Call it an ERROR and promise a full refund with no charge for the new medication.If pt ingested the medication, call physician immediately to obtain guidance on proper clinical care. "I understand your frustration/concern. We will put preventative measures in place to ensure this doesn't happen again." Do NOT delete the incorrectly filled script no place on hold: Inactivate it!
Mistake happened. how to record it?
1. submit the Initial Report in Retail Pt Safety Event Reporting System by the end of next day.2. report incident to district leader.3. complete detailed report within 3 days of incident. 4. district leader will follow-up to ensure accuracy of report. peer reviews may also happen in specific states (RxNet has more info)
After a dispensing error, the pt may want to speak with someone else in charge. who do you refer to?
• Inform the patient that you will arrange for the District Leader or covering Field Manager to contact him/her• Provide the patient, parent or caregiver with the District Leader's name, mobile phone and office telephone numbers
The district leader may not always be alerted. but there are some situations that they MUST be involved:
1. pt used wrong medication, dose, or strength. 2. error disrupts pt's therapy.3. if additional support is appropriate, like requests for compensation or for supervisor contact info, potential media involvement, etc.NOTE: if district leader/pharmacy supervisor is unavailable, notify Regional Director.
where to document a pt safety event
main menu (RxConnect), then M1 (reports), then 15 (quality assurance and pt safety reports), then Pt safety event reportingFrom there, you reach The Info Center, where you can see incomplete reports and a white Report icon on the left to being a new Initial Report.
RxNet is an Intranet site available from Radar Store. There are many references and resources available within RxNet such as Pharmacy Operations Manual, Workload Calendar, and Quality Assurance website. It also is a great reference for our CVS Patient Care programs.
CVS Intranet site. Accessible from F6.Contains:1. RxNet2. Workload Manager3. Store-level reports4. Email5. Bulletin
Red Bags are an interoffice mail system. Hardcopy communications and other items that need to be delivered to the stores are delivered via Red Bag. For example, Connections is a CVS newsletter that keeps all CVS colleagues informed about changes, initiatives, and important news within the company.
The script processing system, as well as report generator and pt record holder.
How to transfer a script from another CVS to your store?
Menu, then C (CVS Copy)
How to transfer a script (or at least indicate that) from another pharmacy to your store?
Menu, then TI (Transfer In)Alt:Profile, then TI
How to inactivate a script from menu?
Menu, then I (Inactivate)This allows you to inactivate a prescription without deleting the prescription record. This feature cancels all the future refills.
How to pre-enter a script in drive-thru?
Go to QD (Queue Drive-Thru) and enter it there.
Exceptions QueueThis queue contains prescriptions that need additional processing time that cannot be hastened with pharmacy involvement. Spefically, there are 2 types of scripts that are involved:1. Scripts that are in auto-retry: those that are automatically attempting re-adjudication to the customer's Third Party. 2. Scripts that were categorized as Suspended Fill (SF). SF happens when a 3rd party, specifically Workers comp, needs to review the Rx after a pharmacy-initiated PA.
Reconcilliation QueueThis queue lists prescriptions processed during Offline or store downtime that are awaiting reconciliation. This queue will display ONLY if there are pending Offline prescriptions.
Downtime QueueThis queue lists prescriptions processed during Third Party Downtime, in the last 60 days, with a status of Waiting Bin or Sold.
Inventory Queue partial and complete Out-of-Stock prescriptions.
Patient Care QueueThis queue lists all prescriptions for patients with active outreach opportunities. For example, patients beginning a new medication therapy or a patient who has not filled or picked up a prescription as prescribed. A line item will appear in the QP and QV to prompt Team Members when a Patient Outreach call must be made.
Page-Level Help (F9)
The Help topics most relevant to your current screen are displayed. In addition, you can perform keyword searches within the Help pages as well.
Alternating Between Screens
Another great feature of the RxConnect system is that you can alternate views between two screens from the same monitor. Functionally, you can perform the same activity on each screen. In case you are tied up on one screen waiting to speak to a Prescriber, you can switch to the other screen and continue filling other prescriptions. The only limitation is that you can't work on the same Patient Profile on both screens at the same time.While your monitor will never look exactly like this, it paints the picture for what you might be able to do, using two screens.In order to open the second screen, you must simultaneously press the Alt and F2 keys. The login page for the second screen will display.To switch back to the first screen, you need to simultaneously press the Alt and F1 keys.
The Enterprise Patient Pharmacy Profile
The Enterprise Patient Pharmacy Profile displays information from our enterprise pharmacies -- CVS Retail, Caremark Mail Order and Caremark Specialty Pharmacies to better serve the patient.The Enterprise Patient is highlighted with a green header to help you easily identify these patients.
AN below the Fill Number in the pt profile
Action Note IconAn Action Note indicator will appear beneath the Fill # when there is an associated Action Note. The icon will appear orange when the issue has not been communicated to the customer and gray after the issue has been communicated to the customer.
How to transfer a script to another competitor?
