Real Time Benefit

The TruBridge EHR platform Real Time Benefit output format, consisting of sent and received Real Time Formulary and Real Time Prescription Benefit files.

Table of contents

1. The Real Time Benefit file naming scheme

2. The detailed file format definition

File Naming Scheme:

The Real Time Benefit files are named following the naming convention as follows:

Rx_spid_profile_visit_Title_CreationDate_CreationTime

An example of this naming convention:

Rx_1_12345678_123456_SSRTF00015573_58_4_T00000000023149_1_sent_20230101_1200000000

Detailed File Format:

The file output consists of XML data in the NCPDP format(NCPDP SCRIPT Version 20170715).

Example data file format:

<?xml version="1.0" encoding="UTF-8"?>
<rfs-pmbc:Message TransactionDomain="SCRIPT"
                  DatatypesVersion="v2013101"
                  TransactionVersion="rfs-pmbc-0.1.0"
                  ECLVersion="v2013101"
                  StructuresVersion="v2013101"
                  TransportVersion="v2013101"
                  xsi:schemaLocation="http://www.surescripts.com/messaging rfs-pmbc.xsd"
                  xmlns:datatypes="http://www.ncpdp.org/schema/datatypes"
                  xmlns:script="http://www.ncpdp.org/schema/script"
                  xmlns:structures="http://www.ncpdp.org/schema/structures"
                  xmlns:transport="http://www.ncpdp.org/schema/transport"
                  xmlns:ecl="http://www.ncpdp.org/schema/ecl"
                  xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"
                  xmlns:rfs-pmbc="http://www.surescripts.com/messaging">
    <rfs-pmbc:Header>
        <transport:To Qualifier="ZZZ">SurescriptsID</transport:To>
        <transport:From Qualifier="ZZZ">T00000000001025</transport:From>
        <transport:MessageID>1231214</transport:MessageID>
        <transport:RelatesToMessageID>876543211</transport:RelatesToMessageID>
        <transport:SentTime>2016-10-25T19:00:33.2974466Z</transport:SentTime>
        <transport:SenderSoftware>
            <transport:SenderSoftwareDeveloper>EMRCOMPANY</transport:SenderSoftwareDeveloper>
            <transport:SenderSoftwareProduct>EMRSYSTEM</transport:SenderSoftwareProduct>
            <transport:SenderSoftwareVersionRelease>V1</transport:SenderSoftwareVersionRelease>
        </transport:SenderSoftware>
        <transport:TestMessage>0</transport:TestMessage>
    </rfs-pmbc:Header>
    <rfs-pmbc:Body>
        <rfs-pmbc:BenefitRequest>
            <rfs-pmbc:BenefitCheckFormularyLists>
                <rfs-pmbc:FormularyID>T9X40904FS</rfs-pmbc:FormularyID>
            </rfs-pmbc:BenefitCheckFormularyLists>
            <rfs-pmbc:BenefitsCoordination>
                <rfs-pmbc:PayerIdentification>
                    <datatypes:PayerID>T00000000001001</datatypes:PayerID>
                </rfs-pmbc:PayerIdentification>
                <rfs-pmbc:PBMMemberID>PXS000002321937%549953231662%001</rfs-pmbc:PBMMemberID>
            </rfs-pmbc:BenefitsCoordination>
            <rfs-pmbc:DrugDBSourceCode>FDB</rfs-pmbc:DrugDBSourceCode>
            <rfs-pmbc:MedicationRequestedInformation>
                <rfs-pmbc:MedicationRequested>
                    <rfs-pmbc:DrugDescription>LIPITOR 10 MG TABLET</rfs-pmbc:DrugDescription>
                    <rfs-pmbc:DrugCoded>
                        <rfs-pmbc:ProductCode>
                            <datatypes:Code>00071015534</datatypes:Code>
                            <datatypes:Qualifier>ND</datatypes:Qualifier>
                        </rfs-pmbc:ProductCode>
                    </rfs-pmbc:DrugCoded>
                    <rfs-pmbc:Quantity>
                        <datatypes:Value>30</datatypes:Value>
                        <datatypes:CodeListQualifier>38</datatypes:CodeListQualifier>
                        <datatypes:QuantityUnitOfMeasure>
                            <datatypes:Code>C48542</datatypes:Code>
                        </datatypes:QuantityUnitOfMeasure>
                    </rfs-pmbc:Quantity>
                    <rfs-pmbc:DaysSupply>30</rfs-pmbc:DaysSupply>
                </rfs-pmbc:MedicationRequested>
            </rfs-pmbc:MedicationRequestedInformation>
            <rfs-pmbc:Patient>
                <structures:Name>
                    <datatypes:LastName>SMITH</datatypes:LastName>
                    <datatypes:FirstName>JOHN</datatypes:FirstName>
                </structures:Name>
                <structures:Gender>M</structures:Gender>
                <structures:DateOfBirth>
                    <datatypes:Date>1967-08-13</datatypes:Date>
                </structures:DateOfBirth>
            </rfs-pmbc:Patient>
            <rfs-pmbc:Pharmacy>
                <structures:Identification>
                    <datatypes:NCPDPID>1234567</datatypes:NCPDPID>
                    <datatypes:NPI>1223456789</datatypes:NPI>
                </structures:Identification>
                <structures:BusinessName>Name</structures:BusinessName>
                <structures:CommunicationNumbers>
                    <datatypes:PrimaryTelephone>
                        <datatypes:Number>5156667777</datatypes:Number>
                    </datatypes:PrimaryTelephone>
                </structures:CommunicationNumbers>
            </rfs-pmbc:Pharmacy>
            <rfs-pmbc:Prescriber>
                <rfs-pmbc:Identification>
                    <datatypes:NPI>2123112346</datatypes:NPI>
                </rfs-pmbc:Identification>
            </rfs-pmbc:Prescriber>
        </rfs-pmbc:BenefitRequest>
    </rfs-pmbc:Body>
</rfs-pmbc:Message>