About Specialty Expedite®
Specialty Expedite helps reduce the back-and-forth between your office and our pharmacy by accessing medical record summary documents through existing interoperability networks. If your office uses a compatible platform that’s configured to share medical records with other health institutions, CVS Specialty® can leverage existing connections.
For connected offices, more than 50 percent of prescriptions are processed without additional outreach during the benefits verification and PA process1. This minimizes manual work (paperwork, faxes, and phone calls), helps prevent errors, and helps patients get started on therapy sooner.
Specialty Expedite solves challenges inherent in the specialty medication prescribing process through Electronic Health Record (EHR) system interoperability. CVS Health®, along with many other health systems, is a member of Carequality®, which allows our system to reach about 90 percent of all EHRs nationwide.
Specialty Expedite complements virtual business processes by enabling secure, electronic sharing of patient data. You won’t need to be in the office to respond to requests for information or review inbound faxes from our pharmacy.
After your EHR is connected, simply send prescriptions to CVS Specialty or any of our nearly 10,000 CVS Pharmacy® locations – including those inside Target stores. We will gather relevant patient information directly from your EHR.
EHR Systems and Compatibility
Specialty Expedite is available to practices and hospitals with EHR systems that participate in the Carequality® Interoperability Framework. These include athenaClinicals® (athenahealth), eClinicalworks, and NextGen Enterprise. A complete list of EHRs participating in Carequality can be found here: https://carequality.org/members-and-supporters.
Contact your EHR vendor for specific instructions on opting into the Carequality network. You can also search for active Carequality providers here: https://carequality.org/active-sites-search.
Carequality is a national interoperability framework that enables health information sharing between health data networks. It offers secure access to health information across diverse networks, including those operated by EHR vendors, record locator service providers, health information exchanges, and others. Connectivity is governed by technical and policy agreements developed and maintained by a broad group of industry and government stakeholders.
EHR vendors – “implementers” – agree contractually to abide by the terms of the Carequality Interoperability Framework. The implementer agreement language includes terms that are passed on for their customers and members who participate as “Carequality Connections.”
This approach enables communication between networks and is conceptually like how cell phones work today. If you use a cell phone on AT&T’s network, you can still call your friend who uses the Verizon Wireless network.
Carequality does not charge a fee to providers. Most EHR venders do not charge a fee. Please contact your EHR vendor for specific pricing details.
Today, Specialty Expedite is exclusively available to practices and hospitals that use an EHR system that participates in the Carequality Interoperability Framework. This may change as we continue to expand our EHR connectivity and interoperability capabilities.
In most cases, no. Your organization’s patient authorization settings will determine whether outside entities can access patients’ medical records, and you may need to grant authorization for CVS Health access to medical records. There may also be some areas of the medical record that are not configured to share through Carequality. Contact your EHR vendor for specific information and instructions.
Specialty Expedite helps reduce the amount of time it takes to respond to requests for information related to PA and prescription clarifications. We will gather what we need directly from your EHR.
Specialty Expedite helps improve PA coordination work but does not eliminate it completely. Specialty Expedite allows your office more time to focus on all patient needs, not just the PA. It also enables CVS Specialty pharmacists to leverage medical records for prescription clarifications and verification of dosage changes.
When the patient’s plan allows, CVS Specialty will gather relevant clinical data when a PA is required. A pharmacy staff member will initiate benefit verification and identify the needed clinical information from the EHR without contacting your office. PAs are completed according to plan design. If a PA was previously completed by your office and approved, the prescription will progress to the next stage of the dispensing process.
You can refill active prescriptions when they are ready for refill. They’ll be listed under My Prescriptions with a red Refill button next to them. Prescriptions you’ve refilled before, but aren’t yet ready to be refilled again, will appear under Recent Prescriptions.
If you see Please Call for Refill, your medication may need special handling, so you won’t be able to request a refill online. You will need to call the phone number on your prescription label.
The process is similar to any other pharmacy submitting PA requests to CVS Health. No preferential consideration is given for PA requests submitted through Specialty Expedite.
Yes. If your in-house pharmacy cannot dispense the recommended specialty therapy or the patient’s health plan requires CVS Specialty to be used, we can help.
We comply with applicable privacy laws and regulations for handling patient information. As a Carequality® participant, CVS Health has a legal obligation to follow common rules. We also use third-party auditing to help ensure that we only review medical records for patients when a prescription has been sent to CVS Specialty. An audit record of patient requests by CVS Specialty can be found in your EHR depending on which platform is used.
No. We only access records when a prescription is received, and we can only view the portion of the patient record shared through Carequality (as determined by your EHR configuration). The information we can see is similar to the documents you would traditionally print and fax to send clinical information to a pharmacy.
We are also limited by your organization’s (or the state’s) policy on patient authorization to view medical records for patients with sensitive health information and diagnoses.
No, our access is view-only. CVS Specialty cannot edit, remove, or add to information to records in your EHR.
In states where patient consent to view the electronic health records is required; we cannot access records without authorization from the patient. Regardless of whether or not a provider is enrolled in Specialty Expedite, your organization must acquire consent directly from the patient for records to be visible to CVS Specialty.
Specialty Expedite is available exclusively for providers who use EHR systems that participate in the Carequality® Interoperability Framework. If you have a compatible EHR and would like more details on getting connected, contact your CVS Specialty Account Representative.
If you do not know who your contact is, send an email to email@example.com. Please include provider name, NPI number, practice name, and complete address. We will locate the closest CVS Specialty Account Representative, and they will reach out to you as soon as possible.
There is no change. Simply continue to send us referrals by e-prescription, fax or phone. However, you can stop sending us bundles or packages of patient health records – we'll gather what we need from the EHR.
You may still receive calls if the necessary information is not visible in the EHR. However, pharmacy outreach to your practice will decrease dramatically.
No. There is no fee or development cost for Specialty Expedite. This is an internal system enhancement to our standard CVS Specialty pharmacy process to enhance patient onboarding.
To opt-out of expedited prescription onboarding, please notify us at firstname.lastname@example.org. Include provider name, NPI number, practice name and complete address. CVS Specialty will honor opt-out requests within 30 days of receipt.