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Rx E-Log TM. Evaluate Our Full Version Program For 30 Days Call Medi-Ez, Inc. For Details 815-838-8885. Pharmacy Picks Payor. Touch Pen Here For Additional Payors. Print Patient’s Name. Previous Patient-> Will Not Require A Privacy Policy. Tap Electronic Pen To Initial Of Last Name.
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Rx E-LogTM Evaluate Our Full Version Program For 30 Days Call Medi-Ez, Inc. For Details 815-838-8885
Pharmacy Picks Payor Touch Pen Here For Additional Payors
Print Patient’s Name Previous Patient-> Will Not Require A Privacy Policy
Print Prescription Numbers Touch Pen Here To Add Additional Prescriptions
Additional Screens For More Prescription Numbers A Third Screen Is Available If Necessary Touch Pen Here For Additional Payors
Ask Patient If They Have Received Your Privacy Policy Touch Pen Here If Patient Has Previously Received Privacy Policy
Print Patient’s Name New Patient-> Will Require A Privacy Policy
Tap Electronic Pen To Initial Of Last Name Necessary To Sort Reports By Last Name
Ask Patient If They Have Received Your Privacy Policy Touch Pen Here If This Is a New Patient Who Has Not Received Privacy Policy
Patient Acknowledges Receiving Your Privacy Policy Touch Pen Here If Patient Refuses To Sign
For Privacy Policy Only. Must Obtain DOB/PIN This Is Required To Retrieve Signature At A Later Time This Can Be The Last Four Digits Of SS #
Tap Electronic Pen To Initial Of Last Name Necessary To Sort Reports By Last Name
Report Includes All Payors/Hipaa Print Report Hipaa Sig. 3 Sets Of Rx Numbers
Report Includes Payor/Hipaa for a SinglePayor Single Payor Report All Payors “AARP”
Hipaa Signature Verification Report Hipaa Signature Only
Individual Hipaa Acknowledgement Date Of Acquired Signature Date Report Printed
Payor Acknowledgement For All Payors Date Patient Signed For Prescriptions
Payor Acknowledgement For A Single Payor Single Payor Report All Payors “AARP” Payor Acknowledgement For A Single Payor
Rx E-LogTM • **Pharmacist in Charge must check with all Federal and State regulations and 3rd Party Payors as to acceptance of Electronic Signatures and acceptable verbiage. 3rd Party verbiage is available upon request.**