Specialty pharma contracting provider makes prior authorization paperwork easy

Getting prior authorization for reimbursement for specialty pharmaceuticals can be a key stumbling block to connecting patients with prescribed meds. Without the prior auth, patients sometimes return to their physician to seek cheaper or alternative meds that their health plans allow. Now, Armada Health Care (Florham Park, NJ) has collected the prior authorization forms of “virtually all insurance plans and drugs,” according to the company, and makes them available, free, at the ApproveRx website. Prescribers can download the forms, pre-populate them with existing patient data, and get the forms on their way to the health plan. A dashboard feature allows for tracking the authorization status, which Armada says will reduce the incidence of abandoned prescriptions.

“This is an adaption of our existing ReachRx Online Therapy Management service for Armada pharmacy members,” says Darcy Brennan, VP of marketing at Armada. ReachRx OTM automates pharmacy care and intervention scheduling for pharmacists, thereby enhancing the service offering of Armada to those pharmacies. Brennan says that a natural next step for ApproveRx will be to automate the prior auth process through to health plan decisions—but that would require a much higher degree of IT linkage with plans than is available now.

Coincidentally, Armada has now set the agenda for its annual Health Care Summit (May 1-4, Las Vegas), which it expects will draw 2,000 participants from the specialty pharmacy (and pharmaceutical) industry. Philip Hagerman, CEO of Diplomat Pharmacy, will keynote.