Profile, then X, then TO, then Enter
physical counting to update inventory to correct BOH (balance on hand) as needed. This is initiated automatically, when detected for an item is put in QI, or can be done at will.
How to access Inventory Management
Alt + F3.
OV Order Review
Outside Vender Order Review
WH Order Review
Warehouse Order Review
How to do delivery check-in
Start at Menu, then QI, or Menu then Alt + F3. Then select the Deliveries line. Then press A# (Add Delivery) to check-in a shipment. Then non-control and OTC invoices will automatically populate. If a discrepancy is found, type the line number (written as Edit Line) and edit the number of packages that were shipped. Otherwise, type U (BOH) to state that the packages received is correct. For controlled items, team members must scan/enter NDC or select the corresponding line to initiate an "Edit Number of Packages Received" box. A prompt will appear requesting a scan of the hardcopy invoice/manifest for controlled NDCs. RxNet has job aids to help with manual checking.
How to Cycle Count (update inventory)
First, enter the Cycle Count menu from the main menu. Follow prompts. Use the pill scale, an electronic weight measuring system that measures how much a stock bottle weighs to generate a quantity, which automatically updates BOH. Must be kept on at all times, or needs to be warmed up for half an hour after turned on. Be sure to adjust the leveling feet to ensure balance. For open bottles (which are the only ones you should use), remove desiccant, cotton, foil, and package insert/monograph.
Quantity Available to Dispense
When a preferred NDC is unavailable due to being on backorder or other supply chain disruptions, what do you do?
Leave all scripts in QI, to allow CFRx to send the order specificing non-preferred NDC, and dispense product with the relavent QAD indicators to ensure that the non-preferred NDC is only used temporarily.
Waiting Bin Physical Inventory
The actual, physical inventories of the Waiting Bin are completed on the 2nd Saturday of each fiscal month (a reminder is sent in the Hub days in advance, so don't worry about memorization). For select stores, if the initial scan is missed or the results are significantly different from expectations, then the 4th Saturday can be used for a re-take. Begin within 2 hours of closing. Use the RF Unit or Smart Badge to scan bags Also do all with status of SCAN READY or VERIFY READY in the computer system. Then print the report and compare the results
The Waiting Bin Report (14-day)
This report is printed DAILY and identifies prescriptions that have been filled for 14 days or more but not yet picked up Every day, take the list and pull out all of the 14-day-or-greater bags which are on the list. You must RTS these meds by the end of the day, or else those meds will appear on the next day's report and confuse people.
The Cash Loss Report
This report is used as a tool to locate prescriptions over 28 days old
The POS Discrepancy Report
This report identifies prescriptions that were rungup at a price different than the one recorded in the Pharmacy Computer System
The steps for completing a daily RTS (Return to Stock) are
1. Use the Waiting Bin Report to identify all Return to Stock prescriptions.2. After identifying the prescriptions that need to be returned to stock (in the bins for 14 or more days), retrieve theseprescriptions from the waiting bin area.3. Access the Batch RTS Queue from the main menu by selecting option (R). Scan all vials into the Batch RTS Queue If the prescription entered is an original fill, you will have the option toplace the prescription on hold. You should place the prescription on holdto maintain a record of the prescription in the patient's profile. The corresponding label will print once these steps are completed for theprescription4. Retrieve RTS labels from the printer5. Perform accuracy scan. Scan a RTS label, and then complete accuracy scan byscanning the appropriate prescription vial to confirm a product match. In doingso, the line item is then removed from the Queue. Immediately after performingaccuracy scan, affix the RTS label to the vial prior to proceeding to the next RTS.(Note: Accuracy scan should be performed for each prescription, one at a time.Rely on the system to ensure the match is correct). If performing a RTS on an automated drug, scan the long automationbarcode to initiate accuracy scan. The system will not recognize theshort automation barcode if scanned from the Batch RTS Queue. When returning sealed manufacturer bottles to inventory, scan the RTSlabel and then the manufacturer barcode on the sealed bottle, NOT the Rx label, so that the system recognizes that you're returning a stock container to the shelves. .Remove the prescription label from the sealed manufacturer bottle andreturn to the shelf as stock product. (You should only perform this processif you are able to fully remove the prescription label).6. Return all RTS product directly to the shelf, placing the vials next to the stockbottles for the same NDC To maintain BOH (Balance on Hand) integrity, re-stock the bottles to theshelf as soon as possible after the prescription has been edited in thePharmacy Computer System Remember to cover or remove all PHI (Protected Health Information)
POS Discrepancy Report
