A clinician finishes an online visit, approves a prescription, and clicks send. A few seconds later, the order shows up in a pharmacy's system, ready to fill. If you're asking what Surescripts is, it's the network that usually carries the prescription across that gap. Most patients never hear its name, and many telehealth founders only meet it when a vendor asks whether their prescribers are "enabled on Surescripts."
Surescripts is a health information network that connects the software prescribers use with pharmacies, pharmacy benefit managers, and health plans. It carries electronic prescriptions and related data, such as medication history, prescription benefit details, and prior authorization requests, using shared industry standards.
For a telehealth business, the practical question is how your prescribers reach that network, not whether to join it. In most cases, they connect through certified EMR and e-prescribing software rather than through a contract you sign yourself. This guide explains what the network does, how a prescription moves through it, and what to check before you choose a platform. If e-prescribing itself is new to you, our explainer on how e-prescribing works covers the basics first.
What Surescripts Does
Surescripts calls itself a health intelligence network. In March 2026, it reported 30.5 billion transactions across its network in 2025, up 12.3% from the year before, and 2.32 million connected healthcare professionals and provider organizations. Those transactions fall into a few groups that matter to anyone running prescriptions online.
Electronic Prescriptions
The core job is moving prescriptions from prescriber software to pharmacy software. That includes new prescriptions and the messages around them: renewal requests from the pharmacy, change requests, and cancellations. Without the network, each e-prescribing system would need its own connection to every pharmacy system in the country.
Medication History
Prescribers can request a patient's recent fill history, which helps them spot duplicate therapy or a missed interaction. In telehealth, where the clinician has never met the patient in person, that history fills a gap the intake form can't.
Real-Time Prescription Benefit
Before sending a prescription, a prescriber can check what the patient will likely pay under their benefit and whether a covered alternative exists. Surescripts reported that 973,463 prescribers used this service in 2025. Our RTPB explainer explains where it fits and what CMS now requires.
Electronic Prior Authorization
When a medication needs approval from the patient's plan, the request and response can travel electronically instead of by fax and phone. Surescripts reports that for some medications, approvals now come back in seconds.
Where Surescripts Came From
The network began as two rivals. SureScripts was formed in 2001 by the National Association of Chain Drug Stores and the National Community Pharmacists Association, which represent pharmacies. RxHub was set up the same year by three pharmacy benefit managers: CVS Caremark, Express Scripts, and Medco. In 2008, the two agreed to merge, which put the pharmacy side and the benefit side of prescribing on one network. That history explains why the network reaches both retail pharmacies and the plans that pay for medications.
How a Prescription Moves Through the Network
Here is the path a typical e-prescription takes, from the visit to the pharmacy counter.
- The prescriber writes the order inside e-prescribing software, usually part of an EMR.
- The software formats it as a standard message. U.S. e-prescribing uses the NCPDP SCRIPT standard, so every system on the network reads the same fields the same way.
- The network routes the message to the pharmacy the patient chose, along with any checks the software ran before sending, such as benefit or medication history lookups.
- The pharmacy system receives it, and the pharmacist reviews and fills the prescription.
- Messages flow back when needed: a renewal request, a change request, or a note that the prescription can't be filled as written.
The standard itself is changing. Under CMS e-prescribing requirements, Medicare Part D e-prescribing currently uses NCPDP SCRIPT version 2017071, and version 2023011 takes over beginning January 1, 2028. If you're comparing platforms, ask how and when each vendor plans to move to the new version.
What a Telehealth Business Needs to Connect
Founders often assume they need their own agreement with Surescripts. Usually they don't. The connection runs through software, and the work falls into three areas.
Certified E-Prescribing Software
Surescripts certifies the software that connects to its network, not each business that uses it. If your platform's e-prescribing module is already certified, your prescribers send through that connection. If you build your own prescribing software, certification becomes your project, with the testing and timeline that come with it.
A Surescripts Provider Identifier for Each Prescriber
Every prescriber who sends e-prescriptions needs a Surescripts Provider Identifier (SPI), which the software vendor requests during enrollment. The time this takes varies by vendor. One EHR vendor's help center, for example, quotes 1 to 3 business days. A prescriber who already receives electronic renewals through another system at the same location may need a change-of-vendor step, which takes longer. Plan for this before launch, not during it, because a clinician without an SPI can't send electronic prescriptions.
