| Data Review | Manual Uploads

Retail Status Change Overrides

When uploading a Retail Status Change file within the Manual Uploads page, the file will be checked for a number of exclusions, listed below. 

  • Orphans
  • Excluded Items
  • Medicaid
  • Frozen Prescriptions
  • Not a 340B Drug (not in the Drug Catalog or no 340B price)
  • Patient Residence Code Excluded 
  • Slow Mover 
  • Within Test Wait Days (TWD) 
  • Reversal Matched
  • Outside of 340B Eligibility Date
  • User does not have access to PID 
  • Script ID does not match Rx Number
  • New Status is the same as old status 
  • File Size Exceeded
  • Invalid Template


If any of these exclusions are found, an Alert Message will populate in the Manual Uploads page table. 


Delete

Alert Messages will remain on the Retail Status Change file type page until they are cleared, even after switching between pages in Architect or changing PIDs. When you have finished making the necessary status changes, click Clear Data at the top of the page.  


Override Permissions

You may wish to override an Alert Message in your Retail Status Change upload. Depending on the type of exclusion and retail pharmacy PID type, either Chain or Independent Retail PIDs or CE-Owned Retail PIDs, you may or may not be able to make an override. 

If permissions allow, you can override an exclusion by selecting the alert message and clicking the Override button. The tables below break down these override permissions by retail pharmacy type and exclusion type.


Chain or Independent Retail PIDs:

Exclusion

Alert Message 

Overridable? 

MHI Orphan = Y 

Exp Orphan = N 

NDC classified as Orphan 

Y 

MHI Drug Exclude = Y 

Cannot Override: NDC classified as Excluded 

N 

MHI Medicaid = Y 

BIN/PCN/Group classified as Medicaid 

Y 

Frozen = Y 

Cannot Override: Rx is frozen. Contact Support 

N 

MHI Drug = N 

NDC has no 340B price in Drug Catalog 

Y 

Patient Residence Code = Y 

Patient Residence Code from this prescription is classified as excluded. 

Y 

Slow Mover Date Populated (has been rewound) 

Cannot Override: This prescription was previously rewound. 

N 

Within Test Wait Days 

Cannot Override: Prescription is within Test Wait Days. Contact Support. 

N 

Reversal Matched 

Cannot Override: This prescription has been matched to a reversal. 

N 

 


 

CE-Owned Retail PID:

Exclusion

Alert Message 

Overridable? 

MHI Orphan = Y 

Exp Orphan = N 

NDC classified as Orphan 

Y 

MHI Drug Exclude = Y 

Dispense classified as Excluded 

Y 

MHI Medicaid = Y 

BIN/PCN/Group classified as Medicaid 

Y 

Frozen = Y 

Prescription is frozen.  

Y 

MHI Drug = N 

NDC has no 340B price in Drug Catalog 

Y

Patient Residence Code = Y 

Patient Residence Code from this prescription is classified as excluded. 

Y 

Slow Mover Date Populated (has been rewound) 

This prescription was previously rewound. 

Y 

Within Test Wait Days 

Prescription is within Test Wait Days.  

Y 

Reversal Matched 

Cannot Override: This prescription has been matched to a reversal. 

N 

New Status is same as old status 

Cannot Override: Prescription is already in requested status. 

N 

MHI Elig = N 

Cannot Override: Prescription date is prior to the 340B Eligibility Date 

N 


Additional Scenarios

In addition to the user permissions above, there are some other unique scenarios that may determine if an override is possible and/or if alert messages will populate. The outcome of a status change is dependent on 1) the fill number 2) exclusions and 3) Apply Change type. 


The Apply Change field is a numeric indicator on the Retail Status Change template for whether or not you want this change to apply in the past and/or future fills.

  • 0: this fill only
  • 1: this fill plus all future fills
  • 2: this fill plus all previous fills
  • 3: this fill plus past and future fills (all fills)

 


Scenario 1: Test Wait Days


If one of a prescription's fills is frozen due to being within Test Wait days, and you are disqualifying the prescription with Apply Change = 1 or 3, an override is possible. 

