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!