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).

A phone with a green pattern on the back of it.A phone with a green pattern on the back of it.

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.

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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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• 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.

Implement RTPBC IG
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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.

Want to have a conversation about Real-Time Pharmacy Benefit Check?