Overview
Hospital Users have the ability to change the status of a prescription in Retail PIDs. Once a change has been submitted, the status and accumulations will be updated and a recalculation will be processed automatically.
How to Make a Retail Status Change
In Utilization Manager, right-click on the prescription you want to update and select CHANGE STATUS.
The CHANGE STATUS window will open. The Status drop-down options are dependent on the PID’s Split Sequence and Default Account in Pharmacy Settings.
It is required to provide a reason for the status change in the Reason field.
This will be recorded in the Transaction Log and also viewable in the Add/View Notes option from the right-click menu.
Click the Save Changes button to submit the update. A confirmation message will pop up once submitted.
The Status Change column in Utilization Manager will be set to Y when the status has been manually changed.
Change Status Alert Messages
You will be alerted when they attempt to change the status of a prescription to 340B when there is an exclusion that would normally prevent it from automatically qualifying.
When you attempt to Save Changes, the alert will appear below the Status drop-down in the CHANGE STATUS popup window. You have the option to override the system and move forward with changing the status by selecting the Change Status button.
Any changes made are your responsibility.
You may encounter the below messages when changing the status of a prescription:
Exclusion |
Message (CE-Owned) |
CE Owned PID
|
Message (Non-CE-Owned) |
Non-CE-Owned PID
|
| MHI Orphan = Y Exp Orphan = N |
"This NDC is classified as orphan which your settings exclude from 340B eligibility. Confirm the status change of this prescription to 340B." |
Y |
"This NDC is classified as orphan which your settings exclude from 340B eligibility. Confirm the status change of this prescription to 340B." |
Y |
| MHI Drug Exclude = Y |
"This dispense is classified as excluded from 340B eligibility. Confirm the status change of this prescription to 340B." |
Y |
"This dispense is classified as excluded from 340B eligibility. Please contact Support if you wish to change this prescription to 340B." |
N |
| MHI Medicaid = Y |
"The BIN/PCN/Group is classified as Medicaid which your settings exclude from 340B eligibility. Confirm the status change of this prescription to 340B." |
Y |
"The BIN/PCN/Group is classified as Medicaid which your settings exclude from 340B eligibility. Confirm the status change of this prescription to 340B." |
Y |
| Frozen = Y |
"This prescription is frozen per Pharmacy Settings. Confirm the status change of this prescription to 340B." |
Y |
"This prescription is frozen, and the status cannot be changed to 340B without CP approval, per the PSA agreement between the CE & CP. Please contact Support if you wish to change this prescription to 340B." |
N |
| MHI Drug = N |
"NDC is not in Drug Catalog with 340B pricing. The status of this prescription cannot be changed" |
N |
"NDC is not in Drug Catalog with 340B pricing. The status of this prescription cannot be changed" |
N |
| Patient Residence Code = Y |
"Patient Residence Code from this prescription is excluded from 340B eligibility. Confirm the status change of this prescription to 340B." |
Y |
"Patient Residence Code from this prescription is excluded from 340B eligibility. Confirm the status change of this prescription to 340B." |
Y |
| Slow Mover =Y Slow Mover Date Populated |
"This prescription was previously rewound. Confirm the status change of this prescription to 340B." |
Y |
"This prescription was previously rewound. Please contact Support if you wish to change this prescription to 340B." |
N |
| Test Wait Days |
"The dispense date is within the Test Wait Days. Confirm the status change of this claim to 340B." |
Y |
"The dispense date is within the Test Wait Days. "Please contact Support if you wish to change this prescription to 340B. |
N |
| Reversal Matched | One or more fills in this prescription are reversal matched and cannot be status changed. You can change the status of this fill only. | N |
"One or more fills in this prescription are reversal matched and cannot be status changed. You can change the status of this fill only." |
N |
Overrides: Chain/Independent Pharmacies, Same Rx
If you change the status of the same Rx with a different fill number, and apply this to anything other than "this fill only" an error message will appear, giving you the option to override by clicking Change Status.
- This only applies to Chain/Independent (non CE-owned) pharmacy claims that are NOT frozen.
- If you override, we will process this most recent status change request.
Charge Note appears under Add/View Notes in Utilization Manager.
NOTE: If the prescription has multiple exclusions, each one will be listed unless one of the exclusions is MHI 340B Drug = N.
View Utilization Manager