goes for the doctor. Most likely, you'll need to enter a new doctor into the system. Go ahead and press "F2" or click on the Prescriber F2 button with your mouse.

The prescriber file only requires you input the doctor's name. However, the insurance company will most likely require their NPI and possibly DEA. When you're done, click "Save & Exit".

Automatically, your cursor will skip to the drug field, and you will need to add a drug into the system as well.

Drugs can be added multiple ways but most employ either the help of a Master Drug File, or by adding a drug manually. For this step, we'll be using a combination of searching the master drug file and adding a drug directly from it. Also, you can choose to simply search for the drug on the main screen, with the caveat of seeing less information than the master drug file normally provides. Left-click on the "Misc" section of the top file menu and select "9. Search Master Drug File"

This screen will allow you to partial search by name of the medication or NDC.

Type the name of the medication. In this example, we're using a partial search for any Tylenol product, using "tyl" to search.

The records with black lettering on white/beige background are ones that you do not currently have added in the system. The records shaded in gray are ones that are already added in the system. At any point, you can click any one of the records' check box on the left and click the button "Add to Your Drug File" in the bottom left part of the screen. After you have added at least one drug, press the "Exit" button in the bottom right.

Now, back in the Drug field, type a search string for the medication added and select the drug that comes up in the search box; this should be the drug from the previous step.

Continue filling out the prescription indicating the quantities ordered and filled, refills indicated, directions and so forth.

For this prescription, you can "freehand" the directions in the larger Sig box below the Sig search line.

Once you've entered all information, you can verify that it is correct and go ahead and click "Save & Transmit Now" in the bottom left of the screen. In just a few seconds you should see a response from the insurance company and hopefully have your first paid claim!

For further explanation on each menu and topics, please refer to the rest of the manual.

Split Billing Setup

We provide options in the Pharmacy Setup screen for how a pharmacy can set up their split billing.

COB Billing Prompt Type: The available options are All Plans or Only Linked Plan

Show COB Billing Prompt When: The available options are User Will Prompt, Auto-Prompt When Copay > 0.00 or Auto-Prompt Always

“Only Linked Plan” option is selected

A “linked plan” is when you indicate a “Secondary Plan” for a patient in the Patient Insurance screen. In this instance, the primary plan would be “EPIC” and the linked plan would be “MCD”. In most cases, when you indicate a secondary plan, you will also enter values for the “OP ID Qualifier” and the “OP ID”.

When billing a claim, if there is a plan linked to the primary insurance, then the program will prompt the user to ask if they want to bill the secondary plan. If the user chooses “Yes”, then the BestRx program will automatically populate the COB info for the prescription and proceed to bill the secondary plan.

“All Plans” option is selected

After billing the primary plan, if the claim was paid and there is a copay or if the claim was rejected, the program will ask the user if they want to bill a secondary plan. It will display a list of all plans for the patient and the user can choose which plan they want to bill.

If the patient has a linked plan on the Patient Insurance screen for the primary plan, then the linked plan will be the first option and displayed in bold. This will let the user know this is a linked plan. The rest of the plans will be displayed in the same order they appear on the Patient Insurance screen for this patient.

In most cases, you don’t have to do anything with the “OP ID Qualifier” and “OP ID” fields.. The program will attempt to automatically determine those values and assign them to the COB tab. If the user want to enter a value that is different from the ones that will be automatically generated, then they can change them from here.

Note: If the claim is being billed for the secondary plan, then the program will prompt to bill another plan only if there is a plan linked to the secondary plan.

From here the user can also add an new plan to the patient’s profile. If the user chooses this option, then a screen will pop up where the user can enter some basic plan information. If they need to enter more detailed information, the user will need to access the Patient screen and enter the plan the normal way.

Now, there is a Split Bill button on the bottom of the Claim Response screen. This button will be visible for all claims. The user can click this button at any time to display the little panel that allows you to choose what plan they want to split bill to.

