Frequently Asked Questions
1. The # 1 question asked by physicians concerning physician in-office dispensing: Is it legal?
2. How much will physician in-office dispensing cost my practice?
3. Does physician in-office dispensing comply with state and federal drug dispensing regulations?
4. What is Stark law? How does this affect me if I become a dispensing practitioner?
5. Can I process Medicare or Medicaid claims?
6. Will your system work for workers comp claims?
7. What is the profit potential to my practice?
8. Why have I not heard of this before, is physician in-office dispensing a new concept?
9. Does the physician need a special license to dispense medications in the office?
10. How will physician in-office dispensing benefit my patients?
11. What if patients ask about our pricing versus their retail pharmacy?
12. Who can dispense the medications in our office? Will I need a pharmacist, additional staff or a pharmacy tech to dispense?
13. What liability does the physician practice assume with physician in-office dispensing?
14. What if we have multiple physicians in our practice?
15. Will dispensing cause my malpractice premiums to increase?
16. Can we only dispense medications to patients who have a prescription benefit card?
17. Can I use manufacture cash offset or co-pay assistance cards?
18. Is the UniteRx U-fill software easy to use? Will UniteRx train my staff or a pharmacy tech? How long will the training take?
19. Is physician in-office dispensing efficient? How much time will it take my staff or a pharmacy tech to dispense a medication?
20. Does the UniteRx U-fill program have a patient database with dispensing history?
21. How much time will it take to enter a new patient into the database?
22. Does the UniteRx U-fill program have an inventory tracking process?
23. How much space is required to have a mini-pharmacy and dispense?
24. How do we determine which medications we should dispense and how much to order? Can UniteRx provide any FDA approved medications I choose, including controlled substances?
25. How do we re-order medications?
26. How do I set pricing for generic cash and carry medications?
27. Which medications generate the most income for the practice?
28. What about theft?
29. Why purchase only FDA approved medications vs. re-packaged medications?
30. What happens if there is a product recall from a drug manufacturer?
31. Who do I call if I have questions about the U-fill software, medication delivery, dispensing etc.?
Here are the answers to some of our most commonly asked questions.
1) The # 1 question asked by physicians concerning physician in-office dispensing: Is it legal?
Yes, every physician is allowed by law to dispense medications to his/her own patients within the practice environment. Under Stark regulations, physician dispensing is considered acceptable when the dispensing is limited to the physician's own patients; and the medications and products dispensed meet FDA guidelines for re-packaging and labeling. There are only five states (Massachusetts, Montana, New York, Utah, and Texas) that have more restrictive laws concerning point of care dispensing; it is allowed, but limited.
2) How much will physician in-office dispensing cost my practice?
The UniteRx U-fill program requires a reasonable enrollment fee, which pays for everything you will need to become an in-office dispensing pharmacy. We do all the heaving lifting for you. The UniteRx team will credential the entire practice to electronically process pharmacy claims through the respective insurance payer. This means that regardless of the number of physicians within the practice all prescriptions written at that location will be eligible for electronic claims adjudication. We have found that this small investment is quickly recouped within the first few months of dispensing.
3) Does physician in-office dispensing comply with state and federal drug dispensing regulations?
The UniteRx U-fill dispensing program complies with state and federal requirements.
4) What is Stark law? How does this affect me if I become a dispensing practitioner?
Stark law pertains to physician self-referral for Medicare and Medicaid patients. There are exemptions to this status for in-office ancillary services including physician dispensing. The in-office ancillary services exception of Stark law permits physician owners of a medical group, and other members of the group, to refer patients to their group for certain Designated Health Services (DHS). An outpatient prescription drug given to a patient in the physician's office, but taken by the patient at home, is now covered by the in-office ancillary services exception.
To qualify for protection under the in-office ancillary services exception, the DHS must be furnished personally by the referring physician or another physician member in the same group practice or by individuals who are "directly supervised" by the referring physician or group practice member. The in-office ancillary services must be furnished in the same building in which the referring physician or a group practice member furnishes substantial physician services unrelated to the furnishing of DHS.
5) Can I process Medicare or Medicaid Claims?
Yes when the state allows or there is a part D supplement and/or medications that are covered by a third party insurance payor such as BC/BS, Caremark, Medco, etc.
6) Will your system work for workers comp dispensing?
Yes UniteRx and the U-fill program can help you when dealing with works comp dispensing.
7) What is the profit potential to my practice?
