Prescribers Manual

This is the operational and clinical playbook for every provider on PrescriberNow. It explains how the platform works, how to run a telehealth session, how to use the redesigned prescription panel, and the legal and compliance guardrails you operate inside of. Read it once end-to-end; come back to the formulary section any time.

Version 3.0 — Summer 2026. Biggest provider release yet. Diagnoses now save to the chart and auto-send a personalized education packet to the patient. The queue splits into Available and Mine tabs with pagination. The availability tab is per-day. The intake adapts to the patient's program (eye-care vs. weight management vs. mental health, etc.) so you only see questions that matter. See What's new for the full changelog or click Take the guided tour for a 90-second walkthrough.

New here? Take the guided tour. Click ? Take tour in the bottom-right corner of your provider dashboard (or append ?tour=1 to the URL) for an 8-step walkthrough of the queue, chart, Rx panel, profile, and calendar. It only takes about a minute.

What's new in v3.0

ICD-10 codes save to the chart permanently — pick from 200+ codes in the chart-codes panel. Each diagnosis is timestamped and attributed to you. Re-opening the chart shows the saved chips pre-checked.
Send patient packets in one click — after saving the diagnosis, click Send packet. The patient receives a multi-diagnosis education summary by email (powered by our 142-condition patient-education library).
Available / Mine queue split — the queue is now two tabs: Available (live pool you can claim) and Mine (everything assigned to you). Both paginate 25 per page so you're never scrolling 1000-row lists.
Per-day availability schedule — Profile > Availability now has a grid for Mon-Sun with on/off toggle plus start/end time per day. Patients book against this when they schedule a visit.
Adaptive intake by program — patients see only the questions that matter for their condition. Weight Management patients don't get a urgent-care intake. Mental health, GI, derm, hair-loss all have their own deduped question sets that don't repeat the general intake.
Patient notifications fire automatically — Rx signed, Rx sent to pharmacy, Rx filled, visit booked, visit-tomorrow reminder, visit-in-an-hour reminder, refill due, message received. 9 templates, all routed through [email protected].
Fixed KPI counters — "Reviewed today", "This week", and "Awaiting review" now compute correctly from the local records cache. Removed the Estimated $ tile (we don't bill insurance, so it was meaningless).
Licensed states + Availability persist (final fix) — the bug where the 50-state grid "went away" after save is fixed for real this time. Object.assign was clobbering local state with empty strings from the backend; the merge now skips empties.
Wider formulary (914 lines) — added 30 drugs: SSRIs, bupropion, buspirone, propranolol, trazodone, ramelteon, doxepin, topiramate, amitriptyline, lisinopril, amlodipine, losartan, HCTZ, atorvastatin, rosuvastatin, MetroGel-Vag, Cleocin-Vag, adapalene, benzoyl peroxide, ketotifen, penciclovir, PEG 3350, fosfomycin, Advair, Flovent. Plus 30 matching quick-templates.
Conditions catalog & site — 121 condition landing pages live at /conditions/<slug>.html. Each one rendered with SEO + schema.org. The catalog at /conditions/conditions.html shows telehealth-fit chips (Rx available / Conservative + Rx) so patients know what to expect.
PDF preview taller — the in-app Rx preview pop-out is now min(1080px, 94vh) tall — no more squashed iframe.

Previously, in v2.1

Preview before you send — clicking Sign & queue fax now opens the rendered Rx PDF in-app first. You confirm, THEN it transmits. No more accidentally faxing typos.
Provider note on the Rx — a textarea inside the sign modal saves to the chart AND prints as an amber block on the prescription. Use it for the clinical rationale the pharmacy needs.
Branded Rx PDF — replaced the plain doc with a one-page clinical template (PrescriberNow letterhead, ℞ sigla, signature block, attestation).
New patient queue — dense EMR-style rows with status pills (LIVE MINE CLAIMED OUT-OF-STATE), wait timers that turn amber after 30 min, and a one-click claim button. See §11 Working the queue.
Real calendar tab — the Calendar tab is now an actual month-grid with your video visits plotted on each day. Click a day to see that day's visits with one-click Join lobby links.
Clinical intake card — each chart now has an amber "Clinical intake details" panel at the top, showing patient-collected answers for the condition (UTI dysuria/blood, eye discharge/vision, weight history, etc.) with red-flag values bolded in red.
Notifications you control — you'll get an email and desktop ping for each new patient in your licensed states. Toggle off either channel, or set quiet hours, in §12 Notifications & profile.
Licensed states actually save — the bug where checking states didn't persist is fixed. Update yours in Profile > Licensed states.
Custom signature credentials — the suffix on your e-signature ("MD", "DO, FAAFP", etc.) is editable in Profile. Live preview shows what the pharmacy will see.

