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MEDICAL BILLING HANDLING OF RECHARGES *

Effective Date: 
Sun, 08/21/2011
Reviewed: 
Mon, 03/26/2018
Revised: 
Sun, 08/28/2011
Policy: 

Medical services performed at the Student Health Center for UCSC departments such as TAPS, EPC, OCEAN SCIENCES, OPERS etc.. are reimbursement via inter-department transfer called “Recharge”.

A recharge document is either sent out in advance of services being performed or shortly after a request has been made from the Student Health Center. 

Procedure: 

SEE PDF for additional images accompanying text procedure.

The recharge form must be filled out in advance by the “requesting” department.  Medical billing will complete the form by filling in data such as; totals, FOAPAL for the Student Health Center, and the descriptive data relating to the services in need of reimbursement.  

Attached File: 

FTP BURSAR FILE TO SHS/AIS SYSTEM **

Effective Date: 
Wed, 08/03/2011
Reviewed: 
Sun, 08/21/2011
Revised: 
Sun, 08/28/2011
Policy: 

After the Bursar Export Procedure is completed and a file is created to export, the file will need to be transferred to AIS, so the charges can be billed.

Procedure: 

SEE PDF for additional images accompanying text procedure.

On the billing desktop locate the Shortcut to PncImportExport on shs-pnc-fs.ad folder

Attached File: 

HOW TO RETURN PRIVATE CARRIER CHECKS [EXAMPLE/TEMPLATE] *

Effective Date: 
Wed, 08/03/2011
Reviewed: 
Wed, 03/28/2018
Revised: 
Sun, 08/28/2011
Policy: 

When the UCSC Student Health Center receives a reimbursement check from a private insurance company such as Kaiser, Blue Shield, Anthem Blue Cross (contracts other than UC SHIP) : use the following procedure to return private carrier checks.

UNIVERSITY OF CALIFORNIA, SANTA CRUZ

Attached File: 

CAPS Manual

Effective Date: 
Mon, 07/11/2011

PHARMACEUTICAL REPRESENTATIVES *

Effective Date: 
Wed, 09/01/2004
Reviewed: 
Wed, 02/21/2018
Revised: 
Wed, 02/21/2018
Policy: 

Pharmaceutical representatives must check in at the pharmacy unless they have a prescheduled appointment with a clinician.

Procedure: 

Pharmaceutical representatives will check in at the pharmacy first and will be introduced to clinicians as needed or directed to a clinician with an appointment. If a representative does not have an appointment, the pharmacist will determine whether there is important information to be shared and if so will contact the medical director or other clinical manager for a meeting or will disseminate the information.

The pharmacist may arrange inservices for staff on new products important to our service.

Key Points: 
  • Pharmaceutical representatives need to check in at the pharmacy before entering the clinic.

PHARMACY SECURITY AND ACCESS *

Effective Date: 
Wed, 09/15/2004
Reviewed: 
Wed, 02/21/2018
Revised: 
Wed, 02/21/2018
Policy: 

The UCSC Student Health Center Pharmacy is securely maintained in accordance with regulatory requirements. Authorized access is granted only to staff Pharmacists. An alarm system is in place to maintain security when the Pharmacy is closed. The Ancillary Services Director, as the Director of Pharmacy and Pharmacist-in-Charge, is responsible for Pharmacy security.

Procedure: 

Staff Pharmacists have key and Omni-Lock access to the Pharmacy, and are authorized to arm and disarm the security system.

The Pharmacy is locked at all times.

The alarm system is armed at the close of each working day.

C2 controlled substances are locked and accessible by the pharmacists.  Pharmacists perform all the dispensing for C2 items.

In the absence of a staff pharmacist, the Pharmacy is closed.  The student will be directed to an outside pharmacy as necessary.  However, at times throughout the day, the Pharmacist may not be inside the Pharmacy.  Pharmacy technicians staffing the pharmacy may dispense already filled authorized refills and sell Over-the-Counter goods at this time.  All new prescriptions must be dispensed only when a pharmacist is present and available for consultation.

