Understanding the Prescription Filling Process Between Doctors & Pharmacies

How Do Prescriptions Get Filled Between Doctors and Pharmacies – Overview

We often wonder how our prescriptions are filled, especially when there’s a delay in getting our medicines. It is helpful to understand how prescriptions are filled between doctors and pharmacies. There are several steps in the process of filling prescriptions. These include the necessary evaluation, verification, and maintaining a record, among other vital stages.

Here are the stages that go into filling out prescriptions – from the moment your doctor writes it to when you receive your prescribed medications from the pharmacy.

Step 1 – The Doctor Sends a Prescription to the Pharmacy

How do Prescriptions get Filled between Doctors and Pharmacies – The stages that go into filling out prescriptions

Today, most prescriptions are sent electronically by the doctor to the pharmacy, which is considered the safest and most efficient method. In certain circumstances, prescriptions can also be transmitted via fax or telephone or provided as hard copies directly by the patient. Electronic prescribing is mandatory in some states for all prescriptions, including controlled substances, to enhance safety and reduce prescription errors.

Once the pharmacy receives a prescription from your doctor, it takes measures to verify and ascertain its authenticity. Often, the prescription can be invalid or fraudulent, or some parts may need clarification. In such cases, resolving the issue takes the pharmacist some time.

Pharmacists prefer electronic prescriptions because they are safer and easier to read than handwritten prescriptions. It decreases the risk of fraud and ensures prompt service. In some states, like New York, prescribers (doctors) must send prescriptions to pharmacists using only electronic means.

Step 2 – The Pharmacist Records the Prescription

Any time a pharmacist receives a prescription, regardless of the method, they must enter the prescription details into their computer records. The pharmacist, pharmacist technician or pharmacist intern does this data entry step.

In this record, pharmacists must accurately enter the correct drug name with corresponding strength, clear directions for use, precisely calculated days and quantity supply, select the correct prescriber, and triage the billing information.

The data entry stage is also effective in detecting any missing or conflicting information on the prescription. In such cases, the pharmacist will contact the prescribing doctor for clarification.

Such situations also tend to delay other prescriptions at times.

Step 3 – Pharmacist Checks Billing Information

This step is integral to the prescription filling process and occurs after the medication details have been entered into the pharmacy’s computer system. The pharmacy staff member will process the billing, either through the patient’s insurance plan, a discount program, or determine the cash price. This step can be time-consuming, especially if it involves verifying insurance coverage for new patients or dealing with insurance rejections and prior authorizations. Next, the pharmacist or staff member must either bill the prescription to your insurance plan or a discount savings card or sometimes fill out its cash price.

Though prescription coverage for insurance is convenient, it is often the cause of delays in filling a prescription. The pharmacist and the patient find it one of the toughest parts of filling a prescription.

The pharmacist must first identify the patient’s insurance plan to do this. This step takes longer if the insurance plan needs to be identified for first-time patients. It helps if the patient contacts the pharmacy directly to update insurance information.

Once the correct insurance plan is determined and selected for the patient’s profile, the pharmacist will immediately know if the insurance plan covers the prescribed medication and at what cost.

On the other hand, the pharmacy team member also learns if the patient’s insurance plan does not cover the cost of the prescribed medicine. In such cases, the pharmacist will inform the patient and contact the doctor to prescribe an alternative medicine. The pharmacist can also check if you, the patient, are eligible for a discount card.

Step 4 – Pharmacist Checks Prescription Details

Pharmacists must be highly diligent and double-check the prescription details entered into their computer records. This step also requires them to double-check the patient’s insurance information in the records.

The pharmacist will assess a patient’s clinical status using their knowledge of medicinal drugs. They will analyze and compare the latest prescription to the patient’s profile. This allows them to evaluate whether the prescribed medicines are safe and effective for the patient’s use.

Once the pharmacist determines that the prescribed medicines are appropriate for the patient, the prescription is released for filling.

Step 5 – The Pharmacist Sends the Prescription to be Filled

The prescription filling task is typically assigned to a pharmacy technician or intern under the pharmacist’s supervision. Pharmacies manage a significant volume of prescriptions, with larger pharmacies filling thousands weekly while smaller ones may fill hundreds. The process involves accurately dispensing the medication as per the prescription, which can be delayed by factors such as high prescription volume, staffing levels, and medication availability. Pharmacies usually have long lines of medicines to fill. Hence, the pharmacist measures their prescription volume by the number of prescriptions filled weekly. A large pharmacy can fill thousands of prescriptions per week, while a smaller pharmacy may be able to fill several hundred prescriptions a week.

Usually, there are delays in filling prescriptions at pharmacies with a higher volume, as every prescription needs to be carefully filled physically by the technician or intern. Delays in filling your prescription can often be caused due to staff shortages at the pharmacy or limited time.

Sometimes, the prescribed medicine may be out of stock or insufficient to fill the entire prescription, which also causes significant delays.

Step 6 – The Pharmacist Verifies the Prescription

In this critical step, the pharmacist conducts a final verification of the prescription before it’s dispensed. They ensure that the medication is correctly prepared with the accurate strength, dosage form, and quantity and properly labeled. This quality control measure is vital for patient safety and is designed to catch any discrepancies or errors before the medication is provided. Often, pharmacies with high volumes of prescriptions may mislabel a bottle or fill the wrong medicine or strength. This step is necessary to catch and correct such errors and ensure that the patient receives the prescribed medicine.

Step 7 – The Pharmacist Sends Medicine to the Patient

Once the pharmacist has double-checked the medicines, they are given to the patient through direct pick-up, drive-thru or delivery, depending on the pharmacy. This step is the quickest but can get slowed down if the patient asks for the prescription to be re-billed to a different insurance plan or another discount saving card. In such cases, the pharmacist must repeat steps 3 and 6.

Conclusion

Pharmacists usually have to perform all the steps detailed regularly while answering numerous calls, attending to patients at the counter, and completing several other pharmacy-related tasks. So, it is important to have patience in case your prescription gets slightly delayed to be filled.

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What is the Prescription Filling Process Between Doctors & Pharmacies