The Profile tab will have read-only patient data for the selected patient.  The current patient details, IKC (Integrated Kidney Care) program data, provider’s contact information for all facilities where the patient dialyzes, the patient’s primary, secondary, and tertiary insurance data will be shown, if available.  To add, update, or remove any data, the patient’s DaVita care team must be contacted.

Click the “Pharmacy” button to view the patient’s current pharmacy data, as set in Rcopia. 

The Pharmacy field will default to that patient’s most recently used pharmacy.  Click the dropdown arrow to view all pharmacies.  The pharmacy can be modified by using the pharmacy management options.

If the patient participates in an IKC program, the IKC section will be present and displays the IKC Program name, IKC Care Team members' names, and blue email address hyperlinks.  When clicked, the email address hyperlink will automatically launch your email client so you can send a message to the IKC Care Team member.

The “Medications Eligibility” link under the Insurance Details section contains a list of select medications where coverage and Pharos approval must be verified prior to administration.  

When the link is clicked, a read-only modal appears and gives providers visibility into whether a patient is eligible to receive medication through DaVita based on the patient’s insurance, payer prior authorization requirements, and Pharos Formulary Exception (FE) status.

Medication eligibility data is pulled from DaVita’s Pharos and Nautilus systems.  The data includes the “Auth First” medication, related facility, Payor Coverage Eligibility, Payor Prior Authorization (PPA), and Pharos FE Request Status. 

The information displayed is detailed below.

Column Description
Payer Coverage Eligibility The medication’s coverage eligibility by the payer.  The values are Yes or No.
Payer Prior Authorization (PPA)

The payer’s requirement for prior authorization.  Statuses include: Required, Not Required, or N/A when the Payer Coverage Eligibility is No. If a PPA is required for the medication, no action is required from the provider.  Facility teammates can submit a patient-specific Formulary Exception Request in Pharos for review of clinical eligibility.

If clinically eligible, DaVita’s Clinical Pharmacy Management (CPM) team will partner with DaVita’s Revenue Operations (ROPS) team to request the PPA from the external payer.

Pharos FE Request Status

The Pharos Formulary Exception (FE) Status.  DaVita’s Auth-First medications require patient-specific Pharos approval prior to initiation.  Facility teammates are able to submit and view details directly in Pharos. Statuses include: Pending, More Information Needed, PPA Pending, Approved, Denied, Withdrawn, and Discontinued.

A read-only eRX medications list is available by clicking on the “Medication List” button.

Content on this site is for informational purposes only and does not represent actual patient data.

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