2019 Pharmacy Preferred Newsletter

This newsletter covers recent updates from Pharmacy partners and billing/coding for prescription drugs.

Providers: Update NPPES Taxonomy

On May 20, 2019 Express Scripts will be implementing additional enhanced prescriptive authority logic for prescribers of CHPW Medicare and Medicaid patients. This additional logic will validate the prescriber has the appropriate authority to prescribe controlled substances, based on WA state prescriptive authority rules and the prescriber’s taxonomy in the National Plan and Provider Enumeration System (NPPES). Prescriptions will reject if the prescriber does not meet criteria determine by WA state law. An override will be made available if the pharmacist has validated the prescriber has prescriptive authority.

All the applicable taxonomy codes based on the National Uniform Claim Committee will be grouped within the following license types for the state prescriptive authority validation:
• Clinical Nurse Specialist (CNS)
• Medical Psychologist (MP)
• Naturopathic Doctor (ND)
• Nurse Midwife (NM)
• Nurse Practitioner (NP)
• Doctor of Optometry (OD)
• Physician Assistant (PA)
• Pharmacist (RPh)

To reduce potential rejections, providers should takeproactive steps to ensure selection of the correct taxonomy code on the NPPES website located here: https://nppes.cms.hhs.gov


Arcadia for Medication Measures

Did you know Arcadia is a powerful data integration tool to help clinics support Quality Improvement, Revenue Improvement, and Cost Management?

Did you know Arcadia augments the data in your clinic E.H.R. by adding claims and eligibility data from CHPW?

Did you know Arcadia can be used to generate medication reports such as:
• Examining Harmful Drug-Drug Interactions
• Filtering and Identifying Population Specific
Medication Management Opportunities such as Antidepressant Adherence in Spanish Speaking Patients
• Tracking Unfilled Prescriptions

Did you know it is easy to obtain an Arcadia user account if you do not have one? You will need to request access to Arcadia through your Clinic’s IT Administrator. You will first need One Health Port Access which is also set up by your site administrator.

CHPW’s Clinical Data Integration and Operations team is ready to support questions at CDI&O@chpw.org. The team is also available for onsite training and has a number of resources available. We are grateful for your feedback and suggestions.

Read updates about our pharmacy network.

DID YOU KNOW...?

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Doctors in an emergency room with patient,What kind of care do you need? Not every medical issue needs emergency care. If you have a medical issue that doesn’t seem to be life-threatening, but you’re not sure what to do, you can call our Nurse Advice Line for help. They can help you decide if you should see a primary or urgent care doctor. The Nurse Advice Line is free and available 24/7 for members at 1-866-418-2920 (TTY Relay: 7-1-1).

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