In NextGen® Mobile, you can verify the medication eligibility status of a patient when you are prescribing medications. For properly configured NextGen Healthcare clinics, the patient’s medication formulary eligibility status appears in Rx Eligibility on the Patient Chart view. If Rx Eligibility status appears as No eligibility status, you can select No eligibility status to check the eligibility status. NextGen® Mobile submits the medication status request to Surescripts, RxHub, or other available formulary services, and displays the eligibility results with one of the following statuses.
- Single - The patient has single eligibility enabling you to search only the formulary that the patient has eligibility for. The medication search field displays the Surescripts benefit source with a plan. You can select the field to search medications based on that plan.
- Multiple - The patient has multiple eligibility enabling you to search multiple formularies. The medication search field displays the first Surescripts benefit source with a plan. You can select the field to search medications based on that plan, or select the Medication Search list to select the other available benefit sources with their respective plans. The search field displays the plan you select. You can search for a medication based on the selected plan.
- Not Eligible - The patient is not eligible but has insurance. You can perform a generic (non-formulary) search. You cannot view a search list in the Medication Search field.
- Pending - The patient eligibility response is not received.
You can use the eligibility status data to determine the most clinically appropriate and cost-effective medication therapy for the patient. Since this request can take some time to complete, the process runs in the background and does not lock the application. You can check eligibility for each patient only once in a twenty-four (24) hour period and the result is valid for 72 hours.
Note: You must be registered with Surescripts to perform medication eligibility checks.
