7 Prescription Processing Free Online FlashCards

What is the purpose of prescription processing?

Prescription processing turns a prescriber’s order into a correctly selected, documented, labeled, and, when applicable, insurance-billed medication.

How should staff match an order to the correct patient?

Match the order to the patient profile using reliable identifiers, such as the patient’s full name and date of birth.

Which prescription details must be entered faithfully?

Enter the drug, strength, dosage form, route, directions, quantity, refills, and prescriber exactly as authorized. Do not silently change the order.

What information should a Sig communicate?

A Sig should communicate the dose, route, frequency, duration when specified, and any special instructions.

What should staff do when an order is unclear or incomplete?

Do not guess. Refer unclear, contradictory, incomplete, or potentially unsafe orders to the pharmacist for clarification with the prescriber.

How is quantity calculated for a fixed schedule?

For a fixed schedule: $\text{quantity} = \text{units per dose} \times \text{doses per day} \times \text{number of days}$. Use the prescribed dose and schedule.

What product characteristics must match the order?

The active ingredient, strength, dosage form, route, and release characteristics must match the authorized drug or permitted substitution.

What are the three segments of a current FDA NDC?

In the current FDA system, an NDC has three segments: labeler, product, and package.

How is an NDC converted to the 11-digit HIPAA format?

For many HIPAA transactions, convert an NDC to the 11-digit 5-4-2 format by adding a leading zero to the short segment—not automatically to the whole number.

What does an insurance claim rejection permit staff to do?

A rejection is an issue to investigate, not permission to alter the prescription or bypass a clinical or legal requirement.

What should staff do when a plan requires prior authorization or step therapy?

Notify the patient and follow pharmacy procedures to contact the prescriber or plan when prior authorization or step therapy is required.

What should staff check for a refill-too-soon rejection?

Check the previous fill, directions, quantity, and days’ supply. Follow payer and pharmacy procedures for any legitimate exception.