Home

PA PROMISe™ ePrescribing User Manual

Contents

1. eese 76 8 3 2 Deny a Renewal Due to License Number eese rennen TI 8 4 Fata ELC OUs tscsoatesaessy ads caeeauins dea tayestcn tents a teases yataas a e mas TI 9 View Prescriptions suco deren tro eo eek I a eka Ea a Rad evi s a S ek dv Da Cuv sein ea bu d Fork Ll Fuga sva inkl da Pu Ta dua 79 10 GIOSSIEV SEEE mr Ri aeo D Petit aid rade i vade dtm ed PO EY PNE TUE 81 Appendix A AMA Specialty Lasts ciccscccssccacecscecnscesneceevnccouentcovgnstovsconnscoovessneecesaredesnoseseeavoersecees 83 PA PROMISe ePrescribe User Manual v1 2a docx June 22 2012 ePrescribing Summary The new PROMISe ePrescribing application gives Pennsylvania Medical Assistance MA providers the ability to electronically transmit most prescriptions directly to the pharmacy MA enrolled prescribers utilizing the new PROMISe ePrescribing application will be able to transmit prescriptions electronically to a Surescripts participating pharmacy designated by the MA recipient The transmission occurs through the network connections between the prescriber s office Surescripts and the pharmacy As part of this process prescribers will have access to the MA preferred drug list PDL and prior authorization requirements In order for the Surescripts participating pharmacy to be eligible for payment the pharmacy must be enrolled in the MA Program All providers who intend to use the new PROMISe ePrescribing application must first register
2. If there is an incorrect pharmacy listed and needs to be removed click the Remove button PA PROMISe ePrescribe User Manual_v1 2a docx June 22 2012 36 5 3 1 Adding Preferred Pharmacies From this page you can view Preferred Pharmacies or you can search for and add new pharmacies There are several criteria for searching for a new pharmacy Pharmacy name and city Pharmacy name city and state Pharmacy name city and zip code Address and state City and state EOM deo ie I9 Zip code Q OVE E DA Do PUBLIC WELFARE PROMISe Internet Lug Prescribe Kacy MESI UI MR dE dE ePrescribe gt Search Patients gt Patient Information gt Health Conditions gt Preferred Pharmacies gt Search Pharmacies Tuesday 08 24 2010 03 31 PM EST g Search Pharmacies raa hormay enter the Pharmacy and City or State or ZIP Code or Address and State or a City and State or ZIP Code Pharmacy9 cys Address Contains9 City Harrisburg State SENN V zip Codeo Search Results Total Records 6 Pharmacy a Address Action CVS Pharmacy 1624 ROUTE 22 amp COLONIAL ROAD HARRISBURG Pennsylvania 17109 Select Office 1 717 652 6621 Fax 1 717 545 2833 CVS Pharmacy 1641 4402 OAKHURST BOULEVARD HARRISBURG Pennsylvania 17110 Office 1 717 545 2121 Fax 1 717 541 0440 CVS Pharmacy 1917 6007 ALLENTOWN BLVD PAXTON SQUARE HARRISBURG Pennsylvania 17112 Office 1 717 540 8621
3. P I TaD eee PROMISe Internet My Home ePrescribe ePrescribe gt Search Patients gt Patient Information gt Preferred Pharmacies Wednesday 08 25 2010 10 00 AM EST ePrescribe Smith Jane Patient Information Medications Health Conditions Preferred Pharmacies 01 01 1980 Preferred Pharmacies A single pharmacy can be designated as primary and will appear as the default pharmacy on the prescription Click Add to search and add a preferred pharmacy Pharmacy Address Action 1116 CARLISLE RD CAMP HILL Pennsylvania 17011 Office 1 717 612 5067 Fax 1 717 761 7970 6007 ALLENTOWN BLVD PAXTON SQUARE HARRISBURG Pennsylvania 17112 Office 1 717 540 8621 Fax 1 717 540 5663 Sak n PAMAN S s y Y CVS Pharmacy 1630 CVS Pharmacy 1917 Add Pharmacy 1 Click on the Remove link for the line you want to remove A message will display verifying you wish to remove the record Are you sure you want to Remove the record 2 Clicking the Yes button will remove the record PA PROMISe ePrescribe User Manual_v1 2a docx June 22 2012 38 5 3 3 Setting a Primary Preferred Pharmacy If the patient uses more than one pharmacy you have the ability to choose one as the Primary Pharmacy The preferred pharmacy will automatically populate on the Prescription Pad Click the Set as Primary link PROMISe Internet Reports Outpatient Fee Sch Wed
4. 53 6 1 9 SIG Dispense Page Using this page you enter the directions for drug use dispensing information and notes to the pharmacist All fields are mandatory except the Comments to the Pharmacist and Brand Medically Necessary Dispense as Written fields The contents of the Comments to the Pharmacist field are sent to the pharmacy but do not display on the prescription label New Prescription SIG Dispense Select Drug Indicates a required field Alternatives Coverage Pennsvivania DeotofPublic Welfare Formulary Status Non Formulary Brand Coverage Medication Wellbutrin 100 mg Tab Supplied Rx Limitations Co Pay Unknown gt SIG Dispense Dispense 69 Tablet v Either enter the number of refills or check the PRN indicator Refill Qty 5 or Refill as Needed PRN El Days Supply Brand Medically Necessary 30 Dispense as Written SIG 1 twice daily Please verify that the SIG applies to the Dispense and Days Supply data entered SIG Verified Comments to Pharmacist Note The Comments to Pharmacist will not display on the prescription label 1 In the Dispense field enter the number of units you wish to prescribe and choose the type of unit the drug comes in 2 In the Refill Qty field enter the number of refills available or click the PRN field to indicate the prescription should be refilled as needed Note The PA Medicaid Pharmacy Program allows prescriptions to be refilled as lon
5. Fax 1 717 540 5663 CVS Pharmacy 1922 6301 GRAYSON RD SWATARA SQUARE S HARRISBURG Pennsylvania 17111 Office 1 717 561 4573 Fax 1 717 561 0136 CVS Pharmacy 2370 3865 DERRY STREET HARRISBURG Pennsylvania 17111 Office 1 717 558 1603 Fax 1 717 558 1545 CVS Pharmacy 4037 221 223 MARKET STREET HARRISBURG Pennsylvania 17101 Office 1 717 238 1584 Fax 1 717 238 6092 1 Inthe Pharmacy field enter the pharmacy name or at least the first three characters 2 Inthe Address Contains field enter at least the first three characters that the address starts with or contains In the City field enter at least the first three characters of the city 4 Inthe State field use the drop down to select the state PA PROMISe ePrescribe User Manual_v1 2a docx June 22 2012 37 In the Zip Code field enter the zip code or at least the first three characters 6 Click the Search button A list of pharmacies meeting the search criteria will display If your patient s pharmacy does not display use more specific information 7 Once the correct pharmacy is displayed click on the Select link The selected pharmacy will be added to the patient s preferred pharmacy list 5 3 2 Removing a Preferred Pharmacy If the patient has moved or now prefers a different pharmacy you can remove from the Preferred Pharmacies panel Click the Remove link to remove any pharmacies that are no longer valid SN pennsylvania
6. Jane Patient Information Medications Health Conditions Preferred Pharmacies 01 01 1980 Female Prescribe Patient Information The patient information associated to the selected patient profile is displayed below The fields related to patient eligibility cannot be updated while a prescription is in progress for the selected patient Last Name Smith First Name Jane Middle Name Ann Suffix _ Patient 123456789 Birth Date 01 01 1980 Gender Female Pregnant 7 Status Active The patient demographics associated to the selected patient profile are displayed below Address 445 Sycamore St City Harrisburg State Pennsylvania Zip Code 17110 Phone Home 1 717 555 5555 Ext _ Phone _ Ext Patient consent for medication history is indicated below If the patient is below the age of consent then the parent guardian consent is provided Patient Consent All Prescriber History The patient information for orhi carrier for which the patient is eligible i is listed below Please confirm each Coverage selection that should be included for the identified patient Update i i i pecessary Deselecting a listed Coverage will make it unavailable on the Prescription Pad g Pennsylvania Dept of Public Welfare Coverage Determined on 06 18 2012 Covered Mail Order Retail Long Term Care Coverage not specified Specialty Last Name First Name JANE Middle Name ANN Suffix _ Gender Female Birth Date 01 01 1980 Address 445 Sycamore
7. 2a docx June 22 2012 35 5 3 Preferred Pharmacies You have the ability to add and view the specific pharmacy where the patient would like to pick up prescriptions In the event there is more than one preferred pharmacy listed one pharmacy can be selected as the primary The primary pharmacy will be pre populated when writing a new prescription Pharmacies listed for selection participate in the Surescripts network and are equipped to receive electronic prescriptions Note Pharmacies listed participate in the Surescripts network but may not be PA Medicaid participating pharmacies SN pennsylvania DEPARTMENT OF PUBLIC WELFARE PROMISe Internet ePrescribe gt Search Patients gt Patient Information gt Health Conditions gt Preferred Pharmacies Tuesday 08 24 2010 03 15 PM EST ePrescribe Smith Jane Patient Information Medications Health Conditions Preferred Pharmacies 01 01 1980 i Female Prescribe Preferred Pharmacies A single pharmacy can be designated as primary and will appear as the default pharmacy on the prescription Click Add to search and add a preferred pharmacy Pharmacy Address Action 1116 CARLISLE RD CAMP HILL Pennsylvania 17011 v L CVS Pharmacy 1630 Office 1 717 612 5067 Fax 1 717 761 7970 Add Pharmacy Remove 1 Click the link for Preferred Pharmacies 2 Ifthe patient s preferred pharmacy is not listed click the Add Pharmacy button
8. American Medical Association Note You must select a Provider Specialty for ePrescribing from the drop down list Please see Appendix A AMA Specialty List for the list of AMA specialties 5 Select Yes if you want to give your PROMISe portal alternates access to ePrescribing This will allow registered alternates access to the system to perform administrative functions such as obtaining eligibility Alternates will not have the ability to submit prescriptions Select No if you do not want to grant alternate access Note By granting access for alternates all alternates will have the ability to enter the ePrescribing application No access would indicate that no alternate would have access to the application Note The four digit prescriber PIN established during registration is required to finalize and submit a prescription and should not be shared with alternates 5 Enter a four numeric Personal Identification Number PIN This prescriber PIN will be required to complete a prescription and to complete a response to a renewal request PA PROMISe ePrescribe User Manual v1 2a docx June 22 2012 6 Enter the prefix to your name first name middle name last name and suffix Note The prefix middle name and suffix fields are optional 7 Enter your primary service location name optional address city state and zip code Note The primary service location cannot be a P O Box 8 Enter a phone number facsimile number a
9. Gender Female Pharmacy CVS Pharmacy 1630 1116 Carlisle Rd Camp Hill PA 17011 Office 1 717 612 5067 Select Patient The following patent s match the last name birth date and gender for the patent listed on the renewal request please select the patient you would like to include in your response to the pharmacy if you need to add a new patient go to the Add Patient page Jane Smith 555 Elm St Harrisburg PA 17109 Birth Date 01 01 1980 Gender Female Prescription Details Medication Amoxil 500 mg Oral Tab Total Dispensings Approved o Dispense 20 Tablet Date Written 04 01 10 Substitution NA Days Supply 0 SIG Teke 1 856 5 Dy Orai Rove BD Message _ s Prescriber s Response to Pharmacy Submit sends your response to the pharmacy Upon successful completion the item is deleted from the worklist and you are returned to the workhst If the Deny Renewal option is chosen ether Comments to the Pharmaost field or the Denial Reason dropdown must be entered Denial Reason Change Not Appropriate O Deny Renewsl Write New Prescription Comments to the Pharmacist Disclaimer Please note that formulary Coverage and drug alerts will mat be checked Enter the four digit PIN and click Submit to subenit the response Indicates required field PIN Teses EE Review the patient and pharmacy selection Select the patient for the renewal request Review the prescription details Click Deny Renewa
10. Liu ePrescribe Merian MEI C CMT Orden d ete Ct a a ePrescribe Profile Search Patients Review Renewals Search Pharmacies Prescriptions in Error View Prescriptions ePrescribe gt Search Patients gt Patient Information Monday 06 18 2012 08 46 AM EST ePrescribe Smith Jane Patient Information Medications Health Conditions Preferred Pharmacies 01 01 1980 Patient Information The patient information associated to the selected patient profile is displayed below The fields related to patient eligibility cannot be updated while a prescription is in progress for the selected patient Last Name Smith First Name Jane Middle Name Ann Suffix _ Patient 123456789 Birth Date 01 01 1980 Gender Female Pregnant f Status Active The patient demographics associated to the selected patient profile are displayed below Address 445 Sycamore St City Harrisburg State Pennsylvania Zip Code 17110 Phone Home 1 717 555 5555 Ext Phone _ Ext Patient consent for medication history is indicated below If the patient is below the age of consent then the parent guardian consent is provided Patient Consent All Prescriber History PA PROMISe ePrescribe User Manual v1 2a docx June 22 2012 41 6 1 1 Retrieving the Patient s Medication History Medication history is published by pharmacy benefit managers or payers based on pharmacy claims filed on behalf of or by the patient Medication history along with information from
11. Medicaid coverage Note Due to confidentiality laws regarding AIDS HIV treatment these drugs will not be included in the Medication History from PA Medicaid PA PROMISe ePrescribe User Manual v1 2a docx June 22 2012 42 To retrieve Medication History on the Patient Information page click the link for Medications r N pennsylvania Logou DEPARTMENT O BLIC WELFARE PROMIS e Interne My Home ePrescribe Claims Eligibility Trade Files Reports Outpatient Fee Schedule ePEAP Hospital Assessment Help ePrescribe Profile Search Patients Review Renewals Search Pharmacies Prescriptions in Error View Prescriptions ePrescribe gt Search Patients gt Patient Information Monday 06 18 2012 08 46 AM EST ePrescribe Smith Jane Patient Information Health Conditions Preferred Pharmacies 01 01 1980 Patient Information The patient information associated to the selected patient profile is displayed below The fields related to patient eligibility cannot be updated while a prescription is in progress for the selected patient Last Name Smith First Name Jane Middle Name Ann Suffix _ Patient 123456789 Birth Date 01 01 1980 Gender Female Pregnant Status Active The patient demographics associated to the selected patient profile are displayed below Address 445 Sycamore St City Harrisburg State Pennsylvania Zip Code 17110 Phone Home 1 717 555 5555 Ext Phone Ext Patient consent for medication history is indic
12. St City HARRISBURG State Pennsylvania Zip Code 17110 Aetna Retail Coverage Coverage Determined on 06 18 2012 Covered Mail Order Retail Coverage not specified Long Term Care Specialty Last Name SMITH First Name JANE Middle Name ANN Suffix Gender Female Birth Date 01 01 1980 Address 445 Sycamore St City HARRISBURG State Pennsylvania Zip Code 17110 Note Pennsylvania Department of Public Welfare refers to the Medicaid Fee for Service FFS program Information from Managed Care Organizations MCOs regarding PA Medicaid patients will be identified by the name of the MCO For each patient you will see the pharmacy coverage details the payer and health plan name type of coverage mail retail or both and demographic information as known by that payer PA PROMISe ePrescribe User Manual v1 2a docx June 22 2012 23 If Surescripts returns patient information that differs from what 1s on the patient profile a red icon as shown below will appear next to the eligibility coverage In that case review the information with the patient to ensure the data on file is accurate Make updates to the patient profile as needed Q ennsylvania d ESD poney PUBLIC WELFARE PROMISe Internet Eligibility Trade Files Reports Outpatient Fee Schedule ePEAP Hospital Assessment Help ePrescribe Profile Search Patients Review Renewals Search Pharmacies Prescriptions in Error View Prescriptions ePrescribe
13. Use of the ePrescribe application is not intended to replace the requirements for any prescriber to perform the proper due diligence with their patients before authorizing any prescriptions on their behalf PA PROMISe ePrescribe User Manual v1 2a docx June 22 2012 3 Add a New Patient One of the first actions a prescriber must perform is to add patients into the PROMISe ePrescribing application Patients are uniquely related to the prescriber and are not shared with any other provider Once the patient s profile has been added a prescriber can view the patient s eligibility for pharmacy coverage as well as add the patient s medications allergies disease conditions and preferred pharmacies to the patient s profile To add a new patient select the Search Patients menu item and then click on the link Add a New Patient in the bottom right corner EN pennsylvania DEPARTMENT OF PUBLIC WELFARE PROMIS e Internet ePrescribe i ePrescribe Profile Search Patients Review Renewals Search Pharmacies Prescriptions in Error View Prescriptions Prescribe gt Search Patients Friday 08 13 2010 02 38 PM EST Search Patient Patient Name Patient Search for a new patient by Last Name All other fields are optional Then select the Search button to search for all available patients with matching information ndicates a required field Last Name 9 First Name Birth Date s Ge