“Show COB Billing Prompt” option

The Show COB Billing Prompt option tells the program when to prompt the user for split billing. This option does different things depending on the value of the COB Billing Prompt Type option.

COB Billing Prompt Type is set to All Plans

COB Billing Prompt Type is set to Only Linked Plan

Split Billing Explanation

On the Insurance Plan screen, when you click the COB / Dual Billing tab you will see the following options for Coordination of Benefits/Dual Billing Settings. In this document, I will explain how each of these fields work.

Send Other Payer Amount Paid (OPAP) Info

If this value is set to “Yes” then the OPAP fields will be sent to the secondary insurance. The OPAP fields refer to the fields circled in the image below. These fields let the secondary insurance company know how much the primary insurance paid. If the patient was set up for dual billing prior to sending the claim to the primary insurance, these fields will populate automatically.

Most of the time the only value that will need to be reported is the 07-Drug Benefit. The Drug Benefit will be equal to the Cost+DispensingFee that the primary insurance actually paid, not counting the copay. In the example below, the primary insurance approved a total of 63.99 but they only paid 53.99 because 10.00 of that was a copay. Therefore the OP Amount Paid would be 53.99.

In some instances other values besides the 07-Drug Benefit will be required. If the primary insurance paid a tax, then you would have to report the 10-Sales Tax value or if a compounding fee was paid you would have to report the 09-Compound Preparation Cost value. If these values are required, they will be available on the response screen of the primary insurance.

The sum of all the OPAP values should be equal to the total amount actually paid by the primary insurance, which does not include the copay.

Anytime OPAP values are sent, the Other Coverage Code on the main screen should be either 02 (approved claim where primary paid something), 03 (rejected by primary) or 04 (approved claim where primary did NOT pay anything).

Send OP Patient Responsibility Amount (OPPRA) Info

If this value is set to “Yes” then the OPPRA fields will be sent to the secondary insurance. The OPPRA fields refer to the fields circled in the image below. These fields let the secondary insurance company know how much the patient still owes for the prescription and why. If the patient was set up for dual billing prior to sending the claim to the primary insurance, these fields will populate automatically.

The values that need to be sent will be displayed on the response screen for the primary insurance. Some insurances want to know each individual component of the Patient Pay Amount, others only want to know the total Patient Pay Amount, and others will want to know both. This is explained in further detail on the following pages.

When OPPRA values are sent, if the OPAP values were also sent, then the Other Coverage Code on the main screen should be 02 (approved claim where primary paid something), 03 (rejected by primary) or 04 (approved claim where primary did NOT pay anything). But if the OPAP values are NOT sent, then the Other Coverage Code should be either 03 (rejected by primary) or 08 (approved by primary).

Send OPPRA Component Amounts

The total Patient Pay Amount could consist of many different values. The values of 05-Amount of Copay and 01-Amount Applied to Periodic Deductible are the most common values, but other values such as 07-Amount of Coinsurance or 03-Amount Attributed to Sales Tax or others may also be in play. Click on the drop-down box on the COB screen to see all the possible values.

If an insurance company requires that the individual components of the Patient Pay Amount be reported, then you must report the necessary values. These values can be found on the response screen of the primary insurance. If the only thing you see on the response screen is the total Patient Pay Amount, it means the only component is the 05-Amount of Copay. Since that is by far the most frequent reason for a Patient Pay Amount, to avoid confusion we do not list it separately. But if the Patient Pay Amount consists of anything besides the Copay or there are multiple components to a Patient Pay Amount we will list the individial components along with the total Patient Pay Amount on the response screen. If the patient was set up for dual billing prior to billing the primary insurance, these fields will populate automatically.

Screenshot with Copay as the only component of Patient Pay Amount

Screenshot with only one Patient Pay component that is not a Copay

Screenshot with multiple Patient Pay components

Send OPPRA Total Amount

When an insurance company requires that the Total Patient Pay Amount be sent in the OPPRA fields, you would use the value of 06-Patient Pay Amount and enter the value there. This value can be found on the response screen of the primary insurance plan. If the patient was set up for dual billing prior to billing the primary insurance, this field will populate automatically.

