For new e-prescribers in MD HQ (or anyone who completed eRx registration in MD HQ before Feb. 2018 and wants to add on the ability to prescribe controlled substances): before you can send prescriptions electronically via the Surescripts e-prescribing network in MD HQ, you must undergo an identity verification and registration process.


Note: at this time, e-prescribing in MD HQ does not currently allow for e-prescribing of compounded medications.


Overview

  1. Verify your User Information in the EMR - verify that your name, NPI number, and DEA number are correct in your User profile (under Admin > Manage > Users), and make sure you have an valid prescriber suffix in your profile.
  2. ID Proofing - basic identity verification is required for all e-prescribing and takes ~5 minutes to complete.
  3. EPCS Token Registration - for controlled substances prescribing, you must take an additional step of obtaining your EPCS token; this takes ~15 minutes to complete.
  4. EPCS Permissions Set Up - for controlled substances prescribing only.
  5. Finalize eRx Registration


* Controlled substances prescribers are strongly encouraged to complete ID proofing and EPCS token registration in one sitting (~20 minutes to complete). Otherwise, you will need to start at the beginning (and re-do ID Proofing) when you go back to complete EPCS token registration at a later time.


General Tips for Success


*** Use Chrome or Firefox browser! Not Safari browser, which lacks a scroll bar at a key step.

  • If you do not pay your own bills (e.g. your spouse handles them), ask that person to sit with you/ be available while you are doing the ID proofing. The ID proofing step will require correct answers to very specific questions about your mortgage, car loans, credit accounts, or other bills.
  • Pick a time to do the ID proofing that is not rushed or stressed. If it is noisy or you keep getting interrupted it makes it much harder than just waiting and doing it when you have a few quiet free minutes.
  • If you have frozen your credit: you may need to temporarily lift the freeze or get a pin # so the ID Proofing can access your files.
  • Keep this help section open and carefully review it at each step. We have tried to highlight significant potential pitfalls in yellow. Contact us at support@md-hq.com if you run into difficulty.

1. Verify your Information in MD HQ

Under Admin > Manage > Users, click on your username, and verify that:

  • Your name is correct and matches what is in your credit file (the name on your credit cards, e.g.)
  • You have a valid prescriber suffix (MD, DO, NP, ARNP, PA-C, etc.)
  • Your NPI and DEA numbers are correct. If you do not have a DEA number and are not going to sign up for controlled substances eRx, you can leave that blank.

Click Edit this User to save any changes.


2. ID Proofing

Every prescriber must complete an identity verification process. This process requires that you answer personal questions drawn from your credit file which, presumably, would be extremely difficult for someone other than yourself to answer correctly. These questions can be tough, and may require that you refer back to your financial files. If you are not the primary person in charge of your personal finances, please have that person present or available to you during the ID proofing step. You will only have 3 tries to answer provided questions during any 24 hour period.


To begin ID proofing, hover over your initials in the top menu, and click on ERx Registration

  • If you have previously completed ID proofing in our system, you will see a window to "Update your eRx Profile." Click on Manage EPCS  in the top right to begin.

  • If you have not yet completed ID proofing in our system, you will be prompted to do so. Click I understand! Let's start! in the prompt window to begin.
  • If you do not see the Manage EPCS or I understand! Let's start! option (this should rarely be the case), please contact support@md-hq.com to request that that the new eRx process be enabled for you.


2.A. Personal Information


Once you have navigated through the first two screens and acknowledged the terms and conditions, you will be prompted to enter your personal information. The name in the Prescriber Name field is drawn from the name in your user profile in the EMR, and must match exactly the name in your credit file (e.g., the name on your bank accounts and credit cards). If it does not match, please exit this window, edit your name under Admin > Manage > Users, and then navigate back to this point.


Personal Cell Number: enter your personal cell number, ideally to a smartphone that is held under your own name

Experian Freeze PIN #: (uncommon - generally, leave blank): if you have placed a freeze on your credit, you may need to lift the freeze temporarily, or obtain a PIN to bypass the freeze for the purposes of completing the ID Proofing process. If you have a PIN, enter it here.


By clicking I Agree >>, you are authorizing the program to obtain information from your personal credit file solely for the purpose of confirming your identity.


2.B. ID Proofing


The ID proofing step will prompt you for answers to questions drawn from your personal credit profile - for example, questions about your mortgage, credit cards, auto loans, etc. You may need to refer to your financial records to answer correctly. If you answer any of the questions incorrectly, you will not be able to proceed. You will be presented with a new set of questions, but may only try 3 times in any 24 hour period. Please have your financial records - and/or the person in your household who is primarily responsible for your household finances - available to complete this step.


2.C. Activation Code


Once your ID and credentials are verified, you will be prompted to enter an activation code, which is sent either via SMS/ text message (if your phone number was verified successfully as being registered to your name), otherwise via postal mail to your verified home address. 


The screen that asks for you to enter your activation code will show a message in red (see second screenshot, below) if your phone number was not able to be verified and the activation code was sent by postal mail.


