If you're an in ER Nurse, you know that Thanksgiving isn't much of a holiday when it comes to work. So instead of posting a cheery Turkey Day graphic, we thought we'd point out some little known holidays that you might appreciate. And a belated Happy Nurse Practitioner Day to all of you!
We have a few big readers in the office who have all mentioned how summer is their time to catch up on reading materials. Even more true for instructors, there is no better time to sit down with a book than a long summer evening.
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
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).
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.
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.
With a month or less of summer left, we know many instructors fill summer with assessing new resources, planning for the coming year and attending conferences. We'd like to make another suggestion if you find yourself with a little extra time during long summer evenings: get your CE credits out of the way!
We talk a lot about how EHRs can help improve the cost effectiveness of medical treatments. But what's one of the primary ways to cut costs? Turns out it revolves around nurses.
Hiring more nurses is crucial for things such as lowering patient mortality, and reducing number of days patients spend in hospitals and other cost-related items. As you can see, hospitals with lower patient-to-nurse ratios had total of 6,239 fewer infections, with an annual cost saving of up to $68 million. You can find out more by taking a look at the full infographic here:
According to a Gallup poll done in 2014, the most trusted professionals in the US happen to be Nurses. 80% of respondents surveyed said that the level of honesty/ethics found in nurses was high or very high. That's compared to 65% of respondents who rated doctors as having high or very high levels of honesty.
One of our sales people recently did a tour of a defunct West Virginia prison and came back with some interesting insight into the medical care that existed between 1876 and 1995, especially the role of nurses at the facility.
We often talk about how an EHR system can be used in the classroom as well as in the Simulation Lab or after clinical rotations. However, we realized we rarely post ideas for how to do so on this blog. Sure, we've mentioned it in passing in relation to EMS/EMT programs, Vaccines, Nutrition and our recently added Polling Feature, but we've decided to do a few posts specifically with classroom and lecture ideas.
Join our Webinar: How to get the most out of simulation hours while using an EHR - in reference to recent NCSBN report
February 17, 2015 at 3:00pm ET
Register here: http://www.anymeeting.com/PIID=EB55DB84844F3D
Diane Yeager, Founder of EHR Tutor and FreeNurseTutor.com, will be discussing a few ideas for how to get the most out of your simulation time in light of the new NCSBN study on simulation hours vs. clinical hours. We'll be sharing ideas specifically related to using an EHR system to enhance the simulation experience in this 20 minute
webinar.
To learn more about the "The NCSBN National Simulation Study: A Longitudinal, Randomized, Controlled Study Replacing Clinical Hours with Simulation in Prelicensure Nursing Education" before the
webinar, view our
blog post on the topic.