If the component values of the Patient Pay amount are also being sent, then the sum of the Component Values should equal the Total Patient Pay Amount value. For example, if the primary insurance said that the Copay was 10.00, the Deductible was 25.00 and the Processor Fee was 2.00, then for the OPPRA fields you would send the values below. Note how the sum of the component values is equal to the Total Patient Pay Amount.

• 25.00 (01 - Amount Applied to Periodic Deductible)

• 10.00 (05 – Amount of Copay)

• 2.00 (13 – Amount Attributed to Processor Fee)

• 37.00 (06 – Patient Pay Amount)

In the example above, if the secondary insurance did not require the component values, then the only value that would have been sent is the 37.00 (06 – Patient Pay Amount).

Send Benefit Stage Info

If the primary insurance is a Medicare Part D or Medicare Part B claim, the secondary insurance may require that the Benefit Stage info be sent. The Benefit Stage Info lets the secondary insurance know how the primary insurance came up with the total amount they approved for the claim. This information can be found on the response screen of the primary insurance claim. If the patient was set up for dual billing prior to billing the primary insurance, these fields will populate automaticallly.

The Benefit Stage Info cannot be sent on its own. It must be accompanied by either the OPAP info, OPPRA info, or both. If both the OPAP and OPPRA info are sent, then theoretically the sum of the Benefit Stage values should be equal to the sum of the OPAP values plus the sum of the OPPRA values (excluding the 06-Patient Pay Amount value if both component and total values are sent).

If the primary insurance company does not provide the Benefit Stage information in their claim response, it is impossible for us to send that information to the secondary insurance. We can not make any guesses or assumptions about what the correct Benefit Stage values might be. If the secondary insurance absolutely needs this information and the primary insurance won’t provide it, we would have to get on the phone with the insurance companies to figure out a solution. But so far this situation has not come up and hopefully it never will.

The Other Coverage Code value would be dependent on whether the OPAP or OPPRA values are being sent along with the Benefit Stage Info. See the sections for OPAP info and OPPRA info for more details.

A screenshot of the COB screen containing Benefit Stage information along with the Response screen that led that situation are provided below.

COB Screen for Claim with Benefit Stage Info

Response Screen for claim with Benefit Stage Info

Send Payment Info for Rejected Claims

This option comes into play when a claim is rejected and the secondary insurance is one that requires the OPAP info. Some plans will require that you send a value of 0.00 for 07-Drug Benefit while other plans will require that you leave those fields completely blank. If the Send Payment Info for Rejected Claims option is set to Yes, then we will send the value of 0.00. If the option is set to No, we will not send any OPAP values.

For secondary plans that require OPPRA values, currently my understanding is that we don’t send any OPPRA values if the primary insurance rejected the claim. This is because since the claim was rejected, it is impossible for the primary insurance to have returned any Patient Pay Amount values in the claim response.

For all instances where the primary plan rejected the claim, the Reject Codes should be provided to the secondary insurance so they know why the claim was rejected. These values can be found on the response screen of the primary insurance. If the patient was set up for dual billing prior to billing the primary insurance, these fields will populate automatically.

Send COB Info on Reversals

When reversing secondary claims, some insurance companies require that we send the OP Coverage Type from the COB segment to acknowledge the fact that we know we are reversing a secondary claim. Some insurance plans do not want the COB segment to be sent at all on claim reversals and will reject the reversal if that information is sent. Most insurance plans don’t care whether we send that information. They don’t require it and if we do send it, they will just ignore it.

For the insurance plans that do require the COB info for reversing secondary claims, make sure this option is set to Yes. For the plans that absolutely do not want it, make sure the option is set to No.

