Caitlin Graham VP General Manager CoverMyMeds PA process Prior Authorization
Caitlin Graham

According to CoverMyMeds Analytics, approximately 10% of prescription claims are rejected at the pharmacy. On average, 66% of those prescriptions require prior authorization (PA), and 36% of those prescriptions will be abandoned due to the complex paper- and phone-based process.

This pattern of abandonment increases the risk of future health problems or hospitalization for the patient. The utilization of an electronic solution can increase patient medication adherence by helping to ensure the patient leaves the pharmacy with a prescription in hand.

Learn more by visiting go.covermymeds.com/integrate

CoverMyMeds has made it its mission to get these patients the medication they need to live healthy lives by streamlining the PA process for pharmacists, providers, and health plans to improve time to therapy and decrease prescription abandonment.

To help accomplish this, CoverMyMeds offers a cost-free integrated electronic prior authorization (ePA) solution for pharmacies called IntelligentPA.

When a PA-related claim is rejected, the pharmacist follows the normal process to resolve the claim outside of the PA process. After 10 minutes, if the claim is not resolved, IntelligentPA analyzes historical data and auto-starts a PA if one is most likely to be required. The prescriber is then automatically notified of resolution options, also available at no cost, to fill the patient’s prescription.

The result is a consistent, streamlined workflow for all pharmacists and techs within their existing pharmacy software that boosts efficiency and increases the likelihood that a patient will receive the originally prescribed therapy in a timely manner.

Read The January/February 2019 Cover Story For More On Reducing Claims Rejects ⇒

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