Discussion 6 john cathar | Human Resource Management homework help

Billing Procedures

Describe the e-prescribing incentive program and discuss benefits and costs.

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Discussion Guidelines

Remember to use citations and references as appropriate. Your post should be of at least 250 words in length and in appropriate APA style.



Billing Procedures

     The Electronic Prescribing (eRx) Incentive Program is a reporting program that uses a combination of incentive payments and adjustment payments to encourage eligible professionals to utilize and become electronic prescribers (e-prescribers).  E-prescribing was included in the Medicare Prescription Drug Improvement and Modernization Act of 2003, and was enacted on July 15, 2008.  Eligible professionals may include:  physicians, physician assistants and nurse practitioners.  E-Rx used incentive payments for using the program through 2013, and penalties were imposed for non-compliance starting in 2012.


     E-prescribing is the “transmission, using electronic media, of a prescription or prescription-related information, between a prescriber, dispenser, PBM, or health plan, either directly or through an intermediary, including an e-prescribing network” (Baker & Baker, 2014, p.326).  Very simply put, e-prescribing means that the prescriber uses a software system, either a e-prescribing system or a electronic medical record (EMR) system with a prescribing module, to write and transmit a prescription electronically to the patient’s choice of pharmacy.  E-prescribing is used for new prescriptions, refills, changes to an existing prescription and canceling a prescription.


     Through the e-Rx module or EMR systems the prescriber has access to clinical data, which includes; patients medical history, medication history, allergies, and drug information such as; drug referencing, drug interactions, generic and trade names, formulary, and benefits eligibility information.  This lends to safer prescribing.  It is also considered bi-directional, which means when the patient has run out of refills, he/she can call the pharmacy, who can then electronically send a message to the prescriber to authorize or deny a renewal of the prescription (McGrath, 2008, p.50).  The advantage with this is it is more efficient, and a time safer for the pharmacy, and prescriber.


     Electronic prescribing improves patient safety, efficiency and reduces errors.  Benefits can be seen on platforms other than clinically, such as administrative and financially and can include:


Enhancing pharmacy efficiency

Promotes formulary adherence

Decrease prescribing errors-including dosage errors and drug-drug interactions

Reduces adverse drug reactions

Improves quality of care and reduces malpractice claims

Increases patient pick-up from the pharmacy (reduces wait time) and increases patient compliance

         (Salmon, Jiang, 2012)

     Electronic prescribing can be a simple program of electronic drug reference to a fully integrated reference, prescribing and decision support in an EMR therefore the cost can widely vary.  The size of the practice, location and electronic technology already in place also play a role in the cost factor.  Stand alone systems are a good way to introduce electronic workflow with limited cost and risk to a practice (McGrath, 2008, p.51).  Costs include: the initial purchase price of the system that is chosen, cost associated with daily use and maintenance and education and training for staff  (Baker, Baker, 2014, p.328).


Baker,J.J., & Baker, R.W. (2014).  Health Care Finance Basic Tools for Nonfinancial Managers Fourth Edition.  Burlington, MA: Jones & Bartlett Learning

McGrath, D. (2008).  E-Prescribing.  Medical Practice Management, 50-52.

Salmon, J.W., & Jang, R. (2012).  E prescribing: History, issues, and potentials. Online Journal of Public Health Informatics 4(3), OJPHI.V413.4304





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