How do I send e-prescriptions (eRx) and approve refills for controlled substances?

Practice Fusion’s e-prescribing for controlled substances (EPCS) feature is certified to meet all DEA requirements. Once you’ve activated the EPCS feature in your Practice Fusion account, EPCS-enabled prescribers can begin sending e-prescriptions and processing e-refill requests for controlled substances. The workflows for sending e-prescriptions and processing refill requests for controlled substances are similar to the workflows for non-controlled substances, though they entail additional steps.
 

Sending an eRx for controlled substances
You can create an e-prescription from multiple places in the patient chart, including the Summary tab and within the Plan section of an encounter.
 
1. Add a new medication to the plan section of a patient’s encounter and send an e-prescription, scroll to the Plan section of the encounter and click Record as shown in Graphic 1 below.
 
Graphic 1: Record medication

 
 
2. Expand the fly-out pane and select the Medications tab. Click Record to search for a new medication (see Graphic 2 below). If you select a medication from your Frequent list or the patient's medication list, it will first be attached to the encounter. Once attached, click on the medication name to create a new prescription.
 
Graphic 2: Attach medication to encounter


 
3. Alternatively, type the first few letters of the medication name to search (see Graphic 3 below). The most common route, strength, and form will appear at the top of the list. The search results will display both generic and brand choices, based on the active ingredient of the drug you searched for.
 
Graphic 3: Medication search
 

 
4. After selecting a medication, enter the SIG (see Graphic 4 below). Click Enter Shorthand to choose from a list of the most common SIGs for the medication you selected. Alternatively, type in the free-text field below. Click Order to begin creating the prescription.
 
Graphic 4: Enter SIG
 

 
5. Review the patient’s drug formulary and any drug interaction or drug allergy alerts if present.
 
6. Click Next to enter the dispense quantity and units (see Graphic 5 below). You may also use the fly-out pane to review the patient’s recent prescription details. You can associate a diagnosis from the patient’s chart and enter a start date. If you associate a diagnosis with the medication, the diagnosis code will be included in the electronic prescription transmitted to the pharmacy. To discontinue the medication at a later date, you may also enter a future stop date. For additional information about discontinuing medications, click here. Although you may send a custom note to the pharmacy using the Note to pharmacy field, this field should not contain redundant or conflicting information that has already been entered as part of the prescription. You may also record an internal Rx comment for your own reference. Once you have completed the necessary fields, click Next.
 
For Schedule II medications, additional fields are required:
  • Number of days’ supply
  • Earliest fill date
Note: The Refills field cannot be edited for Schedule II medications.
 
Graphic 5: Fill required fields


 
7. On the Order Summary screen, check the Ready to sign box for each controlled substance that is included in the order prior to sending the prescription electronically (see Graphic 6 below).
 
Graphic 6: Ready to sign checkbox

 
 
8. Select a pharmacy to fill the order. If the order includes at least one controlled substance, the pharmacy selected must be able accept controlled substances. This will be indicated next to the pharmacy type as shown in Graphic 7 below.
 
Graphic 7: Pharmacy that accepts controlled substances


 
9. If applicable law requires you to identify the Supervising provider, please select from the drop-down menu (see Graphic 8 below). Only providers who are active in the EHR and enabled for e-Prescribing will be displayed in the drop down.
 
Graphic 8: Supervising provider
 

 
10. Once you have reviewed, confirmed and approved the prescription summary, click Send eRx.
 
11. You will be prompted to complete two-factor authentication. Enter your Practice Fusion password and click Continue as shown in Graphic 9 below. Then click Authenticate with ID.me (see Graphic 10 below) to receive a push notification or a security code displayed within the ID.me Authenticator application on your smartphone. If you have included multiple prescriptions for controlled substances in the order, you will only need to enter the security code once. Once your password and authentication code are confirmed, the order will be sent electronically (see Graphic 11 below).
 
Graphic 9: Authentication required - Enter PF password


 
Graphic 10: Authenticate with ID.me


 
Graphic 11: Security token confirmed and order sent


 
Processing refill requests for controlled substances
Once you’ve activated the EPCS feature in your Practice Fusion account, EPCS-enabled prescribers can begin processing e-refill requests for controlled substances by following the directions below.
 
