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SHPBN-2019-002 Requesting Electronic Prescription Drug Prior Authorization Using CoverMyMeds

Date: 01/16/19

CoverMyMeds to Simplify PA Process

Sunflower Health Plan is streamlining the prior authorization (PA) process for providers and pharmacists by offering CoverMyMeds for electronic prior authorization requests.

CoverMyMeds streamlines the medication PA process and provides a fast and efficient way to complete PA requests online. Benefits of using CoverMyMeds include:

  • Elimination of telephone calls and faxes, saving up to 15 minutes per PA request.
  • Renew previously submitted PA requests.
  • Complete pharmacy-initiated requests electronically.
  • Secure and Health Insurance Portability and Accountability Act (HIPAA) compliant.

How to Use CoverMyMeds

To use CoverMyMeds, providers should follow these steps:

  1. Log in: Go to CoverMyMeds and register for a free account, or log in to your existing CoverMyMeds account.
  2. Start a new request: Click New Request, enter the drug name and the BIN, PCN and Rx Group from the patient’s insurance card for the best results. If unavailable, enter the patient’s plan or pharmacy benefit manager (PBM). Select the appropriate form and click Start Request.
  3. Complete the request: Enter all demographic fields marked with a “Required” flag and click Send to Plan. Complete the returned list of patient-specific, clinical questions and click Send to Plan again to complete the request.
  4. Confirmation: Once the request has been reviewed, the determination will appear in your CoverMyMeds account.

Training

Our partners at CoverMyMeds have instructional information and support here: https://www.covermymeds.com/main/support/.

Additional Information

If you have questions regarding the information contained in this update, contact: CoverMyMeds at 1-866-452-5017, Monday through Friday, 7:00 a.m. to 10:00 p.m. Central Time (CT), and from 7:00 a.m. to 5:00 p.m. CT on Saturday, or visit https://www.covermymeds.com/main/prior-authorization-forms/ to sign up or request an authorization.

Providers may also contact their provider network specialist with any questions or concerns.