1. Positive Solutions
Serial Prescribing

2. Topics Processing a new Prescription Claiming Subsequent Iterations
The CMS Timeline
Final Iteration, Treatment Summary Reports and New Scripts
PRN’s and Medication Not Required
Returning Issued Items
Interruptions to a CMS Schedule
Cancelling and Amending Claims
Missing Electronic Messages

3. Processing a New Prescription

4. Requesting the serial script
A serial script can be requested by either scanning the barcode on the Scripts Q
or keying the barcode from the AMS/CMS Script Token Entry CtrL-T option
When the script has been retrieved the hourglass becomes a blue arrow.
To dispense select the script and click Expand

5. The Master script
The Master Script is then displayed and the Dispensing Schedule created
Master Script – see next slide

6. The Master script cont’d
System calculates the quantities based on:
Total quantity prescribed
Dispensing Frequency
c. Term
An indications is given as to how many iterations have been dispensed. As this is the original dispensing it shows as 1.
New screen for CMS dispensing
E-script on left, note the iteration count
System creates schedule based on a. b. and c.
Scroll up and down to view all of the drugs.

7. The Master script cont’d
It is possible to change the schedule specified by the prescriber. If major changes are required the script should be returned and replaced.
Best not to change the figures, as no check by system that calculations are accurate
Main reason may need to amend are for ‘When required’ where GP hasn’t given the required quantities for the iterations
Select either the Edit schedule link or Schedule button.,
This should not be necessary in the majority of cases.
Click Close once you are ready to dispense

8. Dispensing Schedule
If you select to edit you can amend the quantity to be dispensed and the frequency
Enter the quantity to be dispensed and the frequency
Best not to change the figures, as no check by system that calculations are accurate
Main reason may need to amend are for ‘When required’ where GP hasn’t given the required quantities for the iterations
Click Reset if you want to return to the original schedule
Click OK once you are happy with the changes

9. Labelling Having selected Expand dispense as normal
Dispensing proceeds as normal
Consider the quantity as defaults from prescribing

10. Endorsements
All necessary Endorsements must be included electronically. From the dispensing screen select the item to be endorsed
Endorsing Pane will display the endorsement for the highlighted item
Select Endorse and amend as required

11. Additional Endorsements
CMS relies on electronic claims/No paper endorsing
Do all staff who label know how to electronically endorse?
How will they handle Special prices/Short supply etc. e.g. holding claim until invoice received
MOST IMPORTANTLY
CMS relies completely on the electronic claim for payment purposes.
You MUST ensure that all endorsements including, if appropriate, any additional are entered via the Endorse button for each item

12. Parking a script Scanned scripts will remain on Script Q.
If required use Recall to view previous date.
New Scripts will not appear on CMS Prescriptions screen until after Expand has been selected. N.B.You do not need to dispense to see them.
Prompt re possible changes and option to discard and re-request script will be displayed when you select
Expand
If it’s a new CMS script and e.g. the patient collected a previous AMS script yesterday. Select Expand, then End. This will now show on CMS Prescription Request and you can Sync the due date

13. CMS Script Q Icons
The Blue arrow indicates the item is ready to dispense
Alternative icons could be :

14. Claiming

15. Claiming
All claims for CMS are electronic and must be submitted manually. As scripts are dispensed they are added to the CMS Dispensing Claims Screen to be submitted.
Items MUST be marked as collected before claims can be submitted
A claim is submitted for each collected item after every dispensing
At the point that you send a claim an electronic Item Collected Notification is sent to the GP practice and automatically files in the patient record.
It is therefore important that you send the claim on the day the medicine is collected/delivered to the patient and NOT the day of labelling.
GP notification sent when send claim.
Don’t claim at end of labelling process!!

16. Claiming cont’d
Before you submit a claim it must be “Collected”. Items can be marked as “Collected” by either:
Selecting the items on the Script Q then select CtrL-C (Collect Medication) from the Misc menu OR
Scan out bar-coded bag labels at point of collection, (*configurable option)
* When the bar-coded bag labels option is enabled an extra column will appear on the left of the Script Q

17. The CMS Dispensing Claims screen
CMS Dispensing claims are accessed by either:
Ctrl-L option from the MISC Menu
or CMS Claim

18. The CMS Dispensing Claims screen cont’d
A filter dialogue box is then displayed
By default it will show the last 28 days dispensing activity. If required you can alter the Dispensed on or after date to view a particular medication.
Process for sending claims e.g. consider storing CMS scripts separately when handed out to patient and then submitting claims at set point during day

19. The CMS Dispensing Claims screen cont’d
Alternatively by selecting the bottom section you can select to view Submitted Claims for a specific period by status/type

20. The CMS Dispensing Claims screen cont’d
Submit a claim for each collected item
Claim Status Icon
(See next slides for descriptions)
Select the item or items to be claimed then Submit
Claims can now be amended anytime following submission

21. Claim Status Icons

22. Claim Status Icons cont’d

23. Holding Claims
If you are not ready to send a claim you can HOLD it to ensure it is not processed unintentionally
Select EDIT from the endorsing screen

24. Holding Claims cont’d Hold Claim Submission
To release the claim repeat the process and remove the tick.

25. Subsequent Iterations

26. CMS Prescription Requests
After the initial dispensing all subsequent iterations are managed via the CMS Prescription Requests screen.
This is accessed via the Misc button and selecting ‘CMS Prescription Requests’ or Ctrl + R

27. CMS Prescription Requests cont’d
Patients who have ongoing CMS prescriptions, or who have recently finished a serial script, are displayed in this screen.
Status Indicator (see further slide for descriptions)
Select one more scripts and click Repeat to take scripts to the Script Q to be dispensed

28. CMS Items to be Dispensed from the ScriptQ
The Blue arrow indicates the item is ready to dispense
Alternative icons could be :
If the script is already available on the Script Q you will receive a prompt advising this when you select Repeat

29. CMS Prescription Requests cont’d
History, Script and Patient details are available in addition you can
Terminate and Synchronise items.
Status Indicator (see further slide for descriptions)

30. CMS Prescription Requests cont’d
Displays number of iterations.

31. CMS Prescription Requests cont’d
History
Displays both History
and
Collected Date
Label allows you to reprint if required

32. CMS Prescription Requests cont’d
Patient
Displays Patient details.
If required FULL patient history can be viewed from here.

