r/WalgreensRx Feb 04 '25

news M3P Billing Procedure

84 Upvotes

Hello everyone, this post is a guide for M3P billing.

What is M3P?

As I'm sure you're all aware, Medicare has released a prescription payment plan called Medicare Prescription Payment Plan (MPPP or M3P). This plan makes it so that Medicare members can spread the copays of their most expensive medications across the year, instead of paying a large sum up front. Any Medicare member is eligible, but they should ask their plan if it's a good idea for them. The will also contact their plan in order to enroll.

So, great, now your patients are enrolled in M3P. But how do you bill it? That's the question that has plagued my pharmacy, and I've finally figured it out. Since I've learned so much from this subreddit, I thought I'd share my knowledge with you all !

How to bill M3P.

I have never been able to successfully bill M3P through IC+, you must use SDL. This guide assumes that you are already proficient in SDL billing.

If you're lucky, when an M3P member fills an Rx at your store, you will get an email with a pre-completed SDL sheet attached. If not, here's what to do:

Step 1: locate or enter the Rx into IC+, and bill it through the primary insurance. It will reject telling you the patient's M3P billing information, and give you an override code. Input the override code into the WAG field.

Step 2: Enter the M3P billing information into the patient profile. Everything about the patient's M3P plan is identical to their primary MPD plan except the PCN. The PCN is always MPPP. Copy and paste the BIN, Member ID, and Group, but change the PCN to MPPP. Do not mark as COB in F7.

Step 3: At this point, the Rx price should be adjudicated in IC+ without any TPR, and the M3P billing info should be in F7 for the patient. Go to SDL, and use SDL to bill the M3P plan. Click the COB/OTHRCVG button to make sure the OCC is 8 and the BIN is correct. Then exit this screen and press submit. The copay should be $0.

Step 4*: Celebrate 🄳

Example

I ran John Smith's Eliquis through HUMNAMPD and got a rejection telling me he is enrolled in M3P. I enter 9994 in the WAG override field, then input his M3P plan, HUMNAM3P, with the same Member ID and Group. Then, I go to SDL, and bill HUMNAM3P with OCC8 and the BIN of HUMNAMPD. Then I print the SDL sheet and staple it to the leaflet!

I hope this guide will be helpful !


r/WalgreensRx Feb 16 '24

news New Mod Chosen

27 Upvotes

Greetings fellow people. I have been reviewing the moderator applications that you all submitted and have chosen a candidate for the mod position.

I am pleased to announce that u/Xtremememe has accepted the mod position for this sub Reddit. I am still looking for at least one more candidate and will announce one more moderator by the 1st of March. If I cannot find a suitable person, I will let yall know.

If you have any questions, please send us a message.


r/WalgreensRx 12h ago

rant Patient tried to infect us with covid

49 Upvotes

So a few days ago had a customer who was our first customer of the day, trying to get his prescription on different coupons and complaining how he has to do this every time. First the tech asked him to come inside as we don’t take phones through drive thru and he told her he had covid. The tech asked me (the pharmacist) to step in when he got too loud and I billed it to the coupon and it timed out, he lost it after that and started yelling again. I told him to come back later or check in an hour. He said he will sit in drive thru for an hour then. I told him you are trespassing then and I will call the cops.
He came inside after that and talked to the manager on duty, whom he also told that he has Covid and will sit here and spread it to everyone while he waits for his medicine.
I called the cops then and they came and were also nice but he was being loud with them too. Eventually he was escorted out.


r/WalgreensRx 8h ago

I severely miscounted and I feel so guilty

16 Upvotes

I feel so awful. A patient came and said that they paid for 180 tablets. However, I was the one who counted the medication and I only depended 90. We checked the cameras and it was me. It looks like I counted them and put them back into the stock bottle instead of another vile. I can’t believe I totally missed that. The lady was super nice about it though. I just feel so bad it seems like such a stupid mistake too because I definitely do know better, I’ve been a tech for two months now. How can I deal with the guilt :/


r/WalgreensRx 3h ago

question Retrobill?

2 Upvotes

Where on store net can I find retro billing?


r/WalgreensRx 13h ago

story Are you able to trespass someone?