For the insurance plans that do require the COB info for reversing secondary claims, it is important that when reversing those claims that the secondary insurance be reversed before reversing the primary insurance. This is because when the primary insurance is reversed, the COB information will automatically be deleted. So if you attempt to reverse a secondary insurance after reversing a primary insurance, the secondary insurance won’t be able to find the COB info to send in the claim reversal.

In a situation where the primary insurance is accidentally reversed before the secondary insurance, go the the COB tab and enter in some dummy COB info for the primary plan. All you need to enter is the primary plan from the drop-down box and the OP Coverage Type. Then go ahead and reverse the secondary insurance, the claim reversal should go through. After that, be sure to delete the dummy information from the COB tab otherwise they will have trouble if they need to bill this claim again.

Other notes about COB Billing

• For the OPAP values, the value of 08 – Sum of All Reimbursement should not be sent for D.0 claims. That value was the default in NCPDP version 5.1, but it has been retired for NCPDP version D.0 and if sent, will most likely result in a rejection or a claim that does not pay the proper amount. That value will remain in the drop-down box for the time being since not all insurances will be ready for version D.0, but sometime in the near future that value will be removed from the drop-down box.

• The information about what Other Coverage Codes should be used in certain situations is what was provided to us in the NCPDP seminars and tutorials. Those are the guidelines that insurance companies should follow and so far from what I’ve observed insurance companies are obliging by those rules. But don’t be surprised if you run into an insurance company that does its own thing and requires an Other Coverage Code that goes against those guidelines.

• The Other Coverage Code values of 05, 06, and 07 have been eliminated from NCPDP version D.0 and we will soon remove them from the drop-down box. These fields were never really used in version 5.1 either so this will not cause any issues for anyone.

• For version D.0, the COB segment is now required for all claims being billed to a secondary insurance. In version 5.1, there were certain plans that did not want the COB segment if the Other Coverage Code was 08, but the new rules require it. Let’s hope that those insurance companies oblige by the new rules.

Using ERx for Control Substances

As of software update 2.7.0721, BestRx fully supports Electronic Prescriptions for Control Substances.

There is a new column next to the drug name on the E-Rx -> 1. View Received Messages screen. If an E-Rx is for a controlled substance, there will be an image in that column. For non-controls, the column will be blank, as shown in the image below.

The icon has a blue “C” to indicate it’s a controlled substance. If there is a green check-mark with the “C”, it means that our system was able to digitally verify the message. If there is a red “X” with the “C”, it means that our system was not able to digitally verify the message. If you hover over the icon, it will tell you why we were unable to verify the message.

Electronic prescriptions for controlled substances have to include a digital signature or be verified using other electronic methods. The logic behind it get a bit complicated, but basically it’s to ensure that the records was not altered in any way after it was sent by the prescriber.

When you click on a message, it will display whether the message was verified or not as well as how it was verified or why we couldn’t verify it. If the message couldn’t be verified, the control class of the drug will be displayed in red:

If a message can be verified however, it will display in green:

If prescriber wants to send an electronic prescription for a controlled substance, the prescriber’s software must also be certified for this function. There are ways that a pharmacy can check to see if a prescriber has the ability to send electronic prescription for controlled substances.

If a pharmacy wants to see which prescribers that are in their system have this ability, they can do so from Reports -> 1. Listings -> A. Prescriber Listing. Select the appropriate service level and generate the report.

If a pharmacy wants to see all the prescribers in their state that have EPCS functionality, they can do so from E-Rx -> B. E-Rx Prescriber Directory. Select the appropriate service level and generate the report.

When filling a controlled prescription that was received electronically, the prescription MUST be filled using the Fill Rx button from the screen displaying the original E-Rx message. Clicking the Fill Rx button allows the E-Rx message to be internally linked to the actual prescription record. This is necessary because the Message ID and Prescriber Order Number from the E-Rx message required for the purposes of controlled substance reporting, and linking the E-Rx message to the actual prescription record allows us to retrieve that information.

