Prime Therapeutics Launches Electronic Prior Authorization (ePA)

I’m very excited to be able to finally post this press release. The past year of my life has been spent building out a comprehensive ePA product for Prime’s prescribers and network pharmacies.


ST. PAUL, MINN. – Dec. 20, 2013 –Obtaining prior authorization for prescription medications can be a time-consuming and frustrating process for health care professionals and their patients. The process has traditionally required paper forms, faxes and follow-up phone calls, having the potential to take time away from patient care. To speed up the process, Prime Therapeutics (Prime), a leading pharmacy benefit manager, has contracted with, a health care technology leader, to launch an electronic prior authorization solution that has the ability to process prior authorization approval, often before the patient leaves the office.

Fast access to medications is a necessity for health care professionals today as they help their patients start or continue their journey of feeling better and living well. A recent Prime pilot study of more than 4,000 electronic prior authorizations found Prime’s automated system reduced prior authorization turn-around time by as much as 90 percent. In addition, duplicate submissions were reduced by 10 percent, and the study showed a 100 percent reduction in missing required information.

“Prior authorizations can be time consuming for doctors and their office teams,” said Michael Showalter, senior vice president and chief marketing officer at Prime. “By reducing the time it takes to process prior authorizations, we are making it easier for doctors to help our members. It also means members are less likely to be turned away at the pharmacy due to prior authorization delays. When we help members get the medicine they need when they need it, we improve both medication adherence and the member experience.”

Through the new program, health care professionals and pharmacists can submit the prior authorization directly to Prime online free of charge. Health care professionals and pharmacies receive real-time notifications of the prior authorization outcome. This automated process helps obtain better, more complete prior authorization information and reduces the need for follow up phone calls.

Health care professionals using Prime’s electronic prior authorization capabilities have said the online system, including the status dashboard, is easy to use. “We are helping doctors spend more time on patient care instead of paper work. The efficiencies electronic prior authorization brings are a win for our health plan clients, for doctors and our members,” said Showalter.

About Prime Therapeutics

Prime Therapeutics LLC (Prime) helps people get the medicine they need to feel better and live well. Prime manages pharmacy benefits for health plans, employers, and government programs including Medicare and Medicaid. The company processes claims and delivers medicine to members, offering clinical services for people with complex medical conditions. Headquartered in St. Paul, Minn., Prime serves nearly 23 million people. It is collectively owned by 13 Blue Cross and Blue Shield Plans, subsidiaries or affiliates of those plans. Prime has been recognized by Modern Healthcare as
one of “healthcare’s hottest companies for 2013.”
For more information, visit or follow @Prime_PBM on Twitter.

About CoverMyMeds

CoverMyMeds is the leader in automating Prior Authorizations (PAs), and the first step in patient adherence. Prescribers and pharmacies have submitted over 7 million prior authorizations, and other coverage determination forms through our automated system. CoverMyMeds was recently named the 8th fastest growing healthcare company (Inc 500|5000) in 2013.

Organizations that wish to benefit from electronic prior authorization for prescription drugs can contact us at 866.452.5017 or visit


Original Press Release: