EHR Tutor Blog

A better solution to Prior Authorization with medications

Jul 20, 2016 12:08:00 PM / by user posted in Nurse Practitioner, nursing, guest post, medication administration

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This blog post was written by the CoverMyMeds team and might help practicing nurses learn more about prior authorization for medications. If you're a Nurse Educator, this could also give you some ideas for how to discuss prior authorization with your students or incorporate it into simulation.

Nurses: With Specialty Meds on the Rise, You Need a Better PA Solution
Did you know specialty medications make up the majority of the prescription market? Most require Prior Authorization (PA), which can leave you and your co-workers trapped in the endless paper form and fax cycle of the traditional PA process. Prescribers writing scripts for specialty meds can often lean on their nurses to handle the details when it comes to completing PA requests. Today, the team at CoverMyMeds wants to fill you in on some new stats regarding specialty meds and the new electronic solutions available to help alleviate some of the headache when completing PA requests.
What defines specialty medication?
Specialty medications often manage chronic disorders (multiple sclerosis, hepatitis C and immune deficiencies are a few examples), and can require special administration (i.e., through injectable or intravenous (IV) infusion).
Another defining characteristic: specialty medications are expensive. The industry generally recognizes any medication costing $1,000+ per 30-day supply as specialty.

So is PA required for all specialty medications?

While there are always exceptions, specialty medications likely require a PA request. With a significant increase in specialty meds, we’ve seen a direct correlation to PA requests spiking as well. As new medication continues to develop, this will be something that continues to trend upward.




What takes the PA process so long, anyway?
First, let’s review a quick definition:

  • Prior Authorization: The patient’s prescription coverage plan needs extra information about why your patient needs the prescribed medication in order to determine benefit coverage.

The PA process involves several parties (pharmacy, doctor, health plan, patient) and is often time consuming. CoverMyMeds steps in to limit the inevitable back and forth, with an electronic, streamlined solution for nurses and their staff. Instead of printing a form, manually filling it out and sending a paper copy to the plan, you can now complete all requests, from start to finish, through the CoverMyMeds web portal or directly through your electronic health record (EHR), at no cost.


Wait, so who are you again?

Our story began back in 2008 when a pharmacist and a tech guy questioned, “Why won’t the health plan just cover my meds?” Today, we are the leading electronic prior authorization (ePA) company in the nation, helping more patients receive the medications they need in order to live healthier lives. In fact, more than 600,0000 providers and staff use CoverMyMeds to manage PA requests, along with 80 percent of the pharmacy network, nationwide.

As a Provider or Medical Professional, how do I make the process easier, like you mentioned? An electronic solution, such as CoverMyMeds, is your best bet. You may already have access to manage PA requests within your EHR system. If not, it’s easy to get started with the CoverMyMeds HIPAA-compliant online portal. Simply create a free account or log in to complete your next PA request in minutes!

By completing PA requests electronically, your office will save time, reduce administrative waste and help patients get the medications originally prescribed. On average, users indicate they complete PA requests in 3-5 minutes through CoverMyMeds versus the traditional fax or phone process, which often requires 15-20 minutes. The CoverMyMeds solution works with all health plans and for any drug (retail and specialty). This is important to ensure you only need to work through one process for any scenario — even Medicare and Medicaid.

Want personal help getting started?

Live chat our PA experts or call 1-866-452-5017.

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Teaching ideas for Medication Carts and Medication Dispenser Cabinets

May 25, 2016 3:13:00 PM / by user posted in medication dispenser cabinet, nursing education, omnicell, pyxis, simcabrx, simcartrx, capsa, first dose, medication administration, medication cart, simulation, teaching idea

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After our last webinar on Medication Cabinets, Carts and EHRs, we realized that not only is there confusion about what each product does, but there is confusion regarding how to use any one of these products in a Nursing or Health simulation lab.

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Medication Administration - lab idea and quiz

Feb 4, 2016 6:31:00 AM / by user posted in nursing education, skills lab, academic EHR, academic EMR, barcode scanning, medication administration, simulation, teaching idea

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We have a few instructors who all came up with an excellent lab idea independently. It's really interesting when we hear from schools because so often people will arrive at similar use-cases without interacting with each other at all. This activity was one of those times. A modified version adapted from each instructor's idea is below:

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Pocket Nurse(R) Demo Dose(R) and EHR Tutor Integration and Webinar

Jan 13, 2016 6:45:00 AM / by user posted in pocket nurse, academic EHR, academic EMR, barcode scanning, demo dose, medication administration, simulation

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Medication Administration in Nursing and Allied Health Simulation with EHR Tutor and Pocket Nurse® Demo Dose® Integration
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Free Webinar: Barcode Scanning in Simulation

Dec 14, 2015 10:41:00 AM / by user posted in webinar, barcode scanning, medication administration

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Join us for our free, 20 minute webinar this Wed at 3:30pm ET: Barcode Scanning the Easy Way. We'll be doing a short presentation on how you can easily integrate barcode scanning and medication administration into your lab using EHR Tutor.

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Nursing & Math Teaching Idea: pounds to kilograms

Jun 24, 2014 9:38:00 AM / by user posted in electronic medical records, nursing education, academic EHR, classroom, electronic health records, EMR, math, Medical Assistant, medication administration, teaching idea

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In honor of sponsoring the Medical Math Competition at Skills USA this year, we thought we'd post another idea for incorporating math into your Nursing and Health Occupations classroom while using an EHR.

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EHRs and Math Skills - kill two birds with one stone!

Jun 12, 2014 9:28:00 AM / by user posted in EHR Tutor, electronic medical records, nursing education, academic EHR, academic EMR, classroom, EHR, electronic health records, EMR, math, Medical Assistant, medication administration, teaching idea

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For non-nurses, it may come as a surprise that math is such a big factor in nursing education and nursing in general. But here at EHR Tutor, we understand just how crucial it is for a nurse to be able to determine the correct dosage of a medication or attach the proper amount of fluid in an IV bag.

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All this talk of medications... Why?

Feb 19, 2014 1:00:00 PM / by user posted in EHR Tutor, electronic medical records, tools for nursing instructors, academic EHR, academic EMR, EHR, electronic health records, EMR, medication administration

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We recently hosted a free webinar on medication administration and have been promoting our barcode scanning feature for the last few weeks. Why? Because medication administration is a big deal in the world of EHR meaningful use measures. For stage two of meaningful use requirements, medical practices must "enable a user to create a single reconciled list of medications, medication allergies, or problems" among other medication related requirements.

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Join our free webinar: Teaching Medications and Med Administration

Feb 17, 2014 8:10:00 PM / by user posted in nursing education, tools for nursing instructors, webinar, Diane Yeager, medication administration

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We'd like to invite you to join us for a free, 20 minute webinar: 

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Jumping Right Back Into School: Learning Medications (for students)

Jan 4, 2014 3:42:00 PM / by user posted in medical terminology, freenursetutor, medication administration, Nursing Students, pharmacology abbreviations

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We've seen dozens of talented students pass through nursing school, medical terminology classes and CNA programs in our day. But no matter how gifted/intelligent/kind a person is, learning medications and terminology usually comes down to rote memorization - something we're not all great at.

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