If your clinicians come from a shared provider network, ask who handles their enrollment. On a platform with an integrated network, the platform usually manages it. If you bring your own clinicians, someone has to enroll each one, and launch waits until that's done.
Separate Rules for Controlled Substances
Controlled substances follow DEA rules on top of everything above. According to the DEA's EPCS guidance, an approved third party must audit or certify the prescribing application, prescribers must have their identity verified before they receive credentials, and every controlled-substance prescription must be signed with two-factor authentication. A platform can be on the Surescripts network and still not support controlled substances, so ask directly. Our guide to EPCS for telehealth businesses covers the requirements in more detail.
Questions to Ask a Platform About Surescripts
Before you sign, these answers tell you how much of the prescribing setup you'll own.
- Is your e-prescribing module certified on the Surescripts network?
- Who enrolls our prescribers and requests their SPIs, and how long does it usually take?
- Do you support controlled substances, and how do you handle identity proofing and two-factor signing?
- Which transactions are available beyond new prescriptions: medication history, benefit checks, prior authorization?
- How do renewal and change requests from the pharmacy reach our clinicians?
- What happens after the prescription is sent, and how does it connect to pharmacy fulfillment?
How Bask Handles Surescripts
Bask is certified with Surescripts, so brands on the platform send prescriptions through Bask's connection and don't need their own certification. Prescribers complete Bask's own onboarding, which for prescribers includes a background check, as described in Bask's setup guide.
Prescribing sits inside the same system as the rest of the patient journey. Intake, the clinical visit, the prescription, and the order to the pharmacy stay connected, and every plan includes integrated doctor networks, so a new brand doesn't have to recruit and enroll clinicians before it can start. If the next step after prescribing concerns you, our article on what happens after the prescription is written follows the process from approval to the patient's door.
The network handles the hand-off between prescriber and pharmacy. What a brand still has to get right is everything around it: the clinical protocol, who prescribes, which products need controlled-substance rules, and how the patient is kept informed after the prescription is sent.
FAQs
Is Surescripts an EHR?
No. Surescripts is the network that connects systems. Prescribers work in an EHR or e-prescribing application, and that software sends prescriptions and requests over the Surescripts network to pharmacies and benefit managers.
Do telehealth brands need their own Surescripts certification?
Usually not. Certification applies to the software that connects to the network. A brand using a platform with certified e-prescribing sends prescriptions through the platform's connection. Brands that build their own prescribing software are the exception.
What is a Surescripts Provider Identifier (SPI)?
An SPI is the identifier Surescripts assigns to a prescriber so their software can send electronic prescriptions. The e-prescribing vendor requests it during enrollment.
Who created Surescripts?
Surescripts came from the 2008 merger of two networks founded in 2001: SureScripts, created by the National Association of Chain Drug Stores and the National Community Pharmacists Association, and RxHub, created by the pharmacy benefit managers CVS Caremark, Express Scripts and Medco.
Can controlled substances be prescribed through Surescripts?
Controlled-substance prescriptions can be sent electronically when the prescribing software and the prescriber meet DEA's EPCS requirements, including an audited or certified application, identity proofing, and two-factor authentication. Not every platform supports them, so confirm before you plan a program that needs them.
References
- BioSpace. (2026). Surescripts annual impact report shows collaboration, innovation gains in interoperability, prior authorization automation and medication access in 2025. https://www.biospace.com/press-releases/surescripts-annual-impact-report-shows-collaboration-innovation-gains-in-interoperability-prior-authorization-automation-and-medication-access-in-2025
- Drug Topics. (2008). SureScripts and RxHub agree to merger to boost e-prescribing. https://www.drugtopics.com/view/surescripts-and-rxhub-agree-merger-boost-e-prescribing
- Centers for Medicare & Medicaid Services. (n.d.). E-prescribing standards and requirements. https://www.cms.gov/Medicare/E-Health/Eprescribing/Adopted-Standard-and-Transactions
- Canvas Medical. (n.d.). ePrescribing (eRx) enrollment. https://help.canvasmedical.com/articles/6085016786-eprescribing-erx-enrollment
- Drug Enforcement Administration, Diversion Control Division. (n.d.). Electronic prescriptions for controlled substances (EPCS) Q&A. https://deadiversion.usdoj.gov/faq/epcs-faq.html
