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  • Prescription Processing Virtual Assistant

    Prescription Processing Virtual Assistant

  • Welcome to the Morrison Clinic Prescription Processing Virtual Assistant

    To best serve you we need to gather information and ask you a few questions. Our goal is to provide you with an immediate answer and/or next step to help you self advocate and problem solve difficulties you might be experiencing with getting your medication.
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  • Ticket Summary for your records

    Upon submission of this form a summary will be created and emailed to you for your records. This summary will include your protected health information including and not limited to your name, date of birth, medication information, and details about your health you entered. It will also contain the outcome of your request and instructions or next steps you are required to take.

  • Filling Your Prescriptions

    Navigating the pharmacy and insurance process can be confusing and frustrating. Understanding the roles of the prescriber, patient, and pharmacy can empower you to advocate for yourself effectively.

  • The Role of Your Morrison Clinic Prescriber

    • Informed Decision-Making: Your prescriber helps you make informed decisions regarding your medication based on various factors such as your medical history, medication formulation, insurance coverage, out-of-pocket costs, and potential drug shortages.

      Appointment-Based Changes: Any changes to your treatment plan must be made during a medical appointment. This ensures that all relevant factors are considered and that you are fully informed about your options.
       

    Steps During Your Appointment

    1. Discuss Medication Options: Your clinician will discuss different medication options with you, considering factors like your past experiences with medications, formulation preferences, and potential drug shortages.
    2. Estimate Costs: Morrison Clinic encourages you to use your insurance cost estimator during appointments. This tool helps determine:
      1. Insurance Costs: Estimate your out-of-pocket costs for the prescribed medication.
      2. Prior Authorizations: Identify if prior authorization is needed for your medication.
    3. Plan for Payment: Your clinician will help you explore payment options, which may include:
                Submitting prior authorizations.
                Estimating out-of-pocket costs.
                Considering the use of coupons instead of insurance.
    4. Backup Plan: Agree on a backup plan in case your insurance denies coverage for the prescribed medication.
    5. Finalizing the Treatment Plan:Once you and your clinician have agreed on the treatment plan, the medication is prescribed and sent to the pharmacy of your choice.

    The collaborative approach between you and your clinician at Morrison Clinic ensures that your treatment plan is tailored to your specific needs and preferences. By respecting your role in the decision-making process and not making changes outside of appointments, your clinician ensures that you remain fully informed and involved in your healthcare decisions. This partnership fosters trust, improves treatment adherence, and ultimately leads to better health outcomes.

  • PATIENT'S ROLE DURING MEDICAL APPOINTMENT:

    Active Participation During Appointments:

    • Using the Insurance Cost Estimator Tool: It is your responsibility as a patient to use the insurance cost estimator during your medical appointments. This ensures that you have a clear understanding of the financial implications of your treatment options. 
    • Real-Time Information: By navigating the cost estimator in real-time during your appointment, you can make informed decisions about your treatment based on accurate and current cost information.
    • Determining Prior Authorization and Step Therapy:
      • Prior Authorization: Some medications require prior authorization from your insurance company before they will cover the cost. This means your clinician must obtain approval from your insurance company, which can take time.
      • Step Therapy: Step therapy requires patients to try one or more lower-cost medications before the insurance company will cover the prescribed medication. This process ensures that less expensive treatments are attempted first.
    • Informed Decisions: Understanding the cost implications allows you to make more informed decisions about your treatment. You can weigh the benefits of a medication against its cost and choose an option that fits your budget.
    • Avoiding Surprises: Using the cost estimator helps prevent unexpected expenses by providing a clear picture of what you will owe out-of-pocket. This can reduce financial stress and allow for better financial planning.
    • Exploring Alternatives: If a medication is too expensive, you and your clinician can explore alternative treatments or strategies, such as generic options, different dosages, or patient assistance programs before a prescription is issued.

    To manage your medication costs effectively, you are responsible for determining if your insurance requires prior authorization or step therapy. Use your insurance cost estimator with the help of your clinician, but also have GoodRx ready during your appointment to compare cash prices at different pharmacies. By doing so, you ensure that you can make informed decisions about where to purchase your medication based on both insurance coverage and cash prices. Here are the key points to remember:

  • Morrison Clinic Responsibilities:

    • Timely Appointment Scheduling:
      • Medication Issues: The clinic will attempt to work you in for an appointment as soon as possible if you are having difficulty getting your medication filled at the pharmacy.
      • Prior Authorizations: If you need an insurance prior authorization submitted before your scheduled appointment, the clinic will do its best to accommodate you with an earlier appointment.
      • Medication Changes: For any changes to your medication, the clinic will also try to schedule you in promptly.

    Patient Responsibilities:

    • Attend Scheduled Appointments:
      • Ensure you attend all scheduled appointments to stay on track with your treatment plan.
      • Always confirm you have a follow-up appointment scheduled before logging out of your virtual appointment.
    • Requesting Additional Appointments:
      • Work-In Appointments: If a change in your treatment plan is needed between appointments, or if you encounter issues such as difficulty in getting your medication filled, schedule or request a work-in appointment with the clinic.
      • Proactive Communication: Communicate promptly with the clinic if you need an earlier appointment for prior authorization or medication changes.

