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Initiate a Manual or Electronic Verification Request
Initiate a manual or electronic pharmacy benefits verification request to generate patients’ benefits packages, and furnish a concise summary of the benefits related to the medications prescribed within a care program.
Required Editions
| Available in: Lightning Experience |
| Available in: Enterprise and Unlimited Editions with Life Sciences Cloud or Health Cloud |
| User Permissions Needed | |
|---|---|
| To create a verification request: | Manage Pharmacy Benefits Verification permission set |
Before you create the verification request, you must set up the data for patients, member plans, purchaser plans, practitioners, payors, drugs, and pharmacies.
A verification request consists of the data related to the patient’s prescriber, drug, and pharmacy. To speed up the request creation process, by default, prescriber, drug, and pharmacy fields are auto-populated with the values used in the last verification request.
Regardless of the type of verification request, follow the steps to launch the guided flow.
- From the App Launcher, find and select Care Program Enrollee.
- Select care program enrollee.
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Click the Pharmacy Benefits Verification tab.
Note The tab name for your Salesforce org can vary based on your admin setup. - To launch a guided flow, click New Manual Request for a manual verification request, or click New Electronic Request for an electronic verification request.
- Select the name of the patient's practitioner.
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Under Prescriber Details, select the name of the patient's practitioner.
The National Practitioner ID is automatically populated.
- Click Next.
- Under Drug Details, select the name of the drug prescribed to the patient's prescribed drug name.
- Enter the supply duration in days.
- Enter the quantity.
- Select the unit of measure.
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Under Pharmacy Details, select the pharmacy name.
The other details of the pharmacy, such as Pharmacy ID, Phone, Type, and Address are automatically populated.
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Click Submit.
You see a message that confirms the submission of the benefit verification request.
- Click Done.
