Uploading Prescriptions (For Billing Admins) - New Order Screen (10/2022)

In an effort to increase Medicaid-compliant prescriptions, McGuinness has made design changes to the prescription upload process.  

There are eight (8) required elements that must be on a Medicaid prescription.  The new order screen was designed to correlate to the list of the required prescription items shown in the Medicaid Handbook (Page 21).  

Billing Admins can use either the Medicaid>Prescriptions>Prescription Entry Maintenance 

Enter the child's last name, first name into the search box and click SEARCH.  

Click the SELECT link for the correct child in the list (if more than one).  

Click the "Upload Prescription Image" button.  

The prescription template comes up.  To start the process you will upload the prescription image.  

Click the Choose File button.

Browse to the scanned image on your computer (desktop or folder)

Click the Upload Image Button.

To begin the process you will upload the prescription image.  

Enter the child's last name, first name into the search box.  Click SEARCH.

Click SELECT for the correct child in the list (if more than one).

After you click the SELECT link for the correct child, the Order Image Details Screen comes up and you can begin entering the term of service information.

There are four steps to uploading a prescription.  The first step is uploading the image, which was shown above.  

1)  Upload the image 

2)  Enter the Image Details Screen (Required Field Checklist) - five of the eight required Medicaid items

3) Select and/or Enter the Order Details Screen (Service Type, ICD Code, Frequency/Duration) - The remaining three required Medicaid items.

4) Attach the Enrollment to the prescription.  

The screenshot shown below is what you will see on the Upload Order Image Screen...

On the left is the screen that you will use to enter five of the eight required elements of a Medicaid prescription.  

On the right is the scanned prescription where you will obtain the information to enter to the Image Details Screen. 

 

Now that Step 1, uploading the prescription image, has been completed, you are ready to move to Step 2, completing the Image Detail Screen.  

The Image Detail Screen correlates directly with the list of required elements for a Medicaid prescription on page 21 of the Medicaid Handbook.  

The first five Medicaid items are interactive; the screen builds as you enter information.  The remaining Medicaid items (ordering practitioner's address, phone # and signature) require manual selection after you visually inspect the prescription.  

Please see the screenshot below, which shows the list of required Medicaid elements on the left and the Order Image Details Screen on the right where you will enter the Rx image details.

The Order Image Screen will begin to populate with the first Medicaid element, the Child's Name to start the process.  

Since you searched and selected a specific child when uploading the image, the child's name is auto-filled to this screen to start the process.  

Each subsequent Medicaid element (following the child's name) will populate after each element has been entered.  If you cannot enter any of the required Medicaid elements (because the required item is illegible or missing on the hardcopy prescription) you will not be able to continue with the upload process.  You will need to secure a replacement prescription from the ordering practitioner.  

You will notice that the Upload Order Image screen shows a "Required Field Checklist" at the bottom of the screen.  As you progress through the "entering process" each required Medicaid element will be auto-checked in the selection boxes to the left of the Medicaid item.  You will also see a list of the entered information building (in red) to the right of the Required Field Checklist.  This list will continue to grow with the information that you enter from the hardcopy prescription.  Please see screenshot below.

As you can see the child's name has been auto-filled and shows in three places on the template.  At the top, in the Child Box and in the Required Field Checklist box.  

The first item that you will enter is the Period of Service (Term of Service) for the prescription.  The Period of Service section shows three options for the provider to select.  

1) Applies to the entire school year

2) Applies to specific school year/session

3) Applies to specific date range

The information that you enter in this section is pre-determined by what is written on the hardcopy prescription.  Please see examples noted below.

Applies to entire school year will be selected if the term of service dates are delineated on the prescription as 7/1 to 6/30 (encompasses the entire school year).  

Applies to specific school year/session will be selected if the term of service dates are delineated on the prescription as 7/1 to 8/30 or 9/1 to 6/30, which encompasses the entire school session.  This option should not be selected if there are specific dates of service listed (as shown in the next option). 

Applies to specific date range will be selected if the term of service dates on the prescription are very specific (For Example, 9/8/22 to 6/21/23).  

