Aprima Electronic Prescribing User guide

Surescripts Electronic
Prescribing Requirements
This document describes the Surescripts® requirements for providers using electronic
prescribing, their policies for suspending privileges, and Surescripts’ and Aprima’s polices for
requesting reinstatement of privileges. It also describes the information that must be entered
in the Aprima PRM database in order to enable electronic prescribing. Finally, it contains
general information on writing and tracking electronic prescriptions.
Surescripts Requirements
Becoming an Active Prescriber
You must have a valid NPI number to enroll with Surescripts. Once enrolled, Surescripts will
assign you a Surescripts provider ID (SPI). Both your NPI and SPI must be entered in Aprima
PRM for you to submit electronic prescriptions.
You must submit at least 5 new prescriptions within 30 days of enrolling with Surescripts to be
considered an active prescriber. Failure to meet this requirement will result in suspension by
Surescripts.
You must meet the requirements for an active prescriber before you will begin to receive
electronic refill requests.
New Prescription Requirements
As an active Surescripts prescriber, you must submit at least 1 new prescription within each
180 day period. Failure to submit any new prescriptions for 180 days will result in suspension
by Surescripts. This suspension will include new prescription, refill prescription, medication
history request, and prescription benefits request privileges.
If you will take a long vacation or leave of absence or have some other reason for not
submitting electronic prescriptions for an extended period, you may request in advance that
your Surescripts privileges be suspended for that period. There is no fee for voluntary
suspension or reinstatement. To request suspension or reinstatement, contact Aprima
Support.
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Refill Processing Requirements
If you are not receiving prescription refill requests from pharmacies, please contact Support
to verify that you are enrolled for the refill service.
It is recommended that you enroll in the prescription refill service 90 days after enrolling for
electronic prescribing. This allows enough time for you to electronically prescribe most of
your current prescriptions through Aprima PRM and Surescripts. This is important because a
pharmacy can send you an electronic prescription refill request for any prescription that they
have on file, including prescriptions that were not originally sent electronically. The
application will not be able to map the refill request to a medication in the patient’s history
if the original prescription was not sent electronically through the application.
Surescripts requires that you respond to at least 70 percent of your electronic refill requests
within 48 hours. Valid responses include filling the request, denying the request, and denying
the request and providing a new prescription. Failure to meet the refill response requirement
will result in the suspension of electronic refill privileges by Surescripts. Therefore, you must
start responding to refill requests as soon as you start receiving them.
You can easily refill a medication that the application has mapped to the patient and
medication by accepting the request. When the application cannot map the medication to the
patient’s history, the refill request message will include a note that says “Warning: Unable to
match refill request with medication history for the patient” and the Accept radio button is
inactivated. In this case, you cannot accept the request as it is written. You do, however,
have options for processing the refill request.
•
Select the ‘Deny With New’ radio button (this is defaulted when the medication can’t be
mapped). Then select Find icon for the Drug field to select the medication. This accesses
the SIG Writer so that you can write a new prescription and send it electronically.
•
Select the ‘Deny’ radio button. Then, select one of the denial options in the drop down
denial list.
If you know that you will not be responding to refill requests for an extended period, you may
request in advance that your Surescripts privileges be put on hold for that period. There is no
fee for voluntary suspension or reinstatement. To request suspension or reinstatement,
contact Support.
Controlled Substance Requirements
Electronic prescribing of controlled substances (EPCS) has very specific requirements. These
requirements are not covered in this document. Please refer to the Provider Setup for EPCS
document and the IdenTrust Certification Process document for information and instructions.
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Suspension and Reinstatement Policies
Suspension
If Surescripts suspends your electronic prescribing or electronic refill privileges because of
failure to meet the requirements, they require a waiting period of 30 days before you can
apply for reinstatement of privileges.
To request reinstatement of Surescripts privileges, please contact Support. There is a
reinstatement fee for processing reinstatement requests when privileges are suspended by
Surescripts for failure to meet their electronic prescribing requirements.
Reinstatement
It may take 24 to 48 hours after your reinstatement for Surescripts to begin processing your
electronic prescriptions. The functionality is available when the Provider window’s ePrescribe
Setup tab becomes active again.
You must submit at least 5 new prescriptions within 30 days of being reinstated with
Surescripts to be considered an active prescriber. Failure to meet this requirement will result
in suspension by Surescripts.
Please note that Surescripts reviews reinstated providers’ prescribing records for the 1st
through the 15th of each month. Because this time period may not correspond with your first
30 days after reinstatement, it is possible that Surescripts may suspended you again. Should
this happen, please contact Support for assistance. There is not an additional fee for this.
Aprima PRM Configuration
Pharmacy Clearinghouse and Pharmacies
If you are using electronic transmission of prescriptions, the application will be configured
with the Surescripts clearinghouse. You should not change the clearinghouse transmission
settings unless directed to by Support. You do, however, need to set up your providers for
electronic prescribing and identify the area codes or ZIP codes of the pharmacies to which
you will be sending prescriptions.
In addition, each provider’s record must include the required identification information.
Please see the Information Required for Electronic Prescribing section below for a list of the
needed identification information.
