Ease and Efficiency Through Electronic Prior Authorization

Sep 29, 2015
Electronic Prior Authorization returns coverage decisions instantaneously and improves efficiency for physicians, while continuing to safeguard patients from treatment that may be harmful, ineffective or more costly than need be

Plan sponsors save thousands of dollars each year by effectively managing the pharmacy benefit to ensure people take the most cost-effective and clinically appropriate medication to treat a condition. As higher-cost drugs enter the market and increasingly become adopted, physician administrative burden also climbs with the management of these prescriptions. This process can delay people getting their medications quickly. Express Scripts is investing in ways to streamline and automate the prior authorization process. As the market becomes more complex with increased specialty medication costs, we are innovating our process to be more transparent and simple.

As physicians operate under severe time constraints, advancement from the standard processes of forms, faxes and phone calls to more efficient electronic processes are critical.

Time for Operational Efficiencies

With 75% of physicians preferring electronic communications, electronic prior authorization (ePA) is an important enhancement that helps physicians and healthcare payers improve the quality and affordability of patient care.

ePA can return coverage decisions instantaneously and improve efficiency for physicians, while continuing to safeguard patients from treatment that may be harmful, ineffective or more costly than need be.

Strategic Partnerships

Express Scripts has teamed up with a variety of partners to provide flexibility designed to fit the physician office preference. We want to meet physicians how and where they operate. By offering multiple tools and partners, we are able to integrate electronic prior authorization options into the physicians’ existing workflow, ensuring patients safely receive their medication as quickly as possible.

Working collaboratively with a variety of vendors, Express Scripts streamlines the process of prior authorization by seamlessly integrating within a physician’s electronic health record (EHR) vendor’s ePrescribing tool or through web-based portals.

  • Surescripts: Integrated within EHRs, as well as connected to PBMs and pharmacies, Surescripts works to ensure that healthcare providers have the most efficient process and the most complete picture of a patient’s health.
  • CoverMyMeds: Advancing the coverage review process, CoverMyMeds’ electronic prior authorization technology integrates with pharmacy systems, EHRs and PBMs to accelerate patient access to their medication.
  • Allscripts: Leveraging point-of-care prior authorization for prescriptions, Allscripts works to improve efficiencies, foster adherence and reduce costs.
  • ExpressPAth: This proprietary online provider solution portal offers real-time information about coverage and clinical rules to encourage optimal prescribing decisions. ExpressPAth ensures that every dollar spent is appropriate for the patient’s treatment, and it can seamlessly manage claims under both the pharmacy and medical benefit.

By providing a suite of tools that offer flexibility and a streamlined process, physicians and their staff can focus on patient care and ensure patients receive the medication they need.

To learn more, physician offices should visit Express-Scripts.com/PA.

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