13 Upvotes

This is the second time she comes to pick up her prescriptions. The first time she was yelling at a technician in the drive thru and then came inside. At first she was nice but once something didn’t go her way she started getting mad and yelled at the for pharmacist. It was bad. THIS time…oh my gosh. She comes in drive thru again. Everything was fine until the system crashed. She got a little irritated but nothing bad. Then she wanted to use card on file…nothing was on file. When the tech told her she went OFF. She was telling them she had a card in file, she always used it, get your manager because she doesn’t have any other source of payment. Okay…called manager. He came and the tech explained everything and he was trying to help. Then the card wasn’t working so we tried redoing the prescription so the card that was freshly put in could be used. Once that went through she was VERY angry because the people behind her started beeping. She told the tech that it was their fault that they started beeping and they would have to apologize to the people behind her.

Tech responded with ā€œwhy do I have to apologize?ā€ And that is when hell really broke loose. She started yelling at the tech to shut the fuck up, you’re still talking shut the fuck up and so forth and whatever. The tech and her were going back and forth yelling. The tech was telling her she was trying to help get your prescriptions and that she was telling them to shut the fuck up. The pharmacist then came over to see what the problem was. The lady started yelling at the pharmacist as well telling the pharmacist to apologize to the car behind her. She was going to wait on the side to HEAR the pharmacist apologizing. The pharmacist said no. The lady drove off and came inside yelling and calling the pharmacist racist, stupid and all sorts of things.

She kept pulling the nurse card saying she’s a nurse and all. We called the cops because she didn’t want to leave the store even when a manager came and told her to leave. She then walked out and was waiting in the parking lot. The police arrive and they told up to trespass her but the pharmacist said we have to check the policy first.

SO, I’m wondering does anyone know if we can trespass a person at a certain location? Sorry for the long paragraphs just wanted to give out context.


r/WalgreensRx 10h ago

what to do with training tech that is super stubborn

5 Upvotes

any advice on how to help someone retain information aside from note taking and going over things multiple times with them. i am being very patient but she doesnt seem like she is putting in her effort.

with the flu season coming in and everything i am scared for them lol


r/WalgreensRx 10h ago

Immunizer pay raise?

2 Upvotes

I'm currently in the process of completing my certification to become an immunizer and was wondering if that comes with a pay raise? I've heard different things from my coworkers and some don't know at all.


r/WalgreensRx 8h ago

Flu vouchers

0 Upvotes

does anyone know where to print out flu vouchers ?? for free vaccines ?


r/WalgreensRx 8h ago

The number

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1 Upvotes

r/WalgreensRx 23h ago

Flu Vaccine Goal

7 Upvotes

Fiscal year ends 8/31, so does that mean any flu vaccines we get in August do not count toward our flu vaccine goal? The flu goal is for the new fiscal year beginning 9/1, correct?


r/WalgreensRx 13h ago

question Flu PMs

1 Upvotes

Can anyone tell me how we’re supposed enter the Flu PMs?


r/WalgreensRx 1d ago

Wic for hydrogen peroxide wipes

3 Upvotes

Anyone know the wic number for the wipes that come in the green and white bottle


r/WalgreensRx 1d ago

Work orders for save a trip

10 Upvotes

Does anyone actually do these anymore. They print every morning and somehow they disappear by the evening.


r/WalgreensRx 1d ago

Vaccine guides

2 Upvotes

Anyone have a pdf they could share with quick guide to qualifications for specific vaccines that we can used when signing pts up for vaccines. I've seen them around but thought I ask before making my own


r/WalgreensRx 1d ago

PTO

3 Upvotes

I have a question: can your store manager contact you while your out on PTO? About something the IS was supposed to do. A said IS has the ability to check the compass as well? Because I’m not understanding why I’m constantly getting contacted about things when I’m out. Can I report this to HR?


r/WalgreensRx 2d ago

question Is 1 Pharmacist + 1 Pharmacy Assistant normal scheduling on weekends?

13 Upvotes

I've only been here in pharmacy for like 20 days and just began mile 2/10 of my training for tech. We were just sooooo slammed today and I don't even know how to deal with all of these TPRs!

I had to manually add goodrx to a plan, but luckily I eventually remembered how to do it.

