Rx Change Requests

RxChange is a new requirement for Surescripts certification that allows pharmacies to contact prescribers regarding the following 3 general scenarios:

1. 1. Prior Authorization

   2. Prescriber Authorization

   3. Rx Substitutions

RxChange Requests are messages sent by the pharmacy and received by DrChrono Practice Groups within the message center and assigned to the original prescriber.

Below are the workflow descriptions for each RxChange Requests

1. Prior Authorization

• Pharmacy is asking whether or not the Rx has a prior authorization and the associated number.
• If the Prescriber has the prior authorization, the prescriber sends it to the pharmacy using the Prior Authorization Number Field.
• If the Prescriber does not have the prior authorization number, the prescriber can select “deny” and note whether or not there was an attempt to contact the payer to get one. This will indicate to the pharmacy whether or not it would be appropriate for the pharmacy to attempt to try to approach the payer or send another RxChangeRequest suggesting another medication that is more affordable.

2. Prescriber Authorization

• Prescriber authorizations ask for additional IDs from the prescriber to check that the prescriber is allowed or authorized to send the medication or to provide additional reporting information (i.e. for national registries).
• When a pharmacy sends a RxChangeRequest, they send a MessageRequestSubCode as well

See descriptions below

3. Rx Substitutions

• The pharmacy is suggesting a different medication(s) for one of the given reasons. Pharmacies can send multiple options in terms of alternative recommended Rx to the prescriber. The prescriber can only choose 1.

1. Generic

2. Therapeutic Interchange/Substitution

3. Out of Stock

4. Script Clarification

   *This is when the pharmacy is not sure about prescribing a particular medication. The pharmacy will send back the prescription with their interpretation of the prescriber’s Rx as the alternative Rx.

5. Drug Use Evaluation