Home Forums Discussions Problems Rx Under Doctor But also Sign Charts

Hi All,

We have a bit of a unique situation at our practice. Some of our staff see patients for coaching/lifestyle consultations so they need to have the ability to sign charts and have a schedule. However, we also need to be able to transmit prescriptions to pharmacies under the doctor's name (not their own name).

There doesn't seem to be a configuration that allows one to prescribe under the name of a doctor but also have a schedule/sign charts??

Perhaps I pose this to support as a suggestion for improvement?

Any suggestions for a work-around??

Thanks,

Sam

Sam,
There is a time and place for work-arounds, but keep in mind that if a provider is seeing patients, doing consultations, generating and signing a note, and having a schedule...then AC would consider them to be providers and would probably expect you to buy a license for each.

Jon,

I didn't even consider the extra provider aspect. Hmm. I thought that was for licensed physicians only, not uncertified/unlicensed staff who spend time with patients discussing certain topics. Would a mid-level provider be considered a separate provider?

Thanks,

Sam

Mid-levels a definite yes.
A little murkier if unlicensed staff seeing patients for teaching or other activities

Greg

Sam,
Just to be clear, I don't speak for AC, and do not in any way want to be the "AC police"; I just want you to be aware of that consideration. Perhaps a call to them would be the best way to be clear about the rules. In my experience they have always been pretty liberal and understanding.

I'm no kinda police either but I would be afraid of any Rx being generated by other than the Licensed Physician. Have the Doctor review the laws in your state for that. In California you can't delegate this, (and no I never ever had a staff member refill "any refills for BP meds until I get back from vacation" or any thing of the sort, we all use to do something like that, but with an EMR it is a thing of the past).

Maybe the safe thing to do is have the unlicensed forward the chart to the supervising physician. The problem then becomes closing the chart and keeping any of these "coaching fees" out of the insurance billing, as this is not likely a legitimate covered service.

interesting problem.

i would agree with Marty. Prescribing is limited to those authorized by the state, generally licensed practitioners.

Signing the charts could be done as a midlevel, but that gives them the ability to write Rxs, which is NOT legal. Perhaps if they are not verified to write Rx's it would block them from that ability.

It would be a provider that should have to pay yearly fees to AC however.

It's probably simpler to write the note completely, then forward to the provider to sign.

I decided to only allow the physician (me) do any charting in AC. I do have a nutritionist and a psychologist working in my practice (bariatric surgery). They generate a note which gets imported in the patient's chart. That is my work around. I sign /e script all prescriptions. I personally do not delegate that ability to anyone else. I had the unfortunate experience of having staff call in prescriptions for themselves and others for narcotics many years ago. Nasty deal, had to call police and DEA. Be very careful who you allow to sign prescriptions for you as you may be leaving yourself in a very vulnerable position, both legally and with the local medical board.

I have talked with Jon B. about the ability to have a schedule and he had said that they would try to rectify this after PM, as far as scrips I agree with many others as I do all my refills and scrips which is easy using e scrips and faxing and makes me feel much better.

Thanks for everyone's thoughtful replies.

We are a very small office with no concern for abuse of prescribing privileges (though it could and does happen as happened to Gerardo...).

So our goal would be to have the ability for someone to have a schedule (but not necessarily sign charts) and also electronically transmit Rx's on behalf of the licensed physician. Right now this is allowed for "Medium: Nursing" and "Low: Secretarial" users.

Steven, if the scheduling issue gets addressed after PM as far as allowing other user types to have schedules this would solve our problem.


Currently this does not seem to be an option, so we'll just manage a work-around.

Thanks again,

Sam