Encore Presentations
Saturday, November 11, 2023
11:30 AM–01:00 PM
Abstract
TITLE
Retraining of transplant pharmacy staff to reduce Medicare Part B prescription billing errors in post-transplant recipients
BACKGROUND
Medicare Part B (MedB) imposes fines for certain errors in prescription billing of post-transplant medications, which can greatly impact pharmacy revenue. To prevent MedB billing fines, pharmacy staff must be cognizant of specific MedB requirements when entering prescription refill orders. The aim of this quality improvement project was to retrain certified pharmacy technicians (CPhTs) on common monthly billing errors and evaluate changes in error rates and potential fines after retraining.
OBJECTIVE
Determine if retraining CPhTs minimizes MedB prescription billing errors and potential fines.
METHODS
This was a single center, pre post analysis including post-transplant patients with at least one MedB prescription billing error who filled prescriptions through Vanderbilt Transplant Pharmacy. All CPhTs involved in MedB prescription billing received retraining focused on the top three errors in MedB billing identified: early refills, missing relationship of caller to patient and/or residence of patient on orders, or no day supply remaining recorded on the order. Retraining consisted of developing a training checklist, testing current knowledge levels, individualized coaching based on technician specific errors, and retesting for knowledge retention. Outcomes included the number of prescriptions with at least one MedB prescription billing error and projected amount of dollars fined due to errors before (12/1/21-2/28/22) and after (4/1/22-7/1/22) retraining.
RESULTS
Fourteen CPhTs received retraining. The average number of prescriptions with at least one MedB error decreased from 45 to 41 after retraining. The overall average error rate reduced by 12.2%. Average refill too soon errors decreased by 37.5% (10.7% vs. 6.7%), average missing relationship by 21.7% (7.7% vs. 6%), and day supply errors by 39.7% (1.7% vs. 1%). Error reductions equaled a 28.2% decrease (approximately $12,700) in potential fines. The number of prescriptions filled was similar between the two time periods.
CONCLUSION
CPhT retraining focused on specific MedB billing errors successfully reduced error frequency and potential resulting fines. Because MedB billing error fines can be costly for pharmacies dispensing high-cost medications, identifying common errors and training staff can be useful and financially prudent.
Presenting Author
Sarah Osman CPhT-AdvVanderbilt University Medical Center
Authors
Chris Hayes PharmD
Vanderbilt University Medical Center
Katie Hosteng PhD
Vanderbilt University Medical Center
Kirsten Mitchell CPhT-Adv
Vanderbilt University Medical Center
Rachel Chelewski PharmD, CSP
Vanderbilt University Medical Center
Carey Vallone CPhT
Vanderbilt University Medical Center
Michael Wilson CPhT
Vanderbilt University Medical Center
Autumn Zuckerman PharmD
Vanderbilt University Medical Center
Chelsea Ray CPhT
Vanderbilt University Medical Center
Keren Rodriguez PharmD, CSP
Vanderbilt University Medical Center
Genny Staff PharmD
Vanderbilt University Medical Center