14. Welfare Coverage Determined on 06 18 2012 Covered Mail Order Retail Long Term Care Coverage not specified Specialty Last Name SMITH First Name JANE Middle Name ANN Suffix Gender Female Birth Date 01 01 1980 Address 445 Sycamore St City HARRISBURG State Pennsylvania Zip Code 17110 Aetna Retail Coverage Coverage Determined on 06 18 2012 Covered Mail Order Retail Coverage not specified Long Term Care Specialty Last Name SMITH First Name JANE Middle Name ANN Suffix Gender Female Birth Date 01 01 1980 Address 445 Sycamore St City HARRISBURG State Pennsylvania Zip Code 17110 PA PROMISe ePrescribe User Manual_v1 2a docx June 22 2012 26 5 1 Medications The Medications page has two sections The first section references the Medication History Request The second section Medications Manually Entered Patient Reported refers to medications specifically reported by the patient which are entered by the prescriber The Medication History request is used to obtain the patient s medication history prior to prescribing or when making decisions regarding renewals This function is described in detail in the ePrescribing section The Medications Manually Entered Patient reported page is used to enter edit and display medications as reported by the patient 5 1 1 Adding a New Patient Reported Medication In the event a patient informs you of any medications or supplements he she is taking where th
15. an allergen you can accomplish that by clicking on the Edit link Allergies Click the Edit link to update the details in a row Click the Remove link to remove the entire row Allergen Reaction Last Update Action Click to add a new allergen BEE POLLENS Hives 08 24 2010 I ove CEDAR LEAF THUJA Sinusitis 08 23 2010 d Remove Allergen CEDAR LEAF THUJA Reaction sinusitis Save Cancel Click on the link for Edit 2 In the Reaction field enter the new reaction information Click the Save button to complete the process The allergen will be modified to reflect the change PA PROMISe ePrescribe User Manual v1 2a docx June 22 2012 34 5 2 5 Removing an Allergy If a listed Allergy is no longer applicable you can remove it from the Health Conditions page Allergies Click the Edit link to update the details in a row Click the Remove link to remove the entire row Allergen Reaction Last Update Action Click to add a new allergen E 3 BEE POLLENS Hives 08 24 2010 CEDAR LEAF THUJA Sinusitis 08 23 2010 Edit Remove 1 Click on the Remove link for the line you wish to remove A message will display verifying you wish to remove the record v Confirmation x Are you sure you want to Remove the record 2 Click the Yes button to remove the record PA PROMISe ePrescribe User Manual v1
16. and indicate whether substitutions are allowed This renewal request was received without a license number therefore the only allowable response options are to either deny the request or deny the request and create a new prescription J Deny Renewal Denial Reason Depas ar Write New Prescription A If you choose to deny this renewal and write a new prescription the prescription s on your prescription pad that are currently in progress will be cleared Comments to the Pharma Disclaimer Please note that formulary coverage and drug alerts will not be checked Enter the four digit PIN and click Submit to submit the response Indicates a required field PIN 1 Review the patient and pharmacy selection 2 Select the patient for the renewal request 3 Review the prescription details 4 Click Deny Renewal Write New Prescription Note If you choose to deny a renewal and write a new prescription any prescriptions on your prescription pad that are in progress will be cleared 5 A confirmation will display to verify you wish to write a new prescription 6 The Patient Information page displays so you can view their pharmacy eligibility and then click Prescribe proceed to the Prescription Pad to write a new prescription PA PROMISe ePrescribe User Manual_v1 2a docx June 22 2012 76 8 3 2 Deny a Renewal Due to License Number PA Medicaid prescriptions require the prescriber s state license number Refill Renewal
17. completion of the prescriber profile the only time the prescriber needs to access the profile is to update any profile information If you are already using a POC or ePrescribing product and receive Renewal Requests through that product you should consider how you want to continue to receive Renewal Requests before registering with the PROMISe ePrescribe application Surescripts allows multiple prescriber registrations using different ePrescribing products It will also route renewal requests to multiple vendor products or provider locations however due to limitations in pharmacy software there may be the potential for a renewal request routing error to occur when a prescriber uses multiple products to receive renewal request services or if the prescriber has multiple locations registered If you choose to use the PROMISe ePrescribe application in addition to or in place of an existing POC or ePrescribing product with renewal request services you will need to request a Prescriber Vendor Release form from the PROMISe Provider Assistance Center PAC at 1 800 248 2152 The completed form must be returned to Surescripts for processing After Surescripts updates your prescriber registration data you will be able to complete the PROMISe ePrescribe registration process PA PROMISe ePrescribe User Manual v1 2a docx June 22 2012 The following chart shows the flow of ePrescribing from the initial logon and prescriber registration th
18. gt Search Patients gt Patient Information Monday 06 18 2012 08 46 AM EST ePrescribe Smith Jane Patient Information Medications Health Conditions Preferred Pharmacies 01 01 1980 3 Patient Information The patient information associated to the selected patient profile is displayed below The fields related to patient eligibility cannot be updated while a prescription is in progress for the selected patient Last Name Smith First Name Jane Middle Name 4nn Suffix _ Patient 123456789 Birth Date 01 01 1980 Gender Female Pregnant f Status Active The patient demographics associated to the selected patient profile are displayed below Address 445 Sycamore St City Harrisburg State PennsyNania Zip Code 17110 Phone Home 1 717 555 5555 Ext Phone Ext _ Patient consent for medication history is indicated below If the patient is below the age of consent then the parent guardian consent is provided Patient Consent All Prescriber History Patient Eligibility The patient information for each carrier for which the patient is eligible is listed below Please confirm each Coverage selection that should be included for the identified patient Updates can be applied to the patient profile as necessary Deselecting a listed Coverage will make it unavailable on the Prescription Pad Pennsylvania Dept of Public Welfare Coverage Determined on 06 18 2012 Covered Mail Order Retail Long Term Care Coverage not specified Sp
19. limitations in pharmacy software there may be the potential for a renewal request routing error to occur when a prescriber uses multiple products to receive renewal request services or if the prescriber has multiple locations registered If you choose to use the PROMISe ePrescribe application in addition to or in place of an existing POC or ePrescribing product with renewal request services you will need to request a Prescriber Vendor Release form from the PROMISe Provider Assistance Center 800 248 2152 The completed form must be returned to the PROMISe PAC so it can be forwarded to PA PROMISe ePrescribe User Manual v1 2a docx June 22 2012 Surescripts for processing After Surescripts updates your prescriber registration data you will be able to complete the PROMISe ePrescribe registration process 2 Registering for ePrescribing The Registration process allows prescribers to request access to the PROMISe ePrescribing application Prescribers are required to fill out the page with the identifying information Fields identified with an asterisk are required fields PA PROMISe ePrescribe User Manual v1 2a docx June 22 2012 pennsylvania PROMISe Internet My Home EET DAT LI My Home gt My Profle gt ePreschbe Registration Thursday 09 30 2010 01 03 PM E 4 Pres riber lngrstration be verify the followng information and make updates before submitting your registration request The NFI i
20. portal Use this link http promise dpw state pa us to access the PROMISe Welcome Page Log on using the credentials you created when registering for the PROMISe Internet portal SN pennsylvania DEPARTMENT OF PUBLIC WELFARE PROMISe Internet Monday 05 03 2010 02 21 PM EST Broadcast Message Providers with Service Plans in HCSIS Waiver providers who bill PROMISe for services that are authorized through service plans in HCSIS should not bill over Forgot User ID the internet during a nightly maintenance window between 11 40PM and 12 10AM Claims errors might occur For m more information click more Register Now Where do I enter my password Notice Due to required Commonwealth system maintenance this web site may be unavailable for short periods between 9 00PM and 1 00AM on the 1st and 3rd Thursday of each month Quick Links i Thank you for your patience Need Help Use the Internet Help Manuals here Notice Demo of PA PROMISe as 3 i Le TUE Welcome to the new PROMISe Internet Portal where you will find a new look along with enhanced security features e Learning courses We appreciate your patience as you may be required to take a few moments to make updates to your user profile a Provider Awareness PROMISe Internet emnon yveICoOme tj UB 04 Outpatient PROMISE UB 04 LTC PA PROMISe ePrescribe User Manual_v1 2a docx June 22 2012 Once
21. received by the pharmacy e Error There was an error in the transmission of the file This condition requires reviewing the medication details and resubmitting the prescription e Print Preview The prescription generally a controlled substance or Brand Medically Necessary drug needs to be printed e Printed The prescription generally a controlled substance or Brand Medically Necessary drug has been printed It should be manually signed and given to the patient to be hand carried to the pharmacy Prescription Pad Transmission Status Do not navigate away from this page until your prescriptions have been printed successfully Lisinopril 5 mg Tab SIG Dispense Refills Comments to Pharmacist Submission Type Pharmacy Prescriber Prescription 1 tablet twice a day 60 Tablet Substitution Allowed T Days Supply 30 Electronic RITE AID 5277 SIMPSON FERRY 5277 SIMPSON FERRY ROAD MECHANICSBURG Pennsylvania 170553515 Office 1 717 766 2533 John Doe D O 444 Walnut St Harrisburg PA 17110 Office 1 717 555 9990 SIG Dispense Refills Comments to Pharmacist Vicodin 5 mg 500 mg Tab 1 tablet 4 times a day as needed for pain 16 Tablet Substitution Allowed 0 Days Supply 4 Prescriber John Doe D O 444 Walnut St Harrisburg PA 17110 Office 1 717 555 9990 This prescription must be printed It is a Schedule III controlled substance PA PROMISe ePrescribe User Manu
22. to use the PROMISe Internet Portal Only MA enrolled prescribers can use the portal for ePrescribing If the provider is one of six provider types permitted to prescribe the Register for ePrescribe link will appear on the main page of the PROMISe Internet portal The six provider types who may prescribe are physicians dentists certified registered nurse practitioners podiatrists optometrists and certified nurse midwives While Physician Assistants are licensed to write prescriptions they are not enrolled in the Pennsylvania Medicaid Program The one time ePrescribing prescriber registration process requires entry of several key pieces of information This includes name and contact information DEA number for prescribing controlled substances on paper state license number provider specialty based on American Medical Association AMA codes and a self created Personal Identification Number PIN which is used by the prescriber to finalize the electronic prescription In addition the prescriber must indicate if he she grants access to alternate users to perform clerical functions such as updating the patient profile or performing an eligibility transaction If the Grant Alternate Access drop down is selected all alternates will have the ability to access the clerical functions of ePrescribe Please note that alternates do not have the capability to finalize a prescription because the prescriber PIN is needed to complete this process Upon
23. will display allowing you to send it to a printer Date Written 10 27 2011 Doctor Alan Smith D O Patient Smith Jane Location Downtown Clinic Birth Date 01 01 1980 Pharmacy Inquiries 1 717 555 6556 Address 555 Elm St Facsimile 1 717 555 6557 Harrisburg PA 17109 Home 1 717 555 9999 Medication Tri Luma 0 01 96 4 95 5 Topical Cream Substitution Allowed SIG Apply every 4 hours Days Supply 10 Dispense 15 FIFTEEN Ounces Refills 0 ZERO Comments to Pharmacist Security features include bordered and spelled quantities microprint signature line visible at 5x or gt magnification that must show HPERX and this description of features Signature MD123456789 License CW9999999 DEA 987654321 NPI Note Do not navigate away from this page until the prescriptions are successfully printed Once a prescription is printed it can be removed from the list Note For best results we recommend the use of a printer that can support 1200 by 1200 dpi dots per inch for all printed prescriptions 3 Click the Remove link if you want to remove the prescription A message will display stating the record has been removed PA PROMISe ePrescribe User Manual v1 2a docx June 22 2012 65 v Confirmation Are you sure you want to Remove the record 4 Click the Cancel button if you don t want to make any changes PA PROMISe ePrescribe User Manual v1 2a docx June 22 2012 66
24. you can search by either name or number to determine if the patient has already been added to your patient database SIG Dispense Instructions on how to the take the medication Surescripts Prescriber ID SPD The Surescripts assigned 10 digit identifier used on all transactions and in the Prescriber Directory to identify participating prescribers PA PROMISe ePrescribe User Manual v1 2a docx June 22 2012 82 Appendix A AMA Specialty List A Allergy ADM Addiction Medicine ADL Adolescent Medicine Pediatrics ADP Addiction Psychiatry AI Allergy and Immunology ALI Clinical and Laboratory Immunology Allergy and Immunology AM Aerospace Medicine AMI Adolescent Medicine Internal Medicine AN Anesthesiology APM Pain Management Anesthesiology AS Abdominal Surgery BBK Blood Banking Transfusion Medicine CBG Clinical Biochemical Genetics CCA Critical Care Medicine Anesthesiology CCG Clinical Cytogentics CCM Critical Care Medicine Internal Medicine CCP Pediatric Critical Care Medicine CCS Surgical Critical Care Surgery CTS Cardiothoracic Surgery CD Cardiovascular Disease CG Clinical Genetics CHN Child Neurology PA PROMISe ePrescribe User Manual_v1 2a docx 83 June 22 2012 CHP Child and Adolescent Psychiatry CLP Clinical
25. 011 Jones Bob Xanax 1 mg Tab Cancel PA PROMISe ePrescribe User Manual v1 2a docx June 22 2012 70 8 2 Approve a Renewal Request If the renewal is appropriate this page allows the renewal to be processed and transmitted to the pharmacy Note The PROMISe ePrescribe application does not automatically check eligibility as part of the renewal approval process Prescribers are encouraged to select the patient profile to review coverage prior to approving renewal requests Note This application does not validate if a Prior Authorization must be obtained from PA Medicaid Prescribers are encouraged to review PA Medicaid guidelines prior to approving renewal requests To access this page select the medication link on the Renewal Request page PROMISe Internet jePrescribe Profile Search Patients Review Renewals Search Phamacies Prescriptions in Error View Prescriptions ePrescribe gt Review Renewals gt Renewal Request Details Friday 08 27 2010 02 41 PM EST Renewal Re Birth Date 01 01 1980 Gender Female Patient Jane Smith 555 Elm St Harrisburg PA 17109 Pharmacy CVS Pharmacy 1630 1116 Carlisle Rd Camp Hill PA 17011 Office 1 717 612 5067 Select Patient The following patient s match the last name birth date and gender for the patient listed on the renewal request please select the patient you would like to include in your resp
26. 8 Renewal Requests Pharmacies can initiate requests regarding prescription renewals refills Prescribers will be able to respond to those requests via the PROMISe ePrescribing application You can review these renewal requests select a patient for inclusion in the response to the renewal request view the prescription details and modify the number of refills approved approve the renewal request deny the renewal request or deny and write a new prescription You can also add a patient if the patient is not listed in the Select Patient panel New renewals are indicated on the ePrescribe page Yoo ennsylvania SN eehed PROMISe Internet ePrescribe Profile Search Patients Review Renewals Search Pharmacies Prescristions in Error View Prescriptions ePrescribe Friday 08 13 2010 02 28 PM EST SE Welcome to Electronic Prescription Processing e We are committed to make it easier or physicians and other providers to perform their business DISCLAIMER Use of the ePrescribe application is not intended to replace the requirements for any prescriber to perform the proper due diligence with their patients before authorizing any prescriptions on their behalf Renewal requests are classified into three Type categories New Duplicate or Error Any recent additions to the renewal work list will be indicated with New A tally of the number of new additions is displayed above the work list A Duplicate renewal request is i
27. 90 Comments to Pharmacist Submission Type Electronic Pharmacy CVS Pharmacy 1630 1116 CARLISLE RD CAMP HILL Pennsylvania 17011 Office 1 717 612 5067 Prescriber Alan Smith D O 555 Anywhere Street Camp Hill PA 17011 Office 1 717 555 4444 Confirm Prescription Pad Cancel Confirmation 1 Click the Confirm Prescription Pad button to process the electronic prescription A message will display stating the prescription is processing When it completes you will be redirected to the Transmission Status page Prescription Pad Processing Prescriptions e Processing your prescriptions Please do not close stop or refresh the page and do not use the browser Back button until you receive confirmation that your prescriptions have been processed successfully 2 Click the Cancel Confirmation button if you would like to cancel the prescription You will be redirected back to the Prescription Pad At this point in the process you cannot modify the prescription PA PROMISe ePrescribe User Manual v1 2a docx June 22 2012 59 6 1 13 Transmission Status From this page you will be able to check the status of the prescriptions you submitted The status types are The following will display indicating the status of the medication being transmitted e Pending The prescription is being processed but is not yet complete e Accepted The prescription has been successfully transmitted and
28. A PROMISe ePrescribe User Manual_v1 2a docx June 22 2012 77 The errors are e 600 Communication Error try again later e 601 Receiver unable to process do not retry e 602 Receiver System Error try again later e 900 Transaction rejected do not retry Errors 601 and 900 will display the renewal error message For these errors you must contact the pharmacy directly to resolve Errors 600 and 602 will allow you to reply to the renewal again PA PROMISe ePrescribe User Manual_v1 2a docx June 22 2012 78 9 View Prescriptions Using the PROMISe ePrescribing application prescribers are able to view all prescriptions and renewals that they prescribed or took action upon You can view the following prescription information patient name date written medication prescription type and the prescription s transmission status The medication information includes drug name strength and dosage form followed by the number dispensed number of refills or PRN refill as needed and number of days supply EN pennsylvania DEPARTMENT OF PUBLIC WELFARE PROMISe Internet M View Prescriptions ePrescribe Profile Search Patients Review Renewals Search Pharmacies Prescriptions in Err ePrescribe gt View Prescriptions View Prescriptions View previous prescriptions including renewals patient information and prescription status Click Search to accept the default search dates or enter a
29. As an alternative to calling you can send an email to PAPAC1I hp com with your user id name Provider ID 1234567890001 phone number and a brief description of the issue you are experiencing Location ID 0001 Providers with Service Plans in HCSIS My Profile Manage Alternates Waiver providers who bill PROMISe for services that are authorized through service plans in HCSIS should not bill over the internet during a nightly maintenance window between 11 40 Man illing Agents PM and 12 10 AM claims errors might occur Thank you for your patience DPW Resources DPW Home PW Provider Inform PA PROMISe ePrescribe User Manual v1 2a docx June 22 2012 Clicking on the ePrescribe tab will direct you to the PROMISe ePrescribing application Here prescribers can update their patient profiles search patients review prescription renewals search pharmacies view prescriptions with errors and view existing prescriptions These functions are described in detail in the following sections Q ennsylvania eka bla strane PROMISe Internet KURA ePrescribe EYCI a MEE Bal Mme Cn eT lice aere T E te Cl ibeaofile Searcby tients Review Renewals Search Pharmacies Prescriptions in Error ePrescribe ig a Welcome to Electronic Prescription Processing LZ Pres eRx Prescriber Profile Search Pharmacies We are committed to make it easier for physicians and other providers to perform their business DISCLAIMER
30. Number s Revisions Completed By 0228 2011 New Document Chris McElheny Version 1 la 11 04 2011 46 50 59 Addition of Chris McElheny 62 Advanced Search Changes to printed prescription Version 1 2a 06 22 2012 Updates to Chris McElheny Patient Information panel and Patient Eligibility PA PROMISe ePrescribe User Manual_v1 2a docx June 22 2012 Table of Contents Il Applica on Features iiie czenticeceosdsnnadeencksdenseesoatnscunativnuclnesesecbndovevseseceuseveuvovsuucaeeedeceys 4 1 1 Key Features and Benefits seccion naci sut edd gucdesie oer e Aa NUR REO RU OD RINUE 4 1 2 secuie Website 2 PIU ba i ue studii ee ed dabat 4 12 8 The Menu Bat eere Ee eee Leet eR Lovee as 4 1 2 2 Logout Link iei ihe dea nete i ete eig de eo Ee wet Eier ieas soeavtaseaneates 6 1 22 37 Radio BUON S cv o tee dee Ne teta ite e eee iae toe e thoro in Get re EE E a en ee p Ee er aed 6 1 3 Timeout NOBTCAUOS nn E E E E E N 7 PME Cur ou AEE E E E ETA 8 2 1 Registering for ePrescribing 4 nsu eire nuiis nn Eii i ene EiS 10 2 2 Editing the Provider Proleg de EN DRM RE QS e pio A R 14 2 3 AICUOeSSIHS ePIreSCEIDDWE n A Aosta ie ua 16 MES UENIT 18 3 1 About the Add a New Patient Page 5a aciei oc eset E US Nt sese etis 19 4 ciu lici cide ccaccaciniecaeatesesoeddsuctnovausedeeadinin nn i nais 21 4 1 Searclitor a Patient Dy Names ode tat donc ve a edge E ve neds 21 4 2 Searclr Tor d Pauent by NUMBeT ssiri eiia R a E tali idi
31. Originally Selected Drug field enter the medication name or at least the first three characters The drugs containing the characters entered will appear in a list for selection 3 Click the Medication field and use the drop down to select the strength and dosage information 4 Click the Continue button to proceed to the next step If the medication has alternatives such as payer or therapeutic alternatives the Alternative panel will display If no Alternatives are available the application will display any Coverage Limitations identified by the selected coverage payer PBM 6 1 4 Advanced Search Using the Advanced Search feature you have the option of searching for a medication by either Therapeutic Class or Organ System To use this feature click on the Advanced Search link to the right of Drug Name enns Ivania M PP e ME PROMISe Internet lePrescribe Profile Search Pais uy Review Renewals Search Pharmacies Pins in Error View Prescriptions ePrescribe gt Search Patients gt Patient Information gt Prescribe gt Select Drug Thursday 10 27 2011 09 50 AM EST ePrescribe Jane Smith Patient Information Medications Health Conditions Preferred Pharmacies 01 01 1980 Female Select Drug Enter drug name or use Advanced Search to search by Therapeutic Class Alternatives Indicates a required field Limitations Coverage Pennsylvania Department of Public Welfare v SIG Dispense Drug Name Augmentin A
32. PA PROMISe M User Manual PA PROMISe ePrescribing User Manual SYSTEM DOCUMENTATION LIBRARY REFERENCE NUMBER 000001 64 SECTION 4 5B LIBRARY REFERENCE NUMBER 0000313 PROVIDER INTERNET USER MANUAL REVISION DATE 06 22 2012 VERSION 1 2a ePrescribing User Manual PA PROMISe System Documentation Library Reference Number 00000313 This document contains confidential and proprietary information of the Pennsylvania PROMISe account of HP Enterprise Services and may not be disclosed to others than those to whom it was originally distributed It must not be duplicated published or used for any other purpose than originally intended without the prior written permission of Pennsylvania PROMISeTM Information described in this document is believed to be accurate and reliable and much care has been taken in its preparation However no responsibility financial or otherwise is accepted for any consequences arising out of the use or misuse of this material Address any comments concerning the contents of this manual to HP Enterprise Services Attention Documentation Unit PA MMIS 225 Grandview Ave MS A20 Camp Hill PA 17011 HP is an equal opportunity employer and values the diversity of its people 2012 Hewlett Packard Development Company LP PA PROMISe ePrescribe User Manual v1 2a docx June 22 2012 Revision History Document Revision Version Revision Page Reason for Revisions Number Date
33. Pathology CMG Clinical Molecular Genetics CN Clinical Neurophysiology CRS Colon and Rectal Surgery D Dermatology DDL Clinical and Laboratory Dermatological Immunology DIA Diabetes DMP Dermatopathology Pathology DR Diagnostic Radiology DS Dermatologic Surgery EM Emergency Medicine END Endocrinology Diabetes and Metabolism EP Epidemiology ESM Sports Medicine Emergency Medicine ETX Medical Toxicology Emergency Medicine FOP Forensic Pathology FP Family Practice FPG Geriatric Medicine Family Practice FPS Facial Plastic Surgery FSM Sports Medicine Family Practice GE Gastroenterology GO Gynecological Oncology GP General Practice PA PROMISe ePrescribe User Manual v1 2a docx 84 June 22 2012 GPM General Preventive Medicine GS General Surgery GYN Gynecology HEM Hematology Internal Medicine HEP Hepatology HMP Hematology Pathology HNS Head and Neck Surgery HO Hematology Oncology HS Hand Surgery ICE Clinical Cardiac Electrophysiology ID Infectious Disease IG Immunology ILI Clinical and Laboratory Immunology Internal Medicine IM Internal Medicine IMG Geriatric Medicine Internal Medicine ISM Sports Medicine Internal Medicine LM Legal Medicine MDM Medical Management MFM Maternal and Fetal Medicine MG Medical Genetics MM Medical Microbiology MPD Internal Medicine Pediatrics MPH Public Health an
34. S Pediatric Surgery Surgery PDT Medical Toxicology Pediatrics PE Pediatric Emergency Medicine Emergency Medicine PEM Pediatric Emergency Medicine Pediatrics PFP Forensic Psychiatry PG Pediatric Gastroenterology PHO Pediatric Hematology Oncology PIP Immunopathology PLI Clinical and Laboratory Immunology Pediatrics PA PROMISe ePrescribe User Manual v1 2a docx 87 June 22 2012 PLM Palliative Medicine PM Physical Medicine and Rehabilitation PMD Pain Medicine PN Pediatric Nephrology PO Pediatric Ophthalmology PP Pediatric Pathology PPR Pediatric Rheumatology PRO Proctology PS Plastic Surgery PSM Sports Medicine Pediatrics PTH Anatomic and Clinical Pathology PTX Medical Toxicology Preventive Medicine PUD Pulmonary Disease PYA Psychoanalysis PYG Geriatric Psychiatry OAR Adult Reconstructive Orthopedics OMO Musculoskeletal Oncology OSM Sports Medicine Orthopedic Surgery R Radiology REN Reproductive Endocrinology RHU Rheumatology RIP Radioisotopic Pathology RNR Neuroradiology RO Radiation Oncology PA PROMISe ePrescribe User Manual v1 2a docx 88 June 22 2012 RP Radiological Physics SCI Spinal Cord Injury Medicine Physical Medicine and Rehabilitation SM Sleep Medicine SO Surgical Oncology SP Selective Pathology TRS Trauma Surgery TTS
35. The prescriber must indicate that the prescriber has received the consent of the patient regardless of which option is selected If the prescriber does not have the patient s consent to view medication history the prescriber should chose the No History option If the patient is below the age at which they can consent to the viewing of medication history then the parent or legal guardian must provide this consent on behalf of the patient until they reach the appropriate age Patient Consent All Prescriber History EETEN NT 1 Enter the new patient s Last Name First Name Middle name and Suffix if applicable 2 Enter the Patient optional This is a prescriber unique number used to reference the patient such as a chart number or patient account number This field can contain combinations of letters numbers and characters 3 Enter the patient s Birth Date or select it from the calendar 4 Select the patient s Gender If the patient is female and pregnant check the Pregnant checkbox Note The provider will need to update this indicator after delivery of the baby 5 Enter the patient s Address City State and Zip Code 6 Select the patient s Phone type and enter the phone number and extension optional You may enter up to two different phone numbers 7 Select the Patient Consent type The patient consent indicates the patient s permission for the prescriber to view the medication history as published
36. Transplant Surgery U Urology UM Undersea Medicine UP Pediatric Urology US Unspecified VIR Vascular and Interventional Radiology VS Vascular Surgery PA PROMISe ePrescribe User Manual_v1 2a docx 89 June 22 2012
37. al v1 2a docx 60 June 22 2012 For a drug that is Brand Medically Necessary the following message will display The prescription would need to be printed and given to the patient ePrescribe Smith Jane 01 01 1980 Female Prescription Pad Transmission Status Do not navigate away from this page until your prescriptions have been printed successfully Prescription Status Xopenex HFA 10mCi Inhaler Print Preview SIG Puff ss needed Dispense Inhaler Substitution Not Allowed Refills Days Supply 30 Comments to Pharmacist m Prescriber Alan Smith D O 555 Anyw here St Camp Hill PA 17011 Office 1 717 555 4444 This prescription is designated as brand medically necessary and therefore must be printed and handed to the patient Note Do not navigate away from this page until the prescriptions are successfully printed If you accidentally navigate away from the page prior to printing the prescription the record will be stored with a status of Printed If this happens you will have to manually write a prescription Note The Print Preview link will be available if you chose paper as your submission method if you prescribed a controlled substance or if the drug was designated as Brand Medically Necessary PA PROMISe ePrescribe User Manual v1 2a docx June 22 2012 61 Note Prescriptions that are printed and given to the patient have several tamper resistant features in
38. amp g drug interactions later in the prescnbe process you There are no prescriptions in the prenia pad Yoo pennsylvania DEPARTMENT OF PUBLIC WELFARE lePrescribe Profile Search Patients Review Renewals Search Pharmacies Prescriptions in Error View Prescriptions ePrescribe gt Search Patients gt Patient Information gt Prescribe gt Select Drug Thursday 10 27 2011 09 50 AM EST ePrescribe Jane Smith Patient Information Medications Health Conditions Preferred Pharmacies 01 01 1980 Prescribe SE New Prescription Select Drug Select Drug You will not be able to prescribe a controlled substance because your DEA is not on record Enter drug name or use Advanced Search to search by Therapeutic Class Alternatives Indicates a required field Coverage Limitations T Coverage pennsylvania Department of Public Welfare v SIG Dispense Drug Name Augmentin Advanced Search Drug Alerts Medication Augmentin 125 mg 31 mg Chewable Tab Continue Cancel 1 Click the Coverage field and use the drop down to select the prescription plan you wish to use to obtain the patient s pharmacy benefits and coverage information A patient may PA PROMISe ePrescribe User Manual_v1 2a docx June 22 2012 46 have multiple pharmacy coverage plans In this case as PA Medicaid is a payer of last resort an alternate coverage should be used for prescribing 2 In the
39. application but must be printed and signed for the patient to hand carry to the pharmacy The Generic Equivalent Drug Act requires the prescriber to handwrite brand necessary or brand medically necessary on a prescription in order for a brand name product to be dispensed by the pharmacist 35 P S 960 1 960 7 Prescribers must therefore continue to use paper prescriptions for brand medically necessary drugs Controlled substances cannot be transmitted electronically and therefore prescribers must continue to use paper prescriptions Although the Drug Enforcement Administration issued a rule that allows electronic prescribing of controlled substances effective June 1 2010 which provided that specified security requirements are met 75 Fed Reg 16236 March 31 2010 Pennsylvania state law requires that Schedule II drugs contain the manual signature of the prescriber 49 Pa Code 27 18 Note Surescripts does not currently accept electronic prescriptions for controlled substances Note Compound drugs requiring more than one drug cannot be submitted via the PROMISe ePrescribing application as the pharmacy transaction does not allow for the designation of compound drugs PA PROMISe ePrescribe User Manual v1 2a docx June 22 2012 40 To begin the prescribing process select Prescribe from the Patient Information page to display the Prescription Pad SN pennsylvania DEPARTMENT OF PUBLIC WELFARE PROMISe Internet
40. armacy Prescriber 1 tablet twice a day 60 Tablet Substitution Allowed 2 Days Supply 30 Electronic RITE AID 5277 SIMPSON FERRY 5277 SIMPSON FERRY ROAD MECHANICSBURG Pennsylvania 170553515 Office 1 717 766 2533 John Doe D O 444 Walnut St Harrisburg PA 17110 Office 1 717 555 9990 SIG Dispense Refills Comments to Pharmacist Vicodin 5 mg 500 mg Tab 1 tablet 4 times a day as needed for pain 16 Tablet Substitution Allowed Days Supply 4 SRA 17110 Office 1 717 555 9990 Confirm Prescription Pad Cancel Confirmation PA PROMISe ePrescribe User Manual v1 2a docx 57 June 22 2012 If the drug is classified as Brand Medically Necessary BMN you will not be able to submit the prescription electronically In this case the Submission Type and Pharmacy fields will not display You will only have the option to Print Preview ePrescribe Smith Jane 01 01 1980 Female Prescription Pad Submission Type and Pharmacy Indicates a required field Prescriptions Action Xopenex HFA 10mCi Inhaler SIG Puff as needed Dispense Inhaler Substitution Not Allowed Refills 1 Days Supply 30 Comments to one This prescription is designated as brand medically necessary and therefore must be printed and handed to the patient Enter the four digit PIN and click Submit Prescription Pad to proceed PIN Submit Prescription Pad Return to Prescription Pad 1 Select P
