Deborah et al,
I concur with Robin's comments, here's my additional 2 cents worth:

1.      Do you use the Meditech pharmacy chargemaster to drop pharmacy
charges and to house their pharmacy price list?

Yes, and we allow "pass-through" charging from PHA to BAR.  When we
went live with PHA a couple of years ago, I looked at patient charges in
BAR.  Many had not been updated in 15 years outside of the annual %
increases.  IMO, using "pass-through" charging is a no-brainer - who
besides PHA has the resources/desire to keep up with drug price changes?
 Initially, the BAR keepers were reluctant to allow "pass-through" until
they understood what advantages it offers.  We do have other PHA charges
that come into BAR via OE.  These use the patient charges as defined in
BAR, so it's important to keep BAR up to date as well.  

2.      If you do use the Meditech chargemaster, how often are your
pharmacy prices updated?

PHA is updated as part of 3 distinct processes (ABC), BAR is updated 2
ways (AB):

A. As Robin describes, we subscribe to a formulary service vendor that
provides quarterly AWP updates.  Once the quarterly PHA update is
complete, I download BAR and PHA current patient charges into MS-ACCESS.
 A query in Access joins the two downloads and outputs a spreadsheet
that lists any patient charges that have changed.  Our IS analyst then
scripts these changes back into BAR to synchronize the two dictionaries.
 

B. In addition to the quarterly AWP updates, we also change the charge
formulas yearly as dictated by our CFO.  PHA and BAR are updated
accordingly at the beginning of the fiscal year.

C. As Robin pointed out, the PHA drug file is very volatile.  New drugs
are added, old drugs are dropped, different generics are bought.   We
keep PHA up-to-date as best we can on a daily basis, which guarantees
that the 90+% of transactions that come to BAR via PHA are accurate. 
Just about all of the OE generated charges are for items that don't
change very often.   We wait for the quarterly BAR update procedure to
take care of these.

3.      If you do not use the Meditech chargemaster do you use a Pyxis
system to drop charges and is your pharmacy staff responsible for
dropping the pharmacy charge on the patient bill?

Everything Pyxis does is funneled through PHA.  PHA patient charges are
applied and passed through to BAR as part of the nightly run.

Alan Miller, RPh


>>> "Robin D. Cullen" <[EMAIL PROTECTED]> 11/01/2006 09:07 >>>
 Deborah,

Thought I would add a few thoughts...

1.      Do you use the Meditech pharmacy chargemaster to drop pharmacy
charges and to house their pharmacy price list?

Due to the volatile nature of drug cost/awp vis a vis other charges in
the
hospital environment(eg.RAD, LAB etc.), many hospitals allow
"pass-through"
billing from pharmacy to billing i.e. they use the patient charge
derived
from the cost basis plus mark-up from the pharmacy application stored
in the
Drug Dict(and related Drug Supporting Dicts.).  I find that if the
culture
demands that the ultimate patient charge be stored in the B/AR
Procedure
Code Dict that that is the case.

2.      If you do use the Meditech chargemaster, how often are your
pharmacy prices updated?

By prices, are you referring to the negotiated cost (unit cost) that
is
determined between the wholesaler and the pharmacy or are you referring
to
the patient charge?  Either way, upkeep as you would expect is
absolutely
necessary.  If the pharmacy chooses to use the average wholesale
price(AWP)
as the cost basis for their mark-up tables, then these can be
automatically
updated each quarter by your formulary service vendor.  However, if you
want
a more accurate cost basis i.e. your unit cost then you either
manually
update these as they are renegotiated/changed or you buy an interface
from
Meditech that does that for you.

As far as the mark-up tables/charge formulas are concerned, these are
updated at the pharmacy's discretion(or for that matter as directed by
billing).

3.      If you do not use the Meditech chargemaster do you use a Pyxis
system to drop charges and is your pharmacy staff responsible for
dropping the pharmacy charge on the patient bill?

As far as I know, Pyxis or any other automated dispensing machine will
pass
vended items/drugs through the HL-7 interface to MT PHA where a
patient
charge will be attached and then ultimately sent through to MT B/AR or
an OV
B/AR via the nightly billing compile.  Barring that, the number of
vended
items/drugs are sent over to billing where a patient charge meets
them.

Hope this helps...





----------------------------------------------------------------------

Message: 1
Date: Sat, 28 Oct 2006 16:14:42 -0400
From: "Julia Carter" <[EMAIL PROTECTED]>
Subject: RE: [MEDITECH-L] Charges for Pharmacy
To: "Garcia, Deborah K" <[EMAIL PROTECTED]>, <[email protected]>
Message-ID:
       <[EMAIL PROTECTED]>
Content-Type: text/plain; charset="us-ascii"

See answers below.



________________________________

From: [EMAIL PROTECTED] 
[mailto:[EMAIL PROTECTED] On Behalf Of Garcia, Deborah K
Sent: Thursday, October 26, 2006 12:59 PM
To: [email protected] 
Subject: [MEDITECH-L] Charges for Pharmacy



Hello.  Our Accounting Director would like to know how other Meditech
hospitals handle pharmacy charges.  Your feedback is greatly
appreciated.

1.      Do you use the Meditech pharmacy chargemaster to drop pharmacy
charges and to house their pharmacy price list?

           Yes.

2.      If you do use the Meditech chargemaster, how often are your
pharmacy prices updated?

           I think that the Pharmacy Director does it as needed.

3.      If you do not use the Meditech chargemaster do you use a Pyxis
system to drop charges and is your pharmacy staff responsible for
dropping the pharmacy charge on the patient bill?

           We also use Pyxis with an interface.

Thanks again for any feedback you can give.

Deborah Garcia

Systems Application Analyst

Memorial Medical Center

(231) 845-3602

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