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CPESN + DocStation Partnership and Pharmacist eCare Plans

DocStation's TSP partnership and how to create and submit eCare Plans

Aubree Dorr avatar
Written by Aubree Dorr
Updated today

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:

  1. navigate to organization settings

  2. then locations tab

  3. then data exchange tab

  4. click the blue plus in the top right corner

  5. select integrations

  6. choose the CPESN integration

  7. 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:

  1. On-demand from the patient's health record

  2. After completing a Task

Generate a Care Plan On Demand

  1. Navigate to the appropriate patient health record

  2. Make sure the information in the health record is up to date

  3. Click the context menu in the top right corner (...)

  4. Select "Create Care Plan"

  5. 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

  6. Select or adjust the appropriate items to populate your eCare Plan including Encounter Type, Method, Payer Code (if applicable), Encounter Reason, & Interventions

  7. Click "Continue"

  8. Review the encounter details in the preview screen

  9. 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

  1. Navigate to the Templates page in Organization Settings

  2. Locate the "Care Plan Templates" section

  3. Click "Create New" to start a new template

  4. 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

  5. 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:

  1. Log in to your DocStation account

  2. Navigate to Organization Settings

  3. Select the Locations tab

  4. Choose the applicable location for which you want to enable the feature

  5. Click on the Data Exchange tab

  6. Look for the CPESN integration section

    1. 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"

  7. Find the Claim Export toggle button

  8. 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)

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