A health IT startup dedicated to streamlining the prior authorization process has seen its physician user base explode in the last few months.
CoverMyMeds (CMM) now has about 330,000 physician users completing prior authorization requests, up from about 130,000 in September, said Sam Rajan, principal and co-founder with the Cleveland-area company.
CMM has developed Web- and phone-based tools that speed up and automate the submission of prior authorization requests to health insurance plans. Insurers sometimes require these requests and other coverage determination forms to be submitted before approving a doctor’s order for a patient’s prescription. For example, an insurer may require prior authorization for a doctor’s order to prescribe a brand-name medicine when a similar generic is available.
Launched in 2008, CMM provides its services to pharmacies and doctors for free. It makes its money from charging fees to drug manufacturers, which have an interest in increasing their sales by expediting the prior authorization process. Clients’ drug reps then promote CMM’s service to doctors and pharmacies.
“We’re driving significant volume through our pharmacies and making a huge impact in the way pharmacies and physicians can work together to the benefit of their patients, rather than each of them working in silos,” Rajan said.