How to Check Coverage with Rx Search
EZSCRIPTRx gives the user two options represented as Tabs to search and check Coverage. One option is “Rx Groups” and the other one is “Rx Search”.
In the “Rx Search” tab there are options to check coverage searching medications by:
Drug
Therapeutic Category
NDC Code
Here it is the step by step about How to check Coverage with Rx Search
Select a Provider by using the predictive box and click on “Continue” button. If the Provider was already added or Add a New Provider.
Once a Provider has been selected, continue by selecting the Patient typing at least 3 letters in the searching box. Then select the result by clicking on the dropdown list and then click on “Select Medications” button.
Once selected the Provider and Patient, click on “Rx Search” tab
Searching by Drug
1. Search “by Drug” option comes selected by default. Type Drug name, Strength, or Dosage and select one of the options displayed on the dropdown list.
2. Select the Mfg. Package Size and the Dispense quantity.
3. Click on the “Add to Search” button
Then, the results that matched with the inputs will be displayed
4. Use the “check boxes” to unselect/select medications for what coverage won’t be checked.
5. Once all the options are in place, click on “Check Coverage” button.
Finally, the results will be displayed with different colors
Green: Product/Service covered
Yellow: Prior Authorization Required
Red: Product/Service Not Covered
By clicking on any of the colored rows the user will see more details of the check coverage result
Searching by Therapeutic Category:
The Rx Search allows the user to find NDCs by browsing the MediSpan database categories, instead of specifying the exact drug and strength. Browsing the categories enables to find other drugs in the same therapeutic category or GPI.
1. Select “Therapeutic Category”
Once it is selected, a tree view will be displayed from which the user can search for the category of the medication to check coverage for.
2. Type a therapeutic category and select one of the options listed on the dropdown list.
3. Click on “Filter” button
Once filtered by category to check coverage for, the user can add the whole category to the search list, or you can be more specific by expanding the subcategories until you find the right one, using the icon.
Remember each category and subcategory will have the number of medications that will be added to the list at the left of the ADD TO SEARCH button.
4. Click on “Add to Search” button of each category for which coverage will be checked
The, the NDC for each category will be added to the list of Rx Search
5. Click on “Check coverage” button and the results will be displayed as we explained in the “Check by Drug”.
Searching by NDC Code
This feature simplifies the search by not having to select the Mfg. Package Size. With just the NDC and the quantity to be dispensed, the user can select a specific medication instead of having several medications listed.
1. Select “by NDC Code”
2. Type the NDC Code and select one of the options listed on the dropdown list
3. Select the Dispense Quantity
In this case, the package size is not necessary to be defined, because the NDC code is tied to a specific product package size.
4. Click on “Add to Search” button
5. Repeat steps 2 to 4 for each NDC for which coverage will be checked