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1.

Kroll
Windows
Version 9.0
User Manual

Contents

Contents
Logging In and Out of Kroll .................................................................................. 1
Logging in to Kroll ........................................................................................................................ 1
Logging Out of Kroll ..................................................................................................................... 2
Method 1 Using the File Option .................................................................................................... 2
Method 2 Using the X Option ....................................................................................................... 5

Permissions ........................................................................................................ 6
Accessing the Group Permissions Form ...................................................................................... 6
Group Permission Descriptions........................................................................................................ 8
Maintenance Permissions .............................................................................................................. 19

Associating Assistants & Pharmacists................................................................ 24


Disassociating Assistants from Pharmacists ...................................................... 26
Changing a User Password ................................................................................ 28
Managing Multiple Sessions ............................................................................. 29
Start Screen ...................................................................................................... 30
Function Keys ............................................................................................................................ 31
Universal Search Field ............................................................................................................... 32
Menu Options............................................................................................................................ 35
Dashboard Icons ........................................................................................................................ 37
Workflow Icon ........................................................................................................................... 38
RX Counts .................................................................................................................................. 39
Scan ........................................................................................................................................... 40
Callbacks .................................................................................................................................... 42
Follow Ups ................................................................................................................................. 46
Notes ......................................................................................................................................... 49
Mail Icon .................................................................................................................................... 51

Searching for a Patient ...................................................................................... 54


Method 1: F3-Patient Search Screen ........................................................................................ 55
Method 2: ALT+X Start Screen ............................................................................................... 59
Method 3: F11 Drop-off Screen ............................................................................................. 62
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Advanced Patient Search .......................................................................................................... 65


Inactive Patient Records............................................................................................................ 67
Configuring the Columns in the Patient Search Screen ............................................................ 69

Creating Patient Records................................................................................... 71


Method 1: Manually Insert a New Patient Record ................................................................... 71
Method 2: Copy an Existing Patient Record.............................................................................. 73

Patient Record Fields ........................................................................................ 78


Information Tabs on the Patient Record ................................................................................... 91
General........................................................................................................................................... 92
Family ............................................................................................................................................. 96
Other .............................................................................................................................................. 98

Patient Medication Profile ........................................................................................................ 99


Medication Profile Views ........................................................................................................ 100
All Rxs SHIFT+F3/SHIFT+F4 ........................................................................................................ 100
Active Rxs SHIFT+F5 .................................................................................................................. 101
Active Rxs C / PASSTIMES SHIFT+F10......................................................................................... 102
Figure 62 Profile Rx Passtimes ............................................................................................... 102
Refillable Rxs SHIFT+F6 ............................................................................................................. 103
Pricing Profile SHIFT+F7 ............................................................................................................ 104
Not Dispensed / OTC Rxs SHIFT+F8........................................................................................... 105
Rx Filled in Error ........................................................................................................................... 106
Perform FDB Analysis ................................................................................................................... 107

Configuring the Columns in the Medication Profile................................................................ 109


Medication Profile Commands From the Patient Record ....................................................... 112
ESC Back to Patient ................................................................................................................... 113
Space Mark Multiple Rxs ........................................................................................................... 113
F-Refill .......................................................................................................................................... 114
M-Modify ..................................................................................................................................... 114
R-Reprint ...................................................................................................................................... 114
C-Cancel ....................................................................................................................................... 115
D-Detail ........................................................................................................................................ 116
I-Inactivate ................................................................................................................................... 119
Medication Profile Commands From the F-Drop-Off Screen ...................................................... 121
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Extra Functions from the Patient Medication Profile .................................................................. 122

Suspend .......................................................................................................... 123


Resume ........................................................................................................... 125
View/Edit Suspend/Resume ........................................................................................................ 126

Add to Doctor Callbacks .................................................................................. 128


Add to Rx To Do List ................................................................................................................ 130
Display Therapeutic Equivalents ............................................................................................. 132
Fax Doctor ............................................................................................................................... 134
Limited Use Request (Ontario Only) ....................................................................................... 139
Section 8 Request (Ontario Only) ............................................................................................ 143
Transfer Rx to Another Store .................................................................................................. 146
Reactivate Rx ........................................................................................................................... 150

Patient Sidebar Functions ............................................................................... 152


Alternate Addresses ................................................................................................................ 153
Charting ................................................................................................................................... 154
Weight ..................................................................................................................................... 155
Height ...................................................................................................................................... 156
Blood Pressure ........................................................................................................................ 157
Blood Sugar ............................................................................................................................. 158
Cholesterol .............................................................................................................................. 159
Creatinine CL ........................................................................................................................... 160
INR International Normalized Ratio ..................................................................................... 161
Clozaril ..................................................................................................................................... 162
Patient Documents .................................................................................................................. 163
Patient Encounters .................................................................................................................. 166
Patient History......................................................................................................................... 172
Limited Use Items (Ontario Only)............................................................................................ 174
To Do ....................................................................................................................................... 176

Searching for a Drug Record ............................................................................ 177


Method 1: Search for a Drug from the F5 - Drug Search Screen ............................................ 178
Method 2: Search for a Drug from the ALT+X Start Screen .................................................... 181
Method 3: Search for a Drug from the F Drop-Off Screen...................................................... 184
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Contents

Configuring the Columns in the Drug Search Screen ........................................ 188


Advanced Drug Search ............................................................................................................ 189
Inactive Drug Records ............................................................................................................. 190

Creating a Drug Record ................................................................................... 192


Method 1: Manually Inserting a New Drug Record ............................................................... 193
Drug Records The Fields ............................................................................................................ 195

Method 2: Copying a Drug Record ......................................................................................... 196


Tabs on a Drug Record ............................................................................................................ 206
General Tab .................................................................................................................................. 207
Ordering Tab ................................................................................................................................ 210
UPCs Tab ...................................................................................................................................... 214
Plans Tab ...................................................................................................................................... 215
Usage Tab..................................................................................................................................... 216
Old Costs Tab ............................................................................................................................... 217
Counseling Tab ............................................................................................................................. 218
Kroll Care Tab ............................................................................................................................... 219

Drug Sidebar Functions ........................................................................................................... 220


Order Drug ................................................................................................................................... 220
Returning to Stock ....................................................................................................................... 222

Performing FDB Analysis ................................................................................. 223


Analyzing Multiple Drugs ........................................................................................................ 225
Printing Kroll Care ................................................................................................................... 227
Alerts ....................................................................................................................................... 228
Generic Equivalents................................................................................................................. 229
Modification History................................................................................................................ 230
Old and New DIN Links ............................................................................................................ 231
Order History ............................................................................................................................... 231

Reason Codes .......................................................................................................................... 232

Cycle Count Procedures .................................................................................. 233


Set up a Cycle Count................................................................................................................ 234
Count Inventory ...................................................................................................................... 237
Adjust Inventory ...................................................................................................................... 239
Kroll Windows version 9.0 | User Manual

Contents

Searching for a Mixture Record ....................................................................... 242


Method 1: Search from the F5-Drug Search Screen ............................................................... 243
Method 2: Search from the F11-Drop Off Screen ................................................................... 246
Advanced Mixture Search ............................................................................................................ 248
Inactive Mixture Records ............................................................................................................. 249
Configuring the Columns in the Mixture Search Screen .............................................................. 252

Creating a Mixture Record .............................................................................. 253


Mixture Naming Convention (Recommended) ....................................................................... 254
Inserting a Mixture .................................................................................................................. 255
Mixture Fields .......................................................................................................................... 258
Inserting Mixture Components ............................................................................................... 262
Mixture Tabs............................................................................................................................ 265
Instructions .................................................................................................................................. 265
Comments Tab ............................................................................................................................. 267
Plans Tab ...................................................................................................................................... 268
Other Tab ..................................................................................................................................... 270

Mixture Pricing ............................................................................................... 273


Setting Minimum & Maximum Mixture Fee ........................................................................... 274
Setting a Flat Mixture Fee ....................................................................................................... 275
Mixture Breakdown................................................................................................................. 276
Component Quantity and Associated Cost .................................................................................. 276

Searching for Prescriber Records..................................................................... 279


Method 1: Searching for a Prescriber from the F7-Doctor Search Screen ............................. 280
Method 2: Searching for a Prescriber from the ALT+X Start Screen ...................................... 283
Method 3: Searching for a Prescriber from the F11-Drop Off Screen .................................... 286
Advanced Prescriber Search ........................................................................................................ 289
Inactive Prescriber Records ......................................................................................................... 291
Configuring the Columns in the Prescriber Search Screen .......................................................... 293

Creating a Prescriber Record................................................................................................... 294


Prescriber Records The Fields ................................................................................................... 296
Prescriber Record General Tab ................................................................................................. 300

Creating an Order ........................................................................................... 303


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Manual Order .......................................................................................................................... 306


Options from the Drug Order Screen........................................................................................... 307
Preview ........................................................................................................................................ 308

Min/Max Versus Days Supply Ordering .................................................................................. 309


Min/Max Pros and Cons .......................................................................................................... 310
Days Supply Pros and Cons ..................................................................................................... 311

Sending a Drug Order ...................................................................................... 313


Resending and Ordering.......................................................................................................... 314

Receiving a Drug Order ................................................................................... 316


Electronic Receiving ................................................................................................................ 317
Manual Receiving .................................................................................................................... 319

New Rxs .......................................................................................................... 321


Drop Off ................................................................................................................................... 322
Tracking a Work Order After Drop-Off ........................................................................................ 327

Input ........................................................................................................................................ 328


Filling ....................................................................................................................................... 340
Check ....................................................................................................................................... 342
Pickup ...................................................................................................................................... 343
Creating an OTC to Profile Record for New and Existing Patients ............................................... 343
Prescription Pickup for a Patient ................................................................................................. 348

Refill Rx .......................................................................................................... 351


Accessing Refillable Prescriptions from the F11 Drop-off Screen........................................... 352
Prescription Number is Known .................................................................................................... 353
Prescription Number is Not Known ............................................................................................. 354

Accessing Refillable Prescriptions from the F3 Patient Search Screen ................................... 357
Input ........................................................................................................................................ 359
Refill Rx: Filling ........................................................................................................................ 360
Check ....................................................................................................................................... 362
Unfill Rx (On Hold) ................................................................................................................... 363
Unfill Rx: Drop Off ................................................................................................................... 364
Unfill Rx: Enter ........................................................................................................................ 368

Modify Rx ....................................................................................................... 373


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Contents

Method 1: Enter Rx Number into the Universal Search Field ................................................. 374
Method 2: If the Rx Number is Not Known ............................................................................. 375

Copy Rx........................................................................................................... 377


Method 1: From the F11-Drop-Off screen .............................................................................. 378
Method 2: From the Patient Medication Profile .................................................................... 381
Copy Rx: Input ......................................................................................................................... 383

Cancel Rx ........................................................................................................ 384


Method 1: Cancel a Prescription from the ALT+X Start Screen .............................................. 385
Method 2: Cancel a Prescription from the Patient Medication Profile .................................. 386

Inactivate Rx ................................................................................................... 388


Reactivate Rx .................................................................................................. 391
Not Dispensed ................................................................................................ 392
Not dispensed: Drop- Off ........................................................................................................ 393
Not Dispensed: Enter .............................................................................................................. 394

Fee for Service Rx............................................................................................ 395


Drop Off ................................................................................................................................... 396
Input ........................................................................................................................................ 398

Transfer Rx ..................................................................................................... 400


Transfer Rx from Another Store .............................................................................................. 401
Drop-Off ....................................................................................................................................... 401
Input ............................................................................................................................................. 401

Transfer Rx to Another Store .................................................................................................. 403

Rx with LU code/Section /SSC/Special Auth # ................................................. 405


Rx with LU Code/Section /SSC/Special Authorization #: Drop-Off ......................................... 406

Rx with LU Code/Section /SSC/Special Authorization #: Input ......................... 408


Mixture Rx ...................................................................................................... 410
Drop-off ................................................................................................................................... 411
Input ........................................................................................................................................ 413
Filling ....................................................................................................................................... 415

Reports ........................................................................................................... 417


Daily Reports ........................................................................................................................... 418
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Contents

End of Day Report ........................................................................................................................ 419


Network Totals Report Adjudication Totals from Network ...................................................... 420

Weekly Reports ....................................................................................................................... 421


Adjudication Totals ...................................................................................................................... 422
Daily/Monthly Totals Report ....................................................................................................... 424
Plan Summary Report .................................................................................................................. 428

Other Reports .......................................................................................................................... 431


Claims Invoice Report .................................................................................................................. 432
Narcotic Report ............................................................................................................................ 438
Profit/Loss Report ........................................................................................................................ 440
Patient Medical History ............................................................................................................... 444
Tax Receipt Report ....................................................................................................................... 447
Rx for Drug / Doctor Group Report .............................................................................................. 450
Drug Inventory Listing Report ...................................................................................................... 457
Drug Inventory History Report..................................................................................................... 466
Rx Totals Report ........................................................................................................................... 471
Price Tree Report ......................................................................................................................... 480
Sig Code Report............................................................................................................................ 483
Future Usage Report .................................................................................................................... 486
Compliance Label Report ............................................................................................................. 487

Report Discrepancies Explained ...................................................................... 500


Fill Date versus Adjudication Date .......................................................................................... 501
Reversals and Net Totals ......................................................................................................... 502
Backdates ................................................................................................................................ 503
Claims Invoice Report.............................................................................................................. 504
Claims Invoice Report Options ..................................................................................................... 505
Tertiary Plans Imbalances ............................................................................................................ 506

Reconciling .............................................................................................................................. 507


Summary ................................................................................................................................. 508

NL DIS (Newfoundland Drug Information System) .......................................... 509


Creating DIS Users ................................................................................................................... 510
Searching for a Patient on the Network.................................................................................. 512
Scenario 1 New Patient (Does Not Exist on Local System) ....................................................... 512
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Contents

Scenario 2 New Patient (Does Not Exist on the Pharmacy Network) ....................................... 515
Scenario 3 Existing Local Patient (Not Synchronized to the Client Registry) ............................ 518

Adding a Patient Allergy to the Pharmacy Network ............................................................... 520


Adding Adverse Reaction to the Drug Information System .................................................... 521
Adding a Patient Allergy to the Pharmacy Network ............................................................... 522
Retrieving Allergies, Adverse Reactions & Conditions ............................................................ 523
Network Options from the Patient Card ................................................................................. 524
Verify Patient Demographics .................................................................................................. 525
Unfilled Profile......................................................................................................................... 526
Not Dispensed Profile.............................................................................................................. 527
Add Observation...................................................................................................................... 528
Add Patient Note ..................................................................................................................... 529
Add Professional Service ......................................................................................................... 530
Add Immunization ................................................................................................................... 531
Add Patient Password ............................................................................................................. 532
Synchronize Patient ................................................................................................................. 533
Unsynchronized Patient .......................................................................................................... 534
Extra Functions from the Patient Network Profile .................................................................. 535
Doctor Search for Existing Local Doctor Card ......................................................................... 536
Filling an Rx to the Pharmacy Network ................................................................................... 537
Filling a Prescription to the NL.DIS .......................................................................................... 538
Filling an Rx for a Device Using OPINIONS .............................................................................. 542
Filling a Prescription to NL.DIS for a Device ............................................................................ 545
Filling an Rx for a Mixture ....................................................................................................... 546
Filling a Not Dispensed Rx ....................................................................................................... 547
Stock Transfers ........................................................................................................................ 548
Filling a Stock Transfer ............................................................................................................ 549
Filling an Rx for an Out-of-Province Patient............................................................................ 552
Prescription Pick Up ................................................................................................................ 554
Pending Network Queue ......................................................................................................... 555

PEI DIS (Prince Edward Island Drug Information System) ................................ 556
Searching for Patients on the Network ................................................................................... 557
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Scenario 1: New Patient without PHN (Not in your Local Database) .......................................... 557
Scenario 2: New Patient with PHN (Not in your Local Database) ................................................ 561
Scenario 3: Existing Patient (In Your Local Database).................................................................. 563

Patient Network Profile ........................................................................................................... 565


DIS Workflow........................................................................................................................... 567
Processing an NL.DIS Prescription ........................................................................................... 568
Refill and Cancel Rules ............................................................................................................ 571
Create Local Rx ........................................................................................................................ 572
Refusal to Fill ........................................................................................................................... 573
Hold Rx .................................................................................................................................... 574
Release Rx ............................................................................................................................... 575
Revoke Dispensing Permission ................................................................................................ 576
Stop RX .................................................................................................................................... 577
Add Note ................................................................................................................................. 578
Retract ..................................................................................................................................... 579
Network Options from the Patient Card ................................................................................. 580
View Claim Log ........................................................................................................................ 581
Verify Patient Demographics .................................................................................................. 582
Unfilled Profile......................................................................................................................... 583
Not Dispensed Profile.............................................................................................................. 584
Add Observation...................................................................................................................... 585
Add Patient Note ..................................................................................................................... 586
Add Professional Service ......................................................................................................... 587
Add Immunization ................................................................................................................... 588
Add Keyword ........................................................................................................................... 589
View Network Access Log........................................................................................................ 591

SK PIP (Saskatchewan Pharmaceutical Information Program) ......................... 592


Kroll Passwords ....................................................................................................................... 593
Technician User Account Setup............................................................................................... 594
Associating Pharmacists to Technicians .................................................................................. 595
Store Configuration Requirements ......................................................................................... 596
Patient Allergies/Intolerances ................................................................................................. 597
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Deleting a Patient Allergy/Intolerance.................................................................................... 598


Synchronizing Network Allergies to the Local Kroll System .................................................... 599
Adding an Intolerance to an Existing Allergy Group ............................................................... 600
Supporting Information ........................................................................................................... 601
Unsynchronize ......................................................................................................................... 603
Retracting an Allergy ............................................................................................................... 604
Get History .............................................................................................................................. 605
View Network Access Log........................................................................................................ 606
PIP Portal ................................................................................................................................. 607
View Claim Log ........................................................................................................................ 608
Create Local Rx ........................................................................................................................ 609
Refusal to Fill ........................................................................................................................... 610
Hold (Suspend) Rx ................................................................................................................... 611
Release (Resume) Rx ............................................................................................................... 612
Revoke Dispensing Permission ................................................................................................ 613
Stop (Abort) Rx ........................................................................................................................ 614
Add Note ................................................................................................................................. 615
Retract Rx ................................................................................................................................ 616
Extra Functions for Not Dispensed Rxs on the Network ......................................................... 617
Update Other Medication ....................................................................................................... 618
Network Options from the Filling Screen................................................................................ 619
Filling SKPIP Prescriptions ....................................................................................................... 620
Cancelling an Rx....................................................................................................................... 624
Filling an Rx for a Device ......................................................................................................... 625
Filling an Rx for a Mixture ....................................................................................................... 626
Transferring an Rx to Another Pharmacy ................................................................................ 627
Filling an Rx using an NPN ....................................................................................................... 628
Filling an Rx for an Animal ....................................................................................................... 629
Filling an Rx for Out of Province Patient ................................................................................. 630
Filling an Rx for Stock Transfers .............................................................................................. 631
Sending Indications to the Network........................................................................................ 632
Prescription Pick Up ................................................................................................................ 633
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Marking a Prescription as Picked Up from the Patient Profile ............................................... 634


Marking a Prescription as Picked Up from Workflow ............................................................. 636
Patient Network Audit Report ................................................................................................ 637
Failed Provincial Claims Flat File Report ................................................................................. 638
What Happens When PIP Goes Down..................................................................................... 639
What to do When PIP Comes Back UP .................................................................................... 640

Professional Services Alberta ....................................................................... 641


Alberta Clinical Pharmacy Services Program .......................................................................... 642
Clinical Pharmacy Services ........................................................................................................... 642
Drugs Used ................................................................................................................................... 642
PINs .............................................................................................................................................. 644
Special Service Codes ................................................................................................................... 645
Filling an AB Clinical Pharmacy Services Rx.................................................................................. 646
Setting up the Doctor Card .......................................................................................................... 647

Professional Services British Columbia ......................................................... 651


British Columbia Prescription Adaptation ............................................................................... 652
Setting up the Doctor Card .......................................................................................................... 652
Filling a Prescription for British Columbia Adaptation................................................................. 653
Reporting British Columbia Adaption .......................................................................................... 661
British Columbia Medication Reviews: Claiming Fees ................................................................. 664
Sending a Medication Review Service to PharmaNet.................................................................. 664

Professional Services New Brunswick ........................................................... 666


Billing for NB Medscheck ........................................................................................................ 667
Documentation Requirements ................................................................................................ 671

Professional Services Saskatchewan............................................................. 673


SK Prescriptive Authority......................................................................................................... 674
Generating Documentation for Saskatchewan Prescriptive Authority Service Prescriptions 676
Billing an Rx for an Saskatchewan Prescriptive Authority Service DIN ................................... 681
Saskatchewan PACT Program.................................................................................................. 683
Eligible Clients ......................................................................................................................... 684
Filling PACT Prescriptions ........................................................................................................ 685
PACT Labels .................................................................................................................................. 691
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Professional Services Ontario ....................................................................... 694


Prescription Authority ............................................................................................................. 695
Requirements for a Pharmacist Authorized Refill: ...................................................................... 695
Conditions for a Pharmacist Authorized Refill ............................................................................. 695
Creating a Pharmacist-Prescriber in Kroll .................................................................................... 696
Filling a Pharmacist Authorized Refill in Kroll (Adaptation) ......................................................... 697

ODB Expanded Services........................................................................................................... 705


Reasons for a Clinical Intervention: ............................................................................................. 705
Outcomes ..................................................................................................................................... 705
Documentation Requirements .................................................................................................... 706

Billing the Expanded Service to ODB ....................................................................................... 707


Creating a Pharmacist-Prescriber in Kroll .................................................................................... 707

Billing the Expanded Service Prescription ............................................................................... 709


Ontario Smoking Cessation Program ...................................................................................... 711
Eligibility ....................................................................................................................................... 711
Pharmacist Education .................................................................................................................. 711
Pharmacist Payment and Program Evaluation ............................................................................ 712
Readiness Assessment ................................................................................................................. 712
Primary Follow-Up Session .......................................................................................................... 713
Secondary Follow-Up ................................................................................................................... 714
Program Evaluation...................................................................................................................... 715
Successful Quit ............................................................................................................................. 715
Unsuccessful Quit ........................................................................................................................ 716
Unknown Status/Program Withdrawal........................................................................................ 717
Billing ODB for Smoking Cessation............................................................................................... 718

ODB MedsCheck (Medication Review) ................................................................................... 721


Submitting an ODB Meds Check Claim for an ODB Recipient ..................................................... 722
Submitting an ODB Meds Check Claim for an Non-ODB Recipient ............................................. 723
Good Faith Intervention............................................................................................................... 724

ODB Medscheck Lost Opportunities Report ........................................................................... 725


Configuring the Drug Utilization Audit Report............................................................................. 725

Professional Services Nova Scotia ................................................................ 730


Advanced Medication Review Service (AMRS) ....................................................................... 731
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Claims Submission........................................................................................................................ 731


Basic Medication Review Service ................................................................................................. 732
Claims Submission........................................................................................................................ 732
Therapeutic Substitution ............................................................................................................. 732
Claims Submission........................................................................................................................ 733
Billing MSI for Payment................................................................................................................ 734

BC PharmaNet in Krollwin ............................................................................... 737


Searching for a Patient by PHN ............................................................................................... 738
Searching for a Patient by Name............................................................................................. 740
Adding Out-of-Province Patients and Infants with Unassigned Personal Health Numbers ... 743
Out-of-Province Patients ............................................................................................................. 743

Infants...................................................................................................................................... 746
Filling for Pets .......................................................................................................................... 747
Viewing a PharmaNet Patient Profile...................................................................................... 749
Viewing Rxs Dispensed by Other Pharmacies ......................................................................... 750
Performing Request Profile Mailing ........................................................................................ 755
Performing a Local Profile Request ......................................................................................... 758
Drug Card................................................................................................................................. 763
Drug Search .................................................................................................................................. 764
Pat Info Long ................................................................................................................................ 766
Pat Counselling............................................................................................................................. 767
Professional Counselling .............................................................................................................. 768

Doctor Card ............................................................................................................................. 769


Searching for a Doctor ................................................................................................................. 770
Non Prescription Medication / OTC ............................................................................................. 773

Prescription Filling ................................................................................................................... 774


Stock Transfers ........................................................................................................................ 776
Discontinuing (Inactivating) an Rx ........................................................................................... 778
Discontinuing a Single Rx ............................................................................................................. 779
Discontinuing Multiple Rxs .......................................................................................................... 780

Cancelling a Prescription ......................................................................................................... 782


Refusal to Fill ........................................................................................................................... 783
Batching Procedures for PharmaNet Down ............................................................................ 786
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Ontario Limited Use and Section 8 ............................................................... 788


Adding LUP Drug to a Patient Profile ...................................................................................... 789
Filling a Prescription for an LUP Drug ..................................................................................... 791
Limited Use Request Report ................................................................................................... 793

Ontario Narcotic Monitoring Program ............................................................ 796


Monitored Drugs ..................................................................................................................... 797
Drug Card................................................................................................................................. 798
Mixtures .................................................................................................................................. 799
Billing a Narcotic Monitored Drug .......................................................................................... 801
Existing ODB Coverage ................................................................................................................. 801

Filling a Prescription with No Existing ODB Coverage or ONNMS Plan Entry ......................... 803
Reversals.................................................................................................................................. 808
Responses from ONNMS ......................................................................................................... 809
Dentists and ONNMS............................................................................................................... 810
Drug Utilization Review Warning Response Codes ................................................................. 811
Future Dating........................................................................................................................... 812
Back date Rxs........................................................................................................................... 813
Inquiry Functionality ............................................................................................................... 814
Nursing Home.......................................................................................................................... 815
Placing Monitored Rxs on Hold ............................................................................................... 816
Narcotic Rx Exceptions ............................................................................................................ 817
Narcotic Rxs for Prisoners and Inmates ....................................................................................... 817
Monitored Rxs for In-patients of a Public Hospital...................................................................... 818
Monitored Rxs for Residents of Long-Term Care Homes ............................................................ 818
Monitored Rxs for Animals .......................................................................................................... 818

Appendix 1: Cardholder IDs provided by the Ministry of Health ............................................ 819

Nova Scotia Prescription Monitoring Program ................................................ 820


How the NSPMP Program Works ............................................................................................ 821
NSPMP Guidelines ....................................................................................................................... 821
Requirement to Register with NSPMP ......................................................................................... 821
Handling Part-Fills ........................................................................................................................ 822
Prescriptions Not Entered into the Online System ...................................................................... 822
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Health Card Types and Numbers ............................................................................................ 823


Methadone Compounds ......................................................................................................... 824
Compounding PINS ...................................................................................................................... 824
Double DINS ................................................................................................................................. 825

Long-Term Care Facilities ........................................................................................................ 826


Federal Penitentiary Inmates .................................................................................................. 827
Office Use Prescriptions (NSOU) ............................................................................................. 828
Seafaring Ships ........................................................................................................................ 829
Stolen Pad Messaging (RUA) ................................................................................................... 830
Void Messaging (RUC) ............................................................................................................. 831
Filling a PMP Prescription........................................................................................................ 832
Troubleshooting PMP scripts .................................................................................................. 836

Who to Call Phone List .................................................................................... 838

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Document Conventions

Kroll Window 9.0 User Manual


Logging In and Out of Kroll
Logging in to Kroll
2. Double click on the Kroll Icon located on your desktop
3. Wait for the login window to appear.
4. Enter your Initials & Password into the appropriate fields and click OK or press Enter on the
keyboard.

NOTE: The Kroll Session Manager will be added to the windows taskbar.

Kroll Windows version 9.0 | User Manual

Logging In and Out of Kroll

Logging Out of Kroll


There are two ways to log out of the system:

Method 1 Using the File Option


1.

Click on the File dropdown menu or press ALT+F on the keyboard

Figure 1 File Option

2. From the File menu select the Exit command. The following window will appear:

Kroll Windows version 9.0 | User Manual

Logging In and Out of Kroll

3. Answering Yes will prompt the next question:

4. Answer Yes to print a day end label

Kroll Windows version 9.0 | User Manual

Logging In and Out of Kroll

Sample Day End Label:

Figure 2 Day End Label

If you answer Yes or No to exit the system without a day end summary, you will be prompted
with a final message:

Follow the above instructions to log out of all Kroll sessions.

Kroll Windows version 9.0 | User Manual

Logging In and Out of Kroll

NOTE: It is not necessary to print the day end totals or network totals for each
session; one printout of each report will include all Rxs for the day.

Method 2 Using the X Option


Click the X on the top right side of your Kroll session to exit the system with the prompts
mentioned above.

Kroll Windows version 9.0 | User Manual

Permissions

Permissions
The Permission settings in Kroll can be configured to allow or prevent access to certain areas
within the software to specific User Groups. Each user group can be assigned a unique set of
permissions.

Accessing the Group Permissions Form


1. Go to File > Configurations > Permissions and select the group you want to set permissions
for.

NOTE: Only managers can perform this function.


2. Select a User Group from the Group dropdown menu.

NOTE: To add additional user groups, go to User Groups > Edit > Users and Groups.
3. Enter your initials and password.

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The Edit Permissions form will appear for the group you have selected.

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Permissions

Group Permission Descriptions


View Clinical Info
This setting controls whether the user has access to view any patient related drug information.
When this option is unchecked, the user will not have access to view patient allergies and
conditions, patient profile, or F12 Filling screen. The user can access individual drugs and
doctors, but not as it pertains to a specific patient.

Allow Viewing Rx Screen


When unchecked, you will not be able to access the F12 Filling screen. This will prevent you
from entering or refilling any prescriptions.

View Patient
When unchecked, you will not be able to search for or access any patient files where address,
plan numbers, allergies/conditions, etc., are contained. You will still have the ability to refill
prescriptions, but not to fill a new prescription as this requires patient selection verification.

Allow Patient Changes


When unchecked, you will not have permissions to change any information on the F3 Patient
card. You will still be able to fill new and repeat prescriptions.

View Doctor
When unchecked, you will not be able to search or access any doctor files where license
number, designation, phone/fax, etc., are contained. You will still be able to refill prescriptions,
but you will not be able to fill a new prescription, as this requires doctor selection verification.

Allow Doctor Changes


When unchecked, you will not have permissions to change any information on the F7 Doctor
card. You will still be able to fill new and repeat prescriptions.

View Drug/Mixture
When unchecked, you will not be able to search for or access any drug/mixture files where DIN,
strength, on hand value, etc. are contained. You will still have the ability to refill prescriptions,
but you cannot fill a new prescription as this requires drug/mixture selection verification.

Allow Drug/Mixture Changes


When unchecked you will not have permissions to change any information on the F5
Drug/Mixture card. You will still be able to fill new and repeat prescriptions.

Allow Drug Bases Changes


When unchecked, intrinsic drug information such as DIN, generic name, drug description,
strength, etc. is grayed out and unavailable for any changes. You will still be able to change
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Permissions

variable drug information like pricing, on hand, order configurations, etc.

Allow Adding New Drugs


When unchecked, you will not have the ability to add or copy a new drug into the database.
You will still have permission to add a new pack size to an existing drug in the system.

Allow Drug Price Changes


When unchecked, the five price fields located on the F5 Drug card will be grayed out and
unavailable for changes. All other F5 Drug fields will be open for changes.

Allow Drug Inventory Changes


When unchecked, the On Hand and Min/Max/Days fields will be grayed out and unavailable
for changes. As well, the No Inventory Adjustment and Disable Automatic Ordering flags
located in the Ordering tab of the F5 Drug card will be grayed out. This prevents you from
making any adjustments that can affect inventory.

Allow Custom FDB Changes


When unchecked, the ability to make customized FDB changes to Counseling Messages, Kroll
Care or Auxiliary Labels is removed from the drug card.

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Permissions

Allow Creation of Purchase Orders


When unchecked, you will not have permissions to generate or send purchase orders by
accessing Utilities > Drug Ordering > Generate Orders. You will still be able to manually place a
drug order by clicking Place Order from the F5 Drug card or by going to Rx > Order Drug from
the F12 Filling screen.

View Financial Reports


When unchecked, you will be denied access to the following financially sensitive reports:
Patient Reports
Medical Expense
Patient Drug Summary
Patient Mailing List
Rx Reports
Network Totals Adjudication Totals Claims Invoice

Compound Prescription Audit Report Coughlin Import


Daily/Monthly Totals
NIHB Claims Invoice

Plan Billing Summary Plan Breakdown Plan Discount Report Plan


Summary
Prescription Sales Analysis

Price Strategy Summary Profit/Loss


Rx Breakdown

Rx for Drug/Doctor Groups Rx Summary

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Permissions

Rx Totals Report
Special Services Fee Report
Time Distribution Report

Drug Reports
Drug Inventory Listing Report
Drug Listing Report
Drug Price Change Report
Drug Usage Report
Generic Sales Analysis Report
Inventory Report
Nursing Home Reports
Nursing Home Drug Usage Report
Nursing Home Drug Utilization Report
Administration Reports
AR Adjustments Audit Report
Pre-Authorized Charges Report
Submitted/Received Difference
Other Reports
Mailing List Report

Network vs. Adjudication Totals Pre-Authorized Charges Report Price Tree


Report

Weekly Comparison Report Workflow Data Report

Old Reports
Old Daily Totals
Old Monthly Totals

View Non-Financial Reports


When unchecked, you will be denied access to the following financially insensitive reports:
Patient Reports
Active Drug Listing Report Compliance Label

Drug Interaction Analysis Report Eligibility/Physician List

Limited Use and Section 8 Expiry Report Limited Use Request

MAR Pak Report Medical Expense Invoice Medical History Medication

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Permissions

Sheet
Patient (Comments Report)
Patient Encounters Report

Patient Limited Use Report Patient Listing Report Patient Medical


Conditions Patient Medication Chart Patient profile Report Persa-Kit
Plain Paper MAR
Plain Paper TMR
Section 8 Request

Shipping Report Tax Receipt

Rx Reports
Daily/Weekly Workload Report

DUR Letter Report


DUR Repot
Future Usage Report
Hardcopy Report
Narcotic Control Record
Narcotic Rx Request Report
Refills Due
Rx (Comments Report)
Rx Stop/Expiry
Rx Transfers Report
Therapeutic Class Report

Drug Reports
Drug (Comments Report)

Drug Inventory History Report


Drug Utilization Audit Report
Narcotic Report
Doctor Reports
Doctor (Comments Report)

Doctor Prescribed Med Report


Doctor Rx Filled Report
Patient/Primary Prescriber Ratio List
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Permissions

Nursing Home Reports


Active Drug Listing Report

Nursing Home (Comments Report)


Nursing Home Passtimes Report
Nursing Home Patient Listing Report
Nursing Home Patient Statistics
Standing Orders Recall Report

Administration Reports
User Information Report
Other Reports
AR (Comments Report)

Comments Report
Delivery Order Summary Report
ToDo Report
Old Reports
Old Dispill (Style 1) Report

Old Dispill (Style 2) Report


View AR Information
When unchecked, you are denied access to the Patient AR Profile screen (Patient > View AR
Profile, or CTRL+R).

Add AR Charges
When unchecked, the user will not have permissions to charge items to a patients Accounts
Receivable profile (CTRL+R). You will still be able to view, edit, and delete charge items.

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Permissions

Edit/Delete AR Charges
When unchecked, you will not have permission to edit or delete charge items from a patients
Accounts Receivable profile (CTRL+R). You will still be able to view and add a charge item.

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Permissions

Add AR Payments
When unchecked, you will not have permissions to add payment items to the Payments tab of
the patients Accounts Receivable profile (CTRL+R). You will still be able to view, edit, and
delete a payment item.

Edit/Delete AR Payments
When unchecked, you will not have permissions to edit or delete payment items from the
Payments tab on the patients Accounts Receivable profile (CTRL+R). You will still be able to
view and add a payment item.

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Permissions

Run AR Reports
When unchecked, you will be denied access to the following accounts receivable (AR) reports:

AR Adjustments Audit Report


AR Taxes Breakdown Report

View Credit Card Information


When unchecked, you will not be able to view, add, delete or edit credit card entries listed in
the F3 Patient card (Patient > View Credit Cards).

Allow Credit Card Password Management


When checked, this permission allows you to access the Credit Card Password Manager located
in the Utilities dropdown menu. This enables you to setup a global credit card access password
to be used by all pharmacy staff. This setting should be reserved for the pharmacy manager, or
other high ranking pharmacy staff.

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Permissions

Allow Clinical Warning Override


This permission allows you to proceed against drug-drug interactions, drug-disease interactions,
allergy warnings, etc., that appear subsequent to FDB analysis. This setting should be reserved
for pharmacists only.

Allow Patient/Doctor Merges


When unchecked, you will not be able to merge duplicate patient, drug, or doctor files from the
merge function located in Utilities > Merge. You will still be able to merge Transfer Stores.

Allowing Viewing History Records


History Records documents the date, time, and user for all changes made to fields in the F3
Patient, F5 Drug, or F7 Doctor cards. When this permission is unchecked, you will not have
access to view changes from Patient > View History, Drug > View History, or Doctor > View
History.

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Permissions

Allow Use of Drug Update Utility


This permission allows the user to update drug configurations and drug fields for multiple drug
cards at once. When unchecked, you will not have access to use the Drug Update Utility
located in Utilities > Drug Utilities.

Allow Manual Communication Queue Changes


This permission setting is only applicable in stores with the Kroll Outbound Call Module (OCM)
activated. When unchecked, it prevents you from performing manual changes to the
communication queue located in Utilities > Communication Management > Create
Notifications.

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Permissions

Maintenance Permissions
Change Plans
When unchecked, the Plans tab in Edit > Plans/Pricing is removed from view, preventing
you from accessing or viewing plan information like provider ID, plan pricing, billing number
setup, etc.

Change Pricing
When unchecked, Strategies, Strategies Exceptions, Drug Price Groups, Patient Price Groups,
and Copays tab is removed from Edit > Plans/Pricing to prevent changes to existing pricing
configurations.

Change Master Lists


This setting configures the options available for selection in dropdown menus within Kroll (e.g.
a phone description has a master list containing Cell, Fax, Home, and Office). When this
permission setting is unchecked, you will not have access to configure any of the dropdown lists
located in Edit > Lists > Master Lists.

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Permissions

Change Users
When unchecked, you will not have access to Users and Groups (Edit > Users and Groups)
where Kroll users are added/removed, and group permissions are assigned.

Change Sig Codes


When unchecked, you will not be able to add, edit, or delete SIG codes from Edit SIG Codes
(Edit > Edit SIG Codes). You will still be able to print a Sig Code Listing from Reports > Other.

Change Vendor List


When unchecked, you will not be able to access Utilities > Drug Ordering > Edit Vendor List.
The Vendor List contains information such as customer account number, ordering/receiving
settings, catalog load parameters, etc.

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Permissions

Change Nursing Homes


When unchecked, you will not be able to view, edit, delete, or add nursing home information
from the nursing home list (Nursing Home > Edit Nursing Home List). The nursing home (NH)
form contains information on filling cycles, label/reports configurations, unit dose packaging
settings, etc.

Change Adjudication Config


When unchecked, you will not be able to access adjudication configurations from File >
Configurations > Adjudication. This area sets the adjudication routes that plans send claims
through.

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Permissions

Change Workstation Config


When unchecked, you will not be able to access workstation configurations from File >
Configuration > Workstation. This configuration controls printer settings, input devices (i.e
scanners and cameras), and backup location.

Change Store Config


When unchecked, you will not be able to access any store configurations from File >
Configurations > Store. Store configurations control a multitude of settings including, but not
limited to label configurations, FDB Settings, security logging, prescription prompting, etc.

Change Services Config


When unchecked, you will not be able to access and service configurations from File >
Configuration > Services.

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Permissions

Change Workflow Config


When unchecked, the user will not have access to File > Configuration > Workflow > Edit
workflow queues, Edit workflow Action Names, Edit Workflows, or the Edit Workflow
selection Matrix.

Change Central Fill Config


When unchecked, you will not have access to Central Fill > Configuration.

NOTE: This option will appear on your system only if you have paid for the
Central Fill Module.

Change Province
When unchecked, you will not be able to change the province that the Kroll system is working
in from File > Configuration > Set Province.

Change User Permissions


When unchecked, you will not have access to File > Configuration > Permissions.

Change Mail Distribution Lists


When unchecked, you will not be able to alter or change the users in the mail distribution list
from File > Configuration > Mail Distribution.

Manager
When checked, this option signifies that the user group is a managers group.

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Associating Assistants & Pharmacists

Associating Assistants & Pharmacists


Assistants working within the dispensary must be associated with a pharmacist in order to
process prescriptions because Third Party and Drug Information System (DIS) claims submission
requires assistants to be associated with the acting pharmacist in order for the pharmacist
license number to be submitted as a part of the claim record.
Associating Assistants to Pharmacists:
1. Click on the File dropdown menu or press ALT+F on the keyboard.
2. Click Users or press U on the keyboard.
3. From the sub-menu, click User Pharmacist or press A on the keyboard; this will display the
Pharmacist Association Form.

Figure 3 Users associating with Pharmacist

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Associating Assistants & Pharmacists

4. The pharmacist must enter their Initials and Password into the applicable fields.

Figure 4 Pharmacist Association Form

5. Optionally change the expiry time of the association; the expiry automatically defaults to
23:59 (i.e. 1 minute before midnight).

NOTE: Association cannot extend past the current day; therefore, association must
be performed daily by the acting pharmacist(s).
6. Place a checkmark next to the assistant(s) working with the pharmacist by clicking the
checkbox to the left of the user initials, or highlight the user line-entry and press the
Spacebar.
7. Finalize the association by clicking User, or by pressing Enter on the keyboard; this will
automatically close the Pharmacist Association Form.
Users can optionally check on the association status by accessing File Users User
Pharmacist.

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Disassociating Assistants from Pharmacists

Disassociating Assistants from Pharmacists


Pharmacists can disassociate from assistant(s) as follows:

NOTE: Once disassociated, the assistant(s) will need to user with another pharmacist
in order to continue processing prescriptions.
1. Click on the File dropdown menu or press ALT+F on the keyboard.
2. Click Users or press U on the keyboard.
3. From the sub-menu, click Disassociate Pharmacist or press D on the keyboard.

Figure 5 - Users disassociating with Pharmacist

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Disassociating Assistants from Pharmacists


4. The pharmacist will be prompted to enter their Initials and Password to complete the
disassociation.

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Start Screen

Changing a User Password


Users have the ability to change their Kroll passwords as follows:
1. Click on the File dropdown menu or press ALT+F on the keyboard.
2. Click Users or press U on the keyboard.
3. From the sub-menu, select the option to Change Password or press P on the keyboard.

Figure 6 Changing a User Password

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Start Screen

Managing Multiple Sessions


Users can open multiple sessions on any terminal. This allows users to work and access data
without having to exit from their current screen. Users can see what session they are on by
looking at the upper-left hand corner of the screen. Pressing ALT+Esc or ALT+Tab will allow
users to switch from session to session on the terminal.
WARNING: It is not recommended to have more than 3 sessions open on any terminal
because this can slow down computer processing times.

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Start Screen

Start Screen
The Start Screen is displayed when a user successfully logs into a Kroll session; note that
multiple sessions can be opened on one terminal, but it is not recommended to have more than
3 sessions per terminal as this may slow down computer processing times.

Figure 7 Start Screen

The Start Screen is where all main functions can be accessed; it is considered the home base
of the Kroll Pharmacy Software. Pressing ALT+X on the keyboard will always return to this
window. The Start Screen is broken down into the following key sections:
1. Function Keys
2. Universal Search Field
3. Menu Options
4. Dashboard Icons

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Start Screen

Function Keys
The Function Keys (i.e. F3, F5, F7, F9, F11, and F12) are located directly below the menu
options. These keys are explained in detail in later sections of this user manual.

Figure 8 Function Keys

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Start Screen

Universal Search Field


The Universal Search Field is used to search for patients, drugs, prescribers, and prescriptions.
It is located right below the F3-Patient button in the upper left corner of the ALT+X Start
Screen.
In the Universal Search Field, enter search criteria for a patient, drug, prescriber or Rx, and
press the corresponding function key to obtain search results that match the criteria entered.
For example, users can enter a patients phone number and press F3-Patient to search for
patient records with that phone number, or enter a DIN and press F5-Drug to search for the
associated drug record.

Figure 9 Universal Search Field

Users can also enter a prescription number (Rx) or transaction number (Tx) into the Universal
Search Field and choose one of the following options:

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Start Screen

Figure 10 Universal Search Field-1

F11-Drop-Off:
Refill the prescription

Modify Rx:
Modify the most recent Tx in the Prescription Chain without generating a new transaction
number when possible (e.g. Add missing repeats to a prescription).

Reprint Rx:
Displays options for the user to reprint vial labels, hardcopies, Kroll Care, privacy labels, and
receipts for the most recent Tx in the Prescription Chain.

Cancel Rx:
Allows users to reverse a prescription

Modify Specific Rx #:
Modify a Tx that is NOT the most recent Tx in the Prescription Chain.
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Start Screen
Reprint Specific Rx #:
Displays options for the user to reprint vial labels, hardcopies, Kroll Care, privacy labels, and
receipts for an Rx that is NOT the most recent Tx in the Prescription chain.

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Start Screen

Menu Options
The menus located across the top of the window (File, Edit, Reports, Cards, etc.) can be
accessed by clicking on the word with the mouse, or by pressing ALT and the underlined letter
(e.g. ALT+F to access the File dropdown menu).

Figure 11 Menu Options

File/Edit:
The File and Edit menus contain commands used for configuring and managing the Kroll
Pharmacy Software. Since a large majority of system configurations will be centrally
maintained, users will rarely have to access these two menus unless otherwise specified.

Reports:
The Reports menu contains a comprehensive list of Kroll reports. This menu is organized into
categories for quick access to desired reports. Reports will be discussed in more detail in latter
sections of the User Guide.

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Start Screen
Cards:
The Cards menu is a reiteration of the function keys (i.e. F3, F5, F7, F9, F11, and F12). Clicking
on one of the commands in this menu is equivalent to pressing the associated function key on
the keyboard.

Utilities:
The Utilities menu contains supplementary features of the system including Drug Ordering,
Interactions Checking, Patient Merge, Drug Merge, Quick Price, Print Free Form Labels, etc.

Sessions:
The Sessions menu allows users to open and manage multiple Kroll sessions from one terminal.
See section on Getting Started Managing Multiple Sessions.

Help:
The Help menu provides access to on-screen help and diagnostic tools.

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Start Screen

Dashboard Icons
There are 7 Dashboard Icons located on the system Start Screen:

Figure 12 Dashboard Icons

Each icon provides access to tools that support pharmacy operations; when used properly,
these tools help improve patient care. Note the numbers in the red circles indicate the number
of entries listed under the specific dashboard icon (e.g. there are 2 entries listed under the
Callbacks Icon). The following subsections will provide an introduction to the functionalities
available under each icon.

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Start Screen

Workflow Icon
The Workflow Icon is the default view for the Start Screen; it displays prescriptions that are
overdue, approaching due time, or in the Trouble queue. The Workflow window allows users to
quickly determine the number of Rxs approaching due time at each prescription processing
stage

Figure 13 Rx Work in Progress

Rx Counts are also displayed under the Workflow screen. Users can quickly access the screen to
view how many New Rxs, Repeat Rxs, Cancelled Rxs, and Total Rxs were filled for that day; the
count resets at 12:00am daily.

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Start Screen

RX Counts
The Details button located directly below Rx Counts information provides additional
prescription related totals including prescription number range, dollar value breakdown, and
third party adjudication totals. Users can enter a previous date in the Totals for Date field and
click Recalculate or press Enter on the keyboard to view totals for the inputted date.

Figure 14 Rx Totals Form

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Start Screen

Scan
The Scan Icon displays images that have been scanned into the system via the document
scanner. From the scan window, users can select to view images that were scanned into the
system for a specific number of days (e.g. From the last _7_ days).
The left side of the screen displays a list of entries representing images that were scanned into
the system. Users can highlight an entry on the left side of the screen and the corresponding
digital image will appear on the right. Once an image is highlighted, users can perform one of
the following actions:
1. Add New Rx for Script Image Create a new Rx work order for the Image
2. Add to Patient Documents Attach and save an image to a patient record through Patient
Documents.
3. Send as Mail Send the image via email
4. Print - Print the image
5. Delete Image Delete the image
6. Zoom: Shrink or enlarge the image.

NOTE: Click F5-Refresh or press F5 on the keyboard to ensure that the most recently
scanned prescriptions are displayed in the list.

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Start Screen

Figure 15 Scan

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Menu Options

Callbacks
The Callback Icon displays communications initiated from the system to prescribers. An entry is
automatically created in the Callback list whenever one of the following actions is initiated from
the system:
The Add to Doctor Callbacks command is selected from the Extra Functions menu in the
Patient Medication Profile.
The Doctor Authorization Report (a.k.a. Fax Doctor Report) is printed or previewed from the
system.

Figure 16 Doctor Authorization Report

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Menu Options

The Call Doctor function is selected from the F12-Filling screen under the Rx dropdown
menu.

Figure 17 Call Doctor Function

From the Callback screen users can choose to view callback entries generated for a specific
Date Range:
Current+ x days = Displays entries that are currently active as well as those that are
scheduled to become active x number of days.
All = Displays all entries, historical and current.
History+ x days = Displays entries that have been resolved for x number of days.
Filter results further by accessing the Doctor dropdown menu (CTRL+O) to view callback
entries generated for a specific prescriber.

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Menu Options

Figure 18 Status of a Callback Entry

The status of a callback entry can be managed by highlighting an entry and selecting one of the
following options:

C (Mark as Call Doctor)


Select this option to indicate that a phone call needs to be made to the doctor for the
highlighted entry. When this option is selected, the user will be presented with a comment box
that allows them to Specify a comment for the doctor callback.

O (OK Refills)
Users can select this option to add prescription repeats to an entry. Once repeats have been
added, the status of the entry will change to Doc Okayed.

F (Fill)
The F (Fill) option is only available for callback entries with a status of Doc Okayed. When this
option is selected, users will be presented with the following choices:

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Menu Options

1. Copying the entry to a new Rx number will create a new Rx Work Order
2. Apply repeats to the existing entry
3. Ignore changes = do nothing

W (Mark as Waiting)
This option changes the status of a callback entry to Wait for Doc.

R (Refuse Refills)
Select this option if the prescriber has declined the pharmacys request for repeats on behalf of
the patient. Selecting this option will change the status of the callback entry to Doc Refused
and add an entry under the Follow-ups Icon to remind the user to contact the patient and let
them know their request for repeats was refused.

D (Summarize Doctor)
Selecting this option will display the address, phone number and fax number of the prescriber
listed in the callback entry. This option makes it easy to access contact information for the
prescriber.

Print Report
Selecting this option will allow users to print the To Do Report. This report can be used to
identify outstanding/resolved notes, refills, follow-ups, and doctor callbacks.

NOTE: Callback entries generated from printing/previewing the Doctor


Authorization Report will automatically be removed from the list when the Rx(s) are
refilled using the Copy Rx function. The system recognizes that the authorization
request has been resolved through the act of copying the old Rx to a new Rx number.
Regular maintenance of the Callback screen is essential for ensuring that entries in the list are
relevant to pharmacy operations for that day. For example, entries that have been resolved or
have become irrelevant need to be deleted so that only current and active entries are
displayed.

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Menu Options

Follow Ups
The Follow-ups Icon displays entries that serve as reminders to follow up with patients
regarding a specific matter; the actual follow up can be performed via phone call or face-to-face
interaction. Follow up entries can be added as follows:
Manually add a follow up entry by clicking INS or pressing Insert on the keyboard from the
Follow Ups window.

Figure 19 Patient Note

The Patient Note screen has a number of options which are explained below:

Due Date/Time
Select when the follow-up is due to occur.

Reoccurring Follow-up
Patient follow-ups can be configured to re-occur every x number of days.

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Menu Options
Patient
Depending on how the follow-up entry was added, the patient field may or may not be
populated. If the patient field is empty, click F2 or press F2 on the keyboard to search and insert
a patient record into the follow-up entry.

Entered by
Users can enter their initials to identify the author of the follow-up entry. The initials are
defaulted to the user who opened the session but can be overwritten.

Resolved by
Users can enter their initials to confirm a follow-up has been completed. Once a follow-up has
been resolved it can only be accessed by setting the date range to History + ___days.

