Sources of Medication Information | Benefits panel | Prior authorization | Medication alternatives | Change payer
When you select a medication, compound, or supply on the Send eRx page, a Benefits panel appears beside it. The panel shows the patient's plan, coverage rules, estimated out-of-pocket cost, and lower-cost alternatives, so you can choose a drug the patient can get and afford before you send the prescription.
The Benefits panel is available for medications, compounds, and supplies. However, Real-Time Prescription Benefit (RTPB) and On - Demand Formulary (ODF) information is available only for medications.
Sources of medication information
Two real-time checks run for every item you select. The panel shows both results side by side but never blends them into one number or label. Each section tells you which check is behind it.
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Real-Time Prescription Benefit (RTPB) pricing depends on the selected pharmacy. If you change the pharmacy, the panel clears and both checks run again.
Benefits panel
Use Expand All or Collapse All at the top of the panel to open or close every section at once. Sections only appear when the plan returns information for them.
Plan Information
Shows automatically as soon as you select an item, with no clicks needed:
- PBM name and plan name
- Formulary status, shown as a plain-language badge
- Brand or Generic, and Rx or OTC indicators
Prior Authorization
Appears only when the real-time benefit check says prior authorization (PA) is required. This includes standard PA requirements and related cases such as transition fills, emergency fills, level-of-care changes, and a PA already approved on file.
- Select Start a Prior Authorization to begin the PA through CoverMyMeds, where available. See Auto-Start ePA using the CoverMyMeds Integration.
- PA status is calculated in real time and may change by the time the prescription is dispensed.
Payer & Therapeutic Alternatives
Payer
- Alternatives the patient's payer recommends, each with its own real-tim
- The list may include up to 250 alternative medications, organized by insurance preference.
- Scroll through the list or use the search bar to find a specific alternative. The list loads 20 medications at a time.
- Important disclaimer information remains visible at the bottom of the list, even when the list is long.
Therapeutic
- The list displays up to 10 alternative medications, ordered by relevance.
- Important disclaimer information appears at the end of the list.
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Changing the patient's payer
If the eligibility check finds more than one payer for the patient, you can choose which one the benefit checks use.
- Select Change Payer to open the payer drawer.
- Review the Prescription Coverage Information table. Active payers can be selected; inactive payers are listed but grayed out.
- Select a different active payer. The Change Payer button becomes available only after you pick a payer other than the current one.
- Select Change Payer to confirm. The payer summary on the Send eRx page updates.
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