NDFP - Placing an Order with Multiple NDFP Drugs

NDFP - Placing an Order with Multiple NDFP Drugs

If a clinician orders a chemotherapy regimen that contains one or more NDFP (New Drug Funding Program) eligible drugs, a form needs to be completed in order for UHN to get reimbursed. This form is filled in electronically using the CCO eClaims system.

After the clinician saves and signs the chemo order in OPIS, the system will automatically launch the CCO eClaims application in a separate browser window. The clinician will then enroll the patient for the appropriate policy.

Certain criteria need to be in place in order for the eClaims application to launch.

They are as follows:

Patient must have a valid OHIN (Ontario Health Insurance Number).
Patient must be an Ontario Resident with a valid postal code starting with either ‘K’, ‘L’, ‘M’, ‘N’ or ‘P’.
Chemo order must have valid NDFP drug(s).
Dose must be greater than 0.
Route of Administration should be either IV or IJ or SC.
Chemo type is either ‘O’ for outpatient or ‘I’ for inpatient.
Patient must have Height, Weight and BSA on the order.
Patient must not have already been enrolled in eClaims for the NDFP drug and disease site group combination.

The steps are as follows:

1. The order has been placed (i.e. GI-Folfiri-Bevacizumab) and is now ready to be signed off which will initiate the eClaims process. Click the Sign Order button.

2. The Signature dialog box displays. Note the message in blue indicating eClaims will launch due to eligible drug(s). Type your Signature/password and click the OK button to proceed.

3. As there is more than one drug eligible for funding, the NDFP Drugs window appears. You will be filling in one form for each drug. Notice that the first drug is already highlighted. Click the eClaims button to proceed.

Note for Clinical Trial nurses: If you are a Clinical Trial nurse entering the order, you may close the NDFP Drugs window and continue to step 12 below. eClaims will launch for the physician at the time of co-signing the order.

4. The CCO eClaims system now launches with the Patient Information pre-populated. Click the drop down arrow. A list of all possible NDFP/EBP forms will appear based on site group and drug of the regimen ordered. Select the appropriate form.

Note for physicians: The only time that it would be appropriate for a physician to not to fill in this form is if you know for certain that the Hospital will be paying and that we will not be reimbursed. Only in this scenario can you close the form without filling it in. In all other instances you will carefully make the appropriate choice from the Matching Policy section in order to launch the correct enrollment form. If you do not select the correct form there could be potential funding and workload issues. It is easier to select the right form now then to try and fix it later. If you have any questions, please contact Day Care Pharmacy.

5. Click the Select button.

6. The selected form appears. Most of the data will be pre-populated from OPIS. Fill in the remaining fields. Note that anything with an * next to it is a required field.

7. Supporting documents (section appears at end of form), if required will be indicated in the Notes section. The documents must be previously saved in an electronic format before you can upload them to the eClaims system. Once the electronic file has been created, click the Browse button to search for the file.

From the file selection window, select your previously saved file and click the Open button.

The attached file appears. Note that you can use the Remove link to delete the file or use the Browse button to attach additional documents.

When you are finished with the form it is important that you Save it, rather than Submit it. Once you save the form, the pharmacist will review it and then submit the enrollment upon order verification. Click the Save button.

Note the message that appears in the final window indicating the form has been saved as a draft. Click the X to close the form.

The drug selection window reappears and the next drug is highlighted. Click the eClaims button to proceed.

Select the appropriate policy, fill in the form and save it as previously outlined above. Click the X to close the form.

You will be returned to the OPIS Order Entry window. A Print window will display next for any non-physicians placing or modifying the order on behalf of a physician. At Princess Margaret, the default option for this window is set to All Days to ensure that all days of the order will be printed. If you click Cancel, no Take-Home scripts will be printed. For non-physicians the Report Submission window will appear next for selecting specific reports to be printed. Click OK.

Note: Physicians do not see the Print window unless the Queman has been turned on. The default option All Days is selected in the background to ensure all days of the Take-Home scripts print once the ordered is signed by the physician.