41. arried by the patient to the pharmacy The last step is to submit the prescription for processing The prescriber is immediately notified of the transmission status for those prescriptions transmitted electronically After the prescription is processed the prescriber has the option to view the history of submitted prescriptions for each client at any time in the future The remainder of this manual describes in detail the various steps outlined in this overview PA PROMISe ePrescribe User Manual_v1 2a docx June 22 2012 1 Application Features The PROMISe ePrescribing application allows providers to safely and securely send and receive prescriptions and prescription related information electronically The PROMISe ePrescribing application supports a shift to a paperless and more informed way for providers to effectively and conveniently manage medications for their patients and improve clinical workflows 1 1 Key Features and Benefits The interactive features of the PROMISe ePrescribing application provide easy access and exchange of information between prescribers and pharmacies One immediate advantage is that prescribers do not need to purchase install or develop special software or applications to use the PROMISe ePrescribing application The PROMISe Internet Portal allows you to log on using a standard Internet browser Any information you pull from this application is specific to your provider number and will not be s
42. ass DIABETIC SUPPLIES 1 Select the Organ System tab 2 Inthe Organ System field use the drop down and select the appropriate Organ System In the Pharmocological Class field use the drop down and select the appropriate Pharmacological Class 4 Inthe Subclass field use the drop down and select the appropriate Subclass Click Search The list of appropriate medications displays They are broken down by Generic and Brand Name PA PROMISe ePrescribe User Manual_v1 2a docx June 22 2012 49 6 Use the radio buttons to select the correct drug and click Select Advanced Search Therapeutic Class Organ System Indicates a required field Organ System DURABLE MEDICAL EQUIPMENT v Pharmacological Class DIABETIC SUPPLIES v Subclass DIABETIC SUPPLIES v Search Results Select a drug name then click Select to continue the prescription writing process Generic Drug Brand Drug O blood glucose cntl hi amp normal O Accu Chek Comp Blue Cont M H O Assure Dose Norm Hi Control Glucocard 01 Hi Normal Control O blood glucose control high amp low O Accu Chek Aviva Control Soln O Accutrend Glucose Control O Assure Pro Control Oo FreeStyle Control O Microdot High Low Control O UltraTRAK High Low Control O victory High Low Control 6 1 7 Alternatives Page If there are alternative drugs for the prescribed drug the New Prescript
43. ated below If the patient is below the age of consent then the parent guardian consent is provided Patient Consent All Prescriber History Medication History Request If you want the system to check for drug to drug interactions you must retrieve medication history The last two 2 years of medication history can be requested PA Medicaid will return up to one 1 year of the most recent medication history Retrieve medication T To9 c history from 9 12 10 2008 X 12 10 2010 w Medications Claims Pharmacy Benefit Manager 10 Medication history may be incomplete It may not include drugs the patient asked not to be disclosed OTC drugs or drugs paid for by the patient Also payers may not report all drugs PA Medicaid does not report HIV AIDS treatment drugs Medication history may also be inaccurate if there were errors in the claims information used by the payer to report medication history Expand All Collapse All AMNESTEEM RXHUBPBM 12 10 2010 ZOLOFT RXHUBPBM 12 09 2010 MINOCYCLINE HCL RXHUBPBM 12 08 2010 CLONAZEPAM RXHUBPBM 12 07 2010 LEXAPRO RXHUBPBM 12 06 2010 CLARAVIS RXHUBPBM 12 05 2010 ATENOLOL RXHUBPBM 12 04 2010 BREVOXYL 8 RXHUBPBM 12 03 2010 DIFFERIN RXHUBPBM 12 02 2010 AMNESTEEM RXHUBPBM L 11 01 2010 J PA PROMISe ePrescribe User Manual v1 2a docx June 22 2012 43 1 Click the Retrieve medication history from field and use the d
44. atient visit Updates may include new allergies or diseases changes to medications or conditions such as pregnancy Prior to prescribing the PROMISe ePrescribing application prompts the prescriber to initiate a medication history transaction If the patient has not granted the prescriber the consent to see medication history records the prompt will not appear Medication history is available to aid in the prescribing process and provides valuable information used to alert the prescriber should a prescribed medication interact negatively with a current medication ePrescribing involves a few easy steps which are listed and described below PA PROMISe ePrescribe User Manual v1 2a docx June 22 2012 e Select the patient s pharmacy coverage followed by the drug and medication specifics e Review the drug alternative and coverage limitations if present and complete the SIG dispense information e Enter the self created prescriber PIN and submit and confirm the prescription for processing The prescriber selects the patient s pharmacy coverage and enters the drug and medication specifics Depending on the patient s pharmacy coverage supplied from the eligibility transaction the prescriber will select the pharmacy coverage to be used for the prescription Pennsylvania Medicaid is the payer of last resort so if multiple coverages are listed coverage other than PA Medicaid should be selected Next the prescriber reviews the drug alterna
45. by any pharmacy benefit PA PROMISe ePrescribe User Manual v1 2a docx June 22 2012 manager or payer participating in the Surescripts network If the patient is a minor consent should be obtained from the patient s guardian on behalf of the minor If All Prescriber History is selected then all medication history including the current prescriber you and any other previous prescribers is displayed This means the patient consents to allow you to view all of his or her prescription history If Current Prescriber History is selected then only the medication history for the current prescriber medications you previously prescribed is displayed This means the patient consents to allow you to view the history of prescriptions only you have prescribed If No History is selected then no medication history will be displayed This means the patient does not consent to allow you to view any of his or her prescription history Note Medication History is retrieved from payer and is based upon claims paid Note Prescribers should have paperwork on site from the patient indicating what level of consent for medication history retrieval they have authorized Note Correct entry of the patient s name birth date gender and zip code are very important because these elements are used to retrieve the patient s eligibility information from the pharmacy benefit managers or payers Note Due to confidentiality rules regarding HIV AIDS this drug histo
46. cluding bordered and spelled quantities and a microprint signature line that displays HPERX that can be seen when viewed at 5x or greater magnification It is not necessary for the prescriber to print using special paper Date Written 10 27 2011 Doctor Alan Smith D O Patient Smith Jane Location Downtown Clinic Birth Date 01 01 1980 Pharmacy Inquiries 1 717 555 6556 Address 555 Elm St j Facsimile 1 717 555 6557 Harrisburg PA 17109 Home 1 717 555 9999 Medication Vicodin 5 mg 500 mg Tab Substitution Allowed SIG 1 by mouth every 4 hours as needed for pain Days Supply 4 Dispense 16 SIXTEEN Tablets Refills 0 ZERO Comments to Pharmacist Security features include bordered and spelled quantities microprint signature line visible at Sx or gt magnification that must show HPERX and this description of features Signature MD123456789 License CW9999999 DEA 987654321 NPI Note Please verify your License number DEA number if prescribing a controlled substance and NPI Sign the printed prescription Note For best results we recommend the use of a printer that can support 1200 by 1200 dpi dots per inch for all printed prescriptions PA PROMISe ePrescribe User Manual v1 2a docx June 22 2012 62 Note Be sure to print the prescription for the controlled substance or Brand Medically Necessary drug before closing the Print Prescription page If you close the page without printi
47. d General Preventive Medicine MXR Maxillofacial Radiology PA PROMISe ePrescribe User Manual v1 2a docx 85 June 22 2012 N Neurology NCC Critical Care Medicine Neurological Surgery NEP Nephrology NM Nuclear Medicine NP Neuropathology NPM Neonatal Perinatal Medicine NR Nuclear Radiology NRN Neurology Diagnostic Radiology Neuroradiology NS Neurological Surgery NSP Pediatric Surgery Neurological Surgery NTR Nutrition OBG Obstetrics and Gynecology OBS Obstetrics OCC Critical Care Medicine Obstetrics and Gynecology OFA Foot and Ankle Orthopedics OM Occupational Medicine OMM Osteopathic Manipulative Medicine ON Medical Oncology OP Pediatric Orthopedics OPH Ophthalomology ORS Orthopedic Surgery OS Other OSS Orthopedic Surgery of the Spine OT Otology Neurotology PA PROMISe ePrescribe User Manual v1 2a docx 86 June 22 2012 OTO Otolaryngology OTR Orthopedic Trauma P Psychiatry PA Clinical Pharmacology PCC Pulmonary Disease and Critical Care Medicine PCH Chemical Pathology PCP Cytopathology PD Pediatrics PDA Pediatric Allergy PDC Pediatric Cardiology PDP Pediatric Pulmonology PDE Pediatric Endocrinology PDI Pediatric Infectious Diseases PDO Pediatric Otolaryngology PDR Pediatric Radiology PD
48. dentified as having the same pharmacy and the same internal reference number as another refill request on your list of renewals If you respond to a request that is identified as a Duplicate all duplicates of that renewal request will be removed from the worklist Duplicates may occur if the pharmacy does not get an immediate or timely response and they initiate the request again A renewal request with an Error icon indicates that a request you previously responded to received a delayed error during processing For renewals marked as errors click on the medication link You will then receive a message that the system was unable to process the PA PROMISe ePrescribe User Manual v1 2a docx June 22 2012 67 renewal You will need to contact the requesting pharmacy to provide a response Once the pharmacy has been contacted click on the radio button to indicate you have responded to the pharmacy and click Submit That will remove the renewal from your renewal worklist If the response to the renewal request transaction is successfully submitted the Renewal Requests page will display and the renewal will no longer be listed on the worklist If the transaction encounters an error the Renewal Requests page displays and an Error icon will display next to the request on the worklist In this case you will need to contact the pharmacy to respond to the renewal For Controlled Substances when the Approval Renewal option is selected and the transmi
49. dvanced Search Drug Alerts Medication Augmentin 125 mg 31 mg Chewable Tab PA PROMISe ePrescribe User Manual v1 2a docx June 22 2012 47 6 1 5 Searching by Therapeutic Class You can search for medication using the Therapeutic Class They are medications that are similar in chemical structure pharmacological effect and or clinical use lt 0 ennsylvania Sis E s oreet PROMISe Internet lePrescribe Profile Search Patients Review Renewals Search Pharmacies Prescriptions in Error View Prescriptions ePrescribe gt Search Patients gt Patient Information gt Prescribe gt Select Drug gt Advanced Search Thursday 10 27 2011 09 59 AM EST ePrescribe Jane Smith Patient Information Medications Health Conditions Preferred Pharmacies 01 01 1980 Female Return to Prescribe Advanced Search A Therapeutic Class Organ System Indicates a required field Therapeutic Class ace Inhibitors ACEIs Combinations Subclass ACE Inhibitor and Calcium Channel Blocker Combinations 1 Select the Therapeutic Class tab 2 In the Therapeutic Class field enter at least the first three characters of the class The therapeutic classes containing the characters entered will appear in a list for selection 3 Inthe Subclass field use the drop down to choose the appropriate selection 4 Click Search The list of appropriate medications displays They are bro
50. ePrescribe tab on the Menu Bar PA PROMISe ePrescribe User Manual_v1 2a docx June 22 2012 2 A horizontal menu appears with sub headers for the ePrescribe options ePrescribe Profile Search Patients Review Renewals Search Pharmacies Prescriptions in Error and View Prescriptions These options are described in detail later in the document 3 Select the desired option The table below describes the menu and page options that are accessible from the Menu Bar Menu Selection My Home Displays or returns to the Provider My Home Page ePrescribing ePrescribe Profile Displays the prescriber s ePrescribe profile Search Patients Displays the functionality to search for existing patients or to add new patients Review Renewals Displays the Renewal requests from pharmacies It also includes any renewal responses that are in error Renewal responses in error were unable to be processed through the system possibly due to a network error You will need to contact the requesting pharmacy to respond to the request Search Pharmacies Displays functionality to search for pharmacies on the Surescripts network based on demographic criteria selected Prescriptions in Error Displays prescriptions that were submitted but not processed successfully possibly due to a network error View Prescriptions Displays previous prescriptions by date range Help O
51. ecialty Last Name SMITH First Name JANE Middle Name ANN Suffix _ Gender Female Birth Date 01 01 1980 Address 445 Sycamore St City HARRISBURG State Pennsylvania Zip Code 17110 Aetna Retail Coverage Coverage Determined on 06 18 2012 Covered Mail Order Retail Coverage not specified Long Term Care Specialty Last Name SMITH First Name JANE Middle Name ANN Suffix _ Gender Female Birth Date 01 01 1980 Address 445 ElmSt City HARRISBURG State Pennsylvania Zip Code 17110 PA PROMISe ePrescribe User Manual v1 2a docx June 22 2012 24 4 2 Search for a Patient by Number From the ePrescribe Main page select Search Patients and click on the Patient tab DEPARTMENT OF PUBLIC WELFARE PROMISe Internet SN pennsylvania M 2 ePrescribe g Tr E ePrescribe Profile Search Patients Review Renewals Search Pharmacies Prescriptions in Error View Prescriptions ePrescribe gt Search Patients Friday 08 13 2010 02 38 PM EST Search Patient Mr n Patient Ngme Patient Search for a new patient by Patient Then select the Search button to search for all available patients with matching information Indicates a required field Patient 11111 Include Inactive Patients f Enter the patient number in the Patient field This is a number entered by the prescriber that is specific to the prescriber or practice It is used to reference the pat
52. ed reaction Disease Conditions Click the Remove link to remove the entire row Description Last Update Action E Click to collapse Indicates a required field Disease9 516 Acute Duodenal Ulcer with Hemorrhage Central Diabetes Insipidus 08 23 2010 Remove 1 In the Disease field start by typing the name of the disease A list of potential matches using the ICD 9 descriptors will display for selection Choose the appropriate disease 2 Click the Add button to complete the process The disease will display under Disease Conditions Note Diseases entered in the patient s profile will be used for editing during the prescribing process PA PROMISe ePrescribe User Manual_v1 2a docx June 22 2012 5 2 Removing a Disease Condition If a listed disease is no longer applicable you can remove it from the Health Conditions Use this page to remove diseases that are no longer valid SN pennsylvania DEPARTMENT PUBLIC WELFARE PROMISe Internet Aa ePrescribe Kecy Sees Ti AN A re E a ee hace e o o Met ett A k an lg T Pairs Lope emer vmm p ePrescribe gt Search Patients gt Patient Information gt Medications gt Health Conditions Tuesday 08 24 2010 01 32 PM EST ePrescribe Smith Jane Patient Information Medications Health Conditions Preferred Pharmacies 01 01 1980 Female Prescribe Health Conditions Add the Health Conditions for the patien
53. ennen 45 6 1 3 Adding a New PresctiptiOli o ore ce Eo ere e depen e teenager doses 46 OLA Advanced Search ue t et ar ele ee EA Ete b leto 47 6 1 5 Searching by Therapeutic Class reete eoe tento eed OR eee donee see ia eia 48 6 1 6 Searching by Organ System eerie ue naei E EEEE EE EA aies 49 6 1 7 Alternatives Pages ances iie eee gii tis etse ere Ice pe H Tode ects ee eL aa eri aeri 50 6 1 8 Coverage Limitation Page e deer petere pee eode E ie E oa 52 61 9 SIG Dispense Page e cette eel E Ree ee select wee 54 6 1 10 SIG Dispense Verification 5 o ee sees ee Ete Re tee oe e ee eet eere ite Lot 55 6 1 11 Submission Type and Pharmacy seeeeeeeeeeeeeeee nennen nnne nennen rennen 56 6 1 12 Confirmation of the Prescription Pad ssesseeeeeeeeeeeee eene ener 59 6 1 13 Transmission Status o age eee er eR ette e e E te OP DRE tet debe 60 Prescriptions in Error iieri ee I ERre elo e SERRE E HR crese ST PEE SUE SANE EN RENE PEU E NAR ERIS RU ERO 64 Renewal Reqtests o diserti eerh d p corni vacuo Pi TE ra eta CH eI depo depu aisida s MeUE epe iiaii eresas do sued reda iaioe 67 8 1 View a Renewal Request s Detalls i 2 5 ute top oti ais p ptos er i a 69 8 l I Sortthe Renewal Requ sts ecd te RU ate eter Pede 69 8 2 Approve a Renewal Request cce tegis sommes ds tutae sd fade 71 8 3 Deny a Renewal Request ooi a a a auc id esoss 73 8 3 1 Deny a Renewal Request and Write a New Prescription