You must import from the Surescripts master pharmacy database the pharmacy records for
the pharmacies in your area. The master pharmacy record identifies the pharmacy by name,
address, and phone number, and contains the information needed to enable electronic
transmission of prescriptions and refill requests. Once imported into your database, the
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pharmacy record is not the master; rather it is your pharmacy list record. It contains the
information needed to associate with the master pharmacy record so that prescriptions can
be sent electronically.
Please refer to the Administrative User’s Guide or the Online Help for more information and
instructions. The Surescripts clearinghouse is edited from the Pharmacy Clearinghouse
window.
Jobs and Job Schedules
The following jobs are required for electronic prescribing. These jobs and their job schedules
must be active and properly configured.
•
AprimaVault Downloader
•
AprimaVault Outbound Queuing
•
AprimaVault Sender
•
eRx: Create e-Med Hx Messages, if using medication history functionality
•
eRx: Create Rx Benefits Messages, if using prescription benefits functionality
•
eRx: Process Pharmacy/Prescriber Messages
•
eRx: Process PRVBRD Update Messages
•
eRx: Process Script Messages
•
eRx: Process X12 Script Messages
When any eRx job encounters an error, the error is logged and the job continues to run. The
job will retry its actions infinitely. This is because most errors are the result of temporary
interruptions in Internet connectivity, and the job will complete successfully once
connectivity is restored.
The eRx: Job Monitor watches the error log. It sends an error message to the identified user
when an eRx job fails for over 24 consecutive hours. Failures of this frequency indicate a real
problem. Please contact Support for assistance.
Please refer to the Administrative User’s Guide or the Online Help for more information and
instructions. The Job and Job Schedule windows are used to configure jobs and job schedules.
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Information Required for Electronic Prescribing
The following information must be included for each prescription submitted to the Surescripts
electronic pharmacy clearinghouse.
Provider Identification
You must enter the following information in the Provider window’s Person tab.
•
First and last name
•
Suffix, if included, cannot be more than 10 characters including spaces
•
Complete practice address including ZIP code, in the Primary Address fields
You must enter the following information in the Provider window’s ID Values tab.
•
Surescripts provider ID
•
NPI number (10 digits); this must be the provider NPI, not a group or practice NPI
•
DEA number (2-letters followed by 7 digits)
You must enter the following information in the Provider window’s ePrescribe Setup tab.
•
First and last name
•
Phone number, must include both a 10-digit number and a phone type of Work
•
Fax number, must include both a 10-digit number and a phone type of Fax
•
Complete practice address including ZIP code
•
Email address, only if using electronic prescribing of controlled substances (EPCS)
•
Surescripts provider ID
•
NPI number (10 digits); this must be the provider NPI, not a group or practice NPI
•
DEA number (2-letters followed by 7 digits)
•
Service levels identifying Surescripts functionality for which the provider is enrolled
Patient Identification
You must enter the following information in the Patient window.
•
First and last name
•
Date of birth
•
Complete address including ZIP code
•
ZIP code must be either 5 digits or 9 digit in xxxxx-xxxx format with no spaces
•
Gender
The following information is not required, but must be correct if entered.
•
Phone number, if entered must include both a 10-digit number and a phone type
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•
Social Security number must be 9 digits
Prescription Details
•
Medication name and strength
•
Dosage
•
Form
•
Route
•
Frequency
•
Days
•
Refills
•
Quantity, must be numeric only
Pharmacy Details
A valid pharmacy record, associated with a master pharmacy record, must be associated with
each electronic prescription. The pharmacy may be associated with the patient in the Patient
Demographics window. The pharmacy will then default to the SIG Writer window when a
prescription is written for the patient. Or, the pharmacy may be associated directly with the
prescription in the SIG Writer window when the prescription is written. If the pharmacy is
entered in the SIG writer, it is added to the pharmacy list in Patient Demographics.
Writing and Tracking Electronic Prescriptions
Entering Prescriptions
When entering a prescription, it is important that you enter the required details using the
data fields. You may enter additional or clarifying information in the prescription line. This
information is included with the medication directions (dosage, route, and frequency) when
the prescription is submitted electronically. The medication directions, including details and
addition information, are limited to 140 characters.
It is extremely important that you do not enter prescription details as a text string in the
Pharmacy Inst note field. This can result in a patient safety issue because not all pharmacy
prescribing systems receive text entered in the Pharmacy Inst note field. Pharmacy systems
that do receive the text may not display all of the text and may not display it on the main
window. Therefore, the pharmacist may not receive or see all of your instructions if you enter
them as text.
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Tracking Prescriptions
You can check whether an electronic prescription transmission has completed, and whether it
was successful by viewing the Track Prescriptions window. This window lists all prescriptions
that have been transmitted electronically (to either an electronic or fax-only pharmacy), plus
refill requests received, and indicates if the transmission was successful or if a problem was
encountered. When a transmission fails, information about the cause of the failure may be
available.
•
Each prescription entry includes the visit date, patient, provider, medication, and
pharmacy name.
