service
Electronic Prior Authorization
The Preferred Way of ePA
Improve your ePrescribing workflows with integrated Electronic Prior Authorization software
According to a recent study conducted by the AMA, providers spend nearly 13 hours per week on Prior Authorization activities. Time is money, but those manual processes of the past are changing with ePA.
Within your ePrescribing workflow, a few clicks will open direct communication to ePA approvers and increase patient safety with less interruption to needed therapies. Provider adoption of this enhanced service is on the rise and is one of the many embedded features of our integrated software platform.
*Source: AMA prior authorization (PA) physician survey (ama-assn.org)
Powerful Networks for Expanded Coverage
What is Electronic Prior Authorization?
Electronic Prior Authorization (ePA) represents the next level in the evolution of prior authorization technologies. Unlike basic PA, which involves manual work often completed by medical assistants or other clinical staff, ePA is fully automated, integrating seamlessly with EHR/EMR systems to provide real-time authorization decisions. This means that as soon as a healthcare provider prescribes a treatment, the ePA system immediately checks for insurance coverage and authorization requirements, submitting a request if necessary, and rapidly returning a decision.
ePA Reduces Complexities in Traditional Forms
The PA process is further complicated by the lack of a standardized form at the federal level, leading to variations in the forms used across different states. These forms can vary significantly in the amount of information and specific details they require, adding layers of complexity to the process. This variance is compounded by the fact that different medications or insurance plans may necessitate differing levels of detail.
Information Typically Required in PA Forms:
- Patient demographic information
- Diagnosis
- Previous treatments used
- Relevant lab work
Healthcare providers must meticulously gather and utilize patient information to determine the most appropriate care pathway. The completion and submission of PA requests can then be carried out through various means, including over the phone, by mail, via fax, or through electronic channels. The choice of submission method can affect the speed and efficiency of the PA process, with electronic submissions (ePA) often providing a more streamlined and faster route to obtaining necessary approvals.
We’re Here to Help Streamline the PA Process
Recent findings by the AMA indicate that only about one in four physicians (26%) report that their Electronic Health Record system (EHR) offers Electronic Prior Authorization (ePA) capabilities. If you’re looking to save time, money, and improve the patient experience, ePA integration is the solution you’ve been looking for.
DoseSpot is leading the charge in simplifying the ePA process for healthcare providers by offering:
- Seamless Integrations: Partnering with industry leaders like CoverMyMeds and Surescripts, DoseSpot delivers an integrated ePA solution that effortlessly aligns with your ePrescribing workflow.
- Real-Time Prescription Benefit: DoseSpot provides alternative treatment options using personalized benefits and formulary-specific information, giving both the provider and patient the power of choice.
- Save Your Staff Valuable Time: With ePA, the cumbersome process of completing extensive paperwork, making follow-up calls, and relying on faxes is condensed into a matter of minutes.
- Improve Information Accuracy: Information is transferred more accurately and consistently, enhancing the quality of patient care and reducing the likelihood of delays in treatment due to administrative errors.
Benefits of Integrated ePA
DoseSpot offers ePA integrations through CoverMyMeds and Surescripts. These integrated ePA solutions provide a simpler and more streamlined way to review, submit, and track prior auth requests directly within your ePrescribing workflow.
Streamlined Workflows
Complete a medication prior auth for commercial and government sponsored health plans, including Medicare Part D and Medicaid.
Centralized Operations
Providers submit prior auth requests directly to payers, eliminating the need for back and forth phone calls or the risk of exposing protected patient data by using a fax machine.
Faster Responses
Integrated ePA can increase speed to determination much faster than manual submissions. Patients spend less time waiting, and providers spend less time on paperwork.
Intuitive Workflows Keep the Process Moving
DoseSpot providers can initiate the ePA process electronically within the prescription workflow. Pairing perfectly with our Real-Time Prescription benefit integration, where each prescription in real time is flagged if prior authorization is required. One click prompts the provider to enter necessary information, including patient details, medication details, and supporting documentation directly to the insurance provider for prior authorization.
Alternative Medications are Presented When Prior Authorization is Required
Real-Time Prescription Benefit provides plan-specific information, and makes it clear when prior authorization is required. These two integrations work together. When a medication is flagged, an equivalent therapeutic alternative is also presented, using personalized benefits and formulary-specific information, giving both the provider and patient options. This information is easily readable so the best clinical decision can be made quickly and within the course of the appointment.
Reduce Gaps In Therapy
With ePA, many steps are automated reducing clinician stress and allowing shortcuts for frequent drugs requiring approval. ePA can accelerate treatment plans and your staff will be able to gain efficiencies with fewer post-visit phone calls, faxes and follow-ups with the pharmacy, payers, and patients. Once complete, patients will feel more at ease and have the medications they need to improve their condition.
