RxVIEW

RxView™ is targeted toward our client’s customers. Helpful to employers who assist their members in prescription benefits management by providing a limited but useful look into the members plan information.

RxVIEW is a Web-based application that is accessed through a secure, client-specific URL, and uses RxCLAIM® as the data repository.  RxVIEW presents member information without industry-specific terminology, abbreviations or acronyms, and does not require the user to be knowledgeable of the codes found in RxCLAIM (e.g., Relationship Code) or functionality distinctive of RxCLAIM (e.g., the “roll logic” feature).  A user can be fully operational in RxVIEW with a very limited amount of training.

Components and Functionality

Member/Subscriber Search The member/subscriber search screen is the main default screen for RxVIEW. In order to search for member records, you must know the carrier, account, group, and member ID or subscriber ID of the member.
Update Member The following fields may be viewed and/or updated depending on security role of the user:
 
  • Relationship Code
  • Person Code
  • Full Time Student
  • Birth Date
  • Gender
  • Multi-Birth Flag
  • Eligibility Dates
  • Address
  • Contact Number
  • Social Security Number
  • Subscriber ID
Claim History

The claim history link is used to view claims for the member.  Claim history includes the following links:
 
  • Status of Claim
  • Fill Date
  • Product Description
  • Prescriber
  • Pharmacy
  • Quantity
  • Patient Pay
  • Plan Pay
ID Card Enter a request to create an ID card.
Prior Authorization (PA) History

The PA history link is used to display PA’s for the member. 

 
  • PA Number
  • Product Description
  • Type
  • From Date
  • Thru Date
  • Agent
  • Reason Code
Limited PA Creation

Create a limited PA against a rejected claim.
 
  • The Prior Authorization is valid for two days
  • Ability to enter PA notes against the PA

 

To learn more about RxVIEW™, contact us

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