When a prescription came through AC e-prescribing site, I denied the requested synthroid as patient was due for a TSH and typed in the reason for denial was that she needed labs. The pharmacist called my office and said the denial came across as patient unknown to me. Any one else having similar experience??

I have had countless incidences where the reason for denial I give does not seem to make it to the pharmacy and instead the patient is told I do not have them as a patient. I really am less that satisfied with Newcrop. It takes me longer to go through the refill requests than it did just to go through the faxes. The ONLY advantage I see is that the refill is automatically denoted in the AC chart. And, the fact that the major player CVS Caremark still has no listed account is unacceptable. Newcrop should be on them like you know what on you know what.

Thanks Leslie!!!! I concur,

So, if you really hate the refill system, contact Surescripts and have them turn off your refill function.

I don't take refill requests in AC. Mine still come in to Allscripts. I deny them all, takes only a few seconds, and wait for the patient or the pharmacy to call us if it is really needed. Most of the time refill requests are auto generated by the computer when the last refill is used, not because the patient actually needs it.

We get very few real refill requests since we have trained our patients for years to make sure they get needed prescriptions done at the time of their appointment.

Nearly hassle free!

I found the refills being stored in AC are great - when a refill request comes in I match - this tellls me when last seen and I can generate a letter, e-mail to pt or note to have staff call. Then the refill is matched and stored to chart.

The final issue is Caremark....I don't know why it is problematic as it is listed as Caremark Mailorder Electronic and I have used for many versions, now granted I beta test a lot of new versions of AC but if you search for Caremark it comes up. Ironically all of the mailorder companies have a hard time sending electronic (except Medco which does fairly well) and they do not always catch the e scrips, but granted matching out of a database of 1,000s of patients could be problem.

I get the same issue of difficulty when I fax to mailorder companies.

What happens if you just put the last one? I forget what it says, something about it isn't appropriate.

I suppose you could just choose to send it from AC, and write Do not refill due to such and such, then remove the script.

The reason I continue to muddle through the electronic refills is because I believe it will be mandated in the near future. MU has made it clear that the federal government does not believe faxing is secure.
I just believe Surescripts has a long way to go before being truly useful. Another gripe about this, how hard would it be to be able to approve all refills for the same patient with just one request? grrrr

Surescripts is just the intermediary for communication between all prescribing software and the pharmacies, and works fine. It is the AC/Newcrop software that is the problem. Previous posts from JB indicate that they know it is problematic, so hopefully, it will be improved in some future version.

Interesting thought about the government mandating refill requests. So far, the requirement is just to send prescriptions electronically. Since my refill requests do arrive electronically, I am still covered if that becomes the requirement. After denying the refill in Allscripts, I just write the prescription in AC if it is really needed. So, all of my prescriptions are written in AC electronically, and they are all recorded in AC with the patient's record.

Darn it, Donna, I keep making that same mistake!! I meant Newcrop

Leslie,
Don't feel badly, it is confusing, and it took me a long time to understand who does what with electronic prescribing. When there is an opportunity, I repost this information to help other readers understand where the problems lie.

Leslie,
Have you seen this in writing somewhere? I don't think even MU2 mandates this. If you think about it, automated refills are primarily a way for the drug companies and pharmacies to make more money; there may be an element of convenience, but they do not improve patient care in any way. I have never switched to automated refills; I like being able to trash the ones I want to ignore without providing an explanation. I know some people like the automated system, but until it is improved, I will likely stick with what I am doing (unless the Feds aggressively dis-incentivize me).

I do think they improve patient care.

Automated refills? Care to elaborate?

Any system sure beats handwriting the scripts, but I don't have too many coming through the AC/newcrop e-prescribing site--and often I will deny and just send through AC unless it matches exactly. and it is still recorded either way.
When I denied the med the other day this pharmacist called and said the denial came across as patient unknown to me, when i had typed in needs labs--so my message is not getting transmitted back to the local pharmacy. I think the generic denial came across to pharmacist as patient unknown to Dr.--it's more than a bother really. But thanks to everyone for the input

Jon,

We used to get faxes, which clogged up everything. We had to go to the patient's chart and confirm. Now, with one click I am in. And, what I guess I was getting at is the refill request seems to get here with more reliability. I don't completely like it, but I think it will get better. Certainly better than my MA listening to an audex and doing the refill.

Actually, the easiest way to fix it especially since it doesn't give you very good choices would be to just let it default or tell every pharmacy, please tell my patient to call me.

oops-- its NO more than a bother is what i meant to say--

I wasn't questioning the convenience of automated refills; at least for some people (if not for me)
And I wasn't arguing the value of e-rx; which I think does improve patient care.

I was simply saying that I don't see where auto refills improve patient care.

It's not a big deal, and I guess I will leave the last word to others...

jimmie,

We know you by now. We know what you meant.

[quote=DCubed].

We get very few real refill requests since we have trained our patients for years to make sure they get needed prescriptiodone at the time of the appointment.

This is what we do as well. Accepting refills doubled our workload when we allowed it, and led to mistakes.

Jon,

I was not debating the pros or cons of automatic refills (which by the way I hate). I was commenting on the problems associated with electronic refill requests. I think New Crop is very slow, compared to how quickly I could reply to a fax. I do like the fact that it is recorded in AC but it sure would be nice if it were NOT recorded in Past Encounters.
And when I said I predict it will eventually be mandated, just look at the core measure for a patient portal, sharing of info electronically....faxes are not acceptable. Just as they have mandated eprescribing I feel they will soon be mandating erefills.

Well now I am confused; I use the terms "automatic refills" and "electronic refill requests" almost interchangeably. They are the requests generated by the pharmacy for a refill, sent either by fax (in the first case) or electronically (in the second).

I also get occasional messages from pharmacies as " not our patient" when we deny a rx for a patient who has not attended their FU.
I also have trouble sending electronic scripts to express scripts, caremark .
There seems to be only one listing on AC for them - does anyone know if they have regional addresses for electronic scripts or is there just one place for the entire country that we can send electronic scripts ?
would appreciate any help.
Bala

Caremark is a chronic problem sending both electronic and faxes. The issues are all on their side.

Caremark electronic is nationwide.