33. CMS Prescription Requests cont’d
If Terminate is selected you will be prompted to confirm you want to prevent any further processing of this script

34. CMS Prescription Requests cont’d
If required you can select Sync and defer the next dispense until a date of your choice. e.g. if a patient has had two dispensings due to holidays you may wish to defer for a further 4 or 8 weeks.
Useful to check Collected Date from History then Sync next due dates accordingly.

35. Status Indicators for Prescription Requests and CMS Timeline

36. The CMS Timeline

37. The CMS Timeline
The CMS Prescription Time Line facility allows a patient's CMS current activity and history to be viewed in a single screen.
To open the timeline click Misc and select CMS Prescription Time Line or use the keyboard shortcut of CtrL-1

38. The CMS Timeline cont’d
This displays a list of CMS patients
Dispensing Status column
If multiple items and statuses, the most important will display e.g. due soon or overdue
The TSR column displays the status of their Treatment Summary Report
Explanation for selected line

39. The CMS Timeline cont’d
Select Drugs or Patient to see their personal timeline.
Dispensing & TSR Status for each item is displayed. Most recent at the top
Items on same script turn blue
The info panel displays status for the selected line
History to review dispensing including labels
Patient to open record
Script to review original
Not used as regularly as Prescription Requests Screen. Check regularly for due TSR’s.

40. Status Indicators for Prescription Requests and CMS Timeline

41. Final Iteration, Treatment Summary Reports and New Scripts

42. Final Iteration and TSR’s
Treatment Summary Reports (TSR’s) are documents which are sent electronically to the GP Practice. They include dispensing information for all items and should be used to request new serial scripts when required
TSR’s now cover the period of the script, NOT last 24 weeks
For each item on a TSR you have 3 options, Y, N or Not Now.
Y & N are only available once. i.e. having selected either of these you cannot dispense the item again from the original script.
On receipt of new serial script it will link to old items re next due date
There is no prompt at last dispensing. Due TSR’s are highlighted on CMS Timeline
Overdue Repeat Requests are also highlighted i.e. New script not received
A TSR process should be recorded as part of the pharmacy CMS SOP
? Re next due dates? - At the time of producing these slides it appears the new script takes the next due date from the original scripts schedule, NOT the last collected date.

43. Identifying Due TSR’s
Due TSR’s can be identified from either the CMS Timeline or Patient/ Drug details
This is a configurable option - default is 14 days
TSR Status indicator (see further slide for descriptions)
Repeat Request overdue

44. Creating a TSR
Open the patient record from any preferred route and Select New TSR.
Previous TSR’s are listed on the panel and can be viewed by selecting View TSR
Select New TSR

45. Creating a TSR cont’d Current CMS items are displayed
For each item select from the three options. Required: Not now, Now or Not at all.
Select date new script required by.
Notes for the GP can be added per item e.g. if a patient had holiday dispensing.
View TSR, Dispensing History, Original Script
Send TSR

46. Sample TSR

47. Sample TSR cont’d

48. TSR ICONS
N.B. No dispensings are possible following a completed TSR

49. New Scripts
When the new script is scanned and Expand selected you may see the following:
Select Yes to defer dispensing to next due date or
No to continue
Should you chose to dispense, remember to Sync next due dates accordingly.

50. PRN’s and Medication Not Required

51. PRN’s and Medication Not Required
PRN’s could be Suspended & Resumed
Alternatively From Prescription Request screen select SYNC and defer next dispensing

52. Returning Issued Items

53. Returning Issued Items
It is possible to Return Issued items and decrease the count. Expand then Delete
At the time of creating these slides, this is believed to be correct.

54. Interruptions to a CMS Schedule

55. Interruptions to a CMS Schedule
If a CMS item is prescribed on as AMS you will receive the following prompt
The View link will display the active CMS script
If you chose to continue with the AMS script you will be prompted again.
Continue will dispense from AMS leaving CMS active and unaffected
Suspend will suspend BOTH AMS & CMS
Cancel will leave CMS unaffected

56. Cancelling and Amending Claims

57. Amending Claims
Items can be amended any time including after they have been claimed
Open session to be amended from Script Q
From Patient History select the item to change and amend as required
Amended claims DO NOT need to be revoked before resubmitting
Status indicator shows claim has been amended
Select Submit

58. Cancelling Claims
Highlight claim and select Revoke. You will then be prompted for a cancellation reason

59. Missing Electronic Messages

60. Missing Electronic Messages cont’d
If a new CMS script is not available from the ePharmacy message store you can still dispense and process a claim
Select the line with the yellow triangle icon from the scriptQ
Open Patient record

61. Missing Electronic Messages cont’d
3. Dispense drugs as per GP10 and add dispensing schedule details

62. Missing Electronic Messages cont’d
4. After collection the items will remain on CMS Dispensing claims as Not Reconciled.
Use Submit to reconcile each of the manually dispensed lines, the claims will then automatically submit.

63. Missing Electronic Messages cont’d
5. Add details for each item on the GP10 and increment the item number accordingly.

64. Questions?