This report automatically prints daily, first thing in the morning, along with the end-ofday paperwork. The POS Discrepancy report list ALL prescriptions that were runginto Point of Sale (POS) at a price other than what appeared on the prescriptionreceipt generated from the Pharmacy Computer System. Any variance between thePharmacy Computer price and the amount rung into the register (POS) is generallywritten off as a Cash/Copay or Waiting Bin Loss in your store. It is important toreview the report as it identifies several issues that can help your P & L Action mustbe taken daily to address prescriptions based on the best practices outlined below.Best Practices Retrieve the POS Discrepancy Report from the end-of-day paperwork An assigned Technician should complete the POS Discrepancy Reportactivities EVERY day that report prints with EOD paperwork Review each prescription listed on the report Refer to TYP codes below for steps to take with each type of prescriptionappearing on the report Make a notation on the POS Discrepancy Report next to each prescriptiondescribing the issue and steps taken to resolve At the end of each week, review the previous week's report to identify anypatterns (e.g., Not ringing prescriptions properly or a potential shrink issue)POS Discrepancy Types - Issue Resolution If the prescription type is 'M' - Price Modifyo Attempt to determine the reason for the price modification Attempt to determine if the prescription needs to be edited in thePharmacy Computer System (e.g., cash prescription modified to a Third Party co-pay). Speak with the staff member that rangthe sale to determine why the modification was made. If the prescription type is 'P' - Post Void or 'L' - Line Voido Check the Waiting Bin for the prescriptiono As long as the prescription is either sold or returned to stock accordingto normal procedures, there will be no impact to the Waiting BinAccount If the prescription type is 'R' - Refundo Check the Waiting Bin for the prescription (e.g., waiting for customer toreturn with a prescription card)o As long as the prescription is either sold or returned to stock accordingto normal procedures, there will be no impact to the Waiting BinAccounto If the prescription is NOT in the Waiting Bin, attempt to verify that apharmacist authorized the refund
Pick N Pack
An application to fulfill Home Delivery orders.Alt + F8
Steps for home delivery
0. Alt + F8 to access Pick N Pack. 1. Create the order in Pick N Pack. This is done automatically when a digital order (rather than a phone one) is made. 2. Prepare in Tasks tab, then package.3. Hand the order to the courier (USPS). Only when the courier is in the store do you scan the label in Pick N Pack to register handoff, which then processes payment.
1-2 Day deliveries
Achievable if prepped by 3PM on weekdays and 2PM on Saturday. Put in USPS polybag. Pickup is between 4-5PM each day.
Urgent" deliveries, to be treated as waiters. Pts need the meds immediately!Packaged in a BROWN BAG, not a USPS polybag, to be picked up by SHIPT (no need for DOB or payment during handoff). Don't worry about the specifics of how to package these: Pick N Pack will tell you the process, with clear pictures. Just remember that, if someone says that they're a courier or picking up meds for a patient's delivery, and it's not ready yet, then you need to find the bag, go to Pick N Pack, and process the delivery request.
Medicare B - How to process ranges (e.g. 1-2 times per day?)
ranges are not accepted unless the lowest end of the range is used to calculate the day supply. For example, a script written for Diabetic Test Strips with aquantity of 60 and a testing frequency with a sig range of 1 to 2 times a dayshould be calculated as a 60 day supply.
Medicare B - E-scripts are required. But what about other types?
Verbal or telephone prescription orders require a hard copy follow up prior to dispensing
Medicare Part B requires CVS to collect a signed Assignment of Benefits (AOB) form. How is this form recorded?
1. RxConnect: from the Main Menu Screen by scanning barcode #12. POS: By scanning all three barcodes to recreate an electronic copy of this form. Follow the prompts to scan them in the right order.
There is only one occasion when Medicare B can be processed without an AOB form signed. What is it?
If the person picking up the prescription is a REPRESENTATIVE for the patient, they may refuse to sign the AOB form and the sale may proceed but the form is REQUIRED to be completed priorto the next Medicare Part B fill.
How much does Medicare pay for?
Up to 80 percent (100 percent for immunizations), with pharmacies only allowed a 20 percent copay. Supplemental insurance may remove the 20 percent copay.
At the register, item doesn't scan. what to do?
Enter the SALES tab, then enter the number below the bar code or the 6-digit number on the warehouse price ticket/shelf label.
Monthly Waiting Bin Physical Inventory Steps
1. Start 2 hours before closing.2. Scan all bagged scripts. 3. Go to Hub to Complete the task, then the Waiting Bin Inventory Report (WBIR) prints automatically.4. On the WBIR, an indicator next to each Rx will indicate if successfully scanned. Verify that the report is complete.5. On the WBIR, visually review the co-pays to ensure that they align with expectations. Validate scripts with high co-pays are reflected accurate.For more info, go to: RxNet, then Inventory Management. Or review: https://cvslearnet.cvs.com/tso/my_projects/RxTrainingDocs/204230_LG.pdf
How to do clozapine REMS (from QP)
1. QP, select clozapine. This pops up the Print View page.2. T# (View third party message)3. PrtSc (Print Screen) to verify during QV.
How to do clozapine REMS (from QV)
1. M2 (Functions) 2. 4 (Prescription Maintenance)3. 1 (Prescription Maintenance again)4. 1 (Inspect Prescription)5. Type Rx #, then select fill #, then select line #6. T# (Third Party) 7. M (Third Party Message)