54. er that can be displayed Refine the search criteria for more specific results d Search Results l Total Records 5 Patient Name a Date Written Medication Type Transmission Stat Dispensed Refills Days Supply 08 31 2010 Zoloft 50 mg Tab New Printed Brown John 30 3 30 Brown Jane 08 24 2010 Lantus 100 unit mL Sub Q New Accepted k 10 2 10 John Smith 08 26 2010 Lisinopril 10 mg Tab Error 4 4 4 The following is a list of the possible transmission statuses indicating the status of the medication being transmitted e Pending The prescription is being processed but is not yet complete e Accepted The prescription has been successfully transmitted and received by the pharmacy e Error There was an error in the transmission of the file This condition requires reviewing the medication details and resubmitting the prescription e Printed The prescription generally a controlled substance or Brand Medically Necessary drug has been printed It should be manually signed and given to the patient to be hand carried to the pharmacy PA PROMISe ePrescribe User Manual_v1 2a docx June 22 2012 80 10 Glossary Term Definition Accepted File transmission status indicates the medication was successfully transmitted to the pharmacy Add a New Patient Process to add a new patient to your provider database Once added you can initiate a new prescription Al
55. erm used by Surescripts to inform the prescriber that the pharmacy benefit manager or payer has drug specific coverage constraints or requirements The limits may be patient specific or general and displayed for every patient with that pharmacy benefit Surescripts uses specific labels to designate possible payer coverage limits that can occur including the following e Product coverage exclusion Drug not covered This designation is not applicable to the PA MA Pharmacy program e Prior authorization required Drug is covered but requires prior authorization This designation is applicable to the PA MA Pharmacy program e Medical necessity required Drug only covered if medical necessity has been validated This designation is not applicable to the PA MA Pharmacy program e Step therapy required Drug only covered if appropriate step therapy regimen has been followed This designation is not applicable to the PA MA Pharmacy program e Coverage text message Specific message from payer regarding coverage Specialty Pharmacy Drugs included in the PA MA Pharmacy program will include a message that they must be dispensed from one of the preferred specialty pharmacies Note The first 25 characters of a message that exceeds 100 characters are displayed followed by a Read More link When the message text is 100 characters or less the complete text will be displayed in the coverage limitations panel e Step medication Specific d
56. essment Help Prescribe Profile Search Patients Review Renewals Search Pharmacies Prescriptions in Error View Prescriptions ePrescribe gt Search Patients gt Patient Information Monday 06 18 2012 08 46 AM EST i Patient Information Medications Health Conditions Preferred Pharmacies 01 01 1980 Paucnt Information The patient information associated to the selected patient profile is displayed below The fields related to patient eligibility cannot be updated while a prescription is in progress for the selected patient Last Name Smith First Name Jane Middle Name Ann Suffix _ Patient 123456789 Birth Date 01 01 1980 Gender Female Pregnant Status Active The patient demographics associated to the selected patient profile are displayed below Address 445 Sycamore St City Harrisburg State PennsyWania Zip Code 17110 Phone Home 1 717 555 5555 Ext _ Peon 7 a Patient consent for medication history is indicated below If the patient is below the age of consent then the parent guardian consent is provided Patient Consent All Prescriber History Patient Eligibility The patient information for each carrier for which the patient is eligible is listed below Please confirm each Coverage selection that should be included for the identified patient Updates can be applied to the patient profile as necessary Deselecting a listed Coverage will make it unavailable on the Prescription Pad Pennsylvania Dept of Public
57. ey have paid cash you have the ability to add the medications to the patient profile This screen will allow entry of items reported by the patient SN pennsylvania DEPAR MAENT OF BUSLIG WELEARE PROMISe Internet ePrescribe 1 Eligibility Trade Files Reports O nt Fe ule ePEAP He ePrescribe Profile Search Patients Review Renewals Search Pharmacies Prescriptions in Error View Prescriptions mte cute xm ePrescribe gt Search Patients gt Patient Information gt Medications Monday 01 10 2011 01 13 PM EST ePrescribe Smith Jane Patient Information Medications Health Conditions Preferred Pharmacies 01 01 1980 Female Prescribe Enter a Drug Supplement er Aterhauve herapy Date Drug Supplement Amount and Frequency Action E Click to collapse Indicates a required field Type Supplements Alternative Therapy vj Supplements Multivitamin Alternative Therapy Amount and tablet daily Frequency 1 Inthe Type field use the drop down to select either Drug or Supplement Alternative Therapy 2 If entering a Drug use the Drug Name field to enter the name of the medication the patient reports You can enter a partial name and it will populate a list from which to choose 3 If entering a Supplement Alternative Therapy use the Supplements Alternative Therapy to enter the name of the supplement or alternative history the patient repo
58. fields need to be changed contact the Provider Assistance Center 800 248 2152 to resolve a PROMISe Internet rN pennsylvania My Home Es MES Lo MB AA ise dz i My Home gt My Profile gt ePrescnbe Registration Thursday 09 30 2010 01 03 PM EST E Indicates required field Identification The provider identification for your ePrescribe profile is listed below NPI 1969196916 DEA CW9999999 State License Confirm State License Spectalty Gp General Practice Grant Delegate Access No wv PIN i234 Prefix First Name Middle Name Last Name Suffix Address If you have multiple service locations enter the primary service location The address cannot be P O Box Location Name Address city State v Zip Code Enter phone number and email the pharmacy can contact to ask questions about patient s prescription Pharmacy Inquiries 9 Ext Facsimile Contact Email tonfiem Email P submit concet PA PROMISe ePrescribe User Manual_v1 2a docx June 22 2012 2 3 Accessing ePrescribing Once you have successfully registered from the Provider My Home Page click on the ePrescribe tab to access the application pennsylvania EPARTMENT OF P m PROMISe Internet E ePrescribe DIS Eligibility Trade Files Reports Outpatient Fee Schedule ePEAP Help My Home Wednesday 08 18 2010 11 42 AM EST FL Name Account 0018724100001
59. g as the total authorization does not exceed a 6 months supply from the time the original prescription was filled 3 In the Days Supply field enter the number of days the quantity will last for the drug you prescribe 4 In the Brand Medically Necessary Dispense as Written box enter a check mark if a generic equivalent cannot be substituted for the brand due to medical reasons 5 In the SIG field enter any directions for how to use the medication This field holds up to 140 characters 6 Check the SIG Verified box to indicate the information has been reviewed If the Dispense and or Days Supply data is modified after initial entry this indicator will be cleared You must re check the box to verify the new information has been reviewed see section 6 1 7 PA PROMISe ePrescribe User Manual v1 2a docx June 22 2012 54 Note The Generic Equivalent Drug Act requires the prescriber to handwrite brand necessary or brand medically necessary on a prescription in order for a brand name product to be dispensed by the pharmacist 35 P S 960 1 960 7 7 In the Comments to Pharmacist field type any message you want to be conveyed to the pharmacist This field holds up to 210 characters 8 Click the Continue button to proceed to the next step You will proceed to the Prescription Pad page 6 1 10 SIG Dispense Verification In a case where you have to revise the information in the Dispense or the Days Supply field a mes
60. hared with others 1 22 Secure Website PROMISe provides security to the Internet web based application Using your logon ID password and site certificate features this secure web site is accessible through the public Internet If you have not yet registered to use the PROMISe portal please refer to http promise dpw state pa us The options listed below are available to PROMISe providers who have received authorization to access the ePrescribing functions via PROMISe Portal e Adda new patient profile e View a patient s eligibility medication history health conditions and previous prescriptions including renewals e Write a new prescription Only the following MA enrolled prescribers can electronically prescribe using the PROMISe ePrescribing application Physicians Dentists Podiatrists Optometrists Certified Registered Nurse Practitioners and Certified Nurse Midwives 1 2 1 The Menu Bar SIEQ errescrite DES Eligibility Trade Files Reports Outpatient Fee Schedule ePEAP Help amp ePrescribe Pro atients Review Renewals Search Pharmacies Prescriptions in Error View Prescriptions The PROMISe Internet Portal Menu Bar contains the main heading for providers who are eligible to ePrescribe Additional features commands and page options appear in horizontal sub menus and take you to a specific function or page Select a command or page option in the following manner 1 Move the cursor over the
61. he following optional information first name birth date and gender PA PROMISe ePrescribe User Manual v1 2a docx June 22 2012 21 Note In the first name field enter at least one character to use the starts with search feature 3 Click Include Inactive Patients to include the patients that have an inactive status Inactive patients are patients who may have left your practice and for whom you are no longer maintaining an active patient record Patients can be marked inactive by editing the patient profile and changing the status from active to inactive 4 Click Search to search for the patient The Search Results panel displays patients that match the search criteria If the search returns too many results enter more specific search criteria to display fewer results If you still cannot find the patient you are looking for you may need to add the person as a new patient 5 Click the desired patient name to view and update the patient information view the eligibility information or write a prescription for the patient PA PROMISe ePrescribe User Manual v1 2a docx June 22 2012 22 PROMISe Internet Eligibility Trade Files Reports Outpatient Fee Schedule ePEAP Hospital Assessment Help lePrescribe Profile Search Patients Review Renewals Search Pharmacies Prescriptions in Error View Prescriptions Prescribe gt Search Patients gt Patient Information Monday 06 18 2012 08 46 AM EST ePrescribe Smith
62. ient i e chart number or account number Note The patient number search is an exact match search not a starts with search 2 Click Include Inactive Patients to include the patients that you have designated as Inactive Inactive patients are patients who may have left your practice and for whom you are no longer maintaining an active patient record Note Patients can be marked inactive by editing the patient profile and changing the status from active to inactive 3 Click the Search button to search for the patient The Search Results panel displays patients that match the search criteria If you still cannot find the patient you are looking for you may need to add them as a new patient 4 Click the desired patient name to view and update the patient information view the eligibility information or write a prescription for the patient PA PROMISe ePrescribe User Manual v1 2a docx June 22 2012 25 5 Patient Specific Information This section of the ePrescribing User Manual contains detailed information specific to each of your patients such as self reported medications health conditions and preferred pharmacies This compilation of information is referred to as the Patient Profile This page is accessed after selecting an existing patient or adding a new one as described in the previous sections Yoo CTSNET EE EM one PROMISe Internet Eligibility Trade Files Reports Outpatient Fee Schedule ePEAP Hospital Ass
63. ion Alternatives page displays Here you can select an alternative drug to the originally selected drug Note All payer specified alternatives will be displayed regardless of formulary status preference level Only therapeutic alternatives which have a higher formulary status preference level than the prescribed drug will be displayed You can elect to ignore the alternatives and continue the prescription process using the drug you originally selected select a payer specified alternative or select a therapeutic alternative if the alternatives types are available You can also navigate back to the New Prescription Select Drug panel by using the left navigation bar PA PROMISe ePrescribe User Manual v1 2a docx June 22 2012 50 1 If you do not want to prescribe any of the alternative drugs displayed click the Ignore Alternatives radio button 2 If you do wish to prescribe an alternative select the drug by using the drug s radio button 3 Click the Continue to proceed to the next step The Coverage Limitations panel will then display Note PA Medicaid Formulary equates to the current Preferred Drug List PDL Note Formulary status for all PA Medicaid drugs will indicate On Formulary Preferred Level 1 Note Drugs that are not on the PA Medicaid formulary will indicate a formulary status of Non Reimbursable Yoo pennsylvania DEPARTMENT OF PUBLIC WELFARE PROMISe Internet ePrescribe Profile Search Patie
64. ken down by Generic and Brand Name 5 Use the radio buttons to select the correct drug and click Select Advanced Search Therapeutic Class Organ System Indicates a required field Therapeutic Class ace Inhibitors ACEIs Combinations Subclass ACE Inhibitor and Calcium Channel Blocker Combinations v Search Results Select a drug name then click Select to continue the prescription writing process Generic Drug Brand Drug O trandolapril verapamil O Tarka PA PROMISe ePrescribe User Manual_v1 2a docx June 22 2012 48 6 1 6 Searching by Organ System You can also perform a search by Organ System These are groups of organs that work together to carry out a particular task pennsylvania BN Lougura reuc eire PROMISe Internet LUE ePrescribe Kec MESI UMEN CL SIE Mee ePrescribe Profile Search Patients Review Renewals Search Pharmacies Prescriptions in Error View Prescriptions ePrescribe gt Search Patients gt Patient Information gt Prescribe gt Select Drug gt Advanced Search Thursday 10 27 2011 09 59 AM EST ePrescribe Jane Smith Patient Information Medications Health Conditions Preferred Pharmacies 01 01 1980 Female Return to Prescribe Advanced Search Therapeutic Cla Organ System Indicates a required field Organ System DURABLE MEDICAL EQUIPMENT Pharmacological Class DIABETIC SUPPLIES I i ie Subcl
65. l ME gne oe pe oe Using the drop down select a Denial Reason and or enter comments to the pharmacist to explain why you are denying the renewal request Note If the renewal request is denied a Denial Reason or Comments to the pharmacist must be entered Note Not all Denial Reasons are appropriate or applicable for PA Medicaid Denial reasons include e Change Not Appropriate e Medication never prescribed for the patient PA PROMISe ePrescribe User Manual v1 2a docx June 22 2012 74 No attempt will be made to obtain Prior Authorization Patient has not picked up prescription drug returned to stock Patient has picked up partial fill of prescription Patient has picked up prescription Patient has requested refill too soon Patient needs appointment Patient never under Prescriber s care Patient no longer under Prescriber s care Patient should contact Prescriber first Patient unknown to Prescriber Prescriber not associated with this practice or location Refill not appropriate Request already responded to by other means e g phone or fax 6 Enter your four 4 digit Personal Identification Number PIN 7 Click Submit to deny the renewal request A confirmation dialog box will display Confirmation Your response has been successfully transmitted Cx 9 Click OK to confirm the denial of the renewal request PA PROMISe ePrescribe User Manual v1 2a docx 75 June 22 2012 8 3 1 Deny a Renewa
