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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 or date of birth (mm/dd/yyyy) in the top navigation bar search box.
  2. Click to select the patient from the auto-populated results. The patient's record opens to the Face Sheet.
  3. Click Account in the left menu. The Account page opens.


Review Rx Eligibility

  1. Click the Rx Eligibility tab. The patient's Rx Eligibility page opens.
    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.



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