Healthcare Systems, Pricing & Benefits
Healthcare systems involve complex networks of providers, payers, pharmacies, and patients. These terms cover how prescription benefits are managed, how drug pricing works, and how technology helps patients access affordable medications through insurance verification and cost optimization.
16 terms in this category
Formulary Management
The process of developing and maintaining a list of preferred medications covered by an insurance plan or healthcare organization.
Prior Authorization
Process requiring healthcare provider approval before certain medications can be covered by insurance.
Price & Benefit Transparency
Providing clear information about medication costs, insurance coverage, and out-of-pocket expenses to patients and providers.
Real-Time Benefit Check
Instant verification of medication coverage, costs, and alternatives at the point of prescribing.
Out-of-Pocket Cost Estimate
Calculation of the actual amount a patient will pay for a medication after insurance coverage.
Drug Price Transparency
Making medication pricing information readily available and understandable to patients and healthcare providers.
Pharmacy Benefit Management
Administration of prescription drug benefits on behalf of health plans and employers.
Cost-Effective Alternative
A medication option that provides similar therapeutic benefits at a lower cost.
Medication Affordability Pathway
Systematic approach to identifying and accessing affordable medication options for patients.
Insurance Coverage Verification
Process of confirming a patient's insurance coverage and benefits for prescribed medications.
Benefit Eligibility Check
Verification that a patient is eligible for insurance benefits and that a medication is covered under their plan.
Preferred Drug List
List of medications that are preferred and typically have lower copays under an insurance plan.
Copay Optimization
Process of identifying medications with the lowest copays for patients based on their insurance coverage.
Form 29C
Form 29C is the Israeli institutional drug approval form used by hospitals and healthcare facilities for authorizing the use of specific medications for individual patients.
Pharmacy Management System
A pharmacy management system is comprehensive software that handles all operational aspects of a pharmacy, including prescription processing, inventory, dispensing, and regulatory compliance.
Telehealth Prescribing
Telehealth prescribing enables healthcare providers to evaluate patients remotely and issue electronic prescriptions during virtual consultations.
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Digital Prescriptions & Electronic Prescribing
Everything you need to know about digital prescriptions, e-prescribing systems, and electronic prescription routing. Learn how modern prescription technology is replacing paper-based workflows.
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17 termsHealthcare Technology & Interoperability
Guide to healthcare technology standards including HL7, FHIR, EHR integration, healthcare APIs, AI-driven clinical tools, and digital health infrastructure powering modern healthcare systems.
32 termsHealthcare Regulations & Compliance
Understanding healthcare regulations including HIPAA, EPCS, DEA requirements, and digital prescription compliance standards that govern electronic prescribing and healthcare data security.
6 termsEvery Medication Workflow. Connected.
Formidable develops the systems that let healthcare organizations prescribe, sign, harmonize, and dispense — digitally and compliantly. From electronic prescriptions to FHIR interoperability, we turn complex workflows into production-ready software.