RxSavings Solutions API
RxSavings Solutions helps health plans, employers, and members find lower-cost prescription options, navigate coverage rules, and complete prior authorizations. With an unofficial API, you could pull member-specific prices across pharmacies, check if PA or step therapy applies, gen
What is RxSavings Solutions?
RxSavings Solutions (RxSS) provides prescription drug cost navigation and member engagement technology for health plans, employers, and PBMs. The platform analyzes a member’s benefits, formulary, and network pricing to identify clinically appropriate lower-cost alternatives; it supports outreach to members and prescribers, and helps complete prior authorizations.
Core product areas include:
- Drug price transparency personalized to a member’s benefits and accumulators
- Formulary and utilization management rules (tiers, PA, step therapy, quantity limits)
- Medication alternatives (generic, therapeutic, dosage/form changes, mail-order options)
- Pharmacy network comparison (retail, preferred, mail-order)
- Prior authorization initiation and status tracking
- Member and prescriber outreach to enable safe medication switches
Common data entities:
- Members (eligibility, plan, accumulators)
- Plans/Benefit designs and formulary tiers
- Drugs (GPI/GCN/NDC, strength, form)
- Pharmacies (NCPDP, preferred status, channel)
- Medication history (claims-derived fills)
- Savings opportunities (recommendations and estimated savings)
- Prior authorization cases (status, payer, diagnosis, clinical rationale)
- Prescribers (NPI, contact)
- Outreach events (member/prescriber communications)
The RxSavings Solutions Integration Challenge
Organizations rely on RxSavings Solutions daily, but turning portal-based cost and authorization workflows into automated pipelines can be hard:
- PBM-specific pricing and timing: Patient-specific prices depend on plan design, network status, and real-time accumulators
- Strong enterprise security: SSO/MFA and network controls complicate headless automation
- Portal-first delivery: Savings opportunities and PA helpers often live in web apps; public APIs are limited or unavailable
- Drug data complexity: Multiple identifiers (NDC/GCN/GPI), therapeutic classes, and days supply affect pricing and alternatives
- Compliance and consent: PHI, member consent for outreach, and audit trails are mandatory
- Batch/file interfaces: Roster updates and outreach exports may run via SFTP batches with timing windows
How Supergood Creates RxSavings Solutions APIs
Supergood reverse-engineers authenticated browser flows, batch interfaces, and network interactions to deliver a resilient API endpoint layer.
- Handles username/password, SSO/OAuth, and MFA (SMS, email, TOTP) securely
- Maintains session continuity with automated refresh and change detection
- Normalizes drug, formulary, and pricing objects (NDC/GCN/GPI) for consistent integration
- Aligns with customer entitlements and licensing constraints to ensure compliant access
- Bridges roster, outreach, and reporting file interfaces with signed URL retrieval and delivery
Getting Started
- Schedule Integration Assessment
Book a 30-minute session to confirm your RxSavings Solutions product mix, licensing, and authentication model.
- Supergood Builds and Validates Your API
We deliver a hardened RxSavings Solutions adapter tailored to your workflows and entitlements.
- Deploy with Monitoring
Go live with continuous monitoring and automatic adjustments as RxSavings Solutions evolves.
API Endpoints
Authentication
/sessionsEstablish a session using credentials. Supergood manages MFA (SMS, email, TOTP) and SSO/OAuth when enabled. Returns a short-lived auth token maintained by the platform.
Members
/membersRetrieve member profiles and eligibility for pricing and formulary checks.
Savings Opportunities
/members/{memberId}/savings-opportunitiesRetrieve clinically appropriate lower-cost alternatives, pharmacy switches, and mail-order options with patient-specific pricing and utilization rules.
Price Quotes
/price-quotesGenerate patient-specific prices for a proposed prescription across pharmacies and channels (retail vs. mail-order).
Prior Authorization Requests
/pa/requestsInitiate a prior authorization support request for a member and track status.
Use Cases
Point-of-Care Price Transparency and Rx Decisioning
- Show patient-specific prices across retail and mail-order for a proposed Rx - Compare generics, therapeutic equivalents, and dosage/form changes in workflow - Select the lowest-cost clinically appropriate option and preferred pharmacy
Prior Authorization and Alternatives Workflow
- Detect PA/step therapy/quantity limit requirements before prescribing - Initiate PA with clinical rationale and track status - Offer compliant alternatives to avoid PA when possible
Member Outreach and Adherence
- Trigger consented SMS/email outreach with savings options and pharmacy recommendations - Document actions and track conversions from opportunity to filled prescription - Reduce callbacks and improve first-fill success
Revenue Protection and Denial Avoidance
- Prevent avoidable denials by selecting covered drugs and preferred pharmacies - Verify utilization rules up front to reduce back-and-forth and resubmissions - Feed price and PA status back to billing and scheduling systems
Population Insights and Reporting
- Aggregate savings realized, conversion rates, and PA outcomes by clinic or provider - Identify high-impact drug classes for proactive alternative strategies
Technical Specifications
Authentication
Username/password with MFA (SMS, email, TOTP) and SSO/OAuth where enabled; supports service accounts or customer-managed credentials
Response format
JSON with consistent resource schemas and pagination
Rate limits
Tuned for enterprise throughput while honoring licensing and usage controls
Session management
Automatic reauth and cookie/session rotation with health checks
Data freshness
Near real-time retrieval of member pricing, formulary rules, and PA updates
Security
Encrypted transport, scoped tokens, and audit logging; respects RxSavings Solutions entitlements and HIPAA requirements
Webhooks
Optional asynchronous delivery for PA status changes, outreach conversions, and opportunity updates
Latency
Sub-second responses for list/detail queries; price quotes optimized for point-of-care interactions
Throughput
Designed for high-volume roster sync, pricing checks, and outreach pipelines
Reliability
Retry logic, backoff, and idempotency keys minimize duplicate actions
Adaptation
Continuous monitoring for UI/API changes with rapid adapter updates
Frequently asked questions
Supergood supports workflows across commonly used RxSavings Solutions portals and plan-facing tools, subject to your licensing and entitlements. We scope coverage (e.g., member pricing, formulary rules, savings opportunities, PA initiation/tracking, pharmacy comparisons) during integration assessment.
We support username/password + MFA (SMS, email, TOTP) and can operate behind SSO/OAuth when enabled. For batch flows, we manage SFTP timing windows, roster imports/exports, and signed URL retrieval or delivery confirmations programmatically.
Yes. We expose normalized JSON for prices, formulary rules, and alternatives to power point-of-care decisions. We also support idempotent calls tied to draft orders and can return prescriber-facing outreach links when change authorization is required.
Supergood implements encryption in transit, scoped tokens, and detailed audit logs. We operate within your licensed entitlements, respect consent flags for outreach, and align with HIPAA and organizational security controls.