Non-pharmacy licensed SHS staff must be supervised at all times by licensed pharmacy staff. 

Visitors inside the pharmacy will sign-in on the Visitor Log.  Examples include: maintenance, controlled substance pick up, sharps pick up, returns vendor etc.  This excludes regulary custodial staff and delivery staff.
 

See ABSENCE OF THE PHARMACIST

Key Points: 
  • The Pharmacy is a secured environment.
  • The Ancillary Services Coordinator, the Director of Pharmacy/Pharmacist-in-Charge, is responsible for Pharmacy Security.

PHARMACY CONTROLLED SUBSTANCE INVENTORY *

Effective Date: 
Wed, 09/15/2004
Reviewed: 
Sat, 03/03/2018
Revised: 
Sat, 03/03/2018
Policy: 

The pharmacists at the UCSC Cowell Student Health Center Pharmacy conduct an inventory of C-II controlled substances every 3 months, and C-III-V controlled substances annually. These are incorportated into the legally required “Biennial Inventory”.

A report will be created with each C-II inventory.

Procedure: 

The C-II physical, exact count inventory is done every 3 months.

A report will document all the CA State Board of Pharmacy requirements for C-II inventory reconciliations including the following:

  • acquisitions and dispositions since the prior report
  • a comparison for variances
  • any overages with possible causes incorportated into the report
  • any identified losses and known causes will be reported to the board within 30 days of discovery unless the cause of the loss is theft, diversion, or self-use in which case the report shall be made within 14 days of discovery. If unable to identify the cause of the loss, further investigation shall be undertaken to identify the cause and actions necessary to prevent additional losses of controlled substances

  • the report will be dated and signed by the pharmacists involved in conducting the inventory, and will be signed by the Pharmacist-in-Charge (PIC).

  • The reports are kept in the Controlled Substances binder in the Pharmacy, readily retrievable, for a minumum of 3 years

 

The general inventory is conducted every year and includes all the controlled substances.

The “Biennial Inventory” requires an exact count of any C-II controlled substances and C-III through C-V controlled substances.

This is done during annual inventory in June.

This inventory is maintained in the Controlled Substances binder.

Records are kept for a minimum of 3 years.

MEDICATIONS AND VACCINES STOCKED OUTSIDE THE PHARMACY *

Effective Date: 
Wed, 09/15/2004
Reviewed: 
Mon, 04/16/2018
Revised: 
Mon, 04/16/2018
Policy: 

Medications and vaccines which are stocked outside the pharmacy are checked monthly by nursing staff for appropriate stock levels and for expiration dates. A monthly log/checklist is used in all areas where medications are stored. The Pharmacy staff fills and documents replacement requests sent from nursing.

Procedure: 

Inventory

Nursing staff conducts monthly inventories of medications and vaccines stored outside the pharmacy on the monthly log. These areas include the Nurse's Stations, Treatment Rooms, Allergy Immunization &Travel (AIT), the Nurse's Clinic and the Procedure Rooms.
Inventory levels are checked and additional supplies from pharmacy are ordered on the inventory form by nursing staff if required. The pharmacy staff fills the requisition and documents the transfer of medications.

Expiration Dates

Additionally, expiration dates are checked and any outdated items are removed from stock and replaced by pharmacy, upon nursing staff request.

Multiple Dose Containers

In general, multi-dose vials are good for 30 days after opening, however, in the interest of safety, the Student Health Center has decided that any multi-dose vial not excluded below will be discarded after one use. 

Nursing staff will date and initial multi-dose vials when they are first opened. Any multiple use product will be discarded within 30 days (or upon the date of expiration with special manufacturer documentation), if cross-contamination occurs, or at the discretion of the nursing or provider staff.  Note: some multidose vials are used as "singel dose vials".  See policy.

