Getting Started: E-Rx

Healthie offers a E-Rx integration with DoseSpot as an add-on to your Healthie plan, which enables clinical providers to prescribe medications electronically on behalf of their patients. Here is an overview of E-Rx and Healthie. 

E-Rx is available for members on Healthie's Plus, Group, and Enterprise plans.

E-Prescribing is available specifically for patients located in the US and all US territories. 

Optionally, members on our Enterprise plan can also be given permissions to prescribe controlled substances.

Enable E-Rx for Your Account

There is an approval process from Healthie's Integration partner, DoseSpot / Surescripts, in order to set up E-Rx within Healthie. Verification of your professional credentials will be required. In order to get started, please complete our E-Rx Application Form with your business & personal information. Please indicate if you would like your team members to have prescribing access, or proxy access as you complete the form. 

When completing the application, the following information is required: 

• Clinic Name & Address
• Clinic Phone Number 
• Clinic Fax Number (an active fax number is required) - if you need a fax line, a fax line can be provided via Healthie 
• Legal name of team member 
• Team member's Healthie email address 
• Team member's date of birth 
• Team member's NPI number (required for prescribing permissions - NPI must be for the individual, not an organizational/type 2 NPI). 

If you are part of a larger (parent) organization that uses Healthie, please reach out to your organization admin to see if there is a specific E-Rx Application that should be used for your account. Using an organization-specific application allows us to streamline your E-Rx requests. 

Once your application is received, it will be sent to DoseSpot for review and approval, which typically takes 7-14 business days. Our team will contact you once approval has been received, if there are outstanding questions, and to let you know when E-Rx has been enabled on your account. 

Here is a Dosespot Guide to help you learn more about leveraging Dosespot in your clinic, and how Dosespot directly integrates with SureScripts to populate patient information. 

E-Rx (DoseSpot) Self Sign-Up: Turning on E-Rx Self Sign-Up for Your Org Members [In Development]

Organization Member Settings

If you are an Organization owner/admin, and your DoseSpot connection has been approved through the steps listed above, non sub-Organization users who are providers and proxies can self sign-up for DoseSpot.

Once the Organization owner/admin account has E-Rx enabled, navigate to Organization (left navigation sidebar) > Members > Organization Member > Action [...] > Edit Settings.

Click on Permissions, and scroll down until you reach the Integrations section. Enable the checkbox called "Should see option to use E-Rx (Dosespot) within Healthie." Then, select an E-Rx Role: "Prescribing Provider" or "Proxy."

E-Rx (DoseSpot) Self Sign-Up: Signing Up as an Org Member [In Development]

When an Organization member has been set up with DoseSpot Self Sign-Up permission by the Organization owner/admin, they can navigate to a Client Profile (Overview).

• If that Organization member should have access to see existing clients, then you should adjust their permissions accordingly (i.e enable Can search across all clients in the organization / Sees all clients in the organization on the Clients Page)
• If that Organization member shouldn’t have access to see existing clients (i.e, they should only see their own clients) you can create a test client in order to access the E-Prescriptions widget)

The Organization member can scroll down to their E-Prescriptions section, and now they should be able to see the E-Prescription widget section/"Connect E-Rx" button.

Once they click on the "Connect E-Rx" button, a menu titled "Enable E-Rx" will appear from the right hand side. The Organization member should fill out the form.

Once the Organization user submits the application, they will see an E-Rx processing request. Once the E-Rx processing request is approved, the Organization user will be an active Organization DoseSpot user, allowing them to add their own e-prescriptions.

When E-Rx Proxy has been enabled for your account, you will receive the following email from Healthie:

After receipt of "E-Rx: Account is enabled" Healthie email

After you receive an email from Healthie reflecting that E-Rx has been enabled on your account, you should be able to e-prescribe from your account within the next 24-48 hours. 

DoseSpot will initiate the Identify verification process for your account, which is a needed step for all prescribers using the feature.

