DrChrono has implemented a CoverMyMeds (CMM) new enhancement, Electronic Prior Authorization (ePA). The improvement will allow for a Prior Authorization to be submitted to the Payer directly from the "send eRx" page, making it quicker for a patient to immediately begin or continue treatment with as little delay as possible.
Key Enhancements
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Information will be sent to the provider indicating whether Prior Authorization is required for a medication.
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Patient information will be sent to CMM’s allowing the provider to submit an ePA request to the payer through CMM’s platform.
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ePA message populates in the DrChrono message center.
New workflow
Provider initiates PA Request to Payer from send eRx page 
PA Request & Response(s) save in Patient’s Chart > Demographics > Authorizations PA Responses from Payer are forwarded to Message Center with patient's name attached.
Initiating a Prior Authorization Request
- From the patient's chart, perform a prescription benefits check via the Eligibility section.
- Once the prescription benefit has been confirmed navigate to Send eRx (via the patient's chart).
- Enter the following required fields ( Medication, SIG, Dispense, Dispense Unit, Days Supply, and Diagnosis Codes). The diagnosis code must first exist in the Problem list in order to appear.
- The Initiate PA box will only appear if a PA is required.
- Click Initiate Standard Request or Initiate Urgent Request.
*Urgent Request = payer is required to provide a response in a specific timeframe (typically within 24hrs).
- A pop-up notification will appear if there is an existing PA request for the medication. If not...
- Go to the next step to complete the authorization request.
Completing a Prior Authorization Request
The prior authorization request can be completed via the Message Center OR the Authorization tab within the patient's chart.
Via the Message Center (envelope located at the top right corner)
- Scroll to Prior Authorization (column on the left side under ERX section).
- Click the Prior Authorization with the title START PA.
- Once the message has been opened, click the button Start PA.
- The page will auto-navigate to the Prior Authorization Request screen.
- Fill in the required information needed. Documents can also be attached (ie: clinical notes).
- Click Submit request.
Via the Authorization tab within the patient's chart
- Navigate to Demographics > Authorizations tab.
- Locate the Prior Authorization Medication > the status will show as Open.
- Click the 3 dots (...) to the right under the Action column.
- Choose Send PA.
- Fill in the required information needed. Documents can also be attached (ie: clinical notes).
- Click Submit at the bottom of the request.
Viewing Prior Authorization Responses from the Payer
- Navigate to the Message Center.
- Scroll to Prior Authorization (column on the left side under ERX section).
- Select the message applicable to the patient's name.
- View response (Approved, Complete More Questions, Denied).
- Payer notes are located at the bottom of the response (i.e. a denied payer's response and/or payer response file attachments).
Example PA Responses
APPROVED
COMPLETE MORE QUESTIONS
- Click "Complete More Questions" button.
- Complete additional questions requested by the payer.
- Submit PA at the bottom of the request.
DENIED
Viewing Existing Prior Authorization Requests
- (via Patient Chart) Navigate to Demographics > Authorizations.
- Clicking the 3 dots (...) under the action column allows a PA to be sent, canceled, archived and view the payer's response.
*If a canceled PA Request has been approved, the user can send a new PA Request using the same drug via the Send eRX page.
Here is a link to a video that will walk you through Submitting a Prior Authorization using the CoverMyMeds integration
FAQ- Submitting a Prior Authorization using the CoverMyMeds integration (Web)
(Beta phase) Submitting a Manual Prior Authorization - CoverMyMeds integration(Web)