Challenge
Every transaction type needs separate certification
Agnotic approach
We plan certification per transaction into the schedule from the start and sequence them so the highest-value transactions certify first.
Surescripts · e-Prescribing
E-prescribing and pharmacy integration
Surescripts is the backbone of US e-prescribing and medication history. We build real integrations against the NCPDP SCRIPT standard (new prescriptions, renewals, cancellations, RxHistory, EPCS, and real-time benefit) and carry you through certification, not just the demo.
NCPDP SCRIPTEPCSRxHistoryHIPAA-Ready
Trusted by global innovators
What is e-prescribing integration?
E-prescribing integration connects your EHR, telehealth or pharmacy software to the national network that carries electronic prescriptions, most often through Surescripts or a certified partner. Agnotic Technologies builds the NCPDP SCRIPT transactions, medication history, pharmacy directory lookup and EPCS workflow, so prescriptions reach the right pharmacy and controlled substances meet DEA rules.
Surescripts runs the national e-prescribing and medication-history network linking prescribers, pharmacies and payers. Integrating means implementing NCPDP SCRIPT transactions (NewRx, RxRenewal, RxChange, CancelRx, RxFill), medication history (RxHistory), eligibility, formulary and benefit, and Electronic Prescribing of Controlled Substances (EPCS) with identity proofing and two-factor authentication.
The non-trivial part is that this is a certified network, not an open API. Surescripts certifies each transaction type, requires exact NCPDP SCRIPT conformance and, for EPCS, an audited two-factor and identity-proofing workflow. We scope transactions, certification and directory and eligibility dependencies first.
E-prescribing integration architecture
See how we design e-prescribing integrations that pass certification: SCRIPT transactions, medication history, and EPCS wired correctly.
Common failure modes
Where do Surescripts integrations fail?
Challenge
EPCS identity proofing and two-factor are underestimated
Agnotic approach
We design the DEA-conformant identity-proofing and two-factor workflow, with audit logging, as a first-class part of the build rather than a bolt-on.
Challenge
Non-conformant messages fail certification late
Agnotic approach
We validate against NCPDP SCRIPT conformance and the Surescripts test network continuously, so message issues surface in build, not at certification.
Challenge
Directory mismatches misroute prescriptions
Agnotic approach
Reliable prescriber and pharmacy directory resolution with verification before a prescription is transmitted.
What do we build for Surescripts integration?
The exact NCPDP SCRIPT transactions, services, and controlled-substance requirements that carry e-prescribing data.
NCPDP SCRIPT transactions
NewRx, RxRenewal, RxChange, CancelRx, and RxFill implemented to the NCPDP SCRIPT standard for prescriber-to-pharmacy exchange.
Medication history (RxHistory)
RxHistory requests and responses so prescribers see a consolidated fill history across pharmacies and payers at the point of care.
EPCS with two-factor
Electronic Prescribing of Controlled Substances with DEA-conformant identity proofing, two-factor authentication, and audit logging.
Eligibility, formulary & benefit
Eligibility checks and formulary and benefit data, plus Real-Time Prescription Benefit so prescribers see patient-specific cost at prescribing.
Directory services
Prescriber and pharmacy directory resolution so prescriptions route to the correct, verified endpoint.
Certification-ready messaging
Conformant message construction and validation built to pass Surescripts certification for each transaction type on the first pass.
Where it runs
Who needs e-prescribing integration?
EHR e-prescribing
In-workflow prescribing with NewRx, renewals, and cancellations.
Telehealth prescribing
Virtual-visit prescribing with EPCS for controlled substances.
Pharmacy platforms
Pharmacy-side receipt, RxChange, and RxFill notifications.
Medication history
RxHistory retrieval for reconciliation and adherence programs.
Benefit transparency
Real-Time Prescription Benefit surfaced at the point of prescribing.
Adherence & reconciliation
RxFill-driven adherence tracking and med reconciliation workflows.
E-prescribing built to pass certification
Surescripts is a certified network, not an open API. We build conformant messaging and carry you through certification as part of the plan.
5
Core SCRIPT transactions (NewRx, Renewal, Change, Cancel, Fill)
Per type
Certification planned for each transaction type
EPCS
Two-factor signing, identity proofing and audit logging
Compliance-First Healthcare App Development Services Backed by Global Standards
15-Minute Scoping Call01
HIPAA
Health Insurance Portability and Accountability Act
Protect PHI with privacy-first architecture, encrypted storage and transmission, strict access controls, and traceable audit logs.
02
GDPR
General Data Protection Regulation
Implement lawful consent flows, data minimization, retention controls, and secure processing for sensitive health data.
03
FHIR
Fast Healthcare Interoperability Resources
Enable standardized health data exchange across apps, care teams, and systems through standards-based FHIR APIs.
04
HL7
Health Level Seven International
Support enterprise-grade interoperability with HL7-based integrations for records, events, and clinical messaging workflows.
05
HITRUST
Health Information Trust Alliance
Align security programs to healthcare-specific control and risk management practices trusted by providers and ecosystem partners.
06
HITECH
Health Information Technology for Economic and Clinical Health Act
Design with breach notification readiness, digital record safeguards, and operational controls that support regulated care programs.
07
SaMD
FDA Software as a Medical Device
Plan software quality, traceability, and documentation pathways for products that may require SaMD review and submission.
08
MDR (EU)
Medical Device Regulation (European Union)
Prepare EU market-ready processes for risk classification, evidence tracking, and lifecycle governance under MDR expectations.
