New Prescription Request Workflow

​

Overview

Use this workflow when a facility or patient is requesting a new medication order, not just a refill on an existing prescription. The Concierge/Ops team ensures:

• The request is appropriate (not a duplicate of an existing order or refillable med)
• A complete tele-encounter is created for the provider in ECW
• The provider’s decision flows into PioneerRx, AllCare.ai, and Freshdesk

​

Quick Reference

SLA: Urgent requests within 4 hours; routine within 24 hours
Escalation: Provider no response after 24 hours (urgent) or 48 hours (routine)
Systems: ECW, PioneerRx, AllCare.ai, Freshdesk

---

​

Workflow Diagram

---

​

Step-by-Step Procedure

​

1. Receive and Validate Request

In Freshdesk:

• Receive request via facility fax, email, or Freshdesk ticket
• Confirm patient details and medication requested

In ECW:

• Open patient chart → Medications tab
• Review medication history to check if this medication has been prescribed before

In PioneerRx:

• Search for patient and check existing orders
• Verify the medication does not already have remaining refills

Decision Point:

• ✅ Truly new medication → Proceed to Step 2
• ❌ Has refills available → Contact requestor to clarify if they want a refill instead
• 🔄 Requestor confirms refill → Go to Medication Refill Workflow

​

2. Create Tele-Encounter for Provider

In ECW:

• Navigate to patient chart → Encounters → New Tele-Encounter
• Encounter type: “New Prescription Request”

Fill in Medication Details:

• Drug name (generic and brand if specified)
• Strength and dosage form (tablet, capsule, liquid, etc.)
• Quantity (e.g., #30, #90)
• Directions for use (e.g., “Take 1 tablet by mouth daily”)
• Refill count (e.g., 0, 3, 11)
• Any special instructions (e.g., “Take with food”)

Attach Supporting Documents:

• If facility faxed an order, attach the fax to the encounter
• Include any relevant clinical notes or context
• Add facility contact information for follow-up questions

​

3. Assign to Provider and Set Priority

Assign to Treating Provider:

• Select the patient’s assigned treating provider from the dropdown
• Ensure the encounter is properly assigned (not left in draft)

Set Priority: URGENT (mark clearly in encounter title and Freshdesk):

• Antibiotics for active infection
• Pain medications
• Time-sensitive therapies (e.g., steroids for acute conditions)
• Safety-critical medications

ROUTINE:

• Maintenance medications
• Chronic disease management
• Non-urgent symptom management

Notify Facility:

• Call or email: “New prescription request submitted to provider. Expected response within [timeframe based on priority].“

​

4. Monitor Provider Response

Check Tele-Encounters:

• Monitor for provider action on the encounter
• Check both:
  • Encounters assigned back to you
  • Provider’s own tele-encounter list

Provider Actions: A) Provider Approves and E-Prescribes:

• Provider sends e-script directly from ECW to PioneerRx
• Proceed to Step 5 (Verify E-Script)

B) Provider Returns with Questions:

• Provider marks encounter with questions or requests clarification
• Contact facility/requestor to get additional information
• Create new tele-encounter with clarified details
• Return to Step 3

C) Provider Handles Directly:

• Provider contacts facility or pharmacy directly
• Monitor for completion
• Update Freshdesk with provider’s actions

Escalation Timeline:

• Urgent requests: No response after 24 hours → Send reminder, escalate to Clinical Supervisor
• Routine requests: No response after 48 hours → Send reminder, escalate if no response after 72 hours

​

5. Verify E-Script in PioneerRx

Wait Period:

• Allow 30 minutes for e-script transmission after provider sends

In PioneerRx:

• Search for patient
• Check for new incoming e-script matching the requested medication

If E-Script Received:

• ✅ Proceed to Step 6 (Update and Close)

If E-Script NOT Received:

• Check ECW to confirm provider actually sent the e-script
• If confirmed sent: Contact PioneerRx support for transmission issue
• If not sent: Follow up with provider to confirm they completed the e-prescribe action

​

6. Coordinate Pharmacy Processing

Update Freshdesk:

• Log: “E-script sent to pharmacy, order initiated by treating doctor”
• Update ticket status to reflect pharmacy processing

In AllCare.ai:

• Add note linking to ECW encounter: “New prescription for [medication] ordered by [provider] on [date]”

Monitor Delivery:

• Pharmacy team processes and dispenses
• Confirm delivery ETA with dispatchers
• Notify facility of expected delivery

​

7. Document and Close

In Freshdesk:

• Final update: “Order initiated and sent for dispensing by treating doctor. Delivery ETA: [date].”
• Change ticket status to Resolved
• Close ticket after pharmacy confirms dispensing

---

​

Systems Used

​

ECW

• Create tele-encounter with all required medication details
• Attach any faxed orders or supporting clinical documentation
• Monitor for provider decision and e-prescribe action

​

AllCare.ai

• Add summary note linking to ECW encounter
• Document request details and outcome

​

PioneerRx

• Verify e-script arrival and readiness for processing
• Coordinate with pharmacy intake team

​

Freshdesk

• Track request from intake through provider decision to pharmacy delivery
• Log all communications and escalations

---

​

Priority & Safety Considerations

​

Urgent Medications

Mark clearly in ECW encounter title and Freshdesk ticket:

• Antibiotics for active infections
• Pain medications (acute pain management)
• Time-sensitive therapies (steroids, anticoagulants)
• Safety-critical medications (seizure, cardiac, respiratory)

Follow-up Timeline:

• Check for provider response within 4 hours
• Send reminder after 24 hours if no response
• Escalate to Clinical Supervisor if no response after 24 hours

​

Routine Medications

Standard follow-up cadence:

• Check for provider response within 24 hours
• Send reminder after 48 hours if no response
• Escalate if no response after 72 hours

---

​

Troubleshooting

​

Issue: Unclear if request is new prescription or refill

Solution:

• Check ECW medication history and PioneerRx active orders
• If medication was previously prescribed, check refill count
• Contact facility to clarify: “This medication has X refills remaining. Do you need a refill or a new order?”

​

Issue: Provider returns encounter with questions

Solution:

• Review provider’s questions/comments in ECW
• Contact facility or review available clinical documentation
• Create new tele-encounter with clarified information
• Reference original encounter for continuity

​

Issue: E-script sent but not received in PioneerRx

Solution:

• Wait 30 minutes for transmission
• Verify in ECW that provider actually sent (check encounter status)
• If confirmed sent, contact PioneerRx support with:
  • Patient name and DOB
  • Medication details
  • Provider name and NPI
  • Time e-script was sent from ECW

​

Issue: Facility requests urgent new prescription but provider unavailable

Solution:

• Check if patient has alternate provider assigned
• Contact Clinical Supervisor for urgent coverage
• If critical/emergent, follow emergency medication protocol
• Keep facility informed of escalation and timeline

---

​

Video Walkthrough

🔗 Training videos available in Concierge Training Manual

---

​

Related Workflows

• Medication Refill Workflow
• Medication Changes
• Medication Reconciliation