So if someone is filling a controlled prescription and they are putting an Rx Origin Code of “3 - Electronic”, the prescription must be linked to the original E-Rx message. Otherwise they will receive an error message and they will not be allowed to save the prescription.

Entering a New Compound

Entering a compound is a simple process similar to manually adding a drug to BestRx.

With nothing populating the drug field on the main screen or completely in NewRx mode, click Drug File (F4) then Add New Drug.

The required fields (outlined in red) are the same as when adding any other drug; there are only a couple other things that distinguish a drug as a compound. The fields marked with the red arrows pertain to this step.

Drug Description : Enter the description for the compound you're making. Be sure to be descriptive as it will make it easier for you to find this compound for later use.

NDC / Product ID : Enter any number in place of the NDC number. This number is not important as the only identifying information sent with the claim will be the NDC number for the ingredients. It helps not to use an NDC number that matches any drug already in the system; the price update will mistake the compound for that drug and update the price accordingly. While with the more recent BestRx updates this is not damaging, it can be particularly confusing for the user and it just general good practice not to do so.

Package Size : Enter the base size for the compound you'll be creating. Don't worry if you have to fill for more later/on another prescription. BestRx will correctly adjust the size/ingredients to match your quantities. It's important that this one base record is correct to what you are making.

Unit of Measure : Indicate the unit of measure for the compound you're creating.

Drug AWP / Direct Price / Fed Mac / Special Dispense : For this step, simply enter 1.00 into the Drug AWP and tab one field down. BestRx will populate the other three fields automatically with that value. We'll get back to these fields later.

Compound Drug : Make sure to mark this field Yes.

When the fields have been filled out as listed above, click on the Compound Details tab up top.

This tab lists all ingredients included in the compound, and some details about the compound itself.

Compound Type : Indicate the compound type.

Level of Effort : Indicate the level of effort if any. In most situations the level of effort will not exceed 13 - Level 3 and the insurance will not pay above that level. It is the pharmacy's responsibility to determine the level of effort in coordination with the insurance company. 00- Not Specified, 11- Level 1 (Lowest, 1 to 4 minutes of time), 12- Level 2 (Low Complexity, 5 to 14 minutes of time), 13- Level 3 (Moderate Complexity, 15 to 29 minutes of time), 14- Level 4 (High Complexity, 30 to 59 minutes of time), 15- Level 5 (Highest, equal or greater than 60 minutes of time)

Route of Administration : Indicate how the compound will be administered.

Dosage Form : Indicate the dosage form

Dispensing Unit : Indicate the dispensing unit. This will be the same as indicated on the main screen.

Next proceed to enter the ingredients, one by one, by searching and selecting the drug in the Drug Name / Product ID field, selecting the quantity and clicking Add Ingredient. The Basis of Cost and Modifiers field should not be used unless the insurance company specifically directs the pharmacy to do so. Proceed adding ingredients in the same manner until finished with all the ingredients.

When all ingredients have been added, BestRx will automatically calculate the total ingredient AWP and ACQ cost. It is a general rule NOT to pay attention to the quantity total when creating a compound. This total is rarely representative of the actual compound size result and can only confuse the user. Keep track of these two numbers; they will be used in the next step to properly determine the cost for this compound.

The AWP and Acquisition totals from the previous step will replace the placeholder number 1.00 from before in these fields. This will properly determine the cost for this compound. When all five fields have been filled out, simply click Save & Exit.

When you are taken back to the RX Processing Screen, the compound details for ingredients are not immediately copied over after a first time creation of a compound. This is easily rectifiable by going to the Compound Details tab on the main processing screen and clicking the "Get Details from Drug File" button. After copying over the details you can get back to the main tab by clicking the "Back to RX Processing" button and continue filling your prescription as normal.

Congratulations on entering your first compound! Follow these steps to add any other compounds into the BestRx system.

