Clinical Pharmacist Practitioner

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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!
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