Application Certification Requirements
2 min
s 209 the customer shall implement and maintain a surescripts approved drug compendia that is updated at least monthly acceptable drug compendia include the following elsevier scholz databank first databank (fdb) cerner multum wolters kluwer medi span merative (formerly ibm truven health analytics) or others as approved by surescripts f 200 if the application displays formulary from sources other than surescripts, the application shall identify which formulary was retrieved via surescripts f 201 during the prescription writing process, the application shall make the following available formulary status with preference levels, coverage factors, and copay factors (mail and retail at a minimum) for medications at the medication name/strength/dosage form level utilizing unique, actionable indicators or abbreviations is permissible when coverage factor(s) applies copay applies user action on the indicator presents all details in their entirety note for alternatives, only formulary status and copay factors (mail and retail at a minimum) are required for display f 202 the application shall make available for display alternative medications with a more preferred formulary status when the target medication is the following o on formulary/non preferred c carve out n non formulary x non reimbursable without authorization y non reimbursable note note the application may further filter alternatives by utilizing decision support logic (e g only showing alternatives applicable due to gender, age, diagnosis, etc ) f 203 if payer specified alternatives are available for the target medication, they shall be displayed most to least preferred, according to the preference level of the alternative f 204 payer specified alternatives shall be displayed first when therapeutic alternatives are also available f 205 the customer shall ensure that end users are using the latest formulary information at least every week f 206 formulary file publishers shall support the following file transmission actions full replace, update, and delete f 207 formulary publishers shall support, at a minimum, the formulary status file type f 208 formulary publishers shall ensure the eligibility response (271) transaction correctly identifies the corresponding plan’s formulary files per table in appendix a field mapping note see formulary ids and eligibility fields overview for more information on field mapping