Submitting Control Rxs to State

The process of submitting controls to the state agencies varies slightly from state to state. We update the software each time this changes to reflect the correct laws per each state. The control report, much like the price update will pop up a prompt when logging into the software for the first time after the state selected day. For some states this report is submitted every day; for some states this report is submitted every week, every month or other frequency as required.

Just like the price update, you can choose to perform the update now, be reminded tomorrow or choose to skip the reminder until the week after (unless the law specifies otherwise; ex. the state of NY will be reminded on the following day regardless of button title)

You can also submit the report or access the screen manually by going to Administration -> 5. Controlled RX Reporting.

Error Report

For most states, the appropriate agency that handles control reporting is able to respond with error reports that can be fixed directly from BestRx. This replaces the faxes/emails you were receiving and instead the report is delivered automatically into BestRx. For the above states, this screen and option will display BEFORE the regular Controlled Reporting screen, and we are showing it here as such. If you are not located in any of the above states, proceed to the CONTROLLED PRESCRIPTION REPORTING header instead.

If there were errors present in the previous report that require correction, a screen much like the one below will display.

This is the Pending Errors from Previous Data Submissions report screen. It displays any errors that have occurred in previous submissions and allows you to fix them. Just like the regular report, all that's required is that you click on the error fields, highlighted in PINK, and correct the values. When clicking the field, a following box will pop-up allowing you to correct these mistakes.

Simply enter or correct the value in error and click the "Save" button. You will be taken back to the previous screen, allowing you to fix the rest of the errors. When you're done fixing the report, just like in the regular report click the "Send Data" button to have the report uploaded to our servers, and we will upload it to the appropriate agency for you. After the corrections have been uploaded, you will be taken to the regular report screen, as shown below.

Controlled Prescription Reporting

To create a Control Triplicate Rx Processing report, enter in the appropriate start and end dates in the From and To fields, respectively. Next, click the "Generate" button or press the "Enter" key when the "Generate" button is highlighted to generate the list of prescriptions which contained control drugs.

If an Rx is highlighted in red, it means that it has some incomplete information. These prescriptions also show in their separate "RXs with Missing Info" tab.

If there are any errors present, you will see the image above. This gives the pharmacy a chance to correct any errors that might have occurred in the previous report and re-submit the correct information. Simply click the error field (highlighted in pink) and enter the information required. This can be the field itself (not shown in the image above, the field appears when scrolled to the right) or the field as listed in the error message on the line below.

Clicking on the field will display the following pop-up window:

Enter the information that is incorrect/missing and click "Save". This will correct the record and the fields will no longer be shown as red.

NOTE: For all states except Indiana, the files do not have to be uploaded manually; BestRx handles the upload of these files for you. The pharmacies in the states listed display a "Send File" instead of a "Make File" button. The files will be sent to the BestRx server and a message will display on your screen showing progress. When the message displays that the file was sent successfully, you can consider the report to be submitted.

Any prescription that has been checked will be written to the control triplicate file. To check a prescription manually, click anywhere on the row of the prescription. When all the necessary prescriptions have been checked, click the "Make File" button or press the "Enter" key when the "Make File" button is highlighted to create a control triplicate file. The program will display in a pop-up window where the file's been created. The two default directories are the root directory of "C:\" and the "C:\BESTRX" folder on the computer. The file name depends on the pharmacy's state, and will be a variant of NCPDP or NPI+today's Date. Remember this file name and location; after clicking "OK" the program will automatically open the reporting website state appropriate, and the user will be allowed to log in and upload the control file to the state agency, from the path shown in the previous window.

Using Med-Sync

Med-Sync is a new feature included with version 5.8.0904 and forward that allows your pharmacy to easily automate the process of syncing up your patients' prescription refills. Prescriptions can be synced directly from the patient's profile and BestRx can also prompt you to sync a new prescription when it is entered into the system. The Med Sync feature will automatically calculate short fills, link up multiple prescriptions for the same therapy, and recognize when a new prescription is required to continue a certain med sync regimen.

