In order for your medications to be billed appropriately ,one of the important tasks that will need to be taken care of before you begin generating claims is to ensure your medication files are loaded from your pharmacy and/or PBM into ebilling.
If you do not have a dedicated pharmacy, this may be difficult , however is necessary for Medicare compliance & ordering of patient's medications.
Options:
Private Pharmacy-Hospice Tools does not directly integrate with private pharmacies, a aggregate 8358 file template can be sent to the pharmacy ,and then needs to be sent directly to the provider ,and manually uploaded into the ebilling module.
Process:
- The 8358 aggregate file should be sent directly from the pharmacy to the provider monthly, or established frequency as directed by you ( weekly, biweekly).
- Once the file has been received from the pharmacy, proceed to upload the aggregate 8358 file under the Prescriptions tab, located in the ebilling module: Prescription File Upload Help Guide
- Ensure if there are any errors with patient names that these are corrected prior to transmitting your claims to Medicare
- From edocs , the medication forms, located within the Medication Tab of the patients chart should be used to indicate which medications need to be ordered for the patient. The process of filling these orders depends on the pharmacy you use. ( Calling the orders in, writing a prescription, faxing or emailing to the pharmacy to fill the order).
PBM-Ask your Client Representative for a list of applicable PBM vendors & Contact Information
- If working with one of the applicable vendors, the PBM will automatically dispense the medication files on an automatic basis, normally this occurs monthly, however the provider can request that the vendor transmit the files on a more frequent basis.
- From edocs , the medication forms (comfort kit, single medication, or multiple medication form) should be used to identify the medications , where they are electronically signed by the appliable Medical Director and/or NP. Once the medications forms have been signed in edocs, the Patient details, and medication(s) identified will filter on the backend of the system to the provider's PBM dashboard.
**Providers cannot access the PBM portal through the Hospice Tools dashboard, a separate browser tab should be opened to access the patient details to proceed with filling the medication orders.
RXNT- e-Prescribing - If interested in RXNT ask your Client Success Representative to connect you with our assigned RXNT representative for Pricing, Onboarding and Training. Once you have completed the initial RXNT training and security processes you'll want to schedule a training to review the workflow in Hospice Tools.
If using RXNT, the Medication forms in Hospice Tools should NOT BE USED, this will cause duplicates in the software. All medications should be filled directly in RXNT and sync back into Hospice Tools.
- Once fully onboarded with RXNT, contact your Client Success Representative to initiate a support ticket to enable your RXNT integration in Hospice Tools
- Once the integration is enabled, Click into External Credentials section, enter your username and password: RXNT Credentials Help Guide
- From the Medications chart section, Click the Open Patient in RXNT , and proceed to fill the applicable medication orders, or send them to pending for your Medical Director to sign
- From Hospice Tools, via the Medication tab, Select Sync Medication from RXNT to pull the medications back into the Medication Dashboard in Hospice Tools
* Please Note: If using RXNT, you'll want to also use a preferred PBM, and/or private pharmacy. RXNT does not dispense the medication files for billing purposes.