To complete this process: 

• Log in to Healthie
• Navigate to a client's profile
• Scroll to the e-prescriptions section
• Click the "Add and Manage Prescriptions" button
• Accept the 3 agreements on the first screen (if you have not done so already) 
• Click on the exclamation point icon within that area and follow prompts from there. 

Note: Please allow 24-48h after receiving "E-Rx: Account is enabled" email from Healthie for E-Rx to become accessible to your account. This is the typical timeframe for DoseSpot to approve clinician profiles. 

If it has been 24-48h since you've received that email and you are still unable to initiate/complete the Identity Verification Steps, you can reply to that email for support. 

***As part of the verification process, you will be asked for your SSN, driver's license number, cell phone number, and credit card number. The prescriber’s credit card is run through Experian to verify that they are who they are and that their information matches up with the information on the credit card/report. The card is not charged nor is it kept on record. This is done for the prescriber’s protection from fraudulent activity. A soft inquiry is placed on the report and does not affect your credit score or your ability to borrow. 

If your initial attempt at identity verification is not successful, you will be prompted to wait for a physical letter from Experian in the mail as an alternative method of verifying your identity. We have outlined those steps here in our Help Center: Approval process for EPCS. We also attached DoseSpots EPCS Guide, which should accurately walk you through the process. 

Please note: If you were using an e-Prescribing feature through another EMR, DoseSpot may request additional information from us. Should that happen, we will submit a ticket to their support team to get that switched over for you. 

Let us know if you have any questions as you dig in, we're here to help.

** As of 3/31/24 - Facial recognition is now a part of identity verification. Please note that this process is only necessary for providers who have not yet completed IDP prior to 3/31/24. Facial recognition identification is an easier, more secure method to complete, and involves just a couple steps to take a photo of your identification (such as a driver's license or passport) and a selfie of your face. You will see a pop-up, IDP Facial Recognition, that will provide more information on completing the Experian Facial Recognition Process on your cell phone.

See the attached guide for more info: DoseSpot Facial Recognition Guide.

After Completion of Identity Verification Process (following up on your EPCS enrollment to prescribe controlled substances)

After completion of the Identify Verification Process, there is still one more step for you to complete. You need to set up Two-Factor Authentication. This is done through Healthie and Duo Mobile, a mobile app. 

Essentially, every time you place an order for a controlled substance, you will need to get a code from the Duo Mobile app to verify your identity. You enter this code into Healthie to complete the prescription order. 

Please follow the steps below to complete the TFA enrollment process, and trigger an invitation from Duo Mobile to download the app (you will need the SMS text invitation for Duo Mobile in order to connect the app to your E-Rx account). 

You can refer to this EPCS Supplement Guide as well for details. 

To set up 2FA:

• Log in to Healthie
• Navigate to a client's profile
• Scroll to the e-prescriptions section
• Click the "Add and Manage Prescriptions" button
• Click on the exclamation point icon within that area and follow prompts from there (top left of the prescriptions page) and follow the on-screen prompts! 

***You will be prompted to add a mobile phone number. At this point, there are TWO text messages you should receive from Duo Mobile. One is the link to download the app, and the second is the link your Duo Mobile account with DoseSpot.

Note: If you need to change your PIN, please click "Change PIN" below the PIN field.

Once you have the Duo Mobile app downloaded, and you click on the link to connect to DoseSpot, you will be able to generate a TFA code. You'll need to go back into Healthie, and add that TFA code to complete the enrollment process. 

Please see pages 4-7 of the EPCS Supplement Guide for step-by-step instructions, and let us know if you get stuck!

Access E-Rx with a Patient's Healthie Profile

When you have been approved by DoseSpot to E-prescribe via Healthie, you will see a new box "E-PRESCRIPTIONS" within the Overview Section of each patient profile. E-Rx cannot be accessed from elsewhere in the platform, only directly through an individual Patient Profile.  

