Has anyone integrated covermymeds for any or all of their products - prior authorization and Rx benefits check?
I have not had any funding for that project yet. I have had a few people ask about it but no real support has materialized. Where you thinking of creating a community module?
With any integration, the other side needs to allow integration code to be published. And of course the costs need to match the savings. Have you contacted them?
Do they provide an API? I can’t tell from web site and solution access info is vague.
Yup - they do have API and not much seems to be public except this. Sadly OpenEMR not on list of 500 vendors.
We’re integrated with more than 500 EHR vendors to initiate PA requests at the point of prescribing. Search for your vendor to find out how to access CoverMyMeds within your EHR. Don’t see your EHR listed? Request an integration.
This looks like it’d be a good addition to the project and would be willing to help out.
I’d imagine that once our EMR is approved our only responsibility would be updates etc. where our user can create an account and openemr would only be the gateway, similar to SMS.
If we have folks that would be willing to follow through with the development, I’d be willing as an Admin to make the request. Unless there is a down side I’m not seeing.
Their site asks users for EHR vendor. So somehow they will need to be contacted “officially” to get the process started. Also looks like FHIR has some say in this. Best to have dedicated entities handle this can of worms.
I filled out the form to connect with them. I will update here once I have more information.
I have heard back from them. It is a paid service and they want a single point of contact for all the accounts. Eligibility API Onboarding
It is a minimum of $400/mo to have an account with them. They offer a volume-based account system. If the request volume is 5000 requests per month. The cost is 0.08/request. But the account cannot be charged for less than $400.
This is the content that they provide for the fee. I don’t know if this is good or not.
I asked another provider to look at the provided content and whether it was significantly better than what could be accessed elsewhere. The answer was no. So, I don’t see any upside to developing a module for this service.
@juggernautsei , I am not sure if they provided information regarding provider related products. The eligibility API would be more applicable to pharmacy or those who include medications as part their billing claims. While it would be nice for providers to ping a system and know if the rx they are about to write needs to go thru prior authorization, most physician learn quickly from experience which meds need authorization. Without that knowledge the pharmacy asks them to get it authorized.
However, filling up prior authorization requests on their website and then monitoring the approval or denials takes lot of employee hours. We just need API access to submit/manage requests within EHR rather than employees cutting and pasting stuff in the browser.
Here is their companion product for pharmacy benefits. Benefit it adds is definitely not worth the cost for most small practices using this EHR.
@juggernautsei Maybe ping your contact to check because their blurb on website seems to suggest these are two different APIs. One would think ePA will be free since there is no relayHealth or prescription monopolies involved. And EHR links should help them speed up the process. I would think pharmacies and payors compensate them handsomely.
Yes, I will ask Trey.
@mdsupport the answer is:
“We are not allowed to sell the pharmacy benefits API to anyone other than fulfilling pharmacies due to regulations.”
So, it is not free and it is only for pharmacies. =^(
@juggernautsei, his response does not sound right. One last time could you try the following verbatim?
We are interested in covermymeds ePA product which the website claims is in use by 500 EHRs. We do not require pharmacy benefits information. We know the Rx we are writing will need prior authorization. All we want is the ability to initiate that prior authorization process thru covermymed with as much data from OpenEMR filled in automatically as possible. This is no different than what our staff already does manually at the website if and when they find time. We have no interest in the RxBenefit Clarity product or its subscription.
Sending now. I will update you as soon as I get a return reply. The only reason my message is this long is because this forum is making me type so many characters to make a reply.
Trey wrote: “McKesson still owns covermymeds. We do not own that product.”
I just realized that I have gotten two companies mixed up. Cover my meds and Change healthcare.
I did get a reply back from cover my meds and his name is Kevin. I just sent him your question.
I will let you know Kevin’s reply.