Med-Sync, as a feature that combines prescriptions and creates a synchronization regiment, stars with the patient's profile as mentioned above and can additionally prompt the user when entering new prescriptions into the system.

Setup

There are some settings in BestRx that can be modified to the user's liking, and they are located under File > Pharmacy Setup > Med-Sync

Auto-prompt for Med-Sync: Indicate how you'd like the software to prompt for Med-Sync. The choices are All Medications, Maintenance Medications Only, or do not auto prompt.

Refill Queue for Med-Sync RXs: Select the default queue to utilize for Med-Sync. You can add a new queue by simply clicking the "Add New Queue" button. This is particularly helpful when the pharmacy does not want the MedSync queue to automatically pull traits from the Refill Queue settings and want the queue to behave differently. Please refer to the Manage Rx Custom Queues article.

Indicate Ready for Refill: Indicate how early prescriptions should be ready for refill. The default is set to 3 days, a small change from our regular 5 day interval. This is in effort to avoid patients from ending up with prescription refills being overlapped and the patients ending up with more pills than needed.

Remove Patient from Med-Sync: Indicate how many months to wait for no activity before removing the patient from Med-Sync. This will help prune the feature a bit and automatically remove patients that are not frequently visiting the pharmacy.

Synchronizing Prescriptions

When all queue options have been set to desired settings, simply open the patient's profile as shown below to begin synchronizing prescriptions.

In the above example we will attempt to synchronize two prescriptions that are ready for a refill with a prescription that currently has refills, but is not yet ready. After selecting the prescriptions, the user needs to select the Sync processing mode, and click Process Rxs or hit Enter when the button is highlighted. **Please keep in mind that the software and therefore MedSync respects the "Indicate Ready for Refill" setting from MedSync in the Pharmacy Setup menu, and options will default to that interval. The default is 3.** The software will then display the following screen.

This is the main MedSync form window, where we can select the synchronization regiment and its details. For this example we've modified these test prescriptions for shorter and uncommon directions and day supplies. In addition, the software automatically chooses some of the information for us, and has the option to Short Fill Eligible Rxs on Yes by default.

• Yellow Fill Info means the prescription will be Short Filled as needed. Please keep in mind that some medications have locked in intervals, and therefore cannot be short filled; these medications will always take priority during calculations as the software attempts to find the appropriate synchronization combination.

• Orange Fill Info means the prescription is in pre-sync status, and the software is filling the script normally, however it's not yet considered synchronized with other scripts. This can be common for prescriptions with shorter day supplies that will be filled numerous times before other prescriptions are refilled.

• Green Fill Info status means the prescription will be considered properly synchronized on the date of fill.

• Gray Fill Info status with Red text means the prescription has no refills left, and a new prescription will be required to continue this synchronization with the prescription.

• Bright Yellow RX/Drug fields mean the fill will require a new prescription as also mentioned in the field above.

• Pink Qty Remaining indicates the quantity is low, and the software will display more info in other fields, such as the above mentioned prescription required/fill info.

Given the information and the examples, we can deduct some of the following details about these prescriptions:

• The prescription with the longest day supply, Xanax (RX# 100006), by default controls the synchronization date and day sync interval based on day supply. This causes the software to automatically calculate rest of the details accordingly. Based on its first fill date of 09/05/2018, then adding 20 day supply while subtracting 3 days for our refill indicator, leaves the prescription to be available to first normally sync on 09/22/2018. As the prescription is currently the Anchor (more on that below), the one and only fill will show up as a sync fill.

• The software then takes a look at all the other quantities and day supplies, and attempts to figure out what the proper interval should be. In our case, we have the lowest day supply prescription for Ambien (RX# 100002) at a 5 day supply. This minus the 3 indicator days, causes the software to pre-sync fill the prescription at a 2 day interval as shown by the dates above. Every one of the prescriptions, due to its short day supply, is a pre-sync fill as mentioned previously. The prescription will however need a new script written as it will have no remaining refills on the 5th step of the pre-sync process.

