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Automatic Rx Formulary and Eligibility Retrieval

Q: How do I check the patient's drug formulary eligibility?

1. Enable Auto Formulary and Eligibility Retrieval

1. Enable Auto Formulary and Eligibility Retrieval
  1. Go to Tools > Options and select Workflow.
  2. Check the box next to Auto Rx Formulary and Eligibility Retrieval.

2. Insert Demographics for the Patient

2. Insert Demographics for the Patient

Complete all demographic fields with warning signs (a yellow triangle with an exclamation mark inside), as these fields will be required to check the patient's drug formulary.

3. Open Rx Manager

Press F8 on the keyboard to open Rx Manager.

4. Correct/Review Invalid or Shortened Data

4. Correct/Review Invalid or Shortened Data

When retrieving Rx Eligibility by clicking the Retrieve Eligibility Info button, the SOAPware eligibility scrubber will review the patient's demographics and provider information.  If there are items that need to be corrected prior to retrieving Rx eligibility, the above alert will appear to the user. This alert means that some required demographic information is either missing or has exceeded the maximum character length for Rx eligibility requests.

  1. Invalid Data: To correct the invalid information, click the Cancel button and modify the information for the patient or provider as needed. After correcting the invalid information, return to this window to retrieve Rx eligibility.
  2. Shortened Data: If there are items that have exceeded the maximum character length for Rx eligibility requests, the values will be displayed above. These values will be shortened upon submission. Click the Retrieve Eligibility button to request eligibility based on the shortened value.

Formulary Eligibility Displayed

Formulary Eligibility Displayed
  1. Once Rx eligibility has been retrieved for the selected patient, the available policy information will display within the Notes section of Rx Manager.
  2. The available formulary information will display to the right of each medication.