OptumRx Streamlines Authorization Process with CoverMyMeds’ Electronic Prior Authorization Platform


Date Posted : December 9, 2014

  • Solution enables physicians to submit drug prior authorization requests online
  • CoverMyMeds improves member experience through immediate processing of authorization requests – often before the patient  leaves the doctor’s office

BOSTON (Dec. 9, 2014) — OptumRx is implementing a new electronic prior authorization (ePA) platform from CoverMyMeds that will help streamline prescription authorization requests and give patients quicker access to the medications they need.

With the CoverMyMeds ePA platform, OptumRx will offer physicians a more modern and efficient process that enables them to submit drug prior authorizations online. The requests process immediately, and care providers receive notification of the patient’s authorization status, often while the patient is still at the doctor’s office.

“CoverMyMeds will enable medical offices to save time and reduce administrative hassle by submitting prior authorization requests directly into our system online,” said Mark Knutson, senior vice president of Customer Service, OptumRx. “Most importantly, we will decrease the time patients wait to receive authorized medications.”

Prior authorization ensures certain medications are used properly in the appropriate circumstances, protecting the patient from dangerous drug interactions or side effects, as well as undue expense. Along with improving the authorization request process, OptumRx’s new automated, Web-based model with CoverMyMeds will make OptumRx one of the prescription benefit managers (PBMs) that meet the National Council for Prescription Drug Programs’ (NCPDP) standards for ePA and comply with state mandates requiring ePA availability for care provider networks.

“Our relationship with OptumRx gives care providers access to a streamlined process with real-time determinations that will enable patients to quickly receive their needed medications,” said CoverMyMeds’ PBM Manager Julie Hessick, RPh.

OptumRx’s new ePA platform from CoverMyMeds is now available. Prescribers may sign up at www.covermymeds.com/epa/optumrx. Care providers with questions about submitting electronic prior authorizations to OptumRx should contact CoverMyMeds at 1.866.452.5017 or help@covermymeds.com.

OptumRx is a leading pharmacy care services organization and one of the Optum companies of UnitedHealth Group (NYSE: UNH).

About CoverMyMeds

CoverMyMeds is the leader in Prior Authorization and one of the fastest growing healthcare technology companies in the US. We help physicians, pharmacists, and their staff complete PA requests for any drug and all plans. Our technology integrates with pharmacy systems, EHRs, and PBMs to create the most efficient electronic prior authorization (ePA) strategy for all participants. With one million PAs submitted each month, CoverMyMeds is the only vendor using the NCPDP ePA standard at scale. For more information, visit www.covermymeds.com.

About OptumRx

OptumRx is an innovative pharmacy benefit management business managing the prescription drug benefits of commercial, Medicare, Medicaid and other governmental health plans, as well as those of employers and unions through a national network of 66,000 community pharmacies and state-of-the-art mail service pharmacies in California and Kansas, both of which have earned the prestigious Verified Internet Pharmacy Practice Sites™ (VIPPS) accreditation by the National Association of Boards of Pharmacy. OptumRx is part of Optum, a leading information and technology-enabled health services business dedicated to making the health system work better for everyone. Visit www.optum.com for more information.

About Optum

Optum is a leading information and technology-enabled health services business dedicated to helping make the health system work better for everyone. With more than 80,000 people worldwide, Optum delivers intelligent, integrated solutions that help to modernize the health system and improve overall population health. Optum is part of the UnitedHealth Group (NYSE:UNH).