Payer/PBM FAQs

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How do I connect to the Surescripts network?
What will this cost me?
What advantages does a connection to Surescripts offer my membership?
How many physicians/prescribers are connected to Surescripts?
How many pharmacies are connected to Surescripts?

How do I connect to the Surescripts network?
A mutual non-disclosure agreement and contract need to be in place. Then an implementation project is launched between your IT staff and the implementation managers at Surescripts. Industry approved transactions are certified from your system to our network. These transactions include membership loads, formulary loads, eligibility and prescription history transaction sets and electronic prescription transactions if you offer mail order services. Surescripts works with your IT staff to secure your connection to the Surescripts network.

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What will this cost me?
There is an initial implementation fee that is charged to the payer that connects to Surescripts. The fee varies and is associated with the level of effort for the implementation project. You will pay a fee when Surescripts receives a request for prescription benefit, uniquely identifies your member and then sends a request for prescription benefit for that member to you. You will not pay for any prescription benefit requests that Surescripts is unable to uniquely identify a member for.

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What advantages does a connection to Surescripts offer my membership?
Surescripts is working with the nation's payers to offer physicians the ability to access patient prescription benefit and prescription history information at the time of prescribing. This allows payers to assist prescribers in making more informed clinical decisions and prescribing the most cost-effective medication.

By making more drug plan data available to more prescribers, the probability that a prescriber will receive a match to patient benefit queries increases. The higher the "match rate," the "cleaner" the prescriptions being sent to pharmacies. And "cleaner" prescriptions require less follow-up phone calls.

A connection to Surescripts allows for a secure exchange of patient prescription benefits and medication history information from your data source to certified technology solutions that provide their software to physician practices.

Benefits include:

      Improved quality of care
      Lower healthcare costs
      Saves beneficiaries money
      Fewer medication errors

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How many physicians/prescribers are connected to Surescripts?
More than 90,000 prescribers are actively e-prescribing on the Surescripts network as of February 2009. Surescripts promotes the benefits of e-prescribing to encourage adoption and use. Prescribers who wish to connect to the Surescripts network may find out more by calling 1-866-RxReady (866-797-3239).
 
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How many pharmacies are connected to Surescripts?
Over 75% of community pharmacies in the U.S. are accepting e-prescriptions, and more are connecting every day. In addition, Surescripts provides access to 7 of the top ten mail order facilities in the United States.

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