The GPI Count feature gives you the ability to track the total number of fills over time. It can also be used to set limits on the number of times a medication can be filled for a specific patient. This functionality is useful for tracking fill counts for specific classes of drugs, such as narcotics. What’s more, patient GPI counts can be managed from the patient profile, rather than the authorization form, saving you time and improving productivity.

This article describes how to:

• add a GPI counter to a patient’s profile,
• view and interpret fill counts,
• set a fill limit on a medication for a patient,
• add a fill limit to an existing patient GPI counter, and
• override patient fill limits.

Article Contents

How to Add a GPI Counter to a Patient

Adding a GPI Counter is the go-to solution for tracking the number of times a particular drug was filled for a patient.

To add a GPI counter to a patient:

1. Go to ehorx.com and log in using your credentials.
2. Enter the patient’s name or ID into the patient search bar at the top right of the page. A list of patient names will display.
3. Select the patient needed from the list of names on the screen. The patient profile will display.
4. Select GPI Counts from the left sidebar menu on the patient’s profile. The Add GPI Counter form will display.
5. Enter the GPI code to be tracked. The system currently supports the 10-digit GPI code corresponding to the drug name.
6. Specify a start date. An optional stop date can also be entered.
7. Click Add. 
8. A GPI counter has been added to the patient’s profile. A table with the GPI counter details will display on the screen. 

How to View Patient Fill Counts

Fill count totals for the specified GPI will populate in a table after a GPI Counter is added to a patient. Fill totals are listed on the right side of the table under Fill Counts and broken down into three categories:

1. In Network: Number of fills processed with EHO360.
2. Out of Network: Number of fills processed outside of EHO360.
3. Total: The sum of the in and out of network fills.

The In Network value for the specified GPI will increase by one after a claim processes. If a claim is reversed, the In Network total will decrease by one. A GPI Counter has to be added on a patient for the fill count values to change following a claim submission or reversal. 

The system cannot keep track of Out of Network fills at this time. However, values in the Out of Network field can be edited and updated if needed. GPI counters can also be edited to adjust allowable limits or make changes to start/stop dates.

Set a Fill Limit Using a GPI Counter

Fill limits can be set for a specific patient and medication without making an authorization! Here’s how:

1. Go to ehorx.com and log in using your credentials.
2. Enter the patient’s name or ID into the patient search bar at the top right of the page. A list of patient names will display.
3. Select the patient needed from the list of names on the screen. The patient profile will display.
4. Select GPI Counts from the left sidebar menu on the patient’s profile. The Add GPI Counter form will display.
5. Enter the GPI code to be tracked. The system currently supports the 10-digit GPI code corresponding to the drug name.
6. Specify a start date. An optional stop date can also be entered.
7. Enter the number of fills permitted in the Limit field. Update the In-Network and Out of Network fill counts if there are existing fills on file that need to be accounted for. 
8. Click Add.

A GPI counter with a fill limit has been added to the patient’s profile. A table with the GPI counter details will display on the screen. The limit will be listed in the column labeled Limit. This column is highlighted in yellow in the image below. 

Add a Fill Limit to an Existing Patient GPI Counter

After a GPI counter is added to a patient’s profile, a table will display on the screen.

To set a limit on an existing GPI counter listed in the table:

1. Click Edit in the row containing the GPI you want to set a limit on. The Edit GPI Counter form will display.
2. Enter the number of fills allowed in the Limit field. 
3. Click Update. 

A limit has been set. The value entered will display in the Limit column of the table. 

Override Patient Fill Limit Set Using a GPI Counter

Fill limits set on a specific patient and GPI can be overridden.

To override a patient fill limit:

1. Select Authorizations from the left sidebar menu on the patient’s profile.
2. Go to the options listed in the panel to the right and click Add Authorization to Patient. The authorization form will display.
3. Enter a seven-digit authorization number (A/N) in the field provided. The A/N must be in the 01000-000 to 09999-999 range.
4. Click the p-code radio button.
5. Expand the p-code dropdown menu by clicking the down arrow on the right.
6. Select OVRTS423-Patient GPI Code Limit from the p-code dropdown menu.
7. Enter the 10-digit GPI code in the Selection section of the authorization form.
8. Scroll to the bottom of the page and click Add Authorization.

Contact Support

Our team is here to help!

For plan-specific or urgent needs, contact your account manager directly.

For general Authorization System questions, contact EHO360 Operations at ops@ehorx.com