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DUBUQUE, Iowa — MedOne Pharmacy Benefit Solutions announces a new collaboration with CoverMyMeds that will
allow members enrolled in a MedOne benefit plan to experience a streamlined prior authorization process via direct integration with CoverMyMeds’ network of prescribers, EHR (electronic health records) systems, pharmacies, and pharmacy system vendors. This benefits both members and prescribers – helping reduce the amount of time between when a medication is prescribed and when it reaches the hands of the member.
MedOne offers custom-built pharmacy benefit plans that employ a series of cost containment strategies in addition to operating on a pass-through model. These strategies, while cost-conscious in nature, ensure the appropriateness of medications prescribed to members enrolled in a MedOne plan. One of the most common strategies involved is the use of a prior authorization. This is a review conducted by an on-staff clinical pharmacist and ensures the safest and most cost-effective option within a therapeutic class is used as the first line of treatment. Prior authorizations are typically conducted on high-cost medications.
“Prior authorization continues to be an effective tool in helping ensure the treatments funded by our clients are safe, effective, and prescribed appropriately. The clinical information received and reviewed is critical in ensuring our members are treated with high performing treatments and setup to achieve positive health outcomes,” said Dr. Nate Harold, VP of Clinical Services at MedOne.
The process for conducting prior authorizations has evolved but often requires paperwork to be faxed to/from the prescriber’s office and MedOne. The integration with CoverMyMeds leverages the use of ePA (electronic prior authorization), which helps eliminate the need for additional or dual paperwork to be submitted. This, in turn, minimizes the delay in claims processing, helping members to access their medications more quickly without sacrificing the process for determining a prescription’s therapeutic appropriateness.
“It is clear that prior authorization and the process of obtaining and reviewing clinical information has become an increasing burden on our healthcare system and specifically our providers. As technology has advanced, we are in an ideal position to address these challenges to streamline the process, improve the time patients wait for a decision, improve information accuracy, and elevate the labor-intensive process of prescribers submitting clinical information. CoverMyMeds’ ePA solution provides a fast and easy way to complete prior authorization requests for our clients, pharmacies, prescribers, and most importantly, our members,” said Dr. Harold.