  • Compliance with Medical Appointments

    IN ORDER TO PROCESS YOUR REFILL REQUEST YOU MUST BE COMPLIANT WITH YOUR MEDICAL APPOINTMENTS.   IF YOU ARE OVERDUE BECAUSE YOU POSTPONED/RESCHEDULED OR MISSED YOUR SCHEDULED APPOINTMENT, YOU MUST BE SCHEDULED FOR AN APPOINTMENT WITHIN THE NEXT 14 DAYS

  • NONCOMPLIANCE WITH MEDICATION MANAGEMENT APPOINTMENTS AND RECOMMENDED FOLLOW UP

  • Prescription Processing Request Screening

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    PATIENT'S ROLE 

    Verify Prescriptions: Patients are responsible for verifying that prescriptions were sent by Morrison Clinic. They must communicate effectively with both the pharmacy and their insurance if there is difficulty getting a prescription filled.

    • Self-Advocacy: Patients are responsible for self-advocating, including using the steps detailed in their Morrison Clinic care plan or the instructions given by their clinician during their appointment.
    • Understand Issues: Patients must ensure they have a clear understanding of why a pharmacy is unable to fill their prescription before reaching out to Morrison Clinic for help. If texts or phone calls do not provide clarity, the patient should go to the pharmacy in person and ask for additional help.
    • Addressing Delays: If a pharmacy delays filling your medication by recommending that you or they ask the prescriber to change your medication, you should ask to speak to the manager and express your concerns about the pharmacy stepping outside of their role.

     PHARMACY ROLE 

    • Clear Communication: Pharmacies must clearly communicate any issues with filling prescriptions.
    • Support and Options: Pharmacies should support you and help explore options if the medication is out of stock, including adhering to state and federal laws that allow for the transfer of controlled prescriptions to another pharmacy one time if necessary.
    • Insurance Denial: Pharmacies should not delay filling your medication due to insurance denial. They should help you identify the most affordable way to purchase your medication without insurance.
    • Appropriate Recommendations: Pharmacies should not step outside of their role and recommend changing your medication outside of a medical appointment.
    • Follow Protocols: Pharmacies should follow Morrison Clinic office protocol and submit an e-ticket at morrisonclinic.com/mychart to communicate any concerns, errors, or problems that need prescriber attention.

  • Patient Verification of Scripts sent by Morrison Clinic

    Login to patientfusion.com, click on health record,  click on the white triangle, then click medications.  You will then see a screen like the image below.
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  • Copy and paste the information from Patient Fusion medication list into the spaces below.  

  • C2 PRESCRIPTION PROCESSING REQUEST

  • ADHD STIMULANT SHORTAGE EXECUTIVE FUNCTION SELF ADVOCACY TREATMENT PLAN

    The nationwide shortage of ADHD stimulants has been a challenge for many of our patients.   In order to help you self advocate and navigate the business world of pharmaceuticals we recommend you read through the below information:

     EDUCATION ABOUT BUSINESS MODEL OF DRUG DISTRIBUTION IN THE UNITED STATES
     

    There are 3 major whole sale drug distributors, Cardinal, McKesson, AmerisourceBergen, that are the middle man between the pharmaceutical company and the pharmacy.    When the pharmacy does not have your medication in stock at their local store they can order it from their distributor.    


     SYSTEMATIC APROACH TO FIND YOUR MEDICATION IN STOCK AT A LOCAL PHARMACY   
     

    If your local pharmacy does not have your medication in stock you don't want to wase time calling pharmacies that use the same distributor.   Instead call the following pharmacies and ask them if they have the medication in stock.  Specifically ask them to check the local stores.  If their local stores don't have it in stock ask if they can order it from their distributor:
     

    CVS (Cardinal is their distributor)
    Walgreens (AmerisourceBergen is their distributor)
    Walmart McKesson is their distributor)

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  • FILL DATES 

  • ACTIVE FILL DATE

  • Pharmacy Dispensed Less Than Quantity on Script

    When a pharmacy dispenses less than the quantity written on the prescription of a C2 medication they have a 72 hour window to fill the remaining amount.  If the remaining amount is not filled in that 72 hour window they are obligated to advise the prescriber of the quantity they did not dispense.   They can send a fax to (847) 787-1437 or they can submit an e-ticket at morrisonclinic.com/mychart.

  • C2 PRESCRIPTION TRANSFER 

  • Both federal law and state law allows pharmacies to transfer an ADHD C2 Stimulant prescription one time to a different pharmacy.