Comment
Details of the patient follow-up can be recorded in the Comment field.
Mark a Callback entry as Doc Refused. When a prescriber refuses to authorize repeats for a
patient, the pharmacy needs to follow-up with the patient so they can make other
arrangements to obtain their medication.
From the Follow Ups window users can choose to view entries generated for a specific Date
Range:
Current+___ days = Displays follow-up entries that are currently active as well as those that are
scheduled to become active in x number of days. <Blank> will display follow-up entries due
today.
All = Displays all follow-up entries; historical and current.
History+___ days = Displays follow-up entries that have been resolved x number of days ago.

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Menu Options

Add a patient encounter from the patient record and flag it as a follow up.

Figure 20 Adding a Patient Encounter

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Menu Options

Notes
The Notes Icon is a communication tool used by pharmacy users to communicate with each
other. The intention is to reduce paper clutter within the dispensary by using a system
supported function that facilitates user-to-user communication.
For example, the pharmacist may wish to leave a message for the afternoon assistant indicating
that drug expiry checking should be continued to the second to the third bay; the pharmacist
can relay this message to the assistant by inserting an entry into the notes section.

NOTE: The key to using the notes function effectively is to ensure that pharmacy
users look under the Notes Icon for messages from their team members.

Figure 21 Notes To Do Note

From the Notes window, users can choose to view note entries generated for a specific Date
Range:
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Menu Options

Current+___ days = Displays notes entries that are currently active as well as those that are
scheduled to become active in x number of days. <Blank> will display note entries due today.
All = Displays all note entries; historical and current.
History+___ days = Displays note entries that have been resolved x number of days ago.
Users can add an entry to the notes section by clicking INS, or by pressing Insert on the
keyboard to bring up a To Do Note screen. Any message relating to pharmacy operations can
be inputted here for all users to view.
The To Do Note screen has a number of options which are explained below:

Due Date/Time
Users can select when the note entry will become active. Active notes contribute to the
running count on the Notes Icon.

Reoccurring Notes
Notes can be configured to re-occur every x number of days.

Entered by
Users can enter their initials to identify who created the note; the initials are defaulted to the
user who opened the session but this can be overwritten.

Resolved by
Users can enter their initials to confirm that a note has been read or acknowledged. Once a
note has been resolved it can only be accessed by setting the date range to History +
___days.

Comment
Responses or general comments regarding the note can be entered in the comments field.

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Menu Options

Mail Icon
The Mail Icon is an internal email system built within the Kroll Pharmacy Software. The Mail
Module is the tool Head Office will use to send fan out messages to pharmacy users for
various communications including, but not limited to, provincial network broadcasts.

Figure 22 Mail Icon

The red number beside the mail icon indicates the number of unread messages available for the
user that is currently logged into the system. Clicking on the Mail icon will invoke the Mail
system to start up.
As long as a user is set up in the Kroll Pharmacy Software, they will have the ability to send a
message to another local system user. Namely, pharmacists and assistants within a particular
pharmacy will be able to send email messages to each other as long as they maintain an active
user account within the system.

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Menu Options

Figure 23 Mail-Inbox

To compose a new message:


1. Click on the New Message button found in the upper left hand corner of the screen.

NOTE: Messages can only be directed to other users on your local system.

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Menu Options

Figure 24 New Mail Message Window

2. To: Type in the name of an existing system user


3. Subject: Type in an email subject
4. Add Attachments: Optionally select this option to add an email attachment as you would for
any email application.
5. Once the email is ready, press Send to send the mail message.

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Searching for a Patient


There are three (3) methods to search for a patient in Kroll:
1. F3-Patient Search Screen
2. ALT+X Start Screen
3. F11- Drop-Off Screen

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Method 1: F3-Patient Search Screen


From the ALT+X- Start Screen, click F3-Patient with the mouse or press F3 on the keyboard; this
will bring up the F3-Patient Search Screen.

NOTE: From the F3-Patient Search Screen, notice the yellow bar across the top of the
window. Yellow denotes patient records throughout the system.
In the patient search field, enter one of the following patient search criteria:
1. Last Name, First Name (e.g. Doe, Jane OR doe,j OR Doe OR ,Jane)
2. A period (.) and the Patient Quick Code (e.g. .DoeJ)
3. 7 or 10 digit phone number (e.g. 800-263-5876 or 263-5876)
4. A number sign (#) and the +Third Party Billing number (e.g. #123456789)
5. An asterisk (*) to search ALL patients in the database

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Figure 25 Patient Search Screen Method 1

Once the patient search criterion has been entered, click Search or press Enter on the keyboard
to search the database for matching results.

NOTE: The more detailed the search criteria, the smaller the result-set will be.
Conversely, the broader the search criteria, the larger the result-set will be.
A list of patients matching the search criteria will be displayed. Select the applicable patient
record by:
1. Using the Arrow Keys to highlight the entry and press Enter to select
2. Typing in the line number corresponding to the applicable entry and press Enter to select
3. Double click on the desired patient with the mouse.

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Figure 26 Selecting Patient Record

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The F3-Patient Record will be displayed:

Figure 27 Patient Record Displayed

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Method 2: ALT+X Start Screen


1. From the Start Screen (ALT+X), move the cursor to the Universal Search Field.

Figure 28 Patient Search Screen Method 2

2. In the Universal Search Field, enter one of the following patient search criteria:
a) Last Name, First Name (e.g. Doe, Jane OR doe,j OR Doe OR ,Jane)
b) A period (.) and the Patient Quick Code (e.g. .DoeJ)
c) 7 or 10 digit phone number (e.g. 800-263-5876 or 263-5876)
d) A number sign (#) and the +Third Party Billing number (e.g. #123456789)
e) An asterisk (*) to search ALL patients in the database
3. Once the search criterion has been entered, click F3-Patient or press F3 on the keyboard to
execute the patient search.
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4. A list of patients matching the search criteria will be displayed. Select the applicable patient
record by:
a) Using the Arrow Keys to highlight the entry and press Enter to select
b) Typing the line number corresponding to the applicable entry and press Enter to select
c) Double click on the desired entry with the mouse.

Figure 29 Selecting Patient Record

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The F3-Patient Record will be displayed.

Figure 30 Patient Record Displayed

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Method 3: F11 Drop-off Screen


1. From the F11-Drop-Off Screen, move your cursor to the Patient Search field.

Figure 31 - Patient Search Screen Method 3

2. In the Patient Search field, enter one of the following patient search criteria:
a) Last Name, First Name (e.g. Doe, Jane OR doe,j OR Doe OR ,Jane)
b) A period (.) and the Patient Quick Code (e.g. .DoeJ)
c) 7 or 10 digit phone number (e.g. 800-263-5876 or 263-5876)
d) A number sign (#) and the +Third Party Billing number (e.g. #123456789)
e) An asterisk (*) to search ALL patients in the database

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3. Once the search criterion has been entered, press Enter on the keyboard to execute the
patient search.

4. A list of patients matching the search criteria will be displayed. Select the applicable patient
record by:
a) Using the Arrow Keys to highlight the entry and press Enter to select
b) Typing the line number corresponding to the applicable entry and press Enter to select
c) Double click on the desired entry with the mouse.

Figure 32 Selecting Patient Record

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The F3-Patient Record will be displayed

Figure 33 Patient Record Displayed

5. Click F11-Drop-Off or press Enter on the keyboard to select the Patient Record into the F11Drop-Off Screen.

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Advanced Patient Search


If a patient is not found through a regular patient search as described in the previous section,
an Advanced Patient Search can be performed as follows:
Locate the Advanced flag from the Patient Search Screen (F3). Place a checkmark next to the
Advanced flag by using the mouse, or by pressing CTRL+A on the keyboard.

Figure 34 Advanced Patient Search

An Advanced search can also be initiated from the Patient Search Screen by clicking on the
option to Show Advanced Options from the Patient Sidebar on the far right side of the screen.
The Advanced Search will reveal additional fields for searching a patient:
a) Inactive Patients
b) Address
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c) City

d) Birthdate (DD/MM/YYYY)
e) SubPlan (i.e. Third Party Plan)
f) Group (i.e. reporting groups)
g) Price Group
Enter any available advanced patient search criteria and click Search or press Enter on the
keyboard to search for the patient record.

Figure 35 Entering details for an Advanced Patient Search

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Inactive Patient Records


Users have the ability to inactivate patient records in the system by un-checking the Active flag
located on the patient record. Inactivating a patient record means that the patient will not
show up in the regular patient search; an Advanced search for inactive patients will have to
be initiated in order to access the record.

Figure 36 Uncheck Active to Inactivate Patient Record

NOTE: An Inactive Patient Record cannot be used in prescriptions. The user will have
to reactivate the patient record by placing a checkmark next to the Active flag in order
to fill their prescription.

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There are various reasons why a user may choose to inactivate a patient record. For example,
the patient may be deceased, or may have moved to another country. Inactivating these
records allows the regular search to provide more succinct results; this reduces the chances of
selecting the wrong patient record into a prescription.

Figure 37 Locating Inactive Patients

To locate inactivated patient records in the system, perform an Advanced search and make
sure the Inactive or All flag is marked on the far right. Search for the patient as usual to find the
applicable record.

NOTE: Inactive patient records will appear in RED in the patient search screen.

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Configuring the Columns in the Patient Search Screen


Users can configure the information columns that are displayed on the Patient Search Screen
by clicking on the option Change Columns from the Patient Sidebar. The default columns are
set to:
Last Name
First Name
Sex
Address
City

Plan
Birth
Age
Phone

By selecting the option to Change Columns, the Edit Scan Columns window will appear with
opportunities to customize the type of patient information displayed in the search results. For
example, users can select to view Gender as one of the information columns. As well, users can
highlight an entry from the Edit Scan Columns window and click Move Up or Move Down to
determine where the information is displayed relative to the other information columns. At any
time, the user can select the option to Use Default Columns which will cause the column view
to revert back to the default.

Figure 38 Edit Scan Columns

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Once the user has selected the columns they want displayed on the Patient Search Screen, they
can click OK or press Enter on the keyboard to save changes until the session is closed. If the

user wants the changes to be permanent, they must right click with the mouse on the columns
and select the option to make these the Default Columns.

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Creating Patient Records


There are two (2) methods of entering a new patient record into the system:
Method 1: Manually Insert a New Patient Record
Method 2: Copy an Existing Patient Record

Method 1: Manually Insert a New Patient Record


Insert a new patient into the system as follows:
1. Perform a thorough search to ensure the patient does not already exist in the database. It is
advisable to perform an Advanced search for inactive patients as well.
2. Once the user is satisfied that the new patient does not exist in the system, click Ins-Insert
or press the Insert key on the keyboard to add a new patient record.

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Figure 39 Performing Patient Record Search

3. The user will be brought to a new patient information window where data can be entered.
4. The cursor will default to the Last Name field; use the TAB key to move from field to field to
fill in all available patient information (SHIFT+TAB will move the cursor back a field).

Figure 40 New Patient Information Window

5. Once the patient fields have been filled out, click Save with the mouse or press Enter to
save the patient record.

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Method 2: Copy an Existing Patient Record


If a new patient has a family member who already exists in the system, the user can copy
information from the family member to a new patient record by using the Copy Pat function
from the Patient Search Screen as follows:
1. Perform a thorough search to ensure the new patient does not exist in the system. It is
advisable to perform an Advanced search for inactive patients as well.
2. Once the user is satisfied that the new patient does not exist in the system, click Copy Pat
with the mouse or press CTRL+Y on the keyboard.
3. A second patient search window will appear; search for the family member who should
already be in the system.

Figure 41 Copy Patient Record

4. From the list of results, highlight the family member of the new patient by using the Arrow
Keys.

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5. Press Enter to select; or type in the line number corresponding to the applicable entry and
click Edit; or press Enter to select; or double click on the desired entry with the mouse.

Figure 42 Selecting the Family Member Record of the New Patient

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The patient record of the relative will appear. Review the information and confirm that this is
the patient you want to copy information FROM by clicking Select or pressing Enter on the
keyboard.

Figure 43 Existing Family Member Record Display

If the patient you are copying FROM has third party plans, the system will ask you Do you
want to copy the patients plans? Answer Yes or No accordingly.

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If the user answers Yes to copying the patient plans, a window will appear prompting the user
to select a relationship to the cardholder. Once the relationship has been selected, click OK
with the mouse or press Enter on the keyboard to continue.

Note that the third party plan will be Linked to the patient that the information was copied
from. If any changes to the plan numbers need to be made, it must be done from the
originating patient record.
Enter missing information for the new patient record such as birthdate, gender, snap cap
preference, phone numbers, etc.

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Figure 44 Filling the New Patient Record

Click Save with the mouse or press Enter on the keyboard to save the patient record.

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Patient Record Fields

Figure 45 Patient Record Fields

Last Name
Type the Last Name of the patient (do not add any symbols to this field).

First Name
Type the First Name of the patient (do not add any symbols to this field).

Salutation
Type the salutation (e.g. Mr, Mrs, Miss, Dr, etc) or click on the down arrow to select the
appropriate salutation from the options.

Address 1 & 2
Type the patients street address in one or both lines.

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City, Province, Postal Code Country
Type in the rest of the address information.

Email
Enter the email address of the patient.

Phone
Phone numbers can be entered in this area. The phone number will auto-format so simply type
in the numbers without using hyphens or brackets.
To add a phone number click Ins, press Insert on the keyboard, or simply begin typing the
number in the field.
To delete a phone number, highlight the entry you want removed and click Del or press Delete
on the keyboard. A window will appear asking the user to confirm the deletion.
To edit a phone number, highlight the entry and either:
a) Click F2 with the mouse
b) Press F2 on the keyboard
c) Double click the entry

Family Doctor (Optional)


Click F2 with the mouse or press F2 on the keyboard to search and select the patients family
doctor. When a prescriber is populated into this field, all prescriptions processed for the patient
will default the prescriber to the one indicated here; be careful of prescriber errors when using
this function.

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Birthdate
Enter the patient birthdate as DDMMYYYY. The year can be entered as a 2 or 4 digit number
(e.g. 1950 or 50). Once the birthdate is entered, the system will automatically calculate the
patients age in years.

Gender
Type the letter M or F to indicate Male or Female, or click on the down arrow to select the
gender.

Language
The patient language will default to English. Click on the down arrow to select a different
language for the patient. Be careful when changing the language setting as this will cause the
SIG on the vial label to print in the language selected if the language is configured into the
system. (Note: English translations will appear on hardcopy for pharmacist checking).

Height
Enter the patients height. Pharmacy users should use the same measurements to record height
to maintain database consistency (i.e. make a decision to use Feet or Centimeters, but not
both).

Weight
Enter the patients weight. Pharmacy users should use the same measurements to record
weight to maintain database consistency (i.e. make a decision to use Kg or lbs, but not both).

Provincial Plan
Enter the patients provincial health number (i.e. ODB, HSN, PHN, ULI) in this field.

Load Patient Image


Users can load a patient photo into the patient record by using the document scanner. Simply
feed the photo into the scanner and click Load to initiate scanning.

Groups
Patients can be included in a group for reporting. Patient Groups are created by head office and
can be applied by pharmacy users to any number of patients. For example, a group called
Diabetic can be attached to all patients that are Diabetic. Also note that patients can belong
to more than one Patient Group.

To add a Patient Group, click Ins with the mouse or press Insert on the keyboard to call up a
selection window displaying the available groups to insert.

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To delete a Patient Group, highlight the entry you want to remove and click Del or press Delete
on the keyboard. A window will appear asking the user to confirm the deletion.
To edit a Patient Group, highlight the appropriate entry and either:
a) Click F2 with the mouse
b) Press F2 on the keyboard
c) Double click on the entry

Figure 46 Add/Delete Patient Group

Comments
Patient records can contain any number of comment entries, and each entry can contain a large
amount of data.
To add a comment, click Ins with the mouse, press Insert on the keyboard, or simply begin
typing in the comment field. The following window will appear:

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Figure 47 Patient Comment Box

Select a Topic for the comment by accessing the dropdown menu. A topic must be selected in
order to save the comment.
Each comment has three options. To enable an option, use the mouse to click on the checkbox,
or TAB to the desired option and use the spacebar on the keyboard.
1. Show on Rx: Enabling this option will display the comment at the F12-Filling Screen.
2. Print on Hardcopy: Enabling this option will print the patient comment on the hardcopy.
Note that only one patient comment can be flagged for this option as there is limited space
on the hardcopy.
3. Alert: Enabling this flag will cause the comment to pop up every time the patient record is
accessed, and every time an Rx is filled for the patient.
To delete a comment, highlight the appropriate comment entry and click Del, or press Delete
on the keyboard. A window will appear to confirm the deletion.
To edit a comment, highlight the appropriate comment entry and either:
a) Click F2
b) Press F2 on the keyboard
c) Double click on the comment.
Make any necessary changes and click Save with the mouse or press Enter on the keyboard.

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Plans
Third party plan information is stored in the Plans section of the patient record. A patient can
have unlimited number of third party plans, and the system will support billing to all plans listed
in the patients record.
To add a plan, click Ins with the mouse, press Insert on the keyboard, or simply begin typing the
name of the plan. The following Patient Plan Information screen will appear. Users can fill out
third party details from this window.

Plan
Select the third party provider by clicking on the down arrow or by typing the name of the plan.

Order
If there is only one plan for the patient, it will automatically be set as the Primary plan. If there
is more than one plan, the user must specify the sequence of billing for coordination of benefits
(i.e. primary, secondary, tertiary, etc.)

Carrier ID, Group ID, Client ID


Obtain these numbers from the patients plan card. Note that some plans do not require all of
these fields to be filled out.

CPHA Pat Code


This field is only used by certain plans (e.g. Green Shield).

Relationship
Select the relationship of beneficiary to the cardholder of the plan. Type the number
corresponding to the correct relationship, or click on the down arrow to view all options.

Deduct Type
This field is only used for manually billed plans and refers to how the patient deductible is
calculated (e.g. select whether the deductible amount is calculated based on percentage or
dollar amount).

Deduct Value
This field is only used for manually billed plans and must be left blank for real-time plans. If the
plan is a manual plan, enter the value of the deductible in this field (works in conjunction with
Deduct Type).

Expiry Date
If applicable, enter the date the plan expires; the date should be entered as DDMMYYYY.

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First Name
Enter the patients first name as it appears on the plan card if it is different than what is
entered on the patient record. The first name entered here will be sent to the plan. For
example, if the patients name on the plan card is Robert, but on the patient record it is
recorded as Bob, type Robert into the First Name field.

Cardholder Name
Enter the last name of the cardholder if it is different from the last name entered on the patient
record; the last name entered here will be sent to the plan. This field is useful for women who
have kept their maiden names after marriage but are beneficiaries under their husbands plan.

Inactive
Place a checkmark next to this flag if the plan no longer accepts claims for the patient. An
alternative to inactivating a plan is to delete it.

Always Use in Rx
This flag is ON by default and applies the plan to all Rxs filled for the patient. This flag may be
turned OFF for plans that only cover certain medications/products (e.g. STI Plans, Workman
Compensation Plan, etc.)

Figure 48 Patient Plan Information

To delete a plan, highlight the appropriate plan entry and click Del with the mouse or press
Delete on the keyboard. A window will appear to confirm the deletion.
To edit any plan information, highlight the appropriate plan entry and either:
a) Click F2
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b) Press F2 on the keyboard


c) Double click on the plan entry.
Make any necessary changes and click Save with the mouse or press Enter on the keyboard.

Allergies
Any number of allergies can be added to a patient record. Note that allergies entered into the
patient record will be cross-checked against prescriptions filled for the patient using the First
Data Bank (FDB) clinical module.
To add an allergy, click Ins with the mouse or press Insert on the keyboard. Options to search
the allergy can be done by selecting the Starts with or Contains option beside the search
field. Click Search or press Enter on the keyboard to begin the search.

Figure 49 Entering list of allergies to a Patient Record

Use the Arrow Keys to highlight the desired allergy entry and click Select with the mouse or
press Enter on the keyboard to continue. Once the allergy is selected, the Patient Allergy
Information window will appear with fields to indicate the Source of the allergy, the Date the
allergy was reported, and Comments regarding the allergy.

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Figure 50 Patient Allergy Information

NOTE: Allergy entries that have a comment will have an asterisk next to it.
Once all necessary information has been entered into the Patient Allergy Information form,
click OK with the mouse, or press Enter on the keyboard to save changes.
Allergies can also be added by searching and selecting specific drugs (as opposed to using
therapeutic classifications). To add an allergy by searching for a specific drug, click on the Add
Drug button from the allergies section of the patient record.

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Figure 51 Drug Search Screen

A Drug Search Screen will appear; search for the drug the patient is allergic to (Refer to
Searching for a Drug). Once a drug is selected, a screen will display all components of the
drug; all components will be selected by default. If the patient is only allergic to a fraction of the
components, uncheck the rest of the components.
Once the components of the drug have been selected, click OK or press Enter on the keyboard
to call up the Patient Allergy Information window where comments and other supplementary
information can be entered.

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Figure 52 Selecting the Drug

To delete an allergy record, highlight the appropriate entry and click Del or press Delete on the
keyboard. The system will prompt the user to confirm the deletion.
To edit an existing allergy record, highlight the appropriate entry and either:
a) Click F2
b) Press F2 on the keyboard
c) Double click on the desired allergy entry.
Make any necessary changes and click OK or press Enter to save changes.
Medical Conditions: Any number of medical conditions can be added to a patient record. Note
that medical conditions entered for a patient will be cross-checked against prescriptions in the
patient medication profile using the First Data Bank (FDB) clinical module. Users should only
add physician-diagnosed medical conditions to the patient record; this prevents inaccurate
clinical warnings from showing up during the prescription filling process.
To add a medical condition, click Ins, press Insert on the keyboard or simply begin typing the
medical condition in the field. The Select a Condition window will appear with the option to
search by Starts with or Contains. As well, users can search by ICD-10-CA conditions, FDBDX
conditions or both. Click Search with the mouse or press Enter on the keyboard to begin the
search.

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Figure 53 Selecting Medical Condition

Use the Arrow Keys to highlight the desired condition and click Select or press Enter to
continue. Once the condition is selected, the Patient Condition Information form will appear
allowing the user to add supplementary information such as Source of the medical condition,
the Date the condition was reported, and Comments regarding the medical condition (Note:
medical condition entries that have a comment will have an asterisks next to it).

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Figure 54 Patient Condition Information

Once all necessary information has been entered into the Patient Condition Information form,
click OK with the mouse, or press Enter on the keyboard to save changes.
To delete a condition, highlight the appropriate condition entry and click Del or press Delete on
the keyboard. A window will appear to confirm the deletion.
To edit a condition, highlight the appropriate condition entry and either:
a) Click F2
b) Press F2 on the keyboard
c) Double click on the entry to call up medical condition details.
Make any necessary changes and click OK or press Enter on the keyboard to save changes.

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Information Tabs on the Patient Record


The Patient Record contains tabs of information located at the bottom right of the screen (e.g.
General, Family, etc.). Move from one tab to another by pressing CTRL in conjunction with the
underlined letter on the tab (e.g. Press CTRL+F to access the Family tab). Users can also flip
from tab to tab by pressing CTRL+ to move right or CTRL+ to move left.

Figure 55 Information Tabs on a Patient Record

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General
The General tab displays general information and preferences of the patient.

Figure 56 General Tab

Active
Patient records are active by default. Uncheck the Active flag if the patient has not filled
prescriptions with the pharmacy for an extended period of time and you do not want them
appearing in the regular patient search. Inactive patients are excluded from reports unless
otherwise specified in the Options tab of the report.

Animal
If the patient is an animal, place a checkmark next to this flag; the corresponding text field will
open up so the users can enter a descriptor such as dog or cat. In certain provinces,
activation of this flag triggers taxes to be applied to the patients prescriptions (i.e. Veterinarian
Rxs are taxable). In certain DIS provinces, activation of this flag will prevent the patients
prescriptions from being sent to the pharmacy network.

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Patient
Deceased on
If the patient has passed, enter their deceased date in this field. If a deceased date is entered,
the Active fag will become automatically unchecked.

Delivery Type
Not available at this time.

Delivery Route
Not available at this time.

Price Group
Patients can be placed into a Price Group to activate patient specific pricing. Click on the down
arrow to select from the available Patient Price Groups which are set up by head office.

Drug Line 1
Drug Line 1 refers to first piece of drug information printed on the vial label; users can choose
from: None, Brand, Generic, Description, Equivalent To, or Description 2. The drug information
is pulled directly from the Drug record.

Drug Line 2
Drug Line 2 refers to the second piece of drug information printed on the vial label; users can
choose from: None, Brand, Generic, Description, Equivalent To, or Description 2. The drug
information is pulled directly from the Drug record.

Double Count
This field allows users to indicate if double counting is necessary for the patient. The options
are: Not Required, Always or Narcotics Only. If an option to double count is selected, a
message will display on the packaging screen at the filling stage to prompt the user to double
count medications for the patient.

Snap Caps Requested


Place a checkmark next to this flag if the patient has requested snap cap vials. If snap caps are
requested for the patient, a message will display on the packaging screen during the filling
stage to prompt the user to package medications in snap cap vials.

Snap Caps Documented


This flag is only available when the Snap Caps Requested flag is ON. Place a checkmark next to
this option if the patient has provided written documentation/consent for packaging their
medications in snap cap vials.

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No Kroll Care
Place a checkmark next to this flag if the patient has requested not to receive Kroll Care
Monographs. Activation of this flag will prevent the Kroll Care from printing for any
prescriptions filled for the patient.

Print Compliance Calendar on Label


A calendar will print according to the day supply on the Rx. The calendar is intended for the
patient to record when a dose has been taken.

Encounters
This section is used to track and record encounters with the patient; this includes drug
education, privacy consent, medication reviews, professional services and more. Detailed
explanations of Encounter functions are available from the Patient Sidebar Functions section of
the Kroll Pharmacy Software User Guide.
The Encounters section allows the user to quickly determine if there are any Open (i.e.
unresolved) interactions with the patient. Users can also quickly see if privacy consent has been
provided to the pharmacy.
To add an encounter, click Show to access the Patient Encounters window; then click Add
Encounter. From the options select the type of encounter you would like to add to the patient
record (options may be different for some provinces).
To delete an encounter, highlight the desired encounter entry and click Del or press Delete on
the keyboard. A window will appear to confirm the deletion.
To edit or pull up details of an existing encounter, highlight the desired entry and click F2 with
the mouse, press F2 on the keyboard, or double click on the entry. The details of the encounter
will be displayed onscreen; make any necessary changes and click OK or press Enter on the
keyboard to save the changes.

Unit Dose
Enter unit does packaging details in this section. Note that whenever a Unit Dose Type or Unit
Dose Cycle is selected, the user will be prompted to activate and configure unit dose packaging
for each prescription that is processed for the patient.

Type
Enter the type of unit dose packaging used for the patient. Select from Dosett, Pilpak,
Pilpak 28 Day.

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Cycle
Enter the number of weeks of medication packaged for the patient for one cycle.

Price Group
Enter a pricing strategy that adds a supplementary charge to unit dose Rxs.

NOTE: Unit Dose Price Groups are configured and set up by head office.

Rx Total
This is a read-only section that keeps a running total of the number of Rxs filled for the patient
and the cumulative dollar value of those Rxs. Click Reset to reset the counters to zero.

ID
Whenever a patient record is created, it is assigned an ID; this read-only ID is used to track the
patient within the system tables.

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Family
Family members can be grouped together in the system for managing records more efficiently.
Once members of a family are grouped together, changing the information of one member (i.e.
address, telephone number, and/or third party plan information) will allow the user to extend
the change to other family members. Once the updated information is entered, press enter on
the keyboard and a window with the existing family members will show up. If the changes
apply, click the checkbox.
In addition, linking family members together in the system will link their work orders together
at point of sale. For example, if John and Jane are linked as family members and both have
prescriptions ready for pick-up, when the pharmacy user accesses Johns prescriptions at
pickup, Janes prescriptions will be displayed as well. The user will have the choice of asking the
patient if he wants to pick up prescriptions for his family members. This functionality ensures
that patients do not have to make multiple trips to pharmacy as well as helping users manage
the Pickup Bins more effectively.
To add a family member, click Ins with the mouse or press Insert on the keyboard. This will call
up a Patient Search Screen. Search and select the applicable patient as you would regularly; if
the family member you are linking has a different address than the original patient, you will be
prompted to optionally update the addresses so they match.

NOTE: If a patient is added into the database by copying an existing patient, the
Family link will automatically be created.
To remove a family member, highlight the member you want to remove and click Del or press
Delete on the keyboard. You will be asked to confirm the deletion.

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Figure 57 Family Tab

Figure 58 Change Address

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Other
The Other tab displays information on when the patient record was created, when it was last
changed, and when a prescription was last filled for the patient.

Figure 59 Other Tab

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Patient Medication Profile


The Patient Medication Profile is a list of medications the patient has filled at the pharmacy.
Each line within the profile represents a written prescription with details including, but not
limited to: Unit Dose, Rx Status, Rx Number, Dispensed Quantity, Drug Brand Name, SIG,
Authorized Quantity, Remaining Quantity, Prescriber, Dispensed Date, etc. Users can perform
actions against the Rx entries in the profile such as Refill, Modify, Cancel, Inactivate, Detail and
more.
In addition, the medication profile gives pharmacy users the opportunity to actively participate
in monitoring patient care by comparing new medication orders to all of the medications that
the patient has been taking. This reconciliation is done to avoid medication errors such as
omissions, duplications, dosing errors or drug interactions. This verification should be
performed at every transition of care in which new medications are ordered or existing orders
are rewritten.

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Medication Profile Views


There are seven (7) Patient Medication Profile views available in the Kroll Pharmacy Software.
Different views allow the user to filter and display prescription information that is relevant to
the users needs at that time. The Patient Medication Profile views will be explained below:

All Rxs SHIFT+F3/SHIFT+F4


The All Rxs medication profile displays ALL prescriptions filled for the patient regardless of
when the Rx was filled, or the Rx status. This view is useful for viewing prescriptions that have
been inactivated or transferred out.
Access the All Rxs patient medication profile as follows:
a) From the Patient Record or F11-Drop-off screen, press SHIFT+F3 on the keyboard.
b) From the Patient Record or F11-Drop-off screen, press SHIFT+F4 on the keyboard.
c) From the Patient Record or F11-Drop-off screen, click on All Rxs from the Sidebar.
d) From the Patient Record, click on the Profile dropdown menu (ALT+O) and select the All
Rxs command.

Figure 60 Profile All Rxs

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Active Rxs SHIFT+F5


The Active Rxs medication profile displays prescriptions that have an Active prescription status.
Prescriptions that are Unfilled, Not dispensed, Transferred-In or have a <blank> status is
considered active and will be displayed. This view is useful for filtering out prescriptions that
have been inactivated or transferred-out.
Access the Active Rxs patient medication profile as follows:
a) From the Patient Record or F11-Drop-off screen, press SHIFT+F5 on the keyboard.
b) From the Patient Record or F11-Drop-off screen, click on Active Rxs from the Sidebar.
c) From the Patient Record, click on the Profile dropdown menu (ALT+O) and select the
Active Rxs command.

Figure 61 Profile Active Rxs

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Active Rxs C / PASSTIMES SHIFT+F10


The Active Rxs w/ Passtimes profile displays active prescriptions with columns that show unit
dose information for prescriptions that are configured for unit dosing. The additional columns
include Passtime, Unit Dose Quantity, and Passtime Note.
Access the Active Rx w/ Passtimes medication profile as follows:
a) From the Patient Record or F11-Drop-off screen, press SHIFT+F10 on the keyboard.
b) From the Patient Record or F11-Drop-off screen, click on Active Rxs w/ Passtimes from
the Patient Profile Sidebar.
c) From the Patient Record, click on the Profile dropdown menu (ALT+o) and select the
Active Rxs w/ Passtimes command.

Figure 62 Profile Rx Passtimes

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Refillable Rxs SHIFT+F6


The Refillable Rxs medication profile only displays prescriptions that have a Remaining
Quantity left on the prescription. In other words, this view filters out prescriptions that cannot
be refilled, while only displaying those prescriptions that can be refilled.
Access the Refillable Rxs patient medication profile as follows:
a) From the Patient Record or F11-Drop-off screen, press SHIFT+F6 on the keyboard.
b) From the Patient Record or F11-Drop-off screen, click on Refillable Rxs from the
Sidebar.
c) From the Patient Record, click on the Profile dropdown menu (ALT+O) and select the
Refillable Rxs command.

Figure 63 Profile Refillable Rxs

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Pricing Profile SHIFT+F7


The Pricing Profile displays ALL the prescriptions filled for the patient with columns displaying
cost, markup, fee and Rx Total. The values represent amounts pulled from the last filled Rx in
the Prescription Chain. This view is useful for determining prescription pricing and resolving
pricing discrepancies.
Access the Pricing Profile as follows:
a) From the Patient Record or F11-Drop-off screen, press SHIFT+F7 on the keyboard.
b) From the Patient Record or F11-Drop-off screen, click on Pricing Profile from the
Sidebar.
c) From the Patient Record, click on the Profile dropdown menu (ALT+o) and select the
Pricing Profile command.

Figure 64 Profile Pricing

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Not Dispensed / OTC Rxs SHIFT+F8


The Not Dispensed/OTC Rxs medication profile displays prescriptions that have been marked
with a status of Not Dispensed. Over-The-Counter (OTC) products are added to the patient
profile by marking them as Not Dispensed to allow drug interaction checking to occur without
generating official prescription receipts.
Access the Not Dispensed/OTC Rxs profile as follows:
a) From the Patient Record or F11-Drop-off screen, press SHIFT+F8 on the keyboard.
b) From the Patient Record or F11-Drop-off screen, click Not Disp/OTC Rx from the
sidebar.
c) From the Patient Record, click on the Profile dropdown menu (ALT+O) and select the
Not Disp/OTC Profile command.

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Rx Filled in Error
The Rx Filled in Error profile displays prescriptions filled in error for the patient. This profile is
commonly known as the Garbage Profile because it houses prescriptions for the patient that
should not have been filled and contain wrong information. Entries in this profile are
excluded from drug interactions checking and should not influence dispensing decisions.
Access the Rx Filled in Error profile as follows:
a) From the Patient Record, press SHIFT+F9 on the keyboard.
b) From the Patient Record, click Rxs Filled in Error from the sidebar.
c) From the Patient Record, click on the Profile dropdown menu (ALT+O) and select the
Rxs Filled in Error command.

NOTE: Users cannot access the Rx Filled in Error profile from the F11-Drop-Off
window.

Figure 66 Profile Rxs Filled in Error

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Perform FDB Analysis


Users can easily initiate a First Data Bank (FDB) clinical interactions analysis for a patients
medication profile by selecting the option to Perform FDB Analysis from the patient sidebar.

Figure 67 Perform FDB Analysis

From the selection screen, place a checkmark next to the clinical information you want to
retrieve from FDB; the Select All and Select None buttons allow users to quickly check or
uncheck all the options. Once selections have been made, click OK or press Enter on the
keyboard to execute the FDB analysis; the analysis will be based on information contained in
the Patient Medication Profile.

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Results of the analysis will be displayed in the Clinical Reports window under separate tabs
across the top of the screen; click Back to move left a tab, click Next to move right a tab. There
is also an option to print the clinical report by accessing the File dropdown menu and selecting
the command to Print.

Figure 68 Clinical Reports

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Configuring the Columns in the Medication Profile


Users can customize the information columns displayed on the Patient Medication Profile by
accessing the Edit Scan Columns window in one of three ways from the patient medication
profile:
a) Right click anywhere on the patient medication profile columns to display a list of menu
options.
b) Select the command to Change Columns.
c) Click on the Extra Functions button located on the upper right of the patient medication
profile.
d) From the Extra Functions menu, select the command to Change Columns.
e) Ensure your cursor is somewhere on the patient medication profile and press x on the
keyboard to access the Extra Functions menu; from the menu, select the command to
Change Columns.

Figure 69 Edit Scan Columns

The Edit Scan Columns window gives users the ability to customize the Rx columns displayed on
the patient medication profile; simply place a checkmark next to the information you want
displayed. Users can also highlight a selected option and click Move Up or Move Down to
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determine where the information is displayed relative to the other information columns. At any
time, the user can select the option to Use Default Columns which will cause the column view
to revert back to the default.
Once the user has selected the columns they want displayed on the Patient Medication Profile,
they can click OK or press Enter on the keyboard to save changes until the session is closed. If
the user wants the changes to become permanent, they must right click on the columns and
select the option to make these the Default Columns.
The below chart lists all the column options available for selection and provides a description of
the information contained within the column:

Column Name

Column Description

Unit Dose Indicator. Y means yes, the prescription is configured for


unit dosing. N means no, the prescription is not configured for unit
dosing.
Prescription Status (e.g. <BLANK> = Active, Inactive, Unfilled, Not
Dispensed, Transferred In, Transferred Out, etc.)
Prescription Number of the last filled Rx in the Prescription Chain.
Dispensed Quantity
Brand Name of the drug
SIG code for the prescription (not expanded)
Authorized prescription quantity in units (e.g. the number of
tablets/caplets)
Remaining prescription quantity in units (e.g. the number of
tablets/caplets)
Name of the prescriber of the prescription.
Date of the last filled Rx in the Prescription Chain.
Number of days ago the prescription was filled
Original prescription number for the Prescription Chain.
Generic Name of the drug
Brand name equivalent of drug product being dispensed. This column is
not always populated because the associated field may not be
populated on the drug record.
The expanded SIG code for the prescription. For example, Take one
tablet once daily until finished.
The calculated cost of the last filled Rx in the Prescription Chain.
The calculated markup of the last filled Rx in the Prescription Chain.
The calculated fee of the last filled Rx in the Prescription Chain.
The calculated mixture fee for the last filled Rx in the Prescription
Chain.

Status
Rx Num
Qty
Brand Name
Sig
Auth
Rem
Doctor
Date
Ago
Orig Rx
Generic Name
Equivalent To

Sig Expansion
Cost
Markup
Fee
MixFee

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Column Name

Column Description

SSCFee

Special Service Code Fee; the dollar value of the fee will be displayed in
this column.
Total dollar value of the last filled Rx in the Prescription Chain (Cost +
Markup + Fee + MixFee + SSCFee = Total).
Total fees of the last filled Rx in the Prescription Chain (Fee + MixFee +
SSCFee = Total Fee).
Days supply of the last filled Rx in the Prescription Chain.
Indicates whether the prescription is inactive
Drug Identification Number of the drug product.
User initials of the pharmacist who worked on the prescription.
User initials of the assistant who worked on the prescription.
Remaining number of refills (e.g. 1 refill, 2 refills, etc.)
Authorized number of refills (e.g. 1 refill, 2 refills, etc.)
Number of days before the prescription is due to be refilled (e.g. 10
days until due)
Date when the first Rx of the Prescription Chain was filled.
Expiry Date of the written prescription (Note: expiry dates for written
prescriptions vary from province to province and drug schedule to drug
schedule).
Batched prescription: Y = Yes; N = No
Nursing Home prescription: Y = Yes; N = No
Central Fill prescription: Y = Yes; N = No
Indicates the blister card number the prescription is assigned to.
Indicates the current workflow state the prescription is at.
Displays the Methadone Ingest Date for methadone prescriptions.

Total
Total Fee
Days
Inact
DIN
Initial
Tech
Rem #
Auth #
Due
OrigDate
ExpDate

B
NH
CF
Card #
Tracking
Methadone Ingest
Date
MI

Indicates if a prescription has been billed to a third party with an MI


intervention. Y = yes; N = no.

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Medication Profile Commands From the Patient Record


There are eight (8) key commands that can be executed when you call up the Patient
Medication Profile from the patient record. These commands are outlined below in RED and
will act on the highlighted or tagged prescription(s) in the medication profile.

Figure 70 Patient Medication Profile

ESC Back to Patient


Space Mark Multiple Rxs
F - Refill prescription(s)

M-Modify prescription(s)
R-Reprint prescription(s)
C-Cancel prescription(s)

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I-Inactivate prescription(s)

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ESC Back to Patient


Press ESC on the keyboard or click on the word Esc to return to the Patient Record from the
Patient Medication Profile.

Space Mark Multiple Rxs


Users can execute a command (e.g. Refill, Reprint, Cancel, Modify, etc.) on multiple
prescriptions at once. For example, users can tag multiple prescriptions on the profile and
select the command to Cancel which will bring up one prescription after another to be
cancelled until all Rxs are reversed.
To tag prescriptions on the medication profile:
1. Highlight an Rx entry and pressing the spacebar on the keyboard
2. Once a prescription is tagged it will appear in bold.
3. Step 1 and 2 can be repeated to tag any number of Rxs in the profile.

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Figure 71 Tagging Prescriptions

F-Refill
To tag prescriptions for refill:
1. Highlight or tag prescription(s) to be refilled by pressing F on the keyboard or clicking FRefill with the mouse.
2. Once the Refill command has been executed, the F12-Filling screen will appear.

NOTE: Notice that the status of the prescription on the upper left hand corner of
the window will read Refill. A work order due time must be selected from this
screen in order to continue processing the prescription.

M-Modify
To tag prescriptions to modify:
1. Highlight or tag prescription(s) to be modified by pressing M on the keyboard or clicking
M-Modify with the mouse.

NOTE: Once a prescription has been adjudicated to a plan, only certain fields will be
open for modification; any field that impacts price will not be editable.

R-Reprint
To tag prescriptions to reprint:
1. Highlight or tag prescription(s) from the patient medication profile
2. Select to reprint various labels such as vial labels, hardcopies, Drug Information
Monographs, Privacy label, and Receipts.

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Figure 72 Reprint Rx Paperwork

C-Cancel
Cancelling a prescription means the user would like to reverse a prescription; if an Rx is being
cancelled after adjudication to a third party, a reversal will also be made for financials. Users
can highlight or tag prescription(s) from the patient medication profile and press C on the
keyboard or click C-Cancel with the mouse. Once the Cancel command has been executed,
the prescription will be brought up in cancel mode; the user will be asked to confirm whether
or not they would like to cancel the prescription.
When cancelling any prescription, the user will be presented with a message box asking Is this
the Rx that you want to cancel?
Yes Proceed with reversing the prescription
No Do nothing, return to the previous screen
Cancel and Refill Used in scenarios where the user has made an input error and needs to
reverse the Rx, make a correction, and refill the Rx to the third party plan.

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When cancelling an Unfill (i.e. On hold Rx), users will be presented with a message asking Do
you want to Cancel this Unfilled Rx and mark it as a mistake? If the user answers Yes the
prescription will be removed from the medication profile.

When cancelling the first fill of a prescription, the user will be presented with a message box
with two options:
Make this Rx Unfilled (i.e. put the prescription on hold)
Filled in Error Remove from profile

When cancelling the first fill of a Not Dispensed Rx (i.e. OTC to profile prescription), the user
will be prompted to mark the prescription as Filled in Error Remove from profile.

D-Detail
The Detail command allows users to view adjudication details for a prescription. This command
is useful for identifying and resolving pricing issues. Obtain adjudication details from the patient
medication profile as follows:
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Highlight the prescription of interest and press D on the keyboard or click D- Details to view the
Rx Detail form.

This screen will bring up all the transaction numbers (Tx Number) used with the original Rx.

Figure 73 Rx Detail

Highlight the Tx Number of interest and press D on the keyboard or click D-Billing Detail to view
the Rx Plan Detail Form. This screen breaks down the amounts paid by each third party payer
for the Tx selected.

Figure 74 Rx Plan Detail Form

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NOTE: Any value for Cash is indicative of the patient pays amount.
Highlight the third party plan entry, in this case the AHE, and press D on the keyboard or click DAdjudication History to view the Rx Plan Adjudication History form which shows the details
and messages sent back from the third party plan.

Figure 75 Rx Plan Adjudication History

At this point, pressing D or clicking D-View Adjudication Detail will bring up the Adjudication
Claim and Response Form. The left side of the screen, Claim Values, shows all the values being
sent to the third party payer. The right side of the screen, Response Values, shows all the
values and messages sent back from the third party payer.

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Figure 76 - Adjudication Claim and Response Form

Escape from the various adjudication detail screens by pressing ESC on the keyboard.

I-Inactivate
User can highlight or tag prescription(s) from the patient medication profile to be inactivated by
pressing I on the keyboard or clicking I-Inactivate with the mouse. Once the Inactivate
command has been chosen, the user will receive a screen showing the eligible and ineligible
prescriptions.
Once a prescription is inactivated, it can be reactivated by accessing the Extra Functions menu
and selecting the command to Reactivate (Please refer to Extra Functions Reactivate for
details).

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Figure 77 Inactivate Prescription

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Medication Profile Commands From the F-Drop-Off Screen


There are five (5) key commands that can be executed when you call up the Patient Medication
Profile from the F11-Drop-Off screen. These commands are listed in RED and act on the
highlighted or tagged prescription(s) in the medication profile.

Figure 78 Rx Drop-off Form

ESC Escape back to the F11-Drop Off window


Space Mark Multiple Rxs
F-Refill prescription(s)
Y-Copy to New
D-Detail prescription(s)
The ESC, Space, F-Refill, and D-Detail commands available from the F11-Drop-off medication
profile are the same as the commands from the patient medication profile; however, there is a
new command on the F11-Drop-off which is Y-Copy to New. This command allows users to

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highlight or tag prescription(s) from the medication profile and copy to a new prescription
number (or work order).
1. Using the spacebar highlight or tag the prescriptions that you want to copy to a new
prescription number.
2. 2. Press Y on the keyboard or click Y-Copy To New with the mouse; the F11-Drop-off
window will be populated with prescription information from the copied Rx.

Figure 79 Highlighting the spacebar

Once all prescriptions have been copied, click on Finalize Work Order or press Enter on the
keyboard to move the work order to the Input stage.

Extra Functions from the Patient Medication Profile


Whether the Patient Medication Profile is accessed from the Patient Record or from the F11Drop Off screen, users can tag prescriptions on the profile using the spacebar, and proceed to
execute actions on the selected prescription(s) by accessing the Extra Functions menu. The
following subsections will explain how to use the applicable functions listed under the Extra
Functions menu.
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Suspend
The Rx Suspend feature allows prescriptions to be suspended from filling and appearing on
reports (including all blister packaging reports) for a specific amount of time or indefinitely.
Suspended prescriptions can be filled interactively if needed. During an interactive fill, the user
will receive a warning that the Rx is suspended. However, the dispensed quantity cannot be
adjusted since the day the patient started taking the medication for this fill is unknown.
An active prescription can be suspended for a number of reasons (e.g. Drug-to-drug
interactions, hospital admission, etc.). The pharmacist can suspend selected prescription(s)
on the profile as follows:
Tag prescription(s) on the Patient Medication Profile you want to suspend. Use the Spacebar
on the keyboard to tag prescriptions.
Access the Extra Functions menu by clicking Extra Functions with the mouse, or by pressing x
on the keyboard. Select the command to View/ Edit Suspends/Resumes, and then choose the
options to Suspend.
The Suspend Rx(s) window will be displayed:

Figure 80 Suspend Rx(s)


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Under the Suspend section, enter the Date, Time, and Reason for suspending the Rx(s). Users
can select a reason for suspending the Rx(s) from options available in the dropdown menu, or
they can type in a free-form reason. There is also an optional Comment field for entry of
supplementary information regarding the suspend action.

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Resume
When users suspend an Rx, they can also choose to set a Date, Time and Reason for
resuming the Rx if this is known; if this information is unknown, leave it blank to suspend the Rx
indefinitely. Users can select a reason for resuming Rx(s) from one of the options available in
the dropdown menu, or they can type in a free-form reason. There is an optional Comment
field for entry of supplementary information regarding the resume action.
Towards the bottom of the Suspend Rx(s) window, details for the selected prescriptions are
displayed. If more than one Rx is being suspended, the first tab will show an Rx Summary listing
all prescriptions selected for the suspend action. Subsequent tabs will contain information
specific to the Rx number listed on the tab.
Once the suspend information has been inputted, click Suspend Eligible Rxs or press Enter on
the keyboard; prescriptions with a status of OK to suspend will become suspended (NOTE: Rx
with the following statuses cannot be suspended - Inactive, Inactive (Copied), Inactive
Transferred Out, Fee for Service, Stock Transfer or Unfill).
A suspended prescription will appear on the Patient Medication Profile with a status Suspended.

Figure 81 Suspended Prescription on a Patient Medication Profile

Only prescriptions with a status of Suspended can be resumed. Resume a suspended


prescription as follows:
1.

Tag prescription(s) on the Patient Medication Profile you want to resume. Use the
Spacebar on the keyboard to tag prescriptions.

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2. Access the Extra Functions menu by clicking Extra Functions with the mouse, or by pressing
x on the keyboard. Select the command to Suspend/Resume, and then choose the options
to Resume.
3. The Resume Rx(s) window will be displayed:

Figure 82 Resume Suspended Prescription

Select the Date, Time and Reason for resuming the Suspended Rx. Users can select a reason for
resuming Rx(s) from one of the options available in the dropdown menu, or they can type in a
free-form reason. There is an optional Comment field for entry of supplementary information
regarding the resume action.
Once the resume information has been inputted, click Resume Eligible Rxs or press Enter on
the keyboard, prescriptions with a status if OK to Resume will become active again.

View/Edit Suspend/Resume
Users can access the suspend/resume history for a specific prescription by highlighting the
prescription from the Patient Medication Profile and accessing Extra Functions
Suspend/Resume View/Edit Suspend/Resume.

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Figure 83 History of Suspended Prescriptions

To edit an existing suspend/resume entry, highlight the entry and press F2 on the keyboard, or
double click on the entry to bring up the Edit Rx Suspension window. Users can add or change
data in any of the fields and click OK to save changes.

Figure 84 Modify Suspension

Once a suspension has been set for a prescription, users are prevented from deleting the
suspension when the suspend date is set to a previous date. Prescriptions that have a suspend
date set to the future can be deleted.

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Add to Doctor Callbacks


The Add to Doctor Callbacks function serves to add entries to the Callback icon on the System
Start Screen to remind users to call the doctor regarding a specific prescription. The callback
reminder may serve to clarify prescription dosage, SIG instructions, refills, etc.
Users can tag prescription(s) on the Patient Medication Profile that require a call-back to the
prescriber. Subsequent to tagging applicable prescription(s), access the Extra Functions menu
and select the command to Add to Doctor Callbacks.

Figure 85 Selecting Add to Doctor Callbacks

Once prescription(s) have been flagged for doctor callback, access the System Start Screen by
pressing ALT+X on the keyboard and click on the Callback Icon. The prescriptions that were
selected for Add to Doctor Callbacks will appear as callback entries with a status of Call
Doctor. Users can double click on a specific entry to add a comment regarding the callback, or
to resolve the callback.

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Figure 86 Prescription set to Call Doctor

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Add to Rx To Do List
The Add to Rx To Do List function allows users to quickly create a work order for refill
prescriptions. Users can tag prescriptions that need to be refilled from the Patient Medication
Profile and assign a due time for the work order. For example, if Ms. Jane Doe arrives at the
pharmacy to refill her Cortate and Clotrimaderm creams, the user can create a work order
from the Patient Medication Profile as follows:
1. Access the Patient Record for the patient requesting the repeat(s).
2. Access the Patient Medication Profile.
3. Using the Spacebar on the keyboard, tag all prescriptions that need to be refilled
4. Click on Extra Functions with the mouse or press x on the keyboard.
5. Select the option to Add to Rx To Do List.

Figure 87 Selecting Add To Rx To Do List

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The Create Refill Reminder(s) window will appear prompting the user to enter a due date for
the refill prescription(s). Users can click on the Down Arrow to select one of the pre-configured
due times. Or the user can click F2 to enter a specific Due Date and Time. Once the due time
has been selected for the refill work order, click OK with the mouse or press Enter on the
keyboard.

Figure 88 Entering the Due Date and Delivery Route

The refill(s) will be prioritized against all other exiting work orders in the system and presented
to the user for processing at each applicable Rx stage.

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Display Therapeutic Equivalents


The Display Therapeutic Equivalents function allows the user to highlight a prescription from
the Patient Medication Profile and display any therapeutic equivalents the patient may have
had in the past.
Display therapeutic equivalents for a prescription as follows:
1. Highlight the prescription you want to view therapeutic equivalents for.
2. Click on Extra Functions or press x on the keyboard.
3. Select the command to Display Therapeutic Equivalents.

Figure 89 Selecting Display Therapeutic Equivalents

Once the command is selected, the Patient Medication Profile will only display therapeutic
equivalents for the prescription that was initially selected.

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Figure 90 Therapeutic Equivalents displayed

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Fax Doctor
The Fax Doctor command generates a refill request for prescriptions tagged from the Patient
Medication Profile. Multiple prescriptions can be tagged to appear on the Fax Doctor Report.
Generate a Fax Doctor Report for one or more prescriptions from the Patient Medication
Profile as follows:
1. Search and access the record for the patient who requires a Fax Doctor Report.
2. Access the Patient Medication Profile.
3. Using the Spacebar on the keyboard, tag all prescriptions that need to be included in the
Fax Doctor Report.
4. Click on Extra Functions with the mouse or press x on the keyboard.
5. Select the option to Fax Doctor(s) and wait for the Doctor Authorization Report window to
appear.

