SmithRx: Partner Portal Quick Start Guide
SmithRx Partner Portal
Contents
- Accessing the Partner Portal
- Registration
- Home Page
- Reports
- Claims
- Drug Coverage
- Prior Authorization
- Connect Status
- Member Management
- Group Management
- Troubleshooting
Accessing the Partner Portal
The SmithRx Partner Portal makes accessing data, viewing reports, and member management easier for our partners.
Note: To view the information in another language, change your web browser’s language preferences or use its built-in translation tool.
Registration
Registration is not required if you already have an existing account with us.
If you do not have an existing account, please reach out to your Account Manager (AM).
For first-time users, look out for the partner portal invitation via email from hello@smithrx.com with the subject line ‘Welcome to the New SmithRx Partner Portal’ (Your invitation is valid for 7 days).
Create An Account
- In your email, you will have an invitation from SmithRx.
- If you don’t see this email, please check your spam folder.
- Your username will be your business/work email address.
- Click ‘Create password’ to create a password.
- Once you create an account with that password, moving forward, you can log in by going to partner.mysmithrx.com/login.
- Every time you log in, you will be prompted to provide a secure code that will be sent to your email.
Home Page
The home page displays dashboards, your managed group(s), and the menu can be found on the right side of the screen.
What’s on the homepage:
- Top level navigation
- Report Highlight
- Shortcuts
- Forms
SmithRx Resources
- View resources including guides, clinical information, FAQs, and overviews for you, admins, and members.
- Available Training Videos:
- Connect 360 Overview
- Connect 360 Programs (various)
- Invoice Overview
SmithRx Blogs
- These articles will be updated periodically to provide you with the most relevant news and updates.
Reports
Navigate to Reports, your gateway to self-service reporting. By default, all your groups are selected and the last year’s worth of data is summarized. You can change this with the filters at the top right. Customize your timeframe with date filters and download full or partial reports for easy sharing (e.g. quarterly business reporting).
Easily access key insights into your plan spend, rebates, Connect 360 savings, PMPM, and more.
Filters vary based on data your group(s) have available (pending on your group start date).
Overview
Top menus allow you to navigate to PMPM reports, Connect savings, pass-through rebates, and top plan pay drivers.
- You can dive deeper into each report either by clicking on the square summary or using the top navigation bar.
- You can download any of the reports by clicking on the three vertical buttons in the top right corner.
- To download your full set of reports, click “Combined Reports”.
- Click here to learn more about Quarterly Reporting >>
- You can customize the timeframe by month or quarter for all of the reports.
- Please note that Quarterly Reports will update on the 20th of the month following the complete quarter (e.g., on October 20th, you’d be able to view Q3 data). Monthly Reports will update on the 20th each month (e.g., on September 20th, you’d be able to view August data).
Per Member Per Month (PMPM)
- You can see your PMPM by month over time gross vs net, connect savings impact, member and claim count over that time period, and divided out by component.
- For any specific section of the PMPM report, you can set an alert to notify you based on given parameters - if a number drops below a certain threshold for example.
SmithRx Connect
Connect savings shows the realized savings by quarter, total ROI, and the top drugs by total connect savings broken down by connect program. Top groups by savings are also displayed for the given groups selected and time period.
Connect Programs are now consolidated into ‘Program Categories’:
- Access Plus Programs include Access Plus + Med-Pharm Access Plus.
- Access Programs include Access Traditional + Access Specialty + Access Specialty - Limited Distribution Drugs.
- Autoimmune Programs include Humira and Stelara Biosimilars.
- Third Party Sourced Programs.
- Diabetes Programs include Low-Cost Insulin + Diabetes Non-Insulin.
- Partner Pharmacy Programs include Cost Plus Drugs + Multiple Sclerosis.
- Weight Management.
Pass-Through Rebates
Shows total issued rebates and projected rebates. Payments are issued quarterly 7 months following the end of the claim quarter (e.g., Q4 2024 rebates will be issued on 07/31/25).
Top Plan Pay Drivers
- Top Therapy Areas by Plan Pay (by total billed plan and claim count).
