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May 2019 Cigna News: View Drug Benefit Details Using Real-Time Benefit Check

On October 1, 2018, Cigna began offering real-time benefit check.

This new service can give you access to drug benefit information for your patients with Cigna-administered coverage, during the electronic prescribing process, through your electronic medical record (EMR) or electronic health record (EHR) system. 

Real-time benefit check enables you to access patient-specific drug benefit details, such as: 

  • Out-of-pocket costs for the prescribed drug in the requested days’ supply (e.g., 10, 15, 30, or 90 days). 
  • Drug alternatives. 
  • Prior authorization information. 
  • Step therapy information. 
  • Quantity limits. 

Your patient’s out-of-pocket costs for maintenance drugs will show for a 90-day supply through Cigna Home Delivery Pharmacy. 
Drug alternatives are identified for several acute and maintenance medications based on certain factors, such as clinical effectiveness and cost. Drug alternatives are referenced for certain drug classes related to diabetes, cholesterol, and asthma, along with several others. More drugs will be added to this list on an ongoing basis. 

EMR or EHR system requirements 
Most EMR and EHR vendors enable providers to access real-time benefit check. To access this functionality, you must have a version of their system that supports this feature. For additional information, contact your EMR or EHR vendor.

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