OfficeEMR is integrated with CoverMyMeds Real-Time Benefit Checks & Electronic Prior Authorizations to provide prescribers with prescription price transparency and an electronic prior authorization module directly within the EHR. This feature set is available to all practices at no cost. If you are interested in signing up please complete the Type Form. A support representative will be reaching out once this has been enabled. Before you are ready to begin using the feature you will want to configure the User & Company settings appropriately to initiate the ePA during the prescribing process appropriately. See the Step By Step Guide to review the necessary configurations and gain a deeper understanding of the feature.
Real-Time Benefit Checks (RxBC)
The CoverMyMeds Real-Time Benefit Check module provides prescription cost information at the time of prescribing. This unique algorithm provides the cost based on the patient's insurance, pharmacy, and drug selected during the prescribing process. This solution also identifies if a Prior Authorization is required and if a discount card might be available to save the patient some money.
Electronic Prior Authorization (ePA)
For years, practices across the country have used the CMM ePA website at no charge to streamline the process of submitting Prior Authorizations on high-dollar medications to ensure patients can get the care they need. The OfficeEMR - CoverMyMeds Electronic Prior Authorization (CMM ePA) module allows users to automatically submit an ePA within the prescribing workflow. ePAs can be completed within the My Task List - CoverMyMeds ePA.
The diagram below illustrates the flow of the prospective electronic prior authorization process. Starting with the initial prescribing being written in the EMR to the final adjudicated request being received from the payer. It is important to note the below describes the "happy path" of this process, payers may return multiple question sets or return denials and/or close an ePA as opposed to the ePA Approved workflow below.
Prospective ePA Diagram
Key
Prescription Step
ePA Assignee Step
CoverMyMeds / Payer / PBM Step
