Supergood | RxSavings Solutions API
Programmatically access member-specific drug pricing, formulary coverage, savings opportunities, and prior authorization workflows in RxSavings Solutions with a stable REST API. Supergood builds and operates production-grade, unofficial RxSavings Solutions integrations so your team can surface point-of-care price transparency and automate pharmacy cost workflows without heavy custom engineering.
In plain English: 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, generate clinically safe lower-cost alternatives, and trigger prescriber change requests or member outreach—all from your own app.
If you’re a healthcare tech startup supporting providers, practice management, or revenue cycle, integrating with RxSavings Solutions unlocks concrete value:
- Pull: Member profiles and eligibility, plan design summaries, drug pricing per pharmacy, formulary tiers and restrictions (PA, step therapy, quantity limits), medication history, savings opportunities, PA case statuses
- Push: New/updated member rosters, proposed prescriptions for price check, PA initiation data with clinical rationale, prescriber change requests, consented outreach actions (SMS/email)
- Build: Point-of-care real-time benefit checks in your eRx/EHR, authorization-aware prescribing, automatic alternative recommendations, member savings messaging, and denial avoidance workflows in billing
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
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
Available Endpoints
Authentication
POST /sessions: Establish 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.
curl --request POST \
--url https://api.supergood.ai/integrations/<integration_id>/sessions \
--header 'Authorization: Basic <Base64 encoded token>' \
--header 'Content-Type: application/json' \
--data '{
"username": "[email protected]",
"password": "<password>",
"mfa": {
"type": "totp",
"code": "123456"
}
}'
Example response
{
"authToken": "eyJhbGciOi...",
"expiresIn": 3600,
"user": {
"id": "u_71a02f",
"name": "Rx Admin",
"entitlements": ["pricing", "formulary", "pa", "outreach"]
}
}
Members
GET /members: Retrieve member profiles and eligibility for pricing and formulary checks.
Query parameters
- memberId: string
- planId: string
- activeOn: ISO 8601 date
- search: string (name, subscriberId)
Example response
{
"items": [
{
"memberId": "mem_9b42f0",
"subscriberId": "A123456789",
"name": {"first": "Jordan", "last": "Patel"},
"dateOfBirth": "1988-04-03",
"planId": "pln_acme-hmo-2026",
"eligibility": {
"status": "active",
"startDate": "2026-01-01",
"endDate": "2026-12-31"
},
"accumulators": {
"deductibleMet": 350.0,
"outOfPocketMet": 820.5
}
}
],
"page": 1,
"pageSize": 50,
"total": 1
}
Savings Opportunities
GET /members/{memberId}/savings-opportunities: Retrieve clinically appropriate lower-cost alternatives, pharmacy switches, and mail-order options with patient-specific pricing and utilization rules.
Query parameters
- ndc: string (optional; focus opportunities for a proposed NDC)
- gpi: string (optional; focus opportunities by therapeutic class)
- includeHistory: boolean (include opportunities derived from recent fills)
Example response
{
"memberId": "mem_9b42f0",
"items": [
{
"opportunityId": "opp_7342c1",
"currentMedication": {
"drug": {"name": "Rosuvastatin", "strength": "20 mg", "form": "tablet", "gpi": "39400060100320", "ndc": "00378-0934-93"},
"quantity": 30,
"daysSupply": 30
},
"alternatives": [
{
"recommendationId": "rec_genera",
"type": "generic",
"drug": {"name": "Rosuvastatin", "strength": "20 mg", "form": "tablet", "gpi": "39400060100320"},
"pricing": [
{"pharmacyId": "1427381", "pharmacyName": "Preferred Pharmacy #12", "channel": "retail", "memberCost": 6.0, "planPaid": 18.4, "retailPrice": 36.0, "preferred": true},
{"pharmacyId": "MAIL_OTC_01", "pharmacyName": "Acme Mail Order", "channel": "mail_order", "memberCost": 4.0, "planPaid": 16.0, "retailPrice": 28.0, "preferred": true}
],
"utilizationRules": {"paRequired": false, "stepTherapy": false, "quantityLimit": false}
},
{
"recommendationId": "rec_thera",
"type": "therapeutic",
"drug": {"name": "Atorvastatin", "strength": "20 mg", "form": "tablet", "gpi": "39400010100320"},
"pricing": [
{"pharmacyId": "1427381", "pharmacyName": "Preferred Pharmacy #12", "channel": "retail", "memberCost": 3.0, "planPaid": 12.0, "retailPrice": 20.0, "preferred": true}
],
"utilizationRules": {"paRequired": false, "stepTherapy": false, "quantityLimit": false}
}
],
"estimatedAnnualSavings": 220.00,
"recommendedAction": "switch_drug",
"status": "new",
"referenceId": "ehr-order-42391"
}
]
}
Price Quotes
POST /price-quotes: Generate patient-specific prices for a proposed prescription across pharmacies and channels (retail vs. mail-order).
