Fill Out Your Rx Right Source Form

Filling out the Rx Right Source form incorrectly can lead to delays and complications in patient care. One common mistake is failing to complete all required fields. Every section, from patient information to prescription details, must be filled out accurately. Omissions can result in processing delays.

Another frequent error is providing incorrect or incomplete contact information. Ensure that both the prescriber’s and patient’s phone numbers are accurate. If verification is needed, the pharmacy will contact these numbers. Missing information can significantly slow down the communication process.

Many individuals neglect to include the prescriber’s signature. This is a critical step. Without a signature, the prescription is invalid. It can also lead to confusion, with the pharmacy unable to verify that the prescription originates from a licensed provider.

The dosage and quantity are often misunderstood. Some people overlook the requirement to write both the alpha and numeric value for controlled substances. This can lead to incorrect dispensing or refusal to process the prescription. Accuracy is paramount when specifying the drug name, strength, directions, and quantity.

Another mistake arises when not indicating whether the prescriber wants the brand-name medication. If you want a specific brand dispensed, you must write ‘brand medically necessary.’ Failing to do so will likely result in a generic equivalent. This may not align with what the prescriber intended.

Additionally, the supervising prescriber’s information is sometimes omitted. If applicable, the signature of a supervising prescriber, along with their DEA number and NPI number, is necessary. Not including these details can create further complications in the prescription process.

Sending the form without a secure cover sheet is another oversight. Ensure that you send the completed form with the necessary cover sheet to protect patient confidentiality. Failure to do so can breach privacy regulations, leading to serious consequences.

It is crucial to send the form via the appropriate channels. Using the specified fax number ensures it reaches the intended pharmacy. Misdialing or submitting through an unsecured method can compromise the security of sensitive information.

Lastly, many individuals do not follow up on the submission. After faxing the form, it’s advisable to confirm with the pharmacy that it was received and entered into their system. This simple action can prevent unnecessary delays in medication dispensation.

When submitting the Rx Right Source form, you may encounter other forms and documents that can streamline the prescription process or provide additional information. Each document serves a unique purpose and can be important for both healthcare providers and patients. Below are several commonly used forms that are often submitted alongside the Rx Right Source form.

• Patient Consent Form: This document requires the patient’s signature, granting permission for their healthcare provider to share medical information necessary for fulfilling the prescription. It ensures that the patient is informed about their rights regarding personal health information.
• Prescription Drug Coverage Form: This form provides specific details regarding the patient’s prescription drug coverage under their health insurance plan. It may include coverage limits, copayment amounts, and any prior authorization requirements necessary for the prescribed medication.
• Prior Authorization Request Form: For certain medications, especially expensive ones or those not included in the patient's plan, a prior authorization form may be required. This form is used to justify the medical necessity of the medication before it can be approved for dispensing.
• Medication History Report: This report reviews a patient’s past medication use, including prescriptions filled, changes made, and any allergies noted. It helps prescribers make informed decisions and ensures continuity of care, reducing the risk of adverse drug interactions.

Utilizing these forms in conjunction with the Rx Right Source form can enhance communication between healthcare providers, pharmacies, and patients. By ensuring all necessary information is accurately provided, the medication management process becomes more effective and efficient, fostering better health outcomes.

• Patient Information Form: Similar to the Rx Right Source form, this document collects vital details about the patient, including personal information and medical history. Just as the Rx Right Source requires information like gender and allergies, the Patient Information Form ensures that pharmacists have a comprehensive understanding of the patient's needs.

• Prescription Authorization Form: This document is used to authorize a specific medication for a patient. Like the Rx Right Source form, it mandates the prescriber's input and signature, ensuring that prescriptions are legitimate and tailored to individual patient circumstances.

• Medication Refill Request Form: This form streamlines the process of obtaining refills for prescribed medications. Both the Medication Refill Request Form and the Rx Right Source form require essential patient and prescriber details, which helps in tracking ongoing medication needs and prescription validity.

