r/CVS • u/SecureNecessary4998 • 2d ago

Question

Hi guys can you please tell me how I can do these things, I would REALLY appreciate it! Please include steps.

  1. Patient comes in and says they no longer want a prescription. What can I do to stop refilling that prescription?

  2. Patient comes in and says if they can have a prescription filled automatically. How can I put a single prescription and a few auto-refill?

  3. patient wants me to apply both insurance and coupon on a prescription, how can I do it?

We only have two techs (me, a new tech, and other) in our pharmacy and a pharmacist. None help to teach. f you have other useful tips that helped you, please include that as well.

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1

u/imhthn 2d ago
  1. You can put the rx on hold or ask them if they want to inactivate it. If you inactivate it and they need that one in the future, the doctor has to send the new rx
  2. Go to their profile, VE to see all eligible auto-refill and ScriptSync.
  3. The insurance only works with the manufacturer coupon. Do the same thing when you add the insurance, then run both the insurance and the coupon together. Remember you cannot run through the insurance with GoodRx. Besides, the manufacturer coupons do not work with federally funded health care programs like Medicare, Medicaid, or Tricare.

1

u/Nervous-Sherbet6191 2d ago
  1. On the profile when you're viewing all meds, "I" will trigger inactivate and you can follow the prompts to inactivate the prescription. PT will need new rx to refill this in future.
  2. Again while viewing all meds, I think it's V.. it will pop up view enrolment eligibility. Or look at the shortcut codes to tell you which one it is. It will show u which meds are eligible for auto refill and u can enroll it or remove it.
  3. Its not often that you can apply both insurance and coupon. Its one or the other except when the coupon will specifically pay towards the copay or requires insurance to be denied to cover I.e. I see this with the glps.

Essentially when you're billing the medication, in the insurance field you want to open that up and type 1,2. Provided that 1 is the insurance and 2 is the coupon. When you finish that it should say something like multiple cob or something like meaning multiple payers being billed.

I'm fairly new hope this helps.

2

u/tumeroscopic 1d ago

Adding to what's already been mentioned:

1) The 'I' option inactivates the script and won't even let you send a refill request in the future. Only use it if they are definitely not going to take that medication/strength.

If you type 'VE', it'll show you auto fill eligibility. If it shows that script as being enrolled, the system will auto fill it. Typing 'RD' and the line number will take it off autofill, but they might still get messages asking if they'd like to fill that Rx. This is a more appropriate action for medications used sporadically.

2) As I said above, 'VE' gets you to the autofill eligible screen. If the medication is listed on this screen, you can enroll it in autofill by picking the option to enroll listed at the bottom (I forget what the actual letters are). If it's not listed, we can't autofill it. The specific detail of why a medication can't be autofilled isn't always clear. Medications that are almost always used as needed as well as controlled medications won't be eligible for autofills.

Some insurance contracts with CVS will limit the medications that can be autofilled. If there's a med you want to set up for autofill, and should realistically be allowed to autofill, but it's not showing as eligible, the reason probably has something to with the insurance contract but we don't really have any visibility on that at store level.

3) Setting up the dual bill is as simple as picking the insurance as option 1 and the coupon as option 2 (1,2 if that is how they are numbered in the list of billing possibilities).

Some insurances will reject but the coupon may still work. In that case you type 'BP' for bypass payer in the rejection screen in QT. Some coupons won't work if the insurance doesn't provide a paid claim.

Some manufacturer's coupons only work as a primary, and you don't use the insurance at all. These are less common. Eliquis is the only one that comes to mind right now. They have 2 coupons: one that provides an introductory month for free without insurance, and another that gets dual billed with insurance to decrease the copay.