1. Select the Refill requests tab in your Tasks list. Click Review to open the request as shown in Graphic 12 below.
 
Graphic 12: Review refill request

 
 
2. The system will search for the appropriate patient based on the demographic information listed within the request. Click Assign to associate the request with the patient displayed or, if necessary, search for a different patient (see Graphic 13 below).
 
Graphic 13: Assign refill request to patient


 
3. Review the refill request to ensure that all information is correct (see Graphic 14 below). Please note the following:
  • The dose and quantity cannot be edited. If you would like to update the dose or quantity, you will need to deny the request and send a new prescription.
  • Refills of Schedule II medications are not permitted under federal law. Providers who receive refills requests for these medications must select Deny or Deny Refill, Script to Follow to send a new e-prescription.
 
Graphic 14: Refill request details


 
4. Check the Ready to sign box before clicking Approve as shown in Graphic 15 below.
 
Graphic 15: Approve refill request
 

 
5. You will be prompted to complete two-factor authentication. Enter your Practice Fusion password and click Continue as shown in Graphic 16  below. Then click Authenticate with ID.me as shown in Graphic 17 to receive a push notification or a one time authentication code from the ID.me Authenticator app. Once your password and security token have been confirmed, the refill approval will be sent electronically to the pharmacy.
 
Graphic 16: Authentication required - Enter PF password


 
Graphic 17: Authenticate with ID.me


 
For additional information, please see:

e-Prescribing

  1. How do I sign up for eRx (e-Prescribing)?
  2. How do I send an eRx (e-Prescription)?
  3. How do I process eRx (e-Prescribing) refill requests?
  4. How do I prescribe multiple medications in a single order?
  5. How do I search for a pharmacy or enter a preferred pharmacy?
  6. Why am I unable to send an eRx (e-Prescription)?
  7. What do eRx (e-Prescribing) error messages mean?
  8. Activating e-prescribing of controlled substances (EPCS): Step 1 of 2
  9. Setting up EPCS e-signing permissions: Step 2 of 2
  10. How do I send e-prescriptions (eRx) and approve refills for controlled substances?
  11. How do I enable and use prescription task delegation?
  12. How do I print and format prescriptions?
  13. What is the status of my eRx (e-Prescribing) request?
  14. Prescription Formulary FAQ's
  15. How do I edit my Drug-Drug and Drug-Allergy Interactions Settings?
  16. How do I add my NPI and DEA numbers to printed prescriptions?
  17. Can I be enabled for e-prescribing on two Practice Fusion accounts at the same time?
  18. How do I edit a refill sent by the pharmacy?
  19. Can I e-Prescribe through multiple eRx vendors?
  20. How do I add a pharmacy to the database?
  21. How can I discontinue a medication?
  22. How can you see the status of an eRx (e-Prescription)?
  23. How does I-STOP affect my practice and what is Practice Fusion doing to prepare for EPCS?
  24. What does the eRx (e-Prescribing) "Pending" status mean?
  25. How do I disable my e-prescribing with Practice Fusion?
  26. How do I re-activate eRx (e-Prescribing)?
  27. How can I help a provider verify eRx (e-Prescribing) credentials?
  28. How can I disable refill requests?
  29. How do I update my phone or fax number for eRx (e-Prescribing)?
  30. Who can send an e-prescription?
  31. Why am I not receiving eRx (e-Prescribing) refills?
  32. What if I fail e-Prescribing (eRx) verification?
  33. How do I use eCoupons?
  34. How do I use electronic prior authorizations?
  35. How do I print an e-Prescription receipt?
  36. How do I use medication adherence?
  37. Why am I receiving an alert to update my medical license?
  38. How can I see medication costs and cost-saving alternatives?
  39. What does it mean when a patient medication is no longer available?
  40. Ohio Prescription Instructions
  41. How does the Maine EPCS Opiates Mandate under L.D. 1646 affect my practice?
  42. How do I initiate a request for a prior authorization from the EHR?
  43. How do I submit prior authorizations via Physicians’ Desk Reference (PDR)?
  44. How do I update the ID.me Authenticator application for EPCS?
  45. Electronic Prescribing (eRx) and EPCS sign up with ID.me identity verification

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