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Surescripts
Benefits & Authorizations
Avoid cost concerns, coverage surprises & treatment delays
Leverage prescription benefit insights at the right time
When cost or coverage issues delay important care, it’s an unwelcome surprise for everyone involved. High costs harm adherence. A prior authorization process that depends on faxes and forms takes up valuable time and attention.
Surescripts shares accurate clinical and benefit intelligence when and where it’s needed, making it easy to choose the best option for each patient and expedite (or avoid unnecessary) prior authorizations.
$37
average Real-Time Prescription Benefit savings/prescription ($785 for specialty medications)1
3.2
percentage-point pickup rate gain with Real-Time Prescription Benefit2
Just under 4
minutes to receive a prior authorization response on average3
Key products to help you optimize benefits and authorizations
Eligibility
Give clinicians easy access to prescription benefit coverage information at multiple points of the care journey so patients can get their medications sooner.
Formulary
Provide healthcare providers with plan- and group-level formulary insights within care workflows so they can have more informed conversations with patients.
Real-Time Prescription Benefit
Supply cost and coverage information directly from the prescription benefit plan, including prior authorization flags, days’ supply options and up to five covered alternatives.
Electronic Prior Authorization
Help manage requests more efficiently with dynamic question sets and responses. Let users see if a prior authorization has been started or completed and fill in only the required information.
Therapeutic Alternatives
Reduce medication costs, optimize plan design and deliver exceptional service with an up-to-date catalog of clinically validated medication alternatives.
The Surescripts Platform
Powering the future of healthcare
Health intelligence sharing at scale requires powerful infrastructure. The Surescripts Platform supports every Surescripts product and every Network Alliance participant with industry-leading reliability, security and scalability.
Real-world results
Keep pace with healthcare innovation
- Surescripts, "2023 National Progress Report," March 2024.
- Surescripts, “2022 National Progress Report,” March 2023.
- Surescripts, “2022 Medication Affordability & Adherence Impact Report,” September 2022.
- CAQH, “2020 CAQH Index: Closing the Gap: The Industry Continues to Improve, But Opportunities for Automation Remain,” 2021: p. 6.
- Jaime Y. Smith et al., “E-Prescribing with Decision Support Is Associated with Improvements in Medication Adherence,” The American Journal of Pharmacy Benefits 8, no. 4, (August 17, 2016).
- Surescripts, “2021 National Progress Report,” January 2022.
- Denise Clayton et al., “Evaluation of the Fast Prior Authorization Technology Highway,” Journal of the American Pharmacists Association 62, no. 6 (December 2022): 1843–1847.