curl --request POST \
--url https://api.supergood.ai/integrations/<integration_id>/price-quotes \
--header 'Authorization: Bearer <authToken>' \
--header 'Content-Type: application/json' \
--data '{
"memberId": "mem_9b42f0",
"drug": {"gpi": "68100010000320", "name": "Amoxicillin", "strength": "500 mg", "form": "capsule"},
"quantity": 21,
"daysSupply": 7,
"pharmacyFilter": {
"zip": "64112",
"radiusMiles": 10,
"includeMailOrder": true
},
"referenceId": "ehr-rx-88771"
}'
Example response
{
"memberId": "mem_9b42f0",
"drug": {"gpi": "68100010000320", "name": "Amoxicillin", "strength": "500 mg", "form": "capsule"},
"quantity": 21,
"daysSupply": 7,
"quotes": [
{"pharmacyId": "1439981", "pharmacyName": "Corner Drug", "channel": "retail", "memberCost": 5.00, "planPaid": 9.80, "retailPrice": 18.00, "preferred": true},
{"pharmacyId": "MAIL_OTC_01", "pharmacyName": "Acme Mail Order", "channel": "mail_order", "memberCost": 4.00, "planPaid": 8.50, "retailPrice": 16.00, "preferred": true}
],
"utilizationRules": {"paRequired": false, "stepTherapy": false, "quantityLimit": false},
"referenceId": "ehr-rx-88771"
}
Prior Authorization Requests
POST /pa/requests: Initiate a prior authorization support request for a member and track status.
curl --request POST \
--url https://api.supergood.ai/integrations/<integration_id>/pa/requests \
--header 'Authorization: Bearer <authToken>' \
--header 'Content-Type: application/json' \
--data '{
"memberId": "mem_9b42f0",
"drug": {"ndc": "00093-7421-56", "name": "Semaglutide", "strength": "1 mg/dose", "form": "pen"},
"prescriber": {"npi": "1234567890", "name": "Dr. Lee"},
"diagnosisCodes": ["E11.9"],
"clinicalRationale": "Trialed metformin and liraglutide with inadequate control.",
"previousTherapies": [
{"drug": "Metformin", "outcome": "insufficient_response"},
{"drug": "Liraglutide", "outcome": "intolerant"}
],
"attachments": [{"type": "chart_notes", "url": "https://signed.example/notes.pdf"}],
"referenceId": "pa-case-2026-001"
}'
Example response
{
"paCaseId": "pa_71af2b",
"status": "submitted",
"payer": {"name": "Acme Health HMO", "payerId": "acme_hmo_2026"},
"drug": {"ndc": "00093-7421-56", "name": "Semaglutide"},
"nextAction": "Await payer review",
"payerPortalUrl": "https://pa.rxss.example/signed/abc123...",
"createdAt": "2026-01-19T16:05:42Z",
"referenceId": "pa-case-2026-001"
}
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
Performance Characteristics
- 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
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.
Frequently Asked Questions
Q: Which RxSavings Solutions products can this integration cover?
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.
Q: How are MFA, SSO, and batch interfaces handled for automation?
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.
Q: Can you embed real-time benefit checks in my EHR or prescribing workflow?
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.
Q: How is PHI protected in this unofficial integration?
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.
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Ready to automate your RxSavings Solutions workflows?
Supergood can have your RxSavings Solutions integration live in days with no ongoing engineering maintenance.