Note: Only the prescribing provider or established Proxy members will be able to see the E-Rx box within the provider portal. If E-Rx has not been enabled for a team member, they will not see the Prescriptions section of a patient's profile. 

Note: Basic patient information is required in order to create an E-Rx for a patient. This includes: 

• Patient First and Last Name
• Gender
• Valid Phone Number
• Date of Birth
• Street Address

Please note, height and weight are required fields in the client's profile in order to prescribe for any client 19 years old or younger.

If you are missing this information for a specific patient, the "Add and Manage Prescription" button will appear inactive. You can add this information by navigating to the "Actions" tab. 

Place an E-Rx Order

To place an E-Rx order for a patient, click on " Add and Manage Prescriptions"

Then, click "Add Prescription" > Search for a medication  > Complete the on screen field details

Note: the "Patient Reported" button allows you to add a medication that is self reported by the patient. This option will add the self-reported medication to an "Active Medications" list within "Manage Prescriptions" section (a forthcoming update will display this information on the Patient's Profile page within Healthie).  

Patient Details 

Within the " Manage Prescriptions" section of your patient's profile, you'll see relevant patient details that you can manage or add, including: 

• Add and send a new prescription 
• Check a patient’s insurance eligibility and formulary information 
• Review medication history 
• Add patient reported medications 
• Add patient drug allergies** 
• Add a preferred pharmacy
• A list of active and inactive medications (with ability to adjust the statuses of each medication)
• Coverage details

A Patient ID is automatically generated by DoseSpot for your patient. This is not the same as your patient's Healthie ID. 

A note on insurance & coverage details: 

This information is pulled from SureScripts,  which is connected directly to insurance plans/PBMs. It will use the medication information and days supply to pull copay values. This information cannot be edited, as it is sourced from SureScripts. 

Preferred Pharmacy(ies)

In order to submit an e-Rx to your patient's pharmacy for fulfillment, a pharmacy must be selected as a "Preferred Pharmacy." 

Each client can have a preferred pharmacy saved so that it’s easily assigned to future e-prescriptions. You can set this within the E-Rx portal and are in the viewing area when putting together a prescription for a client. 

Tip: A note can be added for a pharmacy when creating a prescription: 

Can't locate your patient's preferred pharmacy? 

More than 95% of the nation's pharmacies are enabled for electronic prescribing including all of the major drug store chains (i.e. CVS, Walgreens, Walmart, Target, etc.). On occasion you may search for a pharmacy within DoseSpot and no results are provided. This may be due to a number of reasons, but the most important thing to understand is that if a pharmacy is not within DoseSpot then an electronic prescription cannot be sent to that pharmacy. Please proceed to print the prescription instead.

Alternatively, you can request that your pharmacy be added to SureScripts pharmacy database. Please send an email to hello@gethealthie.com with the name, address, and phone number of the pharmacy you would like to add. Healthie will place a request to add the pharmacy to the database, and it should be available to select in 1-2 business days. 

Patient Drug Allergies

Healthie's EHR feature enables providers to collect and document patient allergy information. Patient allergy information currently syncs between Healthie and DoseSpot. Any allergies added into the patient's profile, will automatically send to DoseSpot when issuing a prescription. Likewise, allergy information within the patient's E-Prescribing profile will pull back into Healthie to ensure complete allergy documentation.

Patient allergy information can be reference by navigating to Patient Profile > Actions > Allergies/Sensitivities

You may find it convenient to have the patient "Allergies" tab open in a separate browser tab, while placing a prescription order. 

A Note on Patient Insurance

Based on a patient's insurance plan that might be on record on the DoseSpot side, when a provider is putting together an e-prescription, there will be an indicator if the selected drug is on that patient's formulary or not. Patient insurance information does not currently push directly from Healthie into DoseSpot -- however, providers can update a patient's profile during the prescription ordering/management process as needed. 