Figure 91 Selecting Fax Doctor(s)

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Figure 92 Doctor Authorization Report

The user will have a number of options available from the Doctor Authorization Report
window:

Comments Tab
Users can enter comments specific to the tagged prescriptions. The comment will be deleted
from the report parameters once the report is printed.

Customized Text Tab


User can enter a generic comment for the report. For example, store hours can be entered
here, or an ending salutation, etc. The content entered under the Customized Text Tab will be
saved and printed on all Fax Doctor Reports until the content is manually deleted from the field.

Options Tab
User can check or uncheck any of the options listed in this area. The Preview option located at
the bottom of the reports window allows users to view the report before actually printing.

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Figure 93 Options Tab

Click Print to print the Fax Doctor Report (a.k.a. Doctor Authorization Report).

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Figure 94 Prescription Authorization Request

NOTE: If prescriptions tagged from the Patient Medication Profile are from different
prescribers, the report will print separate pages for each prescriber so that refill
request are grouped and faxed to the doctor that initially prescribed the Rx.
Whenever a Fax Doctor Report is generated for a prescription, the system will automatically
add an entry for the prescription into the Callback Window. The entry serves as a reminder to
follow up with the prescriber regarding the refill request. The Callback window can be accessed
from the ALT+X Start Screen by clicking on the Callback Icon.

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Figure 95 Waiting for Doctor(s) Approval

NOTE: When the Rx Number (i.e. Rx Num) is copied to a new prescription number, the
system will automatically remove the callback entry from the callback window.

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Limited Use Request (Ontario Only)


For certain medications, ODB will only reimburse prescriptions for a medication if it complies
with a medical reason for use as defined by ODB. The Limited Use Request form generates a
request to the prescriber for a limited use code.
Generate the Limited Use Request Form as follows:
1. Search and access the record of a patient who requires a Limited Use Request form.
2. Access the Patient Medication Profile.
3. Use the Spacebar on the keyboard to tag the prescription eligible for a Limited Use Code.
4. Click on Extra Functions with the mouse or press x on the keyboard.
5. Select the Limited Use Request command and wait for a report window to appear.

Figure 96 Selecting Limited Use Request

From the Selection Tab of the Limited Use Request, ensure the Rx Info flag is checked.
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Figure 97 Limited Use Request Selection Tab

From the Options Tab, place a checkmark next to applicable option(s).

Figure 98 Limited Use Request Options Tab

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From the Customized Text Tab, users will see pre-populated information under the First
Section and Second Section; however, the information can be overridden for customized
wording.

Figure 99 Customized Text Tab

Click Print to print the Limited Use Request form for the selected prescription. Note the Limited
Use Code and associated medical reason will be printed towards the bottom of the report.

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Figure 100 Limited Use Request Form

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Section 8 Request (Ontario Only)


A Section 8 Request is a request sent to a prescriber for special coverage of a product that is
not normally covered under the ODB formulary. The prescriber, on behalf of the patient, can
request coverage for a particular drug product not normally covered under ODB for a specific
period of time.
Generate the Section 8 Request form as follows:
1. Search and access the record of a patient who requires a Section 8 Request.
2. Access the Patient Medication Profile.
3. Use the Spacebar on the keyboard to tag the prescription requiring a Section 8 Request.
4. Click on Extra Functions with the mouse or press x on the keyboard.
5. Select the Section 8 Request command and wait for report window to appear.

Figure 101 Selecting Section 8 Request

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From the Selection Tab of the Section 8 Request window, ensure that the option for Rx Info is
checked.

Figure 102 Selection Tab

From the Options Tab, check off the options you want printed on the report.

Figure 103 Options Tab

From the Customized Text tab, users will see pre-populated information requesting the Section
8; however, the information can be overridden for customized wording.

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Figure 104 Customized Text Tab

Click Print to print the Section 8 Report.

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Transfer Rx to Another Store


Generate the Transfer Report as follows:
1. Search and access the record of the patient who requires a prescription Transfer.
2. Access the Patient Medication Profile.
3. Use the Spacebar on the keyboard to tag the prescription that needs to be transferred to
another pharmacy.
4. Click on Extra Functions with the mouse or press x on the keyboard.
5. Select the Transfer Rx to Another Store command and wait for Rx Transfer Report window
to appear.

Figure 105 Selecting Transfer Rx to Another Store

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In the Store Search field, enter the name or address of the pharmacy the prescriptions are
being transferred to. If the pharmacy cannot be found from the Store Transfer List, click the
New button to add the pharmacy store information.

Figure 106 Store Search Field

Figure 107 Adding a new Pharmacy Store

If the pharmacy is found from the Store Transfer List, highlight the pharmacy entry and click
Select.

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Once the pharmacy store information has been populated into the Rx Transfer Report window,
the user can click Edit at any time to change the information entered.
Enter the Pharmacist Name and Comments as required and click Transfer Out Eligible Rxs.

Figure 108 Transfer Out Rx(s) Form

Answer Yes/No when asked Do you want to print the Transfer Report?

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Once a prescription has been transferred to another pharmacy, the Rx will have a status of
Inact (Transferred Out).

Figure 109 Inact (Transferred Out) status

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Reactivate Rx
The Reactivate function allows users reactivate prescription(s) with an Inactive status. Be
careful when reactivating a prescription; be sure you know why the Rx was inactivated in the
first place to avoid dispensing errors.
Reactivate an inactive prescription as follows:
1. Access the Patient Medication Profile.
2. Use the spacebar to highlight the inactive prescription you would like to reactivate.
3. Click Extra Function with the mouse or press x on the keyboard.
4. Select the command to Reactivate Rx.

Figure 110 Selecting Reactivate Rx

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The Reactivate Rx window will appear. Click Reactivate Eligible Rxs with the mouse or press
Enter on the keyboard to reactive prescriptions with a status OK to Reactivate.

NOTE: Only Rxs with the status of Inact can be re-activated.

Figure 111 Reactivate Rx

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Patient Sidebar Functions


Once a Patient Record is called up from the system, users can access/view a number of Sidebar
Functions to the right of the screen. The following sub-section will explain sidebar functions
applicable to Pharmacies.

Figure 112 Selecting Patient Sidebar Functions

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Alternate Addresses
Users have an option to add a secondary address for a patient using the Alternate Addresses
option.
Click Alternate Addresses from the Patient Sidebar to access the Alternate Patient Addresses
window. From the Location field click Ins or Add to add a description for the new address (e.g.
Summer Home, Parents Home, Childs Home, etc.). Fill in the fields as required and click Save
or press Enter on the keyboard when complete.

Figure 113 Alternate Patient Addresses

Users can access Alternate Addresses from the sidebar at any time to add additional addresses,
edit existing information, or delete an address. Simply use the Add, Modify and Delete keys.

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Charting
Patient Charting allows users to monitor and record patient health metrics directly within the
pharmacy management system. Benefits include the ability to print charts, as well as having the
ability to electronically store patient health information in one area for ease of access. Values
can be added to any chart by clicking the Ins key located to the right of the charting window.
Users can edit or delete an entry by clicking F2 or Del respectively.

NOTE: Any chart value that has a comment attached to it will have an asterisk to the
left of the entry. Hovering the mouse over the entry will expand the comment in a
yellow box.

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Weight
Weight charting allows users to record values in kilograms (kg) or pounds (lbs). Only one form
of weight measurement needs to be entered; the system will automatically convert the entered
measurement into the form that is missing (e.g. if the user enters 115lbs, the system will
calculate the kg field to 52.27kg).

Figure 114 Patient Charting Weight Reading

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Height
Height charting allows users to record values in centimeters (cm) or inches (in). Only one form
of height measurement needs to be entered; the system will automatically convert the entered
measurement into the form that is missing (e.g. if the user enters 170cm, the system will
calculate the inches field to 66.93in).

Figure 115 Patient Charting Height Reading

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Blood Pressure
Blood pressure charting allows entry of a Systolic, Diastolic, and Pulse Rate value. The pulse rate
is measured in beats per minute (bpm).

Figure 116 Patient Charting Blood Pressure Reading

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Blood Sugar
The blood sugar concentration is the amount of glucose (sugar) present in the blood. If blood
sugar levels drop too low, hypoglycemia can develop if untreated. If levels remain too high,
hyperglycemia can develop and cause many of the long term health problems associated with
diabetes. Blood sugar values are measured in millimoles per litre (mmol/L) within the system.

Figure 117 Patient Charting Blood Sugar Reading

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Cholesterol
Total cholesterol levels are recorded in millimoles per litre (mmol/L).

Figure 118 Patient Charting Cholesterol

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Creatinine CL
Creatinine clearance values are used to evaluate the rate and efficiency of kidney filtration. It is
used to help detect and diagnose kidney dysfunction and/or the presence of decreased blood
flow to the kidneys. Creatinine clearance charting allows users to enter values for Weight,
Height and Serum Creatinine level (SCr) which is measured in millimoles per liter (mmol/L).

Figure 119 Patient Charting CCL Reading

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INR International Normalized Ratio


An INR is useful in monitoring the impact of anticoagulant medicines, such as Warfarin. An INR
can be too high; a number greater than 4 may indicate that blood is clotting too slowly, creating
a risk of uncontrolled bleeding. An INR less than 2 may not provide adequate protection from
clotting.
INR charting allows the INR Factor to be entered as well as the anticoagulant daily dose.

Figure 120 Patient Charting INR Reading

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Clozaril
Patients taking Clozaril are required to have white blood cells (WBCs) and Absolute Neturophil
Count (ANC) levels monitored on a regular basis by physicians and dispensing pharmacists.
These values can be recorded in the patient record of the Kroll Pharmacy Software for instant
lookup and retrieval.

Figure 121 Patient Charting Clozaril Reading

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Patient Documents
The Kroll Pharmacy Software has built-in functionality to import and attach external files (e.g.
docx, pdf, xslx, jpeg, etc.) to specific patient records through the Document function listed on
the patient sidebar. With this function, users can import medical forms, medication charts, lab
results, etc. into the system for electronic storage. Electronic files facilitate a paperless
pharmacy as well as providing ease of access.
Files are added and saved under individual patient records as follows:
1. Search and access the applicable patient record.
2. Once the patient record is up on the screen, click on the Documents option located on the
sidebar to bring up the Patient Document List window.

Figure 122 Patient Document List

Click Add New Document to display two options:


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a) Selecting From Fax/Network Scan will allow the user to scan an image into patient
documents using the Document scanner.
b) Selecting From Other File will allow the user to search for the file path where the
document is saved.

NOTE: When an image (e.g. jpeg, bmp) is being attached to a patient record,
users will have a chance to crop, rotate or flip the image before saving.
Once the file has been selected, users can add a Description and Comments regarding the
attachment; more than one comment can be associated with an attachment.

Figure 123 New Patient Document

Click Save or press Enter on the keyboard to save information and to return to Patient
Document List. Notice that the description and comments of the highlighted entry will be
displayed at the bottom of the screen.

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Figure 124 Patient Document List with saved entries

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Patient Encounters
Patient Encounters allow pharmacists to electronically document clinical interactions with the
patient. Encounters can be documented under various categories including Counseling, Privacy
Consent, Medication Reviews, and Professional Services.
It is important to note that recording an encounter for a Medication Review or
Professional Service will not account for the billing aspect of the service; this must be
completed separately.
Add a Patient Encounter as follows:
1. Search and access the patient record you would like to add an encounter for.
2. Once the patient record is on the screen, click on Encounters located on the sidebar to
display the Patient Encounters window. Note that the fractional number represents
Unresolved Encounter/Resolved Encounter.

Figure 125 Patient Encounters

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From the Patient Encounters window, click on Add Encounter to display a list of Encounter
Types:

Figure 126 Patient Encounters Add Encounter

If Counseling is selected, users can select a counseling type from the dropdown menu and
record the content that was discussed, how counseling took place (e.g. over the phone, in
person, etc.), and the number of minutes spent with the patient. If users would like to follow up
with the patient at a later time, they can enter a Follow Up date which will create a reminder in
the Follow Up Icon on the date entered. Click Save or press Enter on the keyboard save
information entered into the Patient Counseling Form.

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Figure 127 Patient Counseling Form

Click Resolve once counseling has been completed to satisfaction.


If Privacy Consent is selected, users will be prompted to record whether or not the patient (or
guardian) has given consent to the pharmacy to record personal information on the computer
and/or send it over the network. Users can access the Option dropdown menu to indicate how
consent was provided to the pharmacy, or if consent was not given. Note that a Comment field
is also available for input of supplementary information regarding privacy consent.

Figure 128 Privacy Consent Form

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If ODB Meds Check/Medication Review is selected, a window will appear:

Figure 129 ODB MedsCheck

From the Reason dropdown menu allows the user to indicate the type of medication review
being performed.
Prompt to counsel the patient in ___ number of days;
Prompt to counsel the patient on or after DD/MM/YYYY;
Never prompt the patient for Medication Review This option should only be selected upon
request by the patient.
Print Report This option will call up the Medication Review Report configuration window.
Users can select to include or exclude certain prescriptions from the report as well as configure
options to customize the report.

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Figure 130 ODB MedsCheck Report

Patient Refused Counseling If a patient has refused a medication review for this time only,
users can document the refusal using this option.
The Professional Services option is very similar to the Counseling option. Users can document a
Professional Services Type from the dropdown menu and record the content that was
discussed, and enter the number of minutes spent with the patient. If users would like to follow
up with the patient regarding the professional service, they can enter a Follow Up date which
will create a reminder in the Follow Up Icon on the start screen.

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Figure 131 Patient Professional Service

Once the Professional Service encounter is complete, users can click on the Resolve button to
indicate that the service has been billed and resolved.

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Patient History
Patient History allows users to track changes made to the Patient Record including changes to
third party plans, phone numbers, addresses, etc. The Patient History window is read-only and
displays entries sorted by date and the user who executed the change. To view details of a
patient record change, simply click on the plus sign (+)to expand the details or hide details by
clicking on the minus sign (-).

Figure 132 Patient History

Users can also highlight a history entry and click Display Record After Changes or Display
Record Before Changes. The window that displays record after changes will display the patient
record after the change was made, whereas displaying record before change will display the
patient record before the change was made.

NOTE: Users can print the patient history window as displayed (i.e. details hidden or
revealed) by clicking on the Print button located on the bottom of the screen.

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Figure 133 Patient History Record

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Limited Use Items (Ontario Only)


For Ontario Stores, users can access the Limited Use Items option from the sidebar to view all
prescriptions billed to ODB for the patient with a Limited Use Code or a Section 8. This screen
displays the prescription number, drug product, Limited Use Code used, and the expiry date for
the code.

Figure 134 Patient Limited Use Drugs

To view details or edit information for an entry in the Patient Limited Use Drugs window,
double click on the entry with the mouse; this will call up the Patient Limited Use Form.

Figure 135 Patient Limited Use Form

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From the Patient Limited Use Form, users can click on View Limited Use Reason Code to call
up all applicable reason codes for the drug product. Note that the reason code cannot be
changed for the Rx from this screen, but it can be viewed.

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To Do
The To Do Screen displays all outstanding callbacks and follow ups for the patient. Users can
manually insert a to do item for the patient by clicking Ins or pressing Insert on the keyboard.

Figure 136 Selecting Patient To Do Items

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Searching for a Drug Record


There are three (3) methods of searching for a drug record in Kroll:
1. Method 1: Search from F5-Drug Search Screen
2. Method 2: Search from ALT+X Start Screen
3. Method 3: Search from F11- Drop-Off Screen

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Method 1: Search for a Drug from the F5 - Drug Search Screen


From the ALT+X Start Screen, click F5-Drug with the mouse or press F5 on the keyboard; this
will bring up the F5-Drug Search Screen.

Figure 137 - Search from F5-Drug Search Screen

NOTE: From the F5-Drug Search Screen, notice the green bar across the top of the
window; green denotes drug records throughout the system.
In the drug search field, enter one of the following drug search criteria:
1. Brand/Generic Name, Strength/Pack Size (e.g. Apo-Metformin, 500/360)
2. DIN (5-8 digits)

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3. UPC (11-12 digits)


4. A period (.) and the Drug Quick Code (e.g. TYLE3)
5. # symbol and the Catalog Item Number (e.g. #78945)
Once the drug search criterion has been entered, click Search or press Enter on the keyboard to
search for the drug in the database.

Figure 138 Drug Search

NOTE: The more detailed the search criteria, the smaller the result-set will be.
Conversely, the broader your search criteria (i.e. less detailed), the larger your resultset will be.

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Select the applicable drug record by either:


a) Using the Arrow Keys to highlight the entry and press Enter on the keyboard
b) Type in the line number corresponding to the applicable entry and press Enter on the
keyboard
c) Double click on the desired entry with the mouse.
The F5-Drug Record will be displayed:

Figure 139 Drug Record

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Method 2: Search for a Drug from the ALT+X Start Screen


From the ALT+X Start Screen, move your cursor to the Universal Search Field.

Figure 140 Search from ALT+X Start Screen

In the Universal Search Field, enter one of the following drug search criteria:
1. Brand or Generic Name, Strength/Pack Size (e.g. Apo-Metformin, 500/360)
2. DIN (5-8 digits)
3. UPC (11-12 digits)
4. A period (.) and the Drug Quick Code (e.g. TYLE3)
5. # symbol and the Catalog Item Number (e.g. #78945)
Once the search criterion has been entered, click F5-Drug or press F5 on the keyboard to
execute the drug search.
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Figure 141 Drug Search


A list of drugs matching the search criteria will be displayed. Select the applicable drug record by either:

a) Using the Arrow Keys to highlight the entry and press Enter on the keyboard
b) Type in the line number corresponding to the applicable entry and press Enter on the
keyboard
c) Double click on the desired entry with the mouse.
The F5-Drug Record will be displayed.

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Figure 142 Drug Record

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Method 3: Search for a Drug from the F Drop-Off Screen


From the F11-Drop-Off Screen, move your cursor to the Drug Search field.

Figure 143 - Search from F11- Drop-Off Screen

In the Drug Search field, enter one of the following drug search criteria:
1. Brand/Generic Name, Strength/Pack Size (e.g. Apo-Metformin, 500/360)
2. DIN (5-8 digits)
3. UPC (11-12 digits)
4. A period (.) and the Drug Quick Code (e.g. TYLE1)
5. # symbol and the Catalog Item Number (e.g. #78945)

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Once the search criterion has been entered, press Enter on the keyboard to begin the drug
search.

Figure 144 Drug Search

A list of drugs matching the search criteria will be displayed. Select the applicable drug record
by either:
a) Using the Arrow Keys to highlight the entry and press Enter on the keyboard
b) Type in the line number corresponding to the applicable entry and press Enter on the
keyboard
c) Double click on the desired entry with the mouse.
The F5-Drug Record will be displayed.

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Figure 145 Drug Record

Click Drop-Off or press Enter on the keyboard to insert the Drug Record into the F11-Drop-Off
Screen.

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Figure 146 Inserting the Drug Record

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Configuring the Columns in the Drug Search Screen


Users can configure information columns displayed on the Drug Search Screen by clicking on
the option to Change Columns from the Drug Sidebar. The default columns are set as:
Brand Name
Generic Name
Strength
Pack Size

DIN
Form
Mfr - Manufacturer

Figure 147 Configuring Columns Drug Search Screen

Accessing the option to Change Columns will bring up the Edit Scan Columns window where
users can customize the type of drug information displayed in the search results. For example,
users can select to view Pack Size as one of the information columns displayed. Additionally,
users can highlight a selection from the Edit Scan Columns window and click Move Up or Move
Down to determine where the information is displayed relative to other information columns.
At any time, select the option to Use Default Columns to revert back to the default settings.
Once the user has selected the columns they want displayed on the Drug Search Screen, they
can click OK or press Enter on the keyboard to save changes until the session is closed. If the
user would like the changes to be permanent, they must right click on the columns and select
the option to Make these the Default Columns.
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Advanced Drug Search


If a drug is not found through a regular search as described in the previous sections, an
Advanced Drug Search can be performed as follows:

Figure 148 Advanced Drug Search

Locate the Advanced flag from any Drug Search Screen. Place a checkmark next to the
Advanced flag by using the mouse, or by pressing CTRL+A on the keyboard.

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Inactive Drug Records


Users have the ability to inactivate drug packs in the system by un-checking the Pack Active flag
located on the drug record. Inactivating a drug pack means that it will no longer be displayed in
the Regular drug search; an Advanced search will have to be initiated in order to access the
drug pack information.

NOTE: Inactive Drug Records cannot be used to process any prescriptions. The user
will have to reactivate the drug record, or use another drug record for the Rx.
There are various reasons why users choose to inactivate drug records. For example, a drug
may be inactivated because the manufacturer no longer produces the particular pack size, or
the drug may be discontinued. Inactivating these records allows the regular search to provide
more succinct results; this reduces the possibility of selecting the wrong drug pack into a
prescription.
To locate inactivated drug packs in the system, perform an Advanced search and make sure the
Only Inactive or All flag is marked on the far left. Search as usual to find the applicable record.

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Figure 149 Inactive Drug Records

NOTE: Inactive drug packs will appear as red entries on the Drug Search Screen.

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Creating a Drug Record


There are two (2) methods to enter a new drug record:
1. Method 1: Manually Inserting a New Drug Record
2. Method 2: Copying a Drug Record

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Method 1: Manually Inserting a New Drug Record


Insert a new drug into the system as follows:
1. Thoroughly search for the drug you want to insert to ensure that it does not already exist in
the database.
2. Once the user is satisfied that the drug record does not exist in the system, click Ins-Insert
with the mouse or press Insert on the keyboard to add a new drug record.

Figure 150 Searching a Drug Record to avoid duplication.

A message will appear indicating to the user that they cannot add a new drug record without
performing an Advanced drug search. Click OK or press Enter to initiate the Advanced drug
search.
From the Advanced search screen, click Ins-Insert with the mouse or press Insert on the
keyboard again to add the new drug record.

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A prompt will appear asking the user to enter the Pack Size of the new drug. Enter the pack size
and click OK or press Enter on the keyboard to continue.

The user will be brought to a new drug record screen where data can be entered. The cursor
will default to the Name field; use the TAB key to move forward from field to field and fill in all
applicable drug information (SHIFT+TAB will move your cursor backwards).
Once all the applicable fields have been filled out, click Save or press Enter on the keyboard to
save the information.

Figure 151 Drug Application Record


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Drug Records The Fields

Figure 155 Drug Record Fields

NOTE: Drug Fields with asterisks next to them are mandatory drug fields and must be
filled in order to save the drug record.

Name*
Displays the Brand Name of the drug product

Generic*
Displays the Generic Name of the drug product
Description: Displays an abbreviated physical description of the drug product

Description 2
Displays other physical descriptors of the drug product different from the Description field
above.
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Method 2: Copying a Drug Record


If a drug manufacturer releases a new strength for an existing drug product, users can utilize
the copy function to prevent having to re-enter duplicate drug information. Copy an existing
drug to a new drug record as follows:
Perform a thorough drug search to ensure that the new drug does not already exist in the
database. Users should perform an Advanced Search to make sure the drug record they are
adding is not simply inactivated.

Once the user is satisfied that the new drug does not exist in the system, click Copy Drug with
the mouse or press CTRL+Y on the keyboard. A second drug search window will appear; search
for the drug that already exists in the database.

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Figure 152 - Searching a Drug Record to avoid duplication.

From the list of results, highlight the drug you want to copy by either:
Using the Arrow Keys to highlight the entry and press Enter on the keyboard
Type in the line number corresponding to the applicable entry and press Enter on the keyboard
Double click on the desired entry with the mouse.
The drug record you want to copy will be displayed. Review the information and confirm that
this is the drug you want to copy information FROM by clicking Save or pressing Enter on the
keyboard.

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Figure 153 Drug Application Record

A small window will appear prompting the user to enter the Pack Size for the new drug. Enter
the pack size and click OK or press Enter on the keyboard to continue.

A prompt will occur asking the user to copy the price information. Select the desired response.

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The user will be brought to a new drug record with information copied from the old drug
record. The DIN and price fields will not be copied over.

Figure 154 Entering DIN and Price details

Fill out the remainder of the drug fields and click Save or press Enter on the keyboard to save
the information.

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Equivalent To
If the drug record is a generic product, this field displays the brand name equivalent.

Default SIG
Used to quickly populate the RX with a repeatedly used sig code.

Location
Store level users can enter information about the physical location of a drug product in this
field to facilitate retrieval (e.g. Refrigerator, Safe, etc.)

Generic Type
Displays one of the following options:
1. Brand Multi Source Brand
2. Brand Multi Source Generic
3. Brand Single Source
4. Generic Multi Source
5. Generic Single Source

DIN*
Displays the Drug Identification Number for the drug product. This field can also house PDIN
Pseudo DIN, NPN Natural Product Number, HDIN Homeopathic DIN, or OPIN
OPINION.

Strength*
Displays the strength of the drug product.
Followup (Days): Users can enter the number of days that elapse before a follow-up reminder is
created in the system to remind the pharmacist to follow up with the patient regarding their
drug treatment.

Form*
Displays the form of the drug product (e.g. capsule, tablet, injection, etc.)

Route*
Displays the route of administration for the drug product (e.g. oral, topical, intravenous, etc.)

Manufacturer*
Displays the manufacturer of the drug product (e.g. Astra, Pfizer, Apotex, etc.)
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Handling Instr.
Users can enter handling instructions for a drug product (e.g. for example, sublingual tablets
should be handled with clean dry hands).

Price Group
A price group can be assigned to a drug record for activation of specific pricing requirements.
Drug Price Groups are configured and assigned by head office.

Department
Drug Departments are used to narrow report output to certain clusters of drugs, similar to the
function of Drug Groups. The main difference between Drug Groups and Drug Departments is
that a drug record can only belong to one department which maintains mutual exclusivity
between departments, whereas a drug record can have multiple Drug Groups.

Marketing Message
Marketing messages are configured by head office. These messages promote and support
awareness for certain products as well as facilitate branding of the business. When a Marketing
Message is entered into a drug record, the message will be printed on the patient receipt
whenever a prescription is filled for the drug. For example, if a pharmacy is holding a diabetes
clinic, a marketing message can be attached to diabetic drugs and supplies to promote and
provide information regarding the clinic.

Fee For Service


Fee For Service entries are configured and maintained by head office. When this field is
populated, it means that the drug record is being used to bill a professional service. Some types
of professional service billings require specific indicators to be sent to the third party in order
for the claim to go through; by selecting the appropriate Fee for Service option in the drug
record, billing indicators are automatically sent with the prescription during adjudication.

Reportable*
A checkmark in this field indicates that the system will track prescriptions filled for the drug
product and display results in the Narcotic Report.

Dispense as Pack
A checkmark in this field indicates that the drug product will be billed to third parties as
multiples of one pack rather than billed as dosages. This flag is used for billing of birth control,
inhalers, and nasal sprays in some provinces.

Ward Stock:
This option is used for pharmacys that dispense ward stock to patients.

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Trial: When this flag is checked, a prompt will appear during the first fill of a prescription asking
the user if they would like to fill a trial supply rather than filling the total dispense quantity of
the prescription.

Device
This flag indicates that the drug record is for a medical device, not a drug product. This flag is
also used in the transmission of DIS device transactions in Atlantic Provinces.

Immunization
This flag indicates that the drug record is for an immunization.

Print Compliance Calendar


When this flag is on, a calendar containing empty boxes will appear for the guest to document
once a dose has been taken.

Eligible for Coupon


Coupons are configured and set up by home office. When this flag is on, the configured coupon
will be printed when the drug product is filled in a prescription.

Flavor Rx
This flag indicates that flavoring should be used to augment the taste of the medication. A note
will be printed on the hardcopy to remind users to use flavoring during preparation of the drug.

Health Inform/Rx Canada


Maintained by head office, this flag will be checked for drugs qualifying for programs used to
distribute patient education leaflets complementing Kroll Care.

Class
Displays the therapeutic class code as obtained from First Data Bank.

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Clinical Form*
Displays the clinical form of the drug product as obtained from First Data Bank.
Narcotic Monitoring*: This flag will be checked for drug products that are a part of the
provincial Narcotic Monitoring Program (not applicable in all provinces).

View Reason Codes


This button is only applicable to Ontario pharmacies. Access of this option will display Reason
Codes and Reason Code descriptions for Limited Use products. There is also an option to print
Reason Code information from the window.

Drug Line 1
Displays the type of drug information (i.e. Brand, Generic, Description, Description 2, Equivalent
To) that is printed on the vial label.

Drug Line 2
Displays the type of drug information, different from Drug Line 1 that is printed on the vial
label.

Half-size SIG
When this flag is activated, it will cause the SIG to print at half the size it normally prints at. This
option is useful for drug products that usually have long SIG instructions, for example eye
drops.

Track Lot Num


When this flag is activated, the user will be required to enter the lot number of the drug
product into the Motorola handheld during the filling stage.

Track Expiry
When this flag is activated, the user will be required to enter the expiry date (MM/YYYY) of the
drug product into the Motorola handheld during the filling stage.

Refrigerated
When this flag is activated, the word Refrigerated will appear on the handheld during filling
and at point of sale during the prescription pick up stage.

Drug Substitutions
The Drug Sub function allows users to point the drug record to an interchangeable substitute.
This function allows users to switch away from using one brand to another. When a Drug Sub is
entered into this field, the user will be prompted to use the substitution when inputting a
prescription.
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Comments
Drug records can have an unlimited number of comments. To add a comment, click Ins, press
Insert on the keyboard, or simply begin typing the comment.
Select a topic for the comment by clicking on the down arrow or pressing the down arrow on
the keyboard to view the list of choices. A topic must be selected in order to save the comment.
Each comment has three options. To enable an option, use the mouse to click on the checkbox
or TAB to the desired option and use the spacebar to select.

Show On Rx
Enabling this option will display the comment on the F12-Filling Screen.

Print on Hardcopy
Enabling this option will print the comment on the hardcopy portion of the Rx label. Note that
only one drug comment can be flagged on the hardcopy due to limited space.

Alert
Enabling this flag will cause the comment to pop up every time the drug card is accessed.

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To delete a comment, highlight the appropriate comment entry and click Del, or press Delete
on the keyboard. A window will appear to confirm the deletion.
To edit a comment, highlight the applicable comment entry and either:
1. Click F2 with the mouse
2. Press F2 on the keyboard
3. Double click on the comment and make the necessary changes.
4. Click Save or press Enter to save changes.

Groups
Drugs can be included in a group for a wide range of reporting purposes. Drug Groups are
created by head office and can be applied to any number of drug records. For example, a drug
group called Diabetic Supplies can be created and attached to a drug records for diabetic
supplies. Also note that drugs can belong to more than one Drug Group.

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Tabs on a Drug Record


The Drug Record contains tabs of information located at the bottom right of the screen (e.g.
General, Ordering, UPCs, Plans, etc.). To move to a specific tab, press CTRL on the keyboard and
the underlined letter on the tab (e.g. Press CTRL+R to access the Ordering tab). Users can also
flip from tab to tab by pressing CTRL+ to move right or CTRL+ to move left.

NOTE: Drug Fields with asterisks next to them are mandatory drug fields and must be
populated in order to save the drug record.

Figure 156 Tabs on a Drug Record

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General Tab
The General Tab of the drug record contains a snapshot of drug information including pack
sizes, pricing, on hand quantities, ordering points, UPCs, etc.

Figure 157 Drug Record General Tab

Packs (#)*
This area displays the different pack sizes available for the drug product (in Ontario, this area
will also display ODB pack sizes). When a drug pack is highlighted, the information displayed to
the right will refer to the specific pack size selected.

Pack Active*
Pack sizes that are actively being used, or have been used recently in a prescription should have
the Pack Active flag enabled. Users can remove the Pack Active flag for pack sizes that have
been discontinued, or are no longer in use by the pharmacy. Inactive drug packs will not be
returned on a regular drug search; an advanced drug search must be executed in order to
view inactive drug packs.
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Quick Code
Enter a short code that represents the drug record which facilitates searching (e.g. T3 for
Tylenol with Codeine #3). Note that the Quick Code must be preceded by a period (.) in the
drug search screen to indicate that the user is searching using Quick Code convention.

Purchase Price*
The first price field always displays the price used to purchase the drug product from the
vendor (i.e. acquisition cost). Pricing strategies within the system may pull from this field.

Price Fields*
The four price fields located below the Purchase field will vary from province to province and
will be centrally maintained by head office. Pricing strategies set within the system may pull
from one of these fields.

Default Vendor*
The default vendor will be set to K&F for all drug records.
On Hand*: The On Hand field displays the current amount of medication available for
dispensing. Users will be required to enter their User Initials and Password in order to modify
values in the field.

Min Qty*
The minimum quantity field displays the point when a drug pack is triggered for reordering. For
example, if the minimum quantity is set at 100, when the on hand drops below 100 units, the
drug pack will be placed on order. The Days field will display the minimum number of days
supply that triggers reordering and is related to Min Qty through a calculated formula. Min Qty
is required for perpetual inventory.

Max Qty
The maximum quantity tells the system how much of a drug product should be reordered. For
example, if a drug pack has a Max Qty set to 300, the system will order enough so that the
current on hand reaches 300 units. The Days field displays the maximum days supply a store
should have on hand and is related to Max Qty through a calculated formula. Max Qty is
optional for perpetual inventory; when the field is empty the system will always order 1
package of the drug pack.

UPC*
The UPC field displays the drug pack UPC. If there is more than one UPC for the drug pack, the
UPC marked as default will be displayed here (See UPC section for further details).

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Lot
User can optionally enter the Lot number of the drug product in this field. Note that this field
cannot account for multiple lot numbers.

Expiry Date
Users can optionally enter the expiry date of the drug (DDMMYYY) in this field, or type in the
number of Days that the drug is good for once it is dispensed. The expiry date will print on the
vial label. Note that this field cannot account for multiple expiries.

Only allow manual price changes


A checkmark in this field ensures when updates are ran against the drug card, the pricing fields
will not updated.

Front Store
A checkmark in this flag indicates that the product is available over-the-counter.

Drug Picture
A large majority of drug records will have a drug picture attached. Periodic updates from
central maintenance will ensure that drug records have an associated drug picture.

Created On
The timestamp indicates the date and time the drug record was created.

Changed On
The timestamp indicates the date and time the drug record was last changed.

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Ordering Tab
The ordering tab contains information and configurations related to drug ordering.

Figure 158 Drug Record Ordering Tab

Packs (#)
This area displays the different pack sizes available for the drug product (in Ontario, this area
will also display ODB pack sizes). When a drug pack is highlighted, the information displayed to
the right will refer to the specific pack size selected.

Available Vendor Items


This area displays the default vendor. In addition, the item number, description and catalog
price for the drug product is displayed here.

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No Inventory Adjustment
When this flag is activated, the On Hand field will not be adjusted when the drug is dispensed,
nor will it be adjusted when the product is received into the system; in other words, this flag
causes the On Hand field to remain static. This flag may be used for OTC products that you
create a Not Dispensed prescription for because you want it in the patients medication
history, but you dont want to deduct inventory from the drug record.

Disable Automatic Ordering


When this flag is activated, the drug product will not be included in the automatic order even
when the On Hand quantity is less than the Minimum. Users may activate this flag for expensive
products they want to order on demand rather than through the automatic ordering system.

On Hand
The On Hand field displays the current amount of medication available for dispensing. Users will
be required to enter their User Initials and Password in order to modify values in the field. This
field is also available from the General Tab.

Base Ordering On
Ordering points can be based on Min/Max or Usage/Days Supply (default). In both scenarios, if
automatic ordering is activated, a drug product will be placed on order when the On Hand
value drops below the Minimum value. When Min/Max is selected, the Days Supply fields will
be greyed out and vice-versa.

Benefits of Min/Max ordering:


The user can control the exact point at which a drug is reordered by setting an exact minimum
value.
The Min/Max values do not change once they are set because the values are independent of
usage. This is particularly useful for drugs that the pharmacy wishes to under-stock or
overstock.

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Drawbacks of Min/Max ordering:
The Min/Max values do not change once they are set, so the user must be aware of drug usage
and adjust ordering points accordingly when required.

Benefits of Usage (Days Supply) ordering


Drug reorder points are dynamic values that increase or decrease depending on how often the
drug is dispensed within the days supply indicated. This is particularly useful for cyclical drugs
like allergy medications that are dispensed frequently during some parts of the year and less
during other parts.

Drawbacks of Usage (Days Supply) ordering


The minimum and maximum values are not open for manipulation as they are calculated
values; this may result in less control over the exact point the drug is ordered.

Min Scripts Calc


The system can calculate Script quantity based on Maximum Rx Quantity or Average Rx
Quantity.

Order in Multiples of ___ Packs


This configuration is useful for products that are dispensed in multiple packs. For example, birth
control is usually dispensed in packs of three, so the user may wish to order product in
multiples of threes.

Place Order
Accessing the Place Order function will allow the user to add a manual order for the drug; this
manual order will become a part of the automatic order when it is generated. To create a
manual order, simply select the Vendor (i.e. McKesson), enter the quantity being ordered, and
enter the Order Date. This function is most commonly used when the pharmacy wants to order
more of a product even when the On Hand quantity is greater than the minimum required.

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Additionally, accessing the Place Order function allows users to future-date a drug order so that
the drug product will be placed on order on the date specified. This is useful for drug products
that have short expiries or are costly to stock in advance of dispensing. To future-date an order
simply enter the date in the future that you would like the drug product to be ordered.

Order Grouping
This function is used to create re-order points for a drug grouping. By grouping interchangeable
drugs Kroll will re-order the primary assigned pack when stock depletes from each drug card in
the group.

Usage Values
Usage Values provide users with a succinct snapshot drug movement in terms of daily usage,
average Rx quantity, and maximum Rx quantity. Usage values help users to make optimal
decisions on replenishment.

Outstanding Orders
Whenever the drug product has been ordered, an entry will be created under Outstanding
Orders to indicate that the drug product is on its way to the pharmacy, or is in the process of
being ordered.

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Whenever there is an entry under Outstanding Orders, the drug product will NOT be ordered
even when the On Hand is below the minimum required; this prevents the system from
duplicating orders for drug products.

UPCs Tab
The UPCs tab contains all UPCs listed for the selected drug pack. Highlight the applicable drug
pack on the right hand side to view UPCs corresponding to the pack size. UPCs are centrally
maintained; therefore, any errors should be communicated to the Pharmacy Support Helpdesk
for correction.
The UPCs listed in this section are used to verify that the product being used to package an Rx
at the filling stage is the correct product.

Figure 159 UPCs Tab

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Plans Tab
The information contained in the Plans tab is centrally maintained by head office and serves
two purposes. The first is to display formulary coverage for the drug product; users can look
under this tab and locate the entry for the provincial plan (in this case ODB for Ontario) and see
if the drug product is covered or not. Provincial coverage is updated regularly through
formulary updates to the system.
The second purpose of the Plans tab is to house Pseudo DINs that are adjudicated to third
parties for financial reimbursement. To view details of a pseudo DIN, highlight entry of choice
and press F2 on the keyboard, or double click on the entry; this will call up the Drug-Plan
Information window where detailed pseudo DIN information is displayed.
From the Drug-Plan Information window, users can see which pack sizes the pseudo DIN is
being applied to. When the Default flag is checked, it means that the pseudo DIN will be
automatically sent to the third party during adjudication; if the Default flag is NOT checked, the
DIN on the drug record will be sent to the third party rather than the pseudo DIN. A checkmark
next to the Covered flag indicates that the third party plan will pay for the drug product; this
flag serves information purposes only.

Figure 160 Plans Tab

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Usage Tab
The Usage tab displays information regarding how often and in what volume a drug product is
being dispensed over an annual basis. This information helps users to determine if current
ordering points (i.e. Min/Max values) support optimal replenishment. The graph on the Usage
tab displays how many prescriptions have been filled for the drug product and the total drug
quantity dispensed monthly. A dropdown menu is also available to view historical data from
previous years to identify trends that may be present.

Figure 161 Usage Tab

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Old Costs Tab


The Old Costs tab displays pricing changes made to any of the 5 price fields located on the
General Tab of the Drug Record. Each of the 5 pricing fields will display Current Costs, Old Cost,
Changed On and Changed By columns so that users can accurately identify when, why and by
whom a price change was made.

Figure 162- Old Costs Tab

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Counseling Tab
The Counseling tab displays Patient Counseling messages extracted from the First Data Bank
(FDB) clinical drug module. Counseling messages are broken down into Patient Messages and
Professional Messages.

Figure 163 Counseling Tab

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Kroll Care Tab


The Kroll Care tab displays the Drug Information Monograph that is printed out and handed to
the patient during the prescription filling process. The content of Kroll Care is provided by the
First Data Bank (FDB) clinical drug module. Users can print the drug information monograph on
demand by clicking Print Kroll Care from the drug sidebar, or by accessing the Drug dropdown
menu and selecting the command to Print Kroll Care.

Figure 164 Kroll Care Tab

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Drug Sidebar Functions


The Drug Sidebar is available at the right of the screen whenever a Drug Record is accessed.
The Sidebar options allow users to quickly access functions related to the drug with just a click
of the mouse. The following section will explain how each of the Drug Sidebar functions is used.

Order Drug
Accessing the Order Drug function from the sidebar will open up the same window as pressing
the Place Order button under the Ordering Tab. This window allows the user to add a manual
order for the drug; this manual order will become a part of the automatic order when it is
generated. To create a manual order, simply select the Vendor (i.e. K&F), enter the quantity
being ordered, and enter the Order Date. This function is most commonly used when the
pharmacy wants to order more of a product even when the On Hand quantity is greater than
the minimum required.
Additionally, accessing the Place Order function allows users to future-date a drug order so that
the drug product will be placed on order on the date specified. This is useful for drug products
that have short expiries or are costly to stock in advance of dispensing. To future-date an order
simply enter the date in the future that you would like the drug product to be ordered.

Figure 165 Placing a Drug Order

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Receive Drug

Figure 166 Receive a Drug

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Returning to Stock
From the drug card side menu the user can choose to return inventory to stock using the
Return to Stock feature. Enter the Qty to return to stock in the Return to stock screen, and
provide a reason for returning to stock. (E.g. Returned NH stock)

Figure 167 Return Drug to Stock

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Performing FDB Analysis


Users can initiate a First Data Bank (FDB) clinical analysis of a drug by selecting the option to
Perform FDB Analysis from the sidebar.

Figure 168 Performing FDB Analysis

From the selection screen, place a checkmark next to the clinical drug information you want to
retrieve; Select All and Select None buttons allow users to quickly check or uncheck all options.
Once selections have been made, click OK or press Enter on the keyboard to retrieve data from
First Data Bank (FDB).
Results of the analysis will be displayed in the Clinical Reports window under separate tabs
across the top of the screen; click Back to move left a tab, click Next to move right a tab There
is also an option to print the clinical report by accessing the File dropdown menu and selecting
the command to Print.

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Figure 169 Client Reports

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Analyzing Multiple Drugs


The option to Analyze Multiple Drugs allows the user view interactions between two or more
drugs. The analysis is based on the First Data Bank (FDB) clinical module.
Under the Drug sidebar, select Analyze Multiple Drugs. When the option to Analyze Multiple
Drugs is selected, the Drug Analysis Form will be displayed. Locate the Drug Search Criteria
field and search and select the drug(s) you want to perform the interactions checking against.
Users can add any number of drugs into the analysis. Once the user has added all the drugs
they want to analyze, click Perform Analysis.

Figure 170 Drug Analysis Form

A selection screen that will prompt allowing the user to select what elements they would like to
analyze. Once selections have been made, click OK or press Enter on the keyboard to retrieve
data from First Data Bank (FDB).

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Figure 171 Drug Analysis Options

Results of the analysis will be displayed in the Clinical Reports window under separate tabs
across the top of the screen; click Back to move left a tab, click Next to move right a tab. There
is also an option to print the clinical report by accessing the File dropdown menu and selecting
the command to Print.

Figure 172 Print (Clinical Reports)

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Printing Kroll Care


Selecting the option to Print Kroll Care from the Drug Record will cause the drug information
monograph to be printed.

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Alerts
Alerts are messages regarding the drug products that are pushed down from head office. Click
on the Alerts button to read the details of the message. The bracketed number next to Alert
indicates the number of alert messages for the drug product. Alert messages are printed along
with Kroll care and distributed to the patient as additional drug information. Drug alerts will be
added by head office and can be found under Edit Lists Drug Alerts.

Figure 173 Edit Drug Alert Master Item

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Generic Equivalents
The Generic Equivalents function allows users to view a comprehensive list of generic
equivalents for a drug product. In Alberta and British Columbia, the Generic Equivalent list is
maintained by First Data Bank (FDB) Updates, whereas in the rest of the provinces, the Generic
Equivalent list is maintained by Provincial Formulary Updates. Users can highlight a generic
equivalent entry and click Select or press Enter on the keyboard to pull up the corresponding
drug record. Each entry will display the following information:
Preferred Brand Indicator (1 = Preferred; 2 = 2nd Preferred, etc.)
DIN
Drug Name
Manufacturer
Unit Cost (Acquisition Cost Pack Size)
On Hand Quantity ( Allows users to quickly see what brands are stocked)
Extra info comment if applicable

NOTE: Whenever a Drug Record is up on the screen, users can press ALT+G on the
keyboard to access the Generic Equivalent list.

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Modification History
The Modification History function calls up read-only data regarding any and all changes made
to the drug record. Details of the changes can be expanded (click on the + sign) or condensed
(click on the - sign) depending on the level of detail the user wants to see. For example, if
there is inventory missing or overstated in the drug record, users can go into Modification
History to view what changes were made to the On Hand field.

Figure 174 History for Drug

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Old and New DIN Links


DIN Links are centrally maintained by head office. Din Links appear for drug products that have
had a DIN change. The function of the DIN Link is to link the OLD DIN to the NEW DIN so that
the system recognizes both DINs are for the same product. Users cannot create a DIN Link, but
they can remove a DIN Link by highlighting the entry and clicking Del or pressing Delete on the
keyboard.

Order History
The Order History function displays read-only information on when the drug product was
placed on order (i.e. InitPO), sent (i.e. Ord), and received (i.e.Rec). Users can access the Pack
Size dropdown menu to view order history for different packs of the drug product. This screen
helps users determine root causes of ordering issues and/or discrepancies.

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Reason Codes
The Reason Codes function is only applicable to pharmacies operating in the province of
Ontario. Drug products that are eligible to be billed to the provincial plan (ODB) using Limited
Use (LU) Codes can access the Reason Code sidebar function to view all codes, descriptions and
expiries for the LU drug. User can print the codes by clicking Print or pressing CTRL+P on the
keyboard.

Figure 175 Drug Reason Codes

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Cycle Count Procedures


In the Kroll Pharmacy Software, drug on hands can be managed through a cycle count process
using the cycle count feature. The implementation of a cycle count process provides more
accurate inventory and more efficient tracking of incoming and outgoing product. With the
cycle count process you have the ability to count sections of inventory for example specific
schedules, manufacturers, drug types and therapeutic class.
The cycle count process is a convenient way for inventory values to be verified during quiet
periods and is not necessarily intended solely for yearend inventory counts.
To execute a cycle count:
1. Set up the Cycle Count
2. Count Inventory
3. Adjust Inventory

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Set up a Cycle Count


1. Access the Utilities option from the menu bar located at the top of the start screen.
2. From the Utilities menu select the Drug option and then select Drug inventory Counts.

Figure 176 Drug Inventory Counts

3. The Cycle Count screen will be displayed. Select Create New.

Figure 177 Creating a New Cycle Count

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4. A dialogue box will be displayed:

Users have three options:


a. Create a cycle count for Pre-selected drugs to count
b. Scan and go-start counting now
c. Cancel to exit the cycle count.

Option 1: Pre-Select Drugs to CountThis is selected when you want to cycle count specific drugs. The following illustration displays
the options available for the specific types of drugs that can be counted.

Figure 178 Generating Drug Count List

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To select a type, click or press F2 to view the available options. Select the appropriate option
under the Available column by clicking on the item and then click Insert to move it to the
Selected column on the right side.
The example below illustrates the Drug Schedule options with the Narcotic option selected.

Figure 179 Select Drug Schedule

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Count Inventory
1. Once the user has selected the options, click OK to return to the Generate Drug Count List
and continue to select any other options. When ready, click Search to generate a list of
drugs on the screen. Click on Start Counting and the following window will appear:

Figure 180 Cycle Count Pack

2. Enter the amount counted from the bottle into the Quantity to Add field (in the example
above it is 60). Click Add QTY to add the quantity of another bottle and continue to Add
QTY until you have entered the amount for every bottle for this drug. When you are ready
to go to the next drug on the list click Next. If you are unable to count all the drugs on the
list but want to reconcile what you have counted, then click on Reconcile. The following
message will appear:

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3. Answer Yes and the drugs that were counted will appear on the screen.
4. If the drugs listed are in red, this means that the count entered does not match the Onhand
value in the drug card. When this is the case, the drugs must be recounted and the system is
looking for a match either on the Onhand value of the drug card or a match to the count
that was previously entered. The user must continue to recount until the match is met.

Figure 181 Adding Drug Quantity

5. Continue to recount quantities and add the values into the quantity to Add field, click Next
> to go to the next drug or click Next (with the green checkmark) to go to the next pack for
the same drug.

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Adjust Inventory
1. Once you have gone through all the drugs to recount, click Cancel and then click Reconcile.
If the counted items match either the Onhand value in the drug card or the quantity
counted the first time, then the items in the list will appear in black (which means no
errors).

2. You are then ready for the program to adjust your inventory to the amounts counted in
your cycle count. Click Adjust Inventory to update your inventory.

NOTE: the Qty Diff and the Cost Diff columns identifying the amount in which these
values will change for the drugs.
3. Click Print Report to retrieve a copy of the changes for your records.

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NOTE: Only a pharmacist or pharmacy Manager can adjust the inventory count. If the
user logged into the terminal is NOT a pharmacist, exit out of the Cycle Count
functionality. The user needs to have a pharmacist/pharmacy manager log into the
terminal to access the appropriate Cycle Count screen
The Drug Inventory Count Report will be generated with a Status = Inventory Adjusted. The
Report will include the initials of the individual who performed the count.
4. To close the Report Selection screen click on the Close option.
5. To exit from the Cycle Count Process double click on the Close option.

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Searching for a Mixture Record


Mixture records are composed of two or more drug records. The drug records within a mixture
are referred to as components. The following sections will describe two methods for
searching mixtures in the Kroll Pharmacy Software:

Method 1: Search from the F5-Drug Search Screen


Method 2: Search from the F11-Drop Off Screen

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Method 1: Search from the F5-Drug Search Screen


1. From the ALT+X Start Screen, click F5-Drug with the mouse or press F5 with the keyboard.
This will bring up the F5- Drug Search Screen.
2. From the F5 - Drug Search Screen, indicate that you are searching for a mixture by either:
f) Placing a checkmark next to the Mixture flag.
g) Pressing CTRL+M on the keyboard.
h) Entering the @ sign in the search field (@ triggers a Mixture Search).

NOTE: From the F5-Mixture Search Screen, notice the purple bar across the top of the
window; purple denotes mixture records throughout the system.

3. In the mixture search field, enter one of the following search criteria:
a) Search using Mixture Description, also known as Mixture Name.
b) Search using mixture Components; type in the full or partial component names
separated by commas. It does not matter what order the components are

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c) entered. For example, to search for Hydrocortisone 1% Powder in Clotrimaderm
1% Cream users can search hydro, clot or clot, hydro.
d) Search by entering a period (.) followed by the Mixture QuickCode. If a mixture
does not have a Quick Code assigned to it, this type of search cannot be
executed.
e) Search for ALL mixtures in the database by entering an asterisk (*).

NOTE: Precede the full or partial Mixture Description with an asterisk (*) to instruct the
system to search for the criteria entered whether it appears at the beginning, middle
or end of the description (e.g. *hydro will search for any mixture containing hydro
anywhere in the mixture description.
f) Search using mixture Components; type in the full or partial component names
separated by commas. It does not matter what order the components are
entered. For example, to search for Hydrocortisone 1% Powder in Clotrimaderm
1% Cream users can search hydro, clot or clot, hydro.
g) Search by entering a period (.) followed by the Mixture QuickCode. If a mixture
does not have a Quick Code assigned to it, this type of search cannot be
executed.
h) Search for ALL mixtures in the database by entering an asterisk (*).
i) Once the mixture search criterion is entered, select Search or press Enter on the
keyboard to initiate the search.