2.C.i. Activation Code via SMS/ Text

Enter the activation code in the indicated field, and click Validate Code and Register to proceed, and skip down to the bottom of this section to continue with the instructions.


2.C.ii. Activation Code via Postal Mail

If your phone number was not able to be verified (is not registered in your name) and Experian was not able to find another number in your credit file that you code could be sent to, it will be sent by postal mail to your verified home address. If that is the case, you should see the screen with a red message on it like the below screen: 


Close the window. Once you receive the code by mail:

  • Go to Admin > EPCS Administration.
  • Click on Setup & Tools
  • Click on EPCS Signup
  • In the window that appears, click on Step 1, if needed, to re-open, then click on the button that says Already have an Activate code? Click here to enter it now. DO NOT click Next >>, as this will restart ID Proofing. If you redo ID Proofing, a new Activation code will be issued and the one you received by mail will no longer work.


2.D. Click Finish to Finalize without Controlled Substances eRx OR Select to Proceed to ECPS Signup


Once your activation code is entered and accepted, you have completed the basic ID proofing process! You may now e-prescribe non-controlled substances. Next steps: 

  • Option 1 - If you do not want to set up controlled substances e-prescribing, click Finish to exit eRx registration: proofing and certification. Then skip to step 6. Finalize eRx Registration, below.
  • Option 2 - To set up controlled substances e-prescribing, toggle to "Yes. Start the Signup process for EPCS", then click Finish to proceed. Continue immediately below at step 3. EPCS Signup for Controlled Substances eRx.



3. EPCS Signup for Controlled Substances eRx


To sign up for EPCS (electronic prescribing of controlled substances) to be able to eRx scheduled medications, you will need to set up your 2-factor authentication and your EPCS permissions. 2-factor authentication is required every time:

  1. EPCS permissions are changed via the EPCS management console AND
  2. Every time a controlled substance prescription is sent via eRx.


The two factors, in this case, are a password that you will set, and a security code that you will obtain from your token. The token is either an app on your smartphone (easiest and fastest to set up), or a key fob that you carry with you. Confirmation with something you know (your password) and something you have (the code from your token) is a strong verification of your identity.


*** Note that DEA rules prohibit delegating any aspect of controlled substances prescribing to a non-prescriber (or even sending an EPCS prescription written by another EPCS prescriber). The authorized EPCS prescriber must write and send the controlled substance eRx personally.


Click on the Get Started tab to setup your 2-factor credentials.



3.A. Obtaining your Token


Software or Hardware Token?

  • A software token is an app called "VIP Access" that you will download to your phone and access when needing to complete 2-factor authentication. This is the recommended and fastest option for completing EPCS signup now, without waiting for a hardware token to arrive by mail.
  • A hardware token is a key fob with the 2-factor signing app on it, which will be mailed to your verified home address and should arrive in 5-7 business days. There is a small charge from our third-party EPCS provider to purchase the key fob. If you select this option, you would click Next >> to purchase the key fob and exit the sign up process. Once you receive the key fob by mail, you would open the EPCS sign up again and, once you arrive at this step, select "I already have an approved token - ID Proof and Set it up." To verify that the key fob has not been intercepted by an unauthorized party, you will be required to go through ID proofing again.




If you select to use a software token, you will be required to agree to the Rules and Conditions, and then sent an email with a link to the app store to install the VIP Access mobile app. Open your email on your smartphone to find the app via the link, or search in your phone's app store for VIP Access. If you already have the app (e.g., you used it for eRx at another facility), you do not need to download again. Once you have downloaded and installed the app, return to the EPCS signup screen and click I have it - Register My Token >>


3.B. Token Registration

Note: time pressure at this step!


At the token registration step, you will set the password that you will use when e-prescribing. The password must have at least 6 characters, and must include at least one number or symbol. The Credential ID and Security Code will be obtained from your token (app or key fob). 


Note that the Security Code shown on your token changes every thirty seconds. To give yourself the maximum amount of time to carefully enter your Security code and verify that it is correct, you may want to:

  • First enter and retype your password and enter the credential ID (shown at the top of the app screen)
  • Wait for the Security Code on your token to renew
  • Enter the Security Code in the EPCS signup screen and visually review it for accuracy
  • Then immediately click Register >> (before the Security Code changes again).


Once this is successfully accepted, your token is registered! Expect an automated phone call to your verified phone number with your 2-factor activation code (see below).


3.C. Confirm your 2 Factor Activation Code

As soon as your token is registered, you should receive an automated phone call to your verified phone number (not text message) with your 2-factor activation code. If you do not answer, the automated call will leave a voicemail with the code. If your phone cannot be verified (the account is held under another person's name), the 2-factor activation code will be sent to your verified address by postal mail.


Help! I didn't receive an activation code! If you do not receive an activation code, which will be communicated via phone call to your verified phone number, within 10 minutes of completing EPCS registration, you can call MD Toolbox support to check whether the code was sent and have it resent if needed. Their support number is 206-331-4420They will ask for your practice number but, as this is not information that you will know, you can ask that they look you up by name or other identifying information instead.


