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CoverMyMeds

by CoverMyMeds
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OVERVIEW

A healthcare technology platform that automates the prior authorization process for prescribers, pharmacies, and health plans to accelerate patient access to medication.

CoverMyMeds is a comprehensive healthcare technology solution designed to streamline the complex and time-consuming prior authorization (PA) process. It operates as an electronic prior authorization (ePA) platform, connecting prescribers, pharmacies, health plans, and pharmaceutical manufacturers through a single, unified network.

Key Benefits and Capabilities:

  • Accelerated Time to Therapy: By automating the submission and tracking of PA requests, the platform helps reduce the time from prescription to patient access, often completing requests up to three times faster than traditional phone or fax methods.
  • Reduced Administrative Burden: The software integrates directly with over 350 EHRs and numerous pharmacy management systems, allowing for in-workflow submission, automatic form population, and real-time status updates, significantly reducing paperwork and manual follow-up.
  • Real-Time Benefit Check (RxBC): Provides prescribers with patient-specific prescription cost and coverage information, including prior authorization requirements, at the point of prescribing, which helps reduce prescription abandonment.
  • Extensive Network: The platform connects over 950,000 providers, 50,000 pharmacies, and most health plans and PBMs, representing 96% of prescription volume.

CoverMyMeds is a McKesson company and offers solutions for the entire medication access journey, including affordability and adherence programs, in addition to its core ePA and RxBC functionality. It is the industry leader in electronic prior authorization, helping to complete millions of PAs annually.

RATING & STATS

User Rating
3.7/5.0
16 reviews
Customers
950,000+ Providers
Founded
2008

KEY FEATURES

  • Electronic Prior Authorization (ePA)
  • Real-Time Benefit Check (RxBC)
  • Formulary Management
  • EHR/E-Prescribing Integration
  • Denial and Appeals Management
  • Patient Assistance Programs
  • Pharmacy Workflow Integration

PRICING

Model: freemium
The core electronic prior authorization (ePA) and Real-Time Benefit Check (RxBC) services are available at no cost to healthcare providers and pharmacists. Custom, enterprise pricing is used for solutions tailored for Pharmaceutical Manufacturers, Payers, and Health Systems.
FREE TIER

TECHNICAL DETAILS

Deployment: cloud, saas
Platforms: web, ios, android
🔌 API Available

USE CASES

Streamlining Prior Authorization WorkflowsReducing Prescription Abandonment RatesAccelerating Time to TherapyAutomating Revenue Cycle Management (RCM)Improving Medication Adherence

INTEGRATIONS

EHR Systems (350+ integrated)Pharmacy Management SystemsE-Prescribing SystemsNewCropDrChronoPioneerRxAmazing Charts

COMPLIANCE & SECURITY

Compliance:
HIPAA
Security Features:
  • 🔒User Access Controls
  • 🔒Encryption

SUPPORT & IMPLEMENTATION

Support: email, phone, online knowledge base
Implementation Time: 1-4 weeks
Target Company Size: startup, small, medium, enterprise
TRAINING AVAILABLE

PROS & CONS

✓ Pros:
  • +Free for providers and pharmacies, offering exceptional value for core users.
  • +Significantly streamlines the Prior Authorization (PA) process, saving time and reducing paperwork.
  • +Extensive network connecting over 950K providers and most health plans/PBMs.
  • +Real-Time Benefit Check (RxBC) provides cost and coverage information at the point of prescribing.
  • +API available for deep integration with EHR and pharmacy systems.
✗ Cons:
  • -Can have a steep learning curve for non-standard authorization scenarios.
  • -Some users report integration limitations and occasional unclear error messages.
  • -Limited customization options for highly specialized clinical workflows.
  • -Some users report a lack of adequate training and support for the free service.

ABOUT COVERMYMEDS