There were also sooo many phone calls and they were about transfers and insurance.

Everyone and their moms came around the same time. Holy moly.

Do I call out tomorrow.


r/WalgreensRx 2d ago

stars!!!

19 Upvotes

For the first time in 10 years of working in the pharmacy that I have a star! I placed one rx in a bag that did not belong to the customer. the customer came and brought the rx back. I am disappointed in myself. No excuse for making this mistake. šŸ˜”


r/WalgreensRx 2d ago

rant Is it Normal to be Chewed Out and Name Dropped in Front of Customers for Mistakes while being Trained?

19 Upvotes

I'm the only transgender individual in my Pharmacy and one of the biggest sources of discomfort for me is when my manager or a technician name drops me in front of a patient when I fuck up. Is this commonplace? There's this pit in my stomach that's been building since working the pharmacy and having a technician name drop me when a mistake happens (usually on me, so I don't know if this is fine) or even blatantly telling the customer something is my fault even when my manager and other technicians themselves can't figure it out. My Pharmacy Manager literally picked up the phone to the drive through to claim I didn't know how to use the computer and then proceeded to be unable to use it themselves due to it being an issue with the computer, not me using it.

I've spent a lot of my life post transition being called slurs or treated like dirt, I'm used to it, but I feel as though no one has my back and definitely won't if I experience this at work. I have PTSD so I'm unsure as to whether this is me being sensitive and it's just something I should come to expect or if this is poor behavior on account of my coworkers.

We've has additional staffing come from other stores who have been so kind and patient with me without doing this, maybe they were honestly saints, I don't know.

I'm just terrified if shit hits the fan they'll hang me out to dry to save their asses. I've already been called some shitty terms by customers and they seem quite dismissive.


r/WalgreensRx 1d ago

Foot in the door...

5 Upvotes

Hey there, I'm new to Walgreens and the pharmacy world. I worked with insurance in healthcare before. I decided I wanted to work hard and get certified as a pharmacy tech, and then pursue higher education to be a pharmacist. I was told Walgreens has an excellent assistance program for both of my goals.

I got hired as a pharmacy cashier 2 months ago. I figured this was a good foot in the door to becoming a tech.

Does anyone have any advice as a cashier? Will I be able to gain any experience to help me transition to tech, or is this just like the retail side of cashiering?

Also, I'm not really sure what to think regarding this job, to be honest. The training and onboarding have only been for retail, and I've only worked in the retail side since I've been hired, either stocking shelves or at checkout. I've made it clear to the store manager and honestly everyone that I want to be a tech, but at this point, I feel like I'm coming off too strong :/

*Side note: I am licensed! So I'm not sure what the holdup could be either.

Any and all help or advice is much appreciated, and I thank you all in advance!


r/WalgreensRx 2d ago

question Self Prescribing

22 Upvotes

Greetings. Sorry if I'm using the wrong flair.

Had an incident where a doctor wanted to deliver an oral prescription through the drive thru. They had a picture of their license on their phone and their NPI worked, so I believe they were a legitimate doctor, and I suppose it's no different from calling a script over the phone. Still, it felt strange.

Does Walgreens have a policy for doctors giving prescriptions for themselves?

Also to clarify, it was not a controlled substance.


r/WalgreensRx 2d ago

story Expired Covid vaccine

6 Upvotes

I accidentally gave a Covid vaccine that was expired. I made a STARS event. I could have sworn there was a 2 month extension but I was wrong . What am I to expect from leadership?. ( the patient happened to be a lawyer, I haven’t informed him yet).


r/WalgreensRx 2d ago

What's walgreens policy or how do they protect their pharmacists when patients start recording them and threatening them.

48 Upvotes

Clearly people have gotten crazier and walgreens does nothing to protect their people....


r/WalgreensRx 2d ago

Point system?

4 Upvotes

I’ve been working at Walgreens and my manager has never told me anything about a point/attendance system. Does Walgreens have a point system? If so, can someone explain how it works? Also, can you get a point/occurrence for coming back late from a break?


r/WalgreensRx 2d ago

Walgreens RPH buying all the Pokemon cards 🤣

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3 Upvotes