You can confirm your 2 factor activation code before closing the eRx Registration: Proofing and Certification window by clicking on 3. Enter 2-Factor Activation Code


You may also confirm your 2 factor activation code later, either via the EPCS window (which you can return to via your initials > Register for ERx > Manage EPCS), or when sending your first controlled substance prescription. Once the 2-Factor Activation Code is confirmed, CLOSE the eRx Registration window. You will access the next step from the Admin menu.


4. EPCS Permissions Set Up and Access Control Manager Sign Off


Note that if you are the first person in your practice to complete EPCS signup, you can sign off on your own EPCS permissions set up. Additional EPCS prescribers will need to have an Access Control Manager turn permissions on before then can sign and send EPCS.


Who is an Access Control Manager? This is generally the first person in your practice to complete EPCS signup, as well as any other people that are specifically designated within the practice. There must be at least 2 Access Control Managers per practice, though one of these can be the MD HQ Administrator account.


4.A. Open the EPCS Management Window

  • Go to Admin > EPCS Administration.
  • Click on Setup & Tools
  • Click on EPCS Permissions



***Note that two users are required to sign off on any changes to the EPCS permissions screen. The first must be a prescriber who has signed up for EPCS and will sign off on the changes with their 2-factor credentials. The second may be a prescriber or admin, who is also designated as an Access Control Manager, and who will sign off on the changes using a verification code sent to their email address.


4.B. Enabling Permissions for the First EPCS Prescriber


If you are the first person in your practice to complete EPCS signup, you can sign off on your own EPCS permissions set up, with confirmation from one other user (which, for solo providers without any staff, may be the MDHQ Administrator account).

  1. Enable your own permissions by checking the boxes beside all four of the boxes to the right of your name.
  2. Designate at least one other person as an Access Control Manager by checking that box beside their name. This second person does not need to be an EPCS prescriber, but may be any user with admin permissions. If you are a solo provider with no staff, you may select the MDHQ Administrator account as your second Access Control Manager.
  3. Select yourself as the first user signing off on access control changes using the drop down menu at the top.
  4. Select another Access Control Manager as the second user signing off on access control changes in the second drop down menu. Click Save to proceed.
    1. A box should appear to enter the second user's email address. Make sure to delete the placeholder text before entering the email. If you are using MDHQ Administrator as your second Access Control Manager, enter support@md-hq.com. Click Save again. 
    2. A box will appear for the second user's authorization code. Once you have obtained that code, enter it, again making sure to first delete any placeholder text, and click Save one more time.
  5. You will be prompted to enter your 2-factor credentials to finalize. This is the password that you set during the EPCS signup, and the security code from your token (VIP Access app or key fob). Once this is done successfully, proceed to step 5.


Help! I am the Access Control Manager, but am seeing  a message that I am not authorized to manage EPCS! If you are seeing this message in error, try reloading the page and again navigating from Admin > EPCS Administration. If you continue to be denied access, contact support@md-hq.com.


4.C. Enabling Permissions for Additional EPCS Prescribers


An Access Control Manager must sign off on each additional EPCS prescriber sign up to enable that user to sign and send EPCS. NOTE that To do that, the Access Control Manager would need to:

  1. Check the box for that user to be Allowed to Sign and Send EPCS.
  2. Select an EPCS Prescriber who is also designated as an Access Control Manager as the first user signing off on access control changes using the drop down menu at the top. If the Access Control Manager is an EPCS prescriber, they would select their own name. This person will need to enter their 2-factor credentials to sign off on changes.
  3. Select another Access Control Manager as the second user signing off on access control changes in the second drop down menu. If the Access Control Manager is NOT an EPCS prescriber, they would select there name as the second user.
  4. Click Save to proceed. A box should appear to enter the second user's email address. Enter that and click Save again. A box will appear for the second user's authorization code. Enter that code and click Save one more time.
  5. The system will prompt for the 2-factor credentials of the first user signing off on the changes to finalize. This is the password that they set during the EPCS signup, and the security code from their token (VIP Access app or key fob).



5. Finalize eRx Registration


There is one last step to finalize your eRx registration. Click on your initials in the top menu and on eRx Registration. Check the boxes for New Rxs and Refills, and for Controlled Substances if you have completed EPCS signup, and click Update SureScripts Profile to save. 


NOTE on registering for eRx refillsyou may only be registered with SureScripts to receive refills in one "location". You will see an error message if you try to register to receive refills in this EMR but you have ever registered to receive refills in another system, and haven't specifically de-activated refills in that system. If you receive an error message that refers to eRx refills when you try to update your SureScripts profile, contact your previous EMR system to de-activate refills in that system, then return and check the box to receive them in this one. If you are unable to de-activate in your old system or do not know what system you are authorized to receive refills in, please reach out to support@md-hq.com and we can submit a ticket directly to SureScripts (though this generally takes longer than going directly through your old system).




You should now be all set to route your prescriptions electronically via the Surescripts eRx network!


You can now Delegate ePrescribing Authority to Non-Prescribers.


See also: MDToolbox Help


Other keywords: eprescribe eprescribing e-prescribe e-prescribing EPCS