66. l Reason dropdown must be entered This renewal request was received without a license number therefore the only allowable response options are to either deny the request or deny the reg ate a new prescription Denial Reason v wal Wrnte New Prescription Comments to the Pharmacist A license number is required for renewal request Disclaimer Please nc Enter the four digit PIN and click Submit to submit the response Indicates a required field Prescriber s Response to Pharmacy Submit sends your response to the pharmacy Upon successful completion the item is deleted from the worklist and you are returned to the worklist If the Deny Renewal option is chosen either Comments to the Pharmacist field or the Denial Reason dropdown must be entered This renewal request was received without a license number therefore the only allowable response options are to either deny the request or deny the request and create a new prescription O Deny Renewa Denial Reason o Deny Renewal Write New Prescription Pharmacist The license number on this request is incorrect for this prescribe Disclaimer Please note that formulary coverage and drug alerts will not be checked Enter the four digit PIN and click Submit to submit the response Indicates a required field PIN 8 4 Fatal Errors In some cases a transaction may experience a fatal error preventing it from being processed P
67. l Request and Write a New Prescription This page is used if a renewal is denied and you want to write a different prescription for the patient Renewal Request Patient Smith Jane 555 Elm St Harrisburg PA 17110 Birth Date 01 01 1980 Gender Female Pharmacy CVS Pharmacy 1630 1116 Carlisle Rd Camp Hill PA 17011 Office 1 717 612 5067 The following patient s match the last name birth date and gender for the patient listed on the renewal request please select the patient you would like to include in your response to the pharmacy If you need to add a new patient go to the Add Patient page Jane Smith 555 Elm St Harrisburg PA 17110 Birth Date 01 01 1980 Gender Female Prescription Details This prescription must be printed It is a Schedule III V controlled substance Medication Xanax 2 mg Tab Total Dispensings Approved Dispense 30 Tablet Date Written 09 21 2010 Substitution NA Days Supply 0 SIG Take 1 tab s orally once a day at bedtime Message Patient would like to pick up the medication next day Prescriber s Response to Pharmacy Submit sends your response to the pharmacy Upon successful completion the item is deleted from the worklist and you are returned to the worklist If the Deny Renewal option is chosen either Comments to the Pharmacist field or the Denial Reason dropdown must be entered The renewal request does not specify if substitutions are permitted therefore you should send a new prescription
68. logged in click on the Register for ePrescribe link and you will be redirected to the Prescriber Registration page Note Only the following provider types are able to register and use this application This link will not appear for other provider types e Physicians e Dentists e Certified Registered Nurse Practitioners e Podiatrists e Certified Nurse Midwives e Optometrists Yoo ennsylvania e Pons PUBLIC WELFARE PROMISe Internet My Home Fait o a REM CeO a EU ME UT LI My Home Thursday 10 07 2010 01 40 PM EST nda m 1 e Provider LINER ss S RS RR Name John Doe As an extra security measure the PROMISe application times out after 30 minutes if you have not executed one Provider ID 123456789 of the available claims or eligibility transactions accessed a file or updated your profile information For more information you can click here more Location ID 0001 My Profile Manage Alternates Manage Billing Agents AENT I A Eon 5 mei Register for ePrescribe Note If you already use a POC or ePrescribing product and receive Renewal Requests through that product you should consider how you want to continue to receive Renewal Requests before registering with the PROMISe ePrescribe application Surescripts allows multiple prescriber registrations using different ePrescribing products It will also route renewal requests to multiple vendor products or provider locations however due to
69. nd a contact email The pharmacy can use any means to contact you about the patient s prescription 9 Click Submit to submit your prescriber registration 10 Upon successful registration the following confirmation message will appear You have successfully registered as a prescriber with ePrescribe Cx PA PROMISe ePrescribe User Manual_v1 2a docx June 22 2012 2 2 Editing the Provider Profile If the need arises to edit the profile after initial set up select My Profile from the Provider My Home Page e PROMISe Internet Lia ePrescribe Ber ESI A eel ECCE er cae era E dz GI DEPARTMENT OF P SN pennsylvania My Home Wednesday 08 18 2010 11 42 AM EST SS Name Doe John As an alternative to calling you can send an email to PAPAC1I hp com with your user id name Provider ID 123456789 phone number and a brief description of the issue you are experiencing Losin ID 0001 Providers with Service Plans in HCSIS E Ey 9 gt Manage Alternates Waiver providers who bill PROMISe for services that are authorized through service plans in HCSIS should not bill over the internet during a nightly maintenance window between 11 40 gt Manage Billing Agents PM and 12 10 AM claims errors might occur Thank you for your patience e DPW Provider Information PA PROMISe ePrescribe User Manual v1 2a docx June 22 2012 Note The NPI and DEA number fields are not able to be edited In the case where these
70. nd your current session will end Any unsaved data will be lost If you stop working in the PROMISe Internet for more than 30 minutes the system will log you out and you will receive a Timeout Notification Session Ended message Any data that was not saved prior to the timeout will be lost v Timeout Notification Session Ended x Your session has ended for security reasons due to inactivity Click OK to return to the Welcome page You will have to log on again to start a new session If your session is terminated due to inactivity the following steps will allow you to log back into the application 1 Click the OK button 2 Click the Home tab 3 You will be returned to the PROMISe Provider My Home Page 4 Re enter logon information PA PROMISe ePrescribe User Manual v1 2a docx June 22 2012 2 Registering Prescribers must follow the registration process to be granted access to the PROMISe ePrescribing application Please ensure you have 1 Enrolled with the Commonwealth of Pennsylvania as a valid Medical Assistance provider 2 Provided your NPI as part of the provider enrollment process Acquired a computer with access to the Internet The initial release of this product does not support handheld devices 4 Registered to use the PROMISe Internet Portal at http promise dpw state pa us To register for the PROMISe ePrescribing application first logon to the PROMISe Internet
71. nder z Include Inactive Patients oO PA PROMISe ePrescribe User Manual_v1 2a docx June 22 2012 3 1 About the Add a New Patient Page While there are several fields on this page not all are required Fields marked with an asterisk are required and must be completed to proceed i pennsylvania DEPARTMENT OF PUBLIC WELFARE PROMISe Internet LIAE ePrescribe Kerr CEBIT ago ere ee ee ae Prescribe Profile Search Patients Review Renewals Search Pharmacies Prescriptions in Error View Prescriptions ePrescribe gt Search Patients gt Add a New Patient Monday 06 18 2012 09 50 AM EST Add a New Patient Enter the patient information and demographics to add a new patient profile Once the profile has been created for the patient the option will be available to add allergies disease codes medications and preferred pharmacies to the patient profile Indicates a required field Last Name smith First Name jane Middle Name Ann Suffix Patient 123456789 Birth Date 01 01 1980 x Gender Female Pregnant F Add the primary address for the patient and any associated phone numbers Address 445 Sycamore St City Harrisburg State Pennsylvania Zip Code9 17110 Phone Home s 7175555555 Ext Phone Ext The prescriber has the option to view with the consent of the patient either the history of the medications he or she prescribed or all medication history available
72. nesday 08 25 2010 10 00 AM EST ePrescribe Smith Jane Patient Information Medications Health Conditions Preferred Pharmacies 01 01 1980 Preferred Pharmacies A single pharmacy can be designated as primary and will appear as the default pharmacy on the prescription Click Add to search and add a preferred pharmacy Pharmacy Address Action 1116 CARLISLE RD CAMP HILL Pennsylvania 17011 v CVS Pharmacy 1630 Office 1 717 612 5067 Fax 1 717 761 7970 6007 ALLENTOWN BLVD PAXTON SQUARE HARRISBURG Pennsylvania 17112 Office 1 717 540 8621 Fax 1 717 540 5663 D Set as Primary CVS Pharmacy 1917 Add Pharmacy 1 Click on the Set as Primary link for the Preferred Pharmacy you want to make primary A message will display verifying you wish to set the primary preferred pharmacy Do you want to set this as the primary preferred pharmacy 2 Clicking on the Yes button will set the pharmacy as the primary preferred pharmacy PA PROMISe ePrescribe User Manual_v1 2a docx June 22 2012 39 6 ePrescribing After a patient record has been created or located the prescriber is able to enter prescriptions electronically 6 1 Prescription Pad There are some prescriptions that cannot be transmitted electronically even if the prescriber has entered the DEA number in the profile Brand Medically Necessary and Controlled Substance drugs can be entered into the PROMISe ePrescribing
73. nformation is required and must be associated to your individual physician license Controlled substances cannot currently be ePrescribed through this application if you use the ePresnibing system for controlled drug substances you will be prompted to print the prescription Incheates required fala Identification ADEA number is required to meso ibe com olied drugs mpi 1234557390 DEA 4 Confirm DEA State License Confirm State License Specialty 9 a f you kava multiple servise locations enter the primary serves location The address cannat be a P O Box Location Name Address Enter a phone number and email the pharmacy can Contact to ask Questions about a patient s peescripton Pharmacy Inquiries Ext Facsimile Contact Ema Confirm Email 6 User Agreement The ePrescnbing applicabon provides access to confidential informabon This informabon is to be used only for treatment purposes agree that this informabon wil be accessed only for treatment purposes Osy checking this box you acknowledge that you have read and understood the Prescnber User Agreement and soree to the terms and cendibons as deechbed PA PROMISe ePrescribe User Manual v1 2a docx June 22 2012 1 Click the Register for ePrescribe link located under the DPW Resources section on the PROMISe Provider Main Page Note The prescriber s National Provider Identifier NPI will be populated 2 Enter yo
74. ng the prescription you will not be able to print the prescription later Prescription Pad Transmission Status Do not navigate away from this page until your prescriptions have been printed successfully Prescription Lisinopril 5 mg Tab SIG 1 tablet twice a day Dispense 60 Tablet Substitution Allowed Refills 1 Days Supply 30 Comments to Pharmacist Submission Type Electronic Pharmacy RITE AID 5277 SIMPSON FERRY 5277 SIMPSON FERRY ROAD MECHANICSBURG Pennsylvania 170553515 Office 1 717 766 2533 Prescriber John Doe D O 444 Walnut St Harrisburg PA 17110 Office 1 717 555 9990 Vicodin 5 mg 500 mg Tab SIG 1 tablet 4 times a day as needed for pain Dispense 16 Tablet Substitution Allowed Refills 0 Days Supply 4 Comments to Pharmacist Prescriber John Doe D O 444 Walnut St Harrisburg PA 17110 Office 1 717 555 9990 This prescription must be printed It is a Schedule III controlled substance Note After the paper prescription has printed the status will change from Print Preview to Printed PA PROMISe ePrescribe User Manual v1 2a docx June 22 2012 63 7 Prescriptions in Error You can view prescriptions that were not successfully processed Some possible causes that may prevent a successful transaction are communication errors during transmission or errors on the receiver s end In the event an error is encountered you can print the prescription to finalize it or rem
75. nts Review Renewals Search Pharmacies Prescriptions in Error View Prescriptions ePrescribe gt Search Patients gt Patient Information gt Prescribe gt Alternatives Monday 06 18 2012 09 24 AM EST ePrescribe Smith Jane Patient Information Medications Health Conditions Preferred Pharmacies 01 01 1980 vus New Prescription Alternatives Select Drug Coverage Pennsylvania Dept of Public Welfare Formulary Status Non Formulary Brand P Alternatives Originally Selected Lexapro Supplied Rx Dru Coverage Co Pay Co paytier3 of 3 Any Limitations Medication Lexapro 10 mg Tab SIG Dispense Preferred Alternatives Drug Alerts Select an option anduclichefomtinuc Alternatives are listed in order of preference where the higher preferred level is more preferred a Ignore Alternatives use Originally Selected Drug Payer Specified Alternatives Formulary Status Supplied Co Pay ES fluoxetine 10 mg Cap On Formulary Rx Co pay tier 1 of 3 Any F fluoxetine 10 mg Tab On Formulary Rx Unknown fluoxetine 20 mg Cap On Formulary Rx Unknown fluoxetine 20 mg Tab On Formulary Rx Unknown fluoxetine 20 mg 5 mL Oral Soln On Formulary Rx Unknown fluoxetine 40 mg Cap On Formulary Rx Unknown fluoxetine 60 mg Tab On Formulary Rx Unknown ah Pus 7 fin Farmularw Ry nett m PA PROMISe ePrescribe User Manual v1 2a docx June 22 2012 51 6 1 8 Coverage Limitation Page Coverage limitations is a t
76. of payment The following sections will review the two methods of searching for the patient searching by name and searching by number 4 1 Search for a Patient by Name From the ePrescribe Main page select Search Patients and click on the tab called Patient Name S pennsylvania PROMISe Internet hM gt T e j l ePrescribe a y Tr riles ts z 21 28 E Doma uy ees Nees pes S EAE bebe Ab eco cd TT vy T zi ePrescribe Profile Search Patients Review Renewals Search Pharmacies Prescriptions in Error View Prescriptions 2 gt Search Patients Search Patient Search for a new patient by Last Name All other fields sre optional Then select the Search button to search for all svadsble patients with matching informabon jcates 5 e Last Name Sram First Name p Birth Date 01 01 1963 z Gender fiz ae Include Inactive Patients 7 Search Cancel Search Results Select the patient to view and update ther pabent informator view their ebgibility mformation or write preschpoon for the papers Total Records 3 Patient a Patient Birth Date Address Status Zenith Jo 11111 01 1964 123 First St Active 4 4 T 22222 1964 111 Main Street Active T 1 33333 1964 555 Eim Sreet Active 1 In the Last Name field enter the patient s last name or at least the first character to use the starts with search feature 2 Enter any of t
77. onse to the pharmacy If you need to add a new patient go to the Add Patient page Jane Smith 555 Elm St Harrisburg PA 17109 Birth Date 01 01 1980 Gender Female Prescription Details Medication Amoxil 500 mg Oral Tab Total Dispensings Approved Dispense 40 Tablet Date Written 09 15 2010 Substitution NA Days Supply 0 SIG Take 2 Tablet s By Oral Route BIO Prescriber s Response to Pharmacy Submit sends your response to the pharmacy Upon successful completion the item is deleted from the worklist and you are returned to the worklist If the Deny Renewal option is chosen either Comments to the Pharmacist field or the Denial Reason dropdown must be entered Approve Renewal O Deny Renewal Denial Reason Deny Renewal Write New Prescription Comments to the Pharmacist Disclaimer Please note that formulary coverage and drug alerts will not be checked Enter the four digit PIN and click Submit to submit the response Indicates a required field 1 Review the patient and pharmacy selection 2 Select the patient for the renewal request If it is for a new patient click the link for Add Patient PA PROMISe ePrescribe User Manual_v1 2a docx June 22 2012 71 Note For current patients whose original prescriptions were written on paper it will be necessary to add a patient so the renewal can be done electronically 3 Review the prescription details and modify the Total Dis
78. ormation Medications Health Conditions 01 01 1980 ee ee Health Conditions Add the Health Conditions for the patient If the patient has allergies these can be added by adding the specific allergen and associated reaction Disease Conditions Click the Remove link to remove the entire row Description Last Update Action Click to add a new disease Central Diabetes Insipidus 08 23 2010 Remove Allergies Click the Edit link to update the details in a row Click the Remove link to remove the entire row Allergen Reaction Last Update Action Click to add a new allergen CEDAR LEAF THUJA Sinusitis 08 23 2010 Edit Remove 1 From the Patient Information page click the Health Conditions link The patient s health conditions will display PA PROMISe ePrescribe User Manual_v1 2a docx June 22 2012 5 2 1 Adding a Disease Condition From this page you can view Disease Conditions or add new conditions CQ CYS LZ ETE ESD ce D PUBLIC WELFARE PROMISe Internet ePrescribe gt Search Patients gt Patient Information gt Health Conditions Tuesday 08 24 2010 01 53 PM EST ePrescribe Smith Jane Patient Information Medications Health Conditions Preferred Pharmacies 01 01 1980 Female Prescribe Health Conditions Add the Health Conditions for the patient If the patient has allergies these can be added by adding the specific allergen and associat
