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Electronic Prior Authorization

Overcoming Prior Authorization Hurdles

Activate end-to-end automation and power up specialty drug access with our integrated, all-in-one electronic prior authorization (ePA) technology.

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WE UNDERSTAND YOUR CHALLENGES

 

Prior Authorization Bottlenecks Slow Patient Care

 

Time-consuming manual processes, frequent errors, delays in patient care … sound familiar? Clinicians often struggle to get payer approval for medications because of complex, plan-specific requirements and rework due to missing information. These inefficiencies reduce productivity, increase denial rates, and delay treatments, impacting both patient outcomes and your revenue.

WE HAVE YOUR SOLUTION

 

Intelligent ePAto Reduce Workflow Friction and Get Patients on Therapy Faster

 

Our technology eliminates the back-and-forth and streamlines the ePA process from start to finish, reducing manual work by 70%. Pharmacy and medical benefits are unified into a single workflow, giving providers one clear path to manage prior authorization regardless of benefit type.

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The DrFirst Difference 

AVOID

Avoid PA delays by ensuring the prescription is written correctly the first time—right quantity, right diagnosis code, right pharmacy. If a covered alternative exists, the system surfaces it in the workflow. 

AUTOMATE

Automate by pulling patient data, clinical documentation, and payer-specific requirements directly from the EHR. While 60% of ePA questions can be answered with existing EHR data, DrFirst pushes that figure to 80% by surfacing targeted questions within the prescribing workflow. 

ACCELERATE

Accelerate access by embedding decision logic into the workflow to suggest the next best action, surfacing qualifying pharmacies for specialty medications with LDNs, and providing real-time status tracking from submission to approval. 

Prescribing Specialty Medications

Speed access to innovative drugs that bring hope to patients diagnosed with complex, chronic, or rare diseases.

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KEY BENEFITS

Integrate real-time benefit information and prior authorization insights directly into your workflow by combining low-touch automation with patient health information, clinical documentation, and payer policy details. From end to end, our technology simplifies the ePA process.

HTI-4 COMPLIANCE

Fully compliant with HTI-4 mandates for ePA upgrades, so your organization meets regulatory requirements without added burden. 

Insurance Discovery

Accurately finds all active coverage and specific benefits with smart algorithms.

Automated Process

Determines if prior authorization is needed, checks for errors, submits requests, and tracks status—all in one place.

Patient-Specific Benefit Verification

Instantly identifies medical and pharmacy benefits, copays, deductibles, and more.

UNIFIED PA MANAGEMENT

Pharmacy and medical benefits are managed in a single workflow, eliminating the need to toggle between systems or portals.

Streamlined Specialty Med Access

Automatically handles prior authorization for any prescribed therapy, whether under medical or pharmacy benefits.

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True Workflow Integration

Enhances user experience with a single interface or a FHIR API integration into your EHR.

Patient Financial Responsibility

Calculates out-of-pocket costs for any service using contracted rates and patient benefits, improving patient experience and reimbursement levels.

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PROVEN RESULTS

 

ONE SPECIALTY PHARMACY FOUND THE FOLLOWING RESULTS:

 

93% reduction in PA turnaround time1

 

30% reduction in operational costs associated with each new prescription1

WHO WE SERVE

Our solutions optimize medication management across hospitals and health systems, individual practices, EHR partners, and pharmacies. Partner with us for solutions tailored to your organization’s needs, allowing you to focus on what matters most: patient care.
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Automate Your ePA Process

Optimize the medication management journey from prescribing to adherence. Powered by the nation’s largest medication management network and exceptional customer service, our solutions transform how healthcare organizations deliver patient care, serve customers, and inspire healthcare professionals.  

Sources:
1 DrFirst data, 2021