Veridikal offers several Added Value Solutions as part of our DetectRx Pre/Post Edit service
PriorAuthplus™
Key Features of the PriorAuthplus program:
• Helps ensure patients receive the medication preferred by their doctor
• Reduces prescription abandonment
• Builds relationships and improves PA response via collaboration with other healthcare professionals
• Improves pharmacy and prescriber productivity via a streamlined PA process
• Reduces follow up calls to the prescriber
What is PriorAuthplus?
PriorAuthPlus helps pharmacies initiate medication and plan specific Prior Authorization (PA) forms via a resubmitted claim. This free service works for most commercial and government (i.e. Medicare & Medicaid) prescription benefit plans.
Upon receipt of a Prior Authorization related rejection (“70”-NDC Not Covered, “75”-Prior Authorization Required and “76”-Plan Limitations Exceeded), resubmit the claim to the PriorAuthPlus BIN (BIN #015079). RelayHealth uses the claim and rejection data from the original claim to create a PA form in CoverMyMeds. A rejected response is delivered in response with instructions on how to access the PA form in CoverMyMeds. Confirming the PA form autofills patient, medication and prescriber information from the original claim. The prescriber’s office adds clinical information, digitally signs the form, and faxes the form to the health plan via CoverMyMeds.
