Solutions

Prior authorization

Automating the process providers and pharmacists use to submit prior authorization requests to help patients start their prescribed therapy faster.

Two care team members at their office workstation collaborating to submit prior authorization requests.

The challenge

Manual prior authorization processes between providers, payers and pharmacies can create significant delays and frustration for all parties involved. Providers may switch therapies to avoid the time-consuming prior authorization process, while pharmacists often need to contact providers for additional information. Patients often experience delays and may abandon treatment plans due to these inefficiencies.

Electronic prior authorization benefits

Behind the full power of a connected network, CoverMyMeds' electronic prior authorization solutions can break down barriers through direct payer connections and in-workflow support for providers and pharmacies. This can help minimize therapy switching or medication abandonment for a smoother patient experience.

  • Seamless pharmacy integrations

    Pharmacists can seamlessly initiate a prior auth request at the point of claim rejection with direct system integrations, helping reduce back-and-forth phone calls with providers.

  • Direct payer and provider connections

    CoverMyMeds' electronic payer connections enable fast transmission of prior auth information between payers and providers.

  • Enhanced brand support

    Enable enhanced, brand-specific prior auth support for providers, including appeals, to help patients stay on their originally prescribed therapy.

  • Simplified provider workflow

    Providers and their staff have a simple way to initiate or complete a pharmacy-initiated prior auth request in-workflow to help patients start their prescribed therapy.

  • Faster time to therapy

    Electronic prior auth submission enables faster time to therapy compared to phone and fax methods. Additionally, patients can pick up their therapy up to two days faster on average when notified of an approved prior auth outcome.[0]HubExpress Program data, May 2023

Solution impact

CoverMyMeds is making a measurable impact with our prior authorization solutions

DISCOVER OUR IMPACT

Join CoverMyMeds’
ever-growing network.

  • 950,000+ providers, with 350+ EHRs integrated
  • 50,000+ pharmacies, inclusive of top 10 chains
  • 650+ brands across 95% of therapeutic areas Connect with our team to see how CoverMyMeds can help deliver comprehensive solutions to improve patient access, affordability and adherence.
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