Product Bulletin: Formulary Checking

With the introduction of Practice Partner Patient Records version 7.5, users will have the ability to automatically cross-reference medications against their patients’ insurance formularies at the time a prescription is written. Created in conjunction with the Infoscan drug database, Formulary Checking provides practices with the ability to ensure that the medications they prescribe are covered by their patients’ insurance formularies. This point-of-care checking helps eliminate the prescription of non-covered medications, leading to a reduced number of pharmacy callbacks.

Summary of Key Features and Benefits:

 Automatically checks prescribed medications against the patient’s insurance formulary

ï‚· The Formulary Checking database provides a comprehensive list of insurance formularies

ï‚· Quarterly updates provide up-to-date information

Additional Questions about Formulary Checking

How does Formulary Checking work?

At the heart of the Formulary Checking feature is a comprehensive database of different insurance formularies and their corresponding medications. When a provider looks up the name of a prescription template, Patient Records automatically cross-references the formulary database against the medication being prescribed. If the medication is covered, its template(s) will be displayed in the insurance formulary list. The provider can then choose the correct template from this list. (Patient Records automatically queries the formulary associated with the primary insurance carrier listed in the patient’s demographic section.)

If the medication being prescribed is not part of the formulary, another medication can be chosen from the approved list, a new universal prescription template can be created on the fly, or the physician can choose a medication from the non-covered medication list. If a new universal prescription template is created, the prescribed medication will be cross-referenced against the formulary database to check if it is covered by the corresponding formulary.

Will Formulary Checking work in conjunction with prescription templates?

Yes. Formulary Checking works in combination with universal prescription templates. If the prescribed medication is covered by the patient’s formulary, a list of corresponding prescription templates will appear.

Can new/custom universal prescription templates work with Formulary Checking?

Yes. During the creation of customized universal prescription templates, users have the choice to run the new template against the formulary database. This allows new universal templates created on the fly to be used in conjunction with Formulary Checking.

Which formulary plans are covered?

Formulary Checking covers over 1700 different formulary plans. For a complete list, contact your sales representative. (A complete list will be available at www.mminfotech.com ).

Can medications be prescribed if they are not on a formulary plan?

Yes. If a prescribed medication is not part of the patient’s insurance formulary, the physician can still prescribe the medication.

How often are updates provided?

With an annual subscription, formulary updates are provided on a quarterly basis. These updates ensure that the formulary lists are current and complete. With each update, Formulary Checking cross-references each universal prescription template against the new formulary database. This ensures that each template is linked to the appropriate formulary lists.

Can a user suggest an unlisted formulary be added?

Yes. Infoscan (the company that manages the formulary database) is happy to take input regarding formulary plans that are not currently listed. To request a new formulary plan be added to the database, contact Practice Partner directly. We will facilitate the process of requesting the addition of a new plan.

Are there any configuration steps that need to be completed before implementing Formulary Checking?

In order for Formulary Checking to cross-reference the correct formulary, each patient must have their insurance information recorded in the demographic section of Patient Records. Additionally, the insurance plans in Formulary Checking must match each patient’s insurance carrier exactly. This can be done without changing each patient’s insurance plan spelling. During Formulary Checking implementation, a special cross-reference file allows practices to correlate their insurance spellings with the way Formulary Checking spells them (i.e. BC can be cross-referenced to Blue Cross of Washington). This eliminates the need to change each patient’s insurance spelling individually.

What is the cost?

The annual subscription price for Formulary Checking is $295 per physician, per year. This includes all upgrades during the annual period.

What are the software & hardware requirements?

Formulary Checking requires Practice Partner Patient Records version 7.5 or higher, and Drug Interaction checking (part of Practice Partner Clinical Tools). No special hardware is required for Formulary Checking.