NOTE: The more detailed the search criteria, the smaller the result-set will be.
Conversely, the less detailed the search criteria, the larger the result-set will be
4. Select the applicable mixture record from the list of results in one of the following ways:
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a) Use the Arrow Keys to highlight the entry and press Enter on the keyboard.
b) Type in the line number corresponding to the applicable entry and press Enter
on the keyboard.
c) Double click on the desired entry.
The Mixture Record will be displayed.

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Method 2: Search from the F11-Drop Off Screen


1. From the Alt+X Start Screen click F11-Drop-Off or press F11 on the keyboard to access the
Drop Off screen.
2. From the F11- Drop-Off screen, move your cursor to the Drug Search field.
3. Indicate that you are searching for a mixture from the F11-Drop-Off screen and either:
4. Enter a @ sign in the Drug Search field and press Enter on the keyboard.
5. Click F5-Drug or press F5 on the keyboard to bring up the Drug Search Screen and place a
checkmark next to the Mixture Flag.
6. In the mixture search field, enter one of the following mixture search criteria:
7. Mixture Description, also known as Mixture Name.

NOTE: Preceding the full or partial Mixture Description with an asterisk (*) will tell the
system to search for the criteria entered whether it appears at the beginning, middle
or end of the description. (e.g. *cortate will search for any mixture containing
cortate anywhere in the mixture description.

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8. Search using mixture Components; type in the full or partial component names separated
by commas. It does not matter what order the components are entered. For example, to
search for Hydrocortisone 1% Cream in Clotrimaderm 1% Cream equal parts users can
enter hydro, clot or clot, hydro.
9. Search by entering a period (.) followed by the Mixture QuickCode. If a mixture does not
have a Quick Code assigned to it, this type of search will not provide results.
10. Search for ALL mixtures in the database by entering an asterisk (*).
11. Once the mixture search criteria been entered, click Search or press Enter on the keyboard
to search for the mixture.
NOTE: The more detailed the search criteria, the smaller the result-set will be.
Conversely, the less detailed the search criteria, the larger the result-set will be.
12. Select the applicable mixture record in one of the following ways:
a) Use the Arrow Keys to highlight the entry and press Enter on the keyboard.
b) Type in the line number corresponding to the applicable entry and press Enter
on the keyboard.
c) Double click on the desired entry with the mouse.
The Mixture Record will be displayed.

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13. Click F11-Drop Off or press Enter on the keyboard to insert the mixture record into the F11Drop-Off Screen.

Advanced Mixture Search


If a mixture is not found through a regular search as described in the previous sections, an
Advanced Mixture Search can be performed as follows:
a) Locate the Advanced flag from any Mixture Search Screen. Place a checkmark next
to the Advanced flag by using the mouse or by pressing CRL+A on the keyboard.
An Advanced search can also be initiated from the Mixture Search Screen by clicking on the
option to Show Advanced Options from the Mixture Sidebar.
The Advanced Search will reveal additional fields for searching the mixture:
a) Inactive Mixtures
b) Drug Groups (i.e. Mixture Groups)
c) Price Groups
d) Mixture Times
e) Form
f) Mixture Type
g) (Mixture) Schedule
h) Reportable (Yes/No)
i) Methadone (Yes/No)
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j) IV Mixture (Yes/No)
Enter any advanced search criteria that may be available and search for the mixture as usual.

Inactive Mixture Records


Similar to the Drug Records, users have the ability to inactivate Mixture Records if they become
obsolete or are no longer used. To inactivate a Mixture Record, uncheck the Active flag.
Inactivated mixtures will not show up in the Regular mixture search; an Advanced search
for Inactive records will have to be initiated in order to access mixture information.

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NOTE: Inactive Mixture Records cannot be used to process any prescriptions. The user
will have to reactivate the mixture record, or use some other active mixture record in
the Rx.
Inactivating mixture records that are not actively being used to fill prescriptions allows the
regular search to provide more succinct results thereby reducing the chances of selecting the
wrong mixture into a prescription.
Inactivating mixture records that are not actively being used to fill prescriptions allows the
regular search to provide more succinct results thereby reducing the chances of selecting the
wrong mixture into a prescription.
To locate inactivated mixtures in the system, perform an Advanced Search and make sure the
Only Inactive or All flag is marked on the far left. Search for the mixture as usual to find the
applicable record. Inactive mixture records will appear as red entries on the Mixture Search
screen.

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Configuring the Columns in the Mixture Search Screen


Users can configure the information columns displayed on the Mixture Search Screen by
clicking on the option to Change Columns from the Mixture Sidebar. The default columns are
Quick Code and Description.

By accessing the option to Change Columns, the Edit Scan Columns window will appear with
opportunities to customize the type of mixture information displayed in the search results. As
well, users can highlight a selection and click Move Up or Move Down to determine where the
information is displayed relative to other information columns. At any time, the user can select
the option to Use Default Columns which will cause the column view to revert back to the
default configurations.
Once the user has selected the columns they want displayed on the Mixture Search Screen,
they can click OK or press Enter on the keyboard to save changes until the session is closed. If
the user would like the changes to be permanent, they must right click on the columns and
select the option to Make these Default Columns.

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Creating a Mixture Record


Mixture Records are added and maintained by store level users, not by the central system,
which makes understanding them especially important. Avoid adding a mixture record without
performing a thorough search of the system; duplicate mixture records cause confusion for the
pharmacy and potentially for the patient. A set of optional guidelines to follow regarding
Mixture Naming Convention is outlined in the following subsection to ensure consistency and
to facilitate subsequent mixture searches.
This section includes information about:

Mixing naming convention (recommended)


Inserting a mixture
Mixture fields
Inserting mixture components

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Mixture Naming Convention (Recommended)


When creating a new mixture record, it is recommended to use the following Mixture
Description naming convention:
1. Active Ingredient(s) should come before base ingredient(s). If there is more than one active
ingredient, the one with the higher concentration goes first, followed by the active
ingredient with the second highest concentration, etc.
2. Base ingredient(s) go after active ingredients. If there is more than one base ingredient, the
one with the higher proportion goes first, followed by the base ingredient with the second
highest proportion, etc.
3. Percentages/ratios go after the name of a component (e.g. Hydrocortisone Powder 1%,
rather than 1% Hydrocortisone Powder).
4. Spell out full component names and forms when possible. If there is not enough room,
abbreviate the form before abbreviating the components; furthermore, abbreviate the base
components before active components.
Whenever possible, enter mixture proportions by percentage so that the system can
automatically calculate how much of each component is needed to make the mixture
regardless of dispense quantity.

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Inserting a Mixture
To illustrate the steps required to add a mixture into the system, the following section will go
through adding a mixture for Menthol 1% Crystals USP in Elocom 0.1% Lotion.
1.

2.

Ensure that all mixture components (i.e. drug record) are active and present in the Kroll
Pharmacy Software; in this case, ensure that Elocom 0.1% Lotion and Menthol Crystals
USP are found in the system.
Search for the mixture as described in the section Searching for a Mixture Record.
WARNING: If a mixture component is inactive/missing during mixture creation, the user
will have to open a new Kroll Session to reactivate/add the component before
continuing to create the mixture record.

3. If the regular mixture search does not return any matching records, click Ins-Insert or
press Insert on the keyboard.
4. Upon clicking/pressing Insert, a prompt will appear informing the user that a new mixture
cannot be inserted until an Advanced search for inactive mixtures has been performed;
click OK or press Enter on the keyboard to continue with the advanced mixture search

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5. If the Advanced mixture search does not return any matching records, click Ins-Insert or
press Insert on the keyboard again to create the new mixture record.
6. The user will be brought to an empty Mixture Record screen. Proceed to fill out the fields
accordingly (Refer to section on Mixture Fields).

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Mixture Fields
Quick Code
Optionally assign a code to the mixture that facilitates the mixture search process. The code can
contain up to 10 alpha and/or numeric characters.

Name
Enter the name (i.e. description) of the mixture. The information entered here will be printed
on the vial label.

Enter Proportions by
Identify the best, or most applicable, way to enter the proportions of the mixture.

Percentage
Whenever possible, use percentages (i.e. ratios) to enter mixture proportions. Using
percentages allows the system to calculate how much of each ingredient is required to
compound any dispensing quantity. The Base Quantity for mixtures entered in percentage
proportions is always equal to 100.

Units
Compounds made up of ingredients with different forms may require components to be
entered by units rather than percentages. When Units are used to enter mixture proportions,
the user must indicate the quantity being prepared in the Base Quantity field in order for the
system to correctly calculate how much of each ingredient is required for compounding.

Bags/Capsules
When preparing I.V. bags or pharmacy prepared capsules, enter proportions by Bags/Capsules.
When Bags/Capsules is selected, the user must indicate the number of bags or capsules being
prepared in the Base Quantity field in order for the system to correctly calculate how much of
each ingredient is required for compounding.

Methadone Conc.
When preparing methadone solution, select to enter proportions by Methadone. Selecting this
option will require the user to indicate Drink Volume in milliliters.

Form
Enter the form of the mixture (e.g. GM, CAP, ML, etc.) by accessing the associated dropdown
menu or by typing the form.

Route of Admin
Enter the route of administration for the mixture (e.g. topical, oral, nasal, etc.) by accessing the
associated dropdown menu or by typing the route.

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Schedule
Select the schedule of the mixture which depends on the ingredients of the mixture.
Schedule 1
Schedule 2
Schedule 3
Controlled
Homeopathic
Narcotic
Targeted

Oral/Written
Indicate whether the mixture requires an oral or written prescription; if neither option applies,
select Not Specified.

Mix Type
The mixture type is required for adjudication purposes. Select from one of the following
mixture types:
0-Topical Cream
1-Topical Ointment
2-External Lotion
3-Internal Use Liquid
4-External Powder
5-Internal Powder
6-Injection or Infusion
7-Ear/Eye Drop
8-Suppository
9-Other

Price Group
Created by head office, price groups are used to price Rxs. If this mixture requires special
pricing, the price group field can be populated to maintain the automatic pricing.

Default SIG
If the mixture is always dispensed with the same SIG instructions, users can optionally enter a
Default SIG in this field. The SIG will automatically be carried over to the prescription filling
screen when the mixture record is selected, but can be overridden.

Provincial PIN
Each provinces provincial plan covers certain mixtures; these mixtures have assigned pseudo
DINs (i.e. PINs) which can be viewed under the Provincial PIN dropdown menu. If the mixture
record is covered by one of the pseudo DINs, select the correct PIN from the dropdown menu.

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Expiry (Days)
If applicable, enter the number of days the mixture is good for once it has been compounded;
the system will calculate a calendar date for when the mixture reaches expiry and prints this
date on the vial label.

Active
The Active flag is checked by default. Uncheck the Active flag if the mixture record is no longer
being used in any active prescriptions, or if the mixture has become obsolete.

Reportable
Place a checkmark next to the Reportable flag if the mixture contains a narcotic component.
When the Reportable flag is checked, the mixture will be tracked in the systems Narcotic
Report.

Refrigerated
Place a checkmark next to the Refrigerated flag if the mixture requires refrigeration. When the
Refrigerated flag is checked, a message will appear during the filling stage to remind the user
that the mixture needs to be stored in a refrigerator subsequent to preparation.

Methadone
The methadone flag should only be checked for methadone mixture records. Activation of this
flag enables the carries function and other methadone related dispensing functions.

Mixture Time
The Mixture Time chart allows users to configure the Mixture Fee charged to the patient based
on the amount of mixture being dispensed. Each mixture will have its own mixture fee tier.
Each row in the chart represents a pricing tier:
The first row represents the minimum mixture fee charged to the patient. The Rx
quantity should equal zero because any dispense quantity greater than zero requires a
minimum base fee to be charged.
The second row of the chart is the second tier for the mixture fee; the Rx quantity
entered here should be the threshold value where making more than that quantity will
mean graduating to the next tiered fee.
The user can choose to add up to 5 mixture pricing tiers, however this is not required
and depends on the complexity of the mixture.

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The last entry in the chart or the final pricing tier represents the maximum mixture fee charged;
any dispense quantity greater than the Rx quantity listed here will charge the maximum
mixture fee only.
The above Mixture Time chart reads, When the Rx (dispense) quantity is equal to or greater
than 0, then charge 8 minutes of mixture time; when the Rx (dispense) quantity is equal to or
greater than 100, then charge 10 minutes of mixture time; when the Rx (dispense) quantity is
equal or greater than 250, then charge 16 minutes of mixture time; and any dispense quantity
greater than 250, charge a maximum of 16 minutes of mixture time.

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Inserting Mixture Components


A mixture record is not complete without the addition of mixture components; in fact, users
cannot save a mixture record until components have been selected.
1. From the Mixture Record, ensure the cursor is in the Components section.
2. Click Ins or press Insert on the keyboard to call up a Drug Lookup Search window which
allows for selection of the component.
3. Search for the component in the same way as you would search for a regular drug record.
4. From the search results, highlight the applicable component and click Add or press Enter on
the keyboard to call up the Compound Component window.

5. From the Compound Component window, information will be displayed on the details of
the drug product; there are also fields that may require configuring:
6. Once the Compound Component window has been configured, click Add or press Enter on
the keyboard to add the component to the mixture record. A blank Drug Lookup Search
window will appear for the user to add additional components; repeat step 5 until all
components of the mixture have been added, an unlimited number of components can be
added.

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7. Once all components have been added, close out of the Drug Lookup Search window by
clicking Cancel or by pressing ESC on the keyboard; this will return the user to the mixture
record screen.
8. Click Save or press Enter on the keyboard to save the mixture record.

Pack Size
Users can choose to click on the down arrow to change the pack size.

Percentage/Units
Depending on how the user enters mixture proportions, this field will be labeled Percentage
or Unit. Enter the applicable numeric value; this field is required for calculating how much of
each component needs to be measured out. For example, in our example mixture Menthol 1%
Crystals USP in Elocom 0.1% Lotion, Menthol makes up 1% of the entire mixture and Elocom
Lotion makes up 99%.

Bill in Multiples of Pack Size


Activate this option if you would like to charge the patient the price of one pack, even when
only a partial pack was used to compound the mixture. For example, if the pharmacy only
carries 75ml bottles of Elocom Lotion, but the prescription is written for 50ml, the user can
active this flag to charge full bottle price rather than just partial bottle price. The logic is that
the pharmacy likely cannot use an open bottle of Elocom for other prescriptions, so the
wastage cost is passed to the patient.

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Active Component for 3rd Party
Activate this flag if the component DIN is the DIN you want to send to third party plans for
financial reimbursement. Only one component in the mixture can have this flag checked, as
only one DIN can be sent to a third party plan. (Please refer to Mixture Tabs Plans if you
need to add a pseudo DIN for a mixture).

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Mixture Tabs
There are four (4) tabs of information in the Mixture Record:

Instructions
Comments
Plans
Other

Instructions
The Instructions Tab provides users with the opportunity to provide detailed instructions for
compounding; for example, heating time, use of mixing solutions, etc. Additional fields from the
Instructions Tab are available and will be explained below:

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Handling Instructions
Users have the option to enter special precautions which must be taken when preparing the
compound.

Batch Quantity
Batch quantities of a mixture may be compounded at store level because it is dispensed
frequently. Enter the volume of the batch in this field and the system will deduct quantities
dispensed against the value entered here (equivalent to the drug On Hand).

Print Instructions at Fill


Users have the option to set up the mixture record so that whenever the mixture is used in a
prescription, the instructions page is printed. The options are Never print instructions, Always
print instructions or Prompt to print instructions. Users can also access the Mixture Sidebar
functions to Preview Instructions or Print Instructions.

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Add Component Names to Instructions


Clicking this option with the mouse will add the names of the components into the Instructions
field.

Comments Tab
The Comments Tab functions much like any comment field within the Kroll Pharmacy Software.
Users can access this tab to add comments, remove comments or edit existing comments.

Adding, Editing, and Removing Comments


To add a comment:
1. Select Ins or press Insert on the keyboard.
2. From the Comments window, select a Topic.
3. As with any comment, the user has the option to Show On Rx which will display the
comment on the input screen; Print On Hardcopy which will print the comment on the Rx
hardcopy; or mark the comment as an Alert which will cause the comment to pop up
anytime the mixture record is accessed in the system.

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To edit a comment:
Highlight the applicable comment entry and select F2 with the mouse or by press F2
on the keyboard. The comment window will appear for the user to make and save
changes to the comment.
To remove a comment:
Highlight the applicable comment entry and click Del with the mouse or press Delete
on the keyboard.

Plans Tab
The Plans Tab of the mixture record houses Pseudo DINs that are adjudicated to third parties
for purposes of financial reimbursement. Mixture Pseudo DINs will need to be added and
maintained by store level users.

Adding, Editing, and Removing Pseudo DINs


To add a Pseudo DIN:
Select Ins or press Insert on the keyboard to prompt the Mixture-Plan Information
window; fill out the fields accordingly.
To edit a Pseudo DIN:
Highlight the applicable entry and click F2, or press F2 on the keyboard. The
Mixture-Plan Information window will appear for the user to change existing
information. Click OK or press Enter on the keyboard to save changes.

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To remove a Pseudo DIN:


Highlight the applicable entry and click Del, or press Delete on the keyboard. The
user will be asked to confirm the deletion before removing the record permanently.

SubPlan
From the dropdown menu, select the third party plan that is associated with the Pseudo DIN.

Description
Enter a general description or a note associated to the Pseudo DIN, this field reads Default
unless otherwise specified.

Default
This flag is ON by default and instructs the system to automatically send the pseudo DIN to the
third party plan whenever a prescription is processed for the mixture.

DIN Dropdown
Select from PDIN (Pseudo DIN), NPN (Natural Product Number), HDIN (Homeopathic DIN), OPIN
(OPINIONS). Proceed by entering the 8 digit drug identification number in the field to the right.

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Covered
This is an information flag that indicates third party coverage. Place a checkmark next to this
flag if the associated third party covers the costs of the medication.

Mix Type
Place a checkmark next to this option if the third party plan requires submission of a Mix Type
that is different than what is set on the Mixture Record. This field is commonly used for
Methadone mixtures billed to Green Shield.

Bill As Pack
Place a checkmark next to this flag if the mixture needs to be billed to the third party by packs
rather than by units.

Other Tab
The Other Tab of the mixture record contains miscellaneous information including record
creation details, workflow/packaging configurations, and Mixture Group selections.

Record Creation Details

Created On: Read only field that displays when the mixture record was created.
Changed On: Read only field that displays when the mixture record was last changed
in the system.
Last Rx On: Read only field that displays when the mixture record was last used in a
prescription.

Workflow/Packaging Confirmations

Track Mixture Lot Number when Packaging: Activate this flag if you would like to
require the lot number for each component to be entered/ scanned during mixture
packaging verification (i.e. filling).
Track Mixture Expiry Date when Packaging: Activate this flag if you would like to
require the expiry date for each component to be entered/ scanned during mixture
packaging verification (i.e. filling).
Require Ingredient Confirmation when Packaging: Activate this flag if you would like to
require the UPC for each component to be scanned during mixture packaging
verification (i.e. filling)

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Groups
Mixtures can be included in a group for reporting or dispensing purposes. Mixture Groups are
created by head office and can be applied by pharmacy users to any number of mixtures. For
example, a group called Methadone can be created and attached to all methadone mixture
records. Also note that a mixture record can belong to more than one Mixture Group.
To add a drug group, either:
a) Click Ins with the mouse
b) Press Insert on the keyboard
c) Simply begin typing the name of the drug group.
A window will appear allowing the user to select the drug group from available choices.
To delete a drug group, either:
a) Highlight the appropriate entry and click Del
b) Press Delete on the keyboard.
A window will appear asking the user to conform the deletion.
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To edit a group, either:


a) Highlight the appropriate entry and click F2 with the mouse.
b) Press F2 on the keyboard.
1. Double click on the desired entry to make necessary changes.
2. Click Save or press Enter on the keyboard to save changes.

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Mixture Pricing
Mixture pricing is made up of a number of elements:

Price/Minute
Dollar amount charged for each minute of mixture time (centrally maintained according to
provincial standards).

Mixture Fee
Derived from the Mixture Time Chart on the mixture record. Mixture Fee is calculated based
on the quantity dispensed in the prescription.

Cost of the components


Derived from acquisition cost for mixture components (i.e. Drug Records). Acquisition cost is
maintained through invoice receiving or catalogue feeds.

Markup Strategy
Set by home office and centrally maintained.

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Setting Minimum & Maximum Mixture Fee


To set a minimum and maximum mixture fee, users must first call up the mixture record and
refer to the Mixture Time Chart. The first line of the Mixture Time Chart configures the
minimum fee charged for the mixture; in the chart below, even if the pharmacy makes one
gram (1 gm) of mixture, there will be a minimum of 5 minutes charged. The last line of the
Mixture Time Charge configures the maximum fee charged for the mixture; in the chart below,
even if the pharmacy makes 1000gm of mixture, the maximum time charged will be 10
minutes.

The lines (or tiers) in between the minimum and maximum charge account for prescriptions
where the dispense quantity lies between the two barrier points. For example, according to the
Mixture Time Chart above, if a prescription has a dispense quantity of 100gm, 7 minutes of
mixture time will be charged.

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Setting a Flat Mixture Fee


A flat fee can be set for a mixture, which means that no matter how much is dispensed, the
same mixture fee will be applied to the prescription. A flat fee configuration is achieved by
setting a single line in the Mixture Time Chart. The following flat fee configuration reads any
dispense quantity greater than zero will be charged 12 minutes of mixture time.

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Mixture Breakdown
Whenever a user is filling a prescription for a mixture, it is always recommended to review the
Mixture Breakdown before adjudicating the Rx. The Mixture Breakdown provides exact dollar
amounts for elements that make up mixture pricing (e.g. Mixture Fee, Component Costs, etc.).
1. Access the Mixture Breakdown from the F12-Filling Screen as follows:
2. From the F12-Filling Screen, all prescription information should be entered and populated:
3. From the prescription sidebar, click on the Mixture Breakdown option, or press ALT+V+M
on the keyboard.
4. The Mixture Breakdown window will appear with a breakdown of the following:

Component Quantity and Associated Cost


Total Base Cost
Total acquisition cost of all components.

Embedded/Rx Markup
Centrally maintained.

Dispensing Fee
Regular and Customary Rx Dispensing Fee (centrally maintained).

Mixture Fee
Based on Mixture Time Chart and quantity dispensed

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Mixture Minutes
Used to calculate Mixture Fee

Rx Quantity
Rx Dispense Quantity
Users also have an option to Print Mixture Instructions which will print the comments inputted
in the Instructions Tab of the mixture record as well as other relevant information.
Once the Mixture Breakdown has been reviewed, click Close or press Enter on the keyboard to
escape back to the mixture prescriptions; continue to process the prescription as usual.

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Searching for Prescriber Records


There are three (3) ways to search for a prescriber in Kroll:

Method 1: Searching for a Prescriber from the F7-Doctor Search Screen


Method 2: Searching for a Prescriber from the ALT+X Start Screen
Method 3: Searching for a Prescriber from the F11-Drop Off Screen

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Method 1: Searching for a Prescriber from the F7-Doctor


Search Screen
1. From the Alt+X Start Screen, click F7-Doctor with the mouse or press F7 on the keyboard;
this will bring up the F7-Doctor Search Screen.

NOTE: From the F7-Doctor Search Screen, notice the pink bar across the top of the
window; pink denotes prescriber/doctor records throughout the system.

2. In the doctor search field, enter one of the following doctor search criteria:
a) Last Name, First Name (e.g. house, greg OR hou, g OR house OR ,greg)
b) A period (.) and the Doctor Quick Code (e.g. .house)
c) 7 or 10 digit phone number of the prescriber office.
d) A number sign (#) and the prescriber license number (e.g. #123454)
e) An asterisk (*) to search for ALL prescribers in the database.
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3. Once prescriber search criterion has been entered, click Search or press Enter on the
keyboard to search the database for matching results.

NOTE: The more detailed the search criteria, the smaller the result-set will be.
Conversely, the broader the search criteria, the larger the result-set will be.
4. Select the applicable prescriber record by either:
a) Using the Arrow Keys to highlight the entry and press Enter to select
b) Type in the line number corresponding to the applicable enter and press Enter to
select.
c) Double click on the desired entry with the mouse.

The F7-Doctor Record will be displayed:

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Method 2: Searching for a Prescriber from the ALT+X Start


Screen
1. From the ALT+X Start Screen, move your cursor to the Universal Search Field.
2. In the Universal Search Field, enter one of the following drug search criteria:
a) Last Name, First Name (e.g. house, greg OR hou, g OR house OR ,greg)
b) A period (.) and the Doctor Quick Code (e.g. .house)
c) 7 or 10 digit phone number of the prescriber office.
d) A number sign (#) and the prescriber license number (e.g. #123454)
e) An asterisk (*) to search for ALL prescribers in the database.
3. Once the search criterion has been entered, click F7-Doctor or press F7 on the keyboard to
execute the prescriber search.

A list of prescribers matching the search criteria will be displayed. Select the applicable
prescriber record by either:
a) Using the Arrow Keys to highlight the entry and press Enter on the keyboard.
b) Typing in the line number corresponding to the applicable entry and press Enter
on the keyboard.
c) Double click on the desired entry with the mouse.

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The F7-Prescriber Record will be displayed:

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Method 3: Searching for a Prescriber from the F11-Drop Off


Screen
1. From the F11-Drop Off Screen, move your cursor to the Prescriber Search field.
2. In the Prescriber Search Field, enter one of the following prescriber search criteria:
a) Last Name, First Name (e.g. house, greg OR hou, g OR house OR ,greg).
b) A period (.) and the Doctor Quick Code (e.g. .house).
c) 7 or 10 digit phone number of the prescriber office.
d) A number sign (#) and the prescriber license number (e.g. #123454).
e) An asterisk (*) to search for ALL prescribers in the database.
3. Once the search criterion has been entered, press Enter on the keyboard to execute the
prescriber search.

A list of prescribers matching the search criteria will be displayed. Select the applicable
prescriber record by either:

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a) Using the Arrow Keys to highlight the entry and press Enter on the keyboard
b) Type in the line number corresponding to the applicable entry and press Enter
on the keyboard
c) Double click on the desired entry with the mouse.

The F7-Prescriber Record will be displayed:

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4. Click Drop-Off or press Enter on the keyboard to enter the prescriber record into the F11Drop-Off Screen.

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Advanced Prescriber Search


If a prescriber is not found through a regular search as described in the previous sections, an
Advanced Prescriber Search can be performed as follows:
1. Locate the Advanced flag from any Prescriber Search Screen.
2. Place a checkmark next to the Advanced flag by using the mouse or by pressing CTRL+A on
the keyboard.
An Advanced search can also be initiated from the Prescriber Search Screen by clicking on the
option to Show Advanced Options from the Prescriber Sidebar.
The Advanced Search will reveal additional fields for searching the drug:
Search Active/Inactive prescriber records

Search by City
Search by Address

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Inactive Prescriber Records


Users have the ability to inactivate prescriber records in the system by un-checking the Doctor
Active flag located on the prescriber record directly above the address field. Inactivating a
prescriber record means that it will no longer show up in regular prescriber search; an
advanced search will have to be initiated in order to access the prescriber information.

NOTE: Inactivating Prescriber Records cannot be applied to prescriptions. The user


will have to reactivate the prescriber in order to proceed with processing a
prescription.
There are various reasons why a user may choose to inactivate a prescriber record. For
example, a prescriber may be inactivated because they have retired, or has been relocated to a
different region. Inactivating these records allows the regular search to provide more succinct
results; this reduces the chances of selecting the incorrect prescriber into a prescription.

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To access inactive prescriber records in the system, perform an Advanced search and make
sure the Inactive or All flag is marked. Search for the prescriber as usual to find the applicable
record.

Note: Inactive prescriber records will appear as red entries on the Prescriber Search
Screen.

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Configuring the Columns in the Prescriber Search Screen


Users can configure the information columns displayed on the Prescriber Search Screen by
clicking on the option to Change Columns from the Prescriber Sidebar. The default columns are
set as:
Last Name
First Name
City
Province
Phone Number

By accessing the option to Change Columns, the Edit Scan Columns window will appear with
opportunities to customize the type of prescriber information displayed in the search results.
For example, users can select to view License Number as one of the information columns
returned by the search. As well, users can highlight a selection from the Edit Scan Columns
window and click Move Up or Move Down to determine where the information is displayed
relative to other information columns. At any time, the user can select the option to Use
Default Columns which will cause the column view to revert back to the default settings.
Once the user has selected the columns they want displayed on the Prescriber Search Screen,
they can click OK or press Enter on the keyboard to save changes until the session is closed. If
the user would like the changes to be permanent, they must right click on the columns and
select the option to Make these the Default Columns
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Creating a Prescriber Record


Insert a new prescriber record into the system as follows:
Perform a thorough prescriber search to ensure that he/she does not already exist in the
database. It is advisable to perform an Advanced search for inactive prescribers before adding a
new record.
Once the user is satisfied that the new patient does not exist in the system, click Ins-Insert or
press Insert on the keyboard to add a new prescriber record.

The user will be brought to a new prescriber information window where data can be entered.
The cursor will default to the Last Name field; use the TAB key to move from field to field
within the record to fill in all the available prescriber information (SHIFT+TAB will move the
cursor back a field).

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Prescriber Records The Fields


Last Name
Type in the Last Name of the prescriber (do not add any symbols to this field).

First Name
Type in the First Name of the prescriber (do not add any symbols to this field).

Salutation
From the dropdown menu, select from Dr. Miss. Mr. Mrs. Ms.

Quick Code
Enter an optional code for searching the prescriber. For example, Dr. Gary Thomson may
have a quick code of THOMG. The quick code field can also be used to identify doctors
working at the same clinic or hospital. For example, users can enter a quick code CLINIC for all
doctors working at the nearby clinic; when the user searches .CLINIC all patients with that
quick code will be displayed.

Address
Type in the prescribers street address in one or both lines.

City, Province, Postal, Country


Type in the rest of the address information.

Locations
Physicians who practice in more than one physical location can have multiple addresses and
contact numbers in their record. Users can add, remove or edit locations for a prescriber under
the Location section as follows:

Place a checkmark next to Primary Location if the location listed is the prescribers
primary place of practice. When the prescriber is used in a prescription, the location will
default to the primary location unless otherwise specified.

Add a location by either:


a) Clicking Ins with the mouse
b) Pressing Insert on the keyboard
A window will appear prompting the user to enter a description for the new location (e.g. Clinic,
Hospital, etc.); click Save or press Enter to continue. The Address, City, Province, Postal Code,
Country, Phone and Fax fields will become available to input details for the secondary location;
fill out the fields accordingly.

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Edit a location by highlighting the entry and either:


a) Click F2.
b) Press F2 on the keyboard.
c) Double click on the comment.
Click Save or press Enter on the keyboard to save changes.
Delete an existing location by highlighting the entry and either:
a) Click Del with the mouse.
b) Press Delete on the keyboard.
The user will be asked to confirm the deletion; answer accordingly. When a location is deleted,
the address and contact information is also removed from the record.

Comments
Prescribers can have an unlimited number of comments, and each comment can have an
unlimited amount of content.
To add a comment, either:
a) Clicking Ins with the mouse
b) Pressing Insert on the keyboard,
1. Begin typing in the comment field. The following window will appear:

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2. Select a Topic for the comment by clicking the down arrow or by pressing the down arrow
on the keyboard. A topic must be selected in order to save the comment.
3. Each comment has three options. To enable an option, use the mouse to click on the
checkbox, or TAB to the desired option and use the spacebar on the keyboard.
To delete a comment, highlight the entry and either:
a) Press Delete on the keyboard.
b) Click Del with the mouse.
A window will appear asking the user to confirm the deletion.
To edit a comment, highlight the entry and either:
a) Click F2.
b) Press F2 on the keyboard.
c) Double click on the comment.
Click Save or press Enter on the keyboard to save changes.

Show on Rx
Enabling this option will display the comment on the F12-Filling Screen.

Print on Hardcopy
Enabling this option will print the prescriber comment on the hardcopy. Note that only one
prescriber comment can be flagged for this option as there is limited space on the hardcopy.

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Alert
Enabling this flag will cause the comment to pop up every time the prescriber record is
accessed and every time an Rx is filled for the patient.

Prescriber Groups
Prescribers can be included in a group for a wide range of reporting purposes. Prescriber
groups are created by head office and can be applied to any number of prescriber records. For
example, a prescriber group called Walk-In Clinic can be created and attached to prescriber(s)
that work at the walk-in clinic; reports on Rx volume can be generated for the group.
To add a group, either:
a) Clicking Ins with the mouse
b) Pressing Insert on the keyboard
1. Begin typing the name of the prescriber group.
2. The Add/Delete Groups window will appear allowing the user to select the prescriber group
from available choices.
To delete a group, highlight the entry and either:
a) Click Del with the mouse.
b) Press Delete on the keyboard.
A window will appear asking the user to confirm the deletion.
To edit a group, highlight the entry and either:
a) Click F2 with the mouse
b) Press F2 on the keyboard
c) Double click on the desired entry to make necessary changes.
d) Click Save or press Enter on the keyboard to save changes.

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Prescriber Record General Tab


NOTE: Prescriber Fields with asterisks next to them are mandatory prescriber fields
and must be populated in order to save the record.

Designation*
Select a designation for the prescriber by clicking the down arrow or by pressing the down
arrow on the keyboard.

Specialty
Optionally select a specialty for the prescriber by clicking the down arrow or by pressing the
down arrow on the keyboard.

Dispensing Rights
Select from the following options:

Full Rights
This selection means the prescriber can dispense Schedule 1, 2, 3, Targeted, Controlled and
Narcotic prescriptions.

No Narcs
This selection means the prescriber cannot dispense Narcotic substances. If the user attempts
to process a narcotic Rx using the prescriber record, the system will display a warning message,
This doctor is not allowed to dispense narcotics, and prevent the Rx from moving to the next
Rx processing stage.

No Narcs or Controlled
This selection means the prescriber cannot dispense Narcotic or Controlled substances. If the
user attempts to process a narcotic or controlled Rx using the prescriber record, the system will
display a warning message, This doctor is not allowed to dispense narcotics or controlled
drugs, and prevent the Rx from moving to the next Rx processing stage.

Written Language*
This field is defaulted to English, but can be overridden to another language. This field is not
tied to any functionality and only serves information purposes.
Spoken Language: This field is blank by default, but can be selected to reflect the spoken
language of the prescriber. This field is not tied to any functionality and only serves information
purposes.
Email: Enter the email address of the prescriber.
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Primary License Number*


Enter the license number of the prescriber in this field. Select the applicable province from the
dropdown menu. Note that the Ref ID (or Reference ID) is automatically set when a
designation is selected for the prescriber record; however, it can be overridden, by placing a
checkmark next to Override.

Alternate License Number


If the prescriber practices in more than one region, they may have an alternate license number
which can be entered in this field.

No Kroll Care
Activation of this flag means that Kroll Care will not be generated for prescriptions from this
prescriber.

No Fax Refills
Activation of this flag will cause a warning message to appear whenever the Fax Doctor
Report is generated. The warning will indicate that the prescriber does not accept fax requests
for prescription refills; however, the user will still have the option to print the Fax Doctor
Report after acknowledging the warning.

No Phone Refills
Activation of this flag will cause a warning message to appear whenever the option to Call
Doctor is selected from the Rx Filling Screen, or from the Patient Medication Profile. The
warning will indicate that the prescriber does not accept phone requests for refills.

Signature Load
For terminals hooked up to a Document scanner, users can load the prescriber signature into
the system by scanning the written prescription and cropping the signature. Once the signature
has been scanned and saved, it will be available during Check stages for cross-checking.
To load a prescriber signature, feed the written prescription into the Document scanner and
click Load from the prescriber record.

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Once the image has been loaded, users can crop the scanned image from the Doctor Signature
window by clicking and dragging a box around the signature. Click Save or press Enter to save
the signature.
To remove an existing prescriber image, simply click Delete from prescriber record.

Dates
Created On Indicates when the prescriber record was created.
Changed On Indicates when the prescriber record was last changed.
Last Rx On Indicates when the last time and Rx was filled using the prescriber record.

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Creating an Order
To generate a drug order:
1. Go to Utilities > Drug Ordering > Generate Order. A prompt will appear asking the user to
generate an Automatic or Manual order.

2. Select Automatic to generate an order based on Min/Max or Days Supply values in the
drug record
3. Select Manual to generate an order by selecting items for the wholesaler catalogue. Since
pharmacies keep perpetual inventory, users will be selecting to generate an Automatic
order in a large majority of cases.

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NOTE: A percentage field is available for instances where the user wants to inflate the
quantity being ordered for ALL items in the order (e.g. Increase Min/Max re-order
levels by 10% (for this order only) will cause the order quantity to go up by 10% for
all line items in the order).
If Automatic ordering is selected, the system will check all drugs in the system with automatic
ordering enabled and generate a suggested order. Once the automatic order is generated,
users will have an option to manually add items to the order as well.

NOTE: Drugs that have an On Hand value lower than the Minimum will be placed on
order given the drug record has automatic ordering enabled. The Minimum value is
either entered manually for the record, or calculated based on the Days Supply (i.e.
Usage).

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Manual Order
If Manual order is selected, the user can pick certain items from the wholesaler catalog to be
placed on order instead of having the system auto-generate a suggested order. Click on Ins Add
Item to access the wholesaler catalogue.
Users can search for an item in the Insert Order Item form using the following criteria:
a) Description
b) Drug Identification Number (DIN)
c) Item Number
d) Pack Size
e) UPC

NOTE: The method used to search for drugs in the Insert Order Item form is different
from the method used to search for drugs in the Kroll Pharmacy Software. When
using the Insert Order Item form, search for items as you would on the vendor
Website.
Once the user has finished adding items to the manual order, click on Cancel to escape from
the Insert Order Item from and return to the Drug Order Form.

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Options from the Drug Order Screen


The Drug Order Form contains a list of items being placed on order, be it an Automatic or
Manual order. The following options are as follows:

Delete Item (Del)


This allows you to remove an item from the automatic order. Highlight the item and click
Delete Item; you will be prompted to confirm the deletion.

Add Item (Ins)


This allows you to manually add ad hoc items to the order. Click the Add Item button and you
will be presented with a search screen where you can search for the item you would like to
place on order for. Once the item has been selected, you will be prompted to enter the quantity
you would like to order; once a quantity is entered, click OK to continue.

F2 Edit Order Quantity


Highlight an item and click F2 Edit Order Quantity or press F2 on the keyboard to edit the
quantity of product being ordered from K&F. From this window, users can also adjust the On
Hand value of the drug record, disable automatic ordering for the drug, or prevent inventory
adjustments to record.

Move Selected Items


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This option is used to move an item from one vendor to another.

Preview
This option will display a preview of the printed Purchase Order.

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Min/Max Versus Days Supply Ordering


There are two ways to set re-order points for drug products in the Kroll Pharmacy Software:
Min/Max Ordering versus Days Supply Ordering. In both scenarios, a drug will be placed on
order when the On Hand value drops below the Minimum value, given the drug is activated for
automatic ordering in the system. A Maximum value can be entered optionally, and instructs
the system to order up-until a certain value when the On Hand drops below the minimum. The
benefits of Min/Max Ordering versus Days Supply Ordering are explained in the following
sections.

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Min/Max Pros and Cons


When Min/Max Ordering is turned on, the Ordering tab of the drug card will have the Days
fields greyed out because minimum and maximum values are populated manually by the user
and are independent of drug usage.

Potential Benefits of Min/Max Ordering


The user can control the exact point at which a drug is reordered by setting the Minimum
value. The Minimum/Maximum values do not change once they are sent because the values
are independent of usage. This is particularly useful for drugs that need to be overstocked or
under-stocked.

Potential Drawbacks of Min/Max Ordering


Minimum and Maximum values have to be set manually for each drug record because dosage
formats and usage will vary from product to product. Minimum and Maximum values do not
change once they are set, so users must manually adjust min/max values during spikes or dips
in product usage.

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Days Supply Pros and Cons


When Days Supply ordering is activated, the Ordering tab of the drug record will have the
Minimum and Maximum fields greyed out and the Days fields open. The Min/Max fields are
now calculated values based on the days supply. The user cannot directly manipulate the
Min/Max fields and must instead base reorder points on the days supply they would like to
stock.

Potential Benefits of Days Supply Ordering


With Days Supply ordering, reorder points are dynamic values that increase or decrease
depending on how often the drug is dispensed within the days supply indicated. This is
particularly useful for cyclical drugs like allergy medications that are dispensed frequently
during some parts of the year, but less during others.
Users do not have to manually input min/max values for each drug record because they will be
calculated based on the days supply that is set globally.

Potential Drawbacks of Days Supply Ordering:


The Minimum and Maximum fields are not open for manipulation as they are now calculated
values; this means users have less control over the exact point the drug is placed on order.
The Minimum and Maximum values change depending on how frequently the drug is
dispensed; therefore, this may be a problem for products the pharmacy wishes to overstock or
under-stock.

The Best of Both Worlds


Since there are advantages to using both Min/Max Ordering and Days Supply Ordering, the
system has created a drug specific configuration that allows some drug records to use Min/Max
reorder points, while others use Days Supply reorder points.

NOTE: Generally in pharmacies, all drugs will default to use Days Supply Ordering,
but users can manually override this configuration to use Min/Max Ordering for
exception drug records.
To override Days Supply Ordering with Min/Max Ordering:
1. Use the F5-Drug Search, call up the applicable drug record.
2. From the drug record, click the Ordering tab.
3. Locate the Base Ordering On field and click on the down arrow to select Min/Max. Once
Min/Max is selected, the Days fields will be greyed out and the user Minimum and
Maximum fields will open up for manual manipulation.

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Sending a Drug Order


Once the user has finished editing, deleting and/or adding items on the Drug Order From, the
order can be sent to the wholesaler.
To send a drug order:
1. Click on Place Order from the Drug Order From to call up the Create Purchase Order
window.
2. Enter any delivery codes in the Route Seq Override field (e.g. same day delivery code). Enter
the Narcotic Code for the pharmacist on duty if the order contains narcotic drugs.

3. Click OK or press Enter on the keyboard to create the order file for upload to the wholesaler
website. A prompt will occur indicating where the order file has been placed.

Refer to McKesssons Pharmaclik manual (section Ordering: Quick Upload) for steps to quick
Upload your order.
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Resending and Ordering


Users may need to resend an order if it does not transmit properly to K&F on the first try.
To resend an order:
1. Go to Utilities > Drug Ordering > Communicate With > McKesson > ReCreate Purchase
Order
2. Ensure that the option for Show Sent Orders is marked.
3. Place a checkmark next to the order that needs to be re-sent.
4. Click Create Order or press Enter on the keyboard to re-create the order.

If an existing order is still waiting to be sent a prompt will occur asking to append to that
current order or to Overwrite the existing order, answer accordingly.

The user is then prompted to confirm re-sending the order. Click Yes or Press Y on the
keyboard.

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A final confirmation screen will appear with the new order file details.

Upload the order as instructed in the McKesson Pharmaclik Manual Quick Uploads

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Receiving a Drug Order


Once the pharmacy physically receives their drug order from the wholesaler, the order must be
received into the Kroll Pharmacy Software to update On Hand values and Pricing. An order can
be received electronically (i.e. based on McKessons invoice download) or manually (i.e. based
on the purchase order generated by the user).

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Electronic Receiving
Electronic receiving means that the Kroll Pharmacy Software is importing an invoice McKesson
has posted. The content of the invoice (e.g. shipped quantity, pricing, item descriptions, etc.) is
determined by the wholesaler, and not by Kroll.
Follow the instructions from McKessons Pharmaclik Manual Invoice Download. Once the
invoice is downloaded to the local PC then continue in Kroll as follows:
1. Go to Utilities > Drug Ordering > Communicate With > McKesson > Process Invoice. Kroll
will now look in its destination folder (assigned in Edit Vendor List) for the invoice file. The
Communication Form will appear as well as a message indicating an order has been found
and it will be processed.

Once the invoice file is retrieved, select the option to Receive or Defer the drug order.
Receiving the order will update the On Hand values and Prices for items listed in the order.
Deferring the order will place the invoice in to Utilities > Drug Ordering > Electronic Invoice
Receiving for uploading at a later time.

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Manual Receiving
Manual receiving means that users are receiving orders based on quantities and prices listed in
the Kroll Pharmacy Software purchase order rather than on the K&F invoice/ASN confirmation.
Users may choose to manually receive an order if K&F did not post an invoice/ASN confirmation
for the purchase order (PO) that was sent.
To manually receive a purchase:
1. Go to Utilities > Drug Ordering > Purchase Order Receiving.
2. From the Purchase Orders screen, highlight the order that needs to be received and click F9Receive Selected PO.
3. A message box will display a warning, This supplier is set up for electronic receiving. Are
you sure you want to receive manually? Answer YES.

4. The Receive Purchase Order(s) screen will appear. Click Receive Now or press Enter on the
keyboard to manually receive the purchase order.

NOTE: If there is a discrepancy between what is physically received and what is listed
in the purchase order, highlight the item in question and click F2-Edit selected order
item to edit the receive quantity, receive price, lot number and expiry if required.

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5. A dialogue box will be displayed with If you continue, inventory and prices will be adjusted.
Are you sure you want to proceed? Answer YES to receive the purchase order.

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New Rxs
The prescription filling process is a well-defined series of steps that pharmacy users carry out to
produce prescriptions for our patients. The Kroll Pharmacy Software is designed to work with
the established prescription filling process to provide the safest, most efficient and reliable
prescriptions and services to our patients. Different types of prescriptions are filled every day in
the pharmacy (e.g. New Rxs, On Hold Rxs, Refill Rx, OTC to profile Rxs, Professional Service Rxs,
etc.) and will be explained in the following sections. The steps for filling a New Rx are as
follows:
Drop-Off
Input
Fill
Check
Release
Sell

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Drop Off
There are a number of fields and options available from the F11-Drop Off window; however,
the following steps must be performed at the Drop Off stage to ensure patient safety and to
proceed to the next Rx Processing Stage in the system:
1.
2.
3.
4.
5.
6.

Search and select a patient record


Review the patient medication history
Indicate a prescription due time (i.e. pick up time),
Select a status for the prescription (i.e. Fill, Unfill, Not Disp, Stock Trans)
Scan the written prescription into the system
Indicate the number of Rxs on the written prescription

Pharmacy Assistants, Pharmacy Technicians, and Pharmacists can Drop-Off prescriptions into
the system as follows:
1. From the ALT+X Start Screen, click F11- Drop-Off or press F11 on the keyboard to access the
Drop-Off window.
2. The cursor will default to the Patient Search Field; search and select the applicable patient
record (refer to Search for a Patient from the F11 Drop-Off Screen). Users should not
continue the Drop Off process without entering a patient record.

NOTE: If the patient does not exist in the database, create a new patient record (refer
to Creating Patient Records.
Once the patient record has been selected into the F11- Drop Off window, the cursor will move
to the Due field, click on the down arrow and select a due time for the work order:
Critical = 1 minute
Waiting = 20 minutes
Today After 5pm
Tomorrow 9am
Tomorrow after 5pm
1 Hour
2 Hours
30 Minutes
Users can also click or press F2 to change the Due field to a Date and Time field for entry of a
specific work order due time. (NOTE: click F2 again to change the Date and Time field back to a
Due field).

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Users can access the Patient Profile options on the Sidebar at any time to view the medication
profile in order to identify and record the medication on the prescription as new, had before,
dose increase, dose decrease or Rx on hold. Click OK or press Enter on the keyboard to close
out of the patient profile window.

The Delivery field will default to Pickup, which is the only option available at this time.
Once an Rx barcode sticker has been adhered to the written prescription, feed it into the
Document Scanner and click the large Import Script Image file button or click Select Script
Image from the Drop-Off sidebar. If the prescription was faxed to the pharmacy, users can
select the option to Import Script Image from Fax which allows the user to select and attach a
faxed image to the work order.
Once the image is scanned into the system, options are available to Crop, Flip, Rotate and/or
Fit to Window. Once changes have been made, click Save or press Enter on the keyboard to
insert the image into the Drop-Off screen.

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Enter the number of medications on the written prescription in the # of Rxs On Page field;
this will tell the system how many Rxs are associated with the Rx Image.
To Clear (i.e. delete) or Re-Scan a script image, click Clear Script Image under the Drop-Off
sidebar. This will remove the existing image and allow you to re-scan the old image or scan a
new image.
From the Status field, click on the down arrow to mark the prescription as:
Fill Process and dispense the Rx
Unfill Put the Rx on hold
Not Disp Mark the Rx as OTC to Profile
Stock Transfer Mark the Rx as a stock transfer to another pharmacy.
Enter any workflow specific notes in the Note tab located near the bottom of the F11-Drop Off
window. The note will be displayed a t each Rx filling stage for the prescription.
Once all applicable Drop-off information for the Rx is entered, click Add to create the work
order.
Once the above steps are complete, the user can click Next to proceed to the Drop-Off
Confirmation screen.

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Review the details in the drop-off confirmation screen then click Finalize Work Order or press
Enter on the keyboard to move the work order to the next stage of the prescription filling
process.

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Once Finalize Work Order is selected, a blank F11-Drop-Off window will appear to allow
another work order to be dropped.

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Tracking a Work Order After Drop-Off


Once a work order for a New Rx has been dropped, it will proceed to the next stage which is
Enter. Users can access the F9-Workflow window from the ALT+X-Start Screen by clicking F9Workflow with the mouse, or by pressing F9 on the keyboard.
The dropped order will appear in the Enter queue under the applicable due-time column.
Additionally, there will be a list of Rxs in Progress on the lower half of the window for users to
see which orders are coming up next in the selected queue. Entries on the lower half of the
window are for information purposes only, users cannot change the work order due time on
any of the entries listed.

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Input
The Input stage is where users enter prescription information such as Drug, SIG, Dispense
Quantity, Intervention Codes, etc. into the system for processing. Extra care taken at this point
will ensure that the work order passes through the Check quickly without having to make time
consuming changes later on. Typically, Enter should be performed by a Pharmacy Assistant, but
can also be performed by Licensed Technicians and Pharmacists.
1. From the ALT+X-Start Screen, click F9-Workflow or press F9 on the keyboard.
2. Activate the Enter Queue by clicking on the Enter button.
3. Click on Get Work to view the work orders that need inputting; work orders are always
presented to the user in priority sequence according to the due time assigned to the work
order.

The Input screen (a.k.a Create New Rx From To Do window) will display the Rx image on the left
and the input fields on the right. The patient field will already be populated with the patient
selected at the Drop- Off stage; however, this record can be changed by searching and selecting
another record from the Patient Search field.
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NOTE: Click or press F3 from this window to view the detailed Patient Record.
Changes cannot be made to the patient record at this stage.
4. Search and select the appropriate drug record from the Drug Search Field.

NOTE: Click or press F5 from this window to view the detailed Drug Record. Changes
cannot be made to the drug record at this stage.
5. Search and select the appropriate prescriber record from the Doctor Search field. If the
prescriber record does not exist in the system, create a new one.

NOTE: Click or press F7 from this window to view the detailed Prescriber Record.
Changes cannot be made to the prescriber record at this stage.
6. Enter dispensing information for the prescription:
SIG: Enter the Sig in the SIG field and the expansion will appear in read only
format in the grey box below.
Disp Qty: Enter the dispense quantity for the prescription.

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Days
Enter the days supply for the dispense quantity indicated.

Refills
Enter the number of refills on the prescription.

Auth Qty
The authorized quantity field will auto-populate if the Disp Qty and Refills fields are filled out. If
the Auth Qty field is blank, enter the total authorized quantity for the entire prescription.

Unlimited Refills Until


Place a checkmark next to this flag if the prescription has unlimited refills until a specific date.
From the detailed Enter screen (a.k.a. F12- Screen) a number of additional fields and tabs of
information are available.

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Plans Tab
Users can select to exclude third party plans from the prescription, or change the order of
billing from this tab (remove). The first plan listed is where the Rx is being billed to first; the
second plan is where the Rx is billed to second, etc.

Next Disp Qty


Users can enter a new Dispense Quantity for the next refill (this is especially useful for trial
prescriptions where the first order has a lower dispensing quantity than the next).

Min Interval
The Min Interval field is used for narcotic prescriptions to prevent refilling until a specified
number of days have elapsed.
The bottom field is used for entering prescription comments; the user can type in any free form
comment and it will be saved with the prescription record.

