Pharmacy Benefit Managers (PBMs) currently send information to SureScripts about their subscribers (patients), including medications that are covered or may require prior authorization to be covered by insurance. For patients who are currently subscribers to PBMs which make this information available, their information is automatically pulled into Epic the night before the visit.

Resources

The following resources provide information on Verify Rx Benefits functionality.

• Verify Pharmacy Benefits – Medical & Rx Benefit Crosswalk - (Handout) A patient’s pharmacy benefit plan (prescription coverage) is not necessarily the same as their medical insurance coverage. When more than one pharmacy benefit plan exists, a primary must be verified with the patient and selected.

• Verifying Primary Prescription Coverage for Clinical Staff - (Handout) Many Pharmacy Benefit Managers (PBMs) currently send information to SureScripts about their subscribers (patients), including medications that are covered or may require prior authorization to be covered by insurance. For patients who are currently subscribers to PBMs which make this information available, their information is automatically pulled into Epic the night before the visit. This PBM information is also automatically updated when the patient is checked in and can be manually queried if needed.

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