79. ove the prescription from the list CO pennsylvania 1 DEPARTMENT OF PUBLIC WELFARE PROMIS e Internet amp Prescribe gt Prescriptions in Error Thursday 08 26 2010 02 28 PM EST lePrescribe Profile Search Patients Review Renewals Search Pharmacie iew Prescriptions Prescriptions in Error Listed below are all the new prescriptions that have been submitted but not processed successully These requests were not processed successfully due to either a communication error or an error on the receiver s end Either print these prescriptions in order to finalize them manually or remove them entirely from the list Do not navigate away from this page until your prescriptions have been printed successfully Once a prescription has been printed it must also be manually removed from the list Click the respective prescription link to view prescription details click the link again to hide the details Total Errors 6 New Errors 0 Date Written v Patient Prescription Action E 08 24 2010 Smith John Tri Luma 0 01 96 4 0 05 Topical Cream C enum 3 ove E 08 24 2010 Smith John Tri Luma 0 01 95 4 0 05 Topical Cream Print Preview Remove a Cancel PA PROMISe ePrescribe User Manual_v1 2a docx June 22 2012 64 1 Click the Prescriptions in Error link from the menu bar 2 Click the Print Preview link to print the prescription A printed version of the prescription
80. pens the PROMISe Internet Help function PA PROMISe ePrescribe User Manual v1 2a docx June 22 2012 1 2 2 Logout Link The Logout link is located in the upper right corner of most PROMISe Internet pages Clicking this link will cause the following confirmation message to appear v Logout Confirmation Are you sure you want to logout Cancel Click the OK button to logout You will be returned to the PROMISe Welcome Page in a logged out status 1 2 3 Radio Buttons Throughout this document are references to Radio Buttons Radio Buttons are a selection method of choosing one option from a supplied list of choices To select an option using a Radio Button click inside the circle corresponding to your choice A green circle will display indicating your selection C Deny Renewal Example Radio Button that has not been selected e Deny Renewal Example Radio Button that has been selected PA PROMISe ePrescribe User Manual v1 2a docx June 22 2012 1 3 Timeout Notifications If you stop working in the PROMISe Internet for more than 25 minutes you will receive a Timeout Notification instructing you to click the Extend button to continue working in the portal v Timeout Notification x As 0f 11 43 AM your session will expire in 5 minutes To remain logged in and avoid losing any data that you may have entered please click Extend Otherwise you will be logged off a
81. pensings Approved if necessary Note The amount in the Total Dispensing Approved field includes the current fill and any future refills associated with the renewal request 4 Confirm that Approve Renewal is selected 5 Enter your four 4 digit prescriber PIN 6 Click Submit to approve the renewal request and send your response to the pharmacy A confirmation dialog box will display Confirmation X Your response has been successfully transmitted Cx 7 Click OK to confirm the successful transmission of the renewal request In the event of a transmission failure you will need to contact the pharmacy directly to approve the renewal Clicking the radio button for Response provided to pharmacy will remove the medication from your renewal work list PA PROMISe ePrescribe User Manual v1 2a docx June 22 2012 72 ry pennsylvania PROMISe Internet ePrescribe Profile Search Patents Review Renewals Search Phamacies Prescriptions in Error View Prescriptions newals gt Renewal Request Detais Friday 08 27 2010 02 41 PM EST Patient Jane Smith 555 Eim St Harrisburg PA 17109 Birth Date 01 01 1980 Gender Female Pharmacy CVS Pharmacy 1630 1116 Carksle Rd Camp Hill PA 17011 Office 1 717 612 5067 Select reten The following patent s match the last name birth date and gender for the patent listed on the renewal request please select the patient you would like to include in your re
82. ppropriate From and To dates and click Search Indicates a required field From Date 7 14 2010 E To Date hs 13 2010 E PA PROMISe ePrescribe User Manual_v1 2a docx June 22 2012 79 Enter the From Date by selecting it from the calendar or accepting the default date displayed The From Date is a past date where you want to start searching for the previous prescriptions Note The default From Date is 30 days prior to the current date 2 Enter the To Date select it from the calendar or accept the default date displayed The To Date is populated with today s date Click Search to search for the previous prescriptions 4 The Search Results panel displays with the prescriptions that match the selected dates If you do not find the prescription you are looking for enter a narrower date range oo enns lvania C Bestes PROMISe Internet Laat ePrescribe Kaci CEST E ePresciitia Profile Search Patients ERE Renewals Search Phamacies EN in Error T View TEETE Prescribe gt View Prescriptions Monday 09 20 2010 11 22 AM EST View Prescriptions View previous prescriptions including renewals patient information and prescription status Click Search to accept the default search dates or enter appropriate From and To dates and click Search Indicates a required field From Date 05 21 2010 x To Date9 55 20 2010 E be aayits exceed the maximum numb
83. rint Preview 2 Print the prescription and give to the patient 3 Click Submit Prescription Pad PA PROMISe ePrescribe User Manual_v1 2a docx June 22 2012 58 6 1 12 Confirmation of the Prescription Pad Once you click submit on the prescription pad prescriptions up to five will display on the Prescription Pad You will need to review each prescription for accuracy before you confirm Note If there is more than one prescription on the confirmation page Confirm or Cancel will apply to all prescriptions If the Cancel Confirmation button is used you are returned to the Prescription Pad Submission Type and Pharmacy page Here you have the option to return to the Prescription Pad SIG Dispense page to alter any of the individual prescriptions Yoo pennsylvania E DEPARTMENT OF PUBLIC WELFARE PROMISe Internet My Home ePrescribe Profile Search Patients Review Renewals Search Pharmacies 1 Prescriptions in Error View Prescriptions ePrescribe gt Search Patients gt Patient Information gt Prescribe gt Submit Prescription Thursday 08 26 2010 01 22 PM EST ePrescribe Smith Jane Patient Information Medications Health Conditions Preferred Pharmacies 01 01 1980 S Female Prescribe 1 Prescription Pad Confirmation Prescriptions Augmentin 125 mg 31 25 mg Chewable Tab SIG 1 tablet Q 8 hours until gone Dispense 30 Tablet Substitution Allowed Refills 1 Days Supply
84. rop down to select a start date for Medication History 2 Click the To field and select an end date for Medication History 3 Click the Retrieve button to pull up the Medication History Note Enter the dates to retrieve medication history or use the default dates which include today s date up to two years prior Note While up to two years of Medication History can be returned only one year of PA Medicaid FFS medication history will be returned Note If the patient has not given consent to view history an error message will display in place of the panel 4 Ifthere are more records to be displayed click Retrieve More History to retrieve additional records The additional medication history is added to the end of the initial results To view the additional medication history scroll to the bottom of the panel Additional Medication History To obtain more history for your requested search dates 12 08 2007 to 12 08 2009 ch QL Retrieve More History PA PROMISe ePrescribe User Manual_v1 2a docx June 22 2012 44 6 1 2 Medication History Failures In some cases when attempting to retrieve medication history there may be an issue between the PROMISe ePrescribing application and the Pharmacy Benefit Manager PBM or payer that prevents the Medication History information from being displayed Error messages generated from the PBM or payer system which define the issue s preventing a successful medication histor
85. rough submitting a prescription Logon to the PROMISe Internet Portal Add Search Retrieve A Medication or Edit Patient History where Profile applicable ePrescribe E Add or Change Select Patient Register for d Patient Coverage ePrescribing Profile Reported where Medications applicable Add or Change Select Drug Patient Health and Conditions Medication Add or Change Review Patient Alternative Preferred and Coverage Pharmacy Limitations Complete SIG Dispense instructions Enter PIN Submit and confirm Event i Event one time Required i and as needed After the prescriber profile is created patients must be added to the PROMISe ePrescribing application This includes entering the patient s name patient number if applicable date of birth gender demographic information telephone and fax number The prescriber must indicate the patient s consent regarding the provider s ability to view medication history Patient information is entered into a database unique to the prescriber This data is not shared among other prescribers Each patient s self reported medications health conditions and preferred pharmacy comprise the patient profile Health conditions entered as part of the profile process in addition to medication history returned from claims history are used as part of the prescribing process After the initial entry of the profile updates can be applied with each succeeding p
86. rts PA PROMISe ePrescribe User Manual_v1 2a docx June 22 2012 27 4 In the Amount and Frequency field enter the dosage information 5 Click the Add button to complete the process The drug or supplement will be added to the self reported medications list PA PROMISe ePrescribe User Manual v1 2a docx June 22 2012 28 5 1 2 Editing a Medication If you need to adjust the dosage information for a patient reported medication listed you can accomplish that using this page SN pennsylvania DEPARTMENT OF PUBLIC WELFARE PROMISe Internet LAs ePrescribe ery it Eligibility Trade Files Reports Outpatient Fee Schedule ePEAP Help ePrescribe gt Search Patients gt Patient Information gt Medications Tuesday 08 24 2010 10 17 AM EST ePrescribe Smith Jane Patient Information Medications Health Conditions Preferred Pharmacies 01 01 1980 Medication History Request If you want the system to check for drug to drug interactions you must retrieve medication history The last two 2 years of medication history can be requested PA Medicaid will return up to one 1 year of the most recent medication history Retrieve medication 55 24 2008 X To 58 24 2010 r3 history from wks E niai E Medications Manually Entered Patient Reported 3 Enter a Drug Supplement or Alternative Therapy Click the Edit link to update the details in a row Click the Remove link to remove the entire row Date D
87. rug Supplement Amount and Frequency Action Click to add a new Drug Supplement 9p N 08 24 2010 Lexapro 10mg once daily ET Emove Type Drug Drug Name Lexapro Amount and 10mg once daily Frequency Save Cancel 08 23 2010 Vicodin 1 table per day Edit Remove 08 23 2010 Multi vitamin 1 tablet each day Edit Remove Click on the Edit link 2 Inthe Amount and Frequency field enter the new dosage information Click the Save button to complete the process The drug or supplement will then be modified to reflect the change The date field will be populated with the current date PA PROMISe ePrescribe User Manual_v1 2a docx June 22 2012 29 5 1 3 Removing a Medication If a listed medication is no longer being taken you can remove it from the patient reported Medications using this page SN pennsylvania PROMISe Internet DEPARTMENT OF PUBLIC WELFARE Claims Eligibility Trade Files Reports Outpatient Fee Schedule ePEAP Help ePrescribe gt Search Patients gt Patient Information gt Medications Tuesday 08 24 2010 10 17 AM EST ePrescribe Smith Jane Patient Information Medications Health Conditions Preferred Pharmacies 01 01 1980 Female Medication History Request If you want the system to check for drug to drug interactions you must retrieve medication history The last two 2 years of medication history can be requested PA Medicaid will re
88. rugs or required number of drugs from the same class must be tried prior to coverage of selected drug e Quantity limits Drug only covered up to certain limits on quantity fills dollar amount or days supply within certain time periods e Age limits Drug only covered for patients over a minimum age or under a maximum age e Gender limits Drug only covered for patients of specific gender e Resource link Summary Level Provides link for more information e Resource link Drug Specific Provides link for more information on a specific drug Note If the content of the link is provided within the ePrescribe portal it will be opened in a pop up page Note If the content of the link is provided outside the ePrescribe portal it will be opened in a new browser page PA PROMISe ePrescribe User Manual_v1 2a docx June 22 2012 52 New Prescription Coverage Limitations Coverage Hernsyvenis Der of Pubic esre Non Formulary Generic Medication Lsnopri mg Tab Rx Co pay ter 3 of 3 Any Coverage Limitations o Age bmits apply e Quanbty limits apply Continue Cancel 1 If additional information regarding the Coverage Limitations exists it will be presented as a hyperlink s on the page To view you can click on the available link s 2 Click the Continue button to proceed to the next step The SIG Dispense page will then display PA PROMISe ePrescribe User Manual_v1 2a docx June 22 2012
89. ry will not be present for PA Medicaid patients 8 Click Add to add the new patient s profile A Confirmation dialog box displays Patient Information was Successfully submitted Lox 9 Click OK to close the dialog box At this point the patient s profile is stored The Patient Information panels allow you to add the patient s medications allergies health conditions and preferred pharmacies to the patient s profile You can also write a new prescription for the patient PA PROMISe ePrescribe User Manual v1 2a docx June 22 2012 20 4 Search Patients When submitting an online prescription through the PROMISe ePrescribing application you must first determine if the patient is already entered by using the Search Patient function If not you will need to add the patient to your patient database before a prescription can be submitted Once the patient has been added you can search for the patient record Note Patient files will not be visible or shared by other prescribers The first time you add a patient an ePrescribing eligibility transaction is initiated to determine the patient s prescription coverage and associated payers Each time thereafter that you access the patient record provided it has been more than 3 days from the time the last eligibility was requested an ePrescribing eligibility transaction is automatically initiated Eligibility information obtained during the ePrescribing process is not a guarantee
90. s 1 Days Supply 30 Comments to Pharmacy RITE AID 5277 SIMPSON FERRY 5277 SIMPSON FERRY ROAD MECHANICSBURG Pennsylvania a Remove Vicodin 5 mg 500 mg Tab SIG 1 tablet 4 times a day as needed for pain Dispense 16 Tablet Substitution Allowed Refills 0 Days Supply 4 Comments to Pharmacist This prescription must be printed It is a Schedule III controlled substance Enter the four digit PIN and click Submit Prescription Pad to proceed PIN sese Submit Prescription Pad Return to Prescription Pad 1 Confirm all prescription information is accurate Click the Remove link if you want to remove one or more of the drugs prescribed A message will display to verify you would like to remove the record A message will display to verify you would like to remove the record v Confirmation Are you sure you want to Remove the record 2 In the Submission Type field select the preferred submission type This is where you would select Paper if you choose to have the patient hand carry the prescription Note If you choose Electronic for the submission type you will not be able to print the prescription in paper format 3 In the Pharmacy field select the pharmacy you would like the prescription sent to If you have entered a primary preferred pharmacy in the patient s profile it will populate although you can choose another pharmacy if needed 4 In the PIN field enter the four 4 digit pre
91. s are considered prescriptions therefore PA Medicaid renewal requests require the prescriber s state license number be contained in the transaction from the pharmacy If the license number is not present or is invalid the system will present options for the prescriber to deny the renewal or deny and issue a new prescription Check the box Deny Renewal and place a comment to the pharmacist Renewal Request Patient Jane Smith 555 Elm St Harrisburg PA 17109 Birth Date 01 01 1980 Gender Female Pharmacy CVS Phamacy 1630 1116 Carlisle Rd Camp Hill PA 17011 Office 717 871 5067 Select Patient The following patient s match the last name birth date and gender for the patient listed on the renewal request please select the patient you would like to include in your response to the pharmacy If you need to add a new patient go to the Add Patient page Jane Smith 555 Elm St Harrisburg PA 17109 Birth Date 01 01 1980 Gender Female Medication Amoxil 500mg Oral Tab Total Dispensings Approved 2 Dispense 40 Tablet Date Written 11 15 2010 Substitution Substtuton Allowed Days Supply 40 SIG 1 tablet every 24 hours orally Message The patient requesting for a refill Prescriber s Response to Pharmacy Submit sends your response to the pharmacy Upon successful completion the item is deleted from the worklist and you are returned to the worklist If the Deny Renewal option is chosen either Comments to the Pharmacist field or the Denia
