Bulk Formulary Eligibility Download Changes

Surescripts has outlined several new requirements for checking patient formulary eligibility from the Rx Manager. To certify with these requirements, SOAPware has redesigned the Bulk Eligibility Retrieval window to check for the new Surescripts requirements prior to retrieving Rx formulary eligibility.

The new Rx eligibility feature will check the provider and patient information to ensure that they meet the required character minimum and maximum constraints that are defined by Surescripts.  If there are any fields that need to be corrected or verified prior to checking the patient's formulary eligibility, this new feature will notify and allow the user to make the necessary corrections.

Provider Requirements

Provider Requirements

The table above lists the provider character minimum and maximum constraints that are required to check patient formulary eligibility.  This information can be entered or corrected for the provider by going to Tools > Provider Manager.

Patient Requirements

Patient Requirements

The table above lists the patient character minimum and maximum constraints that are required to check patient formulary eligibility.  This information can be entered or corrected for the patient from within the Bulk Rx Eligibility window or by going to the patient's Demographics tab.

Retrieve Formulary Eligibility in Bulk through Scheduler

Retrieve Formulary Eligibility in Bulk through Scheduler

Rx formulary eligibility can be retrieved in bulk from the Scheduler workspace. When the Bulk Rx Eligibility window is opened, SOAPware will begin processing Rx formulary eligibility for all patients listed on the schedule for the current date.

After processing, each patient will be displayed along with the result that was received.  The results will be display in three tabs:

  • Needs Attention
  • Processed
  • All

Needs Attention Tab

The Needs Attention tab will display patients that need to be corrected or reviewed prior to retrieving their Rx eligibility.  There are 3 types of results that will be displayed in this tab:

  1. Red Exclamation icon: Indicates that there is some required demographics information missing on the patient.  This information must be entered prior to retrieving eligibility.
  2. Yellow Exclamation icon: Indicates that some of the required demographic information has exceeded the maximum character length for Rx eligibility requests.  The information can still be submitted for eligibility, but will be truncated when processed.  Rx eligibility can be retrieved based on the truncated information by clicking the Retrieve Eligibility button.
  3. Red X icon: Indicates that an error occurred while attempting to retrieve eligibility on the patient.  To view the error details, the user may hover the mouse over the error icon.

Processed Tab

The Processed tab will display the list of patients whose eligibility has been successfully retrieved.

All Tab

All Tab

The All tab will display all patients who are on the schedule for the current date and the status of their eligibility retrieval.  

The all tab displays patients with the following color coded status:

  • Red: Requires that information be corrected prior to retrieving eligibility.
  • Yellow: Requires that information be reviewed prior to retrieving eligibility.
  • Green: Indicates that eligibility has been successfully retrieved.
  • White: Indicates an error occurred while processing eligibility.

Hover over each patient's name to view a description of the status.

Viewing Rx Formulary Eligibility

Once Rx eligibility has been retrieved for the selected patient, the information will be displayed within the Rx Manager (as shown in the screenshot above).