Implementing Electronic Prior Authorization

Factors to consider in successfully setting up ePA.

Healthcare is hard enough. At Express Scripts, anything we build for ePA or other digital physician solutions must help doctors work smarter, work faster and give patients a better experience – all by providing essential information at the moment they need it.

If your plan is thinking about offering ePA, there are a couple things to get right first:

  •  Set up all coding for the digital channel needs, which takes a lot of work up front, but pays off for all involved in the end.
  • Set up auto-determination functionality, which enables payers to auto-review requests and provide real-time determinations based on preset criteria. In many cases, providers receive the outcome within moments of submission.

If your plan isn’t considering ePA, maybe you should. 96% of the payer industry is committed to implementing an ePA solution, according to the CoverMyMeds 2018 ePA Scorecard. 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.

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