 

 


Scenario 2:  


A prescription status is changed to 340B and applied to all fills (Apply Change = 3), and there are no exclusions in place. 


Fill Number Before Status Change After Status Change Alert?
0 (original fill) 340B - Not Frozen 340B - Not Frozen
no 
1 (first refill) RTL - Not Frozen 340B - Frozen
2 (second refill) RTL changed to 340B, Apply Change 3 340B - Frozen

Outcome (After Status Change):

  • Fills 1 & 2 will change to 340B and will be frozen.
  • No alert message will display.



Scenario 3: 


A prescription status for fill 2 is changed to 340B and applied to all fills (Apply Change= 3), and there are no exclusions in place. 

Fill Number Before Status Change After Status Change Alert?
0 (original fill) 340B - Frozen 340B - Frozen no 
1 (first refill) RTL - Not Frozen 340B - Frozen
2 (second refill) RTL changed to 340B, Apply Change 3 340B - Frozen

Outcome (After Status Change): 

  • Fills 1 & 2 will change to 340B and will be frozen. 
  • No alert message will display. 


Scenario 4: 


A prescription status for fill 2 is changed to 340B and applied to all fills (Apply Change= 3) or "this fill plus all previous fills" (Apply Change= 2), and there are no exclusions in place.  

Fill Number Before Status Change After Status Change: 
CE-Owned
 		After Status Change: 
Chain/Independent		 Alert?
0 (original fill) 340B - Frozen 340B - Frozen 340B - Frozen yes, fill 1 is frozen
1 (first refill) RTL - Frozen RTL - Frozen RTL - Frozen
2 (second refill) RTL changed to 340B, Apply Change 2 or 3 No change 
unless override 		 No change 
cannot override

Outcome (After Status Change): 

  • For CE-Owned retail pharmacy users:  Fill 2 will not be applied and an alert message will display because fill 1 is frozen. 
    • You can select that prescription and click the Override button to apply the status change to fills 1 & 2. 
    • If you do not override the prescription, no changes will be applied.  
  • For Chain or Independent retail pharmacy users: Fill 2 will not be applied and an alert message will display because fill 1 is frozen. 
    • You cannot override in this scenario and must contact Support if you would like to request a status change. 


Scenario 5: Same status for all fills


5a. A status for fill 2 is changed to a status that is the same as all previous fill number statuses, with Apply Change 1 or 3 and no exclusions. 

Outcome (After Status Change):

  • No alert message will display
  • Future fills that are not in the new status will change. Fills that are already in that status will remain as is. 


5b. A status for fill 2 is changed to a status that is the same as all previous fill number statuses with Apply Change 2 and no exclusions. 

Outcome (After Status Change): 

  • An alert message will display because the prescription is already in that status and Apply Change 2 only applies to previous fills.

  


Scenario 6: One previous fill with different status, "this fill plus previous fills"  


A prescription status for fill number 3 is changed to 340B with Apply Change 2. One of the previous fills has a different status than the rest of the fill numbers. 


Fill Number Before Status Change After Status Change Alert?
0 (original fill) RTL - Frozen 340B - Frozen  yes, multiple scripts are frozen. Can override. 
1 (refill1) RTL - Frozen 340B - Frozen
2 (refill 2) 340B - Frozen 340B - Frozen 
(Status Change= N) 
3 (refill 3)

RTL changed to 340B, Apply Change 2

 If override, 340 B - Frozen 


Outcome (After Status Change): 

  • You will receive an alert message alerting you that previous prescription fill numbers are frozen. 
  • If you override this message, fill numbers 0, 1, and 3 will change to 340B status and be frozen. 
  • Fill number 2 will remain in the same status.



Scenario 7: Chain/Independent Pharmacies, same Rx, changes applied to anything other than "this fill only"   

You are a Chain/Independent pharmacy and change the status of the same Rx with a different fill number and select Apply Change 1, 2, or 3. 


Outcome (After Status Change): 

  • If the fill is NOT frozen: an error message will appear, giving you the option to Override. We will invalidate the original status change entry and process this most recent status change request. 
  • If the fill is frozen: An error message will appear without the option to Override. "Cannot Override: Fills in this Rx have been previously status changed. 



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