Adding and Managing Insurance Plans?

Overview

An Insurance Plan—commonly known as Prescription Drug Coverage—helps cover the cost of medications. Insurance Plans may be included as part of a standard health insurance policy or purchased separately. Coverage details, costs, and covered medications vary by provider.

Within SiCompounding, Insurance Plans are maintained so prescriptions can be billed and processed accurately.

Insurance Plans are managed within the Codes and Classifications area of Pharmacy Settings.

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Accessing Insurance Plans

Follow the steps below to navigate to the Insurance Plans setup area.

Step-by-Step Navigation

1. Click the FileMaker Pro icon to open FileMaker.
2. When FileMaker opens, locate the large menu bar on the left side of the window.
3. Click SiCompounding (near the top).
4. In the next window, several icons appear across the middle of the screen.
5. Click Pharmacy to open the Dashboard.
6. From the blue sidebar menu, scroll to the bottom and select Settings.
7. Under General Settings, select Codes and Classifications.
   • The Code Classifications section allows users to manage standardized codes for prescription orders.
8. From the popup list, select Insurance Plans.

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Insurance Plans Table

The Insurance Plans window opens and displays a list of configured insurance plans.

Table Columns

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Searching Insurance Plans

• Use the Search bar in the upper-right corner of the window.
• Search by:
  • BIN
  • PCN
• Press the Enter/Return key to display search results.

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Adding a New Insurance Plan

1. In the Insurance Plans window, click + Plan.
2. Enter all required insurance plan information, including:
   • Code
   • Name
   • BIN
   • PCN
   • Phone number
   • Status (Active or Inactive)
3. Click Save after all data has been entered.

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Managing Existing Insurance Plans

Each Insurance Plan row includes actions accessed from the Action column.

Edit an Insurance Plan

1. In the Action column, select Edit for the Insurance Plan you want to modify.
2. The plan details window opens.
3. Make the necessary updates.
4. Click Save to apply changes.

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View Change Logs

1. In the Action column, select Change Logs.
2. The Record Modification Log window opens, displaying a history of changes made to the Insurance Plan.
3. Click the X in the upper-right corner to close the window.

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Pharmacy Settings Overview

The Pharmacy Settings section contains system templates and default configurations and must be completed before using any other area within SiCompounding.

Areas Managed in Pharmacy Settings

• Product settings
• Facility Areas
• Equipment
• Workflows
• Costs and Fees
• Lab Work
• COM Templates
• Notifications
• Integrations
• Access logs (available through the Automations tab)

:::callout type="warning" It is important to enter all available and required data for each section and subsection in Pharmacy Settings to ensure accuracy, compliance, and proper system functionality. :::

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Summary

Maintaining Insurance Plans ensures:

• Accurate prescription billing
• Proper insurance plan selection
• Consistent insurance data management

Insurance Plans should be reviewed and updated regularly to reflect payer changes and pharmacy billing requirements.