Electronic prescribing network vendor Surescripts has connections to five national pharmacy benefit management firms, enabling it to offer electronic prior authorization transactions that speed the filling of prescriptions for prescribers covering 75 percent of patients across the nation.
The company also has direct electronic connections with 11 electronic health records vendors, making the electronic prior authorizations available to 290,000 providers. Now, Surescripts has partnered with PDR Network, publisher of the Physicians Desk Reference and distributor of drug safety alerts, to offer easier authorization processes for virtually all prescribers.
Thats because PDR also has an extensive library of electronic prior authorization forms that integrated into Surescripts e-prescribing workflow will automate authorizations for patients covered by nearly all drug insurers, says Mike Pritts, executive vice president of product innovation at Surescripts.
With many medications, especially specialty and expensive ones such as cancer drugs, insurers impose additional restrictions on prescribers before authorizing approval to have the medication dispensed, Pritts explains. Further, many providers do not know that the drug they are prescribing requires prior authorization. That means a prescription can be delayed while the pharmacy seeks approval from the insurer.
When a provider is prescribing in the Surescripts system, the vendor can flag a script that needs prior authorization if the patient is a member of one of the major PBMs, and the provider then is walked through a workflow to answer a series of questions that the PBM needs to authorize the prescription. Now, with PDRs authorization forms available in the Surescripts workflow, the company can offer the same service to payers that dont link to Surescripts.
If Surescripts doesnt have a connection to a payer, its system sends a request to PDR to receive the appropriate authorization form, which is put in the Surescripts workflow, and the form then is sent back to PDR for transmission to the payer.
The process, which enables Surescripts to further optimize its product, reduce waste and enhance prescriber and patient convenience, is transparent to prescribers, Pritts says.
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