Blog by Mark Wolfe, Customer Account Representative, GrandView Pharmacy

Ever wonder why some of your medication orders were not filled when they were called in? Here are some issues that prevent a pharmacy from fulfilling the medication orders for your residents.

  1. The prescription is missing information. There is pertinent information required on ALL prescriptions. If any of the information is missing, the pharmacy is required BY LAW to contact the prescriber/doctor’s office/or facility. In this case, GrandView will contact the facility via phone, fax or email. But this is most frequently done by fax. Keep an eye on the fax machine.

    Each prescription should have:
    a.  Name of the medication
    b.  Strength of medication
    c.  Quantity to be included
    d.  Directions for use
    e.  Date of Prescription
    f.   Patient’s name
    g.  Prescribing Physicians signature

    Please help your residents by taking a moment to review the prescription, ensuring that all of the proper information is indicated on the written order. GrandView will contact the facility informing you that information is missing. Many times, however, we are unable to connect with the facility, especially during the evening shift. (1) Here’s Why Your Pharmacist Won’t Fill Your Prescription, Ronilee Shye, PharmD, GoodRX Latest News, Jan 23, 2019.
  2.  The prescription being faxed to the pharmacy is hard to read. Please take a moment to review the prescription to ensure that the information provided is complete and legible.
  3. Product Availability. Sometimes medications are in high demand making availability an issue. Sometimes there could be a national manufacturer’s back order (production/FDA approval cannot keep up with demand). In these instances, GrandView Pharmacy will make reasonable efforts to obtain the medication from another source. That may include borrowing from another pharmacy or hospital. If these efforts fail, usually due to a national backorder, GrandView will notify the facility of the lack of availability and suggest an alternative medication; of course, with the prescribing physicians’ approval.
  4. Adverse Reactions. Since GrandView Pharmacy is reviewing the resident’s medication profiles, we may see an instance where a newly prescribed medication has the potential for an adverse reaction with the residents’ current drug regimen. (2) Pharmacy Times, Jennifer Gershman, PharmD, July 24-2017

All in all, GrandView believes that there are numerous reasons why medications may not get delivered on time or as requested. GrandView sees these issues daily. In addition to the items listed above we see some common type issues that we have bundled into what we call Six Barriers to Timely Medication Fulfillment.

The six barriers are:
1. Controlled Substances
2. Order Clarification
3. Product Availability
4. Insurance Coverage, Refill Too Soon
5. Insurance Coverage, Non-Covered Items
6. Human Error

CONTROLLED SUBSTANCES: Each controlled substance requires a hard script that we need in hand. However, we ask that you fax a copy of that order to GrandView. Many times we do not receive the fax, nor the hard script.

ORDER CLARIFICATION: GrandView pharmacy staff will call the facility to clarify orders. Please ensure the orders make sense prior to faxing them to pharmacy.
PRODUCT AVAILABILITY: If GrandView does not have the medication, we will borrow it from another pharmacy or hospital. If there is a national back order of medication, we will recommend an alternative medication.

INSURANCE COVERAGE, FILL TOO SOON: Many times, we see that insurance companies will not allow us to dispense it, as it is too soon. However, GrandView Pharmacy works with these insurance companies and sometimes it is possible to receive authorization to dispense sooner.

INSURANCE COVERAGE, NON COVERED ITEMS: Perhaps the resident’s insurance does not cover the particular medication. In that case, GrandView will call the facility to inquire if the facility will authorize the medication, meaning that they will assure payment of the medication in question.

HUMAN ERROR: This is the category that happens more often than we would like. The pharmacy could be the culprit but so can the facility. Orders are forgotten, faxes are never sent, etc. Most frequently, we see that after-hours faxes or phone calls are not being responded to by facilities.

The author of this article does not wish to imply that all responsibility falls upon the facility staff when errors are made, when an order is forgotten, etc. The pharmacy staff are not infallible. We, too, err. However, if keen attention is made on the front end when sending in prescriptions, usually there is much better outcomes at the back end meaning that more residents will receive their medications accurately and on time.

About the Author

Click here to learn more about Mark and the rest of the GrandView team.