Pricing Tab
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The pricing tab displays information regarding the pricing strategy used to calculate the Rx.
Pricing strategies are set by home office and cannot be modified; however, if a pricing needs to
be overridden, users can place a checkmark next to the Manual Price flag which will open up
the Cost, Markup, Fee, Mix Fee and SSC fields for manual manipulation (Manual Pricing should
only be used in emergency situations; incorrectly priced prescriptions should be reported to the
Pharmacy Support Helpdesk so the root cause of the pricing issue is resolved at the root).

Dates Tab

Rx Start Date: This field will automatically be populated with the date the Rx was
processed.
Rx Stop Date: Optionally enter a stop date for the prescription. Users will not be able to
fill the prescription past the stop date unless it is removed.
Written Date: This field will be automatically populated with the date the Rx was
processed, but can be overridden to whatever date the prescription was actually
written.

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Rx Expiry Date: This field will be auto-populated depending on the drug schedule, the
province the Rx was processed in, and the Written Date.
Drug Expiry Date: Users can optionally enter a drug expiry date for the prescription. If a
date is entered here, it will be printed on the vial label so that the patient can also see
the drug expiry. This option is especially useful for liquid antibiotics.
Ingest Date: This field is used to record the ingest date for methadone prescriptions.

Copy Information
This field displays read-only information on the original therapeutic start date, as well as the Rx
number for where the Rx was copied FROM or the Rx number for where the Rx was copied TO.
Transfer Dates
Displays read-only information on where a prescription was Transferred To or where it was
Transferred From.

Comments Tab

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Comments can be quickly added under the Plans Tab; however, inserting an entry from the
Comments tab allows the user to activate certain configurations for the comment as well as
allowing the user to enter more than one comment entry to the prescription record.
1. Click Ins or press Insert on the keyboard to add a comment to call up the Rx Comment
window.
2. From the Rx Comment window, enter a Topic. In addition to the regular comment options
of Show On Rx, Alert and Print On Hardcopy, there are two additional comment options:

Keep Comments for Refill


When this option is checked, the comment will also be saved for any refills against the
prescription.

Keep Comments for Copied Rxs


When this option is checked, the comment will be copied to a new prescription record if the
original is copied.

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Indications
The Indications tab allows users to optionally identify which condition the prescription is
treating. When the user clicks Ins or presses Insert on the keyboard, a list of ICD- 10-CA and/or
FDB conditions will be displayed for selection by the user.

Other
The Other tab displays miscellaneous information regarding the prescription. The Doctor
Authorization Received flag should always be checked because it indicates that prescriber
authorization has been received to dispense the prescription. The flag Include in Narcotic
Report is also available to include the Rx in the narcotic report even if it is not a narcotic
prescription (this flag is rarely used). Lastly, if a work order does not have a written Rx that
accompanies it, users can enter a No Script Image Reason in the associated field.
On the lower right hand side of the input window, there are Warnings listed for the specific
prescription:
Red Warnings will prevent the user from moving the prescription to the next Rx filling
stage.
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Yellow Warnings indicate that there may be a potential issue with the Rx. Reading and
addressing yellow warnings could prevent an input error.
Green Warnings are for general information purposes.

Input
The Input screen contains Rx Options from the Sidebar:
Make Rx Unfilled: Users can mark the prescription as Unfilled (i.e. On Hold) if this was
not indicated at Drop Off.
Make Rx Unfilled: Users can mark the prescription as Unfilled (i.e. On Hold) if this was
not indicated at Drop Off.
Mark Rx Not Dispensed: Users can mark the prescription as Not Dispensed if this was
not indicated at Drop Off. Prescriptions for OTC products are often marked as Not
Dispensed so that the medication can be logged on the Patient Medication Profile
without having to pass the prescription through the different filling stages and without
having to generate vial labels and receipts.
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Make Rx Stock Transfer: Users can mark the prescription as a Stock Transfer to another
pharmacy if this was not done at Drop Off.
Transfer Rx from Other Store: If the prescription is being transferred from another
pharmacy, select this option to input information regarding the pharmacy that is
transferring the prescription.

Call Doctor: Selecting this option will add an entry to the Callback Icon for the Rx to
remind pharmacy users to contact the prescriber regarding the Rx (e.g. SIG
confirmation, Refill request, etc.).

The Input screen also contains View options from the Sidebar:
Script Image: Select this option at any time to view the digital image of the written Rx.
Clinical Interactions: Select this option to perform a clinical review of the prescription
against the rest of the patient medication history derived from the FDB database.
Plan Information: Selecting this option will display a window where users can enter plan
specific information. If there is more than one plan for the prescription, there will be
tabs across the top of the window for each plan (e.g. Tab for AHE-Assure, tab for ESI, tab
for CS-Claim Secure.

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Intervention Code 1: Click F2 to search and select the applicable code. If you want to
remove an Intervention Code, you must click F2 again and select the option None.
Intervention Code 2: Click F2 to search and select a second applicable code. If you want
to remove an Intervention Code, you must click F2 again and select the option None.
Special Authorization #: A Special Authority grants full benefit status to a medication
that would otherwise be a partial benefit or a limited coverage drug. Enter the Special
Authorization Number in this field for billing.
Special Services Code: Click on the dropdown menu to select an applicable option. This
field is often used to bill service fees to Indian Affairs.
Reason Code: Only applicable for Ontario; click F2 to view available reason codes for the
drug in the prescription if applicable.
Claim Type: Do not change this field as it should be configured according to the
parameters of the prescription.
Real Time Plan: Do not change this flag as it is configured according to the third party
plans present in the prescription. Incorrect deactivation of this flag could mean having
to manually bill for a prescription that could have been billed electronically in real time.
Pseudo DIN: Displays the pseudo DIN being sent to the third party for the prescription.
Users can also override the field to send a onetime pseudo DIN with the prescription.
Patient Plan Information: Selecting this option will display the patients Third Party Plan
information. If the patient has more than one plan, there will be separate tabs across
the top of the window to display each plan. The user can adjust Third Party Plan
information from this field and re-adjudicate the Rx if necessary.

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Generic Equivalents: Select this option (or press ALT+G on the keyboard) to view
generic equivalents for the drug record selected in the prescription. At the input stage,
the user can highlight a generic equivalent entry and click Select or press Enter to select
an alternate drug record into the prescription.

NOTE: DA and DB intervention codes are automatically inserted into a prescription


and do not require manual insertion by the user.

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Filling
The next step of the workflow is Fill.
1. From the workflow queue; click the Fill button to show all Rxs ready to be filled.
2. From the ALT+X-Start Screen, click F9-Workflow or press F9 on the keyboard.
3. Activate the Fill queue by clicking on the Fill button and click on Get Work to view the next
work order that needs to be filled.
4. Scan the UPC or type the DIN located on the stock bottle.

5. Enter the Dispensed quantity in the Qty field.


6. If a balance owing is required click the Owe button. If the order can be fulfilled click
Packaged to continue.

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Check
The Check stage must be performed by a pharmacist or licensed technician. Check is the final
check that is made before the prescription is bagged and filed away in the pickup drawers. At
this point, the user should be looking at the filled prescription and verifying that against the
written prescription and the electronic drug image displayed on the screen.
1. From the ALT+X-Start Screen, click F9-Workflow or press F9 on the keyboard.
2. Activate the Check queue by clicking on the Check button and click on Get Work to view the
next work order that needs to be verified.
3. The Check screen will be displayed for the prescription. The user will have to verify that the
packaged prescription matches the electronic drug image and can select either:
a) Save for Later: Return to the F9-Workflow window.
b) Cancel Rx: Reverses the prescription and marks it as Cancelled in the patient
medication profile. Note: Cancelled prescriptions can be filled again.
c) Reject: Rejects the Rx and sends it to the previous stage while still maintaining
the work order priority sequence.
d) Trouble: Removes the Rx from the work order priority queue.
e) Approve: Packaged prescription matches the electronic drug image.

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Pickup
The prescription pick up stage includes the following functions:

Verify the identity of the person picking up the prescription(s).


Identify the number of prescriptions that need to be retrieved from the Pickup bins.
Identify the location of a prescription.
Identify what stage of the prescription filling process an Rx is at.

At this stage the user can either create an OTC to profile record for patients purchasing OTC
products, or check the status of prescriptions for those picking up.

Creating an OTC to Profile Record for New and Existing Patients


Log into the Pickup screen and click on the OTC icon located in the top right corner.

In the drug search field, enter one of the following drug search criteria:

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a)
b)
c)
d)
e)

Brand/Generic Name, Strength/Pack Size (e.g. Apo-Metformin, 500/360)


DIN (5-8 digits)
UPC (11-12 digits)
A period (.) and the Drug Quick Code (e.g. TYLE1)
#symbol and the Catalog Item Number (e.g. #78945)

Search for the product using the arrows and once the correct product is chosen, highlight it and
double click it or click Select located in the top right corner.

Once a product is selected a screen will show up displaying the product. If another product is to
be added, search for it the same way from the search field. If there is no other product to add,
select Next in the top right corner. If at any moment, you want to exit recording an OTC simply
click Exit OTC in the top left corner and it will bring you back to the Pickup Screen.

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The next screen will be the patient search screen. Search for the patient by entering one of the
following patient search criteria:
a) Last Name, First Name (e.g. Doe, Jane OR doe,j OR Doe OR ,Jane)
b) A period (.) and the Patient Quick Code (e.g. .DoeJ)
c) 7 or 10 digit phone number (e.g. 800-263-5876 or 263-5876)
d) A number sign (#) and the +Third Party Billing number (e.g. #123456789)
e) An asterisk (*) to search ALL patients in the database

If the patient already exists, highlight the patient and click Select. OR If it is a new patient, click
Insert and fill in the information of the patient in the following fields.

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Click Save when the fields are populated.


From the confirmation screen, if all the information is correct, click Confirm in the top right
corner, if changes need to be made choose Back or Start Over in the top left corner. The user
has an option of adding in a stop date. For example, if a patient is using Tylenol No.1 to treat
acute back pain, the stop date could be in 10 days.

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WARNING: Clicking Confirm may produce DUR actions for the pharmacist to resolve.

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Prescription Pickup for a Patient


1. Log into the Pickup: Start Screen and click on the Pickup icon located in the top right
corner.

2. In the patient search field, enter one of the following patient search criteria:
a) Last Name, First Name (e.g. Doe, Jane OR doe,j OR Doe OR ,Jane)
b) A period (.) and the Patient Quick Code (e.g. .DoeJ)
c) 7 or 10 digit phone number (e.g. 800-263-5876 or 263-5876)
d) A number sign (#) and the +Third Party Billing number (e.g. #123456789)
e) An asterisk (*) to search ALL patients in the database
3. Once the patients information is confirmed, highlight the information and click Select in the
top right corner.

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The patients medication history will show up indicating what stage of the Prescription Filling
Process the medications are in. For example, none of Jane Does medications are ready for pick
up and are in the Input stage.
To pickup prescriptions ensure they have a green check mark, then click Pickup _ Item.

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[Blank]- Indicates Identification is required to pickup this Rx


Counsel Patient Indicates this prescription requires the pharmacist to counsel the
patient.
Refrigerated Indicates this prescription can be found in the refrigerator

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Refill Rx
The Refill Rx section includes information about:

Accessing refillable prescriptions from the F11 drop-off screen


Accessing refillable prescriptions from the F3 patient search screen
Input
Refill Rx: Filling
Check
Unfill Rx (on hold)
Unfill Rx: drop off
Unfill Rx: enter

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Accessing Refillable Prescriptions from the F11 Drop-off


Screen
1. From the ALT+X Start Screen, click F11- Drop-Off or press F11 on the keyboard to access the
Drop-Off window.

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Prescription Number is Known


Enter the prescription number into the Refill Rx Number field and click Lookup to view the
prescription details.

Click Add to insert the Refill Rx to the work order item list. You can continue adding refills for
the patient using the same method. Once all the refills have been added, set a due time before
finalizing the work order.

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Click Finalize Work Order to move the prescription to adjudication. If any DUR messages are
present they will first need to be resolved by the pharmacist before the prescription moves to
the filling queue.

Prescription Number is Not Known


1. From the F11- Drop-Off window search for the patient record in the patient search field and
set a due time.
2. Click on Refillable Rxs located under the Patient Profile sidebar. To promote efficiency, this
window will show all the prescriptions that the patient has repeats left on. Use the spacebar
on the keyboard to tag the prescriptions that the patient would like a refill on and either
click on F-Refill or press F on your keyboard

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3. Make any changes that need to be made on the drop off screen (e.g. changing the Disp
Qty). Click Add or press Enter on the keyboard once changes have been made.

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4. Click Next to move the prescription to the Drop-Off confirmation screen. Add any
additional information such as Auto Refill status and press Finalize Work Order to continue
to the adjudication state.

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Accessing Refillable Prescriptions from the F3 Patient Search


Screen
1. In the F3-Patient Search field, enter one of the following patient search criteria and press
Enter on the keyboard or click Search:
a) Last Name, First Name (e.g. Doe, Jane OR doe,j OR Doe OR ,Jane)
b) A period (.) and the Patient Quick Code (e.g. .DoeJ)
c) 7 or 10 digit phone number (e.g. 800-263-5876 or 263-5876)
d) A number sign (#) and the +Third Party Billing number (e.g. #123456789)
e) An asterisk (*) to search ALL patients in the database
2. Once the patient is found either press Enter on the keyboard or double click on the patient
3. Click Refillable Rxs from the Profile Sidebar on the right side of the screen. To promote
efficiency, this window will show all the prescriptions that the patient has repeats on.
4. Highlight the medication(s) that the patient would like to refill and tag them using the
spacebar and either right click on the patient profile or click on Extra Functions and select
Add to Rx to Do List.
5. Select a due time for the work order and this will put the prescription into the Enter Queue.

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Input
At the Enter Queue, changes can be made to the prescription if necessary before adjudicating
it. Press F12- Fill Rx to move the prescription to the next stage, Fill.

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Refill Rx: Filling


1. From the workflow queue; click the Fill button to show all Rxs ready to be filled.
2. From the ALT+X-Start Screen, click F9-Workflow or press F9 on the keyboard.
3. Activate the Fill queue by clicking on the Fill button and click on Get Work to view the next
work order that needs to be filled.
4. Scan the UPC or type the DIN located on the stock bottle .

5. Enter the Dispensed quantity in the Qty field.


6. If a balance owing is required click the Owe button. If the order can be fulfilled click
Packaged to continue.

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Check
The Check stage must be performed by a pharmacist or licensed technician. Check is the final
check that is made before the prescription is bagged and filed away in the pickup drawers. At
this point, the user should be looking at the filled prescription and verifying that against the
written prescription and the electronic drug image displayed on the screen.
1. From the ALT+X-Start Screen, click F9-Workflow or press F9 on the keyboard.
2. Activate the Check queue by clicking on the Check button and click on Get Work to view the
next work order that needs to be verified.
3. The Check screen will be displayed for the prescription. The user will have to verify that the
packaged prescription matches the electronic drug image and can select either:
a) Save for Later: Return to the F9-Workflow window.
b) Cancel Rx: Reverses the prescription and marks it as Cancelled in the patient
medication profile. Note: Cancelled prescriptions can be filled again.
c) Reject: Rejects the Rx and sends it to the previous stage while still maintaining
the work order priority sequence.
d) Trouble: Removes the Rx from the work order priority queue.
e) Approve: Packaged prescription matches the electronic drug image.

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Unfill Rx (On Hold)


There can be many reasons why patients may not need some of their prescriptions filled at
Drop Off. For documentation purposes and convenience these prescriptions will be put on hold
and referred to as Unfilled Rxs. An Unfill Rx will pass through Drop off, Enter and Check of the
Rx processing steps.

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Unfill Rx: Drop Off


There are a number of fields and options available from the F11-Drop Off window; however,
the following steps must be performed at the Drop Off stage to ensure patient safety and to
proceed to the next Rx Processing Stage in the system:
1. Search and select a patient record
2. Review the patient medication history
3. Indicate a prescription due time (i.e. pick up time),
4. Select a status for the prescription (i.e. Fill, Unfill, Not Disp, Stock Trans)
5. Scan the written prescription into the system
6. Indicate the number of Rxs on the written prescription
Pharmacy Assistants, Pharmacy Technicians, and Pharmacists can Drop-Off prescriptions into
the system as follows:
1. From the ALT+X Start Screen, click F11- Drop-Off or press F11 on the keyboard to access the
Drop-Off window.
2. The cursor will default to the Patient Search Field; search and select the applicable patient
record (refer to Search for a Patient from the F11 Drop-Off Screen). Users should not
continue the Drop Off process without entering a patient record.

NOTE: If the patient does not exist in the database, create a new patient record (refer
to ``Creating Patient Records``).
3. Once the patient record has been selected into the F11- Drop Off window, the cursor will
move to the Due field. Click the down arrow and select a due time for the work order:
a) Critical = 1 minute
b) Waiting = 20 minutes
c) Today After 5pm
d) Tomorrow 9am
e) Tomorrow after 5pm
f) 1 Hour
g) 2 Hours
h) 30 Minutes
Users can also click or press F2 to change the Due field to a Date and Time field for entry of a
specific work order due time. (NOTE: click F2 again to change the Date and Time field back to a
Due field).
Users can access the Patient Profile options on the Sidebar at any time to view the medication
profile in order to identify and record the medication on the prescription as new, had before,
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dose increase, dose decrease or Rx on hold. Click OK or press Enter on the keyboard to close
out of the patient profile window.

The Delivery field will default to Pickup, which is the only option available at this time.
4. Once an Rx barcode sticker has been adhered to the written prescription, feed it into the
Document Scanner and click the large Import Script Image file button or click Select Script
Image from the Drop-Off sidebar. If the prescription was faxed to the pharmacy, users can
select the option to Import Script Image from Fax which allows the user to select and
attach a faxed image to the work order.
5. Once the image is scanned into the system, options are available to Crop, Flip, Rotate
and/or Fit to Window. Once changes have been made, click Save or press Enter on the
keyboard to insert the image into the Drop-Off screen.
6. Enter the number of medications on the written prescription in the # of Rxs On Page field;
this will tell the system how many Rxs are associated with the Rx Image.
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7. To Clear (i.e. delete) or Re-Scan a script image, click Clear Script Image under the Drop-Off
sidebar. This will remove the existing image and allow you to re-scan the old image or scan
a new image.
8. From the Status field, click on the down arrow to mark the prescription as:
a) Fill Process and dispense the Rx
b) Unfill Put the Rx on hold
c) Not Disp Mark the Rx as OTC to Profile
d) Stock Transfer Mark the Rx as a stock transfer to another pharmacy.

9. Enter any workflow-specific notes in the Note tab located near the bottom of the F11-Drop
Off window. The note will be displayed a t each Rx filling stage for the prescription.
10. Once all applicable Drop-off information for the Rx is entered, click Add to create the work
order.
11. Once the above steps are complete, the user can click Next to proceed to the Drop-Off
Confirmation screen.

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12. Review the details in the drop-off confirmation screen then click Finalize Work Order or
press Enter on the keyboard to move the work order to the next stage of the prescription
filling process.

Once Finalize Work Order is selected, a blank F11-Drop-Off window will appear to allow
another work order to be dropped.

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Unfill Rx: Enter


The Enter stage is where users enter prescription information such as Drug, SIG, Dispense
Quantity, Intervention Codes, etc. into the system for processing. Extra care taken at this point
will ensure that the work order passes through the Check quickly without having to make time
consuming changes later on. Typically, Enter should be performed by a Pharmacy Assistant, but
can also be performed by Licensed Technicians and Pharmacists.
1. From the ALT+X-Start Screen, click F9-Workflow or press F9 on the keyboard.
2. Activate the Enter Queue by clicking on the Enter button.
3. Click on Get Work to view the work orders that need inputting; work orders are always
presented to the user in priority sequence according to the due time assigned to the work
order.

4. The Input screen (a.k.a Create New Rx From To Do window) will display the Rx image on the
left and the input fields on the right. The patient field will already be populated with the

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patient selected at the Drop- Off stage; however, this record can be changed by searching
and selecting another record from the Patient Search field.

NOTE: Click or press F3 from this window to view the detailed Patient Record.
Changes cannot be made to the patient record at this stage.
5. Search and select the appropriate drug record from the Drug Search Field.

NOTE: Click or press F5 from this window to view the detailed Drug Record. Changes
cannot be made to the drug record at this stage.
6. Search and select the appropriate prescriber record from the Doctor Search field. If the
prescriber record does not exist in the system, create a new one.

NOTE: Click or press F7 from this window to view the detailed Prescriber Record.
Changes cannot be made to the prescriber record at this stage.
7. Enter dispensing information for the prescription:

SIG: Enter the Sig in the SIG field and the expansion will appear in read only format in
the grey box below.
Disp Qty: Enter the dispense quantity for the prescription.

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Days: Enter the days supply for the dispense quantity indicated.
Refills: Enter the number of refills on the prescription.
Auth Qty: The authorized quantity field will auto-populate if the Disp Qty and Refills
fields are filled out. If the Auth Qty field is blank, enter the total authorized quantity for
the entire prescription.
Unlimited Refills Until: Place a checkmark next to this flag if the prescription has
unlimited refills until a specific date.

8. From the detailed Enter screen (a.k.a. F12- Screen) a number of additional fields and tabs of
information are available. (See New Rx: Enter)
9. Double check the RX status is set to unfilled. If it was missed at Drop off; Click Make RX
Unfilled from the side toolbar on the Enter screen to change the RX status to unfilled. Then
Hit F12 to save the Rx to the patients profile

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Modify Rx
Once a prescription has been processed, there are some fields that can be modified and some
that cannot. For those fields that can be modified, namely prescription comments, refills, unit
dose activation, and other fields that do not have clinical or financial impact, users can modify
the prescription to edit those fields.
The following section will describe two methods for modifying prescriptions:

Method 1:Enter the Rx number into the Universal Search Field


Method 2: If the Rx Number is Not Known

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Method 1: Enter Rx Number into the Universal Search Field


1. Enter the Rx number into the Universal Search field and press Modify Rx.
2. On the following input screen only certain fields can be modified. Once changes have been
made, click F12- Save Changes with the mouse or press F12 on the keyboard.

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Method 2: If the Rx Number is Not Known


1. Search for the patient by entering the search criteria into either:
a) The F3-Patient search screen and press Enter on the keyboard.
b) The Universal Search field from the ALT+X Start Screen and press F3 on the
keyboard.
2. Select the patient by highlighting their information and pressing Enter on the keyboard. To
access the Medication Profile either:

3. Click All Rxs located under the Profile sidebar on the far right of the screen.
4. Press Shift+F3 on the keyboard.
5. Tag the prescription(s) that you would like to modify by using the spacebar on the
keyboard. Once the Rxs have been tagged, click M-Modify or press M on the Keyboard.

6. This will bring up the prescription in the Modify Mode. Certain fields cannot be modified
such as patient, SIG and doctor information. However, fields such as dispense quantity,
authorize quantity, interchangeable drugs and unit dose information can be changed in the
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Modify mode. Once all modifications have been made, click F12- Save Changes with the
mouse or press F12 on the keyboard to save the changes on the prescription.

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Copy Rx
The Copy Rx function allows the user to copy information from an existing prescription to a new
prescription. This function is often useful when the doctor renews a patients existing
medications and there is no change in dosage or SIG. It is not recommended to use this function
when there are changes in dose, SIG, or prescriber because when a prescription is copied, a link
is created between the new and old prescriptions. The original prescription that was copied will
automatically have a status of Inact (Copied) and cannot be transferred out.
There are two methods of copying a prescription:

Method 1: From the F11- Drop-off Screen


Method 2: From the Patient Medication Profile

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Method 1: From the F11-Drop-Off screen


1. From the ALT+X Start Screen, click F11- Drop-Off or press F11 on the keyboard to access
the Drop-Off window.
2. Search for the patient in the Patient Search field and select a Due time for the work order.
3. Click All Rxs located under the Patient Profile sidebar and tag the prescriptions you want to
copy by using the spacebar. Once the prescriptions have been tagged either press Y on the
keyboard or click Y-Copy to New.

4. The following screen will display how many Rxs are being copied. Once the changes are
made to the prescription click Add to add the Rx to the work order.
In this example, two prescriptions are being copied. Once the second Rx is added, click Finalize
Work Oder to move it to the next queue, input.
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NOTE: The prescriber, drug, and dispensing information will be copied from the old Rx
record but can be changed if necessary.

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Method 2: From the Patient Medication Profile


1. From the F3-Patient Search screen, bring up the patient record and select one of the
patient Profile views (All Rxs, Active Rxs, Refillable Rxs etc) from the sidebar on the far
right of the screen.

2. Use the spacebar to tag the prescriptions you need to copy and press F or click F- Refill. A
message will be prompted if no refills are left for the prescription. The message will ask if
you want to copy the prescription to a new number, click Yes.

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3. If the user clicks No accidently and still wants to copy the prescription, click Copy to New Rx
from the Rx sidebar and select a Due time. A message will be prompted for reusing a script
image, answer accordingly.

4. A message will prompt asking the user to specify the number of refills for the new Rx.

5. From the F12-Filling screen select a Due time and make any necessary changes to the
prescription. Click F12-Fill Rx or press F12 to move the prescription to the next queue, Fill.

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The remaining steps of the prescription filling process are the same as Method 1.

Copy Rx: Input


The copied Rx will appear in the F12-Filling Screen and any changes to the dispense quantity,
interchangeable brands, intervention codes, plan billing etc can be made before passing the
prescription to the filling stage. When all supplementary information is entered into the input
screen, click F-12 Fill Rx or press F12 on the keyboard to move the prescription to 7 Point &
Adjudication.

NOTE: Under the Dates tab of the F12-Filling screen, there will be information listed
on where this prescription was copied from.

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Cancel Rx
Cancelling a prescription means reversing a prescription which includes reversing claims sent to
third party plans. Users may need to cancel prescriptions for various reasons. For example, a
change in dispensing quantity, wrong SIG inputted; patient does not want the prescription
anymore.
There are two ways to cancel a prescription:

Method 1: Cancel a Prescription from the ALT+X Start Screen


Method 2: Cancel a Prescription from the Patient Medication Profile

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Method 1: Cancel a Prescription from the ALT+X Start Screen


If the prescription number is known, the user can enter it into the Universal Search field and
click on the Cancel Rx button.

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Method 2: Cancel a Prescription from the Patient Medication


Profile
If the prescription number is not known, the user must access the patient record and search
through the medication profile.
1. From the ALT+X Start Screen, click F3-Patient with the mouse or press F3 on the keyboard
to access the F3-Patient Search Screen.
2. In the patient search field, enter one of the following patient search criteria:
a) Last Name, First Name (e.g. Doe, Jane OR doe,j OR Doe OR ,Jane)
b) A period (.) and the Patient Quick Code (e.g. .DoeJ)
c) 7 or 10 digit phone number (e.g. 800-263-5876 or 263-5876)
d) A number sign (#) and the +Third Party Billing number (e.g. #123456789)
e) An asterisk (*) to search ALL patients in the database
3. Once the patient search criterion has been entered, click Search or press Enter on the
keyboard to search the database for matching results.
4. Once the patient is found, press Enter on the keyboard and this will bring up the patient
record. Select one of the Profile options from the sidebar on the far right. Use the spacebar
to tag the prescriptions that need to be cancelled and press C on the keyboard or click CCancel using the mouse.

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Depending on the type of prescription you are cancelling the system will prompt you with
different messages for cancelling the prescriptions.

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Inactivate Rx
Prescriptions should be inactivated if patients are no longer using certain medications as a part
of their medication therapy. Prescriptions are automatically inactivated when they are copied
to a new prescription number or if they are transferred out of the pharmacy; otherwise any Rx
that needs to be inactivated will need to be done manually.
1. Press F3 on the keyboard or click F3-Patient using the mouse. Enter search criteria for the
patient and press Enter to execute the search. Once the patients information is confirmed
press Enter on the keyboard.
2. Select one of the Profile options (All Rxs, Active Rxs, Refillable Rxs etc) from the sidebar on
the far right of the screen.
3. Use the spacebar to tag the prescriptions that need to be inactivated and press I on the
keyboard or click I-Inactivate with the mouse.

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4. An Inactivate Rx(s) window will appear with the prescription entries tagged. Each Rx will
have a status indicating to the user if the Rx is eligible to be inactivated. If the Rx
information is correct, click on Inactivate Eligible Rxs.

NOTE: A status of OK to Inactivate means it is eligible to be inactivated.

5. You will be prompted to enter an optional reason for inactivating the Rx. Click Save to
continue. The status of the prescription will be indicated as inactivated in the patients
medication profile.

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NOTE: Prescriptions will automatically become inactive if they are copied or have
been transferred to another pharmacy

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Reactivate Rx
1. Use the spacebar on the keyboard to tag the prescriptions that need be reactivated and
click on Extra Functions or press X on the keyboard.

2. The Reactivate Rx window will appear indicating whether the Rx is eligible for reactivation.
If it is, click Reactivate Eligible Rxs to reactivate the inactive prescription

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Not Dispensed
Creating an OTC to profile record for patients is known as Not Dispensed Rxs in the system.
The term not dispensed is used because these prescriptions are not dispensed by the
pharmacist. Rather they are over-the-counter medicines that are taken by the patient and
therefore included in the medication profile for drug interaction analysis.

NOTE: Not Dispensed prescriptions can be added from the Kroll Fill session or from
the Pickup screen.

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Not dispensed: Drop- Off


1. From the ALT+X Start Screen, click F11- Drop-Off or press F11 on the keyboard to access the
Drop-Off window.
2. Search for the patient in the patient search field and select a Due time. If there are any
counseling notes written in regards to the OTC product it should be scanned into the system
via the Document scanner.
3. Set the Rx status to Not Dispensed. Once all the relevant information has been entered,
click Add to add the work order. The user must enter the prescriber, drug and any
dispensing information before completing drop-off.

NOTE: Enter the name of the pharmacist on duty in the prescriber field.
4. Click Finalize Work Order or press Enter on the keyboard to move the prescription to the
next queue, Enter.

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Not Dispensed: Enter


At this stage, the prescriber, drug and dispensing information will be brought over from dropoff if it was entered. If not, this information needs to be entered at this stage. If the user desires
to enter a stop date for the Not Dispensed prescription, it can be done by clicking on the Dates
tab and entering an Rx Stop Date. For stores connected to a Drug information System, entering
stop dates for Not Dispensed/OTC to profile Rxs may be required.
Once all relevant information for the OTC product has been added to the patients medication
profile, click F12-Fill Rx or press F12 on the keyboard.

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Fee for Service Rx


Fee for service prescriptions are prescriptions billed to third parties for professional service
rendered by the pharmacist to the patient. For example, some Fee for Service prescriptions can
be prescription adaptation services, medication reviews, refusals to fill, smoking cessation etc.
Since services are not physically tangible and do not involve the dispensing of a dug product,
some elements of prescription processing may be eliminated. Fee for service prescriptions
should always be filled after the service has been provided to the patient.

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Drop Off
1. From the ALT+X Start Screen, click F11- Drop-Off or press F11 on the keyboard to access the
Drop-Off window.
2. Search for the patient in the patient search field that the professional service was provided
to.
3. Set an appropriate Due time so that priority prescriptions will to be processed first. Fee for
Service prescriptions can always be processed at a later time after the patient has left the
pharmacy.

4. The Rx status should be set to Fill. Feed any written documentation produced from the
professional service into the Document scanner and click Import Script Image file option.
For example, if a medication review is going to be conducted, then a medication review
form listing the patients medications should be scanned into the system as a supplement to
a prescription. Once all the necessary drop-off information has been entered, click Add to
create the work order.

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5. Click Finalize Work Order to send the prescription to the Enter, stage.

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Input
Any professional service will be processed through the Kroll Pharmacy Software and will have a
drug record associated with it. Typically a Fee for Service drug record will have a DIN or
Pseudo DIN used for billing, but will not have UPC, counseling, drug monograph or ordering
tabs because these do not apply for services rendered to a patient.
1. From the F12-Filling screen, search for the Fee for Service in the drug search field.
2. Select the correct professional service and press Enter on the keyboard. In some cases,
depending on the selection made in this field, the system will send a Special Services Code,
Intervention Code, Rx prefix, etc. to third parties as a part of billing requirements.

NOTE: In the Drug Price Group field, there may be a strategy applied to the drug
record to instruct the system to use a specific pricing strategy for prescriptions filled
for the service.

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3. For prescriber information on the F12-Filling screen, enter the pharmacists information
that provided the professional service. If the pharmacist record does not exist, insert a new
record as you would for a prescriber.
4. From the F12-Filling screen users can access the Plan information option from the sidebar
to view any intervention codes or special service codes that being submitted to third parties
as a part of the claim.

The warnings tab will display an information message to let the user know they are filling a Fee
for Service prescription. The pricing tab will indicate any special pricing strategies being applied
to the Rx. Make sure the Dispensed Quantity and Days Supply field is filled in.
5. Once all the information has been inputted, move the Fee for Service prescription to the
next stage by pressing F12-Fill Rx or pressing F12 on the keyboard.

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Transfer Rx
Prescriptions can be transferred into or out of the pharmacy. In both cases, information
regarding the transfer should be recorded in the system.

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Transfer Rx from Another Store


When a transfer is received from another pharmacy, the user must treat the transfer as a new
prescription. Therefore, the prescription must go through:
Drop-Off
Enter
Fill
Check
Release

Drop-Off
1. From the ALT+X Start Screen, click F11- Drop-Off or press F11 on the keyboard to access the
Drop-Off screen.
2. In the patient search field, search for the patient whose Rx is being transferred in by
entering either:
a) Last Name, First Name (e.g. Doe, Jane OR doe,j OR Doe OR ,Jane)
b) A period (.) and the Patient Quick Code (e.g. .DoeJ)
c) 7 or 10 digit phone number (e.g. 800-263-5876 or 263-5876)
d) A number sign (#) and the +Third Party Billing number (e.g. #123456789)
e) An asterisk (*) to search ALL patients in the database
If the patient does not exist after performing an advanced search, create a new patient record:
1. Feed the transfer report into the Document scanner and click Import Script Image file.
2. Click Add to enter the work order.
3. Press Enter or click Finalize Work Order to move the work order to the next queue.

Input
1. From the F12- Filling Screen, click on Transfer Rx from Other Store located under the Rx
sidebar to the far right.
2. Either type in the name or address of the pharmacy that transferred the prescription in
order to view any matching pharmacies from the existing list. If a matching pharmacy is
located from the list either:
a) Double click the applicable entry
b) Highlight the entry and press Enter on the keyboard.

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3. If a matching pharmacy cannot be found click, New to insert a new transfer pharmacy
record. In the pharmacist Name field, enter the name of the pharmacist who authorized the
transfer. The user can optionally enter a First Fill Date, Last fill Date, Rx # and Total original
fills. Click OK to save the transfer information.

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Transfer Rx to Another Store


1. Search and access the patient record for the patient requesting the transfer from the F3Patient search screen. Once the patient is found, press Enter on the keyboard.
2. Access the Patient Medication Profile by choosing an option located under the Profile
sidebar located on the far right of the screen. Tag the prescriptions that need to be
transferred out by using the spacebar on the keyboard.
3. Click on Extra Functions and select the option to Transfer Rx To Other Store.

4. Search for the pharmacy you are transferring to. If it is not found, click New to add the
stores information.

NOTE: The Rx status indicates its eligibility to be transferred out.


5. Enter the name of the pharmacist receiving the transfer and click Transfer Out Eligibility
Rxs.
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6. The following window will prompt asking the user if they want to print the transfer report.
Click Yes to print the transfer repot.

7. On the following screen, the user can choose additional information to be included on the
transfer report under the Options tab. Click Print to print the report.

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Rx with LU code/Section /SSC/Special Auth #


In Ontario, some prescriptions require supplementary plan information to facilitate billing; this
can take the form of a Limited Use Code, Section 8 Intervention code, Special Authorization, or
special service code. Some of these supplementary items will be added to the system
automatically; for example, DA and DB interventions. Other supplementary items need to be
added manually.

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Rx with LU Code/Section /SSC/Special Authorization #: DropOff


Drop off a prescription as usual by searching for the patient, setting a due time and Rx status.
Feed the document into the Document scanner and click Import Script Image file. Click Add
once you are done and click Finalize Work Order on the Drop-Off confirmation screen, to move
the work order to the next queue, input.

NOTE: From the drop-off screen there is no field to enter supplementary plan
information; this must be done at the input stage.

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Rx with LU Code/Section /SSC/Special


Authorization #: Input
At the input stage enter the Drug, Prescriber and dispensing information as usual. From the
F12-Filling Screen, if there is an ODB plan in the patient record and the drug product has a
Limited Use Code, a prompt will appear asking the user to:
a) Bill to ODB with a Reason Code
b) Bill to ODB as a Section 8 Drug
c) Do not bill to ODB

To bill the prescription with a Limited Use Code:


1. Select the first option. The user will be presented with a list of Limited Use Codes specific to
the drug. Depending on the selected code, the expiry date will automatically be populated
on the lower portion of the screen.
2. Once the applicable LU code has been selected, click OK or press Enter on the keyboard to
continue.

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NOTE: Some drugs may have Limited Use Codes with no expiry date.
In the event the user accidently bypasses the prompt to add a Limited Use Code or wishes to
add an intervention code, SSC or Special Authorization number to the prescription, they can
access the plan information by accessing the View menu from the sidebar and selecting the
option Plan Information.
There is a separate Plan Information tab for each plan listed in the patient record.
If the drug in the Rx is a Limited Use drug, click F2 from the Reason Code field to view all the
codes associated with the drug. Users can re-select a code from here.
To add/view intervention codes, click F2 from the associated Intervention Code field. If the
intervention code is known, type in the letters to access the code you want.
The Claim type, Real Time Plan flag and Pseudo DIN fields are automatically set and should not
be changed. Once all necessary Plan Information has been set, click OK or press Enter on the
keyboard to continue. Proceed to move the prescription to the next Rx processing stage, Fill by
pressing F12-Fill Rx or pressing F12 on the keyboard.

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Mixture Rx
The key to filling a mixture easily and efficiently is to ensure that the mixture record is created
and available before you start inputting the prescription.

NOTE: In the Kroll Pharmacy Software, a mixture is made up of individual drug


records which are known as component records when we are speaking about
mixtures.

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Drop-off
1. From the ALT+X Start Screen, click F11- Drop-Off or press F11 on the keyboard to access the
Drop-Off window.
2. Search and select the patient that requires a mixture prescription. Set a Due time for the
prescription keeping in mind the time it will take time to compound the mixture. Feed the
prescription into the Document scanner and click Import Script Image file. Click Add to
create the work order.
3. Click Finalize Work Oder to proceed the mixture prescription to the next queue, Input.

NOTE: It is not recommended to add the mixture record at drop-off because of the
potential time it takes to search and/or input a mixture record which could cause
delays in serving other patients.

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Input
1. From the F9-Workflow window, activate the Enter Queue and click Get Work.
2. From the input screen, place the cursor on the Drug Field and click F5-Drug or press F5 on
the keyboard, this will call up the drug search window. Place a checkmark next to the
mixture flag to indicate that you are searching for a mixture record.

NOTE: A purple bar across the top of the window denotes mixture records
throughout the system.
3. Users can search for a mixture by using either:
a) The mixture name/description.
b) Mixture components separated by commas.
4. If a matching record is not found and the user clicks Insert or presses Insert on the
keyboard, a message will prompt.
5. Click OK to the message and this will prompt the system to automatically perform an
advanced mixture search.
6. If a matching mixture record is still not found, click Insert again and this will bring you to a
new mixture record screen. Fill in the fields of the mixture record. Users must be aware that
whatever name is typed into the Name field is what will be printed as the mixture
description (Refer to Mixture naming Convention). In addition, enter proportions by
Percentage if the amount of each component depends on the total dispensed quantity of
the mixture. If the mixture is composed of fixed units of ingredients, select the option to
enter proportions by Unit.
7. Click Save or press Enter on the keyboard. Then Press F12 on the keyboard or click F12New Rx to return to the F12- Filling screen. Once all the information has been inputted, click
F12-Fill Rx to move the prescription to the next queue, Fill.

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Filling
1. From the workflow queue; click the Fill button to show all Rxs ready to be filled.
2. From the ALT+X-Start Screen, click F9-Workflow or press F9 on the keyboard.
3. Activate the Fill queue by clicking on the Fill button and click on Get Work to view the next
work order that needs to be filled
4. The mixture will appear requiring each ingredient UPC to be scanned. Scan the UPC of the
first ingredient. Press Package if dispensing the entire Rx quantity.

The mixture ingredients Expiry Date and Lot number can be documented, aswell as the Mixture
Expiry Date and Lot number.

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5. Scan the UPC for each ingredient and click Packaged.

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Reports
This section describes the various report types that can be generated in Kroll:

Daily Reports
Weekly Reports
Other Reports

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Daily Reports
Kroll can be used to generate two (2) kinds of daily reports:
End of Day Report
Network Totals Report

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End of Day Report


At the end of the day, a Day End Label can be printed which provides a snapshot of the
prescription totals for that day.
To print an End of Day Report:
1. Select File > Exit or press ALT + F, X on your keyboard.

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Network Totals Report Adjudication Totals from Network


At the end of the day, a network totals report will communicate real time to the third party
plans providing the totals of the day for those plans. The Day End Label and Network Totals
should balance.

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Weekly Reports
Kroll can be used to generate three (3) kinds of weekly reports:
Adjudication Totals
Daily/Monthly Totals Report
Plan Summary Report

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Adjudication Totals
The Adjudication Totals Report represents what Kroll has recorded as being paid by the third
parties (unlike the Adjudication Totals from Network Report, the Adjudication Totals Report
does not communicate real time to the third party plans). There are options to run the report
by date range, this report can be run for various plans and with the option to include details
and daily summaries.
This report is easily accessed from the Reports Menu under Rx -> Adjudication Totals with the
options to run the report by various date ranges, this report can be run for various plans and
with the option to include details and daily summaries.

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Daily/Monthly Totals Report


The Daily/Monthly totals reports summarizes the total dollar values for the date range specified
on either grouping them daily or monthly based on your selections in the report. It is important
to note that this is a fill based report. This means it will only ever reconcile with other fill based
reports.
To access this report, go to Main Menu > Reports > Rx > Daily/Monthly Totals

NOTE: all reports can also be easily accessed if you are familiar with the name of the
report by clicking on Reports - > Search and enter any part of the Name of the
Report. For this example you could enter Daily.
In the example we have chosen a custom date range and chosen to group it daily, including all
patient groups. To change the patient groups hit F2 on the keyboard or click F2 on the report
and change to an individual group of patients. It is important to note that you may narrow this
report by patient, Nursing home or by Patient Group.

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Sample Daily/Monthly Totals Report:

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This example is the same as the one above only except we are chosing to group the report
monthly.

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Sample Daily/Monthly Totals Report:

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Plan Summary Report


The Plan Summary Report summarizes the total dollar values generated for all plans including
cash within a specified date range.
To access this report, go to Main Menu > Reports > Rx > Plan Summary

NOTE: all reports can be easily accessed if you are familiar with the name of the
report by clicking on Reports >Search > Enter any part of the Name of the Report.
For this example you could enter Plan.

For this report you can enter a date range, and run for a specific Nursing Home, or all patients
and you can also include or exclude patient groups.

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In the Options Tab you can choose to group by the following:


First Paying Plan
Primary Plan

Include Summary for all Plans Except Cash and Provincial Plan
This is important if you are only interested in a summary of all other third parties.

Print Gross Profit $


This option will include Gross Profit totals along with Gross Profit percentage. You also have
the option to include Fee for Service Rxs, these Rxs are usually pure profit.

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Sample Plan Summary Report

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Other Reports
Other reports that can be generated in Kroll include:
Claims Invoice Report
Narcotic Report
Profit/Loss Report
Patient Medical History Report
Tax Receipt Report
Rx for Drug/Doctor Group Report
Drug Inventory Listing Report
Drug Inventory History Repoert
Tx Totals Report
Price Tree Report
Sig Code Report
Future Usage Report
Compliance Label Report

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Claims Invoice Report


This report will capture the prescriptions filled to non-real time plans (i.e. manual billing plan).
To access this report, go to Main Menu > Reports > Rx > Claims Invoice

NOTE: all reports can be easily accessed if you are familiar with the name of the report
by clicking on Reports > Search and Enter any part of the Name of the Report. For this
example you could enter Claims.
In the Selection Tab enter a date range, and then select your choice of Patient, Home or All.
Under Plans, press F2 to display a list of all plans, and select only the manual plans.

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The options tab of this report is significant in how the report generates. We have highlighted
the most common fields that should be enabled:

Print Cost, Fee & Markup


This is required when manually submitting to a plan in order for them to pay.

Print Total
The plan wants to see this information.

Print Prev Paid/3rd Party Pays


This is important to the manual bill plan if a previous online plan has paid any of the amount of
the claim.

Print Co-pay
This is also important to the manual bill plan if there is a preset deductible for that plan. (i.e.
the manual plan pays 80% and the patient pays 20%).

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Show Sub-plans Instead of Plans


This covers if the plan is a manual bill plan of another for example: I create a manual bill plan
under the Assure plan, it then becomes a sub plan of Assure.

Include Same-Range Cancels


This is important to include in case the prescription has been cancelled and then rebilled. The
manual billed plan will want to see the cancel for that number and then the rebill with the new
rx number.

Include Items Where Plan Pays $0.00


Best to include this amount so that it picks up any of the plans where we have said bill
manually.

Include Data for Real-Time Plans


We want to include the data of real time plans that may have paid a portion of the prescription
previously or we have said to bill manually.
This is the first page, the claims page. This page details out the patient information as well as
the Rx information and is what is typically submitted to the manual plan for reimbursement.
Sample Claims Invoice Report (Claims)

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This is an example of the Plan Summary page: This shows the totals number of Rxs billed,
reversed and net amounts due. It also includes the cost, mark up, fee total; co-pay and 3rd party
pay amounts. This is typically kept for pharmacy records.
Sample Claims Invoice Report (Plan Summary)

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The last page is the Report Summary Page, this page is typically kept by the pharmacy to track
what they have submitted.
Sample Claims Invoice Report (Report Summary)

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Narcotic Report
This is the report used in most provinces to track the reportable and forced reportable drugs
that have been dispensed from the pharmacy.
To access this report, go to Main Menu > Reports > Drug > Narcotic Report.

NOTE: all reports can be easily accessed if you are familiar with the name of the
report by clicking on Reports > Search > Enter any part of the Name of the Report.
For this example you could enter Narcotic.

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Sample Narcotic Report

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Profit/Loss Report
Run this report to identify your profit and loss margins. This report can print all Rxs for a
specific profit and loss amount or percentage for date range selected. This report will also
identify discounts provided by users during the adjudication process.
To access this report, go to Main Menu > Reports > Rx > Profit / Loss.

NOTE: all reports can be easily accessed if you are familiar with the name of the
report by clicking on Reports > Search > Enter any part of the Name of the Report.
For this example you could enter Profit.

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Print Same Day Cancels


When enabled, this option will include Rxs that were cancelled on the same day they were
filled.

Exclude Cancelled Rxs


When enabled, this option will exclude cancelled Rxs from the report.

Show Discount
Enable this option to include any discounts that were given to the prescriptions by the user
during the adjudication process.

Show Initials
Enable this option to include the users Initials who filled the prescription

Include Fee in Rx Total Calculation


Enable this option if you wish to include the Fee in total $ calculations.

Summary Only
Enable this option to print a summary (no details) of the options enabled.

Print Rxs where the Profit Amount > than XX

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Enable this option to open up fields to include profile, loss or discounts, amounts or
percentages that are >, <, =, >=, or <= than a specific dollar amount.

Print Rxs where Total > than 0


Enable this option to include Rxs where the total is >, <, =, >=, <=, than XXX (any given dollar
amount).

Print only Rxs with Manual Price


Enable this option to include only the prescriptions that have been setup with a manual price
override.

Fee for Service


Enable this option to include Rxs flagged as Fee for Service, exclude Rxs flagged as Fee for
Service or only include Rxs flagged as Fee for Service.

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Sort
Select the sorting option desired, i.e. sort by GP amount

Sample Profit/Loss Report

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Patient Medical History


This report will print a patients profile.
To access this report, go to Main Menu > Reports > Patient > Patient Medical History
NOTE: all reports can be easily accessed if you are familiar with the name of the report by
clicking on Reports > Search > Enter any part of the Name of the Report. For this example
you could enter Medical.
The Selection Tab has options that include running the report for specific Date Range, specific
Patient, Nursing Home or All patients. There are options to include Patient Groups or exclude
Patient Groups.

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Select the Options Tab to include a variety of options.

Print Store Logo


Enable this option to print your store logo on the report.

Print Billing Info


Enable this option to include patient billing information such as the patient plan and billing
number.

Include Inactive Rxs


Enable this option to include prescriptions that are inactive for the patient.

Display Refills
Enable this option to group refills together.

Print Disclaimer
Enable this option to print a disclaimer at the bottom of every page or the option to only print
the disclaimer at the end of the report.

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Sample Patient Medical History Report

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Tax Receipt Report


The Tax Receipt Report will print the totals amount prescription dollar spent and is commonly
used for tax purposes. This is not a detailed report as Revenue Canada only requires the total
dollars spent and not the Rx details.
To access this report, go to Main Menu > Reports > Patient > Tax Receipt.

NOTE: all reports can be easily accessed if you are familiar with the name of the
report by clicking on Reports > Search > Enter any part of the Name of the Report.
For this example you could enter Tax.

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Sample Patient Tax Receipt Report

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Rx for Drug / Doctor Group Report


This report is used to find a particular dispense for a specific drug or doctor, or drug or doctor
groups. This report is especially useful for drug recalls.
To access this report, go to Main Menu > Reports > Rx > Rx for Drug/Doctor Groups

NOTE: all reports can be easily accessed if you are familiar with the name of the
report by clicking on Reports > Search > Enter any part of the Name of the Report.
For this example you could enter Groups.
The Rx for Drug/Doctor Groups Report has two search choices:
1. Search by currently All active Rxs (this would include unfilled prescriptions)
2. Search by Rxs filled. By choosing Rxs filled you may then also choose a date range. You
may include or exclude specific paying plans and Rx Lot Number.

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Under the Patient tab, you have the choice to print for an individual Patient, a Home (Nursing
Home) or to create the report for All Patients. You also have the option to narrow your search
by Patient Group and by Province or State should it apply.

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Under the Drug tab there are significant options available to narrow your search. You may
search by:

Drug Groups
Any drugs that have been put into a specific drug group

Drug Schedule
This covers all drugs within a specific drug schedule

Drug Pricing Groups


This includes drugs that have been put into a specific Drug Price Group

Drug Departments
This includes drugs that have been put into a Department within the drug card

Drug
This area allows you to choose a specific drug. For example, if you want a printout of all of the
patients who have been dispensed Arthrotec 50. In this field you have the option to choose as
many or a few drugs you want by clicking on Add. This will bring up the Drug Search Screen for
you to select a drug or you can leave blank to include for all.
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Under the Doctor Tab there are two choices providing the ability to narrow the report
specifically by Doctor or Doctor Group.
1. Doctor Groups: When selected, the report will only print for doctors in a specific Doctor
Group.
2. Doctor: This area allows the user to run the report by a specific doctor.

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Options Tab
Allows the user to dictate exactly the extra information to be contained in the report

Print Unfills
Include all Unfills (Rxs placed on Hold) in the report

Print Not Dispensed


Include all Rxs marked as Not Dispensed (i.e. OTC Rxs)

Print Inactive
Include all Rxs that have a status of Inactive

New Rxs only


This option will only print new prescriptions

Show Drug
This will print the drug name

Show Lot#
If you maintain lot numbers in your drug cards this will include them on the report
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Show Rx Details
When this option is enabled it will print the Rx quantity, the status, the first fill, remaining
quantity, authorized quantity and the current fill date.

Financial Breakdown
This option will include all financial details of the prescription, for example: Actual Acquisition
Cost, Effective Markup, Markup Percentage, Fees, Special Services Code Fee, Total of the
prescription (including the previous amounts), and Gross Profit Percentage along with the CoPay amount.

Separate Special Services Fee


With this option enabled, it will separate the SSC field (Special Services Fee Field) from the
other cost fields.

Print Sig Codes


With this option enabled, it will print with the sig code for the prescription.

Sort by Province/State
When this option is enabled, it will sort by Province or State.

Page break on new Prov/State


With this option enabled, it will print all patients in the same province or state that are grouped
together on a separate page.

Show Patient Address Information


When selected this will include patient address and telephone number

Show Extended Patient Information


When enabled, it will print Nursing Home, Ward, and Postal Code information.

Show Room and Bed Number


If a patient is in a Nursing Home, it will include the Bed Number assigned to that patient.

Show extended Doctor Information


When this option is selected it will then include doctors License number, phone number and
address.

Checked by
With this option enabled, it will print a signature line found at the bottom of the report.