There are a few statuses that could appear regarding insurance & prescription availability: 

• Non-Formulary: Prescription drugs that are not on a plan’s formulary.
• On Formulary/Non-Preferred: Non-formulary drugs are often covered by the health plan, but at a higher patient copay.
• On Formulary/Preferred: (Higher number = More preferred)
• Non-Reimbursable: Non-Reimbursable are Prescription drugs that the patient’s health plan will not pay for.
• U: Unknown Status

If the medication selected is non-formulary or not preferred, the provider will be shown alternative medications that are preferred under that patient's formulary plan. 

Below is an example of what this looks like:

Manage E-Rx

Once an order is placed, it will appear in the "E-PRESCRIPTIONS" tab of your patient's Healthie profile. The following details will display for each E-Rx order: 

• Medication name and dosage 
• Date ordered 
• Number of refills ordered
• Pharmacy status (if they have received & verified the E-Rx order). The DoseSpot prescription status terminology includes:  
  • Entered: prescription has been added, and is now in the patient's "pending" medication list within DoseSpot. 
  • Active: a prescription record has been created within the DoseSpot system. This happens simultaneously as the prescription is entered, and indicates that actions can now be performed with this order.  
  • Sending: when provider "approves and sends" a prescription, the medication will move from the patient's "pending" medication list, to their "active" medications within DoseSpot.  
  • eRx Sent: the prescription order has successfully reached the destination/pharmacy.  
  • Pharmacy Verified: confirms that the pharmacy has received and reviewed the prescription order. 

For additional details, there are two icons next to each E-Rx 

• Notepad icon: will show any listed directions that were written by the provider during the ordering process
• Location icon: shows which pharmacy the E-Rx order has been sent to

Note, the Medications section in a Client's Profile is  currently separate from the E-Prescriptions section. Learn more about historical medication data here: 

• E-Rx: Medication History
• Client Medication History

You can return to add or manage any prescriptions by clicking the "Add & Manage" tab   

DoseSpot Electronic Prior Authorization (ePA)

Initiate ePA

Locate the medication in the patient’s Pending Medications list. From the Actions dropdown, click “Start Prior Auth.”

A pop up will open with the option to either complete the Prior Authorization process electronically or offline.

Click "EPA Request" to send a PA initiation request to the payer. The medication will move from the pending medications list to the "Active Prior Authorization Requests" section.

Active Prior Authorization Requests

The Active PA Requests section displays a list of the patient’s PA requests that are currently in progress. Here, the clinician can review prescription details, and PA status and notes. The Status icon shows the current PA request status.

To view more details, click on the status Icon to open the Prior Authorization Log.

Prior Authorization Questions

Before approving a PA request, the Payer can request for additional information from the clinician. This is indicated by the “Action Required” status icon. From the Actions dropdown, click “Answer Questions” to open the PA question workflow.

Complete the question set. Review all answers in the question set summary, and click Submit to send the info to the payer.

A pop up will appear to confirm the submit. Click OK.

E-Rx Notifications 

When there's an error, it will appear on the patient's profile below "problems" with a red icon. 

There will also be an "E-Rx Notifications" that appears as a red circle with a number on it in the bottom-left menu bar. This notifications tab will disappear after the notification/error has been resolved. Providers are still able to access e-Rx directly from a patient's profile. 

Lastly, it will also appear within the "Notifications" section when managing prescriptions. Add & Manage > Notifications

From here, providers have the option to view the error, or ignore it. Ignoring an error will dismiss the notifications within your account but will not necessarily resolve the prescription error. 

"Invalid Information" Error Message

DoseSpot requires certain client information to be on file in order to e-Prescribe. If you are trying to update some of these required fields, you may seen an error message if the updated fields are blank or not valid. If you are seeing incorrect information for your client, or are unable to make changes to their information, please email hello@gethealthie.com for further support.

Common E-Rx order errors 

• This document includes common errors that might occur after a provider submits an e-prescription. 

Additional Resources

• E-Rx and Healthie
• FAQs: E-Rx
• Video demo of Healthie's e-Rx integration
• E-Rx: Medication History