    • If your medication is out of stock at the pharmacy the script was sent to you should call other pharmacies to find one that has it in stock.
    • Then call your pharmacy and ask them to transfer it to the pharmacy that has it in stock. If you need the prescription transferred for any other reason you need to call your pharmacy and ask them to transfer it.
    • It is the responsibility of your pharmacy to transfer prescriptions. If the pharmacy says it is against the law tell them you have verified with the Texas State Board of Pharmacy that it is not against law. Pull up this link on your phone ibit.ly/r-xC2, scroll to #23, and show them the following wording:

    " Regarding initial dispensing of a previously unfilled EPCS, if both pharmacies (originating and receiving) have the capability to forward and receive the EPCS utilizing an electronic sharing program, e.g., SureScripts® or other software, then the pharmacies may engage in electronically forwarding the EPCS for all Schedules (including Schedule II). "

  • PHARMACY C2 VOID AND SEND TO ANOTHER PHARMACY

  • If your pharmacy will not provide this service for you then proceed to use the virtual assistant to submit a Prescription Processing Request to Morrison Clinic to intercede on your behalf.

  • PHARMACY CANNOT FIND PRESCRIPTION

    When the pharmacy cannot find a script that you verified was sent because it has posted on your medication log in Practice Fusion bypass the tech and ask to speak directly to the pharmacist. Use your Practice Fusion medication log to advise how many scripts were sent and the day they were sent. The pharmacist is able to see these scripts in their system's e-script timeline. For example if 3 scripts were sent the pharmacy will see something like this:
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  • Pharmacy likely isn't clicking on each script to see post dated fill dates

    In the above image you can see that 3 scripts were sent to the pharmacy but you cannot see the fill dates of the prescription. The pharmacy must click on each prescription in order to see the post dated fill date. When the pharmacy says they don't have a script but you have verified they do, it is because they are not clicking on the scripts that are over 21 days old. They are jumping to the conclusion that the script is expired and not considering the script could have a post dated fill date. When they click on the script they can see the fill date and fill the script with an active fill date.

  • An example

    In the above picture you can see 3 scripts were sent and verified as received by the pharmacy on 7.17.24. It is now September 20th and you need your third script filled. You would ask the pharmacist to click on each of the 3 scripts sent on 7.17.24 and fill the script with a 9.19.24 fill date that looks like the one below
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  • Talking to the pharmacy

    Feel free to make us the bad guys and tell the pharmacy that we require you to fill out a detailed form verifying your encounter with the pharmacy before we will dispense a new prescription. Let them know our form requires you to speak directly to the pharmacist.

  • PRESCRIPTION PROCESSING REQUEST FOR NON C2 MEDICATION

  • PRESCRIPTION ERROR

  • RAN OUT OF MEDICATION

  • REFILL NEEDED DUE TO RESCHEDULING OF APPOINTMENT

    Refills will not be processed if you do not have an appointment scheduled.  Go to patientfusion.com and find an appointment date and time that works for you.  If the appointment is not within the next 2 weeks then add a note to your request to be worked in sooner since you need a medication refill.   Once your appointment is confirmed it will take up to 2 business days to process your refill request.

  • Morrison Clinic Rescheduling Led to Refill

  • Medication Prior Authorization

    At your last appointment you were instructed to look up your medication in your insurance cost estimator during your appointment so you could advise your clinician to complete a prior authorization during your appointment. If your medical insurance changed in between appointments and your new insurance requires a prior authorization, you need to schedule a work in appointment. Prior authorizations are only completed during medical appointments.

  • Cover My Meds Prior Authorization Initiated During Medical Appointment

    If you requested a prior authorization for an active medication, then your clinician attempted to submit it in real time during your appointment. Based on the outcome of the submission you & your clinician determined your possible next steps and you were asked to make notes or follow the instructions in your patientfusion.com care plan.

  • Prescription Processing Fee

  • VERIFICATION TO NOT PROCEED WITH PRESCRIPTION PROCESSING REQUEST

  • CONSENT AND AUTHORIZATION TO CHARGE PRESCRIPTION PROCESSING FEE

    Per your new patient consent forms, you are required to pay a prescription processing fee of $20 should you need Morrison Clinic to provide prescription processing services in between your appointments.  Payment of the $20 fee is not a guarantee that your insurance will cover your medication or the pharmacy will fill the prescription.
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  • Thank you for completing this form.  We are glad you were able to get a quick answer to your question.

  • Next Step for Unanswered Questions

  • $40 Fee if answers submitted are not accurate

    If it is determined that the form does answer your question but the answers you chose to submit did not reflect your situation or were not accurate then a $40 processing fee will be charged. This fee covers the Morrison Clinic staff administrative time that will be needed to provide you with individualized support since this virtual assistant was not able to meet your needs.
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  • Please click the submit button.

    If your request requires the support of Morrison Clinic Staff a Prescription Processing Request ticket will be opened on your behalf.   We do our very best to process tickets within 48-72 business hours. 

  • We are open and processing tickets Monday-Thursday 9am-3pm. Tickets received outside of these hours will be placed in queue the next business day.   Tickets are processed in the order received.  
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