--- title: E-Prescribe | Avara description: In-chart electronic prescribing over the Surescripts network — setup, EPCS, agents, compounds, pharmacy message types, and reconciliation. --- ## Introduction The Clinical Platform includes **electronic prescribing (eRx)** in the patient chart — NewRx, refills, changes, cancels, compounds, and controlled substances over the **Surescripts** network. Any pharmacy enrolled in Surescripts is reachable from Avara. Avara eRx is the **most modern e-prescribe experience on the market for any EHR**. The prescribing UI is built for speed and clarity, and the platform runs **reconciliation logic other EHRs do not support** — inbound refill and change requests match back to the original prescription, and unmatched pharmacy traffic lands in an inbox your team can resolve instead of disappearing. It is also the **cheapest eRx on the market**: **$75/month per prescribing provider** per organization, plus **$50/month per prescribing agent** per organization. See [Pricing](/clinical-platform/pricing/#users/index.md). ## Pricing **$75/month per provider** with **Can Prescribe (Rx)** at that organization. That fee covers Surescripts network access and **EPCS** (electronic prescribing of controlled substances). You pay per provider, per organization — a provider enabled at two organizations is two seats. **$50/month per prescribing agent** at that organization. Agents authorized at two organizations are two seats. **Referral agents** (Connect sending agents) remain free. Nurses and other staff who are not prescribing providers and are not prescribing agents are not billed as eRx seats. Clinic enablement is **irreversible**. Billing follows active **Can Prescribe** grants and active prescribing-agent authorizations. See [Getting Set Up](#getting-set-up). ## Getting Set Up eRx takes **three layers**. Permission without self-enable does nothing; self-enable without permission does nothing. ### 1. Enable eRx for the clinic Admin or owner users turn on eRx under **Settings → Organization configuration**. The organization’s name, street address, city, state, ZIP, and clinic contact phone must be complete first. **Confirm the address before you enable.** Once eRx is on, you **cannot disable it** for the organization, and that address **cannot be changed**. ### 2. Grant prescribing permissions Invite or edit the provider under [Users](/clinical-platform/inviting-users/index.md). Two permissions apply: - **Can Prescribe (Rx)** — electronically prescribe medications. Requires an **NPI** and a **provider role**. - **Can EPCS** — electronically prescribe **controlled substances**. Requires Can Prescribe (Rx). Grant this only to providers cleared to write CS for your organization. You control whether a given prescriber can write **controlled substances**, **non-controlled only**, or **not prescribe at all**. There is no separate clinic-wide CS kill switch — withhold **Can EPCS** for providers who should not write controlled substances. ### 3. Enable prescribing on the profile Each provider turns on their own prescribing profile under **Profile → Rx & Referrals**. That step is **independent** of the organization grant and **cannot be turned off** once enabled. The provider needs a complete prescribing profile: provider status, valid NPI, name, date of birth, phone, and address. **A valid state medical license is required to prescribe (Can Prescribe / eRx).** Add it on the profile before enabling. **A valid DEA license for this organization is required to enroll in EPCS** and prescribe controlled substances. Both licenses live on **Profile → Rx & Referrals** (and credentials) after enablement. ## Controlled Substances and EPCS **EPCS** is required to send controlled substances electronically. Enrollment is available when the organization has granted **Can EPCS** and the provider has a **valid DEA license** for that organization. ### Enrollment Set aside about **15 uninterrupted minutes**. You will need: - The **Duo Mobile** app - A cellphone for SMS (identity proofing and Duo) - A **driver’s license** (photos and a selfie) - A **credit card** (not debit) for identity verification - Your **Social Security number** — identity proofing runs a **soft credit check through Experian**. You must know your SSN to complete that step. The wizard covers legal agreements, identity proofing, knowledge-based verification, and two-factor setup. You create a **4-digit EPCS PIN** (not `1234`, not four identical