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Integrated PA Functionality For Pharmacy Systems

CoverMyMeds’ EasyButton solution for pharmacy systems integrates prior authorization functionality, enabling pharmacists to initiate and track PA requests.

Reduces Rx Abandonment

CoverMyMeds speeds the PA process resulting in decreased patient abandonment and more filled prescriptions.

Eliminates Administrative Waste

With EasyButton, pharmacists click one button in their pharmacy system to initiate requests, eliminating phone calls and faxes to provider and plans.

Faster Determinations

Electronic prior authorization requests through CoverMyMeds result in faster determinations that allow scripts to be filled faster.


Resources

Learn more about the successes and innovations of CoverMyMeds technology.

CASE STUDY: Discount Drug Mart’s Electronic Prior Authorization (ePA) Solution and Medication Adherence Program Read More »

BLOG: American Pharmacists Month: A Conversation with Dan Kelly and Pam Rowan, Clinical Pharmacists at CoverMyMeds Read More »


Integrated Pharmacy Systems and Pharmacies

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Top FAQs for pharmacy systems


Use our Pharmacy Claims API. This API is a secure web-service that transmits a telecom-like data structure over vanilla HTTP(s).


Fixing PA is an opportunity to reduce a big source of administrative waste and suboptimal health outcomes:

  • PA is responsible for prescription abandonment rates between 40 and 70% (Hansen et al, JMCP, September 2009; Belazi, AJMC, June, 2013).
  • More than 200M claims are rejected each year for PA or PA-like requirements (CMM internal data)

When these problems are solved, you’ll be helping your pharmacy customers fill more prescriptions with less waste.


About 25 pharmacy systems have now completed the integration. The fastest so far was “two days of programmer time” and the average seems to be about 60 days.


We integrate electronically with plans that represent 75 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 connect to plans that represent 75 percent of U.S. prescription volume. You can see our full ePA payer list.


Pharmaceutical manufacturers are interested in ensuring patient access for their medications. These organizations work with CoverMyMeds to reduce the chance that a prescription is abandoned after a claim rejection in the pharmacy, and to educate doctors and their staff about the opportunity to make their PA process more efficient.

Importantly, CoverMyMeds makes its service available for all drugs (not just those of sponsoring manufacturers), does not influence the prescribing decision of the provider and does not share any Protected Health Information (PHI) with the manufacturer.

Much like the way we work with payers, the involvement of pharmaceutical manufacturers helps make it possible for CoverMyMeds to offer our service for free to pharmacies, physicians and their staff, and to pay transaction fees to vendor participants.