Pharmacy Toolbox Parameters
Magic 5.64 Release
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ADM Database:[High Impact] Define the Admissions (ADM) database from which patients entered into the ADM Module flow to the Pharmacy Module.
MRI Database:[High Impact] Define the Medical Records (MRI) database from which the Pharmacy Module receives medical records information.
LAB Database:[High Impact] If you would like Pharmacy to receive information from the Laboratory (LAB) Module, enter a LAB database. The following information is included:
- Lab results appear during order entry
- Creatinine clearance results appear on the patient header
- Microbiology Report is available
MM Database:[High Impact] If you plan to use the Materials Management (MM) interface to track inventory in Pharmacy, enter an MM database.
NUR Database: Define the Nursing (NUR) database from the Pharmacy Module can look up into the NUR dictionaries. If your hospital enters adverse drug reactions, defining a NUR database will provide a look up into the Nurse Dictionary when you select a nursing staff member for adverse drug reactions. In addition, if your hospital uses the eMAR, and would like to require a specific skills for administering a medication, defining a NUR database will provide a lookup into the Skills Dictionary in the PHA Drug Dictionary.
ONC Database:[High Impact] Enter the Oncology (ONC) database from which the Pharmacy Module receives Oncology information.
RXM Database:[High Impact] If your hospital plans to use the Prescription Management (RXM/ AOM) interface, enter an RXM database.
NOTE: Before the RXM database can be defined, MEDITECH programming must run a re-translation of the code.
Inp RX # Length: [High Impact] This numeric value (6-9) will determine the length of the inpatient medication order number. At inpatient order entry, an RX number is automatically assigned to an order. The default is 6, however many sites that use override medications from dispensing machines will choose 9 for an RX number length since they move through the RX number wheel at a quicker pace than customers not using this functionality.
If a facility selects 6, upon filing RX #999999, the system will start assigning open values, beginning at RX# 000001, if it is available. The Inpatient RX Number length cannot be the same length as defined in the Outpatient Medication Order number length.
Out RX # Length:[High Impact] This numeric value (6-9) will determine the length of the outpatient medication order number. The default length is 7, which is the most common response.
Unv RX Prefix: If the mediation order is in an unverified or incomplete status, this prefix is assigned to the unverified prescription order. The prefix can be a letter from A-Z, the most common being U (Unverified) or T (Temporary). Example: U1234567
Recalc Charge: This prompt determines if the system should recalculate a patient's charge for a medication order if the price of the drug changes during the duration of the order.
Y: The system will recalculate the charge based on the current price in the Drug Dictionary. The benefit of setting this prompt to Yes allows pharmacies to charge the most up to date pricing for patients.
N: The system will continue to charge and use the same calculations as was charged in the initial order. A benefit of setting this prompt to No is it allows pharmacies to maintain consistent billing while an RX is active.
Example: Original Price is $1.00 per tablet for initial dose on 6/24. A formulary service update is run that increases the price from $1.00 to $2.00 on 6/26.
When Recalculate Charge is set to Yes, the system will generate a $1.00 charge for the medication until 6/26. Any tablet administered on or after 6/26 will charge $2.00.
When Recalculate Charge is set to No, the system will generate a charge of $1.00 for the entire length of the RX.
Use Only Backup ADM DB?: To allow Pharmacy the ability to admit patients in the Pharmacy Module if the ADM module is unavailable for an extended period of time, enter Y. Otherwise, enter N.
Expunge Stop Date:[High Impact] Enter a date to indicate the last day a user is able to expunge Dictionary entries in the Pharmacy module. The expunge functionality is only available in TEST environments, as information should never be expunged in a LIVE environment. Meditech suggests a date be entered approximately two weeks prior to going LIVE with the Pharmacy module. After this date, Dictionary entries can only be Inactivated, and never expunged.
Midnight Run Start:[High Impact] Enter the time at which the Pharmacy Midnight Run should automatically start. If this field is left blank, the system automatically starts the Midnight Run soon after midnight. The Midnight Run Background Job is the job that compiles statistical information for multiple reports, performs file maintenance, starts purging and archiving activity and sends batches of information to other modules (Materials Management, B/AR, etc.).
B/AR Compile Start:[High Impact] Enter the time you would like the system to compile and send the Pharmacy charges to Billing/Accounts Receivable (BAR) module. This time can be set before the midnight run or soon after. The default setting is 0000. After Pharmacy creates a batch, the BAR Module takes the batch and prepares the charges for processing.
First Databank Interface: This parameter determines if users have access to the First Databank Formulary Service routines in the Pharmacy module. If your facility has purchased a formulary service interface to First Databank the parameter will be set to Yes, otherwise it will be blank.