- Top 20 Drugs by Plan Pay: Identify root causes of your prescription spend and pinpoint where to take action.
Custom Insights: How We Classify Drug Spend
| Category | Definition |
|---|---|
| High Impact Cost Drivers (High Cost + High Volume) | What it means: Triggered when a drug’s average cost exceeds SmithRx Book of Business (BoB) average for Top 20 drugs and its utilization exceeds your group’s volume thresholds. Typical examples: High-utilization weight-loss medications (like Wegovy or Zepbound) or heavily utilized brand-name diabetic therapies. |
| High Cost & Low Frequency Drivers (High Cost + Low Volume) | What it means: Triggered when a drug’s volume is below average, but its cost-per-claim is significantly higher than the BoB average. This flags low-frequency, high-cost medications where fewer members are driving an entire category of spend. Typical examples: High-cost specialty medications. |
| Volume Driver (Low Cost + High Volume) | What it means: Triggered when a drug’s cost-per-claim is relatively low, but its overall claim share is above average—or it is prescribed to more than 1% of your total covered population. Typical examples: High-frequency, generic maintenance medications (such as blood pressure or cholesterol-lowering drugs). |
| Adherence Driver (High Frequency + Moderate Cost) | What it means: Triggered when a drug's overall volume and unit cost are moderate, but the members taking it are refilling it more frequently than average. This helps spot long-term, highly consistent chronic utilization patterns. Typical examples: Multi-month maintenance therapies or medications requiring strict, continuous adherence. |
| Baseline Outlier (The Fallback Category) | If a drug in your Top 10 list does not trigger any of the specialized categories above, it falls into this baseline category. |
Top Connect Cases
- Shows the transitioned Connect cases by realized savings.
- Shows in-progress Connect cases by annualized savings, which is a projection of potential savings a member will have if they continue to fill under connect for a 12 month period.
Claims
Investigate inquiries with our Claims Lookup tool. Here, you can search, view, and download claim details as needed.
- To begin your search, enter a member name in the search bar.
- To narrow your search further, click on the icon on the right side of the search bar to open a module where you can add more filters.
- You can also apply a status filter if you wish to only see claims with a specific status – e.g. Paid, Rejected, or Reversed. Otherwise, this will only display paid claims by default.
- A date filter is available at the top right of the page where you can specify a date range for your search.
- The Claims details includes:
- Claims info: member pay amount, plan pay amount, drug name, date processed.
- Member information: personal information, member ID, member relationship.
- If the claim is rejected, you will instead find the rejection code and reason.
- Hover over the top right corner of the data table and click the three-dot menu to download your data.
Drug Coverage
Lookup the coverage of a specific drug based on Group and Plan.
Group & Plan Selection
- Start by entering/selecting a group.
- The Plans for a particular group will populate after a group has been selected.
Drug Coverage Search
- Search for a particular drug and filter by pharmacy type and/or quantity.
Details Panel
- All information about the drug expanded upon in detail section.
- Coverage section
- Coverage: If the drug is covered under the plan.
- Copay: Member responsibility. This is not unique to a particular member but general for the drug and plan.
- Cost section
- Tier: What tier of coverage the drug falls under on the plan.
- Payment Type.
- Copay/Coinsurance: A member will either be responsible for a flat fee (copay) or a percentage of the cost (coinsurance).
- Amount section
- Days Supply.
- Quantity Limit.
Search by drug name
- Filter by Member, Group, Status, time, or Reference number.
- Sort by date.
Prior Authorization Status
Look up the status of a Prior Authorization case and its history.
Search by drug name, member name or ID, or reference number using the dropdown menu.
- Filter by Member, Group, Status, time, or Reference number.
- Sort by date.
Note - If a member is not registered for the SmithRx Member Portal, you will not be able to view their member notifications, such as the PA notification with the “Mimic Member” tool. Members are encouraged to create an account via https://member.mysmithrx.com/login/sign-up
Details Panel
- View case history.
