Prior Authorization

Through their ongoing collaboration, CVS Caremark and Surescripts have partnered to provide free electronic prior authorization services for all your CVS Caremark patients.

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Electronic Prior Authorization

Electronic Prior Authorization integrates directly with electronic health records (EHRs), enabling healthcare professionals to easily obtain prior authorizations in real time at the point of care.

Relieves administrative burdens

Electronic requests eliminate time-consuming paper forms, faxes and phone calls.

Improves time to therapy

Integrated into the provider’s EHR workflow, Electronic Prior Authorization identifies medications that do not require a prior authorization to reduce delays.

Improves patient and physician satisfaction

Healthcare professionals answer only relevant patient-specific questions with patient data already pre-populated, giving them more time with patients.



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Prior Authorization Portal

Our Prior Authorization Portal provides a free, online way to easily submit fully electronic prior authorization requests right away, even if the service is not yet available within the EHR.

Eliminates manual prior authorization hassles

Saves users valuable time by eliminating the forms, faxes and phone calls associated with manual prior authorization

Improves patient and physician satisfaction

Provides rapid prior authorization approvals while patients are in the office, allowing more time for meaningful patient engagement and eliminating surprises at the pharmacy

Provides quick and easy access

Offers free, immediate access to electronic prior authorization when an EHR-integrated solution is not available



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FAQ

Will clinicians be informed of approval or denial decisions in real-time?

Yes, Electronic Prior Authorization is connected to health plans and pharmacy benefit managers (PBMs) to ensure that clinicians get real-time approval or denial decisions within the EHR, often seconds after submitting a completed question set.

How does the manual prior authorization process impact patient care?

69% of patients who get their medications report waiting two or more days for prescription approval, while many others abandon their prescriptions when faced with the prior authorization process.ii

Will clinicians have to enter patient demographics or medication information into a form?

No, Electronic Prior Authorization is fully integrated into the EHR workflow, allowing the automatic transmission of all patient and provider demographic and medication information to the correct payer, at the touch of a button, without extra work for the clinician.

Is it necessary for clinicians to fill out a paper form or visit a website with Electronic Prior Authorization?

No, Electronic Prior Authorization is completely integrated within the EHR workflow and does not require physicians to leave the familiar context of their EHR to answer prior authorization questions.

Does my EHR have Electronic Prior Authorization?

Electronic Prior Authorization is already available in many of the top EHRs with more adopting the capability all the time. Below is a partial list of EHRs that are already certified for Electronic Prior Authorization. Contact your vendor to request Electronic Prior Authorization.

  • Aprima Medical Software
  • Care360
  • Cerner
  • Connexin
  • DrFirst
  • eClinicalWorks
  • Epic
  • GE Healthcare
  • Greenway Health
  • Henry Schein Medical Systems
  • MD Toolbox
  • NextGen Healthcare
  • RxNT
  • STI Computers

Let’s Discuss How Our Prior Authorization Solutions Can Work for You