Medi-Span Interface: This parameter determines if users have access to the Medi-Span Formulary Service routines in the Pharmacy module. If your facility has purchased a formulary service interface to Medi-Span the parameter will be set to Yes, otherwise it will be blank.
Micromedex Interface:This parameter determines if users have access to the Micromedex Formulary Service routines in the Pharmacy module. If your facility has purchased a formulary service interface to Micromedex the parameter will be set to Yes, otherwise it will be blank.
Disp. Mach. I/F: This parameter determines if users have access to the Dispensing Machine Dictionary and the Dispensing Machine Interface routines. If your facility has purchased the Dispensing Machine Interface the parameter will be set to Yes, otherwise it will be blank.
NOTE: Once the interface is purchased, the facility will work with the NMI and Pharmacy group for set up and testing procedures.
Type:This parameter will determine if your facility will send over multiple-component or single-component orders to the dispensing machine vendor.
Y: The system will send IVs, compound medications, split medications and single-component orders over to the dispensing machine vendors via MIS outbox messages.
N or BLANK: The system will only send over single-component orders.
NOTE: This is only for sites that are using profiling Dispensing Machines.
Disp. M Inact Rx Delay Hrs: This parameter identifies the number of hours that canceled and discontinued medications remain in the dispensing machine interface index file. This allows nursing users to vend and return medications on the patient before Pharmacy purges them from the interface. After the time period has passed, the transaction will generate an error in Pharmacy of “unable to match transaction to existing Rx” if the nurse attempts to vend or return against the medication order. These errors will need to be acknowledged in the Pharmacy Dispensing Machine Error Routine and then manually corrected in the the MEDITECH software.
$T PHA Segment: Define the $T Pharmacy segment that the system references when running a conversion program.
NOTE: This parameter is only applicable for sites converting from $T to NPR Pharmacy.
$T PHA Directory: Define the $T Pharmacy directory that will be referenced when running any conversion programs from $T to 4.8.
NOTE: This parameter is only applicable for sites converting from $T to NPR Pharmacy.
Billing Type:[High Impact] This parameter determines how pharmacy medication orders will be charged and deducted from inventories.
FILL (Refill Billing): The system will charge, dispense, and decrement inventory when a user runs the Refill List. This is the only option for facilities that are not LIVE with the eMAR. Facilities can be LIVE with the eMAR and still maintain Refill Billing.
ADMIN (Administration Billing):With the ADMIN billing option, charges are generated when a user documents a medication order as administered via the eMAR. Administration billing therefore turns the medication billing process from Pharmacy over to Nursing. eMAR administrations create charges, while Undo activity will generate credits.
In the case of orders dispensed from dispensing machines, charges will be generated at the time the medication is administered on the eMAR. This includes profiled orders and stock medications. Override orders can be charged when the medication is vended from the machine or when administered on the eMAR based upon settings in the Dispensing Machine Dictionary.
*Note: This field works in conjunction with the Admin Billing Location parameter. If this is set to ADMIN and no locations are listed in the parameter, then the whole hospital is billing upon Administration. If specific locations are entered in the Admin Billing Location parameter, then only those locations will use Administration billing. All other locations will still charge based upon the refill list. This flexibility allows sites to implement Administration billing in certain parts of the hospital and add additional locations in the future.
eMAR Format: The eMAR format defined here is used with the eMAR Billing Report. You must enter a format here if the Billing Type parameter is set to ADMIN. The system first looks for the eMAR format defined in the Location dictionary and then to the Customer Defined Parameters. If no format is defined, the system uses this format to sort the billing information on the eMAR Billing Report.
Location:[High Impact] This parameter determines which locations will charge via Administration billing when the Billing Type parameter is set to ADMIN. If specific locations are entered in the Admin Billing Location parameter, then only those locations will use Administration billing. All other locations will still charge based upon the refill list. This flexibility allows facilities to implement Administration billing in certain parts of the hospital and add additional locations in the future.
Example:
Scenario #1: Billing Type = ADMIN / Admin Billing Location = blank
-All locations will bill upon administration
Scenario #2: Billing Type = ADMIN / Admin Billing Location = 2N,3N,ICU
-2N, 3N, ICU locations will bill upon administration, but all other locations will still charge based upon refill list activity.
Billing Transfer Type: This parameter determines how Pharmacy charging information is sent to B/AR. When the prompt is set to:
NPR: The system will automatically send information via the Pharmacy Billing Compile background job. This information is pulled over by B/AR and then appears on the Pharmacy Billing Log. This is the standard response.
TAPE: The system will compile patient charges to a tape for transmission to another vendor BAR.
NONE: No information would be sent to B/AR.
B/AR Databases:[High Impact] Identify the B/AR databases to which Pharmacy sends charges. If you define multiple B/AR databases, to ensure that the patient charges are sent to the proper B/AR database, the system creates a billing transaction after checking the patient's facility.