digits) and enroll Duo on the phone. ### Sending a controlled substance Once enrolled, signing and sending a controlled-substance prescription requires: 1. Your **EPCS PIN** 2. A **2FA push approval** on the **Duo** app on your mobile device The send waits on that approval. You can view or change the PIN later from **Profile → Rx & Referrals**. Prescribing agents **cannot** send controlled substances and **cannot** approve controlled-substance RxChange requests. See [Prescribing Agents](#prescribing-agents). ## Prescribing Agents Providers who have enabled eRx can authorize **prescribing agents** — non-provider staff **without an NPI** — to send **non-controlled** prescriptions **on their behalf** at that organization. Each authorized prescribing agent is **$50/month** at that organization. Agents need a complete profile (date of birth, phone, and address). The provider manages the authorized list from **Profile → Rx & Referrals**. When an agent writes an Rx, they choose which authorized prescriber they are sending for. Agents never enroll in EPCS and never send CS. **Referral agents** used for Connect referrals are a separate, unpaid role. ## Writing a Prescription Open **New Rx** from the patient chart. The patient must have the demographics the network requires (name, date of birth, phone, and address; height and weight if they are 18 or under) before you can start. From there you can: - Search and prescribe **coded medications** - Build **compounds** (up to five ingredients — coded search or free text) - Attach up to **four ICD-10 diagnoses** - **Report an existing** outside or paper prescription without transmitting to a pharmacy ### Review, interactions, and allergies Before send, the review step runs **allergy and drug-interaction** checks. Chart allergies, clinic-written prescriptions, and **patient-reported / externally recorded medications** all feed the **same interaction engine**. [Intake forms](/clinical-platform/patient-forms/index.md) can prefill medications and allergies so that list is already in the chart when you prescribe. ### Pharmacies Pharmacy search reaches **any pharmacy enrolled in the Surescripts network**. Each result shows the **message types that pharmacy supports** — so you can see NewRx, refill, RxChange, cancel, fill status, eligibility, prior auth, and EPCS capability before you pick it. Patients can keep **favorite pharmacies**. Those favorites are offered first on the next New Rx. ### Favorites Save **prescription favorites** and **compound favorites** for the clinic under **Templates → Rx Favorites**. They autofill medication and sig fields on the next New Rx. Pharmacy, effective date, and diagnoses are not stored on the favorite — those stay visit-specific. ## After You Send Avara supports the message types practices use day to day: - **NewRx** — transmit a new prescription - **Cancel** — cancel request to the pharmacy - **Refill / renewal** — approve, deny, or replace - **RxChange** — approve, deny, or modify a pharmacy-initiated change - **Fill / status** — inbound pharmacy updates - **Prior authorization** — initiate and track ePA where the pharmacy and plan support it Pharmacy search displays those capabilities **per pharmacy**. A pharmacy that cannot accept EPCS or cancel, for example, is visible before you send. ### Reconciliation When a pharmacy sends a refill or change, Avara **matches it to the original prescription**. That inbound traffic does not vanish into a vendor portal. If a request cannot be matched automatically, it appears on **Rx Overview** as an **unmapped event**. Your team can **map it to a prescription** or **dismiss** it. That inbox — plus matching refill and RxChange queues in the chart — is the reconciliation layer most EHRs do not give you. **Rx Overview** is also the clinic-wide view of prescriptions, filters, and outstanding pharmacy requests. ## Compliance Avara eRx is **certified by Surescripts** for network prescribing and by **Drummond Group** for **electronic prescribing of controlled substances**. EPCS in Avara uses identity proofing, a PIN, and Duo two-factor approval as described in [Controlled Substances and EPCS](#controlled-substances-and-epcs). DEA registrations are stored **per organization**. The platform flags licenses that are nearing expiration. For permission design, see [Inviting Users — Can Prescribe](/clinical-platform/inviting-users/#can-prescribe/index.md) and [Can EPCS](/clinical-platform/inviting-users/#can-epcs/index.md).