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Slide Presentation from the AHRQ 2007 Annual Conference

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Eligibility Checking (All UHMP)

Text Description is below the image.

UHMP Practice using OnCallData™ with a Formulary Database sends X12 270 Requests and receives X12 271 Responses through RxHub to and from PBMs (Medco, Express, Caremark, Anthem*)

* Anthem live as of 11/06

Jan—Dec '06: 176K + responses / 300K checks (~59% hit rate)

Foundation Standard: Eligibility (X12 270/271)
OnCallData™ sends name, dob, zip, gender to RxHub, gets formulary identifier in return (informs formulary selection for that prescribing session)

Notes:

Numbers represent ALL of UHMP e-prescribing practices, including specialty. However, ¾ of UHMP eRx volume is represented by our study group prescribers in the 25 primary care practices (~ 30K of monthly UHMP total of ~40K eRx), so presumably ¾ of these eligibility transactions are coming from the 25 study group practices.

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