Pharmacy requests — refills and changes
Pharmacies do not only receive prescriptions — they also write back. When a patient's medication runs out, the pharmacy sends a refill request. When it cannot fill a prescription as written (the drug is out of stock, the insurance wants something else, a prior authorization is needed), it sends a change request.
Every such request needs the doctor's own answer. SightHub never answers for you, and there is no "answer all" button.
Where the requests appear
On the Doctor's Desk, in the Pharmacy Requests card — bottom row, to the right of Unassigned Exams. This is the only place they appear.
The card header has:
- a white counter next to the title — how many requests wait for an answer (shown only in the default view);
- a filter list:
- Waiting for an answer — the default, your to-do list;
- Answered;
- Withdrawn by the pharmacy;
- Asked again — older copies of a request the pharmacy sent again;
- Expired;
- All;
- a refresh button that reloads just this list.
Reading the list
Each row shows:
- what kind of request it is — Refill request or Change request — and, as a grey badge, what exactly the pharmacy wants (for example a prior authorization);
- an amber asked again badge when the pharmacy repeated the request;
- on a request that is no longer waiting, a small outlined badge with its state (for example responded or expired);
- the drug;
- the patient's name and date of birth, and the pharmacy;
- for refills, Pharmacy asks for N fills;
- on the right, how long ago it came (just now, 5 h ago, 2 d ago) and answer by — the deadline after which the request expires.
Rules of thumb:
- 48 hours. The pharmacy network expects an answer within 48 hours. A request still waiting after that turns red and says over 48 h.
- Patient not matched means SightHub could not tie the request to a patient. No prescription of ours matched this request — read it carefully means it did not match a prescription sent from SightHub. You can still answer — just read the request closely.
Press Open to answer, or View to look at a request that is no longer waiting.
Reading the request
The window title says the kind of request; under it are the patient, date of birth, pharmacy and the pharmacy's Rx number.
- The pharmacy's reason — for a change request, a yellow box with the pharmacy's explanation in its own words.
- Exactly as the pharmacy sent it — the full message, field by field. Nothing is cut or folded; only empty fields are hidden:
- Patient — name, gender, date of birth, address, phone, height and weight, and the allergies the pharmacy has on file (or No known allergies);
- Prescriber and Pharmacy — name and number;
- the medication blocks — What was prescribed, What the pharmacy dispensed, and each What the pharmacy asks for — option N, with quantity, days supply, refills, how many fills the pharmacy asks for, substitution, directions, note, written date, diagnoses and other dates. Compound drug — check the details below marks a mixed preparation.
- What the pharmacy asks for — the same options as clickable cards (Option 1, Option 2…). On a change request, click the option you agree to; it turns blue. Option 1 is chosen by default, so check this before approving.
Answering
Choose in Your answer:
| Answer | When it is offered | What you fill in |
|---|---|---|
| Approve | Always | Refill: how many fills. Change: the option you clicked, and optionally new quantity, days supply or directions. |
| Approve with my own changes | Refill requests only | How many fills, plus the new quantity, days supply or directions. |
| Deny | Always | A reason from the list, or your own words, or both. |
| Not yet — I need more time | Always | A reason from the Why list, and I will answer by (a date). Both are required. |
| Confirm my registration | Only when the pharmacy asks to confirm the prescriber's registration | What confirms it, from the list. |
Refills: "How many fills in total"
On a refill, How many fills in total * means the total number of times the pharmacy may dispense — not "refills after the first fill" as on a new prescription. 3 here = the first fill plus 2 more. It is prefilled with what the pharmacy asked for; change it if you want. It must be 1 to 99.
Changing quantity, days supply or directions
These fields appear for Approve with my own changes and for Approve on a change request. Leave a field empty to keep it as it was.
- Quantity — up to 3 decimal places (2.5, 0.375).
- Directions — Take the pharmacy's wording copies the quantity, days supply and directions from the option you chose, so you do not retype them. Edit after copying if needed.
A prior authorization change request can only be approved as it is: the fields are hidden and the form says A prior-authorization request can only be approved as it is, without changes.
Note to the pharmacy
Once you pick an answer, a Note to the pharmacy field appears — up to 70 characters. The note icon next to it opens My phrases: the same saved phrases as Note to pharmacist in e-Prescribing. Click one to put it in the field (it is cut to 70 characters). + Add opens a box with the current text already in it; press Save to keep it as a new phrase.
Preview, then send
- Press Preview. A blue box shows This is what the pharmacy will get, with any warnings, the answer in full (The answer in full), and — if your answer creates one — A new prescription will be recorded for the patient. Show the message opens the raw message.
- If you change anything after the preview, press Preview again — the box does not update by itself.
- Press Send the answer.
What you may see:
- Answer sent to the pharmacy — done; the request leaves Waiting for an answer.
- Answer sent — a new prescription was created for the patient — an approval became a new prescription. It shows on the patient's Prescriptions (eRx) card.
- Not confirmed yet — send the same answer again — the window stays open. Press Send the answer again.
- The pharmacy network refused the answer, or its own reason — not delivered.
- If someone already answered, the pharmacy withdrew the request, or it expired, you see the reason and the request drops out of the list.
Looking at an answered request
Pick Answered (or All) in the filter and press View. A grey box at the top says why it cannot be answered — Already answered: …, The pharmacy withdrew this request — it cannot be answered., or that it is expired. At the bottom, Answered: shows the answer type, its delivery status and the time, and What we sent back shows the full answer field by field.
Good to know
- Answer the newest copy. If the pharmacy got no answer, it sends the request again. The new copy carries the asked again badge; copies that were replaced by a newer one are listed under Asked again in the filter.
- Not yet is a real answer — it tells the pharmacy you are working on it and by when. You still need to give the final answer later.
- A denial needs a reason — from the list, in your own words, or both. Otherwise you see Pick a reason or write one.
- Nothing is sent until Send the answer. Preview and Close send nothing.