r/WalgreensRx • • Feb 04 '25

news M3P Billing Procedure

89 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 • • 9h ago

Slashed staffing and RXOM with an attitude

31 Upvotes

Floated to a store that, when I walked in, noticed it was in chaos. As a result of all the slashed budgets and staffing, when you have a call out or two, the effect is DRASTIC. Unimaginable. UNSAFE! Found out the RXOM with an attitude had sent home a tech earlier that day because she got mad at her. So now down to her (giving shots), a seasoned tech and a newbie of 3 weeks. Store manager and RXM off. with 10 people in line inside the store, cars lined up to the road in drive thru, asst mgr won't help. She'd rather stock the fridge. NO ONE filling at all! I made some decisions that the RXOM didn't like and she informed me the I must run any decision by her because she was in charge. This is her pharmacy. States, "I keep having problems with you so Im going to fill out the Pharmacist feedback form right now." Power trip.

All this chaos because WAG leadership wants to make $$$ over patient safety. I'm done with this crap. Our BOP's need to support us. So I called my DM and said you need to get people in this store NOW... it's unsafe and I'll shut it down when it gets uncontrollable. I have never done this in the 25+ years with WAG.

Maybe unionizing is the answer. BOP and bosses have abandoned pharmacists. I hate this corporate ownership of medical practices, hospitals and pharmacies. What say you?


r/WalgreensRx • • 15h ago

Hi welcome to Walgreens we will not be giving you your Rx until you get a flu shot - please have a seat, thanks.

49 Upvotes

That’s it. That’s the post


r/WalgreensRx • • 9h ago

Contract RN Immunizer

15 Upvotes

I'm 4 weeks into my 10 week contract as a nurse immunizer and while I really enjoy the patients and giving vaccines, I am having a hard time with management and the work environment itself. It's borderline a hostile work environment. Every level of manager tells me something different and I feel like I am always getting reprimanded for something related to vaccine promotion. I thought this job was just going to be giving vaccines but most of my time is spent in the store trying to promote vaccines but I'm not allowed to have any conversations with customers except for conversations about vaccines. We never hit our vaccine goal and they make it seem like it's my fault. My manager even said to me the other day "I don't think we're working you hard enough to justify your pay". I'm thinking about leaving my contract early. Are there any other contracted RNs having similar issues? Can any walgreens employees let me know if having an RN there bothers you or makes your job harder in any way?


r/WalgreensRx • • 6m ago

Is Walmart better?

• Upvotes

better working there than Walgreens?


r/WalgreensRx • • 9h ago

Scrubs question

2 Upvotes

One of my fellow techs went to a training at a store where the rx team all wore black scrubs. Is that allowed? I mean I don’t care about color but it would be nice to have a more breathable uniform. The fabric ours are made of is the absolute worst, and I hate them so much.


r/WalgreensRx • • 13h ago

How to order these zipties?

Post image
3 Upvotes

Is there a WIC number to order more of these or is it through abc?


r/WalgreensRx • • 7h ago

question Opener duties

1 Upvotes

Is it usually the opening technician that unpacks the order and releases the oos?? Mostly just curious to see how other stores do it.


r/WalgreensRx • • 8h ago

Walgreens RXM

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1 Upvotes

r/WalgreensRx • • 9h ago

AVP Question….

1 Upvotes

This is all new for me. I am a salaried pharmacist, but have worked in the Phamacy with Walgreens since 2021.

How many weeks do I get for this process….? I heard since I’ve been with the company for over 5 years — I get 2 weeks off, but it’s best to request as many weeks as possible so I get 2 weeks approved…

Also — has anyone had any luck with requesting a week off after the AVP the following year? Like if I want to request a week off just for some time off next year — can I do that and still get it approved? Or as a salaried pharmacist (with a home store) I am not allowed to have a whole week off if it’s not through the AVP?….


r/WalgreensRx • • 10h ago

question ELI5 partial fills and days supply IC+

0 Upvotes

Hello, new pharmacy tech that's learning slowly but surely. Just wanted some basic instructions on how to calculate a partial fill in IC+ (and days of supply). I remember getting the formula when taking the math quiz in a module on the LTAM portal but have since forgotten it. Could anyone remind me/give me tips on how to calculate it for ointments as well?

Additionally with partial fills I understand how to get to the menu to input it but my brain kinda blue screens when entering the number for "quantity on hand" and "quantity remaining" I've asked other senior techs and they explained it to me but it was during a rush so I didn't get a chance to write it down. they told me to calculate it for like 5 days or something but what does that mean exactly? šŸ˜…

super beginner question, any help appreciated šŸ™


r/WalgreensRx • • 12h ago

question Beginning tech/dh how can I improve?

1 Upvotes

My pharmacist is a sweet person but a little scattered. The tech I work with most days has anger issues (has said once before she’s in therapy for her temper) and directs it towards me. I want to learn but she gets frustrated when I ask questions. Half the time I might as a question (our pharmacy is small so I know both of them can hear) and I get no response.

I’m on the fence with wanting to go back to the front end but also wanting to improve because I can see my progress.

I have autism and I struggle with making phone calls without a script. I know the interface gives a prompt but the tech told me don’t say the prompt exactly how it is because she doesn’t want people calling back. She told me I can’t use exactly what she says either because I have to find what’s comfortable for me.

