Real-Time Prescription Benefit and Electronic Prior Authorization will go live at all UMMC locations on Wednesday, February 15, 2023. 

Real-Time Prescription Benefit allows prescribers to view medication costs and therapeutic alternatives in real time at the point of care. This will allow providers to make the best possible care decisions for their patients. With true prescription price transparency, providers are able to prescribe the best available medications, leaving patients confident in the cost of their therapy and more likely to adhere to it. 

Real-Time Prescription Benefit also includes: 

• Coverage alerts including age and quality limits, prior authorization and step therapy. 
• Channel options (retail, mail order, and specialty pharmacy) 
• Member pay details such as out-of-pocket and deductibles. 
• Equally viable, less expensive theraputic alternatives

Medications that need a prior authorization can now be requested electronically. If the payer needs additional clinical information to determine an approval or denial status, an inbasket message will be sent to support staff noting the payer is waiting for a response. Answers to question sets can be completed and sent back to the payer. The Prior Authorization inbasket folder can be used to monitor request statuses. 

Click here to review the tip sheet: Real-Time Prescription Benefit Workflow Presentation.