Navigate Rx Eligibility

Updated: 03/27/2024 | Views: 2533

The Rx Eligibility tab in a patient's record shows the patient's medication coverage.

An Rx eligibility check runs for a patient when a provider with an NPI prescribes a medication, performs a medication history check, or visit the Rx Eligibility tab in a patient's account. The information is pulled from Surescripts using the patient's name, date of birth, address, and gender.

Available for Clinical subscribers.

Access Rx Eligibility

  1. Enter the first 2–3 letters of the patient's name or date of birth (mm/dd/yyyy) in the top navigation bar search box.
  2. Click to select the patient from the auto-populated results. The patient's Facesheet page opens.
  3. Click Account. The Account page opens.
  4. Click the Rx Eligibility tab. The Rx Eligibility page opens.
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Navigate Rx Eligibility

  1. Status: Displays whether the medication coverage is Active or Inactive.
  2. Plan Name: Displays the medication coverage plan name.
  3. Rx PCN: Displays the medication coverage plan number.
  4. Pharmacy Benefit Manager (PMB): Displays the company that manages the prescription drug benefits for the plan.
  5. Last Checked: Displays the last eligibility check date.
  6. Pharmacy Coverage: Displays the plan coverage for Retail, Mail Order, Specialty, and Long Term Care.
  7. Mismatched Demographic Info: If applicable, displays error messages when there is a discrepancy in the patient information.
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