Utilize NDC Default?: This parameter will determine if the system should send an NDC # to B/AR or not. This field pertains to the Refill Lists as well as the Debit routine in PHA. When the prompt is set to:
Y: The system will use the primary NDC # to send to B/AR for Refill Lists. The system will also send the NDC # defined in the Debit routine to B/AR.
N or BLANK: The system will not send any NDC # to B/AR for Refill Lists or the NDC # defined in the Debit routine.
Display NDCs in Debit Routine?:This parameter will allow/disallow previously scanned NDC #'s from appearing in a look up in the Debit routine in PHA. When the prompt is set to:
Y: The system will allow previously scanned NDC #'s to appear in the NDC # look up.
N: Any previously scanned NDC #'s will be suppressed from the look up.
Capture NDC Billing Data Start:[High Impact] This parameter will notify the system when to begin compiling the NDC information and sending it to B/AR. Once the start date/time have passed, the system will capture this information and send to B/AR. The information is captured only after the system passes the start date/time. This is not retroactive. Once the start date/time have passed, this field will no longer be accessible.
NOTE: Hospitals should take caution when setting this parameter as once the date is set the system will begin using this functionality and cannot be unset.
Always Match Svc Dt for Credits?: This parameter impacts how the Pharmacy module determines the service date for auto credits performed by the system.
Y: The system will match the service date of the debits/credits.
N: The system will not match the service date of the debits/credits.
B/AR DB for Dx:[High Impact] If multiple B/AR Databases are defined, this prompt determines which will be used to obtain the billing codes for the Charge Type and Drug dictionaries.
Group Charges by Billing Number: This prompt establishes how Pharmacy will send charges over to B/AR. When the prompt is set to:
Y: This will place 2 lines on the patient's bill in BAR for each billing number, one line for debits, and another for credits. Note that additives and fluids will not appear together, as they have two separate billing numbers.
N: This creates a separate line for each transaction by procedure code. For IVs, the billing number is supplied by either the first additive or fluid (as determined by the “Default from First” prompt on the IV tab of the Order Type Dictionary).
Doctor: This system will group charges by ordering doctor. This would allow ordering doctor to appear for each billing compile on the Pharmacy Billing Log.
NOTE: In order for billing transaction rules (such as the NDC to BAR rule for Medicaid reporting) to evaluate properly, this prompt must be set to N.
Send Number of Doses or Items to BAR: This prompt establishes whether Pharmacy will send over the number of doses or items that make up an order to B/AR. The most common response is I for Items. When the prompt is set to:
D: The system will send number of doses that make up the Rx to B/AR
I: The system will send the number of items that make up the Rx to B/AR.
This changes how the Pharmacy billing reports present information, such as the Pharmacy Billing Log and Billing Inquiry.
For IV orders, the system sends the number of bottles. For outpatient orders, one dose is equal to 1 refill, regardless of how many items are in each refill.
Example: An order for a 650mg dose is equal to two 325mg tablets. If the parameter is set to D for Dose, a number of 1 will cross to B/AR. If the parameter is set to I for Items, a number of 2 will cross to B/AR.
Send Description to BAR: This parameter determines if a Pharmacy transaction description appears on a patient's bill. When the prompt is set to:
Y: The Pharmacy description will appear under the B/AR description from the Procedure Dictionary.
N: The Pharmacy description will not appear under the B/AR description.
Send 0.00 Charges to BAR: This parameter controls how Pharmacy orders with a charge of $0.00 are sent to B/AR for processing. When the prompt is set to:
ALWAYS: Pharmacy will send all transactions with a $0.00 charge to B/AR.
NEVER: Pharmacy will block all transactions with a $0.00 charge from crossing to B/AR.
CHARGEABLE: Pharmacy will only block transactions for orders that have a $0.00 charge when the “Charge Patient” field is set to N in the Drug Dictionary from crossing to B/AR. All orders for drugs with a $0.00 charge and the “Charge Patient” field set to Y will be sent to B/AR.
Service Date By:This prompt defines the source of the service date that is associated to transactions sent to B/AR from Pharmacy. This service date also appears in Pharmacy billing reports like the Billing Inquiry and Billing Profile. When this parameter is set to:
DISP (Dispense) Date: The billing transaction will cross over to B/AR with the service date of the order's next administration date.
TXN (Transaction) DATE: The billing transaction will cross over to B/AR with the service date that the transaction was entered into the system.
Example: On 7/1 a user runs a refill list that dispenses/charges an initial dose for 7/2 @ 0900. If the Service Date By is set to Dispense Date, the system will send a service date of 7/2 to B/AR. If the Service Date By prompt is set to Transaction Date, the system will send a service date of 7/1, the date the refill list was run.