MedsCheck

Claim Validation of MedsCheck Claims:

MedsCheck program documentation must be readily retrievable and includes “original records” that could be original paper documents, electronic scanned images of original paper documents or electronic records.
Required documentation that must be available at the pharmacy in a readily retrievable format includes:

• MedsCheck Patient Acknowledgement of Professional Pharmacy Services (standardized form). The completed form replaces the patient signature on the final MedsCheck Personal Medication Record.
• Pharmacist’s worksheet/professional notes — for every MedsCheck, pharmacists must have professional notes and/or a worksheet. Notes may be shared with the patient and/or primary prescriber on request.
• MedsCheck Personal Medication Record (standardized form). The record must be signed and dated by the pharmacist indicating the date of the consultation and all drug therapy problems must be followed up or have a plan for resolution prior to providing the form to the patient.
• MedsCheck Patient Take-Home Summary. This record, if used or if offered to the patient, must be signed and dated by both the pharmacist and the patient.
• Mandatory Fax/Letter to the primary prescriber (standardized form). Pharmacists must share the MedsCheck record with the primary prescriber using this form, thereby indicating the MedsCheck was shared with the patient’s prescriber.
• Other documents, as necessary, as referenced in the Professional Pharmacy Services Guidebook.
  It is important to document all patient interactions to support payment. Documentation may be requested for inspection purposes. MedsCheck documents must be kept in a readily retrievable format (either electronically or as a hard copy) at the pharmacy for the Retention Period for claim validation purposes, and in accordance with O Reg 264/16 if applicable.
  Ontario Drug Programs Reference Manual 191
  Note: Billing a MedsCheck service without complete documentation or without patient consent or for purposes that are outside of the specified program criteria may be subject to recovery.
  Examples of improper billing include MedsChecks for patient monitoring programs, medication reviews conducted over the phone or by video-conferencing; medication reviews incorporated in medical directives.
  Program details and mandatory requirements on the MedsCheck program are detailed in the Professional Pharmacy Services Guidebook.
  The Ministry may recover funds for claims lacking documentation meeting mandatory requirements.

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