1 · Scope of practice

You are an independent contractor providing telehealth services through PrescriberNow. Every prescription you write is your own clinical decision; PrescriberNow does not direct your medical judgment.

What you can prescribe

The platform is built for the kind of care a competent primary care or urgent care provider can deliver asynchronously or by short video visit. The formulary skews toward:

Common bacterial, viral, and fungal infections (urinary, respiratory, skin and soft tissue, ophthalmic, dental, vaginitis)
Acute symptomatic care (asthma exacerbation, allergic rhinitis, dermatitis, musculoskeletal pain, nausea)
Maintenance therapy in stable, ambulatory adults (TRT, HRT, thyroid, weight management, hair and skin)
Sexual health (PDE5 inhibitors, PT-141, compounded options)

What you should not prescribe through this platform

Schedule II controlled substances (opioids, stimulants, certain benzodiazepines) — these require an in-person evaluation under most state and federal rules
Anything outside your training, comfort, or state license
Anything for a patient whose identity or clinical history you cannot verify
High-risk medications without baseline labs or imaging when the standard of care requires them (e.g. methotrexate, isotretinoin, oral antifungals without LFTs)

State licensure

You may only prescribe to patients in states where you hold an active, unrestricted license. PrescriberNow's intake routing checks the patient's state against your license list before a chart reaches your queue, but the final responsibility is yours. If a chart appears in your queue for a state you do not cover, decline it and message support immediately.

DEA registration. If you are prescribing a controlled substance, you must be DEA-registered in the state where the patient receives the prescription. Telehealth flexibilities introduced during the public health emergency have been progressively tightened. When in doubt, decline and refer to in-person care.

2 · Taking a telehealth session

Every patient interaction follows the same shape, whether it is an asynchronous chart review or a live video visit.

1Open the chart

From your provider dashboard, claim an intake. The chart shows the patient's responses to the intake questionnaire, ID upload, prior medications, allergies, and any messages from prior visits. Read it end-to-end before forming a clinical decision.

2Verify identity

Every intake includes a government ID upload. Confirm the name, date of birth, and photo match the patient's stated identity. If anything is inconsistent, send a "needs more info" message before prescribing.

3Make your clinical decision

Decide one of three things: (a) prescribe, (b) decline with a brief explanation to the patient, or (c) request more information / schedule a video visit. Document your reasoning in the provider-notes field — this is what protects you if anyone ever audits the encounter.

4Schedule a video visit if you need one

Use the in-dashboard Google Meet scheduler. The link is emailed to the patient automatically. After the visit, document what you discussed in chart notes before signing any Rx.

5Sign and route

If you decide to prescribe, open the Rx panel (see next section). Clicking Sign & queue fax opens an in-app PDF preview of the actual prescription that will go out — nothing transmits until you click "Confirm & send to pharmacy" on the preview. The Provider Note you write in the sign modal both saves to the chart and prints on the Rx as an amber block. Once you confirm, the PDF is generated, the fax is queued, and the encounter is locked. You can still message the patient afterward.

3 · Writing a script (new flow)

The prescription panel was redesigned to make most scripts a one- or two-click action. It works like this:

1Quick templates

The top of the panel shows a row of one-click templates for the medications most providers reach for: Amoxicillin URI, Augmentin sinusitis, Azithromycin Z-Pak, Cephalexin cellulitis, Macrobid UTI, Medrol dose pack, Tamiflu, Moxifloxacin eye drops, Doxycycline acne, Prednisone burst, Zofran nausea, Albuterol rescue. Click one and the entire panel pre-fills.