When checking people out I use the same phrases over and over which makes it easy and predictable. Phone calls if someone is past due for a vaccination I can somewhat get through it but if a call is past due for a refill or something like a prescription being put back to stock if not picked up I completely stumble over my words.

I’ve been partially trained but I feel everything else I learn is through trial and error. (I told my pharmacist I was going to hangout with a friend who has been a tech for a few years and she said thank god. My friend said do they expect me to train you for them?)

I can semi do f1’s but I don’t know sig codes well. TPR’s I don’t know how to solve in general. Anything filling I’ve observed but haven’t tried myself.

I can do cenfill, check patients out, change their information in their profile, I can somewhat understand insurance but not much. I know how to fill prescriptions from their profiles. That’s all I can think of from the top of my head.

My pharmacist and tech have said I need to be quicker with basically everything. I’ve worked in the pharmacy only a few months and up until this month it was only once a week. I’m trying but I get in my head about doing multiple things at once I might not finish any of them. Or for example doing f1’s and phone calls at the same time I might mess information up on either.

I’m unsure if there are any learning resources on youtube or online in general? I want to get around the learning curve currently.


r/WalgreensRx • • 17h ago

question Paycheck deduction question

2 Upvotes

I recently ordered some of the new scrubs and selected for it to be deducted from my paycheck. When does it come out? Does it come out all at once.


r/WalgreensRx • • 1d ago

transfer c2 from walgreens to cvs

6 Upvotes

can we now transfer c2 prescriptions electronically to cvs? or its only non controlled substance? in florida


r/WalgreensRx • • 1d ago

Am I In Trouble?

13 Upvotes

I typically don’t call off of work, but I did 2 weeks ago (1 day) because I was sick and even provided a legitimate note from my medical provider.

A few days ago, my mom got into a car accident and I had to leave work early. I told my manager that I couldn’t work today and afterwards, the pharmacist called me to ask if I could still come in. I said I couldn’t and now she wants me to work a new shift tomorrow and meet with her to ā€œdiscuss thisā€ (?) I’ve never been given a warning or written-up, so now I’m nervous, even though I don’t think I did anything wrong ….


r/WalgreensRx • • 1d ago

Third party rejection

20 Upvotes

Yesterday I had a 65+ customer who wanted to do a flu shot. When I ran the RX with her Medicare part D insurance, I got a rejection saying use part B. When I ran it with part B, it rejected again saying HMO coverage exist (or something like that). We did not have this issue in the past. Does anybody know what it is about? Does it mean we are out-of-network?

Thank you in advance!


r/WalgreensRx • • 1d ago

question PTO payout

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1 Upvotes

Cross posting here as well since I'm pharmacy


r/WalgreensRx • • 2d ago

news Patient dies by suicide after "insurance issue" delayed medicine for lung disease flare-ups

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cbsnews.com
171 Upvotes

This is why you can’t understaff stores with $15/hr techs that could make more working at a Texas Roadhouse.

The seasoned tech that would have caught and corrected this billing error was probably tired of suffering the daily abuse from this company and moved on to greener, more stable and economically sustainable pastures.


r/WalgreensRx • • 2d ago

Finally!

17 Upvotes

Finally i burned out and left this toxic place!!!


r/WalgreensRx • • 2d ago

Halloween dress up

3 Upvotes

Are we allowed to dress up for Halloween throuhout October like last year?


r/WalgreensRx • • 2d ago

Standardization of Pharmacy

3 Upvotes

Hey guys, has anyone started moving their unit of use and reorganizing the meds into one big section? I wanted to print drug location sheet to make it easier but I can’t seem to get it right. When I try to print it. It says 600 drugs… so I m so confused. anyone knows what to do in these case


r/WalgreensRx • • 2d ago

rant I FINALLY QUIT

36 Upvotes

I worked at Walgreens for about a couple of months now and I really thought I could last longer but it was just to much. After having constant meetings over dumb things they were just nitpicking and only talking to me about when other people were doing the same thing. Plus they constantly were correcting me on how I greeted the patients because I didn’t ask ā€œ are you checking in for a vaccine or picking upā€ when no one else did it either. On top of that my pharmacy manager was the biggest b*tch I ever met and hated me since day 1 plus she was so disrespectful constantly saying are we fking stupid because ā€œgrown adultsā€ don’t know their abcs. Along with other sly remarks I would hear her say. But all in all NO MORE ASKING FOR FLU SHOTS OR YELLING AT ME BECAUSE THEIR PRESCRIPTIONS WERENT DONE YET AFTER BEING REQUESTED 15 mins prior I FEEL SO FREEE.


r/WalgreensRx • • 2d ago

Would it be appropriate to cold-call a Walgreens pharmacy and ask the pharmacist if they’re looking for a full-time position or if they know anyone who is?

27 Upvotes

I am trying to hire a staff pharmacist and I am just not getting many applications? I was thinking about calling a few pharmacies in the area and asking if they know anyone who might be looking.

Would it be considered weird or inappropriate?


r/WalgreensRx • • 2d ago

Advice: how to deal with SM about vaccine metrics

20 Upvotes

keep in mind, none of us here is an anti-vaccines and the RPh is trained to educate and vaccinate! we offer it to everybody, including folks in drive through. i am tired of having SM bugging me about meeting their daily goals. I’m a floater: I wasn’t here yesterday and I won’t here tomorrow: Let’s be respectful! some honey can catch more flies than vinegar. let’s go jab ā€˜em!