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Kareo Help Center

Review Rx Eligibility

The Rx Eligibility tab in a patient's record shows the patient's medication coverage.

An Rx eligibility check will run for a patient when a provider with an NPI prescribes a medication, performs a medication history check, or visit the Rx Eligibility tab in a patient's account. The information is pulled from Surescripts using the patient's name, date of birth, address, and gender.

Navigate to the Patient Account Tab

  1. Enter the first 2–3 letters of the patient's name in the top navigation search box.
  2. Click to select the patient from the auto-populated results. The patient's chart opens to the Face Sheet.
  3. Click Account on the left menu. The patient's Account page opens.

PF access account tab.png

Review Rx Eligibility

  1. Click the Rx Eligibility tab at the top of the window.
    1. The plan name of the medication coverage.
    2. The Rx plan number associated to the name.
    3. Pharmacy Benefit Manager (PMB) administers the prescription program for the plan.
    4. The date of the last eligibility check.
    5. The Pharmacy Coverage displays what is covered under the plan. It will display Covered, Not Covered, or N/A based on the information provided by the PMB.
    6. The status of the plan.
    7. Error messages will display if there is a discrepancy in the patient information.

 

rx_eligibility_callout.png

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