2Or browse the formulary

Below the templates is a category picker (Urgent care, Anti-infectives, Respiratory, Eyes, GI / nausea, Acute care, TRT/HRT, Sexual health, Hair/skin, Weight loss, Peptides) plus a search box. Click a category or type to filter the 90+ drug catalog. Click a drug to select it.

3Confirm strength, form, quantity, refills

When you pick a drug, the strength dropdown auto-populates with the available strengths for that drug, and the form (tablet, capsule, drops, etc.) auto-fills. Default quantity and refills are set to a reasonable starting point — adjust if needed.

4Use the smart sig builder

The smart sig builder has three dropdowns (dose, route, frequency) and a row of toggle buttons for common add-ons ("with food", "for 10 days", "finish entire course", "avoid alcohol", etc.). As you change anything, the patient-facing directions sentence rebuilds live in the blue box at the bottom. You can also edit the dose field freely if you need something the dropdown does not cover.

5Route to a pharmacy

By default the Rx goes to the network pharmacy assigned by the patient's refCode (this is how compounded programs route to their partner pharmacy). For non-network meds, switch to "Patient's pharmacy" and enter the pharmacy name and fax. The patient's preferred pharmacy will pre-fill if they entered one on the intake.

6Add a provider note (optional)

Above the attestation is a Provider note textarea. Use it for the clinical reasoning behind this Rx — exam findings, why you're choosing this drug vs another, return precautions, anything the pharmacy or a future auditor needs to see. The note saves to the patient chart AND prints on the Rx PDF in an amber box right above your signature. Skip if there's nothing extra to say.

7Attest, preview, confirm

Check the attestation box and click Sign & queue fax. This opens a full-screen preview of the actual signed Rx PDF — the same bytes the pharmacy will receive. Review:

Drug name, strength, sig, quantity, refills
Patient name + state
Pharmacy fax destination
Your provider note (if you added one)
Signature block with your credentials

If anything is wrong, click Back to edit — nothing has transmitted yet. If it looks right, click the green Confirm & send to pharmacy button. Only THEN does the fax queue and the chart status flip to "Ready to Fax".

What the patient and pharmacy see. The PDF that goes out is a single-page, brand-letterhead document with: patient block, dispensing pharmacy block, the medication and sig in a blue Rx panel, your amber Provider Note (if set), a prescriber attestation, your e-signature with credentials, and an electronic-issuance footer. The Rx is also stored under the patient's folder, accessible via the in-app viewer (no Drive auth needed).

4 · Formulary reference

This list is pulled live from the same catalog the Rx panel uses, so when a medication is added or a default changes, the manual stays in sync automatically. Use the filters to focus on a category, or search by drug or brand.

5 · Controlled substances

PrescriberNow makes it possible to write controlled prescriptions through the platform, but it does not relax any legal or regulatory requirement.

What you must verify before writing a controlled Rx

You hold an active DEA registration in the state where the patient resides
The patient's identity has been verified by photo ID
You have completed the in-person or telehealth evaluation that current federal and state law requires for that schedule
You have checked the state PDMP (prescription drug monitoring program) within the last 7 days
Your encounter documentation justifies the prescription, the dose, the quantity, and the refill count

Schedule II. Schedule II prescriptions (oxycodone, hydrocodone, Adderall, etc.) are not appropriate for this platform unless you have an established in-person relationship with the patient that satisfies federal rules. When in doubt, decline and refer.

Scheduled drugs in the current formulary

Most of the catalog is non-controlled. Items that carry a schedule are flagged in the Rx panel's "DEA schedule" field when selected.

CIII — testosterone cypionate, testosterone enanthate, testosterone cream/gel, AndroGel
CIV — phentermine, tramadol (when added)

6 · Refills and early fills

Refills are part of the original prescription. If a patient asks for a refill, message you, or submit a refill intake, your job is to decide whether continuation is still clinically appropriate — not just to rubber-stamp the prior decision.

Standard rules

Chronic, stable medications (HRT, thyroid, finasteride, statins-when-added) can be refilled with up to 11 refills if appropriate; expect a re-evaluation visit at least annually
Acute antibiotics, antivirals, and steroid bursts get zero refills
PRN meds for sexual health (sildenafil, tadalafil) get 3-5 refills; consider re-evaluation if usage outpaces the prescribed quantity
Weight-loss GLP-1s should be refilled in 4-week supplies during titration, then larger supplies once stable

Early fills

If a patient requests a refill earlier than the supply justifies, treat it as a red flag. Document the request and your reasoning before approving or declining. Repeated early-fill requests on controlled substances should trigger a chart review.