• Prior Authorization Request Form: Similar in submitting necessary patient and medication information, this form is aimed at securing approval for specific treatments. Both forms necessitate that healthcare providers accurately detail patient conditions and treatment plans, ensuring that patients receive the appropriate care.

• Emergency Medication Dispensing Form: This form is used in urgent situations to expedite medication access. Like the Rx Right Source form, it demands the prescriber's affirmation of the necessity and appropriateness of immediate medication, underscoring the importance of timely care.

• Controlled Substance Prescription Form: This document governs the dispensing of medications classified as controlled substances. Requiring a prescriber’s detailed affirmation and special handling, it operates under similar guidelines to the Rx Right Source form, ensuring that prescriptions adhere to strict regulatory standards and secure patient safety.

When filling out the Rx Right Source form, adhering to proper guidelines ensures accuracy and efficiency. Here’s a helpful list of dos and don'ts to keep in mind:

• Do provide complete patient information, including gender, date of birth, and contact details.
• Do ensure the prescriber’s signature is included before sending the form.
• Do specify the quantity of medication and the number of refills clearly.
• Do indicate “brand medically necessary” if a brand-name product is required.
• Don't forget to complete all mandatory fields; incomplete forms can lead to delays.
• Don't use the form for CII medications, as it is not valid for these types of prescriptions.
• Don't assume that your fax will be processed immediately; allow up to 48 hours for entry into the system.
• Don't neglect to double-check the fax number to ensure it is sent to the correct location.

• It is only used for new prescriptions. The Rx Right Source form can also be used for refills and prior authorizations, not just new medications.
• Any medication can be prescribed using this form. However, it is important to note that this form is not valid for CII medications, which are classified as highly controlled substances.
• You must fax the form every time. While faxing is one option, prescribers can also send prescriptions electronically through their e-prescribing tool, making the process more efficient.
• The form only requires a prescriber’s signature. If applicable, it also needs a supervising prescriber’s signature and their DEA and NPI numbers if they are supervising the treatment.
• All prescriptions will be filled as written. Pharmacies typically fill prescriptions with generic equivalents unless the prescriber specifically indicates “brand medically necessary,” leading to potential changes in copayment.
• All faxed forms are processed immediately. After submission, faxed forms can take up to 48 hours to be entered into the pharmacy’s system, which may delay the processing of prescriptions.
• The form is the same for all patients. The information required on the form differs based on the patient’s specifics, such as their allergies and the medications they are prescribed.
• It does not matter who sends the fax. The form must be completed, signed, and sent directly from the provider’s office. This ensures authenticity and accuracy.
• You can skip the allergies section. It is essential to fill out the allergies section to inform the pharmacy of any potential adverse reactions, ensuring patient safety.
• This form can be used for over-the-counter medications. The Rx Right Source form is intended for prescription medications only and cannot be used to prescribe over-the-counter treatments.

When using the Rx Right Source form, it is important to carefully provide the necessary information to facilitate a smooth prescription process. Here are key takeaways to consider:

• Patient Information: Ensure that all patient details, including gender, member ID, and date of birth, are accurately filled out. Miscommunication can lead to delays in receiving medications.
• Allergy Information: Specify any allergies clearly. If there are no known allergies, indicate this as well. This can help prevent adverse reactions during treatment.
• Prescription Information: Complete this section thoroughly, as it must be filled out, signed, and sent directly from the provider's office. Remember that prescriptions for Schedule II (CII) medications cannot be processed with this form.
• Signature Requirements: The prescriber’s signature is mandatory. If a supervising prescriber is involved, their signature and DEA number must also be included if applicable.
• Faxing Instructions: After filling out the form, it should be faxed to Humana Pharmacy using the designated number. Alternatively, electronic prescriptions can be sent by selecting Humana Pharmacy from e-prescribing tools.
• Generic Substitution: Be aware that it is standard practice for pharmacies to substitute generic medications for brand-name when possible. To ensure a brand-name medication is dispensed, the prescriber must write “brand medically necessary,” which could result in higher costs for the patient.

These considerations can significantly impact the effectiveness and efficiency of the prescription process. Proper use of the Rx Right Source form is essential for both patients and healthcare providers.