09
SAMHSA
Substance Abuse and Mental Health Services Administration
Apply confidentiality controls and consent-aware sharing models for behavioral and mental health data experiences.
Standards we build against
Which standards govern e-prescribing?
NCPDPEPCSRxHistoryRxNormHIPAA
Our Process
How do we build a Surescripts integration?
We treat certification, transaction build, and go-live as parallel tracks so e-prescribing reaches production certification predictably.
1.
Discovery & Scope
We map the transaction set you need (NewRx, RxRenewal, RxHistory, EPCS) and the certification path for each before any code is written.
Certification-aware design
2.
Certification Onboarding
We initiate Surescripts onboarding, secure test-network access, and confirm the conformance requirements for each transaction type.
Network onboarding
3.
Build & Test
We build the NCPDP SCRIPT messaging and EPCS workflow, validating against the Surescripts test network and certification scripts.
Conformance-validated
4.
Go-Live & Monitoring
Certification, phased production go-live, and transaction dashboards with alerting for rejected or unacknowledged messages.
Certified & observable
Transaction table
Which NCPDP SCRIPT transactions do you need?
How we approach the main transactions: the SCRIPT type and the friction to expect.
| Capability | SCRIPT / service | Notes |
|---|---|---|
| New prescription | NewRx | Baseline certification; directory resolution must be correct. |
| Renewal / change | RxRenewal / RxChange | Request/response state and pharmacy round-trips add complexity. |
| Cancellation | CancelRx | Straightforward once NewRx is certified. |
| Medication history | RxHistory | Consent and consolidated response handling. |
| Controlled substances | EPCS | Identity proofing and two-factor add DEA-conformance work and audit. |
Each transaction type carries its own certification. Network onboarding and certification, not engineering, set the pace, so we date the plan after scoping.
Facts and sources
Which rules shape e-prescribing integration?
Short facts we design around, each linked to its primary source.
Medicare Part D rules require prescribers and dispensers that send prescriptions electronically for covered Part D drugs to use the NCPDP SCRIPT standard.
Source: 42 CFR 423.160 (eCFR)Since January 1, 2021, Medicare has required prescribers to issue at least 70 percent of their Schedule II to V controlled substance prescriptions for Part D drugs electronically, with exemptions such as prescribers who issue 100 or fewer a year.
Source: 42 CFR 423.160(a)(5) (eCFR)To sign a controlled substance prescription, a DEA-compliant e-prescribing application must authenticate the practitioner with two of three factors: something they know, something they are or a separate hard token.
Source: 21 CFR 1311.115 (eCFR)An electronic prescription application must pass a third-party audit or a DEA-approved certification before it is used for controlled substances, and again when related functions change or every two years.
Source: 21 CFR 1311.300 (eCFR)
Featured case study
Read Case StudyLera Health: compliant women's health platform
Surescripts isn't the subject here, but Lera Health is honest proof of the same rigor: standards-conformant data flows, a privacy-first data layer, and a compliant, integration-heavy platform delivered end to end.
Why Partner With Us
15-Minute Scoping CallWhy teams trust us with e-prescribing integration
We bring the NCPDP conformance and certification discipline that Surescripts integrations actually require.
Compliance-First by Default
HIPAA and DEA EPCS requirements (identity proofing, two-factor, and audit logging) designed into the workflow from the start.
NCPDP SCRIPT Fluency
We know the SCRIPT transaction structure and certification scripts: your team won't be teaching ours what an RxChange is.
Built to Pass Certification
We construct conformant messaging validated against the test network so certification is a checkpoint, not a months-long surprise.
Dedicated Integration Team
One accountable team across discovery, build, QA, and monitoring, with a named engineer for transaction and certification issues.
Our relevant experience
Real integrations, not just familiarity.
Frequently Asked Questions
Network onboarding and certification, not engineering, set the pace. The timeline depends on the transactions you need, whether you add medication history and EPCS, each of which carries its own certification, and whether you connect to Surescripts directly or through a certified partner.
Cost depends on the transaction set: core SCRIPT transactions first, then EPCS, medication history and real-time benefit. Direct network connection or a partner API, and the number of prescribing workflows in your product, also change the effort. We scope against the transactions you need in a discovery conversation.
Yes, if you connect to Surescripts directly: each transaction type (NewRx, RxRenewal, RxChange, CancelRx, RxHistory and EPCS) goes through onboarding and certification. A certified partner's API can shorten that path because the partner holds the network connection. We build conformant NCPDP SCRIPT messaging and plan certification into the schedule from the start.
EPCS is electronic prescribing of controlled substances. DEA rules require the prescriber to sign each controlled substance prescription with two of three authentication factors, require identity proofing before those credentials are issued, and require a third-party audit or certification of the prescribing application before it is used.
Yes. We wire e-prescribing directly into telehealth visit workflows, including EPCS for controlled substances, and connect prescribing to remote patient monitoring and wearable-driven programs over HIPAA-covered pipelines so prescriptions flow from the virtual encounter.
Yes. We implement the full EPCS workflow (DEA-conformant identity proofing, two-factor authentication, and audit logging) as a first-class part of the build, and certify it through Surescripts before controlled-substance prescribing goes live.
Ready to integrate Surescripts e-prescribing?
Tell us your transaction set and whether you need EPCS. We'll return a realistic plan with the certification path and go-live timeline.
contact@agnotic.com
Partnerships
contact@agnotic.com