The life cycle of a prescription, at face value, seems like a simple one:
Pharmacy receives a prescription > Pharmacist puts pills in a bottle > Patient picks up prescription.
Actually, there are many variables and potential roadblocks that can interrupt this journey, and requiring a Prior Authorization is just one of them.
Prior Authorization certainly has an impact on the healthcare industry. According to the CoverMyMeds ePA National Adoption Scorecard, physicians reported that 40% of prescriptions are never claimed due to delays in Prior Authorization, not to mention 30% of the physicians’ received calls were from patients who were looking for their medication.
As a pharmacist, Sam Rajan saw many patients neglected to pick up their prescriptions that weren’t approved by insurance plans. Pharmacists already struggle with the patients who pick their meds up but never take them, along with the patients who never pick them up at all. He responded by working with Matt Scantland, a software developer, to find a solution. Together, they created CoverMyMeds, the first all-care, all medication platform.
Since its conception in 2008, CoverMyMed’s mission has been to help patients “get the medication they need to be healthy.” Technical Account Manager Leslie Gibbs describes CoverMyMeds’ work with Prior Authorization as “one small part of the healthcare industry, but one that makes a difference by helping a patient get their prescriptions.”
“My staff and I are so thankful for the interface that PioneerRx and CoverMyMeds have in place to assist with filling Prior Authorizations. The process of dealing with Prior Auth’s can be frustrating at best, and CoverMyMeds has a great system to streamline communications between the pharmacy, the prescriber, and the third party. – Brad White, Medicine Center Pharmacy
Leslie has worked with pharmacies for two years to streamline their processes in order to prevent any missed pick-ups because of Prior Authorization delays. “I am a process-oriented person,” she explains. “Anytime you can help the pharmacist find a way to spend more time with the patient is a win for everyone. The pharmacy business has been around for a long time, so any time we can use technology to improve processes is a major plus.” Innovation demands the right culture to thrive in, and fortunately, CoverMyMeds is the perfect place for it.
Throughout the past five years, CoverMyMeds has received awards from Glassdoor, Columbus CEO, Modern Healthcare, and Columbus Business First for its outstanding work environment. Leslie attributes this to the company’s location in Columbus, Ohio. “Right now, Columbus has a very strong culture for entrepreneurs,” she observes. “Being a tech company, I feel like we have an environment that is very open in the sense of giving employees the freedom to try new things and be innovative.” She also attributes its success to its tendency to be inclusive. “We have a lot of diversity, and it lends itself to attract the top talent and innovative minds to want to join our team, embrace challenges, and really focus on helping the healthcare industry.” After all, CoverMyMeds began with two forward-thinking entrepreneurs with a unique concept, and they worked together to build their company from the ground up.
“CoverMyMeds and PioneerRx have partnered to reinvent how pharmacy is practiced, truly advancing patient care.” – Jeff Bartone, Hocks Vandalia Pharmacy
Recently, CoverMyMeds and PioneerRx worked together to increase patient engagement through real-time adherence. When the patient picks up their prescription, CoverMyMeds identifies high-risk patients and sends a Clinical Alert to the MTM queue. These alerts give pharmacists the opportunity to counsel patients and offer the vaccinations they currently need. Like PioneerRx, CoverMyMeds constantly listens and reacts to the needs of the market for direction on future endeavors.
As CoverMyMeds works to make its own environment conducive to success and innovation, it carries over to the pharmacists they help every day. Community pharmacists are entrepreneurs, too, and they need the right tools and technology to keep their workflow moving with as few hiccups as possible. CoverMyMeds is an “electronic filing cabinet,” according to Leslie, that involves pharmacists, prescribers, and pharmacy benefit managers so that the entire healthcare team can stay informed and involved throughout the process of a script.