Electronic Prior Authorization: Avoiding Surprises at the Pharmacy

At Express Scripts, our significant Electronic Prior Authorization (ePA) investments are now decreasing turnaround time for all healthcare stakeholders – first and foremost, for patients, but also for physicians, their staff and for our own prior authorization (PA) experts.

When physicians use ePA, any “back and forth” questions are streamlined. ePAs let doctors work smarter – using sophisticated decision tree logic to only ask questions pertaining to that specific PA. Fax forms require doctors fill in every answer, relevant or not, to get a response.

The Express Scripts ePA solution also lets physicians proactively request new PAs and renew existing PAs up to 60 days before they expire. That saves everyone involved from hassles before a patient runs out of his or her medicine.

ePA improves patient care. It happens in real-time - often before the patient leaves the exam room – so that patients can receive their medications faster. This removes patient frustration of going to the pharmacy to pick up medicine for themselves, their child or their parent, only to be told that there are additional steps needed to approve the therapy. According to the CoverMyMeds 2018 ePA National Adoption Scorecard ePA improves adherence and reduces gaps in care. 

The Scorecard summarizes the current state of ePA in the industry, quantifies the impact of prior authorization to patients and providers, and highlights current ePA adoption and implementation rates by market leaders.  View the entire 2018 Scorecard here. Express Scripts partners with a variety of ePA providers so all physicians can find a solution that fits their workflow.