These dates are more specific than school year session dates, which encompasses the entire school year or session.  "Specific" term of service dates that start and end within the school year session dates should use this option.  

Now that you have an idea of how to enter the term of service dates, you will select one of the three options (that correlates with the hardcopy prescription).  

Next you will enter the school year.

You will notice that the Period of Service checkbox has been auto-checked in the Required Field Checklist and the term of service dates that you entered are shown to the right in red.  The dates that you enter for the term of service (on this screen) will auto-fill to the From and To dates (for the prescription) on the Order Details screen. 

After you enter the period of service dates, the next Medicaid element populates for you to enter, the ordering practitioner's NPI information.  

You can obtain the NPI # one of two ways:  1) Type in the NPI # and click Search, or 2) If you cannot read the NPI #, you can search by the person's name and click Search.  

After you click SEARCH, you will see one or more providers listed below the NPI Search Criteria box.  Click SELECT for the correct provider in the list.

After you click SELECT for the correct provider, you will see that the Ordering Practitioner's Name, Address and NPI # are listed (in red) in the Ordering Practitioner Details Box.  You will also notice that the checkbox in the Required Field Checklist has been auto-selected and the Ordering Practitioner's NPI # appears in the growing list of entries to the right (in red).

The next Medicaid element for you to enter is the signature date of the prescription.  If the signature date is missing or incomplete, you will need to secure a replacement prescription.  

After you enter the signature date, the "Signature Date" field is auto-checked in the Required Field Checklist and the signature date appears in the growing list of entries on the right.  

The Required Field Checklist now shows five checkboxes that have been auto-checked throughout the entering process.  Three checkboxes remained unchecked.  

1) The Ordering Practitioner's Address,

2) The Ordering Practitioner's Phone Number, and

3) The Ordering Practitioner's Signature.

This information requires the person uploading the prescription to visually inspect the prescription for these required Medicaid elements.  If these Medicaid elements are not listed on the prescription, you will not be able to proceed any further and you should secure a replacement prescription.  If these three elements are delineated on the prescription and are legible, you will select each of the (three) remaining boxes.

Now that all the entries and selections have been completed, you will click the SAVE ORDER IMAGE box in the lower right-hand corner of the screen. 

Important Note:  You will notice in the first screenshot below that the last checkbox (Signature) remains unchecked.  You will also notice that there is no save option (Save Button is Missing).  

The second screenshot below shows that all three checkboxes have been selected and the option to save (Save Order Image Button) is available.  All Medicaid items must be checked and/or entered or you will not have the option to save.  

If any of these items are missing from the hardcopy prescription, you will need to secure a replacement prescription - the upload process cannot be completed.  

Please do not check the boxes if the required information is not delineated on the prescription.  

It is not recommended that you add or alter the prescription to include the missing and/or illegible information.  

Altered scripts will be deemed invalid for Medicaid purposes.  A "replacement" prescription should be requested from the ordering practitioner if any information is illegible or missing.

After you click the Save Order Image button, you will receive a message indicating that the Order File saved successfully (Yellow bar/top of screen).

The following Medicaid elements were not addressed in Part 2 (Image Details/Checklist Screen) of the upload process and will need to be entered on this screen.

1) The Service Type (OT/PT/ST/PSY)

2) The ICD Code

3) *Start Date/End Date - The dates that you entered for the term of service dates on the Image Detail Screen will auto-fill into this screen.

4) Per IEP

5) Specific Frequency/Duration and Class Designation (I/G).

 

After you enter all the order details, click the "Add Detail" link at the end of the row.  

After the remaining details have been entered and you have clicked the "Add Detail" link, you will see the following screen.  

For each service type shown, you will click the SELECT link, which will bring up the enrollments for the selected service type within the selected period of service dates that have been previously entered.  

Click the ATTACH link at the end of the row for all the applicable enrollments that apply to this prescription (summer, winter, individual, group).

 After you click the ATTACH link, the link will change to "Detach."  

The prescription is now uploaded and is attached to the child's enrollments!