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Prior Authorization, Automated

CoverMyMeds’ secure, HIPAA-compliant software automates prior authorization (PA), saving pharmacists, providers and their staff valuable time and ensuring patients receive the medication they need faster.  

Eliminate Paperwork

CoverMyMeds securely and electronically transmits PA requests, eliminating the need for hand-written forms or calls to the plan. 83 percent of our users say we help them save between 1 and 3 hours per week, and shorten the PA process to 1-3 minutes instead of 15 minutes by phone.

Faster Determinations

The new ePA transaction with plans provides the ability to receive approvals in real-time. Available for Caremark, Prime, Humana, U.S. Script and many more coming soon.

100% Free

Our service will always be free to pharmacies, providers and their staff, because we are financially supported by payers, who want to improve the efficiency of their PA process, and drug manufacturers, who want to improve patient access to medications.

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Top FAQs for Providers and Pharmacists

More than 700,000 providers and 49,000 pharmacies have decided that CoverMyMeds is an easier way to manage their PA requests.

CoverMyMeds gives you a secure and efficient way to handle all of your PA activity in one place. No more searching for forms, phone numbers or waiting on hold.

In a recent survey, 83 percent of our users said that we save them between 1 and 3 hours per week, and PA requests through CoverMyMeds take 1-3 minutes instead of an average of 15 minutes by phone.

Yes. CoverMyMeds deploys a set of Policies and Procedures, together with technical, physical, and administrative safeguards to maintain compliance with the HIPAA Privacy Rule and its implementing regulations. In addition to our own assessments, many of the largest health care organizations in the U.S. have audited our compliance.

For our users who are Covered Entities (e.g., providers, plans, or PBMs), CoverMyMeds functions as a Business Associate. In some situations, we may also function as a Health Care Clearinghouse (a type of Covered Entity).

CoverMyMeds uses a standard Business Associate Agreement with most providers, and may execute customized Business Associate Agreements with large health systems, pharmacies, and plans or PBMs. CoverMyMeds also publishes a Privacy Policy and Terms of Service among other documents. These materials may be found in our online Privacy Center.

Because our service is used as part of a health care provider’s Treatment and Operations functions, and because we do not sell data or otherwise invoke the requirements, we are not generally required to obtain Patient Authorization or Consent.

We integrate electronically with plans that represent 80 percent of U.S. prescription volume and support the rest through our Universal Last Mile service. This service allows us to connect to any plan using their drug-specific paper PA forms while maintaining an electronic experience for the provider and pharmacy.

We can integrate into your clinical system for free, but need the vendor to agree. We are already integrated into nearly every pharmacy system, and are now integrated with a large number of EHRs. If we are not yet integrated with your system, please let your vendor know you want CoverMyMeds integration. We provide a convenient tool to see if we are integrated and request integration if your system isn’t available yet.

When we connect in a two-way communication with the plan, the plan lets you know when your PA is approved directly inside the workflow, often in real-time. So far, we are seeing real-time approvals approximately 30 percent of the time; however, this rate is increasing rapidly and should eventually approach the overall approval rate for all PA requests (60-90%).

Plans that represent 80 percent of U.S. Prescription volume. See our full ePA payer list.



Pharmacy System Integration

CoverMyMeds is integrated into nearly all commercially available pharmacy systems, allowing pharmacy staff to initiate a PA in their workflow.

See if we work with your pharmacy system and request an integration »

EHR Integration

CoverMyMeds works with electronic health records (EHR) systems to integrate prior authorization technology so that the request can be initiated while E-Prescribing, or after a rejected pharmacy claim.

See if we work with your EHR and request an integration »


Support

We’re here to help. Click the chat box at the bottom of the screen to speak with the support team, or call 866-452-5017 or email help@covermymeds.com

You can also check out the Help section to watch training videos, read FAQs or attend a demo.


Partners
More than 700,000 providers and pharmacists use CoverMyMeds to complete Prior Authorization.

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