E-Rx: Processing Refill and Change Requests
Reconcile incoming pharmacy refill (RxRefill) and change (RxChange) requests against existing patient records in DoseSpot, avoiding duplicate patient accounts when a pharmacy's demographic data doesn't exactly match what's on file. An orange flag on the request indicates a mismatch that needs manual review before the request can be approved or denied. Providers can either accept the incoming demographic data as a new patient or search for and match the existing patient record instead.
Built by Core Engineering
The problem it solves
When a pharmacy's data for a patient doesn't exactly match what's already on file in DoseSpot, approving the request without reviewing it can silently create a duplicate patient account, splitting that client's prescription history across two disconnected records. This solves that by flagging the mismatch upfront and giving the provider a clear choice before the request is processed.
What's included
- Orange flag indicator on RxChange/RxRefill notifications with a demographic mismatch
- Accept New Patient option, for requests confirmed to be a genuinely new patient
- Search Patients option, matching a request to an existing patient record instead
- Manual reconciliation step required before approving or denying the underlying request
How it works
When a pharmacy's refill or change request arrives with patient demographics that don't exactly match a DoseSpot record, the request appears in Notifications with an orange flag next to the patient's name. If the provider is confident this is genuinely a new patient, they select Accept New Patient, which updates the notification with the new information and allows them to proceed to View Details. If the provider recognizes the patient already exists under their account, they instead select Search Patients, search by name, and select the correct existing record from the results; the notification updates accordingly before the provider proceeds to approve or deny the request. Selecting Accept New Patient for a patient who already has an account will create an unaffiliated duplicate record, so providers are encouraged to search first whenever a mismatch is flagged.
This lets providers reconcile incoming pharmacy refill and change requests when a patient's demographic details in SureScripts' database don't exactly match an existing DoseSpot patient record, so the request can be processed without creating an unintended duplicate account. It's built to prevent fragmented patient records, which would otherwise split a client's prescription history across two separate DoseSpot profiles. When a mismatch occurs, the RxChange or RxRefill notification displays an orange flag next to the patient's name, signaling that manual reconciliation is needed before the request can move forward. A provider can either accept the new demographic data (creating a new, potentially duplicate record) or search for and select the existing patient the request actually belongs to.