Billing COVID: Difference between revisions

From QuickSCRIP Wiki
Jump to navigation Jump to search
No edit summary
No edit summary
Line 40: Line 40:
Setup the prescription to bill an insurance as you would normally.
Setup the prescription to bill an insurance as you would normally.
Add the following commands to the SIG lines:
Add the following commands to the SIG lines:
* Submission Clarification Code: \XD02 for First Dose, or \XD06 for second dose
* Submission Clarification Code: /XD02 for First Dose, or /XD06 for second dose
* DUR Codes: \DUIMA (DUR codes may be different from insurance to insurance)  
* DUR Codes: /DUIMA (DUR codes may be different from insurance to insurance)  
* Administration Fee: \ADMFEE$20.00 (or however much you wish to bill for the admin fee)
* Administration Fee: /ADMFEE$20.00 (or however much you wish to bill for the admin fee)


[[File:COVID_SIGs.jpg|COVID SIGs]]
[[File:COVID_SIGs.jpg|COVID SIGs]]

Revision as of 21:12, 8 January 2021

The following instructions are for setting up to bill insurances for the 2-dose COVID-19 vaccine. As of the creation of this guide, this info has only been tested on the MODERNA vaccine, not the PFIZER vaccine, but the same information should be applicable.

Insurances require that COVID Vaccines be billed with an AWP value of $0.01, but will pay an administration fee to cover the labor of dispensing the vaccine.

If you require assistance in setting up or billing a vaccine, please contact Cost Effective Computers, and an agent will assist you. An update may be required to ensure all the features discussed below work properly. It should require no more than 5 minutes to perform.

Setup a 1-cent Price Table

A special price table is required to correctly bill the vaccine.

  1. From the Rx Processing Menu select option 15 "Price Table Maint.
  2. Search for Table 99
  3. Hit Next or Previous a few times and take note of price table numbers, and look gaps in the sequence; these are unused tables. When you've found a number that is not used, write it down, as this will be the new table you create.
  4. Choose A to Add a new table. Assign it the number you chose from the previous step, and give it the description 1 Cent COVID
  5. Setup the following columns (or use the image provided below as a guide)
    1. Line 3: 999999.00
    2. Line 4: -99.99
    3. Line 5: 0.01

After adding the last value, press escape to skip to the bottom of the screen.

    1. Line 123 should be D
    2. Line 124 should be A
  1. E to Exit

Example Price Table

Setup the Vaccine

Add the vaccine to your Drug File Maint screen as you would any other drug (Name, NDC number, etc.) But with the following exceptions:

  • Whatever the Package Quantity is on Line 6, set the AWP value on on Line 16 to be that many cents. (Example: if the quantity is 5, then set AWP to be $0.05)
  • Set the following codes on Line 39, Price Codes (pick them from the menu options listed)
  • Set line 5 Price Table to match the price table you setup in the previous section.
    • Disable Rounding Table
    • Use Drug U&C Price NOT 3pI Price

Use the image provided below as a guide.

Example COVID Drug

Billing the Vaccine in the Fill Screen

Setup the prescription to bill an insurance as you would normally. Add the following commands to the SIG lines:

  • Submission Clarification Code: /XD02 for First Dose, or /XD06 for second dose
  • DUR Codes: /DUIMA (DUR codes may be different from insurance to insurance)
  • Administration Fee: /ADMFEE$20.00 (or however much you wish to bill for the admin fee)

COVID SIGs

Transmit the claim, see if it is accepted, and take note of how much of the administration fee the insurance pays. To help track customers who have been administered their first dose, you can use the Manual Refill Queue to set a reminder for the second dose one month later.