Prior Authorization

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Prior Authorization

ProPharm One+ can work with CoverMyMeds® to help you quickly receive Prior Authorizations for scripts. CoverMyMeds works with physicians to complete Prior Authorization forms and allows you to receive authorization quickly so that claims can be submitted. You can learn more about setting up a CoverMyMeds account at www.covermymeds.com

 

Topics

How Do I Set Up my CoverMyMeds Account?

How Do I Request Prior Authorization for a Claim?

 

 

How Do I Set Up my CoverMyMeds Account?

You can visit the CoverMyMeds website (www.covermymeds.com) to start setting up an account. Once an account has been created:

 

1.Open ProPharm One+ and click on the System menu item.

2.Select Options. The Options setup screen will open.

3.You will need to enter the correct information in each of the following fields:

a.API Key that is used by CoverMyMeds for Authentication

b.Password that is used by CoverMyMeds for Authentication

c.User Name that is used by CoverMyMeds for Authentication

 

All of this information should be provided by CoverMyMeds. You will need this information to request Prior Authorization.

 

 

How Do I Request Prior Authorization for a Claim?

1.When a claim is rejected, you can locate the script in the Patient Profile and click on the Preview Script button.

2.Then click on the Options button and select View Claim.

3.In the Claim Verify window, find the correct claim and click on the Prior Authorization button.

4.The "Prior Authorization" window will appear. To submit the PA to CoverMyMeds, click on the Submit Prior Authorization button.

 

ProPharm will remember the login information that was entered in the Options setup screen and use this information to log you into CoverMyMeds. If you are missing this information, a warning message will ask you to update your CoverMyMeds settings.

 

5.You should be taken to the CoverMyMeds website. From there you will be able to view the information that was submitted and complete the process.

 

See Also

Processing Claims

Options setup