10 Tips for Obtaining Pharmacy Prior Authorizations More Efficiently:
- Stay informed of coverage changes by using Partners For Kids coverage resources.
- Use Partners For Kids resources to determine if a medication can be switched to a covered medication or if a PA needs to be submitted.
- If a PA needs to be submitted, be sure to include reasons that the covered medications would not be useful or are potentially harmful in a patient.
- Create a master list of prescriptions that commonly receive rejections and can be switched to covered medications.
- Develop a PA process and clearly designate PA responsibilities to staff member(s).
- Keep active PAs in a central location accessible to all office staff.
- Embrace technology! Consider keeping approved PA dates in an electronic calendar (i.e., Outlook).
- Create a quick reference guide for optimizing use of CoverMyMeds.
- Consistently document all correspondence you have with the insurance companies and the pharmacies.
- Follow-up with the pharmacy and patient once a PA is approved.
Published May 2021