7 · Red flags & contraindications

The intake is designed to surface obvious risks, but you are the final filter. Common things to look for:

Always check

Allergies — especially PCN, sulfa, NSAID, fluoroquinolone
Pregnancy or breastfeeding (and intent)
Current medications — interaction risk
Renal and hepatic disease
Cardiac history if PDE5 / TRT / decongestant

Decline or escalate

Severe symptoms suggestive of emergency (chest pain, focal neuro deficit, severe abdominal pain, sepsis criteria)
Patient under 18 unless platform supports it
Suicidality, psychosis, severe mental health crisis
Identity verification failure
Patient appears to be doctor-shopping or seeking a specific controlled substance

8 · Working the patient queue

The patient queue is your shift. It works like a clinical dispatch board: charts come in, you go on-duty, you claim what you can take, you sign and move on.

On-duty toggle

At the top of the Patient queue page is the duty toggle. When the pill is green you're online — you'll appear in the on-duty pool, get desktop and email pings for new patients in your licensed states, and the Live pool will populate with charts you can claim. When it's gray you're offline — no pings, no incoming charts. Toggle off at the end of your shift.

Row status at a glance

Every row in the queue has a colored left stripe and a status pill so you can scan the list without thinking:

LIVE — Unclaimed, pending, in your licensed states. The green pulsing dot is your signal: click Claim to lock it to you.
MINE — Already claimed by you. The primary action is Sign Rx. Click anywhere on the row to expand the full chart preview.
CLAIMED — Another on-duty provider has it. Greyed out; you can see it but cannot act.
OUT OF STATE — Visible but not claimable. The patient is in a state you don't hold a license in. Update Profile > Licensed states if you want these in your reach.
APPROVED / DENIED — Finalized charts. Read-only — click Chart for the full record.

Wait timer

Each row shows how long the patient has been waiting (12m or 2h 14m). The timer turns amber and bold past 30 minutes so you can spot patients who've been sitting too long. The queue sorts your claims first, then live patients oldest-first — the longest waiter is always at the top of the actionable pile.

Filter tabs

Above the rows are filter tabs with live counts: Live pool · Mine · Out of state · Approved · All. The default view shows your claims + the live pool — what you can actually work on right now.

The Clinical Intake card

When you open or claim a chart, the very first thing in the Overview is an amber Clinical intake details card. It has two sections:

Today's visit — generic Qs everyone fills (onset, severity 0-10, what helps/worsens, what's been tried, goal).
[Condition]-specific — tailored Qs for the program. UTI shows dysuria/frequency/blood/flank/fever; eye care shows side/discharge color/vision change/pain; weight management shows BMI numbers + GLP-1 history + contraindications; ED shows duration/severity/cardiac/nitrates; etc.

Red-flag values are bolded red with a warning icon. Flank pain, fever, blood in urine, vision loss, eye trauma, cardiac history with PDE-5s, nitrates with PDE-5s, MTC/MEN-2 with GLP-1s, severe pain 7+, etc. If you see red in that card, slow down and think about whether this is the right setting for the patient.

If you can't take the patient

You have three escape hatches on a claimed chart:

Ask patient — sends them a templated "I need more info" message and reopens the intake in their dashboard.
Video visit — schedule a Google Meet, the link is emailed to them.
⟵ Release back to pool — drops your claim. The chart returns to LIVE for another provider. Use this if you realize you can't safely prescribe (out of comfort zone, suspicious history, off-platform meds needed, etc.).

9 · Notifications & profile settings

Your Profile page has six sections. The top two (Account, Licensed states, Availability) you'll set during onboarding. The bottom four are the ones you'll touch as you go.

