Medical Billing Coding - Oncology Drugs Dispensing Program, cpt, codes
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Thread Topic: Oncology Drugs Dispensing Program
Topic Originator: Brian
Post Date February 17, 2009 @ 2:59 PM
Oncology Drugs Dispensing Program


Brian
February 17, 2009 @ 2:59 PM Reply  |  Email Friend   |  |Print  |  Top

Hello all,

Although this might sound like a pharmacy billing, legally it is considered as a "dispensing program". Doctors purchase drug through ION (International Oncology Network). Here's a list of what the MD's would like to prescribe in general:

Amoxicillin, Arimidex, Augmentin, Ciprofloxacin, Dexamethasone, Gleevec,Ixempra, Levaquin, Neulasta, Neupogen, Nexavar, Ondansetron, Pepcid,Prednisone, Prochlorperatzine, Procrit, Sprycel, Sutent, Tamoxifen, Tarceva, Tycaerb, Xeloda (not all are "stocked" as some are very expensive to "shelf")

Now, unless this benefits the practice with a "profit" from what they pay for the drug, they will not dispense in clinic, but they will give the patient a script to fill at their pharmacy.

The MD will write a script and then the Med Tech will come into the exam room, tell the patient they can have it filled in clinic. Clinic will make a copy of the script and get a copy of the script card and pass it to the staff who will be doing the dispensing. The staff will go into the system, enter patient demographics and RX insurance info. They wait for the system to get back to see if "approved" or worse scenario, "rejected". In that circumstance, it needs to be investigated why the rejection, try to correct and proceed with the dispensing.

Once done, the steps followed are similar as it you would go to Walgreen's for your prescription. Come to the window, have the pharmacist go over what was prescribed, side effects etc., have them "sign" for the prescription, collect any co-pay due and send them on their way. This is still relatively new, but it is monetarily beneficial to the company.

Are there anybody who are aware of these dispensing program, what is the process and what software us used and how is this accounted? Any insight / inputs truly appreciated. Could someone throw light to this topic and is there someone who are using dispensing program for your practice who could how this works out for others in the forum can better understand.

Thanks in advance

Brian

Brian
February 18, 2009 @ 12:17 PM Reply  |  Email Friend   |  |Print  |  Top

Folks,

We need to understand the billing perspective about the Dispensing Program for Drugs and its appreciated if you someone could help answering the following questions:

1. Is it different from regular billing?

2. Do we need to maintain super bills?

3. How do we bill Admin codes ? What are the consequences?

4. Can we reduce biller time ?

5. How do we post payments if we receive checks from insurances? Or Do we get payments upfront?

6. How do we document non payable codes?

7. Can we process regular claims using this software? Knowing above inputs would be really useful for us to better understanding the entire process and decide to go on with a dispensing software for our practice.

Thanks in advance,
Brian



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