PMS (Pharmacy Management System) – the system that manages the back-end (or RX) part of a pharmacy. The PMS primarily supports the insurance billing and prescription drug supply chain process, including automatic dispensing of drugs, and IVR system integration. Eagle for Windows POS integrates with the PMS by reading their barcodes (which include the RX number and co-pay amount), collecting the co-pay, and confirming receipt and payment of the prescription.
The PMS is a different server than Eagle, and the basic flow of information between the two servers is as follows: The PMS generates a label with a barcode and RX number. Eagle POS scans the label and passes a message to the PMS System that includes the RX number. The OMS system passes back information about the transaction/customer, such as HIPAA signature required, co-pay amount, EZ off caps requested, pharmacist consult waived, etc. Based on the response from the PMS, Eagle posts a line-item sale to a generic Rx SKU/Department for the co-pay amount. In addition, Eagle posts any necessary messages pertaining to safety caps and consults, and collects the HIPPA signature if required. When the transaction is complete, Eagle passes data back to the PMS system.
HIPAA – (Health Insurance Portability and Accountability Act) – Customers must sign a Notice of Privacy Practices (NOPP) statement at all pharmacies
HIPAA signature capture – HIPAA imposes several rules on pharmacies, including a mandate to capture a signature after notifying a customer that they can speak to a pharmacist about taking their medicine, or after a customer has refused child-protective caps
Will Call – Integrated into a POS system like the Eagle, will call verifies that all prescriptions are displayed when a single prescription is scanned for a customer. Will call also refers to prescription drugs that are ready to be picked up and may be shown on the POS system, or when a system calls customers to inform them that their prescription is ready.
CMEA – Combat Methamphetamine Epidemic Act of 2005. This federal legislation ensures customer tracking of sales of ephedrine, pseudoephedrine, and phenylpropanolamine
Pseudoephedrine (PSE) tracking – A system that tracks pseudoephedrine so that retailers can comply with limiting the amount of products that contain methamphetamine they can sell to the same customer at the same time and over a given period of time
Controlled Substances – Similar to CMEA, this is simply tracking customers who buy controlled substances (a drug or chemical whose possession and use are controlled by law)
TPA – Third Party Administrators that process insurance claims.
SIGIS and IIAS – (Special Interest Group for IIAS Standards and Inventory Information Approval System). SIGIS was set up as a standards group to support the IRS-imposed requirement that retailers only accept payment from FSA/HRA payment cards for a list of eligible items. The IRS doesn’t want people paying (with pre-tax dollars) for goods that are not qualified (e.g. beer is not eligible, Motrin is eligible). The IIAS is the list of items (defined by UPC) that qualifies. When a customer's purchase is rung up in Eagle POS, Eagle recognizes the items that are on the IIAS list. Eagle POS then groups and subtotals the eligible items. The customer can pay for them using the FSA/HRA payment card. The other items are paid for with another means.
IIAS – Inventory Information Approval System run by the SIGIS (Special Interest Group for IIAS Standards). The IIAS provides the list of IRS-approved products for FSA/HAS/HRA debit purchases.
HSA – A high deductible health insurance plan/policy that people can obtain independently or through work that has reduced premiums and can be funded in tax free accounts. HSA plans eliminate the use of FSA and HRA plans
FSA and HRA – An FSA (Flexible Spending Account) that is used for health expense is essentially the same as an HRA
FSA Debit Card – Issued with FSA, HRA, and HSA, these cards work with IIAS similar to the way food stamps work. To sell front-end merchandise, most independent pharmacies must have an IIAS. Note, however, that certain pharmacies remain exempt--in particular, independent pharmacies that do at least 90% of their overall revenue from qualifying IIAS merchandise (e.g. RX drugs, over-the-counter (OTC) drugs, etc.).
Back End – The Back End of a pharmacy is where all regulated prescription drugs are kept
Front End – The Front End of a pharmacy is where OTC drugs, gifts, novelties, cards, etc. are sold
Safety caps – If a customer declines the safety caps on a prescription, they must sign a decline form
Patient Counseling – Patient counseling is required for prescription drugs; therefore, to decline counseling, a customer must sign a form
PBM (Pharmacy Benefits Manager) – A third-party administrator for processing and paying prescription drug claims
Co-pay – A portion of the price of a prescription drug that the customer must pay that isn't covered by insurance
DME (Durable Medical Equipment--wheelchairs, crutches, blood glucose monitors, infusion pumps, etc) – these items can be sold or rented by approved stores
EBT (Electronic Benefit Transfer) – Food stamp program with a government database of approved purchases
340B Compliance – A federal drug discount program to help ‘the most vulnerable patients’ (e.g. Medicare / Medicaid). This program is relevant to PMS systems rather than pharmacy POS systems.