- Mimic member to go directly to their profile.
| Prior Authorization (PA) Status | Definition |
|---|---|
| Canceled and Withdrawn by Requestor | The case review has been officially closed and recorded as withdrawn at the request of the initiating party. All subsequent actions related to this specific review are hereby discontinued. |
| Created | A case is created and PA review is in progress. |
| Request for Information Sent - Pending MD Response | A request for information has been sent to the provider. |
| MD Response Received - Pending Review | We are in the process of reviewing your request. It has been received, but no final decision has been made. |
| Approved | The requested drug is approved for coverage. The patient may contact the pharmacy to obtain the medication. |
| Denied | The request for this medication has been denied. This determination is based on either a lack of demonstrated medical necessity or the need for additional information before an approval decision can be made. |
| Partially Approved | Coverage for the requested drug has been partially approved. However, the approved amount is less than the amount requested. We require additional information to confirm that the requested amount is both medically necessary and safe for the member. |
| Dismissed-Drug Not Covered Under Pharmacy Benefit | The request for this drug has been closed. This is due to one of the following reasons: the drug is excluded from coverage, the member or provider is currently ineligible or inactive, or the request is for a buy and bill scenario. |
| Dismissed-Authorization On File | The request has been dismissed because the member already has an active prior authorization (PA) for this medication, and it is too early to submit a renewal. Notifications with the PA expiration date have been sent to the member and provider. |
| Dismissed | This may be because we have received a duplicate request or we reviewed the drug requested and recognized that this review is no longer needed. |
| Dismissed-Refill Too Soon | This prescription refill request is unable to be processed at this time. Our records indicate the patient recently filled this prescription, and based on the original dosing schedule, more than 25% of the medication should still remain. |
Connect Status
Here, you can search and view details and history for your Connect cases.
Connect Case Status Definitions:
- New: Case created. Case will be assigned to a patient access specialist and status will be updated appropriately.
- In progress: Case has been started. We may be trying to reach the member, or waiting for the prescription to be sent to the pharmacy.
- Auth Forms Sent: request sent to member to complete docusign for authorization to enroll into the Access Plus or Third Party Sourcing Pathways.
- Additional Info Required: request for additional documentation from the member or other party outside of the provider.
- Need Member Response: We are waiting for a specific member response. This is either the docusign authorization from the member or other requested documentation.
- Need MD Response: We are waiting on information from the provider.
- Under Review: Pertinent to the Access Plus Program. We have submitted the application for review with the manufacturer. We may reach out to the member to initiate a group call for a status update.
- Closed: This case status contains multiple categories.
Member Management
View Member details with the Member Management tool. Here, you can search, view, and mimic members.
- To begin your search, use the dropdown in the search bar to choose how you want to look up the member.
- To narrow your search further, click on the icon on the right side of the search bar to open a module where you can add more filters.
- You can also add a member using the button in the top right corner. Please note that this change may be overridden by the next eligibility file ingestion. Eligibility files must be updated to ensure a permanent change.
Member Detail View
- Deductible is included, and grayed out if the member does not have a deductible.
- Out of pocket max can be expanded to view more details.
- Claims and Eligibility History show just for that particular member or family member.
Important Links
- Find My Meds links directly to the member’s Find my meds using the mimic functionality.
- Member Formulary links to the Formulary for the member’s group and plan.
- Drug Cost and Copays links to the new Drug Cost feature, with the member’s group and plan already selected.
Group Management
View Group details with the Group Management tool. Here, you can search and view details for all your groups.
- Search for Groups.
- Sort by Status.
Group Details
- View Group details including effective and termination dates.
- View departments and plans and search by name.
Important Links
Troubleshooting
Account Locks
On the fifth invalid login attempt within five hours, your account will be locked for five hours. We recommend a password reset after the lock is lifted.
Password Reset
Please follow these steps to reset your password:
- Go to partner.mysmithrx.com/login
- Click ‘Forgot Password’ on the ‘Enter Your Password’ page.
- Please then enter your: Registered email, Date of Birth, and Member ID.
- After clicking “Reset Password”, you will receive an email with a link to reset your password.
Support
If you experience issues or have feedback to share, please email portalfeedback@smithrx.com and cc your designated Account Manager.
SmithRx is on a mission to reduce the complexity and costs of pharmacy benefits with radical transparency and cutting-edge technology.