Prior Authorization

Taking the hassle out of prior authorizations for your practice

According to the American Medical Association, physician practices spend an average of two business days a week per physician to comply with health plans’ prior authorization (PA) protocols. One-third of practices employ staffers that spend all of their working hours on PA requests and follow-ups.

At FountainRx, we realize that many specialty drugs come with complex prior authorization requirements. That’s why we aim to reduce the time you spend managing these processes, streamlining this workflow for you, your staff and your patients.

Prior authorization experts

In fact, FountainRx has an entire pharmacist-led support team dedicated to completing prior authorizations. All of these team members have the training and specialized knowledge needed to request the right information from you and your staff. We then coordinate with each patient’s health insurer to submit this information for approval. We do so in a highly accurate but rapid manner, reducing the time it takes to actually put these important medications into your patient’s hands. We also keep you apprised of this process so that you know exactly when we have received a prior authorization and started the process of dispensing your patient’s medications.

As part of our advanced medication adherence program, we also track prior authorization expirations, so that your patients do not run out of their medications when they need them. Our proactive approach to prior authorization management and support reduces the administrative burden on your practice, while helping secure approval for your patients whenever medically necessary and appropriate.

Securing financial assistance with or without drug coverage

In some cases, your patient cannot afford the cost of their medication, even after drug coverage has been approved by their insurance company. In these cases, we can find out whether they qualify for financial assistance via drug manufacturers, government assistance programs and nonprofits. We also manage this process as we seek approval from insurance companies to promote the most cost-effective solution for your patients.