If your practice is using the UniteRx U-fill dispensing program by promoting it to all patients and encouraging use of the program, the profit potential can be significant. As with any program, utilization is the key. For a single physician practice filling 30 prescriptions per day the annual income generated can be $100,000 or greater.
8) Why have I not heard of this before, is point of care medication dispensing a new concept?
The practice of physician in-office dispensing has been around since physicians began practicing medicine; but a re-emergence as an industry began in the early 1980's. In 1983, a nationwide campaign lead by the retail pharmacy industry was started with the intent to eliminate the physician's rights to dispense. In 1985, legislation in Congress was passed in 46 states to secure the physician's rights to dispense FDA approved medications to their own patients. The 1990's dispensing systems were developing to make the process fast, easy and cost effective for the physician and now in the 2000's with reimbursement cut backs to physicians and only a limited amount of time to see patients which decreases the chance of a physician increasing his patient load, physicians are turning to ancillary services such as in-office dispensing to help increase their profit margins. As well the old “prepackaged generic “cash and carry model was too labor intensive and it forces the Physician to “sell” medications. The UniteRx U-fill program allows Physicians to write a prescription and let the patient know they can “fill their prescription at the in-office pharmacy or they can go to a retail pharmacy”, either way the patient can use their insurance card or pay cash for their prescription and it will cost the patient the same. However when the patient picks up their prescription at a retail pharmacy, the office loses significant revenue opportunities and possibly increases staff workload due to pharmacy and patient phone calls, faxes, etc. Worst of all the retail pharmacy captures the additional income.
9) Does the physician need a special license to dispense medications in the office?
Most states do not require anything beyond your existing DEA and State license in order to dispense medications. There are a few states that have a designated dispensing license. In most cases it is offered at a minimal cost. UniteRx will help you in assuring you have all proper licensure to participate in your state.
10) How will physician in-office dispensing benefit my patients?
First and foremost is the convenience and time saving elements for your patients. No longer will they have to make an additional trip or wait in long lines at a retail pharmacy to fill prescriptions. Filling prescriptions from your practice is an added service to your patients that saves them time and adds no additional cost. In many cases this can also mean a cost savings to the patient because no extra commute is required.
11) What if patients ask about our pricing versus their retail pharmacy?
The UniteRx U-fill system communicates using the same technology that any major retail pharmacy uses in order to process a pharmaceutical insurance claim through the insurance payer. This allows for instant electronic confirmation of eligibility, patient copay and reimbursement to the practice. Therefore, a patient's copay for brand or generic product is exactly the same as if they had gone to the pharmacy.
12) Who can dispense the medications in our office? Will I need a pharmacist, additional staff or a pharmacy tech to dispense?
In most states, a directive from the physician allows other staff members to dispense medications within the office. A few states do require that the physician actually do the dispensing. Check with your state pharmacy or medical board for details.
13) What liability does the physician practice assume with in-office dispensing?
The liability is the same as it would be when a physician writes a prescription that is filled by a retail pharmacy. In physician in-office dispensing, there are stringent guidelines concerning packaging and labeling of the FDA approved medications. The UniteRx U-fill program meets state and federal requirements.
14) What if we have multiple physicians in our practice?
Having multiple physicians in a practice is not a problem, as each physician is assigned a specific password and can track their dispensing history separately for bookkeeping, documentation or patient information purposes. You can also have security access assigned at different levels to approved staff members who will be assisting in the dispensing process. Having additional physicians within the practice can help generate significantly more income.
15) Will dispensing cause my malpractice premiums to increase?
No, whether a physician prescribes medications that are filled at a retail pharmacy or at his practice, the physician's responsibility is the same. Malpractice carriers do not charge higher rates for dispensing physicians.
16) Can we only dispense medications to patients who have a prescription benefit card?
While UniteRx offers and recommends the use our third party insurance adjudication software program you can also dispense medications to cash paying customers. The patient can always opt out of using their prescription insurance benefit card and simply pay out of pocket. All dispensing requirements and regulations apply. The UniteRx U-fill software allows you to run both prescription benefit insurance transactions as well as cash-and-carry claims.
17) Can I use manufacture cash offset or co-pay assistance cards?
The UniteRx U-fill adjudication software allows you to utilize manufacturer cash offset and co-pay assistance cards the exact same way they are used at a retail pharmacy.
18) Is the UniteRx U-fill software program easy to use? Will UniteRx train my staff and how long will the training take?
