The first myth we hear is that EHR vendors only need one RTPB vendor to bring prescription price transparency into their tool. However, since each RTPB vendor has connections to different sets of PBMs – and therefore only has access to a subset of patient data – it is essential that EHR vendors connect to more than one RTPB vendor to avoid gaps in patient coverage. Some of the EHR vendors RxRevu works with have upwards of 2 or 3 RTPB connections. And while RxRevu has access to data on 150 million patient lives, we do not have coverage information on everyone – nobody does. Many think that when they turn on one RTPB data feed, they have finished their work. But in reality, their solution might lack coverage for certain patients, or display inaccurate data altogether.
Another common myth is that RTBP vendors provide the same data if they have the same connections. Some RTPB vendors have set up direct connections to PBM data sources, allowing real-time, patient-specific data transactions to take place. However, others are not able to display accurate pricing information due to lack of direct connections or historic data collection processes. RxRevu brings data directly from PBMs to the EHR. We pride ourselves on our data accuracy, and because of our close relationships with PBM partners, we are able to display accurate pricing are the point-of-care, more often than any other vendor.
We’ve also heard the myth that EHR vendors need the same RTPB vendor as their prior authorization vendor. While there are vendors who offer both RTPB price transparency and prior authorization clearance tools, many vendors specialize in one or the other. RxRevu for example, specializes in RTPB. This allows us to avoid conflict, especially in those instances when there might be a financial incentive to run prior authorization transactions. Instead, we work to reduce prior authorization volumes by helping doctors avoid coverage restrictions altogether. RTPB is one aspect of the ePrescribing process, and the best solutions are not always delivered by prior authorization vendors.
There are a number of RTPB vendors who claim to have ‘all-payer’ solutions that can display data on all patients. While this idea seams attractive, we know it is simply impossible – since not every PBM has turned on or connected to all RTPB solutions. Some vendors use aggregated or historic data to estimate a medication’s cost, and this creates the illusion of an ‘all-payer’ solution. But in reality, these solutions often do not bring accurate pricing information to the EHR. This can lead to a negative provider and patient experience, since unreliable information can display incorrect prices – causing patients to pay more for their medications than expected.
Lastly, we often hear that RTPB tools require extensive training and additional clicks, causing increased friction in the EHR workflow. In fact, the opposite is true. RxRevu has developed a streamlined process for implementing RTPB within a partner’s EHR solution. We provide training modules and materials about how to use RTPB, which can be distributed to provider teams during typical upgrades or training sessions. What we’ve found is that providers actually leverage RTPB without any training at all. Using an RTPB solution does not require any unnecessary clicks – since it is deployed within the ePrescribing workflow. When submitting a medication order, providers can either proactively request a cost estimate, or, they will be prompted to check lower-cost, covered alternatives if they are available. RxRevu understands that providers are often frustrated with overly-complicated processes and unnecessary data. That is why we’ve built our RTPB solution to reduce friction and create a better overall provider experience.
Having coverage and cost information within the EHR can streamline the medication ordering experience, while reducing prescription spend. But being able to trust your data – and your RTPB vendor – is of the utmost importance. RxRevu is committed to creating the most accurate, reliable RTPB tool in the market, and we hope this post helps clarify any myths or untruths you’ve heard about RTPB.
Download our Mythbusters Infographic if you’d like to share this information with your team. And to learn more about RxRevu’s Real-Time Prescription Benefit solution, reach out today.