GoodRx unveils real-time benefit check In Provider Mode

Developed with AssistRx, this new feature enables healthcare professionals to compare insurance prices, cash prices and manufacturer savings programs.
Sandra Levy
Senior Editor
goodrx benefit mode

GoodRx, a resource for healthcare savings and information, is debuting real-time benefit check in Provider Mode.

Developed in collaboration with AssistRx, the advanced therapy initiation and patient solutions provider, real-time benefit check gives healthcare professionals immediate access to eligible patients’ insurance coverage and greater visibility into the cost of brand and specialty drug prescriptions at the point of prescribing.

The company noted that more than 550,000 HCPs have used Provider Mode to date, and GoodRx’s comprehensive price comparison features, which now include real-time benefit check, enable them to see the cost of a prescription with insurance, with GoodRx, or with a manufacturer’s savings program.

Since the launch of Provider Mode in 2022, seamless access to insurance copay information has been the most requested feature by HCPs who want to prescribe the medication that best meets their patients’ health and financial needs. Today, about three in 10 adults report not taking their medications as prescribed at some point in the past year due to cost. With insurance coverage information now available in Provider Mode, coupled with the GoodRx coupon price and options for manufacturer savings programs, HCPs can share a more complete picture of prescription cost options with patients. The goal is to significantly increase  access and adherence.

[Read more: GoodRx unveils Medicine Cabinet]

“Compiling prescription insurance pricing information and affordability solutions such as coupons and manufacturer savings has been a significant pain point for providers. It is time-consuming, and since the information is so fragmented, we often can’t get a holistic view of pricing despite our best efforts,” said Preeti Parikh, executive medical director of GoodRx. “We are confident that healthcare professionals will appreciate both the transparency and the efficiency that real-time benefit check provides to see all affordability options in one place.”

Real-time benefit check is easy and seamless for providers to use. After healthcare professionals log into GoodRx Provider Mode, they can check a patient’s insurance coverage with just a few pieces of information – patient name, date of birth, gender and zip code. Provider Mode is easily accessed through the web on any device. It can be used alongside existing healthcare technology systems, and includes cost comparison tools, faster savings with GoodRx coupons, customized news feeds, enrollment forms for specialty hubs and brand drug savings options that are not available in traditional electronic health records. HCPs also can seamlessly share available GoodRx savings with their patients using a QR code, without having to share a personal email address or phone number with the recipient.

Real-time benefit check also has the potential to deliver significant value to GoodRx’s pharma manufacturer partners. Pharma manufacturers spend a lot of time and resources educating HCPs about their medication access solutions. Through Provider Mode, these manufacturers can help raise awareness with high-intent HCPs that are searching for brand and specialty medications on GoodRx. Cost and affordability are often major barriers to taking medications as prescribed, so by surfacing if a patient is eligible for a copay card or savings programs at the point of prescription, real-time benefit check delivers more transparency in the prescribing workflow. This can ultimately enable manufacturers to reach large, highly motivated audiences at a key juncture in the provider and patient journey, with the goal of driving greater healthcare access and less script abandonment.

[Read more: CVS Caremark, GoodRx launch Caremark Cost Saver program]

In addition, GoodRx has made it easy to locate crucial patient enrollment forms for Hub and PAP within Provider Mode. The singular location provides forms across multiple manufacturers, minimizing the amount of time HCPs have to spend individually searching for the forms on the brand’s own site. With everything in one place, HCPs can download the forms on their devices and then easily fill in, print or share with their patients.

“We are seeing an overwhelmingly positive response to Provider Mode since we launched. Provider Mode brings valuable medication access and savings solutions to our HCP audience at the point of prescribing. The best part is that it is all on the GoodRx platform, an experience that both HCPs and patients have known and trusted for over a decade,” said Akeel Williams, general manager of GoodRx Provider Mode. “The addition of real-time benefit check is a powerful tool designed to make brand drugs more accessible by connecting providers and manufacturers at the point of care.”

“We built our advanced access and patient support solutions to be interoperable and capable of meeting HCPs in their preferred access channels like Provider Mode,” said AssistRx co-founder and chief commercial officer Edward Hensley. “Partnering with GoodRx expands our reach, enabling us to provide more offices with the real-time patient and product-specific benefit information needed to improve price transparency and informed access.”

GoodRx is focused on continuing to innovate and build groundbreaking tools in the Provider Mode experience to improve healthcare affordability and access, while reducing the administrative burden for providers, the company said. In the coming months, GoodRx expects to make this feature available for generic drugs and deliver new ways to help HCPs with key challenges around medication access and affordability.

Real-time benefit check is now live in Provider Mode for hundreds of brand and specialty drugs, with expanded coverage in the near future.

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