Prescription Drugs

For cases that are still in a Work-in-Progress (WIP) status, the Prescription Drugs page allows you to enter drug information for a claimant that is currently taking, or is expected to take, prescription drugs as a part of their Workers' Compensation injury.

Specifically, this page allows you to:

• Set a disposition regarding the claimant's use, or expected use, of prescription drugs
• Look up (search for) prescription drugs
• View the details of selected drugs
• View current and historical pricing for selected drugs
• Select drugs to calculate their individual cost
• Add drugs to a summary page for a claimant and calculate the total pricing for all drugs

Once saved, the prescription drugs are displayed on the Case Summary page. You can edit drug information any time prior to submitting the case.

A drug disposition is required for this page. You must click either Yes or No to the question: "Is claimant currently taking or expected to take prescription drugs as a result of the injury?" An error asterisk (*) will appear on the Case Summary page if no radio button is selected, or if Yes is selected and no drug information is provided.

Notes:

Changing your answer from Yes to No will delete any prescription drug data previously entered on this case.

The information that you enter on this screen is not final. The Workers' Compensation Recovery Center (WCRC) will review and make changes as appropriate.

See also section: Changes in Redbook Pricing.

To Search for Prescription Drugs

1. Click the Drug Lookup button on the Prescription Drugs page.

   The Rx Search page displays.

2. Enter search criteria.

   Entering full or partial phrases or numbers in the Drug Name and Dosage fields, respectively, retrieves all results that include that phrase or number (i.e., Entering "aspirin" will retrieve all variants of the drug name containing the term "aspirin").

3. Click the Search button to initiate the search, or click Clear to remove the search criteria.
4. To add a drug to the Drug Entry grid on the Prescription Drugs page, click the Select button.

To View Drug Details Including Current & Historical Pricing

1. To view current pricing and details, click the Info button for a drug.
2. To view historical pricing and details:
   1. Go to the Pricing History section on the Rx Detail page. This page displays the most recent 24 historical prices in a month/year format.
   2. Click a price hyperlink and time period. The Redbook Historical Details page displays showing the Rx History Detail - [Year] - [Month].

To Select and Calculate Cost for a Single Drug

To calculate the cost of a single drug:

1. From the results listing on the Rx Search page, select a drug by clicking the Select button.

   The drug is added to the Drug Entry grid on the Prescription Drugs page.

2. Enter all required details in the Drug Entry grid.
3. Click the Calculate Total button.

To Add a Drug to the Summary of Prescription Drugs for a Claimant

1. Complete all required fields in the Drug Entry grid.

2. Click the Add button, or click Clear to remove all data.

   The drug information is moved to the Summary of Prescription Drugs grid. This summary can display a maximum of 200 drugs.

3. Click Next to save and move to the next tab, or click Save Work-in-Progress to save your work and return to the Case Lookup page.

All drug information saved on the Prescription Drugs page is also displayed in the Prescription Drugs section of the Case Information page. While the case is still in WIP status, the drug information may be edited. However, once a case is submitted, the drug information becomes view only. No changes may be made to prescription drug information after submission.

Changes in Redbook Pricing and/or Information

Should the current Redbook information or pricing change after saving the prescription drugs for a case, but before submitting the case, the application will automatically update the drug prices and recalculate the totals in the Summary of Prescription Drugs grid at the time of submission based on the newer Redbook version. (Note: The Workers' Compensation Case Control System (WCCCS) users will also see the new pricing on their Pharmacy screen.)

If the application determines that there are invalid or discontinued National Drug Codes (NDCs) for the saved drugs based on a newer Redbook version, you will be required to return to the Summary Information page and re-enter those drugs before submitting a case. The word "Invalid" will display to the right of the invalid prescription drug on the Summary of Prescription Drugs grid.

If prescription drugs are included on a case and the current Redbook version number does not match the Redbook version number used for the prescription drugs on a case, the application will change the Redbook version number and display a warning or alert on the Case Summary page indicating that the Redbook version number has been updated on one or more prescription drug entries.