Prior Authorization Website for Healthcare Systems and Plans

Prior authorization websites are a game-changer for healthcare systems and plans, streamlining the process of reviewing and approving treatments.

These websites often have a dedicated portal for healthcare providers to submit prior authorization requests, which can be accessed through a secure login.

Healthcare providers can submit requests online, reducing paperwork and wait times for patients.

Streamlining prior authorizations can help you work more efficiently and ensure patients get the right medication without unnecessary delays.

By securely delivering plan-specific question sets, decisions, and responses to provider workflows, you can enable faster prior authorization decisions.

Eliminate the inefficiencies and administrative burden of manual processes by automatically sending questions, receiving answers and attachments, and sending responses and initiating renewals.

Transmitting plan- and drug-specific question sets directly to provider workflows can eliminate communication barriers and inefficiencies.

The median time to a decision decreased 69% compared with manual prior authorization in an AHIP study.

Average wait time dropped by more than two days for one health system using Electronic Prior Authorization, which can improve time to therapy and get better, faster information from prescribers.

Electronic prior authorization can streamline the process for healthcare systems and plans. Surescripts automatically triggers a prior authorization request, which then delivers the appropriate question set to the PBM or health plan.

Staff can complete the required information without leaving the EHR, and benefit plans respond within the same workflow. This integration eliminates the need for multiple systems and reduces administrative burdens.

Healthcare systems can also use the Prior Authorization Portal to ease the process for those without an integrated solution. This allows for more efficient workflows and alleviates delays and frustration.

EviCore by Evernorth is a convenient way to manage your medical and pharmacy drug prior authorization needs. It's a single portal that lets you handle prescription drug ePAs for patients with Express Scripts pharmacy benefits.

The EviCore by Evernorth portal is designed to make your life easier, saving you time and reducing administrative burdens. You can manage your medical prior authorization needs with EviCore, streamlining your workflow.

For Cigna Healthcare patients, EviCore by Evernorth offers two options: Medical Oncology Pathways for oncology pharmacy drug and medical prior authorization, and Pharmacy Drugs (Express Scripts Coverage) for other pharmacy drug prior authorization.

To get started with EviCore by Evernorth, simply choose the option that best fits your needs. Here are the options for Cigna Healthcare patients:

EviCore by Evernorth is a valuable resource for healthcare providers, offering a convenient and efficient way to manage prior authorization needs.

For health plans, Surescripts transmits a dynamic electronic question set tailored to the medication from the benefit plan to the EHR. This allows staff to quickly send approvals, denials, or requests for more information based on the information submitted.

The Prior Authorization Portal lets your team proactively initiate requests and receive quick responses within the EHR, making your prior authorization workflows more efficient than ever.

Staff are guided through entering the required clinical details and, if necessary, submitting attachments. This streamlines the process and reduces delays and frustration.

With Surescripts, you can proactively prompt prescribers to initiate renewals, ensuring that patients spend less time waiting for their prescriptions.

Here's a breakdown of the benefits for health plans:

Surescripts lets you or your pharmacy benefit manager (PBM) proactively prompt prescribers to initiate renewals, ensuring that patients spend less time waiting for their prescriptions.

Specialty medications can be a challenge to access due to prior authorization requirements. Quickly understanding when prior authorization is required can help expedite the process for prescribers and patients.

Prior authorization for specialty medications can be initiated and completed directly with the pharmacy benefit manager or health plan. This can help reduce a common barrier to timely treatment.

You can leverage insights from eligibility information and drug-specific question sets to help patients maximize their coverage. For example, Blue Cross Complete offers a Prior Authorization Lookup tool that provides the most recent updates to prior authorization requirements.

Here are some key steps to follow when submitting prior authorization requests for specialty medications:

CoverMyMeds is a one-stop solution that works for all medications and all payers. It helps streamline the process of getting specialty medications, which can be a complex and time-consuming process.

You can use CoverMyMeds to ePrescribe to Workers' Compensation, making it easier to get the medications you need. CoverMyMeds leverages insights from eligibility information and drug-specific questions sets to help patients maximize their coverage.

By using CoverMyMeds, you can quickly understand when prior authorization is required and expedite the process on behalf of the prescribers and patients you serve. This can help reduce a common barrier to timely treatment.

CoverMyMeds connects directly with the pharmacy benefit manager or health plan to initiate and complete prior authorization requests, making it easier to get the medications you need.

Fast-tracking specialty medications can be a game-changer for patients and prescribers alike. Quickly understanding when prior authorization is required can help alleviate delays and frustration.

You can connect directly with the pharmacy benefit manager or health plan to initiate and complete prior authorization requests. This can help reduce a common barrier to timely treatment.

One connection to Surescripts can get you the connections you need to all the providers, pharmacies, and payers involved in medication prior authorizations. This can make the process of getting specialty medications to patients much more efficient.

Fast-tracking prior authorizations at the point of care can make a huge difference. Alleviating delays and frustration can help ensure that patients get the medications they need in a timely manner.

By proactively submitting clinical information to pharmacy benefit plans, you can get efficient determinations and quickly respond to pharmacies. This can help get prescriptions processed sooner.

Surescripts can help you surface prior authorization responses within the workflow, so prescriptions can be processed sooner.

Access Control is crucial for Specialty Medications. To submit prior authorization requests electronically, you can use your Electronic Health Record tool software or one of the online portals listed.

You must submit a request for a prior authorization for your patient, and also submit an override of a drug restriction. Request from pharmacies aren't accepted.

Blue Cross Complete offers electronic authorization inquiries and submission through Medical Authorizations portal accessed through NaviNet. This portal allows you to verify if No Authorization is Required, receive Auto Approvals, submit Amended Authorization, and more.

To access the Medical Authorizations portal, go to the Workflows menu on NaviNet. You can also use Health Information Exchange (HIE) capabilities to submit inpatient concurrent reviews online.

A prior authorization for healthcare common procedure coding system medications is required before they are covered by Blue Cross Complete. You can find a list of codes that require prior authorization by clicking the HCPCS PA List (PDF).

Here are some key features of the Medical Authorizations portal: