Why electronic prior authorization matters
As part of our standard prior authorization service, we utilize an ePA platform called CoverMyMeds® to improve time to therapy. This allows your care team to submit prior authorization requests electronically for any medication and all health plans and PBMs that participate with CoverMyMeds.
By submitting prior authorizations electronically with CoverMyMeds, you can reduce the time associated with manual methods like phone and fax.
Additional prior authorization support
Get additional support for therapy-specific expertise, quality oversight and proven appeals assistance to streamline coverage and improve patient outcomes.
Enhanced prior authorization assistance
We provide therapy-specific staff to help answer clinical questions. You can modify your completion preferences by talking with your account manager.
Quality oversight for therapy
We provide our teams with therapy-specific knowledge and have staff to evaluate trends in insurance denials.
Proven appeals support
We work together on your patients’ behalf. Our appeals team helps overturn an average of 8 out of 10 coverage denials. 1
Explore provider resources
We’re committed to ensuring that providers have access to the resources they need. Here are some helpful tools to get started:
- Specialty Pharmacy Provider Portal: Our online portal to help you manage administrative tasks.
- Optum Pharmacy Drug List: Use this search tool to find medications that Optum can provide or facilitate access to.
- Pharmacy Appeals: Learn how our appeals drafting service works to help patients get medication coverage.
Sources:
- Optum Specialty Pharmacy, Appeals data, 2024.