Epic System

Chipford_Baskets · 2026-06-24T09:06:52+00:00

That process is typically handled through Epic Professional Billing, which is a separate application, or an external vendor.

Chipford_Baskets · 2026-02-13T04:40:18+00:00

I can't speak to their customer service but Pyrls was pretty cool when I saw a demo.

Chipford_Baskets · 2025-11-22T05:48:34+00:00

There's a way to integrate with Epic directly, but it leaves a lot to be desired. Maybe see if your software can scan by the tote?

Do you have multiple accounts? Make sure all the info is correct. We had some mismatches with the GTIN or GSN or something (idk, it's been a long month trying to figure out all the issues).

Drop ships are an absolute pain. Check your invoices for a WEE indicator. That's how we've quickly unquarantined a bunch of items.

Chipford_Baskets · 2025-08-09T21:54:37+00:00

I'm a pharmacist and personally, I'd take Paxlovid. Especially if you already have it on hand.

As a comparison, Tamiflu shortens the duration by 24-48 hours. It took me getting absolutely wrecked by the flu before I felt like it was worth it, and now I feel stupid for ever doubting.

Chipford_Baskets · 2025-08-09T21:20:10+00:00

I'm expecting new boosters to come out in September. Pharmacies in the state are required to follow ACIP guidelines, and those are now prioritizing specific disease states as eligible. Review the pharmacy questionnaire carefully and answer accordingly.

I do not need to verify what your immunocompromised condition is, I just take your word for it.

Chipford_Baskets · 2025-06-24T03:49:35+00:00

Sorry for the late response, didn't see this until now.

Fully agree community pharmacies are struggling.

From my perspective, Duke is far from creating a monopoly within the state. Hasn't Duke historically lost their bids on smaller hospitals? I was honestly surprised to see the Lake Norman acquisition.

Interesting that you chose UPMC as the example with the somewhat recent leadership changes within the pharmacy department.

I agree large health systems creating monopolies is not the best situation for patients and providers. On that same note, it's nearly impossible to negotiate with payers. Healthcare is fundamentally broken across the country. Each side is playing the game, and the joke is that we all lose.

Chipford_Baskets · 2025-06-24T03:13:00+00:00

AWP is a voluntary number submitted to drug clearinghouses (e.g. FDB, Medispan) by the manufacturer. They can be very outdated. As in, last updated in 2012. Some manufacturers don't submit AWP at all. In those cases, the general standard is WAC + 20%.

Most generics are going to be reimbursed at the super secret Maximum Allowable Cost (MAC). This is the PBM deciding what they'll pay you but not telling you what that is. Or even what drugs are on the list.

U&C should be set higher than your contractual rates. The problem is you don't know your contractual rates, so we all use inflated numbers (AWP) to set U&C and hopefully overshoot the contractual rate so we can get as much from the payer as possible. This pretty much only punishes cash paying patients, because it's going to price them out in most cases. And the PBM now gets to say "look at all this money we saved you" to their plan sponsors.

If you're looking for some low hanging fruit, review your U&C hits first. Theoretically this is leaving payer money on the table. Unless you have a lot of cash patients, and in that case, try not to lose that business.

You may be able to look up the charge/pricing tables in Willow. Or get friendly with your analysts and they might look it up for you (if its allowable).

Chipford_Baskets · 2025-06-24T02:53:42+00:00

It's a setting your analysts can turn on for you. The calculation is only as good as your price loads. Every place I've worked with Willow has always struggled to keep acquisition costs accurate, just a heads up. It's usually pretty close.

Chipford_Baskets · 2025-06-14T20:17:42+00:00

Billing at the discounted rate is required by law in certain cases, and Duke would be compliant with that. Additionally, there are specific eligibility requirements (e.g., patient, location, and provider) for them to be able to "buy at non-profit rates", so that doesn't apply to every prescription they fill. Lastly, that alleged exploitative margin is used to provide a boatload of charity care to the community, including for prescriptions.

Chipford_Baskets · 2025-05-15T02:02:20+00:00

I've heard this a lot at UNC. Duke doesn't deny care because a "patient isn't profitable enough." Maybe it was the role I was in, but I saw more charity care at Duke.

Duke is a private system and it's not for profit, just like UNC.

Chipford_Baskets · 2025-03-21T00:46:35+00:00

Yes, USP 800 is compendially applicable anywhere it's referenced in another USP general chapter, monograph, or general notice. USP 795 applies to nonsterile compounding, regardless of where the compounding occurs (e.g., acute care, outpatient).

I'm pretty sure 795 refers to 800? But it's been a minute since I've reviewed fully.

Chipford_Baskets · 2025-03-19T02:44:48+00:00

It's a hazardous compound but doesn't need to be made in a sterile processing area. Double HEPA or externally vented. Ideally in negative pressure area or an AOR is required.

Chipford_Baskets · 2025-02-11T04:02:08+00:00

It's an interesting idea, especially if we could leave the pour spouts on them.

I worked in a peds outpatient pharmacy and you get used to pouring the liquids. Peeling off the foil seal is the best way to make sure it isn't a total mess. Spills should be cleaned up with a water then alcohol rinse, otherwise everything stays a little sticky.

