CoverMyMeds ePA Getting Started

This article describes the functionality of the CoverMyMeds ePA task list. This list is composed of Electronic Prior Authorizations for medications, routed through CoverMyMeds and eventually direct connections to the Payers/PBMs. This document will describe the steps for configuring, accessing, using, and ultimately completing an ePA.

Prerequisites & Configurations

Features

• CoverMyMeds (Legacy SSO)
• CoverMyMeds ePA Integration

Settings

• The settings below are REQUIRED for the Prospective ePA workflow, to begin an ePA with CoverMyMeds, it must first be determined that the prescribed medication requires prior authorization. This is done via the Real-Time Benefit Check (RxBC) functionality on the prescription pad. These settings enable the RxBC to be run when printing/sending/queuing a prescription:
  • Company Setting: Run Real-Time Prescription Benefit Check (RxBC) = True/Checked
  • User Setting: Run Real-Time Prescription Benefit Check (RxBC) = True/Checked
• The two settings below are optional, but recommended. These dictate the default assignee of the ePA Task Item when prescribing a medication that returns "PA Required". The User or User Group will see the ePA task in their CoverMyMeds ePA task list.
  • Company Setting: EPA Processor (optional) = User/User Group
  • User Setting: EPA Processor (optional) = User/User Group

Role

• The "My Tasks - CMM ePA" security screen will need to be enabled for the applicable roles. Write access will need to be granted. 
  1. Setup > Roles > Search "CMM ePA"
  2. Set applicable access