AmeriHealth, in partnership with FutureScripts®, is pleased
to announce a new electronic capability for providers to submit prior
authorization requests for members with an AmeriHealth prescription drug
benefit.
How ePA works
We recently implemented an electronic prior authorization (ePA)
platform that enables providers to receive real-time prior authorization
decisions based on an algorithm created for approximately 100 of the
most-requested medications from all drug classes that require prior
authorization under an AmeriHealth formulary. This makes up over 70 percent of
the total prior authorizations submitted by providers for medications.
When submitting an ePA, providers will be prompted to answer a set of
questions. If the medication is one of the approximately 100 included in the
algorithm, then a series of questions specific to that medication will follow,
and an approval may be automatically generated as clinically appropriate.
However, if an ePA cannot be auto-approved, the ePA will be sent to
FutureScripts for further review. All decision notifications, however, are
available through ePA.
Note: The list of medications and related questions will be
refreshed annually and in accordance with changes AmeriHealth makes to prior
authorization requirements to ensure the most relevant and up to date
information is available.
ePA is available through the following third-party companies:
We encourage you to review the websites for these vendors to learn more
about the ePA process and capabilities. Each vendor allows you to create an
account at no cost. Simply register on the front page of either vendor’s
portal to begin the process of submitting ePAs.
If you have any questions about registering or using the portal, call
CoverMyMeds at 1-866-452-5017 or SureScripts at
1-866-797-3239. If you have any questions about ePA, call
FutureScripts at 1-888-678-7012.