CoverMyMeds Process Diagram

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

Prescription Step
ePA Assignee Step
CoverMyMeds / Payer / PBM Step