DocStation has had the distinct privilege to be a technology solutions partner (TSP) with CPESN USA and many state chapters since 2019. We are proud to offer CPESN-certified ecare plan solutions that make it simple and efficient to report care plans and earn revenue through CPESN's value-based payer programs. Learn more in this article about how to take advantage of this integration and associated tools.
Article Contents:
CPESN Integration
Enabling the CPESN integration is a crucial step in ensuring all generated care plans are submitted to CPESN USA for participation credit in various programs. For organizations with an active CPESN integration, DocStation will automatically send completed eCare Plans to CPESN USA once "Save and Close" is selected on the on-demand care plan, or when the task is completed.
To enable the CPESN integration:
navigate to organization settings
then locations tab
then data exchange tab
click the blue plus in the top right corner
select integrations
choose the CPESN integration
If desired, toggle on the Claims Export option to auto-submit medical claims data to CPESN on a weekly basis.
The claims export option enables you to automatically report adjudicated medical claim data to CPESN USA as desired. This option is not required to submit e-care plans for CPESN value-based programs.
What is an eCare Plan?
The Pharmacist eCare Plan is a standardized document used to communicate pharmacist-provided interventions for various purposes. For example, the eCare Plan is used by CPESN member pharmacies to document and report enhanced services provided to patients across many programs. Learn more about it in this DocStation article and here at ecareplaninitiative.com.
Ways to Generate an eCare Plan
There are two ways to generate an eCare Plan:
On-demand from the patient's health record
After completing a Task
Generate a Care Plan On Demand
Navigate to the appropriate patient health record
Make sure the information in the health record is up to date
Click the context menu in the top right corner (...)
Select "Create Care Plan"
NEW! You'll now see a "Template" option:
Select from your available templates to automatically populate the care plan fields
NOTE: Click "Continue" to create a blank care plan without using a template
Use "Back" if you need to select a different template after reviewing
Select or adjust the appropriate items to populate your eCare Plan including Encounter Type, Method, Payer Code (if applicable), Encounter Reason, & Interventions
Click "Continue"
Review the encounter details in the preview screen
Click "Save and Close"
That's it! Once your eCare Plan is saved, you can review it in the History tab on the patient profile. To provide a copy to the patient or caregiver, select the Print button and follow the printing prompts.
Generate a Care Plan After a Task
eCare Plans can be generated when a task is completed based on the interventions documented in the task.
Once you click "Continue" to complete the task, you'll have an option to generate the eCare Plan and click "Continue". Then, verify the Encounter Type, Method and Payer Code (if applicable), and click "Continue". The care plan will automatically be submitted to CPESN.
You can access these eCare Plans for reference in the History tab of the Tasks section of the profile.
NEW! eCare Plan Templates
The new eCare Plan Template feature allows you to save time by creating standardized templates for common care plan scenarios.
Check out this quick tutorial to see Rachel create a custom eCare plan template and show you how to use it in a patient profile.
Creating a New eCare Plan Template
Navigate to the Templates page in Organization Settings
Locate the "Care Plan Templates" section
Click "Create New" to start a new template
Complete the template details:
Title: Give your template a descriptive name (e.g., "Patient Education")
Encounter Types: Select applicable encounter types (e.g., In-person, Virtual)
Program: Choose the appropriate program to submit the care plan to
Encounter Reasons: Select the relevant reasons for this template
Interventions: Add commonly performed interventions for this template type
Click "Create" to save your new template
Managing Existing Templates
You can easily manage your eCare Plan Templates:
View: All your templates will appear in the Care Plan Templates section
Edit: Click the "Edit" button next to any template to modify its details
Delete: Remove templates you no longer need by clicking the "Delete" button
Notes About Templates
Templates are specific to your account; there are no platform-wide templates
Program selections will appear in the care plan even if they are not visible during creation (for non-CPESN locations)
You can create multiple templates for different clinical scenarios
Templates work similarly to other template types in the system
By utilizing eCare Plan Templates, you'll enhance your efficiency while maintaining high-quality, consistent patient care documentation.
NEW! eCare Plan Review System!
We've released enhanced care plan functionality that streamlines the review process for submitted care plans! You can now:
Customize pharmacist details on care plan templates with editable name and NPI fields that default to the current user
Preview details before saving to ensure accuracy and formatting
Filter care plan submissions by location in the settings area for better organization
Mark care plans as reviewed with a new review status system that automatically filters out completed reviews
The review workflow is particularly clean - once you mark submissions as reviewed, they automatically disappear from the unreviewed queue, keeping your workspace focused on items that still need attention. The history tab maintains a complete record of all generated care plans with the associated pharmacist information.
Medical Claim Export to CPESN
Some CPESN chapters are supporting pharmacists in their medical billing journey. In those cases, it may be beneficial to share your medical claim data with CPSN USA. DocStation makes it easy to automatically report this information on a weekly basis via the CPESN medical claim export.
Follow these steps to enable the claim export integration:
Log in to your DocStation account
Navigate to Organization Settings
Select the Locations tab
Choose the applicable location for which you want to enable the feature
Click on the Data Exchange tab
Look for the CPESN integration section
If you haven't enabled the integration for eCare plans yet, select the CPESN integration from the blue + in the top right corner and click "Enable"
Find the Claim Export toggle button
Switch the toggle to the Enable position
What to Expect
Once enabled, the claims export feature will automatically export adjudicated claims from the last 7 days. Here's what you need to know:
- Export Frequency: The export process occurs every Sunday
- Data Range: Only claims from the past 7 days are included in each export
- Automation: The export process is fully automated; no manual intervention is required
Automated Report Headers and Descriptions
claimId - DocStation claim number (ex: DS123456)
status - Adjudicated status of the claim (ex: paid, denied)
org - Name of organization
serviceLocationName - Name of location providing service
serviceLocationId - DocStation location ID
renderingProviderNPI - Rendering provider NPI
billingProviderNPI - Billing provider NPI
billingProviderState - State location of the billing provider
patientId - Subscriber ID on the claim
dateOfService - Service date of the claim
procedureCodes - Service codes billed (ex: 99605, 99212)
diagnosisCodes - Billable diagnosis codes identified (ex: Z23, I10)
modifierCodes - Modifier codes identified (ex: KX, 25)
placeOfService - Place of service identified (ex: 01-Pharmacy, 11-Office)
amountBilled - Total amount billed
amountPaid - Total amount paid
patientResponsibility - Portion of Amount Paid identified as patient's responsibility to pay
payerName - Name of payer identified (ex: Aetna, Blue Cross Texas)
payerType - Plan type (ex: Medicare, Medicaid, Other)
firstTimeReadyToSubmitDate - First time "Submit Claim" was clicked
sentToClearinghouseDate - Date the claim was sent to the clearinghouse
should typically be the same as the date the claim was submitted, but could be different if any of the following:
claim was initially "invalid"
transmission error occurred, delayed auto-submission
acceptedByClearinghouseDate - Date the claim was acknowledged by the clearinghouse
adjudicatedDate - Date the claim was fully adjudicated, per ERA
adjustmentReasonCodes - CARC to clarify payment details (ex: CO-19)
remarkCodes - RARC to clarify payment details (ex: CO-19)
templateName - Title of the claim template used to generate the claim
viaBinBilling - Whether claim was originated via BIN billing
docStationPayerId - DocStation's PayerID
clearinghouse - Clearinghouse to which the claim was submitted (ex: Availity, Change)