Understand the request
Bring the medication request, member history, clinical notes, and supporting documentation together.
Work through complex pharmacy decisions.
Bring formulary information, coverage criteria, and clinical documentation together so your team can spend less time assembling the request and more time reviewing it.
Talk with Sidechain
Make pharmacy reviews easier to work through.
Check the coverage requirements
Compare the request with formulary rules, prior authorization criteria, step therapy, and other plan requirements.
Prepare the next step
Identify missing information, summarize the review, and draft the communication the team needs next.
Work through a pharmacy review start to finish
Coverage decisions start with the right information.
See what's already been tried
Pull together previous therapies, duration, response, intolerance, and contraindications.
Work through the coverage requirements
Review the indication, step therapy, quantity limits, and other criteria that apply to the request.
Find the documentation the review depends on
Surface required labs, test results, treatment history, or clinical findings — and make missing information easy to spot.
Understand the exception
See the documented reason a preferred therapy or standard pathway may not be appropriate.
Know what needs to happen next
Prepare the reviewer to complete the review, request additional information, or route the case for further consideration.