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Payer Rules : Prescriptions
Payer Rules : Prescriptions

How to create a prescription payer rule

M
Written by Mae
Updated over 5 years ago

What is a Payer Rule?
Prescription Rules

It is safe to assume that all products/services require a prescription no matter what insurance the patient has, however there could be some exceptions. Prescription rules are for HCPCS that don’t require an actual prescription. Once you add the appropriate HCPCS and save, your invoice will not flag the item if no prescription is entered/received.

To enter a prescription rule, once in the rule prescription screen, you’ll have to click “Add Rule” on the right.

The screen will generate the first rule for you to enter. Add the HCPCS that do not require a prescription for that insurance by entering it in the blank HCPCS field with the asterisk. Once you find your code select it and press the plus sign to add it.

No you will see what you have chosen appear to the right  

Select Save on the bottom right to ensure everything saves to the payer rules. 

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