High Cost Medications

High Cost Medications

This article explains how medications are identified and flagged as high-cost in the referral process.

Where are the Medications Pulled From?

  1. Documents: All documents associated with a referral are analyzed by AI to detect medications. These documents can be found under the Documents tab within the referral’s details. Documents may be automatically sent from the hospital and appear in this section, or they can be uploaded manually. As soon as a document is added to the referral, the AI tool scans it to identify medications.
  2. Calculator: Medications can also be added manually to referral calculator under the Ancillaries section. Medications entered here are checked if they are high-cost. If the high-cost medication is removed from the Ancillaries section, it will no longer be flagged as high-cost.







 


Flagging as High Cost

The medications found on the documents or in the calculator are flagged as high cost when:
  1. The daily cost for that medication is above the threshold set in Referral Tracker>Settings>High Cost Meds.
  2. The medication is listed under the High Cost Meds List within the same settings section.
These criteria ensure that both expensive medications and predefined high-cost drugs are properly identified.

List of the Flagged High Cost Meds

The flagged high cost medications are listed in the referral Overview. The referral Overview is found at the top right corner of the referral.


Medications to Ignore

Sometimes, medications are flagged as high-cost even though they should not be. When you notice a medication being flagged that is not relevant, you can add it to the "Meds to Ignore" list to prevent it from being flagged again.
Steps to ignore a medication:
  1. Navigate to Referral Tracker > Settings > High Cost Meds.
  2. Add the medication to the "Meds to Ignore" list.
Info
If you want both the brand and generic versions of a medication to be flagged or ignored, you must add each one separately.

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