UniteRx U-fill dispensing software is easy to utilize, requires minimal training time, is easy to navigate and insures an accurate dispense. This software is utilized in over 10,000 locations nationwide. It features a drug utilization review for possible contraindications, allergies, conditions etc. as well as generates bottle labeling and patient education printouts. State mandated reporting is also compiled and submitted by the intuitive software. UniteRx will provide complete training on the software and we offer a dedicated account manager as well as an 800 number for technical support if you have questions about the software or filling a prescription.
19) Is physician in-office dispensing efficient? How much time will it take a pharmacy tech or trained staff member to dispense a medication?
The UniteRx U-fill dispensing program is easily integrated into your office procedures and patient flow. Filling a prescription can generally be completed between 30 seconds to 2 minutes.
20) Does the UniteRx U-fill program have a patient database with dispensing history?
Yes, patients are loaded in the database automatically when you dispense a medication and you can pull reports on dispensing history by patient, medication, date, etc.
21) How much time will it take to enter a new patient into the database?
A new patient can be added within 30 seconds to 2 minutes while dispensing. Other demographic information is built into the system and can be added at time of dispense or at a later date if desired.
22) Does the UniteRx U-fill program have an inventory tracking process?
The UniteRx U-fill program will automatically tell you when a particular medication is below pre-set levels that are determined by each individual office at the time of installation and training.
23) How much space is required to have a mini-pharmacy?
Minimal space is required to dispense. You will need store your medications in a locked cabinet and some medications are required to be in a locked cabinet in a locked room. The physical space required to fill prescriptions varies depending on the size of the practice, patient flow and space available. Minimally you need space for a computer with monitor, laser printer and location for the pharmacy tech to fill and label medications.
24) How do we determine which medications we should dispense and how much to order? Can UniteRx provide any FDA approved medications I choose, including controlled substances?
UniteRx can supply any FDA approved medications including schedule 2-5 controlled substance as well as over the counter medications, injectables, etc. We suggest that initially you stock one to two week's supply of your top 20-30 medications you prescribe daily. This initial formulary can always be expanded but it is best to start with a conservative inventory. The U-fill system tracks all dispenses which will accurately determine which medications you are using most frequently and an accurate level of inventory control keeps your practice from running low on a particular medication. Your practice's medication offering may develop over time and can change with seasonal practice activity.
25) How do we re-order medications?
UniteRxs’ dispensing program will automatically alert you of low inventory on specific drugs; these inventory levels are determined at the time of installation and training by the physician. When you receive a low inventory notice, you can simply complete the order form and email or fax to our orders department. You can expect delivery, under normal circumstances, within 2-3 business days from order submission.
26) How do I set pricing for generic cash & carry medications?
UniteRx supplies medications to our clients at an everyday low price designed to help provide the in-office dispensary with a strong margin potential. Each practice can set their own generic customer cash pay pricing based on retail competition as well as in-office financial best practices. The patient simply pays the physician's office the amount that the office has set to charge for those cash pay medications. You are in control.
27) Which medications generate the most income for the practice?
Generally, a good mix of both branded and generic medications will offer the largest profit potential for a physician's practice and the greatest savings to the patients.
28) What about theft?
The UniteRx U-fill dispensing process is managed in such a way that theft is rarely a problem. Password protection, an automatic inventory system and dispensing records of who dispensed make it difficult to hide theft of medications. Every container is accounted for in the inventory system and the reports allow the staff to easily and quickly determine if there is a problem.
29) Why should I purchase only FDA approved medications from manufacturers vs. re-packaged medications?
State and Federal regulations state that dispensing is allowed through the physician practice only if the medications are properly packaged and labeled. Products must comply to federally mandated current Good Manufacturing Practices (GMP's) as noted in Title 21 of Code of Federal Regulations. Noncompliance with these laws could render the medication as "adulterated" and or "misbranded". Medications coming directly from the manufacturer have a minimal risk of adulteration or misbranding vs. purchasing products from a re-packager. It is a federal crime to dispense an adulterated or misbranded medication to a patient.
30) What happens if there is a product recall from a drug manufacturer?
The UniteRx U-fill software program can help you quickly identify any patients who are currently using a medication that has been recalled.
31) Who do I call if I have questions about the U-fill software, medication delivery, dispensing, etc.?
We at UniteRx are client focused as well as service oriented and have technical support team members available to help with software, dispensing, ordering, or any dispensary questions. All of our dispensing offices have a dedicated account manager and we provide an 800 number to reach a technical support staff member quickly. A live technical support team member is always available to answer your questions. When you join the UniteRx team we assign a dedicated account manger that will be with you every step of the way and on your team from beginning to end.