The prescriptions Days Supply is 11 days. by: David
So we have a quantity of #90 capsules. We have a sig (directions on the prescription) as 1-2 capsules by mouth every 6-8 hours. How long will this prescription last (days supply)?
First, we calculate the maximum daily amount.
At a maximum, the patient could take 2 capsules every 6 hours daily (2 caps X 4 times daily) which equals 8 caps daily. Then we divide 90 capsules (our quantity for the prescription) by 8 capsules (at the maximum) daily, and we come up with 11 days.
Always remember to round down to the nearest day if you come up with a remainder amount.
Like in this case, the 90 divided by 8 = 11.25. However, we don't have any use for that 0.25 or quarter day.
Insurance companies require pharmacies to enter a days supply for each and every prescription we fill and they cover.
If the days supply is entered incorrectly on an RX that an insurance company or PBM pays for, they could potentially take back their payment to the pharmacy for the prescription or not reimburse the pharmacy for it at all.
Days supply miscalculations are very easy for PBMs and Big Insurance companies to catch. I'm sure that the millions and millions of RX claims that get sent to Insurance companies are data mined for a multitude of variables to sift and search and find errors/miscalculations/wrong info inputted so that they can find any reason to deny payment to the pharmacy. (Can you tell I once worked at an independent retail pharmacy?)
Anyway, Nate, thanks for the question--and sorry for the rant! I'll try to keep that in check the next time!
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