• The Valium (RX# 100001) prescription is the last on our list, and it was filled on 9/4/2018; with our other prescriptions more or less dictating the interval and this particular medication's ability to be short filled, the software will attempt to lock into the 09/22/2018 sync date and figure out what to do with the prescription accordingly. Counting back from the sync date, the software figures out a regular pre-sync fill of a 10 day supply as dictated by the prescription. The software then takes 09/15/2018, the date of that fill, and subtracts 3 days per refill indicator setting, landing us on 09/12/2018. The software then figures that there's only a 6 day supply left, and creates the appropriate short fill.

• With this, the synchronization calculation is done, and we may choose to Sync Prescriptions if everything looks correct.

• The user can in addition deselect any of these prescriptions, or Remove All from Med-Sync.

• Regarding the Anchor mentioned beforehand, and the "A" it's attached to; the anchor function allows the user to re-anchor the synchronization to another prescription. By doing this, the system can re-calculate the interval and date by using the selected prescription's settings instead.

  

• If however the prescription cannot be adjusted to a different sync interval, the software will display a warning regarding doing so as such

  

• The user has an option to simply deselect the prescription that cannot be synced, or cancel the interval change. In this case if we were to accept the interval change, the software would then display the following

  

• As you can see, the prescription with the chosen anchor will display a white A on a blue background, and the synchronization will be re-calculated. The software has made some modifications in order to enhance and lessen the burden and avoid as many pick ups by patient as possible; Ambien as the prescription with a day supply that did not fit was removed, and would need to be set up on a separate regiment.

• If there's a prescription in the MedSync regimen that will require a new script, the software will display the typical messages when attempting to process, such as New RX with info or a prompt for a Refill Request. When the prescription is filled, whether on the spot or after obtaining said refill, not only will the software as if we want to include this prescription in the regimen, but will also ask you to link the prescription as shown below:

  

• If there are any issues with the script, the software will also display the following:

  

• Simply choose the appropriate option, and proceed as normal. In our example we added the script to the regimen and billed it to insurance right after. The regimen will adjust and move forward depending on the settings selected. Remember, you can simply click on any of the calendar icons

  

  throughout the software (when MedSync is available and applicable) to review these regimens.

Reviewing Synchronization Settings and Schedule

When all prescriptions have been synchronized for the patient, some areas of the software will go under small changes to reflect these settings

• The main processing screen and the profile screen will display a sync icon when accessed. The icon shows up on the profile whenever any prescriptions are synchronized, and the icon on the main processing screen will display when working with a sync patient. The icon can be clicked to open up the sync page and review/change the regimen

• The main processing screen will also display the next sync date on the bottom left of any prescription that's being synchronized; clicking the "..." button will open up the sync regimen page same as the icon.

  

• The patient's file will display some information about synchronization as well; just like the main screen, the "..." button will open the same regimen page

  

Calendar Functionality

• The new calendar function will also allow for reviewing of synchronization regimens but more importantly show all scheduled tasks in one convenient place. You can access the calendar from the main screen with the calendar button on the bottom left.

  

• The calendar page will display all tasks as mentioned above; for the purposes of this article, we only see the MedSync occurrences. Reviewing these is as simple as clicking on any particular day, which will bring up the following page

  

• This report's biggest draw is the ability to search by a sync date range, and view many prescriptions at a time in a list. The report can further be narrowed down to be generated by either Patient, or RX number to narrow the results down to a specific record. More features may be added into it in the future.

The function will perform the same for other patients with respect to all limitations; simply repeat the steps to synchronize medications for another patient. You can also review all synchronizations at large from the Calendar function.

NY Electronic Prescribing Control Certification

In order to be able to accept control medication through the ERx interface, a New York pharmacy must fill out and submit the EPCS form back to us in order to process their certification.

The partially pre-filled form is available here; please fill out the empty fields (Pharmacy Name, NCPDP, License, Contact Name, Email, and Phone number) and fax or email the form back to us for submission.