This article is for prescribers caring for our members
Working with Gemini Health1, we’re pleased to let you know that advanced real-time prescription benefits are now available as part of an electronic health record system’s ePrescribing workflow.
How it helps prescribers: This enhancement lets prescribers see key details about a patient’s prescription drug coverage to facilitate conversations with patients about their medications.
Gemini Health leverages existing real-time benefits infrastructure and takes it to the next level with additional features at the point of prescribing. This enhancement is available automatically for practices currently using real-time benefits. No action is required.
Prescribers who don’t use real-time benefits won’t be able to take advantage of this new feature until they’ve deployed real-time benefits.
Features include:
- Patient-specific out-of-pocket costs for the prescribed medication compared to other covered alternatives. The information helps your patient know the cost of their prescription before they leave the exam room.
- Coverage status, alerts, and any prior authorization requirements.
- Information on fulfillment methods, such as retail or mail.
This will help patients (our members) avoid cost surprises and authorization delays when they fill their prescriptions and helps improve adherence with your treatment plan. You’ll find a sample display screen below.
Can our practice view advanced real-time benefits for all Blue Cross members?
Advanced real-time benefits will be viewable for all commercial, fully-insured members. At this time, the enhancement is not available for commercial self-insured accounts, Medicare Advantage, or Federal Employee Program members.
Sample display for illustrative purposes
Below, you’ll find a sample of the information that’s displayed. The actual display will vary, depending on your electronic health record software. However, the features shown below are similar across the various systems.
1. Gemini Health, LLC is an independent company that is enabling advanced real-time prescription benefits for certain Blue Cross Blue Shield of Massachusetts members.
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