What is considered a “billable transaction”?
Although pharmacies are not billed directly by Surescripts, your pharmacy will likely pay a set cost per transaction to your technology vendor for each prescription renewal request you send or new prescription you receive over the Surescripts network. The exact amount of this transaction fee is determined by your software vendor.
On the refills side, a billable transaction consists of when the pharmacy initiates a prescription renewal request to the prescriber (regardless of whether or not the prescriber responds to your request). Refills attached to a new or renewed prescription do not incur a transaction fee. If a prescriber denies a renewal request and sends the exact same prescription electronically as a new transaction, this could indicate a need for training at the practice. We encourage you to report these types of issues directly to your software vendor.