92. sage will display asking if you have reviewed the SIG with the revised prescription s supply and or dispense information Once you have reviewed the SIG select the SIG Verified radio button box and click Continue New Prescription SIG Dispense Select Drug Indicates a required field Alternatives Coverage Pennsylvania DeptofPublic Welfare Formulary Status Non Formulary Brand Coverage Medication Wellbutrin 100 mg Tab Supplied Rx Limitations Co Pay Unknown gt SIG Dispense Dispense 59 Tablet p E Drug Alerts Either enter the number of refills or check the PRN indicator Refill Qty o or Refill as Needed PRN o Days Supply 45 Brand Medically Necessary Dispense as Written SIG twice daily The Dispense and or Days Supply data has changed Please verify that the SIG applies to the Dispense and Days Supply data entered SIG Verified Comments to Pharmacist Note The Comments to Pharmacist will not display on the prescription label PA PROMISe ePrescribe User Manual v1 2a docx June 22 2012 55 6 1 11 Submission Type and Pharmacy From this page you can view all pending prescriptions on the Prescription Pad select how the prescription is submitted and select the pharmacy Prescription Pad Submission Type and Pharmacy Indicates a required field Prescriptions Action Lisinopril 5 mg Tab Remove SIG 1 tablet twice a day Dispense 60 Tablet Substitution Allowed Refill
93. scriber PIN you established during registration for ePrescribing 5 Click the Submit Prescription Pad button to submit the prescription for confirmation PA PROMISe ePrescribe User Manual v1 2a docx June 22 2012 56 Note It is possible to enter five 5 prescriptions on the prescription pad prior to submitting the prescription pad for processing 6 If you wish to return to the Prescription Pad click on the Return to Prescription Pad button where you can add or remove additional prescriptions If the drug is classified as a controlled substance you will not be able to submit the prescription electronically In this case the Submission Type and Pharmacy fields will not display You will only have the option to print 1 Confirm all prescription information is accurate You will see a message stating This prescription must be printed It is a Schedule Controlled Substance 2 In the PIN field enter the 4 digit PIN you established during registration for ePrescribing 3 Click the Submit Prescription Pad button to submit the prescription You will be asked to confirm the prescription before it is electronically transmitted 4 If you wish to return to the Prescription Pad click on the Return to Prescription Pad button where you can add or remove additional prescriptions Prescription Pad Confirmation Prescriptions Lisinopril 5 mg Tab SIG Dispense Refills Comments to Pharmacist Submission Type Ph
94. sponse to the pharmacy if you need to add a new patient go to the Add Patent page Jane Smith 555 Elm St Harrisburg PA 17109 Birth Date 01 01 1980 Gender Female Prescription Details Medication Amuterol 100 mcg maler Total Dispensings Approved 3 Dispense 1 nnair Date Written 05 01 10 Substitution supstzution not allowed by Prescrber Days Supply 90 SIG Take 1 or 2 puffs every 6 hours as needed Message Patient indicated to pharmacy that they took their last dose of Albuterol last week E Prescriber s Response to Pharmacy E Unable to process this renewal Please contact the requesting pharmacy to provide a response to this request To remove this request from your renewal worklist select Response provided to pharmacy and proceed to submit Response provided to pharmacy Enter the four digit PIN and chek Submit to subenit the response Indicates a required eld 8 3 Deny a Renewal Request From this page you will be able to deny a renewal request Note If the renewal request is for a controlled substance only the deny option will be available PA PROMISe ePrescribe User Manual v1 2a docx June 22 2012 73 PROMISe Internet Review Renewals Search Phamacies Prescriptions in Error View Prescriptions ais gt Renewal Request Oetads Friday 08 27 2010 02 41 PM EST Renewal Request Patient Jane Smith 555 Elm St Harrisburg PA 17109 Birth Date 01 01 1980
95. ssion is successful or is pending the Print Prescription page displays so you can print the prescription renewal for the controlled substance since it cannot be sent electronically Successful renewal requests those responded to from the details view of the Renewal Request page will be removed from the worklist You can view all the renewal requests by request date order from the most recent request to the oldest request and view the details of those requests You can also sort the renewal requests by patient name so you can view all the renewal requests per patient Icons will display in the Type field to help you quickly identify renewal requests that are New Duplicate or in Error PA PROMISe ePrescribe User Manual v1 2a docx June 22 2012 68 8 1 View a Renewal Request s Details You can view your Renewal Request worklist The following renewal information is presented Type Request Date Patient Name Medication and Last Fill Date c pennsylvania DEPARTMENT OF PUBLIC WELFARE PROMISe Internet r View Prescriptions lePrescribe Profile Search Patients Review Renewals Search Pharmacies Prescriptions in Erro Thursday 08 26 2010 03 47 PM EST Renewal Requests ee Click on the link in the Medication column to see the details of the prescription Duplicate refill requests are present in the list Click on patient name column to sort all the patient requests together New Requests 1 jew Duplica
96. t If the patient has allergies these can be added by adding the specific allergen and associated reaction Disease Conditions Click the Remove link to remove the entire row Description Last Update Action Click to add a new disease Central Diabetes Insipidus 08 23 2010 C 1 Click on the Remove link for the line you wish to remove A message will display verifying you wish to remove the record Are you sure you want to Remove the record 2 Clicking the Yes button will remove the record PA PROMISe ePrescribe User Manual v1 2a docx June 22 2012 33 5 2 3 Adding an Allergy From this page you can view or add Allergies Allergies Click the Edit link to update the details in a row Click the Remove link to remove the entire row El Click to collapse Indicates a required field allergen 900208 BEE POLLENS Reaction Hives CEDAR LEAF THUJA Sinusitis 08 23 2010 Edit Remove 1 Inthe Allergen field type the name of the allergy A list of potential matches will display for selection 2 Inthe Reaction field enter the physical reaction from the Allergen 3 Click the Add button to complete the process The allergen will then display under Allergies Note Allergies entered in the patient s profile will be used for editing during the prescribing process 5 2 4 Editing an Allergy If you need to change information relating to
97. te Requests 0 amp Requests with Error 0 e Total Records 1 Type Request Date Patient Name Medication Last Fill Date New 08 17 2010 Smith Jane Amoxil 500 mq Oral Tab e Cancel The medication information includes drug name strength and dosage form followed by the number dispensed number of refills or PRN refill as needed and number of days supply 8 1 1 Sort the Renewal Requests You can sort through the patients listed on the Renewal Request worklist In the Search Results panel click Patient Name to sort the renewals in patient name order or Request Date to sort by the date the renewal was written The search results display in the sort order selected You can click on the link for the medication to see the details of the renewal request PA PROMISe ePrescribe User Manual v1 2a docx June 22 2012 69 Renewal Requests Click on the link in the Medication column to see the details of the prescription New Requests 5 jew Duplicate Requests 0 amp Requests with Error 2 e Total Records 38 Medication Jones Bob Amoxil 500 mg Oral Tab 01 28 2011 Amoxil 500 mg Oral Tab Brown Bill 01 28 2011 Jones Diane 01 27 2011 Smith Jane 01 27 2011 Peters Sam 01 25 2011 Brown Bill Xanax 1 mg Tab 01 24 2011 Smith William Amoxil 500 mg Oral Tab 01 24 2011 Smith John Amoxil 500 mg Oral Tab 01 24 2011 Brown Sarah Amoxil 500 mg Oral Tab 01 24 2
98. tens 25 5 Patient Specific Information sseessocsssoccssecosoossoosecscesooccssecsscossoososoccssesosecssosssocessscessesssee 26 5 1 Medications eisin ee Tinnen e e atas obe o Ist D ORAS haa 27 5 1 1 Adding a New Patient Reported Medication eene 27 2 1 2 editing ia Medication etd te eae e pepe ete teen etel etes 29 5 1 3 Removing a Medication 1 cte rere en etit ed a ge tuo eade eri i 30 5 2 Health C Git OnSite saarnan a 2 tat b ates S usitata pe ies 31 5 2 1 Adding a Disease Condition 2 eec dete e aee ge ei er eate 32 5 2 20 Removing a Disease Condition eese nennen nennen nennen nnne 33 223 u Ndding an Allergy 5e e ebrei ecu deeb idee e e eR enden tege 34 5 2 4 Editing an Allergy eee RR ec e e Fear a EE eU o Ee e conde 34 5 2 Remoying an Allergy e e e a epe trs 35 5 3 Preferred Piarmactes 5 226 eL us 36 3 3 1 Adding Preterred Pharmacies eed pd 37 5 3 2 Removing a Preferred Pharmacy orien nennen nennen nennen 38 5 3 3 Setting a Primary Preferred Pharmacy essere nnne nennen ener 39 6 ePrescribih sss T M 40 6 1 Presciption Pad usestutottates dt o UM a E E do hine 40 6 1 1 Retrieving the Patient s Medication History essent eren nre 42 PA PROMISe ePrescribe User Manual v1 2a docx June 22 2012 6 1 2 Medication History Failures esses eene nennen tnnt nenne entren n
99. ternatives Window detailing any available alternatives to the medication being prescribed The Prescriber can either choose one of the alternatives or to prescribe the original medication Coverage Limitations Window detailing specific constraints about the prescribed medication as defined by the Pharmacy Benefit Manager or payer DEA Drug Enforcement Administration ePrescribe Application used to transmit prescriptions electronically as well as manage renewals from pharmacies ePrescribe Profile Page detailing prescriber s information All information except NPI and DEA numbers can be edited as needed Error File transmission status indicates the transaction encountered an error during transmission NPI National Provider Identifier PBM Pharmacy Benefit Manager Pending File transmission status indicates the medication is still being processed and is not finalized yet PIN Personal Identification Number Printed File transmission status indicates the medication was printed and given to the patient PRN Refill as needed ProDUR Prospective Drug Utilization Review Radio Button Selection method of choosing one option from a supplied list of choices To use a radio button click on the selection and a green PA PROMISe ePrescribe User Manual v1 2a docx June 22 2012 81 circle will display to indicate your selection Search Patients Process where
100. the patients profile such as allergies or diseases will be used in the ProDUR Prospective Drug Utilization Review review that is performed when you write a new prescription You should review the patient s medication history as reported by the patient s Pharmacy Benefit Manager PBM Payer Note The Retrieve Medication History feature is only displayed when the Prescription Pad is empty It will not be displayed after prescriptions are added The medication history obtained is viewable from the patient s medication page of the profile If there is no medication history available a note will indicate that no medication history was available Note Medication History may be incomplete It may not include drugs that the patient asked not to be disclosed OTC drugs or drugs paid for by the patient Also payers may not report all drugs PA Medicaid does not report HIV AIDS treatment drugs Medication History may also be inaccurate if there were errors in the claims information used by the payer to report medication history Note Medication History will only display medications paid by the Pharmacy Benefit Manager or payer Medication History will not display medications obtained where the patient paid cash or if the payer is not affiliated with the Surescripts network Note The Medication History Request panel is not available when a patient does not have eligibility coverage Note Medication History is returned for patients with current PA
101. tive and coverage limitations if present The drug information is selected As the prescriber begins to type the drug any drug that contains the typed letters is displayed The prescriber continues to type until the drug appears in the list After selecting the drug the medication options dosage and strength are available for selection Depending on the drug and medication selected as well as the patient s pharmacy coverage payer or therapeutic alternatives are presented The prescriber may opt to choose an alternative medication or ignore the alternative options Coverage limitations or constraints regarding the drug are also provided by the pharmacy benefit manager or payer The next step in the prescribing process involves creating the SIG and dispensing instructions Here the prescriber enters the directions for use as well as the dispense quantity and refill options Before the prescription can be submitted the prescriber must enter the four digit prescriber PIN that was created during the prescriber registration process The prescriber must have entered a DEA number in the registration process to be able to create and print prescriptions for controlled substances State or federal law preclude some prescriptions such as those with controlled substances or those deemed as brand medically necessary from being prescribed electronically These prescriptions may be entered into the system however they must be printed signed and then hand c
102. turn up to one 1 year of the most recent medication history Retrieve medication 5s 008 m To ps 24 2010 E ve oaa 09 24 2 amp bs 24 2 1 Medications Manually Entered Patient Reported 3 Enter a Drug Supplement or Alternative Therapy Prescribe Click the Edit link to update the details in a row Click the Remove link to remove the entire row Date Drug Supplement Amount and Frequency Action Click to add a new Drug Supplement 08 24 2010 Lexapro 10mg cnce daily Kei remove gt 08 23 2010 Vicodin 1 table per day Edit Remove 08 23 2010 Multi vitamin 1 tablet each day Edit 1 Click on the Remove link A message will display verifying that you wish to delete the record 2 Click the Yes button to delete the record Note Medications that are removed will not be stored in history and therefore unavailable for future viewing PA PROMISe ePrescribe User Manual v1 2a docx June 22 2012 30 5 2 Health Conditions You have the ability to add your patient s health conditions diseases and allergies to the patient s profile oN pennsylvania DEPARTMENT OF P WELFARE PROMISe Internet LAE ePrescribe Mer CMS DOMINE om E orl dI Bel Mt ePrescribe gt Search Patients gt Patient Information gt Medications gt Health Conditions Tuesday 08 24 2010 01 32 PM EST ePrescribe Smith Jane Patient Inf
103. ur Drug Enforcement Administration DEA number then re enter it to confirm Note The DEA number is not a required field however if the field is not populated you will not be able to enter controlled substances or print the prescription Note Surescripts will validate the NPI and DEA numbers against their records If any discrepancies exist you will receive one of the following messages For assistance please contact the Provider Assistance Center 800 248 2152 e The DEA number provided is invalid e DEA Duplicate DEA number provided already exists in the Surescripts directory under a different name If prescribing under another person or an institutional DEA please use a unique DEA suffix e Name Duplicate A prescriber with the given DEA and last name already exists in the Surescripts directories e Duplicate A prescriber with the given DEA and last name already exists in the Surescripts directories e Surescripts Prescriber ID SPI root does not exist in the Surescripts directories e Surescripts Prescriber ID SPI does not exist in the Surescripts directories 3 Enter your State License number then re enter it to confirm Note This field is required to register for the ePrescribing application 4 Enter two characters to initiate the Specialty search feature As you enter characters in the field a list of possible matches to your entry will display for selection The search is based on specialties as identified by the
104. y transaction may include but are not limited to Poorly formatted message Cannot find patient identified Patient not eligible Consent not given Responder cannot process a physician only consent Physician identifier is not valid Physician identifier is not supported Date range for medication history is invalid In these instances please contact the Provider Assistance Center 800 248 2152 to resolve the issue PA PROMISe ePrescribe User Manual_v1 2a docx June 22 2012 45 6 1 5 Adding a New Prescription From this page you will be able to add the prescriptions for the patient Once you have completed this process the Prescription Pad will display the prescribed drug Click on the Add New Prescription link to open the Select Drug page Note If the medication history had not previously been retrieved it can be retrieved by selecting the Retrieve Medication History link on the Prescription Pad Medication History should be checked with each new prescription Note The pharmacy transaction does not allow for the designation of compound drugs therefore compound drugs cannot be submitted electronically ray pennsylvania A PROMISe Internet ePresceibe Profile Search Pasents Review Renewals Search Phamacies Prescriptions in Error View Prescriptions e re c gt Search Patients gt Pabent informat gt Medxanons gt gt Prescnbe Thursday 09 23 2010 01 11 PM EST Prescription Pad a m

Download Pdf Manuals

Related Search

Related Contents

Crosley 200 Series User's Manual  Intel S845WD1-E Motherboard  取扱説明書 docomo PRIME series P-05C 日本語  mp2013 - Mairie d`Aix-en  Samsung Galaxy Tab A with S Pen (8.0, Wi-Fi) คู่มือการใช้งาน  Next-generation High-definition Day & Night Video Camera  

Copyright © All rights reserved. Failed to retrieve file