The Prior Authorization Problem

What the heck is going on? Suddenly, every site where I work has become bogged down in paperwork requesting what the insurance industry calls "prior authorization" for medication prescribed to patients. The cost of creating and tracking these requests has become enormous, and the cost in suffering caused by delays in the process is higher, still.

PriorAuthRx.com can relieve the "prior auth" bottleneck, helping providers, consumers, and the insurance industry with tools to improve health care for everyone.

for providers

• PriorAuthRx.com will strive to provide a central clearing house for the formularies? of insurance organizations. One of the biggest frustrations facing doctors, nurse practitioners, physician assistants, nurses, and other health care providers is that it is often impossible to know in advance what drugs are covered for a given patient. Once a patient is seen and evaluated and a prescription is written, it is time-consuming and expensive to see the patient again to change medications, and often dangerous to change medications without a new face-to-face encounter. By providing access to formularies, PriorAuthRx.com aims to allow providers to prescribe formulary-preferred medications the first time whenever it is medically appropriate to do so.
• PriorAuthRx.com will provide example forms and request letters to help providers when requests for non-formulary medications are necessary.
• PriorAuthRx.com will generate, submit, and track prior authorization requests online with just a few mouse clicks. It is fast, efficient, and paperless!

for consumers

• PriorAuthRx.com will help consumers compare the formularies of participating insurers so that they can make an informed choice of health plan.
• PriorAuthRx.com will rate insurers based on their patterns of approving or rejecting requests to cover medically-necessary medications.

for insurers

• PriorAuthRx.com will provide a simple, effective, and free way to get up-to-date formulary information to providers. By giving providers a simple way to check formularies, PriorAuthRx.com should help decrease administrative overhead, delays, and frustrated consumers by enabling providers to write for preferred medications whenever it is medically appropriate.
• PriorAuthRx.com will lower paperwork burdens by giving providers a standardized way to include all appropriate information with prior authorization requests