Once upon a time, doctors prescribed arsenic and mercury; they also used fax machines

Why do so many doctors turn to 30-year old fax technology to complete a prior authorization when a member needs a prescription? Faxing is just no longer necessary with electronic prior authorization (ePA) through CoverMyMeds.

Prior authorizations (PA) are a critical part of the medicine delivery process. PAs help to manage medicines that have a significant potential for misuse, overuse or inappropriate use. Often, doctors are using fax machines to complete these important tasks.  When fax machines are used to complete a standard PA, there are increased risks:

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  • Incomplete information
  • Missing information
  • Manual data entry errors
  • Unnecessary doctor callbacks
  • Delays

PAs no longer have to be such a cumbersome task. Through CoverMyMeds, Prime Therapeutics (Prime) gives doctors and pharmacists a free service to submit PAs electronically for any drug, which includes nearly all plans.

With ePA, doctors and pharmacists receive real-time notifications of Prime's PA outcome / decision. This helps the doctor let the member know when it's time to pick up his/her medicine. This electronic process gives Prime better, more complete information the first time; it minimizes the need for callbacks to complete the PA.

Prime and Blue Cross stay ahead of the competition

ePA is integrated at retail pharmacies to catch rejections. Since about 60 percent of PA volume is initiated by the retail pharmacy, other pharmacy benefit managers may have a significant gap in meeting today’s PA workflow.

Fact — if a member encounters a PA at the pharmacy, the chances that he or she won’t come back to pick up their prescription drastically increase. This is called prescription abandonment and it raises overall health care costs.  We fill that gap with the ePA solution through CoverMyMeds.

  • 74 percent of ePAs turned around in 24 hours versus 2.5 days*
  • 70 percent of doctor offices said their patients received their medicine faster*
  • Available for any drug
  • Minimizes need for doctor callbacks
  • A free service from Prime Therapeutics, CoverMyMeds and NaviNet

Prime works with CoverMyMeds and NaviNet to speed up the process and get members their medicine faster. It’s a helpful service for doctors and pharmacists, and an invaluable one for your employees.

Learn more about how ePA speeds up the medicine delivery process. For more information, contact your representative.

* Results from a CoverMyMeds/NaviNet survey focusing on end-user experience and benefit

CoverMyMeds is a registered trademark of CoverMyMeds LLC, an independent third party vendor that is solely responsible for its products and services. BCBS makes no endorsement, representations or warranties regarding any products or services offered by independent third party vendors. If you have any questions regarding the products or services they offer, you should contact the vendor(s) directly.

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