Open Forum

Hi Tony,

We have our Pharmacy Techs in a central hub doing all of our PAs. I have also had great success with Medical Assistants learning this role and doing a centralized model with MA's leading the charge. I do think that to properly fill out a PA it helps to have some training of the medical field. There is a lot of chart-combing that can go into these PAs (I have done many especially for diabetes supplies and they can be a bear). Clinical knowledge paired with a solid training program and utilizing the tools that are out there like CoverMyMeds will help you be successful. We also implemented an electronic signature system through Adobe so that if a paper PA came through or a company had a specific form they required, we could wire the paperwork to the provider electronically so the person doing the PA's did not have to be in the same room as the provider who was signing. 

Happy to discuss further if you have questions! 

Thanks, Torie. Very helpful. In your system, how do central pharm techs become aware that a prior authorization is needed? 

Hi Tony,

We have our Pharmacy Techs in a central hub doing all of our PAs. I have also had great success with Medical Assistants learning this role and doing a centralized model with MA's leading the charge. I do think that to properly fill out a PA it helps to have some training of the medical field. There is a lot of chart-combing that can go into these PAs (I have done many especially for diabetes supplies and they can be a bear). Clinical knowledge paired with a solid training program and utilizing the tools that are out there like CoverMyMeds will help you be successful. We also implemented an electronic signature system through Adobe so that if a paper PA came through or a company had a specific form they required, we could wire the paperwork to the provider electronically so the person doing the PA's did not have to be in the same room as the provider who was signing. 

Happy to discuss further if you have questions! 

Currently our requests come through fax and CoverMyMeds. We are on Athena EHR, but just signed a contract for Epic beginning in August. When I had Epic at my previous employer, requests came via fax, CoverMyMeds, and via Epic PA function. 

Thanks, Torie. Very helpful. In your system, how do central pharm techs become aware that a prior authorization is needed? 

Hi Tony,

We have our Pharmacy Techs in a central hub doing all of our PAs. I have also had great success with Medical Assistants learning this role and doing a centralized model with MA's leading the charge. I do think that to properly fill out a PA it helps to have some training of the medical field. There is a lot of chart-combing that can go into these PAs (I have done many especially for diabetes supplies and they can be a bear). Clinical knowledge paired with a solid training program and utilizing the tools that are out there like CoverMyMeds will help you be successful. We also implemented an electronic signature system through Adobe so that if a paper PA came through or a company had a specific form they required, we could wire the paperwork to the provider electronically so the person doing the PA's did not have to be in the same room as the provider who was signing. 

Happy to discuss further if you have questions! 

Hi Torie, we are on AthenaOne, and I'm curious whether you have been using the Athena option for electronic prior auth initiation, or whether you've avoided it knowing you were likely going to get one from CoverMyMeds, fax, pharmacy, etc.?  We have been simply not really using it because we ended up with so many duplicates to clean up, but it seems like it could be such a better streamlined option that perhaps we just aren't using as efficiently as we could be?

Thanks!

Erinna Wichland

Currently our requests come through fax and CoverMyMeds. We are on Athena EHR, but just signed a contract for Epic beginning in August. When I had Epic at my previous employer, requests came via fax, CoverMyMeds, and via Epic PA function. 

Thanks, Torie. Very helpful. In your system, how do central pharm techs become aware that a prior authorization is needed? 

Hi Tony,

We have our Pharmacy Techs in a central hub doing all of our PAs. I have also had great success with Medical Assistants learning this role and doing a centralized model with MA's leading the charge. I do think that to properly fill out a PA it helps to have some training of the medical field. There is a lot of chart-combing that can go into these PAs (I have done many especially for diabetes supplies and they can be a bear). Clinical knowledge paired with a solid training program and utilizing the tools that are out there like CoverMyMeds will help you be successful. We also implemented an electronic signature system through Adobe so that if a paper PA came through or a company had a specific form they required, we could wire the paperwork to the provider electronically so the person doing the PA's did not have to be in the same room as the provider who was signing. 

Happy to discuss further if you have questions! 

In my clinic, the non-RN clinical staff do PAs and refill requests. It's working well - the RNs get involved when a letter of appeal is needed. One drawback is that the MAs and LVNs don't always realize that a formulary alternative or workaround (such as ordering combo meds like ciprodex drops as two separate meds) will work and is a way to avoid having to do a PA. Another drawback is that on busy weeks when they are constantly having to room patients they can fall behind which can delay some requests or result in multiple fax messages and reminder calls, which can result in duplicate work. But overall, it's been wonderful for the nurses. I don't think our clinical staff enjoy the extra work, but some of them like the opportunity to learn and have become quite adept, which can be a source of pride for them. This has also freed up our nurses to work nearer the top of our scopes.

Hello :)

In my clinic, the non-RN clinical staff do PAs and refill requests. It's working well - the RNs get involved when a letter of appeal is needed. One drawback is that the MAs and LVNs don't always realize that a formulary alternative or workaround (such as ordering combo meds like ciprodex drops as two separate meds) will work and is a way to avoid having to do a PA. Another drawback is that on busy weeks when they are constantly having to room patients they can fall behind which can delay some requests or result in multiple fax messages and reminder calls, which can result in duplicate work. But overall, it's been wonderful for the nurses. I don't think our clinical staff enjoy the extra work, but some of them like the opportunity to learn and have become quite adept, which can be a source of pride for them. This has also freed up our nurses to work nearer the top of our scopes.