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 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.
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Surescripts operates the national e-prescribing and medication-history network that connects prescribers, pharmacies, and payers. Integrating with it means implementing the NCPDP SCRIPT standard for prescription transactions — NewRx, RxRenewal, RxChange, CancelRx, and RxFill — plus medication history (RxHistory), eligibility, formulary and benefit, and, for controlled substances, Electronic Prescribing of Controlled Substances (EPCS) with its identity-proofing and two-factor requirements.
The non-trivial part is that this is a certified network, not an open API. Surescripts requires a formal certification process for each transaction type, exact conformance to the NCPDP SCRIPT message structure, and for EPCS an audited two-factor and identity-proofing workflow. We scope the transaction set, certification path, and directory and eligibility dependencies up front so you reach production certification rather than stalling in test.
See how we design e-prescribing integrations that pass certification — SCRIPT transactions, medication history, and EPCS wired correctly.

Common failure modes
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.
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
Robust prescriber and pharmacy directory resolution with verification before a prescription is transmitted.
The exact NCPDP SCRIPT transactions, services, and controlled-substance requirements that carry e-prescribing data.
NewRx, RxRenewal, RxChange, CancelRx, and RxFill implemented to the NCPDP SCRIPT standard for prescriber-to-pharmacy exchange.
RxHistory requests and responses so prescribers see a consolidated fill history across pharmacies and payers at the point of care.
Electronic Prescribing of Controlled Substances with DEA-conformant identity proofing, two-factor authentication, and audit logging.
Eligibility checks and formulary and benefit data, plus Real-Time Prescription Benefit so prescribers see patient-specific cost at prescribing.
Prescriber and pharmacy directory resolution so prescriptions route to the correct, verified endpoint.
Conformant message construction and validation built to pass Surescripts certification for each transaction type on the first pass.
Where it runs
In-workflow prescribing with NewRx, renewals, and cancellations.
Virtual-visit prescribing with EPCS for controlled substances.
Pharmacy-side receipt, RxChange, and RxFill notifications.
RxHistory retrieval for reconciliation and adherence programs.
Real-Time Prescription Benefit surfaced at the point of prescribing.
RxFill-driven adherence tracking and med reconciliation workflows.
Surescripts is a certified network, not an open API. We build conformant messaging and carry you through certification as part of the plan.
Health Insurance Portability and Accountability Act
Protect PHI with privacy-first architecture, encrypted storage and transmission, strict access controls, and traceable audit logs.
General Data Protection Regulation
Implement lawful consent flows, data minimization, retention controls, and secure processing for sensitive health data.
Fast Healthcare Interoperability Resources
Enable standardized health data exchange across apps, care teams, and systems through robust FHIR-ready APIs.
Health Level Seven International
Support enterprise-grade interoperability with HL7-based integrations for records, events, and clinical messaging workflows.
Health Information Trust Alliance
Align security programs to healthcare-specific control and risk management practices trusted by providers and ecosystem partners.
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.
FDA Software as a Medical Device
Plan software quality, traceability, and documentation pathways for products that may require SaMD review and submission.
Medical Device Regulation (European Union)
Prepare EU market-ready processes for risk classification, evidence tracking, and lifecycle governance under MDR expectations.
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
We treat certification, transaction build, and go-live as parallel tracks so e-prescribing reaches production certification predictably.
We map the transaction set you need — NewRx, RxRenewal, RxHistory, EPCS — and the certification path for each before any code is written.
We initiate Surescripts onboarding, secure test-network access, and confirm the conformance requirements for each transaction type.
We build the NCPDP SCRIPT messaging and EPCS workflow, validating against the Surescripts test network and certification scripts.
Certification, phased production go-live, and transaction dashboards with alerting for rejected or unacknowledged messages.
Transaction table
How we approach the main transactions — the SCRIPT type, typical timeline, and the friction to expect.
| Capability | SCRIPT / service | Typical timeline | Notes |
|---|---|---|---|
| New prescription | NewRx | 4–8 weeks | Baseline certification; directory resolution must be correct. |
| Renewal / change | RxRenewal / RxChange | 4–6 weeks | Request/response state and pharmacy round-trips add complexity. |
| Cancellation | CancelRx | 2–4 weeks | Straightforward once NewRx is certified. |
| Medication history | RxHistory | 4–6 weeks | Consent and consolidated response handling. |
| Controlled substances | EPCS | 6–10 weeks | Identity proofing and two-factor add DEA-conformance work and audit. |
Each transaction type carries its own certification. Timelines assume network onboarding is underway; certification, not engineering, sets the pace.
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.

We bring the NCPDP conformance and certification discipline that Surescripts integrations actually require.
HIPAA and DEA EPCS requirements — identity proofing, two-factor, and audit logging — designed into the workflow from the start.
We know the SCRIPT transaction structure and certification scripts — your team won't be teaching ours what an RxChange is.
We construct conformant messaging validated against the test network so certification is a checkpoint, not a months-long surprise.
One accountable team across discovery, build, QA, and monitoring, with a named engineer for transaction and certification issues.
Real integrations, not just familiarity.
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
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