Certain medications may be discarded at a time-frame longer than 30 days if supported by documentation from the manufacturer.  These medications may include but are not limited to:  IPOL, Typhim VI and Pneumovax.  The expiration date listed on the medication container will be used.

Key Points: 
  • Monthly inspections are done by nursing staff for all medications stocked outside the pharmacy on the monthly log
  • Supplies are ordered from pharmacy by nursing staff if required

MEDICATION REFILL REQUEST *

Effective Date: 
Wed, 09/01/2004
Reviewed: 
Wed, 02/21/2018
Revised: 
Wed, 02/21/2018
Policy: 

The Student Health Center facilitates requests for prescription refills from outside pharmacies and for prescriptions previously filled at the Student Health Center Pharmacy by both in house and outside providers.

Procedure: 

A) Outside Pharmacies

  • Faxed or telephoned request may be received by Medical Records, Triage or Pharmacy
  • Requests are routed to Medical Records
  • The request is sent to the prescribing clinician or covering clinician if more urgent
  • The clinician determines whether or not to give refills and documents any actions in the medical record
  • The clinician contacts the outside pharmacy with their actions, by a) sending the written request with the documentation, b) sending a new written prescription or c) telephoning the outside pharmacy

B) UCSC Pharmacy

1. SHC Pharmacy patient requests a refill of a prescription written by a UCSC SHC prescriber and none remain (CAPS student patients are referred to CAPS for continuing refills).

In Point and Click

  • The pharmacist reviews the patient profile to ascertain if additional prescriptions or refills are available
  • If none available, in the patient's "Open Chart", select a new Encounter Note then select PRIMARY CARE - TELEPHONE ENCOUNTER
  • Under "Identifying Information", select NOW, and other information as desired, such as preferred provider > at Undersignature, in the blue section, choose CLICK HERE TO SIGN, and sign off accordingly, which will let the provider know who originated the request
  • Under REASON FOR CALL, select PATIENT CALLED TO REQUEST PRESCRIPTION RENEWAL
  • In MESSAGE FORWARDED TO, enter who is to receive the request, usually the Charge Nurse
  • Under CLINICAL NOTES, select PRESCRIPTION RENEWAL REQUEST > enter the medication and any other necessary information > select NEW ENTRY if more than one medication is being requested > Directly under the PRESCRIPTION RENEWAL REQUEST, add Undersignature by pressing CLICK HERE TO SIGN
  • Send to the Charge Nurse, who will triage to the doctor on call or the clinician requested (upper right in Text Macro area).  Note - do not check the CREATE CHART REQUEST button
  • Pharmacist can check under Visits/Notes to confirm that the refill message was sent to the nurse / clinician
  • To create a reminder for the pharmacist, select REMINDERS from the patient chart, select NEW and the category PHARMACY and enter a brief note, i.e. refill OC.  Note: a generic provider "Pharmacist" was set up, so that the reminders can be seen under the generic "Pharmacist" provider listing rather than the individual pharmacist
  • The clinician will receive a secure message, which can be viewed by the covering clinician, and while in the patient chart, can elect to renew or re-write the current prescription and send it electronically to the Pharmacy
  • If the clinician declines a refill or if there is any other communication to the pharmacist, the clinician may document in the Pharmacy - Telephone Encounter under PLAN, in the Provider Notes chart and forward to the Pharmacist
  • The pharmacist documents the refills in the patient’s profile on the pharmacy computer system; if refills are declined and the pharmacist is informed, the pharmacist contacts the patient and documents the declination in the patient notes
  • The UCSC Pharmacy contacts outside clinicians via calls, electronically if possible or faxes to request refills
  • The pharmacist documents the refills in the patient’s profile on the pharmacy computer system

C) Clinicians

  • Clinicians will address refill requests, document actions on the medical record and contact the requesting pharmacy with the actions
     (see above)
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