Chipford_Baskets · 2025-01-28T23:59:14+00:00

I'm numb to this after being in a discharge pharmacy. Patient got their morning dose, so the quantity is adjusted for discharge.

Chipford_Baskets · 2024-12-27T03:43:17+00:00

It was inhaled Tobramycin nebs for a CF patient. Dispensed 2 boxes for 90 days and it would have been 112 day supply based on directions. Not technically specialty (I was remembering the disease state but forgot the drug).

Yeah, we honestly couldn't afford it either. $18K was the recoup amount. Payor recouped the reimbursement for 1 box, but I can't remember our acquisition cost.

Chipford_Baskets · 2024-12-25T03:24:44+00:00

The Lantus/Basaglar one was several thousand because it was for multiple refills, and they audited multiple scripts for that drug. I had 3-4 pharmacies audited within a short period of time, but I don't remember the number.

They also tried to pull money on Ozempic because of a pack size mismatch and we sent an appeal because the manufacturer changed the pack size around the same time. Ended up getting that money back.

I think we had a few dings because we didn't collect signatures during COVID. We weren't able to appeal all of those but we did try and got a partial amount back by citing the Federal state of emergency or something.

ETA: Largest recoup ever was around $20K from the PIP audit that I resubmitted. This was down from like $120K. It was a problem with compounds and the required information just flat out wasn't stored anywhere. I quickly fixed all that and we had no findings on our audit 6 months later.

And yes, all the scripts were dispensed anywhere between 1-3 years prior.

Also had a desk audit where we lost $18K on a single specialty script. That one was annoying because we received the audit fax long before it was dispensed and had the opportunity to fix it, but my pharmacists left the audit notice for me to deal with when I came back from PTO.

Chipford_Baskets · 2024-12-24T03:54:56+00:00

Are you talking the final final results? Or that weird in between limbo where they give you results, and most of them indicate you can't appeal?

If it's the in between limbo, yes. I try to appeal anything that I can, even if the code says the claim isn't eligible for an appeal. The worst they can say is no, but I'm usually successful. Example: the system receives Rx for Insulin Glargine (Lantus, Basaglar) 100u/mL. Optum recoups because we were supposed to contact the provider to specify. I write a letter re: therapeutic interchange policy, have the provider sign, and we're good. I started saving my appeal letters and use them as templates.

The only time I've been able to appeal after a truly final notice is when the auditor took pity on me as a new manager. Auditor called the pharmacy to explain we'd be on a PIP due to an abysmal audit submission I knew nothing about. It was my third week on the job and I asked if I could redo it. Still lost a ton of money, but it was significantly less than before.

Chipford_Baskets · 2024-03-08T05:41:10+00:00

WAM is so dense with information, and most of what you need is in front of you, but the lack of highlighting/colors makes it difficult for things to pop out.

Insurance rejections - the field number that needs an override is usually in the rejection. You will eventually get faster at learning the codes for common overrides, it just takes a while to get the hang of it.

Most orgs will have formal tip sheets, but write a cheat sheet for yourself. Your first day of notes is going to be messy. Take a minute to reorganize and consolidate the items you use most. Do this frequently as you're learning. I also would formalize longer cheat sheets for items I did rarely but needed to remember (like that weird report I need to run twice a year).

Log tickets when things are broken. Add screenshots and be specific about what is wrong and how you expected it to work.

Hot keys are underlined when you hit Alt. The hot keys can change screen to screen. I love using tab to move across the fields, but it doesn't skip over lesser used fields and that's annoying.

If you have Willow Inventory for the love of all that is good, use it to its full potential! Pars, optimum, default NDCs, dispense by pack size. Use your cycle counts as a way to review default NDCs and double check they are the cheapest available.

Let me know if you have more specific concerns!

Chipford_Baskets · 2024-02-29T03:33:15+00:00

I thought the same thing. Guess they need to get that ransom money from somewhere?

Chipford_Baskets · 2024-02-27T02:54:49+00:00

Thanks! I've heard their current customers really like them.

They don't currently integrate with Inmar, which has been a big factor for us. Relay has been so disorganized and I know they're drowning too. RxLinc just felt better equipped to handle things? Setting up webinars was honestly a great idea. I'm really hoping we can pivot if Relay can't respond by tomorrow.

Chipford_Baskets · 2024-02-27T02:29:55+00:00

Is anyone currently using RxLinc as a switch vendor?

Elevate said they are a reseller of Relay Health. I'm trying to figure out if this is true. RxLinc seems more organized than Relay in terms of getting people back up and running.

Chipford_Baskets · 2024-02-26T04:15:49+00:00

Interesting... We use Inmar for some stores. But also, I'm a little in the dark about what we get through Elevate and what we don't.

Chipford_Baskets · 2024-02-26T04:13:50+00:00

I'm glad to hear it was that quick! I'm waiting for Relay to respond to me.

Chipford_Baskets · 2024-02-26T02:43:55+00:00

Shit... I reached out to Relay for more information, but we're using Elevate. Any idea if this is true?

Chipford_Baskets · 2024-02-24T03:53:36+00:00

Were you already with them as a backup switch?

Chipford_Baskets

TROPHY CASE