Humana Inc. (NYSE: HUM) and CoverMyMeds, a leading health care innovation company, have recently teamed up to implement an electronic prior authorization model that allows providers to streamline prescription authorization requests, giving patients expedited access to the medications they need.
Under the new agreement, physicians can submit drug prior authorizations directly to Humana via an online portal. The requests begin processing immediately and providers receive a notification of the status of the member’s prior authorization, often before the member even leaves the doctor’s office.
Prior authorization is a clinical review that ensures certain medications are used properly in the appropriate circumstances, protecting the member from dangerous drug interactions or side effects, as well as undue expense. Humana’s new web-based model with CoverMyMeds eliminates several steps from the existing prior authorization process, saving time for both providers and patients.
During a recent Humana pilot study, one quarter of prior authorizations quickly received an outcome electronically within minutes of submission. In addition to the fast turnaround time, there was an overall consensus among users that the website was user friendly. Many users also found it helpful to receive an online status of their prior authorization determination. In addition, one participant even noted that it took the “guessing game” out of getting access to her prescriptions.
“Depending on the prescription, some medications require prior authorization before coverage which, as of now, is a time-consuming process for all parties,” said Scott Greenwell, Chief Pharmacy Officer of Humana Pharmacy Solutions. “Thanks to our work with CoverMyMeds, we’ll streamline the review process for a better member and provider experience. Prescriptions can now be approved and ready in real-time from the moment a patient leaves their doctor to the moment their prescription arrives at their pharmacy.”
Humana Inc., headquartered in Louisville, Ky., is a leading health care company that offers a wide range of insurance products and health and wellness services that incorporate an integrated approach to lifelong well-being. By leveraging the strengths of its core businesses, Humana believes it can better explore opportunities for existing and emerging adjacencies in health care that can further enhance wellness opportunities for the millions of people across the nation with whom the company has relationships.