PRS PSC Codes: Difference between revisions
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Certain insurance companies require that a pharmacy transmit a Patient Residence Code or Pharmacy Service type. Generally, if an insurance company wants one, they will also require the other. | Certain insurance companies require that a pharmacy transmit a Patient Residence Code or Pharmacy Service type. Generally, if an insurance company wants one, they will also require the other. | ||
Revision as of 18:10, 20 November 2015
Certain insurance companies require that a pharmacy transmit a Patient Residence Code or Pharmacy Service type. Generally, if an insurance company wants one, they will also require the other.
Patient Residence Code
This value is transmitted in field 4X-384 and notes the type of service the pharmacy is providing for this prescription.
Code | Description |
00 | Not Specified |
01 | Home |
03 | Nursing Home/Facility |
06 | Group Home |
09 | Intermediate Care Facility |
11 | Hospice |
Transmitting the Residence Code
QuickSCRIP can be setup to transmit the Patient Residence Code in different ways, depending on your preferences.
In the Business Control File
Setting a /PRS in the Business control file will set QuickSCRIP to ALWAYS transmit a Pharmacy Service Type on every prescription. The system defaults to transmitting a value of 1. This will be overridden by codes that are placed in the Vendor File, Customer Notes, or SIG lines. This is an ideal solution for pharmacies that are frequently getting rejections for this field, and don't want to have to enter the code in all the time.
- Start at the Pharmacy Main Menu.
- Choose number 3 Utilities.
- Choose number 3 Business Control File.
- Choose screen 6 Additional Rx Custom Screen 3.
- On line 18 add a /PRS
In the Vendor File
You can set QuickSCRIP to only transmit the Patient Residence Code on specific insurance companies. Values set here will override codes set in the Business Control File.
- Start in the Rx Processing Menu
- Choose option 14 Insurance Vendor File Maint.
- Search for the vendor you wish to modify and select them from the pick list.
- Type O3 to go to screen 3.
- On line 22 add /PRSxx (where xx is the code you want).
In the third party customer notes
You can also set QuickSCRIP to send a specific residence code for specific patients. This is ideal for long-term-care and nursing hope patients that stay in the same location.
- Start in the Rx Processing Menu
- Choose option 13 Patient File Maint.
- Search for the customer and select them from the pick list.
- Select the insurance that you will send the claim to.
- On lines 12 or 13 add /PRSxx (where xx is the code you want).
In the SIG Lines
Finally, you can set the Pharmacy Service Type directly in the SIG lines of the prescription. This will transmit the code ONLY on that specific prescription, and is ideal for . Values set here will override codes set anywhere else. Set the code as /PRSxx (where xx is the code you want).
Pharmacy Service Type
This value is transmitted in field U7-147 and notes the type of service the pharmacy is providing for this prescription.
Code | Description |
01 | Community/Retail Pharmacy |
02 | Compounding Pharmacy |
03 | Home Infusion Therapy Provider |
04 | Institutional Pharmacy |
05 | Long Term Care Pharmacy |
06 | Mail Order Pharmacy |
07 | Managed Care Organization Pharmacy |
08 | Specialty Care Pharmacy |
99 | Other |
Transmitting the Service Type
QuickSCRIP can be setup to transmit the Pharmacy Service Type in different ways, depending on your preferences.
In the Business Control File
Setting a /PST in the Business control file will set QuickSCRIP to ALWAYS transmit a Pharmacy Service Type on every prescription. The system defaults to transmitting a value of 1. This will be overridden by codes that are placed in the Vendor File, Customer Notes, or SIG lines. This is an ideal solution for pharmacies that are frequently getting rejections for this field, and don't want to have to enter the code in all the time.
- Start at the Pharmacy Main Menu.
- Choose number 3 Utilities.
- Choose number 3 Business Control File.
- Choose screen 6 Additional Rx Custom Screen 3.
- On line 18 add a /PST
In the Vendor File
You can set QuickSCRIP to only transmit the Pharmacy Service Type on specific insurance companies. Values set here will override codes set in the Business Control File.
- Start in the Rx Processing Menu
- Choose option 14 Insurance Vendor File Maint.
- Search for the vendor you wish to modify and select them from the pick list.
- Type O3 to go to screen 3.
- On line 22 add /PSTxx (where xx is the code you want).
In the third party customer notes
You can also set QuickSCRIP to send a specific code for specific patients. This is ideal for customers that you regularly provide nursing home prescriptions for. Values set here will override codes set in the Business Control File.
- Start in the Rx Processing Menu
- Choose option 13 Patient File Maint.
- Search for the customer and select them from the pick list.
- Select the insurance that you will send the claim to.
- On lines 12 or 13 add /PSTxx (where xx is the code you want).
In the SIG Lines
Finally, you can set the Pharmacy Service Type directly in the SIG lines of the prescription. This will transmit the code ONLY on that specific prescription, and is ideal for compounds. Values set here will override codes set anywhere else. Set the code as /PSTxx (where xx is the code you want).