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Group by options
This option allows you to group the report either by Drug (which works well if you have
selected more than one drug), Patient (works well also if you have selected more than one
Patient) or by Rx # (which will group in chronological order of dispense by Rx number).

Page Break
This allows the user to have select items print on separate pages, like the page break on new
prov/state you may also choose to have a separate page to print for each of the following:
Nursing Home, Ward, Doctor, Patient or Room.

Fee for Service


This gives you the option to include fee for service items or not include them.

Sort By
This sort option is only enabled when grouping by patient. If you sort by Patient are presented
with the following sort options:
Doctor/Home/Ward/Patient
Doctor/Home/Ward/Room/Bed
Doctor/Patient
Home/Doctor/Patient
Home/Ward/Doctor/Patient
Home/Ward/Patient
Home/Ward/Room/Bed
Patient.

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Drug Inventory Listing Report


The Drug Inventory Listing Report prints a list of drugs and their inventory values and the
details are based on the options you choose. This report can be run to show a total value of
inventory in the pharmacy or a line for each drug.
To access this report, go to Main Menu > Reports > Drug > Drug Inventory Listing Report

NOTE: all reports can be easily accessed if you are familiar with the name of the
report by clicking on Reports > Search > Enter any part of the Name of the Report.
For this example you could enter Drug Inv.

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In the Selection Tab there are options available for the different types of drugs you can print.

NOTE: the system will default to All unless you select a specific type. To select a
specific Drug Group, Manufacturer, Drug Schedule, Default Vendor, Tier or
Department simply press F2 on the desired type and select from the list presented.

Groups
To print for a specific Drug Group, press F2 and select from the predefined list of Drug Groups.
If you do not wish to run for a specific Drug Group, leave the field defaulted to All.

Price Group
To print for a specific Drug Price Group, press F2 and select from the predefined list of Drug
Price Groups. If you do not wish to run for a specific Drug Price Group, leave the field defaulted
to All.

Schedule
To print for a specific or a variety of drug schedules, press F2 and select from the predefined list
of drug schedules. If you do not wish to run for a specific Drug Schedule, leave the field
defaulted to All.

Default Vendor
To print for a specific vendor, press F2 and select from the predefined list of vendors If you do
not wish to run for a specific vendor, leave the field defaulted to All.

Departments
To print for a department, press F2 and select from the predefined list of departments If you
do not wish to run for a specific department, leave the field defaulted to All.

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The Options tab presents a series of options to choose from:

Pack Status
A drug pack status must be selected to run this report. The following drug pack statuses are
available to choose from: Active, Inactive or Either. Active will print all active drugs in your
system, Inactive will print only inactive drugs in your system and Either will print both (longest
printout).

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On Hand (per pack)


This option will print the onhand inventory values from the drug cards and you can choose
from: Less than Zero, Equal to Zero and Greater Than Zero..

Include No Inventory Adjustment Packs


This will print all drugs not flagged for inventory adjustment (i.e. during the Receive process).

Show Only Packs not Dispensed Since XXX


If this option is enabled with a date, it will only include drugs that have not been dispensed
(filled) by the date entered.

Print Packs with an Inventory Value Greater than XX


Enable this option to print all drugs with an inventory value greater than i.e. 500.00 (the report
would not include drugs with an inventory less than $500.00)

Show Only Drugs with an Onhand Qty Greater than XX Days Supply
When enabled, this report will print any values greater or less than the days supply selected.

Show Inventory Total Only


If enabled, only an inventory value will print, not a detailed list.

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Show only Drugs Excluded from Kroll Price Updates


When enabled, this will present a list of drugs that have been excluded in Kroll price updates.
This is determined from a flag in the Drug Card Only allow manual price changes

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Sort By
Select the sorting option you desire, i.e. sort by Brand Name:

The Options 2 tab has number of other options that can be included in the report.

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Show Quickcode
Enable this option to print any quickcode assigned to a drug. When selected there is also an
option to then sort by quickcode.

Show Manufacturer
Enable this option to print the manufacturer of the drug

Show Din
Enable this option to print the drug identification number

Show Pack Size


Enable this option to include the drugs pack size

Show Acquisition Cost


Enable this option to print the acquisition costs of the drugs

McKesson
Enable this option to include the dollar value listed in the McKesson field of the drug card
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KF
Include this option to include the dollar value listed in the KF field of the drug card.

ODB BAP
Enable this option to include the ODB BAP value (Ontario Only)

ODB MAC
Enable this option to include the ODB MAC (Ontario Only)

Show On-Hand Min


Enable this option to include the min on-hand value (this appears when inventory control is set
to min/max)

Show On-Hand Max


Enable this option to include the max on hand (this appears when inventory control is set to
min/max)

Show Days Supply


Enable this option to include the days supply set inventory control (this appears when
inventory control is set to days supply)

Show Average Daily Usage


Enable this option to include the average daily usage

Show Brand and Generic Names


Enable this option to print the brand and generic names of the drugs

Show UPC
Enable this option to include the UPC. It will include the UPC for each individual drug.

Show Last Used Date


Include this option to print the last time the drug was filled in a prescription

Show Central Maintenance Flag


Include this option to print when a drug is centrally maintained.

Show Blank Line after On-Hand Quantity


Enable this option to present a line after each on hand value. This is often used to record the
number of tablets counted during fiscal inventory process.
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Sample Drug Inventory Report

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Drug Inventory History Report


To access this report, go to Main Menu > Reports > Drug > Drug Inventory History

NOTE: all reports can be easily accessed if you are familiar with the name of the
report by clicking on Reports > Search > Enter any part of the Name of the Report.
For this example you could enter History.

Manufacturer
To print for a specific manufacturer, press F2 and select from the predefined list of
manufacturers. If you do not wish to run for a specific manufacturer, leave the field defaulted
to All.

Drug Group
To print for a specific drug group, press F2 and select from the predefined list of drug groups. If
you do not wish to run for a specific drug group, leave the field defaulted to All.

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Drug Schedule
To print for a specific or a variety of drug schedules, press F2 and select from the predefined
list. If you do not wish to run for a specific drug schedule, leave the field defaulted to All.

Drug Price Group


To print for a specific drug price group, press F2 and select from the predefined list of drug
price groups. If you do not wish to run for a specific drug price group, leave the field defaulted
to All.

Inventory Changes
To print for a specific inventory change (movement that has taken place on a drug card), press
F2 and select from the predefined list of inventory changes. If you do not wish to run for a
specific inventory change, leave the field defaulted to All. Below is a list of the inventory
changes tracked in Kroll:
Adjudication Adjustment if the onhand (inventory value) of the drug has been
decreased or increased from the fill or cancel of a prescription.
Auto Receive if the drug has been received into inventory through an invoice
download
BuddyFill Cancel if this drug was filled through the Buddy Fill system and then
subsequently cancelled
BuddyFill Fill the drug was filled through Buddy Fill
Cancel the prescription has been cancelled
Drug merge the change in on hand inventory is a result of two drug cards being
merged together
Fill A prescription has been filled using this drug
Manual Adjustment someone has gone in and manually adjusted the inventory
Manual Receive Someone has manually received the order and therefore adjusted
the inventory
Sent to CentralFill This drug/prescription was sent to Central Fill
Store Transfer the drug was transferred to another store

NOTE: that for the above inventory changes, the initials of the user logged into the
computer at the time of the change or the user who filled the Rx.

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The Selection 2 Tab allows you to choose Drug Tiers (Ontario) or Drug Departments. However,
this Tab also provides you the option to print for the movement of an individual drug. To do
this, simply click Add, to bring up the Drug Search Screen which allows you to enter a drug
name or din and add it to the Drug box. In this example we have chosen Apo-Simvastatin 40mg.

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The Options Tab provides more options to include in the report. Most often the Show reason
for Inventory change is an important option as well as the dollar value of the units moved.

Print each drug pack on a new page


When selected each pack size will print on a separate page.

Show DIN
When enabled, this will include the Drug Identification Number of the drug(s) selected.

Show Schedule
When enabled, this option will include the drug schedule.

Show Reportable
When enabled, this option will indicate if the reportable flag on the drug card.

Show Acq Cost


When enabled, the drug acquisition cost will be included.

Show Primary Vendors Item Number


When enabled, this will include the drugs primary vendor item number.
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Show Secondary Vendors Item Number


When enabled, this will include the drugs secondary vendor item number.

Show dollar value of Units moved


When enabled, this will include the dollar value of the units moved.

Show Manufacturer
Enable this option to include the manufacturers short code, for example APX for Apotex.

Show Brand/Generic Type


Enable this option to print the type of drug, for example: Generic Multi Source, Generic Single
source, Brand, Brand single source, or Brand Multi source.

Show reason for Inventory Change


When enabled, this option will print the reason for the change in inventory, at the time the user
made the change.
Sample Inventory History Report

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Rx Totals Report
The Rx Totals report will print the number of New Rxs, Repeat Rxs, Total Rxs and Percentage
Totals based on the preferences selected in the options.
To access this report, go to Main Menu > Reports > Rx > Rx Totals

NOTE: all reports can be easily accessed if you are familiar with the name of the report
by clicking on Reports > Search > Enter any part of the Name of the Report. For this
example you could enter Rx Totals.
The Selection Tab provides a choice to print for individual Patient, a Home (Nursing Home) or
for All Patients. You have the option to narrow your search by Patient Group and by Patient
drug Plan. To search by Patient Group simply click F2 and select from a predefined set of
patient groups. To search by Drug Plan, simply click F2 and select from the available drug plans.

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Doctor Group
You can include or exclude specific Doctor Groups by pressing F2 and selecting from a
predefined set of doctor groups. If wish to run the report for all doctor groups, leave the field
defaulted to All.
Doctor
To print for a specific Doctor, click the Add button to bring you to the doctor search screen and
enter the doctor you wish to run the report for. If you do not wish to run for a specific doctor,
leave the field defaulted to All.
Doctor Designation
To run the report for a specific doctor designation, click or press F2 and select from the
predefined list of designations. If you do not wish to run for a specific doctor designation, leave
the field defaulted to All.

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Drug Price Group


You can include or exclude specific Drug Price Groups by pressing F2 and selecting from a
predefined set of groups. If wish to run the report for all drug price groups, leave the field
defaulted to All.
Drug Groups
You can include or exclude specific Drug Groups by pressing F2 and selecting from a predefined
set of groups. If wish to run the report for all drug groups, leave the field defaulted to All

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Users
To include or exclude specific Users, simply press F2 and select from a predefined list of Users
setup in the system. If wish to run the report for all users, leave the field defaulted to All.

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Summary Only
Enable this option to print only a summary of the information you have selected for the report.

Show Address Information


Enable this option to include the patient or doctor address.

Show Percentages of Total


Enable this option to include the percentage of the total Rxs and the total dollar value.

Print NH-Inactive Patients


Enable this option to include inactive Nursing home patients.

Print Deceased Patients


Enable this option to include patients who have been set as deceased within the time frame of
the report.

Print Discharged Patients


Enable this option to include patients who have been discharged from a Nursing Home within
the time frame of the report.

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Include unfilled Rxs


Enable this option to include unfilled Rxs in the Rx count of the report.

Group By
Enable any one of these options to group together on the report.

Show
When All is selected, the report will include All Rxs. When Top XX is selected the report will
only include the top amount indicated.
Sample Totals Report by Doctor

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Example of Totals Report by Age

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Example of Totals Report by Patient

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Example of Totals Report by Therapeutic Class

Example of Totals Report by User

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Price Tree Report


The price tree report will provide all the pricing information setup in the Kroll system which
includes pricing strategies, patient price groups, drug price groups and the pricing strategies
attached to the plans.
To access this report, go to Main Menu > Reports > Other > Price Tree Report

NOTE: all reports can be easily accessed if you are familiar with the name of the
report by clicking on Reports > Search > Enter any part of the Name of the Report.
For this example you could enter Tree.

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Sample Price Tree Report

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Sample Pricing Strategies Report

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Sig Code Report


The Sig Code Report will print all the Sig codes setup in your Kroll System.
To access this report, go to Main Menu > Reports > Other > Sig Code Report

NOTE: all reports can be easily accessed if you are familiar with the name of the
report by clicking on Reports > Search > Enter any part of the Name of the Report.
For this example you could enter Sig.

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Language
Select the language you wish to print from the drop down list.
Select the sorting option you wish to print. For example, Token represents the actual sig code
such as BID. If you wish to sort by Token, click on Token. If you wish to sort by Text (for example
twice a day then select Text.

The Options Tab has an option to show equivalent default language translation. Enable this
option to see the English translation for a foreign language selected.

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Sample Sig Code Listing Report

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Future Usage Report


The future usage report will print the prescriptions due for refill within a certain time frame.
This is helpful when preparing to order medications specifically for inventory you dont readily
keep on hand.

Note all reports can be easily accessed if you are familiar with the name of the report
by clicking on Reports > Search > Enter any part of the Name of the Report. For this
example you could enter Future.
Sample Future Usage Report

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Compliance Label Report


The compliance label report works in conjunction with the Unit Dose feature found at the
prescription level. This report allows you to create compliance labels for 7 day pill packs that
can be affixed onto a Jones Box compliance package hence replacing the need to print a label
for every Rx.
To access this report, go to Main Menu > Reports > Patient > Compliance Label

NOTE: all reports can be easily accessed if you are familiar with the name of the
report by clicking on Reports > Search > Enter any part of the Name of the Report.
For this example you could enter Compliance.

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Section Tab
The Selection Tab has various options allowing you to run the compliance label a specific
Patient, Nursing Home or All patients that have unit dose packaging setup on their Rxs. The
report will default to todays date; however the user may choose the effective date of the first
package. You can also run the report for 1, 2, 3 or 4 week cycles.

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Section 2 Tab
The Selection 2 Tab includes the following options:
Batch Options
All Rxs: Include all Rxs on the profile
Show only: There are three options: 1. Show only Rxs with batch flag on, 2. Rxs in a
batch or 3. Rxs with batch flag on or in a batch. You also have the option to exclude
using the same options.
Include Unfills: this will include all Unfills setup with Unit Dose in the patients profile.
This is particularly helpful if you have copied up to a new number and put a prescription
on hold.
Include ward stock: This option includes Rxs marked as ward stock in Nursing Home
Patients
Cards: For prescriptions that have been separated by card number, for example certain
medications have been placed in card #1 and others in card#2 for titration reasons you
may choose to print the compliance label for card #1, alternately you also have the
option to print for all
Show only meds filled on dd/mm/yyyy: This flag allows you to only show the Rxs filled
on a particular date.

Options Tab
The Options Tab presents three other tabs of options, with the first one being the General Tab.
Pass time 1 through 4: These times are configurable; the default is shown above.
However this can be changed for example: Breakfast, Lunch, Supper and Bedtime
Panels: This refers to the number of panels to print on one page. This becomes
particularly important if you have pre-defined Jones compliance labels in a 2, 4, or 6
panel layout.
X and Y Offset: This is the adjustment for the report layout itself of its left justification
and up and down alignment. These adjustments are specific to this report.
Print Compliance Checklist: This is a checklist for packaging the compliance packages.
Sort By: Here we have options to sort by especially if we have chosen to do more than
one patient. The options for sort are as follows:
o Patient
o Home/Ward/Room/Bed
o Home/Ward/Patient
o Doctor/Patient
o Doctor/home/Ward/Room/Bed
o Doctor/Home/Ward/Patient
Med Sort: This allows us to further sort the order the compliance label prints in. The
user has the following options for the medication sort order:
o Original Rx #
o Brand name
o Generic name
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MAR Sort Order: this is if you have a patient in a Nursing Home and a MAR sort order
already selected.

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There are six header styles to choose from. A sample of each style is presented at the end of
the Compliance Label section.

Swap Patient and store info: This option changes the position of the patient and store
information on the report.
Print family doctor: This information comes from the patient card Family Doctor field.
If a family doctor is selected on the patient it will print the family doctor on this report.
Replace patient addr. With NH info: Replaces the patients address with the Nursing
home information
Print effective date: This option prints the date the compliance package is effective
Print Card Numbers: This option prints the card numbers assigned in the Unit Dose
section of the prescription.
Print Page x of y: This option prints for example page 1 of 1 on the top right corner of
the report.

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Body Tab consists of the most options, however depending on the Panel Style you choose will
depend on what options are available. The options for Panel style are:

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Old style (DOS): This will be familiar to clients who were previously on the DOS version of Kroll
Sample Old Style DOS

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Condensed The options available with this style are as follows:

Show Rx Num as: Label default, Rx Num or Original Rx.


First drug name: Default, Brand, or generic
Second drug name: default, Description, brand, generic, equiv. to or Description to.
Print drug form
Print manufacturer
Print dispense qty (with an option to base on the number of weeks)
Print Child warning
Print small 4-panel pages

Sample Condensed

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Style 1
Includes all options in condensed along with the following:

Print initials
Print DIN
Print effective date
Print card numbers
Print Page x of y
Print repackaging expiry date in the form of dd/mm/yyyy

Example of Style 1

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Style 1 Large

Includes all options in condensed and Style one


Except for Print small 4-panel pages, this option is not available

Sample Style 1 Large

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Style 2

This style includes all options in Condensed and Style 1


Print Rx doctors name
Print Initials
Print alt-N Rx comment
Print doctor license and Print drug Lot number

Example of Style 2

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Style 3
All options are greyed out because these options are already included in the report except for
the options listed below:

Show Rx num as
Print Repackaging Expiry Date
First Drug Name
Second Drug Name

Sample Style 3

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Report Discrepancies Explained


The Report Discrepancies Explained section will cover the following:

Fill Date Versus Adjudication Date


Reversals and Net Totals
Backdates

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Fill Date versus Adjudication Date


An Rx has different date components. The fill date is obvious there is one fill date for an Rx
and this fill date may have been backdated. However, for each plan associated with the Rx, an
adjudication date is also available.
For real time plans, the adjudication date is returned by the third party. For paper plans, the
adjudication date is typically equal to today. A singe Rx could have two or more real time
third party plans whereby the adjudication date fall under different days and each of those can
even be different than the actual fill date. This can be especially true with Rxs that are
backdated the fill date may be set to an earlier day, but the adjudication date is still today.
In most but not all cases, the fill date and the adjudication date will match. It is those
exceptions that can appear to throw off certain reports.
When attempting to compare one report against another, always look at the report header it
will indicate if the report is based on fill or adjudication date. Never compare a fill date report
against an adjudication date report. They might match up, but over a large period, they likely
will not.
Note that most Rx-based reports use the fill date and most plan-based reports use the
adjudication date. Krolls Plan Summary Report is a bad one for dates. Retail clients wanted to
be able to count the number of Rxs filled for each plan. Therefore, this is effectively an Rxbased report but broken down by plan, which is usually based on adjudication date. As a single
Rx can contain multiple plans, we can only count the Rx once. Therefore, the Rx is attributed to
either the first paying plan or the primary plan (based on a user option). Never use this report
to compare against other plan-based reports. It will never appear to balance. Note the
disclaimer on the bottom of this report, ...do not use this report to reconcile your third party
claims...

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Reversals and Net Totals


All of our reports will include explicit Reversal amounts and subtract them from the forward
amounts to provide a Net Totals value. Typically, if an Rx is filled and reversed within the
report date range, it will simply not be included in the totals. When you do see a Reversal
amount, it will be for an Rx that was reversed during the report period but was originally filled
prior to the report period. A script that was filled in January and reversed in February will
appear as a forward claim when printing a report with a January period; will appear as a
reversal when printing a report with a February period; but will simply not appear at all if
printing a report that encompasses the entire January/February period.
Most reports will designate these prior period reversals as Reversals or Prior Day Reversals,
all of which should be read as prior period reversals. Note that the Adjudication Totals Report
is different in that it separates reversals into same day and prior day reversals. Even if this
report is run for a monthly period, any Rx reversed on a day other than the day it was filled will
be counted in the Prior Day column. This report works this way as it is intended to match
exactly with the values returned by real time third party plans when requesting on-line daily
summaries. If you run this report and compare it against another adjudication date-based
report, the reversals count may appear differently as all other Kroll reports are using the entire
report date range to determine if a reversal fell outside of the entire range.

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Backdates
Please be aware that if you run a fill date-based report immediately at the completion of a
period and then, at a later date, rerun that report for the same date range, it may not match
the original report, this is caused by backdates. A backdate is the only way that a report run in
the past can effectively be changed in the future.
When reconciling one report against another, especially with fill-based reports, always use
reports that are printed on the same date and approximately at the same time never try to
balance a fill-based report printed at the end of March with another report for the same period
range but printed at the end of April. If you have specific reporting periods and an Rx is
backdated to a previous period, you might want to manually record this Rx on a form so it can
be properly reconciled. The Kroll database records the real date (today) when a backdate
takes place and this is noted on some reports.
Note that adjudication date-based reports are not affected by backdating. You cannot change
todays date. No matter what date you backdate the Rx, today is always the adjudication
date for this Rxs plan (unless the real time third party should happen to return a different date
such as for a script filled after midnight, Eastern Time.)

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Claims Invoice Report


Net Amount Representation
For retail purposes, when submitting a claim to a third party insurer, some request that the
amount billed on the invoice be inclusive of the local patient co-payment amount; others
require the amount to exclude the co-payment.
The same two claims are shown below, one with and the other without the co-payment
amount included in the Net column.

By default, the Kroll system will include the co-payment amount in the Net column as most
third parties request it this way. This Net amount is also shown in the summary sections of this
report. However, please note that all other Kroll reports always show the amount being billed
to that third party exclusive of the local patient co-payment. If any one of your third parties are
set to the default and you attempt to match up the report summary of the Claims Invoice
report against another report showing the amount billed to the third party, the amounts will
not appear to match when co-payments are involved!
If your paper plan(s) require the non-default operation the net amount should not include the
co-payment value please contact Kroll for assistance to set up each third party to use the
Paper Claim- Net Amount reporting option for each individual plan affected. Only if all third
party plans are set to the non-default setting will the reports grand total Net amount balance
with other plan-based Kroll reports. As this is unlikely, you will not be able to match the Net
amount on this report with that on other reports

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Claims Invoice Report Options

Please be aware of the following report options:


If the Group By option is set to None, all claims will be printed on the same page ordered by
fill date. Grouping by patient is used if you require claims for a single patient to appear on a
page by itself. Group ID will order claims by the patients Group ID entered under their third
party plan. You should ensure the option include data for real-time plans is not checked.
There are other reports that would be more efficient to report real-time plan totals such as the
Adjudication Totals report. Also, by using the above option, the report grand totals should then
match with other Kroll reports that break out paper claims totals assuming there are no
tertiary plans billed as noted in the next section.
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Tertiary Plans Imbalances


For each third party claim, we will provide the various dollar values such as Cost, Mark up, Fees
and Totals if those items have not been hidden via the options on the report form. However,
those values are entities of the Rx as a whole. If the same Rx should have another plan that is
being billed during the same pass of this report, we will also show that plan the same Rx Cost,
Markup, Fee and Total. For each plan, we will subtotal these amounts and then, for the overall
report summary, each plan is shown and the grand total for the report is the sum of all these.
If you had only a single Rx for $100 that was billed to two different plans, both of which are
included in this report, then the subtotal for each plan will show the $100 Rx total, and one
claim. However, the report grand total will show each plans subtotal and add these together to
produce a grand total of $200 and 2 claims when in fact, the true total Rx cost is only $100 and
involves only a single Rx. This anomaly in this reports grand totals is unavoidable and will make
the grand total of this report to not balance with other reports.

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Reconciling
So knowing all of the above, how do you balance one report against another?
For fill date-based reports, you can run the following on the same day for any range and all
should balance:
Daily/Monthly Totals
Rx Breakdown
Rx Totals
Profit/Loss
When explicitly broken out, always look at the Net amounts. For adjudication date-based
reports, run the following:
1. Plan Breakdown (do not check any of the Exclude options)
2. Adjudication Totals (do not exclude zero-amount claims)
Claims Invoice (Best to Exclude items where plan pays 0.00 and NOT Include data for realtime plans as this helps to eliminate most tertiary plan billing that will misrepresent the grand
totals as noted above)
Plan Breakdown breaks out the online plans versus manually billed plans as well as providing a
grand total. Adjudication Totals will also provide the same kind of breakdown. Claims Invoice
report, assuming you have used the options noted above, will show a grand total that should
match the Manual Plans amount of the two other reports.

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Summary
Please be aware of the following key points noted above when attempting to reconcile reports:

Never compare fill date-based reports with adjudication date-based reports. When in
doubt, look at the report header that shows which date is being used.
Never use the Plan Summary Report in comparing with other reports.
Always compare reports printed on the same date look at the Printed On date on
the report header.
Be aware of how previous-period reversals are reported always use the Net amount
columns when comparing reports.

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Newfoundland Drug Information System

NL DIS (Newfoundland Drug Information System)


The Newfoundland and Labrador Centre for Health Information (NLCHI) is a Government
funded organization mandated to build a province-wide Health Information Network (HIN) that
supports a person-specific electronic health record (EHR). The record facilitates sharing of data
between medical professionals. The Newfoundland and Labrador Pharmacy Network is a
component of the EHR.
The Pharmacy Network is a Drug Information System (DIS) that enables pharmacists to make
better informed and timely decisions because it provides tools and processes to support
prescribing, dispensing and compliance monitoring.
Authorized personnel working in community pharmacies will have access to the Pharmacy
Network through Kroll, an authorized Pharmacy Practice Management System (PPMS). Updates
to Kroll have been made to accommodate communication and synchronization with the
Pharmacy Network. The following user guide provides instructions on how to navigate the
Pharmacy Network in Kroll.

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Creating DIS Users


In order for a pharmacy staff member to access the Pharmacy Network through Kroll, they must
have a Network Username and a Network Password. A Kroll user who does not have a
Network Username attached to their user account will be presented with the following
message when trying to access the Pharmacy Network:

1. Go to Edit > Users and Groups.


2. Log in with a Kroll user who has permissions to add a new user.
3. From the Edit users and User Groups screen, click Ins or press Insert on the keyboard to
add a new user into the Kroll system.

4.
5.
6.
7.

From the User Information form, enter the Initials and Name.
Ensure that the Disabled flag is unchecked (if it is checked the user will be inactive).
Optionally enter a date when the user account will expire.
If the user is a pharmacist, place a checkmark on Is Pharmacist and enter the pharmacist
license number in the Pharmacist ID field.
8. Enter the Network Username provided by NLCHI. Patients without a Network Username
attached to their user account will NOT have permissions access the Pharmacy Network.

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9. Enter a local Kroll Password into the Password field and confirm the entry in Confirm
Password.
10. Check Password never expires if the user account expiration is indefinite.
11. Check Force password change on next login to prompt the user to change their local
password upon logging into a Kroll session for the first time.
12. Click on the Groups tab and assign the user a User Group by clicking on Ins or press Insert
on the keyboard.
13. Click Save or press Enter on the keyboard to save the Kroll user account.

Once a user has been registered with NLCHI, they will receive notice of their Network
Username and Network Password. The Network Password that is provided is a temporary
password and must be changed from the Kroll system.
Since technicians do not have license numbers, they are viewed as delegates and must
associate with a pharmacist on duty in order to submit prescriptions and view the Pharmacy
Network. The process of association must be performed by a licensed pharmacist.
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Searching for a Patient on the Network


There are a number of options available to find patient information on the Pharmacy Network.
The best option depends on the situation and the three scenarios are described next.

Scenario 1 New Patient (Does Not Exist on Local System)


1. Search for the patient using the F3 Patient search.
2. Verify that the patient does not exist on the local Kroll system, then press Ins on the
keyboard or click Insert with the mouse.

3. Answer Yes to the prompt Do you want to search the Network for this patient?

4. Enter all available patient information into the Network Patient Search and press Enter on
the keyboard or click Search with the mouse to search the Network for the patient.

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5. Select the applicable patient from the network results by highlighting the record and
pressing Enter on the keyboard or clicking Select with the mouse. Patient information from
the Network will be pulled into the local Kroll patient card.

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6. Input other pertinent patient information (e.g. snap cap preference, plan
information, etc.) into the patient card and press Enter or click Save to save changes. This
will synchronize the local patient information with the Pharmacy Network. Once
synchronization is complete, the following message will appear. Click OK to proceed.

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Scenario 2 New Patient (Does Not Exist on the Pharmacy Network)


1. Search for the patient using the F3 Patient search.
2. Verify that the patient does not exist on the local Kroll system, then press Ins on the
keyboard or click Insert with the mouse.

3. Answer Yes to the prompt Do you want to search the Network for this patient?.

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4. Enter all available patient information into the Network Patient Search and press Enter on
the keyboard or click Search with the mouse to search the Network for the patient.

5. If no records are returned by the Network match the patent you are looking for, and you
have executed proper searching guidelines as proposed by the NLCHI Pharmacy User Guide,
click Add New Patient to Network.

6. Click OK or press Enter on the keyboard when prompted This is a new patient on your local
system. It will be added to the Network once you save then changes to the local patient.

7. Fill out the patient card with all available patient information.

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8. Once all patient information is inputted into the patient card, press Enter on the keyboard
or click Save to save changes. This will add and synchronize the local Kroll patient to the
Client Registry (i.e. Pharmacy Network).
9. Once synchronization is complete, the following message will appear. Press Enter on the
keyboard or click OK to proceed.

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Scenario 3 Existing Local Patient (Not Synchronized to the Client


Registry)
1. Search the patient using the F3 Patient search (This patient exists in the local Kroll system,
but is not synchronized to the Client Registry).

2. Go to Network > Synchronize Patient and log in with the Kroll username and password.

3. Go to Network > Synchronize Patient and log in with the Kroll username and password.

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4. If the local patient already exists in the Client Registry, highlight the entry and click Select or
press Enter on the keyboard. If no records match the patient you are looking for and you
have executed the proper searching guidelines as proposed by the NLCHI Pharmacy User
Guide, click Add New Patient to Network.

5. Once the local patient data has been successfully synchronized with the Client Registry, you
will get a pop up box saying the transaction was successful.

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Adding a Patient Allergy to the Pharmacy Network


Pharmacists also have the ability to add a patient allergy to the NL DIS as well. They can search
the allergy by starts with or contains, once they find the allergy they are looking for they
can click on select. They will be prompted to fill the Patient Allergy Form; after they fill this out
they can click on OK. The allergy will then be added to the Pharmacy Network.

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Adding Adverse Reaction to the Drug Information System


An adverse reaction is any unexpected or dangerous reaction to a drug. It is an unwanted effect
caused by the administration of a drug. The onset of the adverse reaction may be sudden or
develop over time.

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Adding a Patient Allergy to the Pharmacy Network


An adverse reaction is any unexpected or dangerous reaction to a drug. It is an unwanted effect
caused by the administration of a drug. The onset of the adverse reaction may be sudden or
develop over time.

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Retrieving Allergies, Adverse Reactions & Conditions


Pharmacist can retrieve information from pharmacy network as well. Any information such as
allergies, adverse reactions and medical conditions can be looked at after they have been
added.

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Network Options from the Patient Card


Network options can be accessed from the F3 patient card under the Network dropdown
menu.

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Verify Patient Demographics


The Verify Patient Demographics network function is used to validate local patient
information, such as address and phone number, against Network patient information.
If there are no patient demographic differences between the local and Network information,
the following message will appear:

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Unfilled Profile
The unfilled profile filters the patient Network profile to prescriptions that are on hold (i.e. not
filled).

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Not Dispensed Profile


The Not Dispensed profile filters prescriptions coming back from the Network to entries that
are considered other medications such as Gravol, baby Aspirin, vitamins, etc.

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Add Observation
You can add a Patient Observation to the NL DIS network as well. You can choose a
measurement type from the drop down menu as shown below. Then add a comment and click
ok when you are finished.

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Add Patient Note


The Add Patient Note Network function allows pharmacy members to record health related
patient notations on the Pharmacy Network. Choose a note type from drop down menu as
shown below. Then add a comment and click ok.

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Add Professional Service


The Add Professional Service Network function allows pharmacist to provide centralized
documentation on services and consultations provided to the patient. Choose a Service Type
from the drop down menu. You can also add a comment as well. Then click OK once you are
finished.

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Add Immunization
This function allows the pharmacist to Add Immunization information to the NL DIS for a
patient. Just add all of the information that is requested in the screen shot below. There are
drop down menus that allow the pharmacist to choose what is appropriate for the patient.

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Add Patient Password


By setting up a patient password with the Newfoundland & Labrador Centre for Health
Information (NLCHI), patients have the ability to place restrictions on who can access their
personal health information.

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Synchronize Patient
The process of Synchronization links the local Kroll patient to the Pharmacy Network. If the
patient is not synchronized to the Pharmacy network you will get errors when trying to send a
RX to the network.

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Unsynchronized Patient
A local patient account may need to be unsynchronized from the Pharmacy Network if the
initial synchronization was executed in error (e.g. the local patient was linked to the wrong
Network patient).

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Extra Functions from the Patient Network Profile


Modifications can be made to prescriptions on the Patient Network Profile using Extra
Functions. You can access Extra Functions by going into Network > Profile.

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Doctor Search for Existing Local Doctor Card


The Provider Registry contains a comprehensive listing of doctors practicing in the province of
Newfoundland and Labrador. By connecting to the Provider Registry, information from local
Kroll doctor cards can be updated with or verified against Network information.

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Filling an Rx to the Pharmacy Network


Not all patients that receive prescriptions in Newfoundland and Labrador will have a Medical
Care Plan (MCP) number; therefore, an MCP number is NOT required to fill prescriptions in the
province.
However, regardless of whether a patient has a MCP number, their prescriptions still require
logging on the DIS.. All patients in the database require a NL.DIS plan in their F3-Patient Card.
The NL.DIS plan should always be the last adjudicated plan if the patient has other financial
coverage (e.g. NLPDP, AHE, ESI, CS, etc.). Patients with provincial coverage (i.e. Social Services,
Low Income, Seniors) will use their existing NLPDP plan entry for financial adjudication while
using the new NL.DIS plan for clinical recording.

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Filling a Prescription to the NL.DIS


1. Enter the patient, drug, doctor, SIG, and dispense information as usual from the F12 filling
screen.

2. Ensure that the NL.DIS plan is listed in the prescription; a prescription cannot be sent
without the inclusion of the NL.DIS plan. Plan sequence can be moved around, but is not
recommended; NL.DIS should always be the last adjudicated plan if the patient has other
financial coverage (i.e. provincial or private coverage).

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3. Once all the necessary information is entered into the F12 filling screen, click/press F12 to
fill the Rx. The prescription will adjudicate through all the preceding financial plans as usual,
and then go through NL.DIS last. Adjudication through NL.DIS will bring up the CeRx
Adjudication Response screen:

4. The CeRx Adjudication Response screen contains three (3) options:


P View Network Profile: Selecting this option will prompt the user to Enter the
reason for the profile access and subsequently call up the full patient Network
profile. The user can then analyze the medication profile to extract further details.
M Manage: Optionally highlight a warning and press M on the keyboard to specify
a reason (i.e. Management Code) for bypassing the warning and filling the
prescription.

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D Detail: Highlight a warning or message returned by the Network and press D on


the keyboard to call up details of the issue.

5. Continue from the CeRx Adjudication Response screen by selecting one of two (2) options:

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Click OK or press Enter on the keyboard to acknowledge the Errors, Warnings and/or
Messages from NL.DIS.
Click on Cancel Rx to reverse the transaction made to NL.DIS.

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Filling an Rx for a Device Using OPINIONS


1. Bring up the drug card for the non-drug product through an F5 drug search.
2. Click on the Extra Info tab and check off the flag for Device. This flag indicates to the DIS
that the prescription being sent is for a non-drug product.
3. Click on the Plans Tab of the F5-Drug card and click/press Ins to call up the Drug-Plan
Information form to add a Pseudo DIN for NL.DIS

4. From the Drug-Plan Information form, fill out the Sub Plan with NL.DIS-Newfoundland DIS.

5. Select the Pack Size that corresponds to the specific OPINIONS number for that product.
6. Ensure the Default flag is checked. If Default is NOT checked, the OPINIONS number for this
drug will not be sent to NL.DIS.
7. Enter a Description for the Pseudo DIN; this can be anything deemed fit by the user (e.g.
Default, OPINIONS, etc.).

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8. From the DIN Type dropdown menu, select OPINIONS:

9. Enter the OPINIONS number (In this example we are using 97799946 for Accu-Check Softclix
Lancet, pack size of 100).

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10. The flag for Covered should remain unchecked because the NL.DIS plan DOES NOT
financially cover the cost of the prescription.
11. The flag for Bill As Pack should remain unchecked.

12. Click OK or press Enter on the keyboard to save the OPINIONS number.
13. Click Save or press Enter on the keyboard to save changes made to the drug card.

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Filling a Prescription to NL.DIS for a Device


1. Fill out the patient, drug, doctor, SIG and dispense information on the F12-Filling screen as
usual.
2. From the F5-Drug Card, go to the Extra Info tab and double verify that the Device flag is ON;
this flag identifies the product as a non-drug and sends the information to the DIS.
3. Click on the Plans tab of the drug card and ensure the Pseudo DIN for the non-drug product
is configured properly and using the correct OPINIONS number (Please refer to Adding a
Pseudo DIN for NL.DIS using OPINIONS).
4. Ensure that NL.DIS is the last adjudicated plan in the prescription.

5. Press F12-Fill Rx to start adjudicating the prescription.


6. Successful logging of the prescription on the DIS will return a CeRx Adjudication Response
screen that is similar to the following:

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Filling an Rx for a Mixture


When adjudicating a mixture to NL.DIS, please note that the DINs submitted for the Rx are
being pulled from the components of the mixture, and NOT from the mixture card itself. The
DIN of each component is sent to the Network and verified against a database of available DINs
and PINs. If all the components of a mixture contain valid DINs that are recognized by the
Network, no further manipulation is required to successfully log the mixture prescription on the
DIS.
To generalize, all components of a mixture that do not have valid DINs must contain a pseudo
DIN entry for NL.DIS containing a NLCHI assigned PIN. Once that is complete, the user can
adjudicate the mixture to the Pharmacy Network. Remember that a NL.DIS pseudo DIN should
never be added to the mixture card, because DINs are pulled from the actual components of
the mixture.

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Filling a Not Dispensed Rx


Prescriptions filled for other medications such as Gravol, Baby Aspirin, Vitamins, etc, are
often marked as Not Dispensed in Kroll. When a Not Dispensed Rx is filled to the DIS, a
mandatory Stop Date for the prescription must be entered.

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Stock Transfers
To add a stock transfer store:
1. Execute an F3-Patient search for the stock transfer location.
2. Ensure that the stock transfer location does not already exist in the system as a patient.
3. Click Ins or press Insert on the keyboard to add the stock transfer location.

4. Answer No when asked Do you want to search the Network for this patient? The stock
transfer location will not be listed in the Network as an actual patient.
5. Fill out the patient card with the information from the stock transfer location.
6. Under the Plans section, click Ins or press Insert to add the NLSTOCK Plan.

7. Click Save or press Enter on the keyboard to save changes made to patient plans.
8. Click Save or press Enter on the keyboard again to save changes made to the patient card.

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Filling a Stock Transfer


1. Bring up the stock transfer location using the F3-Patient search.
2. Click/Press F12 to bring up the F12-Filling screen.
3. Fill out the Drug, Doctor, SIG, Dispense Information, etc.

4. Go to Rx > Extra Functions and check Stock Transfer. Marking a prescription as a Stock
Transfer in Kroll will signal the Network to register the transaction differently than a regular
prescription.

5. Click F12-Fill Rx or press F12 on the keyboard to fill the stock transfer.
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6. The Network Location Search form appears. Press Enter on the keyboard or click Search to
synchronize the patient with a location.
7. Highlight the appropriate pharmacy/medical office from the Network results and press
Enter on the keyboard or click Select to continue.

8. A successful transaction will return a CeRx Adjudication Response screen indicating The
Office Supply Dispense was successful.

9. Click OK to continue, or click Cancel Rx to reverse the stock transfer.


10. Once the stock transfer is successfully completed, the Patient Plan Information form will be
populated with read-only data from the Network.

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Filling an Rx for an Out-of-Province Patient


To fill an Rx for an out-of-province patient:
1. Search for the out of province patient using the F3-Patient search.
2. Verify that the patient does not already exist in the local Kroll system.

3.
4.
5.
6.

Click Insert to add the out of province patient.


Answer Yes when asked Do you want to search the Network for this patient?
Determine if the out of province patient exists in the Pharmacy Network.
If the out of province patient does not exist in the Pharmacy Network, select the option to
Add Local Patient to Network.

7. The following message will appear: This is a new patient on your local system. It will be
added to the network once you save the changes to the local patient. Click OK or press
Enter on the keyboard to continue.

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8. Fill out the patient card as usual.


9. Under the Plans section, select the NL.DIS plan and leave all other fields blank. Click Save or
press Enter on the keyboard to save changes to Patient Plan Information.

10. Synchronize the local patient card by clicking Save or pressing Enter on the keyboard from
the patient card.
11. Once the local patient information has been pushed down to the Pharmacy Network, a
message will appear indicating The Transaction was successful.
12. Proceed to fill a prescription for the out of province patient as usual.

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Prescription Pick Up
The Newfoundland and Labrador Center for Health Information (NLCHI) currently requires
pharmacies to log when a prescription is physically picked up from the pharmacy.
This can be done by accessing the RXs in workflow within Kroll.

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Pending Network Queue


The reason why the NL.DIS plan is always the LAST adjudicated plan is to give users the ability
to adjudicate through financial plans and print labels even when the DIS is down. The DIS
portion of the claim will be stored in the Pending Network Queue until the DIS is back online at
which time the transactions can be resent.
1. From the Kroll Start Screen (ALT+X) go to Utilities > View Pending Network Queue.
2. From the Pending Network Queue, click Send to resubmit pending claims to the DIS.

Kroll will automatically cycle through all the prescriptions and resend to the Pharmacy Network.

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PEI DIS (Prince Edward Island Drug Information


System)
The PEI Department of Health is building a Drug Information System (DIS) to electronically link
community pharmacies, physician offices, family health centres, addiction centres, hospital
pharmacies and emergency rooms with a database that maintains electronic patient
medication records. Pharmacists in PEI will be required under All Drugs All People (ADAP)
legislation to submit transactions to the DIS for every prescription medication they dispense to
Island residents.
The establishment of a Drug Information System is an important step in PEIs progress towards
an Electronic Health Record for each Island resident. The DIS will provide health care
professionals with secure access to prescription medication information, enabling them to
assist Islanders in making the most informed health care decisions.

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Searching for Patients on the Network


There are a number of options for retrieving patient information from the DIS through Kroll.
Note that the patient database within DIS is also known as the Client Registry (CR). Some
scenarios are described below:

Scenario 1: New Patient without PHN (Not in your Local Database)


A patient has presented an Rx to be filled, but they have no Personal Health Number (PHN)
Card or number available.
1. Search for the patient in Kroll as you normally would to ensure that he/she does not already
exist in the local database.
2. If the local patient search is unsuccessful and the user has exhausted all search options (e.g.
an advanced search for inactive patient has been performed), proceed to insert the new
patient into the Kroll database. Upon clicking Insert to add the new patient, the user will be
presented with an option to search the Network (i.e. PEI DIS) for the patient.

3. Selecting No will return the user back to the local system where the rest of the patient
information can be manually entered and saved (i.e. no connection to the DIS will be made).
4. Selecting Yes in Step 2 opens the Network Patient Search Form.

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The Network Patient Search From is automatically populated with the search criteria entered
in the local patient search. Users can enter additional patient demographics into the Network
Patient Search Form before clicking Search or pressing Enter on the keyboard to search the
Network for the matching patient. As with the local search, entering more search criteria
reduces the number of records returned.
5. Once the search criteria have been entered click Search or press Enter on the keyboard to
send the patient search request to the DIS.
6. All patients matching the search criteria will be returned by the Network. Use the mouse to
highlight the correct patient and click Select or press Enter on the keyboard.

7. Once the user selects the correct patient from the Network Patient Search Form, the
Network patient information will automatically be pulled into the local F3-Patient Card.
8. Choose the Cancel option if the wrong patient has been selected; this will return the user to
the local patient search screen.

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9. The PEI.ADAP plan will automatically be added to the F3-Patient Card; the ADAP plan
should always be the primary plan listed. The Client ID of the plan will be populated with
the patients PHN.

If the patient also has provincial coverage through PHIP, they must insert the PHIP
plan manually. The PHIP plan will also use the patients PHN as the Client ID number,
but should be listed after the PEI.ADAP plan.

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Scenario 2: New Patient with PHN (Not in your Local Database)


A patient has presented an Rx to be filled and they have a PHN card or number available.
1. Search for the patient in Kroll as you normally would; use the Search by Billing Number
option to quickly locate and confirm the patient. Remember when searching by billing
number, the user must enter the number sign # before the PHN (e.g. #10003556).

2. If the local search using the patient PHN turns up zero (0) results, the user will be
automatically brought to the Network Patient Search From with the PHN field populated.
Click Search or press Enter on the keyboard to execute the Network patient search.

3. Since each Island patient has a unique PHN, only one entry should be returned from the
DIS.

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4. Once the Network entry is selected, patient demographic information will be pulled into the
local F3-Patient Card. As in scenario 1, the PEI.ADAP plan is automatically inserted into the
patient card with the PHN in the Client ID field. All other third party plans, including PHIP
plans, must be added manually.

5. Once all information regarding the patient has been entered locally, click Save or press
Enter on the keyboard to save changes.

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Scenario 3: Existing Patient (In Your Local Database)


A patient has presented an Rx to be filled, and they have filled at the pharmacy previously.
1. Search for the patient in Kroll as you normally would; the search should find the patient in
your local database. Call up the F3-Patient Card and locate the Network dropdown menu.

2. Access Network > Patient Search (TPD) to verify your local patient demographics with the
Network patient demographics. To help locate the patient in the DIS, enter the patients
Date of Birth and Gender into the Network Patient Search Form; although not required,
this information will increase the chances of a matching candidate being returned by the
DIS.

3. Select Search or press Enter to send the patient search request to the DIS Network.
4. Highlight the correct patient from the list of candidates returned from the Network Patient
Search and click Select or press Enter on the keyboard.

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5. From the Patient Update Form, update the local patient demographics with the information
provided from the DIS. Use the check boxes to the left of the Name, Address, Birthdate, etc.
to select information you are interested in updating. Information in Green is Network data,
and information in Red is what is currently entered on the local system.

6. Once the user has placed checkmark(s) next to the Network information they would like to
update into their local system, click Update or press Enter on the keyboard. The patient is
now ready for Rx filling.

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Patient Network Profile


The Patient Network Profile shows a snapshot of a patients current health and medication
situation. The user will be presented with the Select Profiles to Query window whenever they
access the Profile option from the Network menu of the F3-Patient Card. Users can choose to
only see certain profiles and/or profile items administered/used in the last x months (where
x is a number between 1 and 12). As well, users can click Select All to check all the profile
types displayed, or click Deselect All to clear any profile selections on the screen.

Once the profile types have been selected, click OK or press Enter to continue from the Select
the Profiles to Query window. The user will be prompted to enter a reason for accessing the
Network Patient Profile. Kroll recommends that users always enter a reason for accessing the
Patient Network Profile in the event of an audit.

A status bar will be displayed to track the progress of the profile request to the DIS Network.

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Once the profile request has been processed, each profile type will be available under the
corresponding tabs across the top of the window. In the below sample, all Profile Types were
selected; therefore, there are 8 tabs available for viewing.
On the Profile tab, users can sort Rx entries by Last Filled, Picked Up, Doctor, DIS Rx #,
Order Date or Drug by clicking on the corresponding buttons.

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DIS Workflow
Once the DIS Network has been integrated into the Kroll Software system, prescription details
are shared between your local system and the provincial DIS system.
Diagram 1:

Diagram # 2:

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Processing an NL.DIS Prescription


A number of concurrent connections are made to the DIS when filling a prescription. The status
of each connection is displayed in a small status window once F12-Fill Rx is selected.

The first request made to the DIS when filling a prescription is to confirm local patient
demographics with Network patient demographics. If there are any discrepancies between local
and Network data, a Patient Update Form will be returned and the user can select to update
local information with Network information.

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The Patient Network Profile is automatically retrieved when filling the first prescription for the
patient for that day (subsequent fills for the patient will not retrieve the Patient Network
Profile). Users can review the profile and click OK or press Enter on the keyboard to continue
filling the prescription.

Subsequently, the system sends the Create Rx Order:

Click OK after successfully creating the Rx Order; the system will proceed to send the Dispense.

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Click OK after successfully creating the Dispense; the system will now send the fiscal portion on
the prescription.

The Rx Order and Rx Dispense responses are only displayed if the DIS system detects and
responds with DUE issues. If no issues are returned, the Rx Oder and Dispense records are
created without any issues. There are three options on the CeRx Adjudication Response
window as explained below:
1. Users can press P on the keyboard to view the Patient Network Profile to search for clues
as to why warnings are being returned from the DIS.
2. DUE issues (i.e. warnings) can be optionally Managed. Highlight the warning and press M on
the keyboard to send a management code with the warning returned from the DIS.
3. Users can also highlight a warning on the CeRx Adjudication > Response window and press
D on the keyboard to Detail the issue.
This provides information on the issue including causes and other management entries.
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Refill and Cancel Rules


Profile request and patient demographic information is only requested for the first prescription
filled for a patient that day. Subsequent fills for the same patient on the same day do NOT
generate a Profile or Demographic request.
Refilling an Rx does not generate a Create Rx Order message; only a Create Dispense Rx
message.
When filling a new prescription, the Rx Order and Dispense messages are sent to the DIS.
However, for unfilled Rxs only the Rx Order is sent; the Dispense message is sent on the first fill
of the Unfill.
When cancelling an Rx it will cancel the fiscal portion of the prescription and the Dispense, but
it will not cancel the Rx Order. In order to cancel the fiscal claim, the Dispense and the Rx
Order, the user must mark the Rx as filled in error.
Users can cancel Unfilled Rxs; this will mark the Rx as filled in error and remove the Rx Order
and Dispense Rx for the Patient Network Profile.

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Create Local Rx
The Create Local Rx function allows users to pull certain prescriptions from a Patient Network
Profile and fill it locally. Network prescriptions information such as drug, doctor, SIG and
dispense data are pulled from the DIS into the local Kroll F12-Filling Screen for processing. The
Create Local Rx function can only be used for Rx entries that do not already exist in the local
database.

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Refusal to Fill
The Refusal to Fill message is used when a pharmacist decides they will not or cannot fill a
prescription request for a patient. The intent of the message is to record the refusal to fill
decision made as a result of one of the following reasons in the red box below:

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Hold Rx
A prescription is put on hold when a pharmacist determines that the drug should not be
taken by the patient for a specified interval of time. This identifies the intent that the therapy
be continued at some point in the future, but should be suspended for the period indicated
on the hold. This can be done in response to a patient entering a hospital, drug-to-drug
interactions, duplicate therapies, etc. The request to put an Rx on hold can be sent throughout
the prescription lifecycle, but if the Rx is already on hold and a request is sent, an error will be
returned. A prescription that is placed on Hold will have a status of Suspended on the Patient
Network Profile.

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Release Rx
The option to Release Rx is used to release prescriptions that are currently on hold (i.e. have a
status of Suspended). For example, a patient who transitions into an inpatient situation back to
the community may require held prescriptions to be released. The request to release an Rx
can be sent through the prescription lifecycle, but if the Rx is not currently on hold and a
Release message is sent, an error will be returned.

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Revoke Dispensing Permission


The option to Revoke Dispensing Permission is used when a provider decides to take away
permission to dispense a prescription. Revoking permission to dispense implies that the patient
should finish taking the remainder of the medication they have in their possession until it is
gone, but no further dispenses are authorized against the prescription (i.e. all remaining refills
are cancelled); this is different from stopping a prescription which implies that the patient
should stop taking the medication immediately and should not finish the amount of medication
they have on hand.

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Stop RX
The option to Stop Rx is sued when a pharmacist or provider determines that a drug should no
longer be dispensed and should no longer be taken by the patient immediately. Situations
where a prescription may need to be stopped are product recalls, duplicate therapy
contraindication, or other serious therapy issues. The Stop Rx message can be sent through the
prescription lifecycle. A prescription that has been stopped will have a status of Aborted.

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Add Note
The option to Add Note is used to document additional information concerning a prescription
or a refill (i.e. dispense). Notes are primarily used to document error corrections, information
change or new information, but can be used for any reason deemed fit by the pharmacist.