Notifications

By default you'll get both an email and a desktop browser notification every time a patient submits an intake in one of your licensed states while you're on-duty. Three toggles control this:

Email me about new patients — turn off entirely if email is too noisy. The desktop notification stays.
Desktop notifications — the browser pop-up + ping when this dashboard tab is open. You need to grant the permission once (a banner appears bottom-right; click Allow).
Quiet hours — set a 24-hour time range during which neither email nor desktop pings will fire. Crosses midnight (22:00 to 07:00 = no pings overnight). Leave blank for none.

Click Save notification preferences after changes. Toggles take effect immediately — no logout required.

Contact info

Your phone number (used for urgent admin alerts and, in a future release, SMS provider pings if you opt in). Your bio is a short one-or-two-sentence blurb patients see on the visit-confirmation page. Optional but encouraging.

My signature on the Rx

The credentials shown after your name on the prescription PDF and fax. Type "MD" or "DO, FAAFP" or whatever you want stamped. The card shows a live preview of /s/ Your Name, Credentials as you type. Pharmacies see this; it's worth getting right.

Security

Change your password. Three fields: current, new, confirm. Minimum 8 characters. Use a password manager.

My performance

Four counters drawn from the live queue: In progress (charts you've claimed but not signed), Approved (all-time), Approved (30d), Denied. Refreshes every dashboard poll. Read-only.

Licensed states (already on the Profile)

The grid of 51 checkboxes is how the system knows where you can prescribe. Check every state where you hold an active, unrestricted license. Changes save when you click "Save licensed states" — until you do, your queue won't see patients from newly-checked states. The dashboard's queue and the email/desktop notifications all filter on this list.

Availability (already on the Profile)

Working-hour bookends (so patients can't book video visits outside them), the on-duty toggle (same one in the queue), and a vacation-mode toggle that hides you from the on-duty pool entirely until a specified end date. Use vacation mode for multi-day breaks so you don't get pinged.

10 · HIPAA basics for providers

You handle protected health information (PHI) every time you open a chart. The short rules:

Do not screenshot, copy, or forward chart information outside the platform
Do not log in to PrescriberNow on a shared or public computer
Do not discuss specific patients on social media or in unencrypted email — even with names redacted
If you suspect a breach (lost laptop, suspicious login, an email sent to the wrong patient), notify [email protected] immediately. We have a 60-day breach-notification clock under HIPAA
The platform maintains a 6-year audit log of every chart access, message, and prescription you sign, per HIPAA §164.316(b)(2)(i)

11 · Documentation expectations

Every encounter should be documentable to a peer reviewer in under a minute. The platform captures most of this automatically, but the provider-notes field is where your clinical reasoning lives.

Good notes

One sentence on the chief complaint and relevant history
One sentence on your assessment (what you think is going on)
One sentence on the plan (what you are prescribing, why, follow-up)
If you declined: why

Things to avoid

Leaving the notes field blank
"Per protocol" with no clinical rationale
Pasting the intake answers back into the notes

12 · Escalation contacts

Clinical questions / unusual chart

Medical Director, via [email protected] with subject "Clinical question".

Technical / platform bug

[email protected], subject "Tech".

Suspected HIPAA breach

Immediate: [email protected], subject "URGENT — possible breach". Include date, time, and what happened. Do not include any PHI in the email body.

Patient threatening self-harm

If imminent, direct the patient to 988 (Suicide & Crisis Lifeline) or 911. Document the conversation and notify the medical director.

13 · FAQs

Can I write off-formulary medications?

Yes. The formulary is the catalog of one-click presets; you are not limited to it. Pick the closest entry, then edit the medication description, strength, qty, and sig manually before signing. If you find yourself writing the same off-formulary drug repeatedly, let us know — we will add it.

How do refunds and pharmacy issues get handled?

Patients message support directly. You do not need to coordinate pharmacy refunds; just be available to message back if the patient needs clarification on the Rx or a re-fax to a different pharmacy.

What if the fax fails?

The fax queue is monitored. If a fax to a network pharmacy fails repeatedly, support will contact you and the pharmacy. For patient pharmacies, you may need to re-confirm the fax number with the patient.

Can I write for someone in a state I am not licensed in?

No. The intake routing should prevent this, but if a chart slips through for an out-of-state patient, decline it and notify support.

Where do I update my preferences and protocols?

Profile > Provider preferences. This is where you set your default templates, your favorite categories, and any clinical protocols you want surfaced on intake.