HL7 FHIR® Implementation Guide: Consumer-facing Real-time Pharmacy Benefit Check, Release 1- US Realm

DESCRIPTION

Using RTPBC, a patient can learn how their medications will be covered at the pharmacy, including out of pocket costs and any coverage restrictions or requirements that might apply.

ALTERNATIVE NAMES

HL7 FHIR® Implementation Guide: Consumer-facing Real-time Pharmacy Benefit Check, Release 1- US Realm may also go by the following names or acronyms:

BENEFITS

• Enables a patient to learn how their medications will be covered at the pharmacy, including out of pocket costs and any coverage restrictions or requirements that might apply.
• Enables a patient to learn of pharmacy options and potential medication alternatives for their prescription.

IMPLEMENTATIONS/CASE STUDIES

• Consumer Applications / Payers / Medication Pricing Sources. This use case enables a patient using a consumer application to retrieve (a) prescription cost, coverage, alternative pharmacy and alternative medication information from their insurer and (b) prescription cash pricing and discount information from a medication pricing source.

DEVELOPMENT BACKGROUND

This Implementation Guide was developed with the sponsorship of the CARIN Alliance, and in cooperation with the National Council for Prescription Drug Programs (NCPDP).

RELATED DOCUMENTS

HL7 FHIR® Implementation Guide: Consumer-facing Real-time Pharmacy Benefit Check, Release 1- US Realm

STU DOCUMENTS

HL7 FHIR® Implementation Guide: Consumer-facing Real-time Pharmacy Benefit Check, Release 1– US Realm Please see the resource detail for link and download instructions.

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TOPICS

• Financial Management
• Pharmacy

BALLOT TYPE

• STU

STATUS DATE

2020-08-25

RESPONSIBLE WORK GROUP

PRODUCT TYPE

• Implementation Guide

STAKEHOLDERS

• EHR, PHR Vendors
• Health Care IT Vendors
• Payors

FAMILY

• FHIR

CURRENT STATE

• Active

REALM

• US Realm