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Retract
The Retract function allows users to reverse certain messages/transactions sent to a patients
DIS profile. A retract message is usually sent in cases where information has been added to the
Patient Network Profile in error. Once an action has been retracted it will no longer appear in
the result set of subsequent queries made on that DIS profile.
A transaction must meet the following conditions in order to be successfully retracted:
1. The DIS user who sent the message must be the user who performs the retract.
2. The message/transaction must NOT have been viewed by another DIS user.
3. The retract must be performed within 24 hours of when the message was sent.

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Network Options from the Patient Card


Patient Network Menu options can be accessed from any F3-Patient Card under the Network
dropdown menu. Note that selecting any option from the Network menu will instruct Kroll to
communicate with the DIS. Information entered, changed or removed via these options will be
transmitted to the DIS.

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View Claim Log


The Network Claim Log provides detailed information regarding the requests sent to the DIS
and the corresponding responses coming back from DIS (e.g. profile requests, consent records,
allergy records, etc.). Entries contained in the Network Claim Log are not organized in a patient
specific manner; it simply lists ALL transactions sent to or received from the DIS in
chronological order for a configurable number of days.

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Verify Patient Demographics


Use this option to verify/update the local patient information with Network patient information
returned from the DIS. Once this option is selected, the user will be prompted to sign in with
their Kroll initials and password. From the Patient Update Form, the user will be shown
discrepancies between local and Network patient information. Place a checkmark next to the
Network information you would like to update into your local system and click Update or press
Enter on the keyboard.

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Unfilled Profile
The Unfilled profile filters the Patient Network Profile so that it only logged Rxs (i.e. Rxs on
hold) are displayed. Users can restrict and refine the Unfilled profile by the Advanced search
function. Narrow search parameters by checking the Advanced flag and entering additional
search criteria. Click Filter or press Enter on the keyboard to obtain refined search results.

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Not Dispensed Profile


The Not Dispensed profile filters prescriptions coming back from the DIS to entries that are
considered Other Medications such as Gravol, Tylenol #1, Baby Aspirin, and other schedule 2
medications that are sold over-the-counter (OTC), but kept behind the dispensary. The purpose
of a Not Dispensed prescription is to allow a comprehensive medication profile for the patient
(i.e. Rx item as well as OTC items).

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Add Observation
The Network function to Add Observation allows the pharmacist to record health related
measurements on the DIS that may have been relayed by the patient, or measured by the
pharmacist directly.
Observations can include:
Blood Pressure
Glucose
Height
Pulse
Respiratory Rate

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Add Patient Note


The Add Patient Note option allows authorized Network users to record health related patient
notes on the DIS. There are five (5) pre-populated Note Types; a Note Type must be selected in
or order to send the message to the DIS.

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Add Professional Service


The Add Professional Service Network option allows the pharmacist to provide centralized
documentation on services and consultations provided to the patient. By recording these
services on the DIS, all providers can provide new and relevant care to the patient. The
following professional service types are available for selection:
Medication Administration
Medication Review
Patient Assessment
Patient Device Education and/or Instruction
Patient Medication Monitoring
Preparation of a Care or Treatment Plan
Research
Self Care Consultation
Smoking Cessation
Wellness and Disease Prevention

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Add Immunization
The Add Immunization Network option allows the pharmacist to provide centralized
documentation on immunizations received by the patient.

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Add Keyword
Island patients have the right to mask their Patient Network Profile so that only providers
privy to their Network Keyword can view their medical history. A patient with a masked
profile will elicit a message similar to the following when a Profile request is sent.

If the patient has provided the pharmacist with a keyword, it can be entered into Kroll by
accessing Network > Add Keyword to call up the Enter Keyword window.

Once the keyword is entered, click OK or press Enter on the keyboard to continue. Now when
the user goes to access the Patient Network Profile, the profile will be displayed without
warnings.

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View Network Access Log


The PEI Ministry of Health is at liberty to request details regarding why a patients personal
health information was accessed from the DIS. Consequently, Kroll always prompts the user to
enter a reason for accessing a patients network profile. Details on whom, when and why the
patients Network profile was accessed can be retrieved via the Network Access Log.

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SK PIP (Saskatchewan Pharmaceutical Information


Program)
The Saskatchewan Health Information Network (SHIN) is managed by the Health Information
Solutions Centre (HISC). SHIN is committed to maintaining a provincial Electronic Health Record
(EHR) that will facilitate the sharing of health related data between medical professionals such
as doctors, pharmacists, nurses, etc. The Pharmaceutical Information Program (PIP) is a
component of the EHR.
Every prescription that Saskatchewan residents receive is captured and stored on the
Pharmaceutical Information Program (PIP). PIP is available to all community pharmacies and
contains information on over 45 million prescriptions. The province is currently incorporating
PIP into the pharmacy software systems used by community pharmacies so that users do not
have to rely on the PIP viewer to access prescription information.

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Kroll Passwords
In conformance with Pharmaceutical Information Program (PIP) standards, Kroll passwords
must be complex and meet the following requirements:

Passwords must be at least 10 characters long.


Passwords must contain different characters.
Passwords must contain a lower-case and an upper-case letter.
Passwords must contain at least two numeric characters and one special character
(!,@,#,$,%,^,&,*).

An example of a password that meets conformance is Password!23.


Passwords must be changed every 60 days. Users cannot re-use passwords from the last 10
consecutive passwords.

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Technician User Account Setup


In order for pharmacy technicians to access and send transactions to PIP, they require a
Common Provider Number (CPN) to be entered in their Kroll user account. The CPN is provided
to the technician once PIP registration has been approved.

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Associating Pharmacists to Technicians


Pharmacy technicians cannot access PIP without associating to a pharmacist because a license
number is required for the retrieval of patient medical information. When a technician is
associated with a pharmacist, the pharmacist must be aware that any network profile requests
initiated by the technician will be authored by the associating pharmacists license number.

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Store Configuration Requirements


PIP requires patient gender to be sent with all transactions. If gender is missing from the
patient card, PIP will reject the transaction and return an error message.

The Provincial Plan must be set to Saskatchewan Prescription Drug Plan (SPDP).

The Clinical Provincial Plan must be set to Saskatchewan Prescription Information Program
(SKPIP).

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Patient Allergies/Intolerances
Recording patient allergies and intolerances on PIP is an integral part of creating a
comprehensive Electronic Health Record (EHR) for Saskatchewan residence. The availability of
this information allows pharmacists and other health care professionals make optimal drug
therapy decisions. The following section describes how to add allergies/intolerances to PIP, and
how to retrieve them through Kroll.
When patient allergies are added locally on Kroll, the information is sent and recorded on PIP.

PIP supports the addition of Allergy Groups and NOT specific Medications or Ingredients. If a
Medication or Ingredient is selected as an allergy, the following warning will appear:

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Deleting a Patient Allergy/Intolerance


Patient allergies can be deleted locally on Kroll, and then the user can decide whether they
want to mark the allergy/intolerance as expired on the Network as well.

Pharmacy users can only mark INTOLERANCE as completed/expired on the network, but not
ALLERGIES. Only doctors can mark an ALLERGY as completed/expired.

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Synchronizing Network Allergies to the Local Kroll System


A Yellow-Network data bar indicates that an allergy entry exists on PIP, but is not synchronized
to a local Kroll allergy. A Red-Local data bar indicates that an allergy entry exists on Kroll, but is
not synchronized to a PIP allergy entry. It is important to keep the local and PIP allergies in sync
so that pharmacists everywhere can make the most accurate dispensing decisions.

You can also retrieve allergy information from PIP.

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Adding an Intolerance to an Existing Allergy Group


It is possible to add an intolerance AND an allergy for the same allergy group; for example, an
allergy and an intolerance can be added for Penicillin.

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Supporting Information
Supporting Information for patient allergies and/or intolerances can be recorded on PIP from
the Kroll system. Supporting Information gives users the option to provide details on Reported
Reactions and Allergy Tests. The Supporting Information tab located on the CeRx Allergy Form is
available when new allergies are added to the system.

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Unsynchronize
The option to Unsynchronize will break the link between the local allergy record and the
Network allergy record. Only Green-Synced Network records have the option to Unsynchronize.
When a Green-Synced Network record is unsynchronized, the resulting allergy profile will have
a Yellow-Network allergy entry and a Red-Local allergy entry.
Before Synchronization:

After Synchronization:

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Retracting an Allergy
Allergies, intolerances, supporting information, and other allergy related transactions sent to
PIP can be retracted (i.e. withdrawn) on two conditions:
1. The transaction is being reversed from the same pharmacy it was sent from.
2. The patient Network profile has not been viewed by another user/pharmacy.
If these conditions are violated, executing a retract function on an allergy transaction will elicit
a rejection message.

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Get History
The Get History option allows users to track incremental changes made to an allergy record
(e.g. when Supplementary Information was added; when a note was added, etc).

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View Network Access Log


The Saskatchewan Ministry of Health is at liberty to request information regarding why a
patients medication and/or allergy profile was accessed from PIP. Consequently, Kroll always
prompts the user to enter a reason for accessing a patient`s network profile.

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PIP Portal
The network option for PIP Portal allows users to access the traditional PIP viewer via web
browser.

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View Claim Log


The Network Claim Log provides detailed information regarding the requests sent to PIP and
the corresponding responses coming back from PIP (e.g. profile requests, consent records,
allergy records, etc.). Entries contained in the Network Claim Log are not organized in a patient
specific manner; it simply lists ALL transactions sent to or received from PIP in chronological
order for a configurable number of days.

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Create Local Rx
The option to Create Local Rx allows users to pull prescription information (i.e. patient, drug,
doctor, and dispensing information) from the Network Profile into the local Kroll F12-Filling
screen. This function allows pharmacy users to select a prescription record from PIP and pull it
into the local system for filling. The Create Local Rx function can only be used for network
prescription entries that do not exist locally.

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Refusal to Fill
This message is used when a pharmacist decides they will not or cannot fill a prescription
for a patient. The intent of the message is to record situations such as suspected abuse, polypharmacy activities, and operational situations such as out of stock item, but can be used as
the pharmacist deems fit. A pre-populated dropdown menu of Refusal Reasons is available for
selection and submission to PIP.

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Hold (Suspend) Rx
A prescription is put on hold when a provider determines that a drug should not be taken by
the patient for a specified interval of time. This identifies the intent that the drug therapy be
continued in the future, but that it is suspended for the period indicated on the hold. A
prescription that is on hold will have a status of Suspended on the Patient Network Profile.

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Release (Resume) Rx
The option to Release (Resume) Rx is used to release prescriptions that are currently on hold
(i.e. status Suspended). For example, a patient who transitions from an inpatient situation back
to the community may require held prescriptions to be released.

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Revoke Dispensing Permission


The option to Revoke Dispensing Permission is used when a doctor has decided that the
prescription should no longer be dispensed to the patient. The intent of the message is to
inform the dispenser (e.g. Pharmacist) that the patient should continue to consume the
medication that they have in their possession until it is gone, but no further dispenses are
allowed against the prescription (i.e. all remaining refills are cancelled).

If a user attempts to fill a prescription that has been revoked on the Network, PIP will accept
the prescription, but will return the following warning:

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Stop (Abort) Rx
The option to Stop (Abort) Rx is used when a pharmacist or provider determines that a drug
should no longer be dispensed and should no longer be taken by the patient. Situations where a
prescription may need to be stopped (i.e. aborted) are product recalls, duplicate therapy
contraindication, or other therapy issues. This request can be sent throughout the prescription
lifecycle.

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Add Note
The option to Add Note is used to document additional information concerning a prescription.
Notes are primarily used to document error corrections, information change, or new
information, but can be used for any reason deemed fit by the pharmacy.

Retrieve notes that have been added to a prescription from the Patient Network Profile by
detailing the prescription entry and clicking on the Notes tab.

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Retract Rx
This function allows users to reverse a Network transaction (e.g. Hold Rx, Release Rx, Stop Rx,
etc.) made to prescription entries on a patient`s Network profile. Once an action has been
retracted it will no longer appear in the result set of subsequent queries made on that
prescription.
A transaction must meet three conditions in order to be retracted:
1. The Network user who executed the transaction must be the user who performs the
retract.
2. No other Network user has viewed the Patient Network Profile after the transaction was
made.
3. The retract must be performed within 24 hours of when the transaction was created.

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Extra Functions for Not Dispensed Rxs on the Network


Not Dispensed prescriptions on the Network (i.e. Rxs filled for other medications) have a
slightly different Extra Functions menu than regular prescriptions.
The options to Add Note, Retract Rx, Detail and Refresh are the same as for regular prescription
entries; however, the Update Other Medication option is unique to Not Dispensed Rxs only.

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Update Other Medication


Highlight a Not Dispensed prescription from the Patient Network Profile and select Update
Other Medication from the Extra Functions menu to call up the Update Other Medication form.

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Network Options from the Filling Screen


From the F12 Filling screen, users can add supplementary Rx Order/Dispense Information to
PIP. Rx Order information is entered one-time only; it is essentially the electronic record of the
written script. Dispense information can be entered each time a prescription is filled or refilled.
Dispense information is specific to a particular fill in a prescription chain. Entering
supplementary Rx Order and/or Dispense information is OPTIONAL.

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Filling SKPIP Prescriptions


With PIP integrated in Kroll, all prescriptions must first be sent to the fiscal plan(s) (e.g. SPDP,
AHE, ESI, CS, etc.) and then sent to the Saskatchewan Pharmaceutical Information Program
(SKPIP) plan for clinical recording; the last plan should be listed as Cash. This sequence of
plans allows prescriptions to be billed online, and then logged clinically before passing down
any monies to the patient in the form of a cash plan. Keep in mind that the process of fiscal
billing to third parties is completely independent from the process of prescription logging on
PIP.
Always enter the patients HSN/DIAND Number in the HSN field; this will automatically
populate the SPDP plan entry. Do not add the HSN/DIAND Number to the Saskatchewan
Pharmaceutical Information (SKPIP) plan.

1. Fill out the Patient, Drug, Doctor, SIG, Dispense Information, etc. as usual from the F12
Filling screen

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2. Ensure that SKPIP plan is the LAST adjudicated plan right before cash.

3. Once all necessary information is entered into the F12 Filling screen, click F12-Fill Rx or
press F12 on the keyboard to fill the prescription.

NOTE: The Patient Network Profile is returned by PIP for the first prescription filled
after entering the F3-Patient card (regardless of whether the Rx is New or Refill). The
Network Profile will not be returned for subsequent Rxs.

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4. Adjudication to the fiscal plans will be completed first, and then the Rx will be sent to SKPIP
for prescription logging.
5. If Errors are returned by SKPIP on the CeRx Adjudication Response screen, they will need to
be managed in order to complete the prescription.

6. The CeRx Adjudication Response screen contains three (3) options:


View Network Profile: Selecting this option will prompt the user to enter an optional
reason for accessing the profile, and subsequently call up the full patient Network
profile.
M Manage: Highlight an error and press M on the keyboard to document the
reason (i.e. Management Code) for bypassing an error. NOTE: All errors returned by
PIP MUST be managed in order to proceed with filling the prescription.
D Detail: Highlight a warning/error returned by the Network and press D on the
keyboard to call up the full issue details.

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7. Once ALL Errors have been managed, continue from the CeRx Adjudication Response
screen by clicking Send Issue Managements or by pressing Enter on the keyboard.

8. Retrieve the management codes sent with a prescription by accessing the Patient Network
Profile. Highlight the Rx entry you want to view management codes for and click Details or
press D on the keyboard to call up the Medication Order Detail screen. Click on the Issues
tab to view management codes sent for the prescription.

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Cancelling an Rx
To cancel an Rx:
1. Call up the local medication profile (SHIFT+F3) from the patient card by accessing Profile >
All Rxs or pressing SHIFT+F3 on the keyboard from the Patient card.
2. Highlight the Rx that has needs to be cancelled and click C-Cancel or press C on the
keyboard.
3. If the correct prescription is being pulled up for cancellation, answer Yes when asked Is this
the Rx that you want to Cancel?

4. Enter Kroll initials and password to continue cancelling the Rx if/when prompted.
5. If you are cancelling the first fill of a prescription, the following screen will appear. Select
the appropriate option.

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Filling an Rx for a Device


Devices are considered non-drug products such as diabetic strips, lancets, alcohol swabs,
compression stockings, etc. When a prescription is filled for a device it is NOT sent to PIP. It
bypasses PIP and carries on to the SPDP financial billing portion.
1. Bring up the drug card for a device by doing an F5 Drug search.
2. Click on the Extra Info tab of the drug card and place a checkmark next to the Device flag.

If the drug being filled has the Device flag ON and the SKPIP plan is included in the
plan sequence, a warning will appear You cannot send a device to the network.
Simply remove the SKPIP plan from the Rx to resolve the issue
The prescription will bypass PIP as a result of the Device flag. As such, when you access the
Patient Network Profile, the Device Rx will appear with a yellow-local data-bar because it only
exists locally on Kroll.

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Filling an Rx for a Mixture


When adjudicating a mixture to SKPIP, DIN numbers are not sent; instead the ingredient names
are logged on PIP.
Since DINs are not sent to PIP, the addition of SKPIP pseudo DINs are NOT required and
mixtures will be added into Kroll in the same manner as always.

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Transferring an Rx to Another Pharmacy


From the Rx Transfer Report form, search for the pharmacy you are transferring the
prescriptions to by typing in any part of the pharmacy name. If the pharmacy does NOT exist in
the list, click New to pull up the Create Store from. Fill out all available information in the
Create store form and click OK.

NOTE: The pharmacys Network ID (i.e. SPDP Provider number) is required for
prescription transfers to go through PIP successfully.

NOTE: There is no way to retrieve transfer details from PIP as this information is not
stored.

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Filling an Rx using an NPN


A Natural Product Number (NPN) is assigned by Health Canada to a product whose
manufacturer has submitted enough human evidence to support the health claims they have
declared.

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Filling an Rx for an Animal


Prescriptions filled for pets are NOT recorded on PIP. Pets in the database must have an animal
indicator turned ON in order to successfully fill prescriptions.

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Filling an Rx for Out of Province Patient


Pharmacies will fill out of province patient prescriptions as usual by ensuring that the SKPIP
plan is not a part of the Rx. These out of province patient prescription will show up on the
Patient Network Profile as LOCAL Rx only.

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Filling an Rx for Stock Transfers


Pharmacies will fill Stock Transfers as usual by filling out the F12-Filling screen and going into Rx
> Extra Functions > Stock Transfer to indicate that the Rx is a stock transfer. When this flag is
on, the Rx will bypass PIP. The stock transfer will show up on the Patient Network Profile as a
LOCAL Rx only.

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Sending Indications to the Network


In medicine, an indication is defined as a condition which makes a particular treatment (i.e.
drug) or procedure advisable. Pharmacy users can add the indication of a drug from the F12Filling screen and send it to PIP for clinical recording.

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Prescription Pick Up
The Saskatchewan Health Information Network (SHIN) requires pharmacies to log when a
prescription is physically picked up from the pharmacy. This information is entered in Kroll and
sent to PIP for clinical recording.
It is important to note that recording prescription pick-ups is a crucial part of the prescription
lifecycle. If an Rx is not marked as picked up and the pharmacy goes to fill another dispense
against the prescription, PIP will return a warning This prescription has one or more dispenses
that have been filled but not picked up. In addition, the remaining quantity for a prescription
listed on the Pharmacy Network is not adjusted until the Rx is marked as picked up.

NOTE: Prescriptions that are UNFILLED, NOT DISPENSED, INACTIVE or CANCELLED do


not need to be marked as picked up on PIP.

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Marking a Prescription as Picked Up from the Patient Profile


To mark a prescription as picked up from the patient profile:
1. Search for the patient who picked up their prescription(s).
2. Access the patient profile (SHIFT+F3).
3. Mark the prescription(s) that were picked up using the spacebar on the keyboard.
4. Click on Extra Functions or press X on the keyboard.
5. Select Mark as Picked Up.

6. Indicate Pick Up Person form appears. Specify whether the Patient or Representative
picked up the prescription.

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When Patient is selected, no additional information is required for input.


When a Representative is selected, a First Name and Last Name must be entered. If
the Representative exists as a Kroll patient, they can be selected using the F2-Select
patient button.
7. Click OK or press Enter on the keyboard to send pick up data to PIP.

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Marking a Prescription as Picked Up from Workflow


To mark a prescription as picked up from workflow:
1. Access the Workflow dropdown menu and select Change Work Order States.
2. Log in with Kroll initials and password.
3. Check Show All Applicable Rxs.

The left side of the screen will list all patients that have prescriptions that are NOT
picked up.
The right side of the screen will list all the prescriptions that are NOT picked up for
the particular patient selected on the left side.
4. Click the Extra Functions button or right-click on the Rx entries to access menu functions.
5. Select the option to Change Status to Picked Up to mark the highlighted Rx as picked up.

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Patient Network Audit Report


The Patient Network Audit Report provides a listing of all network accesses for a given time
period broken down by patient. The report contains supplementary information on when the
patients profile was accessed, who it was accessed by, the reason for access if available, and
the type of access (e.g. CeRx Profile Access).
1. From the Kroll Start Screen (ALT+X), go to Reports > Administration > Patient Network
Audit Report
2. From the Selection tab of the report, select the date range or manually enter the date
range.

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Failed Provincial Claims Flat File Report


The Failed Provincial Claims Flat File Report captures all prescriptions that are NOT clinically
recorded on PIP through Kroll adjudication. For example, the report will capture prescriptions
filled for devices, out-of-province patients, animals, stock transfers, etc.
The report is a requirement of HISC and its purpose is to ensure that there are no gaps in the
clinical recording of prescriptions filled by the pharmacy. After generating the Failed Provincial
Claims Flat File report, it will need to be uploaded onto the PIP GUI Website.
1. Go to Reports > Other > Failed Provincial Claims Flat File.
2. Select the Date Range for report generation.
3. Click Run or press Enter to generate the report. THIS REPORT DOES NOT PRINT. It is saved
into the C:\Krollwin folder as a Comma Separated Values (CSV) file for upload onto the PIP
GUI website.
4. Log onto the PIP website by going to Network > PIP Portal.
5. Upload the Failed Provincial Claims Flat File onto the website by browsing the C:\krollwin
folder.

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What Happens When PIP Goes Down


In the event the PIP server goes down, Kroll will queue all claims (i.e. allergy adds, Rx orders, Rx
dispenses, updates, etc.) in the order of creation so that they can be sent when PIP is up again.
No new claims for a particular patient can be sent to PIP until all queued claims for that patient
have been sent to PIP. A prior queued claim may have an impact on the results of another claim
that is sent down (e.g. an allergy add request must be sent before more dispenses are sent
because that may affect the outcomes of the DUR processing for those subsequent dispenses).
When PIP is down, claims are queued in order of creation in the Pending Network Queue.

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What to do When PIP Comes Back UP


When PIP is up again, users can go to the Pending Network Queue and send all claims at once
by clicking on Send or pressing CTRL+S on the keyboard.

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Professional Services Alberta


This section covers the Alberta Clinical Pharmacy Services Program, and includes information
about:

Clinical Pharmacy Services


Drugs Used
PINs
Special Service Codes
Filling an Alberta Clinical Pharmacy Services Rx
Setting up the Doctor Card

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Alberta Clinical Pharmacy Services Program


Clinical Pharmacy Services
As of July 1, 2012, pharmacists in Alberta, who are participating in the Clinical Pharmacy Service
Program, will be able to electronically submit claims to Alberta Blue Cross for compensation for
clinical services provided. Remuneration will be based on whether or not the pharmacist
providing the service has Additional Prescribing Authority (APA).
The program includes:
Comprehensive Annual Care Plan (CACP)
Albertans living with specific chronic diseases will be supported by pharmacists through
assessment, care plan development and ongoing monitoring
Standard Medication Management Assessment (SMMA)
Pharmacists will conduct medication reviews and develop care plans for patients with at
least one chronic disease and on at least four continuous medications
Professional service following an assessment
Prescription renewal, Adapting a prescription, Emergency prescribing, Administration of
injections and Initial access prescribing

Drugs Used
PINs will be used to differentiate the type of clinical pharmacy service type provided and
whether or not the service was provided by an APA Pharmacist. The drug price group used for
these cards is Clinical Services.

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PINs
The drug card PINs are grouped as follows based on whether the service was provided by a
pharmacist with or without Additional Prescribing Authority (APA):

NOTE: These prescriptions are Fee for Service prescriptions under ABPHAP.

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Special Service Codes


When a clinical pharmacy service has been performed, a Special Service Code and PIN will be
needed to differentiate the type of clinical activity.
PIN
00071111
00071112
00071113
00071114
00071115

SSC
F,H,I,J
L
M
L
M

SSF
$20.00
$60.00
$20.00
$100.00
$20.00

00081111
00081112
00081113
00081114
00081115
00081116

F,H,I,J
L
M
L
M
K

$20.00
$75.00
$25.00
$125.00
$25.00
$25.00

The Special Service codes used are as follows:


Special Service Codes
F

Code Value Clinical Activity


Renew previous prescription

Adapt prescription to current need

Prescribed emergency supply of medication

Medication administration by injection

Prescribe initial supply of medication

Initial assessment of patients needs

Follow-up assessment of patients needs

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Filling an AB Clinical Pharmacy Services Rx


Before filling for a Clinical Pharmacy Services Rx, ensure that the ABPHAP plan exists in the
Patient Card. The patients client ID will be their provincial PHN. Check off the option, Always
Use in Rx.

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Setting up the Doctor Card


To fill a prescription for a fee for service claim, the doctor card must be entered with
Pharmacist credentials. See below:

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Select the appropriate drug (i.e. appropriate PIN) and enter the dispensing quantity and days
with a quantity of 1.

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To select the appropriate special service codes, simply do the following:


1. Click on View >Plan Information > ABPHAP.
2. In the Special Service Code field, click on the down arrow to view the list of codes.

The Special Service Code Fee will be populated automatically based on the SSC code selected.

NOTE: An incorrect submission of the PIN and SSC combination may result in claim
rejection of D1 DIN/PIN/GP/SSC not a benefit.

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As of October 1st, 2012, it will become mandatory to submit an ICD-9 code in order to collect
the prominent disease associated to the assessment. Clicking the F2 button beside the Reason
Code field - on the Plan Information screen - will bring up the list. Ensure that the code selected
represents the prominent disease for the assessment.

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Professional Services British Columbia


This section covers the process of BC Prescription Adaption, and includes information about:

Setting up the Doctor Card


Filling a Prescription for BC Adaption
Reporting BC Adaption
BC Medication Reviews: Claiming Fees
Sending a Medication Review Service to PharmaNet

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British Columbia Prescription Adaptation


Adaptation is the process of taking an existing Rx and altering it. Below explains the process of
Rx adaption.

Setting up the Doctor Card


To fill a BC Prescription Adaptation, the doctor card must be entered with Pharmacist
credentials. See below:

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Filling a Prescription for British Columbia Adaptation


In order to adopt a prescription, it can either be copied from an existing prescription using the
pharmacist as the doctor and a new prescription number, or filled as a new prescription. When
making changes to a prescription that has not been previously filled, the Rx would be entered
as new, with the adaptation mode on the first fill, using the pharmacist as the doctor.

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Once the Rx is copied to a new Rx, enter the word ADAPTED: at the beginning of the Sig line.

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Once the adaptation process is completed, an entry into the Rx Comments will be saved
identifying the Rx as being adapted (or changed). See below:

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All Adapted prescriptions must be submitted with one of the following intervention codes:
NI = Dosage Change
NJ = Formulation Change
NK = Directions for Use Modified
NL = Renewal of Prescription
NM = Therapeutic Substitution
NN = Emergency Supply of Medication
NO = Emergency Contraceptive

NOTE: Two additional intervention codes below have been added for emergency
supply and emergency contraception; these prescriptions are not subject to
adaptation fees.
To Enter an Invention Code:
1. From the prescription filling screen, select Plan Information found on the ribbon bar
located at the right side of the screen. The following window will appear.

1. Press F2, to view a list of Intervention codes and pick the appropriate code.
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2. Before filling the prescription, go the Reports Menu and select the Pharmacist Prescription
Adaptation Report.

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3. The Pharmacist Prescription Adaptation Report will appear and will be prepopulated with
the Original Rx Information.

The Comments Tab is available to enter a comment regarding the reason for the adaptation or
it can be left blank.

The Options tab contains the following options:


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Print Store Logo: Enable this option to include your store logo on the report
Print Patient Allergies and Conditions: Enable this option to print the patient allergies
and conditions
Print Provincial Number: Enable this option to include the patients PHN number on the
report
Print Pharmacist Signature Line: Enable this option to print a signature line for the
pharmacist to sign
Print Doctor Signature Line: Enable this option to print a line for the doctor to sign

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Sample Pharmacist Prescription Adaptation Report

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Reporting British Columbia Adaption


The Rx Comments Report is useful for tracking the number of prescriptions adapted by a
pharmacist for a specific time period or for all active Rxs because this report shows Rxs that
have Rx Comments added.
To access this report, go to Main Menu > Reports > Rx > Rx (Comments Report)

NOTE: all reports can be easily accessed if you are familiar with the name of the
report by clicking on Reports > Search > Enter any part of the Name of the Report.
For this example you could enter Comments.

Selection Tab
The Selection tab provides options for the type of comments you want to view. To view the
number of Pharmacist Adaptation performed, simply do the following:
Show Comments For: Select Rx. The next drop down menu will provide choices for the
type of Rxs filled.
Choice 1: All active Rxs. Select this option to print all prescriptions that have an active
status.
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Choice 2: Comments changed. Select this option to open up the date range fields
allowing you to enter a date range. This will only show the prescriptions where the RX
comment was altered or changed from its original state within the date requested.
Choice 3: Comments created. Select this option to open up the date range fields
allowing you to enter a date range. This will only show the prescriptions where the RX
comment was created within the date requested. This option works well if you would
like to know how many Adaptations have been completed within a certain time frame.
Choice 4: Rxs Filled. Select this option to open up the date range fields allowing you to
enter a date range. This will print the number of Rx Adaptations filled within a certain
time period
Topic: Select Rx Adaptation

Selection 2 Tab
The Selection 2 tab allows you to run the report for a specific Patient, Nursing Home or for All
patients. Alternately, you may narrow the report to a particular patient group by clicking F2 and
selecting a particular patient group.

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Options Tab
The Options tab allows you to select the following items:
Print Store Logo: Enable this option to print your store logo
Print Created Date: Enable this option to print the date the adaptation was created
Print Changed Date: Enable this option to print the date the adaptation was modified or
changed
Print Home: Enable this option to print the name of the Nursing Home
Print Ward: Enable this option to print the Nursing Home Ward
Print Room: Enable this option to print the Room number of a Nursing Home patient.
Print Bed: Enable this option to print the bed number of a Nursing Home patient
Orientation:
o Portrait: Enable this option to print the report in portrait style
o Landscape: Enable this option to print the report in landscape style (default)
Rx Options
o Include Unfills: Enable this option to include unfilled Rxs
o Include Cancels: Enable this option to include cancelled Rxs
o Include Inactive Rxs: Enable this option to include Rxs with a status of Inactive
o Print Fill Date: Enable this option to print the fill date of the Adapted Rx
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o Print Drug Name: Enable this option to print the drug name from the Adapted Rx

British Columbia Medication Reviews: Claiming Fees


Once you have performed a medication review with a patient, you can then claim a fee.
You have 3 different fee options:
PIN
Description
Payment Amount
99000501
Medication Review Standard (MR-S)
$60.00
Medication Review Pharmacist Consultation
99000502
(MR-PC)
$70.00
99000503
Medication Review Follow-Up (MR-F)
$15.00

Medication Review Standard (MR-S)


You can claim this fee when you have reviewed the patients information with them and
have completed the BPMH and the BPMHPN report and that there were no issues that
needed to be followed up on. You can claim this fee once per patient every 6 months.
Either, but not both of an MR-S or an MR-PC may be claimed every six months.

Medication Review Pharmacist Consultation (MR-PC)


You can claim this fee when, conducting your MR-S with a patient, you identify one or
more medication management issues. You can claim this fee once per patient every 6
months.

Medication Review Follow Up (MR-F)


You can claim this fee when a patient required a follow-up from the MR-S or the MR-PC. At this
point, you may need to run updated reports for the BPMH, BPMHPN, and the MMI report to
include new medications that the patient might be taking. You can claim this fee 4 times a year
as long as an MR-S or MR-PC has been claimed in the last 12 months.

Sending a Medication Review Service to PharmaNet


1. From the Prescription Filling screen, enter the Patient receiving the service.
2. In the Drug field, search and enter one of the three Medication Review Service PINs (listed
on previous page)
3. Enter the Pharmacist performing the Medication Review Service in the Doctor field. A
doctor card must be created for the pharmacist if it does not already exist in the Kroll
system.
4. Enter the SIG which must contain the Pharmacies 10 digit phone number.
5. Enter a Dispensing Quantity of 1.
6. Enter Days supply of 1.
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7. Enter the Prod Sel of 3-(Pharmacists Choice).


8. Ensure the Plan is PharmaNet.
9. Press F12-Fill Rx to send the claim to PharmaNet. PharmaNet will return a CD patient not
entitled to drug claimed message for all medication reviews claimed, but will send a
separate cheque for reimbursement to the pharmacy on a monthly basis.

NOTE: The price fields of the drug card will be $0.00 with an attached pricing
strategy that sets the prescription cost to $0.00.

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Professional Services New Brunswick


The New Brunswick Prescription Drug Program (NBPDP) began accepting claims for the NB
PharmaCheck medication review program on June 1, 2012. The programs goal and objectives
are as follows:

Program Goal

To provide a professional pharmacy service focused on the appropriate utilization of


chronic medications to improve patient outcomes.

Objectives

Improve a patients knowledge of and adherence with their medications.


Enhance the potential benefits associated with a patients medications.
Reduce the potential risks associated with a patients medications.

Eligibility

NBPDP Plan A (Senior) beneficiaries taking 3 or more chronic prescription medications.


Only one Medication Check-up will be reimbursed per Plan A beneficiary per year (April
1st to March 31st).

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Billing for NB Medscheck


1. Setup the patient plan with NBPDP Plan A (Senior) as follows:

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2. Fill a prescription with the following PIN: 00121212

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To set up the Physician:


1. Create a Doctor Card with the credentials of the Pharmacist who performed the
Medication Review.
2. Enter the license number of the pharmacist proceeding with 8000.
3. Enter the designation as Pharmacist.

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4. Please note the key points of the prescription

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Documentation Requirements
Patient must leave with a complete, accurate, up-to-date personal medication record that
includes the name and signature of patient and the pharmacist who conducted the Medication
Check-up, as well as, the pharmacy contact information.
A copy of the signed record must be retained by the pharmacy for a period of three (3) years.
It is recommended that consent be obtained from the patient if their personal health
information related to a Medication Check-up is to be shared with another health care
provider.
After completing a Medication Check-up, it is expected that a patient understand:
The names of their medications.
Why they are taking their medications.
The best way to take their medications.
Any special instructions that may be associated with the proper use of their
medications.

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Expected completion time: 20-30 minutes


Frequency: only one Medication Check-up will be reimbursed per Plan A beneficiary per fiscal
year.

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Professional Services Saskatchewan


The Professional Services Saskatchewan section includes information about:

SK Prescriptive Authority
Generating Documents for Saskatchewan Prescriptive Authority Service Prescriptions
Billing an Rx for a Saskatchewan Prescriptive Authority Service DIN
Saskatchewan PACT Program
Filling PACT Prescriptions

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SK Prescriptive Authority
The SK Prescription Authority allows Saskatchewan pharmacist to bill for the following services:

To search for all the enhanced prescriptive authority drug cards, go to the drug search screen,
type SK and then press Enter. The following list will appear:

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Below is an example of a drug card for SK Enhanced Prescriptive Authority. Note the SK
Enhanced Prescriptive Authority drug cards look slightly different from regular drug cards
because it is set as Fee for Service; therefore, the Ordering, UPCs, Counseling and Kroll Care
tabs are not included.

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Generating Documentation for Saskatchewan Prescriptive


Authority Service Prescriptions
All Level 1 Prescriptive Authority services must be documented in accordance with the
Pharmacist Assessment Record (PAR) requirements. Pharmacist must record the prescription
on PIP; in the case of an out-of-province patient, pharmacists can document and file a manual
hard copy of the PAR.
Requirements of a PAR as defined by the Saskatchewan College of Pharmacist bylaws must
include:
Date of prescription
Name and Address of person the prescription is for.

Proper name, common name or brand name, strength, dosage, quantity of prescribed
drug, and instructions for use

Prescribing pharmacists name


Rational for prescribing
The PAR requirements may be fulfilled by completing a PIP generated prescription and
including the rationale to prescribe in the SIG instructions (please refer to the Saskatchewan
College of Pharmacists
Level I Prescriptive Authority Services Pharmacist Guide for more information).
Alternatively, pharmacists may complete a manually generated version of the PAR (please
view the Saskatchewan College of Pharmacists document, Pharmacist Assessment Record
Template:
http://napra.ca/Content_Files/Files/Saskatchewan/PharmacistAssessmentRecordTemplate.
pdf).
As a third option, a Kroll Report is also available which meets the requirements of a pharmacist
assessment record. To generate the report simply do the following:
1. Bring up the prescription you are going to do a prescriptive authority service for.
2. Copy the prescription to a new number by going to Rx > Copy Rx.
3. From the New Rx go to Reports > Pharmacist Prescription Adaptation. The
Original Rx Information tab will be populated with information from the copied
prescription.

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4. Change the name of the Doctor to the pharmacist that is performing the prescriptive
authority service. Make any changes to the SIG, Drug, or Disp Qty fields if necessary

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5. Click on the Comments tab of the report.


6. In the Comments field, type the following:

10. You may create this as a standing comment within the report for future use by clicking Ins in
the window or clicking Insert on the keyboard. By doing so the following window will
appear:
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You may name this Rationale anything you want. In the example we have called it Prescriptive
Authority Service Rationale
11. Click Print or Preview to print the report.

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Sample Pharmacist Prescription Adaptation Report

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Billing an Rx for an Saskatchewan Prescriptive Authority


Service DIN
From the F12-Filling screen in Kroll, enter the following:
1. Enter the patient receiving the prescriptive authority service.
2. Enter the applicable Saskatchewan Prescriptive Authority DIN.
3. Enter the name of the pharmacist who performed the prescriptive authority service.
4. In the Sig field, enter the type of prescriptive authority service Rx being billed (e.g. Interim
Supplies, Emergency Situation, etc.)
5. Select to bill the SPDP plan for the service.

NOTE: The billing of the SK Prescriptive Authority Fee is separate from the billing of the
actual prescription. Fill the prescription portion as you would for regular Rxs.

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Saskatchewan PACT Program


Through PACT - Partnership to Assist with Cessation of Tobacco, individuals can receive
counseling and support from their local pharmacist to quit smoking. Research shows that even
brief counseling and support can double a persons chance of successfully breaking the habit,
and behavior modification therapy can triple the chance of success.
PACT pharmacists are specially trained through the PACT program to provide
tobacco cessation counseling. PACT pharmacists can help individuals to do the
following:
Assess their readiness to quit;

Guide them through the steps to quitting;

Offer advice on medications that may help them quit; and

Provide ongoing support and encouragement.


PACT is available at no cost to the public. The program is financed through a fund established
by Saskatchewan pharmacies to provide patient health services. Reimbursement will be
provided to pharmacies through real-time claim submission to the Saskatchewan
Prescription Drug Program (SPDP).
The PACT program was launched in Saskatchewan on January 18, 2009.

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Eligible Clients
A beneficiary is a Saskatchewan resident with an active Health Services Number (HSN), and
not covered under Workers Compensation, SGI, Non-Insured Health Benefits, Veterans
Affairs, RCMP, or Armed Forces.
Stage

Pseudo DIN

Bronze

00990051

Bronze Plus

00990052

Silver/Gold

00990053

Follow-up

00990054

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Comment
Maximum of 1 submission at
$5.00 (2.5 minutes)
Maximum of 1 submission at
$10.00 (5 minutes)
Maximum of 3 submissions
totaling 90 minutes for a
Maximum of 10 submissions x
$10.00/submission for a total of
$10.00 (50 minutes)

Code
51
52
53

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Filling PACT Prescriptions


The following section will use diagrams to illustrate how to fill and bill PACT fee for service
prescription to SPDP. Note that pharmacies with PIP integrated Kroll software will NOT bill PACT
prescriptions to the SKCeRx plan for clinical recording; the SKCeRx plan must be excluded from
the Rx.
Filling a PACT-Bronze Rx

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Sample Successful Claim Response

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Filling a PACT-Bronze Plus Rx

Sample Successful Claim Response

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Filling a PACT-Silver/Gold Rx

Sample Successful Claim Response

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Filling a PACT-Follow Up Rx

Sample Successful Claim Response

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PACT Labels
Prescriptions filled for PACT fee for service prescriptions will have a PACT FEE watermark on
the vial label and a PACT FEE marker on the hardcopy. Please see examples below:
PACT-Bronze Label

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PACT-Bronze Plus Label

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PACT-Silver/Gold Label

PACT-Follow-Up Label

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Professional Services Ontario


This Professional Services Ontario section includes information about:

Prescription Authority
ODB Expanded Services
Billing the Expanded Services to ODB
Ontario Smoking Cessation Program
ODB Medscheck (Medication Review)
ODB Medscheck Lost Opportunities Report

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Prescription Authority
Requirements for a Pharmacist Authorized Refill:
Effective March 18, 2011, a pharmacist in Ontario may authorize a refill if he or she believes
all of the following:
Reasonable efforts to contact the prescriber have been made and were unsuccessful;
The prescriber of the prescription to be refilled, if available, would have authorized the
refill;

The patient for whom the drug is to be refilled has been prescribed the drug for a
chronic or long term condition;

And, the patient for whom the drug is to be refilled has a stable history with that drug.
If a pharmacist authorizes the refill of a prescription, the total amount of the drug dispensed
shall not exceed the amount of the drug previously dispensed by the pharmacy, or a three
months supply, whichever is less.

Conditions for a Pharmacist Authorized Refill


For each pharmacist authorized refill, ALL of the following conditions must be met:
A unique prescription identification number must be assigned to that refill prescription;
The assigned prescription identification number and the name of the original prescriber
must be recorded in the pharmacys patient record;
The fact that the refill has been made with the authorization of a pharmacist and the
name of that pharmacist must be recorded on the pharmacys patient record;
And, within seven days, the pharmacy must send to the prescriber and, if known to the
pharmacy and different from the prescriber, to the patients primary health care
provider, a report that includes notice that a refill of the prescription was made on the
authorization of a pharmacist and the date, drug and quantity of drug dispensed.
For more information regarding Pharmacist Authorized Refills, kindly contact the Ontario
College of Pharmacist (OCP).

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Creating a Pharmacist-Prescriber in Kroll


The prescriber of a Pharmacist Authorized Refill is the authorizing pharmacist. As such, an F7Doctor card will have to be created for the authorizing pharmacist if one does not already exist
in the database. Add an F7-Doctor card for the pharmacist as follows:
1. Perform an F7-Doctor search for the pharmacist authorizing the refill.
2. If there is no existing record, click or press Ins-Insert to add the pharmacist.

3. Fill out the Full Address and Phone Number of the pharmacy for which the
authorizing pharmacist works.

4. In the Comments section of the doctor card, enter a General comment with the license
number of the authorizing pharmacist. Check the option to Print On Hardcopy and click
Save to save the comment.

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5. Set the provider Designation to Pharmacist.


6. Enter the Primary License Number as 99999.
7. Check the Override flag and set the Ref ID to 99

8. Click Save or press Enter from the F7-Doctor card to save changes.

Filling a Pharmacist Authorized Refill in Kroll (Adaptation)


If the pharmacist on duty determines that all the requirements for a Pharmacist Authorized
Refill has been met, they can proceed with filling the prescription in Kroll as follows:
1. Search for and call up the patient requiring the Pharmacist Authorized Refill.
2. From the F3-Patient Card, click Profile> All Rxs or press SHIFT+F3 to access the
patient medication profile.

3. Highlight the prescription that needs to be refilled and click F-Refill or press F on the
keyboard to call up the prescription.

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4. From the prescription filling screen you will be prompted to copy the Rx to a new
number.

5. Answer Yes when prompted There are no repeats left on this Rx. Do you want to copy
it to a new number? Copying the Rx will generate a new prescription number for the
Pharmacist Authorized Refill.
6. Enter the number of repeats or specify the total authorized quantity for the new Rx and
click OK or press Enter to continue to the New Rx.

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7. Change the F7-Doctor to the authorizing pharmacist.

8. In Rx Comments, enter the name of the original prescriber, and length of time that the
patient has been stable on the drug as these are requirements from the college.

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9. At this point, the user can enter their Kroll initials, and fill the prescription by pressing
F12-Fill Rx. The pharmacist can generate documentation outside of the Kroll application;
however, if the user would like to generate documentation from Kroll, proceed with
step #10 and do NOT press F12-Fill Rx.

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10. From the F12-Filling screen, go to Reports > Pharmacist Prescription Adaptation.
11. The first tab of the report is where Original Rx Information is entered. This original
information is automatically pulled from the Rx that the new Rx was copied from.

12. In the Comments tab of the report, OPTIONALLY type the following (not required by
OCP): PHARMACIST AUTHORIZED REFILL... I have instructed the patient to call your
office to make an appointment to review their drug therapy within... ( ) the next 72
hours... ( ) the next week.

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13. In the Options tab, check off required options and/or change the pharmacist name if
desired.

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Print Store Logo


If the logo is populated in File > Configuration > Store > Reports > General then when this is
checked off the stores Logo will print at the top of the report.

Print Patient Allergies and Conditions


Selecting this option will print on the report all allergies and conditions listed in the patients
profile.

Print Provincial Number


When selected this will prints the patients Health Card number on the report, this will work if
you have the patients ODB number in the patient screen.
Print Pharmacist Signature Line
This will option will also print a line for the pharmacist to sign.

Print Doctor Signature Line


This option will print a doctors signature line.

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14. Click Print or Preview to generate the report.

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ODB Expanded Services


The first stage of expanded services is a clinical intervention at the time of dispensing that
occurs in situations when a pharmacist has identified a concern with a new or repeat
prescription. Based on consultation with the prescriber, the prescription may not be dispensed,
may be dispensed as prescribed or a prescription may be adjusted.
To be eligible for a professional intervention fee, the pharmacist must document and make a
recommendation to the prescriber regarding the medication.
For complete program details please refer to the Ministry website:
http://health.gov.on.ca/en/pro/programs/drugs/expandedservices.
Reasons for a Clinical Intervention:

Therapeutic Duplication; drug may not be necessary


Requires drug; patient needs additional drug therapy
Sub-optimal response to a drug; drug is not working as well as needed
Dosage too low
Adverse drug reaction; possibly related to an allergy or a conflict with another
medication or food
Dangerously high dose; patient may, either accidentally or on purpose , be taking too
much of the medication
Non-compliance; patient is refusing to take the drug, or not taking it properly
Prescription has been confirmed false or has been altered

Outcomes
There are three possible outcomes to the pharmaceutical opinion and a Product Identification
Number (PIN) has been assigned to each outcome for billing purposes to ODB:
1. Not filled as prescribed: PIN 93899991 ($15.00 Reimbursement)
2. No change to prescription; filled as prescribed: PIN 93899992 ($15.00 Reimbursement)
3. Change to prescription: PIN 93899993 ($15.00 Reimbursement)

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Documentation Requirements

Must be on a patients electronic profile or on the prescription hardcopy


record. All documentation must be in a readily retrievable format.

At minimum, documentation must include: outcome; details that describe the drug
related issue; recommendation to the prescriber; action plan/discussion with the
patient; date of transaction; pharmacists signature; date and name of prescriber
contacted; other comments required to substantiate the decision.

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Billing the Expanded Service to ODB


Creating a Pharmacist-Prescriber in Kroll
The prescriber (i.e. F7-Doctor) of an expanded service is the authorizing pharmacist. As such, an
F7-Doctor card will have to be created for the authorizing pharmacist if one does not already
exist in the database. Add an F7-Doctor card for the pharmacist as follows:
1. Perform an F7-Doctor search for the pharmacist authorizing the expanded service.
2. If there is no existing record, click or press Ins-Insert to add the pharmacist.

3. Fill out the full Address and Phone number of the pharmacy for which the authorizing
pharmacist works.

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4. In the Comments section of the doctor card, optionally enter a General comment with the
license number of the authorizing pharmacist. Check the option to Print On Hardcopy and
click Save to save the comment.

5. Set the provider Designation to Pharmacist.


6. Enter the Primary License Number as 99999.
7. Check the Override flag and set the Ref ID to 99.

8. Click Save or press Enter from the F7-Doctor card to save changes.

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Billing the Expanded Service Prescription


1. Press F12-New Rx from the Kroll Start Screen (ALT+X).
2. Using an F3-Patient Search, enter the ODB patient receiving the expanded service.

NOTE: Stage 1 of expanded services will only reimburse patients covered under ODB.

3. Using an F5-Drug Search, search for ODB Expanded Services to call up the three
pharmaceutical opinion drug cards. Insert the appropriate ODB Expanded Service into the
F12-Filling Screen.

4. Using an F7-Doctor Search, enter the pharmacist authorizing the expanded service.
Dispense Quantity: 1
Days: 1
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The F12-Filling screen will look similar to the following after filling out all the necessary
fields:

NOTE: A PS intervention code will automatically be sent to ODB. As well, the


prescription will be billed as a Fee for Service prescription.

5. Click F12-Fill Rx or press F12 on the keyboard to adjudicate the Rx to ODB for
reimbursement.

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Ontario Smoking Cessation Program


The objectives of the Ontario Pharmacy Smoking Cessation Program include the following:
To align with the principles of other smoking cessation programs in primary health
care and community settings to provide smokers with a continuum of care.

To communicate to the public regarding the value of smoking cessation services by


community pharmacists and promotion of available services.

To improve access to and choice of stop smoking services, including advice on smoking
cessation therapy and options, support tolls, resources and follow-up.

To provide patients with a consistent, evidence-based standard of care on a


screening mechanism, cessation counseling, structured documentation and
support.

Eligibility
While the smoking cessation program is available for reimbursement to Ontario Drug Benefit
(ODB) recipients who smoke, future consideration may be given to expanding program
eligibility to non-ODB patients based on outcomes of the program. In other words, at this
point, only patients who have active ODB or Trillium coverage will be covered for the
smoking cessation program.

Pharmacist Education
Pharmacist are required to take a smoking cessation training program to ensure that they have
the basic level of training including motivational interviewing strategies, a familiarity with more
involved smoking cessation counseling and quit smoking planning.
The training program must support the Smoking Cessation Algorithm (5 As) of Ask; Advise;
Assess; Assist; Arrange. Smoking cessation programs are obtainable in Ontario through
organizations including:
Ontario Pharmacists Association
Canadian Pharmacists Association
Centre for Addiction and Mental Health

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Pharmacist Payment and Program Evaluation

Smoking Cessation claims for payment may only be submitted for ODB patients at this
time.
Claims are to be submitted on the date of service.
The claim submission follows the same process for submitting a claim for the
MedsCheck program using special product identification number (PIN).

Readiness Assessment
PIN 93899941 - $40.00 First Consultation (once per year = $40.00 total)
The outcome of the first consultation is to engage the patient in a dialogue about their
smoking history, and to ensure the patient understands the goals and objectives of the
program including their responsibilities towards success. The first consultation occurs after the
pharmacist has conducted the readiness assessment, obtained patient consent for program
enrolment and sharing of health information.

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Primary Follow-Up Session


PIN 93899942 - $15 - session 1-3 (3 times per year maximum = $45.00 total)
The first 3 follow-up counseling sessions should take approximately 10 minutes and should
occur within the first 3 weeks of the program being initiated. Suggested time-lines for primary
follow-up sessions:

Day 3-5 (10 minutes)


Day 7-10 (10 minutes)
Day 14-21 (10 minutes)

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Secondary Follow-Up
PIN 93899943 - $10.00 -sessions 4-7 (4 times per year = $40.00 total)
The four secondary follow-up counseling sessions are approximately 5 minutes in duration.
Suggested time-lines for secondary follow-up sessions:
Day 30-60 (3-5 minutes)
Day 90-120 (3-5 minutes)
Day 180-210 (3-5 minutes)
Day 240-365 (3-5 minutes)

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Program Evaluation
Pharmacists are asked to document smoking cessation program results for the purpose of
program evaluation. The following results are claimed using the ODB health network system
PINs for the purpose of establishing patient success in the Ontario governments quit smoking
program. Only one of the three program evaluation PINs is submitted per patient.
*** The three PINs used for program evaluation provide no remuneration. ***

Successful Quit
PIN 93899944
The Successful Quit PIN is claimed when a patient indicates at any time during the program
that he or she has successfully quit smoking. Once the PIN is claimed, no further meetings
are scheduled or billable.

