Real-Time Pharmacy Benefit Check
Informed understand of medical prescription choices, out-of-pocket cost, requirements, and restrictions with Real-Time Pharmacy Benefit Check (RTPBC).
Make the Right Prescription Choice
Discover a better way to select medicine and treatment with informed decisions at the time you first receive the prescription.
Problem
Currently, there is no method for a patient to learn the cost and insurance coverage related to medications they've been prescribed using their insurance coverage. Here are additional problems related to medication pricing:
• Until you speak to a pharmacist, both the price of the medication after applying your insurance and the price of the medication if paying entirely out-of-pocket are unknown.
• Unavailable — Prescription variation and alternative options (including brand name vs. generic).
• Unknown — Alternative pharmacy options or pricing discounts.
• Missed Opportunity for patients to make informed decisions.
• There is no patient insight or knowledge for approval or denial.
• Up-in-the-Air — It takes days, weeks, or longer to receive a decision.
• Dangerous Delays for acute, chronic and complex conditions.
• Financial and Administrative Burden — Costly provider and payer misalignment.
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Solution
• Convenient at the Time of the Prescription — Patients can leverage consumer apps that support RTPBC request to the payer.
• Consumer Apps found on MyHealthApplication gather prescription information, patient Insurance coverage, and preferred pharmacy to submit to Insurer via HL7 FHIR.®
• Application presents and interprets the cost of coverage, requirements or restrictions, possible discounts, coupons, and memberships, alternative pharmacy options, mail services, and alternative medication options.
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Benefits
At the time of the visit, patients have immediate access to prescription information:
• Patients can discuss all available options directly with Physicians.
• Patients make informed choices on all their prescription options.
• Patients can choose between paying cash or using their insurance deductible.
• Physicians submit order to the chosen pharmacy.
• Patients can rest knowing they made the appropriate decision for their care and budget.