•
The ePrescribed column indicates whether the transmission was successfully transmitted
and processed. There are four possible states:
•
Yes: This includes the date and time of transmission.
•
No
•
Failed
•
Queued: This means the script is awaiting transmission. You will probably see this only
if your eRx Send Job is scheduled to run infrequently.
•
The Note column, when populated, will usually contain a reason for the failure of an
electronic prescription. These notes are similar to the reasons that appear in the
ePrescribe Warning message. The table below explains some common types of notes.
•
The Ready column indicates whether the prescription has been marked as ready to
prescribe.
•
The Message Type column identifies whether the prescription is new or a refill.
•
The Message ID column contains the Surescripts ID for the prescription.
Common Notes
Note
Meaning
Controlled drug cannot
be eprescribed
The prescription is for a controlled substance, and therefore,
cannot be prescribed electronically. The prescription must be
printed or, if allowed in your state, called into the pharmacy.
Mailboxed
The pharmacy uses a third-party vendor to receive prescriptions.
Surescripts transmitted the prescription to the third-party vendor
mailbox, where it is waiting to be retrieved by the pharmacy.
Once the pharmacy retrieves the prescription, the ‘mailboxed’
note will be changed to reflect that the prescription was been
picked up successfully.
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Note
Meaning
Medication not marked
ready to prescribe
The provider has not completed the process for sending the
prescription electronically. This is not an error for the application.
It could mean that the provider is not yet ready to send the
prescription, or it could mean that the provider forgot to
complete the process.
Pharmacy not set
There is no pharmacy associated with the prescription, so it has
not been sent to Surescript. This is not an error for the application
or for Surescripts. This could be the intent of the provider,
because the prescription was or is to be printed. Or it could mean
that the provider forgot to associate a pharmacy with the
prescription. If so, then in order to send the prescription
electronically, the provider must discontinue this prescription,
and then write a new prescription associated with a pharmacy.
Pharmacy not configured
for eprescribing
There is a pharmacy associated with the prescription, but the
pharmacy is not configured correctly and so the prescription has
not been sent to the pharmacy. Either the master pharmacy
attached to the pharmacy is inactive or it is not set up for
electronic prescribing. If the master is not set up for electronic
prescribing, then the pharmacy is a fax-only pharmacy, and your
practice is not set up to send to a fax-only pharmacy. To send the
prescription electronically, the provider must discontinue this
prescription, and then write a new prescription associated with a
different pharmacy record.
Prescribing provider is
not enrolled to
eprescribe with this
clearinghouse
The provider has not been associated with Surescripts in the
Pharmacy Clearinghouse window. Add the provider. Then resend
the prescription.
Sender is not enrolled to
eprescribe
The provider is not enrolled with Surescripts. Contact Support to
enroll the provider. The prescription must be printed or called
into the pharmacy.
Code 000 Description
Code: Transmitted
successfully
The prescription was received by Surescripts and transmitted
successfully to the pharmacy.
Code 010 Description
Code: Successfully
accepted by ultimate
receiver
The prescription was successfully transmitted to the pharmacy,
and the pharmacy acknowledge receipt.
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Error Messages
Error messages are displayed in the Message Center or on the Desktop when the filtering
criteria include the message type Electronic Rx Errors. The Message window shown below
contains an error message, displayed in the Reason field, indicating that provider information
is missing. Other sample error messages are listed as text below.
Error Messages
Error
Meaning
Error Code 602
This may be error code 602 or any other 600 error code. These
errors that indicate a communications failure either between the
application and Surescripts or between Surescripts and the
pharmacy. Resubmit the prescription.
PVD
Errors that begin with PVD indicate there is something wrong with
the prescriber, service site, or practice information.
PTT
Errors that begin with PTT indicate there is something wrong in
the patient’s demographics. Review the information in the Patient
window.
Server Error
These errors vary, and may not include a description. They are
typically random and temporary. The description “Underlying
Connection Closed” means that the server is busy. When this error
occurs, the application continues to retry automatically. For all
other server errors, you should resubmit the prescription if
allowed. If the error reoccurs or if the error does not allow
resubmission, contact Support.
1 errors validating
against …
This phrase may be followed by a number of different codes. Any
error messages that begins with this phrase indicates that some
item or items of information are missing or invalid in either your
practice, service site, provider, or patient records or in the
prescription itself.
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Correcting Errors
To correct the problem or prevent similar errors in the future, you must do the following.
•
If information is missing, then enter the needed information as described in the following
section.
•
If prescription details were entered in the Notes or Comments field rather than in the
prescription details field, then you must:
a. Discontinue the prescription. Surescripts will not send it to the pharmacy as it is, and
it cannot be edited once submitted to Surescripts.
b. Write a new prescription, entering the details in the proper fields.
•
If the prescription was for a controlled substance, then you must print the prescription
and either fax it to the pharmacy or give it to the patient to take to the pharmacy.
Questions or Problems
If you are having problems submitting electronic prescriptions or have questions about the
electronic prescription process, please contact Support immediately. We can help you resolve
any problems or provide any information that you need.
You may reach Support at [email protected] or 866-541-1792, Option 3.
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