Rx Recommendation Engine

Smarter, Faster, Evidence-Based

MyMatrixx by Evernorth offers a cutting-edge, real-time Rx recommendation engine designed to empower claims professionals with intelligent, data-driven medication guidance. Using a powerful rules engine sourced from state formularies, clinical guidelines, industry references and proprietary algorithms, the MyMatrixx Rx recommendation engine transforms complex pharmacy decisions into clear, actionable insights within our MyPassport platform.

Within an instant, our recommendation engine evaluates medication appropriateness based on injury (ICD-10), jurisdictional guidelines, and clinical best practices and delivers a clear, visual recommendation status of:

provides Information for additional context without a firm recommendation.

Each recommendation includes a detailed rationale code and explanation and highlights cost concerns, formulary status, clinical risks (e.g., opioid alerts), and availability of generics or alternatives.

With the MyMatrixx Rx Recommendation Engine you can:

• Reduce Delays: Expedite prior authorization decisions with confidence.
• Improve Outcomes: Align medication choices with clinical and regulatory best practices.
• Control Costs: Identify high-cost drugs and suggest lower-cost alternatives or generics.
• Enhance Compliance: Stay aligned with state-specific formulary rules and injury-based guidelines.
• Support Adjusters: Equip your team with a reliable, easy-to-use tool that simplifies complex pharmacy decisions.