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Unsuccessful Quit
PIN 93899945
The Unsuccessful Quit PIN is claimed when a patient indicates at any time during the program
that he or she has not succeeded in quitting smoking. Once the PIN is claimed, no further
meetings are scheduled. The pharmacist should inform patients who withdraw from the
program of their eligibility to re-enroll at a later date (one year from the date of their first
consultation with the pharmacist).

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Unknown Status/Program Withdrawal


PIN 93899946
The Unknown Status PIN is claimed when a patient cannot be reached to continue with his/her
program or when a patient withdraws from the program without indicating their success in
quitting smoking.

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Billing ODB for Smoking Cessation


When billing for ODB Smoking Cessation, you bill all of these PINS paid or not in the same way
that you bill all fee for service prescriptions: Below are examples.

Once you have the appropriate PIN chosen fill in the rest of the fields as follows:
Doctor: The counseling Pharmacist
SIG: Free Form
Disp Qty: 1
Days: 1

NOTE: the ODB Drug Plan Intervention PS will automatically populate. This tells ODB
that this is a Professional Service.

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To submit a PIN:
Successful Quit: PIN 93899944
Unsuccessful Quit: PIN 93899945
Unknown Status/Program Withdrawal: PIN 93899946 prescription will look as follows:

You will receive a response screen as shown below:

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ODB MedsCheck (Medication Review)


Currently, all Ontarians taking a minimum of three (3) chronic medications qualify for an
annual MedsCheck medication review provided by a pharmacist with the goal of improved
patient care. During the annual timeframe, a patient may benefit from a follow-up MedsCheck
medication review. All MedsCheck policies and procedures apply to the follow-up
MedsCheck.
By utilizing the DINs accepted by Ontario Drug Benefits (ODB) for payment of MedsCheck
reviews, the Kroll Pharmacy System can be configured bill for these services for eligible
patients (i.e. patients on 3 or more chronic medications).
The below table lists the DINs accepted for MedsCheck billing:
Name
ODB MedsCheck Annual Review
ODB MedsCheck Longterm Care Home Resident (annual)
ODB MedsCheck Longterm Care Home Resident (quarterly
monitoring)
ODB MedsCheck At-home Assessment Summary (annual)
ODB MedsCheck Diabetes Annual Assessment
ODB MedsCheck Follow-up Diabetes Follow-up Assessment
ODB MedsCheck Follow-up Hospital Discharge
ODB MedsCheck Follow-up Pharmacist Documented Decision
ODB MedsCheck Follow-up Physician/RN (EC) Referral
ODB MedsCheck Follow-up Planned Hospital Admission

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DIN

ODB Fee

93899979

$60.00

93899985

$90.00

93899986

$50.00

93899987

$150.00

93899988

$75.00

93899989

$25.00

93899981

$25.00

93899982

$25.00

93899983

$25.00

93899984

$60.00

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Submitting an ODB Meds Check Claim for an ODB Recipient


To submit a Medscheck claim to ODB, go to the F12 screen and enter the following information:
1. From the Prescription Filling screen, enter the Patient who was provided the Medscheck.
2. In the Drug field, search and enter the appropriate ODB Medication Review Service PINs
(listed on previous page).
3. Enter the Pharmacist performing the Medication Review Service in the Doctor Field. A
doctor card must be created for the pharmacist if it does not already exist in the Kroll
system.
4. Enter Dispensing quantity of 1.
5. Enter Days supply of 1.
6. Press F12-Fill Rx to send the claim to ODB.
Sample Medscheck Rx billed to ODB

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Submitting an ODB Meds Check Claim for an Non-ODB Recipient


To submit a MedsCheck claim for a person who does not have ODB coverage, the
following information must be included in the Patient Card:
Patient Gender: 'F' = female, 'M' = male
Patient Date of Birth: Valid YYYYMMDD
Health Card Number with a Carrier ID of 'S' (This is the Plan code for the 'Non ODB
MedsCheck Service' plan.)
Ensure Always use in Rx is enabled.

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Good Faith Intervention


All Non-ODB recipient Medscheck claims must be sent with an ML intervention. To enter an ML
intervention, simply do the following:
1. Click Plan Information found on the ribbon bar on the right side of the screen.
2. From the Rx Plan Information window Intervention Code 1 field, click on F2.
3. Select ML Good Faith Standard Coverage Established.

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ODB Medscheck Lost Opportunities Report


Currently, all Ontarians taking a minimum of three (3) chronic medications qualify for an
annual MedsCheck medication review provided by a pharmacist with the goal of improved
patient care. During the annual timeframe, a patient may benefit from a follow-up MedsCheck
medication review. All MedsCheck policies and procedures apply to the follow-up
MedsCheck.
By utilizing the DINs accepted by Ontario Drug Benefits (ODB) for payment of MedsCheck
reviews, the Kroll Drug Utilization Audit Report can be configured to extract a list of patients
who are eligible for the service (i.e. patients on 3 or more chronic medications).
The below table lists the DINs accepted for MedsCheck billing:
Name
ODB MedsCheck Annual Review
ODB MedsCheck Longterm Care Home Resident (annual)
ODB MedsCheck Longterm Care Home Resident (quarterly
monitoring)
ODB MedsCheck At-home Assessment Summary (annual)
ODB MedsCheck Diabetes Annual Assessment
ODB MedsCheck Follow-up Diabetes Follow-up Assessment
ODB MedsCheck Follow-up Hospital Discharge
ODB MedsCheck Follow-up Pharmacist Documented Decision
ODB MedsCheck Follow-up Physician/RN (EC) Referral
ODB MedsCheck Follow-up Planned Hospital Admission

DIN

ODB Fee

93899979

$60.00

93899985

$90.00

93899986

$50.00

93899987

$150.00

93899988

$75.00

93899989

$25.00

93899981

$25.00

93899982

$25.00

93899983

$25.00

93899984

$60.00

Configuring the Drug Utilization Audit Report


Configure the Kroll Drug Utilization Audit Report as follows to obtain a comprehensive listing of
patients who are eligible for ODB MedsCheck medication review:
1. From the Kroll Start Screen (ALT+X), go to Reports Drug Drug Utilization Audit
Report.
2. From the Selection tab of the report, place a checkmark next to Active Rxs filled
dd/mm/yyyy to dd/mm/yyyy'. Enter the applicable date range for the report.
3. The report should be generated for ALL patients in the database.

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NOTE: It is also possible to generate the report for a given Nursing Home or Patient
Group.

4. From the Selection 2 tab, access the Drug field and click ADD.

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5. A Drug Search Form will appear. Search for an ODB Meds Check drug card.

NOTE: It is advisable to enter one DIN at a time into the Drug Utilization Audit Report
in order to isolate a list of patients eligible for a particular type of MedsCheck review
6. Select the ODB MedsCheck drug card by highlighting the appropriate entry from
the Drug Search From and press Enter on the keyboard twice.

7. Under Show Drg/Mix, place a checkmark next to ALL.

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8. Select the options to Exclude the ODB Meds Check drug card, and to Exclude patients
that had selected drug(s) in the past 365 days.

9. From the Options tab, select the options to Show only patients with more than 2
meds.

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10. Click Preview or press CTRL+V to preview the report. OR click Print or press CTRL+P to
print the report OR click Save CSV or press CTRL+C to save the report as a comma
separated values (CSV) file.

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Professional Services Nova Scotia


The goal of the Basic Medication Review program is to provide a 20-25 minute professional
service focused on the appropriate utilization of medications to improve patient outcomes.
The objectives of the program include the following: Improve a patients knowledge of and
adherence with their medications Enhance the potential benefits associated with a patients
medications Reduce the potential risks associated with a patients medications.
Professional Services:
Basic Medication Review Service
Therapeutic Substitution
Prescription Adaptation
o Refusal to fill
o For a clinical reason to enhance patient outcomes

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Advanced Medication Review Service (AMRS)


(Formerly Medication Review Service) AMRS takes approximately one and one-half hours to
complete. It is an insured service under the Nova Scotia Seniors PharmaCare Program.
Pharmacies are required to complete the Pharmacy sign-up form and fax it to the Pharmacy
Association of Nova Scotia (PANS) prior to offering the service to their patients. It is important
for the pharmacy to be registered for billing and audit purposes. To qualify for the program,
beneficiaries must:
Be beneficiaries of the Nova Scotia Seniors PharmaCare Program.
Agree with their pharmacist that they are a suitable candidate for the program. A signed
consent form and all documentation is to be kept on file in the pharmacy for at least
three years for audit purposes
Not reside in a nursing home, home for special care or be receiving medication in
compliance packaging.
Be taking 4 or more prescription medications; OR taking one of the following:
o Methyldopa
o Indomethacin
o Cyclobenzaprine
o Diazepam
o Chlordiazepoxide
o Clorazepate
o Amitriptyline

Have at least one of the following diseases:


o Asthma
o Diabetes
o Hypertension
o Hyperlipidemia
o Congestive heart failure
o Chronic obstructive pulmonary disease
o Arthritis

Claims Submission
Pharmacists may submit claims for AMRS to the Nova Scotia Pharmacare Programs for
reimbursement provided the beneficiaries qualify according to the criteria above and:
One AMRS per beneficiary using PIN 93899999 in each benefit year, April 1st to March
31st.
Pharmacists are permitted to prescribe the AMRS using the pharmacists prescribing
number 71111.
The service fee for advanced medication review (Special Service Code 006) is subject
to a PRP of $150.00. The copayment will be applicable to this claim.
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The Special Service Code 006 is only applicable to the Nova Scotia Seniors Pharmacare
Program.

Basic Medication Review Service


Basic Medication Review Service (BMRS) approximately 20 to 30 minutes to complete - is an
insured service under all the Pharmacare Programs, except the LTC Under 65 Program. To
qualify for the program:
The individual must be a beneficiary of a Nova Scotia Pharmacare Program, except the
LTC under 65 Program.
The beneficiary must agree with their pharmacist that they are a suitable candidate for
the program and sign a consent form which, along with all other documentation, is to be
kept on file in the pharmacy for at least three years for audit purposes.
The beneficiary must not reside in a nursing home, home for special care or be receiving
medication in compliance packaging.
The beneficiary must meet with the pharmacist for an in-person consultation.
The beneficiary must be taking 3 or more prescription medications that are used for the
treatment of chronic conditions, and are covered by the Pharmacare Programs.
The beneficiary must be provided with a comprehensive drug review list that is dated
and authorized with the pharmacists and the patients signatures.

Claims Submission
Pharmacists may submit claims for BMRS to the Nova Scotia Pharmacare Programs for
reimbursement provided all the above criteria are met, and the beneficiary has received their
comprehensive drug review list dated and authorized with the pharmacists and the patients
signatures, and:
One BMRS per beneficiary using PIN 93899995 in each benefit year, April 1st to March
31st.
Pharmacists are permitted to prescribe the BMRS using the pharmacists prescribing
number 71111.
The service fee for basic medication review (Special Service Code 003) is subject to a
PRP of $52.50. The copayment and/or deductible will be applicable to this claim.

Therapeutic Substitution
Therapeutic substitution (TS) is an insured service under all the Pharmacare Programs. This is an
eligible service only when it is in response to a Pharmacare policy such as Pharmacare
Reimbursement Price (PRP), proton pump inhibitor (PPI) policy, etc.

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To qualify for the program:

The individual must be a beneficiary of a Nova Scotia Pharmacare Program, and give
informed and voluntary consent as described in the Nova Scotia College of Pharmacists
Standards of Practice for Prescribing Drugs by Pharmacists. Pharmacists must comply
with all applicable Nova Scotia College of Pharmacists Standards of Practice for
Prescribing Drugs by Pharmacists. Documentation of consent, assessment, monitoring
plan and notification to the prescriber of the medication that being substituted is to be
kept on file in the pharmacy for at least three years for audit purposes.
The beneficiary must be taking a medication for which the Pharmacare Programs have
specifically authorized therapeutic substitution. The list of products will be provided in
Pharmacare News Bulletins.

Claims Submission
Pharmacists may submit claims for therapeutic substitution to the Nova Scotia Pharmacare
Programs for reimbursement provided all the above criteria are met, and the beneficiary has
signed consent authorizing the pharmacist to make the TS, and:
The following steps must be completed in order for the pharmacy to be reimbursed for the
service:
The original claim for the prescription as written by the prescriber is submitted to
Pharmacare and then reversed
Submit a claim for therapeutic substitution using PIN 93899996, with the CPhA Claims
Standard field content below. The hard copy must reference the prescription numbers
for the original claim and the modified claim.
The claims for the new prescription with the changes made is submitted to Pharmacare
Pharmacists are permitted to prescribe the TS using the pharmacists prescribing
number 71111.
The service fee for therapeutic substitution (Special Service Code 002) is subject to a
PRP of $26.25. The copayment and/or deductible will not be applied to this claim.

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Billing MSI for Payment


1. Enter the Patient Plan Information as MSI.

2. Select the appropriate drug for the service provided.

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3. Create a Doctor card for the pharmacist performing the Medication Review, ensure that
you enter the designation as Pharmacist and the license number 71111.

4. From the Prescription Filling screen, press F12 to adjudicate the prescription to MSI.

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BC PharmaNet in Krollwin
This section explains how the BC PharmaNet features work in Kroll.
1.
2.
3.
4.
5.
6.
7.
8.

Searching for a Patient by PHN


Searching for a Patient by Name
Adding Out-of-Province Patients and Infants with Unassigned Personal Health Numbers
Filling for Pets
Viewing a PharmaNet Patient Profile
Viewing Rxs Dispensed by Other Pharmacies
Performing Request Profile Mailing
Performing a Local Profile Request

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Searching for a Patient by PHN


1. If the patient provides their CareCard, enter # followed by their 10 digit PHN to perform a
search on the local system.

a. If the PHN does not exist on the local system and the number is valid based on the
final check digit, a prompt will appear asking you to enter your initials:

b. Once your initials are entered and a matching patient is found, the following window
will appear:

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NOTE: If this is the correct patient, select Yes. The patient will be created
on the local system using the information returned by PharmaNet.

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Searching for a Patient by Name


1.

If the patient does not provide you with their CareCard you can search for the patient on
PharmaNet by entering any part of the last name, a comma, and any part of the patients
given name.
a. If the local search does not return any results, click Insert or press the insert key on
the keyboard. When the prompt Are you sure? appears, select Yes.

2. A prompt will appear. Enter your initials and click OK. This will display the PharmaNet
Patient Search Form.

3. The last name and given name information you chose to use in your local search will be
copied into this form. Though you may need to edit the search criteria, the minimum
requirements for a PharmaNet search are:

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Full Last Name


First Name or Initial (cannot be left blank)
Gender
Year of Birth
Day and month of birthday (optional)

You may need to complete the name, sex and year of birth fields to meet the minimum search
requirements as only the name fields have been copied into the search form.
Press Enter or click the Search button to search your query.

NOTE: If there are too many matches found, an error message will appear
asking you to modify your search criteria with additional information.

4. Press Enter on your keyboard or click Select to select the patient. If more than one match is
returned, use the Up/Down or Page Up/Page Down keys to highlight the correct patient,
and press Enter on your keyboard or click Select.

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A PharmaNet Patient Check Form will open. Each field will be shown comparing
PharmaNet Data with the Local Data. If you have already created the patient on the local
system and you do not want to update a specific field, then remove the check mark.

5. Press Enter on your keyboard or click Update to create the patient locally or update an
existing patient.

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Adding Out-of-Province Patients and Infants with Unassigned


Personal Health Numbers
Out-of-province patients and infants must be assigned a PHN to have prescriptions filled.

Out-of-Province Patients
1.

If a patient does not have a PHN, you must create a patient card with all of the patients
current contact information, including:

Full last name


Full first name (do not use an initial)
Address Line 1
City and Country (if the country is not available from the drop down menu, manually
type in the 3 character country code, i.e.: CHN for China)
Postal/Zip code
Birth Date
Gender
Phone number (this should be a Local Number or a cell number where the patient
can be reached.)

2. When the patient card is complete, click Save.


3. From the Network Menu, select Patient Search.

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The PharmaNet Patient Search Form will open populating the search fields with the
information you provided in the patient card.
4. Click Search to perform a patient search.

a. If no matches are found in the list or if no patients are returned, the following
prompt will appear:

5. Click Assign PHN.

6. Select Yes to confirm the information you entered is correct, the patient information is
entered, and you are sure the patient does not have an existing PHN:

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7. Click Yes on the following prompt. PharmaNet will assign a pseudo PHN for the patient.

The local system will automatically create a PharmaNet plan with this PHN:

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Infants
1. When assigning a PHN for an infant who is not currently registered, enter them on the local
system as follows:
Last Name: Enter the Babys legal surname
First Name: Baby Boy A or Baby Girl A (Single Births)
Baby Boy A, Baby Girl B, Baby Boy C (Multiple Births)
Gender:
Male or Female
Birth Date: dd/mm/yyyy
2. To assign the infant a temporary PHN from the Network/Patient Search, follow the same
instructions as you did for assigning an out of province patient.
Once the infant is registered with PharmaCare, the next time a prescription is filled;
PharmaNet will merge or consolidate the temporary PHN with the new registered PHN.

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Filling for Pets


1. When filling for a Pet you must first create a Patient card using the Owners last name and
PHN.
2. In the first name field of the Patient card enter the pets name followed by the type of pet in
parentheses.

3. Check Animal in the General tab of the patient card.

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NOTE: Ensure the Designation (General > Doctor Information > Designation) is set to
Veterinarian so the Rxs does not appear on the owners PharmaNet Profile.

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Viewing a PharmaNet Patient Profile


1. Go to Network > Profile All Rxs (TRP).

2. On the next prompt, enter your initials and reason for viewing the patients profile.

NOTE: With the exception of performing a fill, you will be required to enter your
initials and your reason for accessing the profile to access a patients profile.

You are now connected to PharmaNet. A display of the patients profile with all
prescriptions dispensed within the last 14 months will be displayed.

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Viewing Rxs Dispensed by Other Pharmacies


1. Go to Network > Profile Last 15 Rxs or Network > Profile Other Store to show only Rxs
dispensed by pharmacies other than your own. This will prompt the PharmaNet Profile
screen.

The PharmaNet Profile screen contains three tabs:


c) Clinical Conditions
d) Adverse Reactions
e) Profile (the actual medication profile)
2. If the patient has any clinical conditions, the Clinical Conditions tab will display. Each
condition is listed and shows the description of the condition and the chronic indicator. To
view more information about a condition listed, highlight the condition and press D on your
keyboard or click Details.

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Press Enter on the keyboard or click OK to return to the PharmaNet Profile screen.
3. Press Enter or click Next to advance to the Adverse Reactions tab. If there are multiple
pages of clinical conditions, go to the last page and click Next.

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To view more information about an adverse reaction, highlight the reaction and press D on
your keyboard or click Details.

NOTE: You may only update an existing adverse reaction form if you are the
originating pharmacy.
Once all pages of the Adverse Reactions have been displayed, you will advance to the
Profile tab.

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4. All prescriptions are grouped by DIN. The total counts of prescriptions associated with that
DIN are displayed to the right of the fill information. To look at all Rxs for this DIN, highlight
the specific Rx and select Detail at the bottom of the page.

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To view more information about a specific fill, highlight the fill and press D on your
keyboard or click Details.

5. You must view a minimum of 15 prescriptions. Press the Next button to view the next page
of Rxs. After you have viewed at least 15 Rxs, the Next button changes to Close. Press Enter
to close these screens. If you wish to view additional pages of Rxs beyond the first 15, press
the Page Down key.

NOTE: You cannot print the PharmaNet Profile screen. Profile information returned
from PharmaNet must not be provided to the patient. If a patient requests a
printed copy of their PharmaNet Profile, make a request to PharmaNet to have a
profile mailed to the patient (See Request Profile Mailing).

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Performing Request Profile Mailing


Request Profile Mailing places a request to PharmaNet to mail the patients official PharmaNet
medication profile.

NOTE: The patient must provide positive identification before the profile is
requested.
1. Go to Network > Request Profile Mailing.

This will send a request to PharmaNet to mail the profile to the address the patient has on
record. You will be required to enter your initials for verification.
2. Click Yes to verify that the patient information PharmaNet has on file is correct.

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a. If the patient information in PharmaNet differs from the patient information on your
local system, the PharmaNet Patient Check Form will appear.

b. If you see that the mailing information in PharmaNet is not current, press the ESC
key on the keyboard or click Cancel to abort the mailing request. Perform an Update
Address request and request profile mailing again.

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NOTE: You must select the update button on this form for the mailing request to
be sent. A message will then appear confirming that the request was sent.

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Performing a Local Profile Request


NOTE: The patient must provide positive identification before a profile printout is
provided.
1. From the Patient card, go to Reports > Patient Profile Report.

This report will provide a list of all medications filled for the patient on the local system.
The patients name will populate automatically.

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2. Go to the Options tab to view the items you can include in the report.

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Print Store Logo


When enabled, the Patient Profile report will include the store logo.

Print Fax Confidentiality Clause


This telecopy is confidential and is intended to be received by the addressee only. If the reader
is not the intended recipient thereof, you are advised that any dissemination, distribution or
copying of this facsimile, is strictly prohibited.

Show Billing Info


This will show the billing information for the patient.

Show Drug Form


This will indicate whether the drug is a cap, tab, injection, etc.

Show Rx# and Fill Date


This will show the prescription number and date the prescription was filled.
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Show Patient DOB
This will include the patients date of birth.

Show Patient Gender


This will include the patients gender.

Include Cancelled Rxs


When enabled, this option will include any prescriptions that have been cancelled.

Include Unfilled Rxs


This will include any prescriptions that have the status of unfilled.

Include Inactive Rxs


This will include any prescriptions that have the status of inactive.

Print Expiry Date


This will include the expiry date of the prescription.

Print Expired Rxs (no refills)


This will include any prescriptions that have expired.

Print Expired Rxs with Refills


This will include any prescriptions that have expired that have refills.

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Drug Card
When you have a drug showing on the F5 Drug Screen, there are various PharmaNet requests
you can make for that drug. These requests are accessed from the Network menu on the Drug
Card.

The various PharmaNet requests that you can make for a particular drug is as follows:
1.
2.
3.
4.

Drug Search
Pat Info Long
Pat Counselling
Professional Counselling

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Drug Search
After selecting Drug Search from the Network menu option, you will be prompted for either
information on this drug or a list of generic equivalents.

1. Select Drug Information to view information for the specific drug.

2. Select Generic Equivalents to view the same drug information along with a list of generic
equivalents.

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Pat Info Long


1. Click Pat Info Long from the Network menu on the Drug Card. This will provide a full page
version of Patient Counselling from PharmaNet.

If desired, you can press the Print button or Ctrl + P on your keyboard to produce a hard copy
format for the patient.

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Pat Counselling
1. Click Pat Counselling from the Network menu on the Drug Card. This will provide a
condensed label size version of Patient Counselling.

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Professional Counselling
1. Click Professional Counselling from the Network menu on the Drug Card. This will provide a
condensed label sized version of Counselling messages directed to the pharmacist.

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Doctor Card
Doctor Card is one of the main tabs on the Patient screen where you have an option to search
for a doctor.

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Searching for a Doctor


1. From the F7 Doctor card, you can enter either a license number or any part of the surname,
a comma and then any part of the given name. If the local search does not return the
matching doctor, click the Search Network button.

Or, you can press the Insert button on the keyboard or click the Insert button and create
this doctor. Then from the Network menu, select Doctor Search. The PharmaNet Doctor
Search Form will open inserting the names entered in the original search or from the
doctor card.

In this form, you can edit your PharmaNet search criteria. The minimum requirements for
a PharmaNet Doctor Search are:
a. Entire Last Name
b. Doctor ID reference AND Doctor license (Doc ID) number

NOTE: If the Doc ID Ref and the Doc ID fields are entered, anything entered in the
name fields will be ignored.
PharmaNet will now be searched and all doctors matching the search criteria will be
displayed.

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NOTE: If there are too many matches found, an error message will appear asking
you to modify your search criteria with additional information and search again.
If more than one match was returned, use the up/down and Page Up/Page Down keys to
highlight the correct doctor and then press Enter to select.
The PharmaNet Doc Check Form will open. Each field will be shown comparing the
PharmaNet information with that of the local system. Beside each field is a checkbox, if you
do not to update your local system with a particular field, remove the check.

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Press Enter or click on the Update button to update your local system with this
information.

NOTE: If you did not already create the doctor on the local system, click the
Update button to create the doctor on your system.

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Non Prescription Medication / OTC


To fill OTCs or other medications when you do not have a prescription, create a Doctor card for
the Pharmacist. Ensure the designation is set to Pharmacist and enter your license number and
province.

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Prescription Filling
1. At the time of adjudication for the first Rx of a patient, the PharmNet profile will display
first.

2. After the profile screens have been dismissed, the Adjudication Response screen will
display indicating any pricing adjustments and patient pay amounts.

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If PharmaNet does not pay for this claim, you will see a message at the top of this screen
showing DUR Only The claim has been adjudicated to 0.
Any warnings and error messages will be shown next.

PLAN= The plan under which the claim is adjudicated


S/A= Y or N if special authority exists
EXP= Expiry date of the special authority, if one exists
DRUG= Accepted drug cost
ACC EXP= Accumulated expenditure for the family prior to this claim
RBP= Y or N if the drug was reduced to RBP pricing
LCA= Y or N if the drug was reduced to LCA pricing
BEN= Y or N if the drug is a benefit
RESTRICTION= Could be none, Patient or Pharmacy
FEE= Accepted dispensing fee

If there were any price adjustments depending on your systems configuration, you may be
prompted as to how to apply the differences.
3. After reviewing the responses, press Enter or click on the OK button to complete the Rx.

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Stock Transfers
1. When selling stock to another pharmacy or when returning narcotics to a supplier, create a
patient card for the other pharmacy or supplier without entering a PHN.

2. To fill a prescription, select Rx > Make Rx Stock Transfer.

3. Press F12 to fill the Rx, and go through the appropriate steps of your workflow without
adjudication.
You will notice the label has a watermark through it to indicate a stock transfer and the
status on the hardcopy also indicates it is a stock transfer. This status is also carried
through to the profile.
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Discontinuing (Inactivating) an Rx
You can discontinue an Rx on PharmaNet by using one of the two methods:
1. Discontinuing a Single Rx
2. Discontinuing Multiple Rxs

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Discontinuing a Single Rx
Bring up the Rx you would like to inactivate from the Patients Profile in modify. Select Rx >
Inactivate Rx.

1. Click Yes to ensure you are about to inactivate the correct Rx.

2. Next you will be presented with a PharmaNet Rx Discontinuation Form. Enter the
discontinuation date and complete the comment section (optional). From the Discontinue
Source dropdown menu, select Source, Doctor, Pharmacist, Patient, or DPIC.

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Discontinuing Multiple Rxs


1. Go to the Patients Profile and press the space bar to tag the Rxs you wish to inactivate.

2. Once each Rx is highlighted, press I on the keyboard to inactivate, and an inactivation


summary screen will appear. Here you will see the Rxs that are ok to inactivate.

3. Click the Inactivate Eligible Rxs button or Ctrl + I on your keyboard. You will be presented
with the discontinuation form. You will have the option to apply the same reasoning to all
items.

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NOTE: By selecting the checkbox Apply to all Items, you have the option to
apply the same reasoning to all items.

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Cancelling a Prescription
1. To cancel a prescription, use the Cancel function from either the Start Screen or the local
patient profile. You will be asked to select an intervention code to indicate why you are
reversing this Rx.

If you select RE Claim Reversed Data Entry Error, the Rx will no longer appear on the
patients PharmaNet Profile. Using any other intervention code will keep the prescription
on the PharmaNet profile showing a status of Reversed.

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Refusal to Fill
1. After the cancel has been completed above, select one of the following options:
a. Click OK option which completes the cancel process
b. Click R to select the Claim Refusal to Fill Fee

You will be asked to select an intervention code to indicate why you are refusing this fill;
typically this code should follow the same reasoning you chose for the reversal.

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A confirmation message will appear:

If you cancelled the prescription and forgot to claim the refusal to fill fee, you can still
claim a Refusal to Fill Fee. Bring up the Rx in modify, and then from the Rx menu select
Claim Refusal to Fill Fee.

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NOTE: This must be done on the same day as the cancel and Refusal to Fill Fees are
only allowed from the First fills.

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Batching Procedures for PharmaNet Down


1. If PharmaNet is down and you attempt to adjudicate a claim you will receive the following
screen:

Retry Claim attempt to adjudicate the Rx again


Back to the Rx returns you back to the filling screen
Send Later sends the Rx to the adjudication later giving you options of - Postpone all
adjudication and process other Rx steps, exit out of Rx complete later or cancel
Trouble send the Rx to the trouble queue to be finished later
Cancel Rx cancels the current prescription

2. If you want to send prescriptions later, select Workflow > Pending Adjudication.

You will be presented with the above Workflow screen, where you can manage the
Network Queue by selecting Send All or Send for Patients:

Send All will send for all patients in the pending network queue.
Send for Patient this will then only send for the current patient you have
highlighted

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Once the claims have completed, you will then be prompted to review the claims.

Once you have reviewed the claims you may then continue with your workflow process
as normal.

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Ontario Limited Use and Section 8

Ontario Limited Use and Section 8


Limited Use products are listed in the ODB CDI Formulary with specific clinical criteria or
conditions for use and will be reimbursed only when those conditions have been met. The
prescriber must include a "Reason for Use" code for the ODB recipient to qualify for the
coverage.
Limited Use reason codes are found in the drug card (F5). Below is an example of a drug that is
covered by ODB under Limited Use. To view the Limited Use codes simply click on View
Reason Codes

Limited Use Codes available for Celebrex 100mg:

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Adding LUP Drug to a Patient Profile


Limited Use numbers are stored at the patient level and they can be attached to a patient
without filling a prescription when presented with a LUP form from the patient. To add an LUP
code to a patient card simply do the following:
1. From the Patient Card (F3), locate the ribbon bar on the right side of the screen and click
View Limited Use Items.

2. The following screen will appear. Click Ins to add a new LUP.
3. Enter the DIN or press F2 to bring up the drug search screen and search for the drug. Click
on View Limited Use Reason Code to display and then select the appropriate Reason Code.

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4. Press OK to save.

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Filling a Prescription for an LUP Drug


To fill a prescription for an LUP drug for an ODB recipient, simply do the following:
1. Enter the prescription as you do normally. A question will appear at the filling screen
identifying the drug as an LUP status. Select the option: Bill to ODB with a Reason
Code. Alternately, for prescriptions that are covered by Section 8, simply select the
option Bill to ODB as a Section 8 Drug.

2. Select the appropriate LUP Code and then click OK.

NOTE: the Reason Code will appear on the F12 filling screen ready to submit to ODB.
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Limited Use Request Report


A Limited Use Request that can be printed and faxed to the Doctor if an ODB patient has
prescription for a drug that is covered by ODB under LUP and the Doctor did not indicated the
appropriate LUP code on the Rx.
To print the report:
1. Select Reports > Patient > Limited Use Request.

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2. Select the Patient, Doctor and Drug by pressing F2 on each field.
3. Click Print or Preview

A report like the following will print. Note the Patient Info, Doctor Info and Limited Use
Codes available for the physician to choose from.

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Ontario Narcotic Monitoring Program

Ontario Narcotic Monitoring Program


The Narcotics Monitoring System (NMS) will collect dispensing data from all dispensaries in
relation to all dispensed narcotics, controlled substances and other monitored drugs
dispensed to patients in Ontario, regardless of who pays for the prescription. The resulting
data will be reviewed and analyzed for a variety of purposes including, but not limited to
educational and public health purposes, reporting possible professional misconduct to
regulatory authorities and reporting possible criminal conduct to law enforcement agencies.
DUR functions will be limited to: double-doctoring, poly-pharmacy, refill too soon, refill too late
and duplicate drug other pharmacy response messages. In addition, when any of these
conditions are found, the NMS will return a message line which will provide the pharmacist
with the pharmacy phone number, date of service, DIN and quantity of the most recent
narcotic or controlled substance NMS submission which generated the response code.
Collectively, these informational messages will be referred to as NMS DUR messages.

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Monitored Drugs
A monitored drug is any drug that is a controlled substance as defined in the Controlled
Drugs and Substances Act (Canada) (CDSA), unless the controlled substance has been excluded
by the regulations under the Narcotics Safety and Awareness Act, 2010 and, in addition, any
other drug designated by the regulations. Under the Regulation, any opioid drug that is not
listed under the CDSA is a monitored drug and no substance under the CDSA has been exempt
for the purposes of the Act.
An updated list of Monitored Drugs can be found on the Ministry of Healths
web site:
http://www.health.gov.on.ca/en/pro/programs/drugs/monitored_productlist.as
px.
Kroll will provide updates to the list of monitored drugs as part of the standard Kroll Formulary
update.

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Drug Card
The checkbox labeled Narcotic Monitoring has been added to all Ontario Drug cards. This will
be updated automatically via the Kroll formulary update according to MOH released list which
can be found via the web:
http://www.health.gov.on.ca/en/pro/programs/drugs/monitored_productlist.aspx .
This field will be open so that the user can check or uncheck to modify if necessary. All the
drugs included in the list will be flagged through the formulary update provided by Kroll.

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Mixtures
For Mixtures, the ONNMS plan is added to the Rx if any component within the mixture is
flagged on the components drug card as narcotic monitored.

NOTE: If there is a pseudo din for ODB for a mixture the pseudo din must also be
entered under the plans tab for ONNMS. In all cases the pseudo DIN for ODB is also
the same for ONNMS

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Billing a Narcotic Monitored Drug


There are two scenarios when filling a prescription for a drug that is flagged as a narcotic
monitored drug. They are:
1. Patient has existing ODB coverage
2. Patient is not covered by ODB
If a patient does not have an existing ONNMS plan entry, Kroll will not allow you to proceed
any further until you add the appropriate plan.

Existing ODB Coverage


When filling (F12) a prescription for a patient that has an existing ODB number in the patients
profile and the drug is flagged as a Narcotic Monitoring Drug, the plan code ONNMS will
automatically be inserted in the patient plan information. In this case the ODB # and the
ONNMS# would be identical.

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NOTE: If a patients client ID is preceded by an S, this prefix will be filtered out


when the Rx is sent to the ONNMS. If the patients client ID is preceded by a C or
D it will have to be removed from the ONNMS plan entry. This can be done by
double clicking on the patients plan or highlighting the plan and pressing F2 on the
keyboard.

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Filling a Prescription with No Existing ODB Coverage or


ONNMS Plan Entry
When filling (F12) a prescription for a patient that does not have an ONNMS plan entry in the
patients profile and the drug is flagged as a Narcotic Monitoring Drug, the following message
will appear:

The patient in this example only has a cash plan. At this point the user must enter some form of
Health Identification from the drop-down list in the Patient ID Type field. The appropriate code
can be found by scrolling through the list. Add the patients health card number in the Patient
ID field. A plan entry for the ONNMS will be added to the patient card.

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NOTE: To avoid being prompted for the ONNMS plan entry, you can enter this
manually on the patient card prior to filling, if you have the required form of ID for
the patient. If this is not available then you must select the appropriate ID during the
Rx process which means (in this situation) the record cannot be added ahead of time.
You may need to scroll down the list to find IDs for the appropriate provinces and/or
plans. Since the plan entry is DUE only, it does not matter if the plan is set to primary
or secondary. The script will still log with the ONNMS.
The Card Holder Name field will automatically be populated with the option selected in the
plan id field.

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In Appendix 1, there is a chart which contains all the available provincial options within Kroll for
the Patient ID Type as provided by the Ministry of Health. At the prescription filling screen, all
the provincial options are made available and can be viewed by using the scroll bar if no plan
entry has previously been set. Once the appropriate option has been selected, the system will
then automatically populate the Cardholder Name field with the corresponding Patient ID
identity code. This information is contained in the patient plan information. If entering the plan
manually, once you select the correct Cardholder ID Type, you then enter the correct Card
Holder Name according to the format specified in the chart.

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All ONNMS Rxs will automatically populate the Claim Type DUE Only and the Special Services
Code 6 as required by ONNMS.

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This information may also be viewed by clicking on plan information under the View menu or
clicking View> Patient Plan Information:

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Reversals
The NMS will allow electronic submission of dispensing information (and reversals) up to 365
days from the date of service; however, the requirement is that submissions are done in realtime, at the time of dispensing.

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Responses from ONNMS


The response messages from the ONNMS will vary depending on how the Rx was filled. When a
claim has been successfully filled and logged with the ONNMS, a message reporting that the Rx
was logged will be displayed:

If a non-monitored DIN is submitted, the following response will be returned:

Below is an example of a warning message accepted by the ONNMS:

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Dentists and ONNMS


When you fill a narcotic Rx for a dentist, the license number must be 5 digits, preceded by the
letter D. If the number is not 5 digits long, simply add a zero to the beginning of the license
number along with the letter D. If the letter D does not work you have 4 other letters to choose
from: A, E, M or S.
Example: DXXXXX or D0XXX

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Drug Utilization Review Warning Response Codes


Receiving the following DUR warning message could indicate the possibility of overuse or
misuse. The pharmacist must evaluate the response code received and determine the
appropriate course of action.
The following DUR response codes could be received from the NMS:
D7 - Refill Too Soon
DE - Refill Too Late
MH - May be Double Doctoring
MI - Poly Pharmacy Use Indicated
MY - Duplicate Drug Other Pharmacy

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Future Dating
Future dating of Rxs is not permitted by the ONNMS.

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Back date Rxs


It is possible to back date and resubmit narcotic prescriptions. The pharmacy has up to 365 days
to back date and refill a script to ONNMS.

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Inquiry Functionality
An Rx with a status of Not Dispensed will not be reported to the ONNMS. To determine if a
prescription will be accepted by the ONNMS, the Rx would have to be filled and cancelled.
Inquiry functionality is not a utility supported in the ONNMS.

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Nursing Home
When batch filling for patients in a nursing home environment, prescriptions for ODB patients
will be processed in the same manner as regular narcotic ODB prescriptions; the ONNMS plan
will be added automatically to the patients profile. The first fill for a patient missing the
ONNMS plan entry will be halted as depicted in the screen shot below and require appropriate
intervention. This error can be prevented by adding an ONNMS plan entry manually to any NH
patient that does not have existing ODB coverage.

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Placing Monitored Rxs on Hold


In some cases, a monitored prescription may need to be unfilled or logged for a patient. All
patients who have a monitored drug that needs to be unfilled go through the process of
Unfilling the Rx as usual, however the monitored drug will be logged with the ONNMS. If the
patient does not have an existing ONNMS plan entry, you will be prompted to add the
appropriate health information as outlined when filling an Rx.

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Narcotic Rx Exceptions
Narcotic Rxs for Prisoners and Inmates
At this time, it is not required to submit Narcotic Rxs for prisoners and inmates of a correctional
facility. Candidates are people confined to:
A correctional institution
A penitentiary
A prison
A youth custody facility
They are not monitored and are exempt from the Act by the Regulation. Patients are identified
by the Nursing Home type specified on the nursing home card

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Monitored Rxs for In-patients of a Public Hospital


Monitored Rxs for in-patients of a public hospital are not required to be submitted to the NMS
when they are being treated while in the hospital. These types of Rxs are exempt from the Act
and are not monitored. However, the Act applies to out-patients of a public hospital, and inpatients of private hospitals or any other institution that is not a public hospital.

Monitored Rxs for Residents of Long-Term Care Homes


Patients within a Long-Term Care facility are subject to the rules of the Act when they are
prescribed and dispensed Rxs for monitored drugs.

Monitored Rxs for Animals


Monitored Rxs written and dispensed by veterinarians are not required to be submitted to the
NMS during the course of their practice. These types of Rxs are not monitored and the Act does
not apply to these types of prescriptions.

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Appendix 1: Cardholder IDs provided by the Ministry of Health


This is the complete list of plan IDs provided by the Ministry of Health. When filling a narcotic
prescription, when prompted you can use the scroll bar to view a complete list of these IDs

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Nova Scotia Prescription Monitoring Program

Nova Scotia Prescription Monitoring Program


The Nova Scotia Prescription Monitoring Program (NSPMP) is a government funded program
implemented to promote the appropriate use of narcotic and controlled medications and
furthermore to control and prevent the misuse and abuse of the same.
This section includes information about:

How the NSPMP works


Health card types and numbers
Methadone compounds
Long-term care facilities
Federal penitentiary inmates
Office use prescriptions (NSOU)
Seafaring ships
Stolen pad messaging (RUA)
Void messaging (RUC)
Filling a PMP prescription
Troubleshooting PMP scripts

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How the NSPMP Program Works


Data is collected from all prescriptions filled for monitored drugs. The new online system
allows information to be entered into the PMP system at the time of dispensing allowing
doctors and pharmacists to have access to real time data regarding patient use and prescribing.
As well, pharmacists are provided with messages when dispensing monitored drugs that are
intended to provide information to the pharmacist and promote communication. Pharmacists
are provided with information regarding patients medications that have been filled elsewhere
as well as messages confirming the validity of the prescription being filled.
NSPMP analyzes all the information on a monthly basis and in some cases will contact
prescribers for additional information. When there is a case of misuse or abuse NSPMP will
investigate the issue with prescribers and may involve law enforcement officials if need be.

NSPMP Guidelines
Prescribing of controlled drugs in Nova Scotia:

A monitored drug is designated as any drug that is a controlled drug pursuant to the
Controlled Drugs and Substances Act (Canada) and appears in the schedules to the
Controlled Drugs and Substances Act (Canada) as it is amended or any successor
legislation except testosterone, when dispensed as a compound and drugs listed in the
Schedule 1, Parts 1 and 2, of the Benzodiazepines and Other Targeted Substances
Regulations to the Controlled Drugs and Substances Act (Canada).

Monitored drugs must be written on a triplicate prescription pad, except as noted


below.

Prescribers are not permitted to share personalized prescription pads.

The new prescription pads contain a PMP ID pre-printed on the pads that correspond
with the individual prescriber. The old pads do not contain this information. The PMP
can supply a reference sheet to look up prescribers PMP IDs by license number if they
receive an old pad. Prescribers have been asked to stop using old pads.

Requirement to Register with NSPMP

Pharmacists and pharmacies are required, by the regulations and legislation, to be


registered with the NSPMP. If a pharmacist is not registered, he/she will be unable to
adjudicate claims within the on-line system.

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When a store changes ownership, opens, or moves to a new location, the NSPMP must
also be notified. Proper coverage has to be reassigned to the new profile for claims to
be adjudicated online.
Prescribers must be registered with the NSPMP to prescribe monitored drugs.

Prescribers are not permitted to share personalized prescription pads.

Prescriptions not currently monitored by the NSPMP:

Prescriptions written by Veterinarians are not monitored at this time.

Prescriptions for monitored drugs for long term care patients, as defined by the Homes
for Special Care Act, are not required to be written on a triplicate form they are to be
adjudicated and sent to PMP on-line using the process outlined below.

Prescriptions for Federal inmates are not required to be written on a triplicate they
are to be adjudicated and sent to PMP on-line using the process outlined below.

Prescriptions for an in-patient of a hospital, as defined by the Hospitals Act, are not
required to be written on a triplicate form. These are not monitored at this time.

Handling Part-Fills

Refills or partial fills of existing prescriptions (the yellow copy has been sent to PMP for
data entry) are not to be submitted to PMP on-line.

Please do not enter total quantity and total days supply on prescriptions that will have
future part-fills dispensed. Each part-fill is to be entered on-line as it is dispensed.

The first fill of a part-fill is received by NSPMP as "N" (new) and all of the following partfills are received as "R" (refill/part-fill).

Prescriptions Not Entered into the Online System

If a pharmacist is unable to submit a prescription on-line to the PMP, they may utilize
the back door functionality that the vendor has incorporated into the stores
software. Please refer to your vendors instructions.

If a prescription is not filled using on-line adjudication, the yellow copy must be
forwarded to the Nova Scotia Prescription Monitoring Program within 30 days.

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Health Card Types and Numbers


Prescribers have been asked to legibly record a valid health card number and date of birth on
each script as below:
Nova Scotia residents select NS and indicate the HCN
RCMP officer, select RCMP and indicate the RCMP ID #
Canadian Forces member, select CF and indicate the CF ID #
Out - of - province patient, select the province and the indicate the HCN
Out -of - country patient, select NSG / indicate Out Of Country
Office use prescription, select NSOU / indicate Office Use
The new PMP system is designed to validate health card numbers and types. The following
table provides the correct format for health card numbers in each province and for special
groups such as the RCMP:
Province

Health Care Number

Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland
Nova Scotia
Nunavat
NWT
Ontario
PEI
Quebec

9 Digits
10 Digits
9 Digits
9 Digits
12 Digits
10 Digits
9 Digits
1 Letter + 7 Digits
10 Digits
8 Digits
4 Letters + 8 Digits

Cardholder
Identity
AB
BC
MB
NB
NL
NS
NU
NT
ON
PE
QC

Saskatchewan
Yukon
Canadian Forces
RCMP
NSG
NSOU

9 Digits
9 Digits
1 Letter + 8 Digits
5 or 6 Digits
0011984275
0011984283

SK
YT
CF
RCMP
NSG
NSOU

Comments

Begins with a 9

First 3 letters of last name and


first letter of first name

For out of country


For office use

NOTE: Due to privacy restrictions the NSPMP does not collect DIAND numbers.

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Methadone Compounds
For methadone compounds, please use the following PINs:
Use the PIN that best corresponds with the patients TOTAL daily dose in Mg.
Indicate the QUANTITY as you enter it currently.
Indicate the DAYS SUPPLY as applicable:
Total Daily Dose (Mg)
< =100
101-200
201-300
301-400
401-500
501-600
601-700
701-800
801-900
>901

PIN
00994100
00994200
00994300
00994400
00994500
00994600
00994700
00994800
00994900
00994999

Compounding PINS
Select the PIN that best corresponds with the MONITORED DRUG in the compound.
Monitored Drug
Generic narcotic compound
Cannabis compound
Cocaine compound
Codeine phosphate compound
Dexedrine/placebo trial
Hydromorphone compound
Ketamine compound topical
Ketamine compound oral
Methadone 1mg/ml compound
Methadone 4mg/ml compound
Methadone 5mg/ml compound
Methadone 10mg/ml compound
Methylphenidate trials
Methylphenidate compound
Morphine hydrochloride compound
Morphine sulfate compound
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PIN
00994000
00994001
00994002
00905518
00903169
00994006
00903072
00994007
00994012
00994004
00994005
00999381
00903149
00994008
00994009
00999955
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Nova Scotia Prescription Monitoring Program

Nabilone compound
Pentobarbital USP compound
Phenobarbitone compound
DHEA (prasterone)

00994003
00903128
00994010
00994013

00994000 is available to use when there is no other suitable PIN available for a
compound that contains a monitored drug.
This PIN is to be used one time only - please notify the PMP when this PIN is used so
that an appropriate PIN can be obtained for future use.
00994012, 00994004, 00994005, and 00999381 are only to be used when filling office
use scripts for methadone clinics. These PINS CANNOT be used for patient fills
00994007 is to be used to differentiate between TOPICAL and ORAL Ketamine
compounds
Placebo drugs for clinical trials do not need to submitted on-line.

Double DINS
The computerized PMP system will electronically accept claims for two or more strengths of the
same drug, written on one PMP prescription pad number. The claims must be for the same
person and from the same prescriber. Each claim may be submitted as a new prescription.
Situations where this may occur include the following:
1. Drug strength written is not commercially available. E.g. A prescription written for MS
Contin 130mg would be filled with two different strengths of MS Contin
2. Ritalin trial prescriptions
The computerized PMP system will accept the first part-fill of a prescription as a new
prescription. Subsequent part-fills will be accepted as refills using the same PMP prescription
pad number.

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Long-Term Care Facilities


Prescriptions written for patients living in LTC facilities are not typically written on a triplicate
prescription pad but the PMP legislation does require that these scripts be submitted on-line to
the PMP Please note one change (PMP pad number) for this claim entry type:
Enter each patents provincial health card number
Patients Name, patients date of birth, patients gender
Enter the prescribers PMP ID (example: NS00000123)
In lieu of PMP pad number , enter LTC

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Federal Penitentiary Inmates


If your store works with federal penitentiaries, please note 3 significant claims entry changes
for this type of claim:
Enter patient type as NSG
HCN 0012124947 (generic health card number to be used for all FEDERAL inmates)
Patients Name, Patients DOB, Patients gender
Enter the prescribers PMP ID (example: NS00000123)
In lieu of PMP pad number, enter FEDP

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Nova Scotia Prescription Monitoring Program

Office Use Prescriptions (NSOU)


Prescriptions that are being filled for use in a clinic or prescribers office are to be entered as
follows:
Cardholder Identity: NS
HCN: 0011984283 (NSOU)
Days Supply: 999
DOB: 01/01/01 (or 01/01/2001)
Gender: U
Last name: CLINIC or OFFICE
First name: Clinics NAME or Prescribers Last name

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Seafaring Ships
Prescriptions that are filled for monitored drugs for a ships supply are to be filled as Office Use
(NSOU). Please populate the following fields as below:
Cardholder Identity: NS
HCN: 0011984283 (NSOU)
Days Supply: 999
DOB: 01/01/01
Gender: U
Last name: SHIP
First name: Ships name

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Nova Scotia Prescription Monitoring Program

Stolen Pad Messaging (RUA)


This message indicates that the prescription pad has been reported stolen by the prescriber and
the prescription cannot be filled.
A stolen message can only be set by the NSPMP.
The Prescription Monitoring Program and its Board of Directors believe that the safety
and health of pharmacists, store staff and customers should take priority in any
situation. No pharmacist should put themselves or others in harms way enforcing
program policy or procedures.
The customer does not need to be detained at the store if they present a stolen
prescription.
Pharmacist should rely on their professional judgment when dealing with a patient.

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Nova Scotia Prescription Monitoring Program

Void Messaging (RUC)


This message indicates that the prescription pad and the script numbers associated with that
pad have been inactivated; probably because the prescriber has moved out of province or
reported he has lost the prescription pads. Unless there are special circumstances the
pharmacist cannot fill the prescription.
Only the Prescription Monitoring Program can void a prescription and it cannot be
adjudicated.
Only the Prescription Monitoring Program can remove a Void message associated
with a prescription.
Pharmacists should always use their professional judgment when dealing with a
patient.
A voided prescription showing up at a pharmacy does not necessarily mean a fraud
has been committed.

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Filling a PMP Prescription


Enter your complete prescription as normal. When you have completed the data entry, the NS
triplicate Prompt will appear.

Fill in the Fields above from the script below:

NS PMP Triplicate #
An 8 digit ID number unique to each prescription
Patients Individual Health Care #
Doctor PMP #
A 10 Character number starting with NS.
**NB the NS must be capitalized for this to go through PMP**

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If you have escaped out of the form, or need to make changes, you can do so by going to the RX
menu, and at the bottom selecting View NS Triplicate PMP.

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Once completed, the triplicate information does the following:


Rx Adds the NS PMP Plan and Intervention codes of DUE for PMP

Patient Card:

Doctor Card adds the PMP Id to the Alternate License Number field:

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Successful Adjudication of your script will result in the following response from PMP:

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Troubleshooting PMP scripts


I keep getting a message back Prescriber Not Authorized and PMP rejects the script.
Check the Doctor Card
Is the PMP license # entered with a lower case ns?
Is the license # entered incorrectly? Do you have 10 Digits
Have you entered the PMP Script number instead of the Prescriber ID?

I have a narcotic mixture prescription that is not prompting me for the PMP info.
Check the Mixture Card. Have a look at the components for the mixture. Then check the
Drug Card for the actual component. Is the Triplicate flag enabled for this drug?

The prescriber has written for part fills. How do I do this?


On the filling screen, in the Qty dispensed field put in the quantity that you are actually
dispensing right now. In the Authorized Qty field, put the total quantity that the
physician has authorized for. Kroll will automatically send to PMP the correct
information about Original Scripts and Refills.

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The prescriber has specified a minimum interval for part fills. How can I make sure it doesnt
get filled early?
Go to the Rx Filling Screen. Go to the minimum interval field found down by the plans.
Fill this in with the interval as specified by the physician.
Kroll Hint: If I need to fill this script early, go into the script, take the min interval off,
fill my prescription and then re-add my min interval.

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Who to Call Phone List

Who to Call Phone List


If you encounter problems using Kroll, refer to the phone list below. Kroll offers specialized
support depending on the equipment involved.
Equipment
Workstations

Supported by
Kroll

Contact
866-285-4457

Printers

Kroll

866-285-4457

Fax Machines

Kroll

866-285-4457

IVR Servers

Kroll

866-285-4457

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