1 CoverMyMeds User s Guide User s Guide

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1 1 CoverMyMeds User s Guide User s Guide

2 2 CoverMyMeds User s Guide TABLE OF CONTENTS Overview 3 Starting a Request 3 Using a Key 4 Completing the Request 5 Address Books 5 Required and Important Tags 5 Sending a Request to the Plan 6 Sending a Request to a Provider 6 Downloading/Printing a Request 7 Patient Follow-up Instructions 7 Renew Request 8 Notes and Reminders 9 Dashboard 9 Shared and Received Tags 10 Using Archive & Notify 10 Prescriber Verification 11 Passwords 12 Tell a Colleague 12

3 3 CoverMyMeds User s Guide Overview CoverMyMeds helps pharmacies and medical offices quickly find, fill out, and submit Prior Authorization (PA) requests for all medications from a free and easy-to-use website. We have forms for Medicare, Medicaid, and most commercial insurance plans. Use CoverMyMeds to: Quickly find the correct form for your patient s plan Fill out the request from your computer. Send the request to the patient s insurance plan with the prescriber s digital signature Easily manage follow-up for all of your PA Requests Starting a Request From your Dashboard, click the New request button in the left panel to navigate to the Find the form you need page. To find a form: 1. Select your Patient s State (The state defaults to your state, so you may need to change it by clicking the blue arrow). 2. In the Medication field, type the name of the requested medication and select the strength from the drop down menu. 3. In the Search terms field, enter in any of the following information: Plan name, Prescription benefits manager, form name, or BIN number. Narrow your search results by adding additional search terms. 4. You will be presented with the best form options. If you need more information before selecting your form, click More info. When you ve located the form you need, click on the image of the form and click Start Request to begin filling out the PA.

4 4 CoverMyMeds User s Guide Using a Key When a request needs to be shared with another healthcare provider through CoverMyMeds, a key is sent to give them access. The key is a unique, alphanumeric code attached to all requests created in CoverMyMeds. Keys can be entered by users with or without a CoverMyMeds account. If a request needs to be shared with another healthcare professional, open the request from your Dashboard and click Send to Prescriber. From the dropdown, you ll choose Fax or . If you select , enter the address on the recipient s CoverMyMeds account and click Send. This will share the form with the user s account and send them an notification. If you select Fax, confirm the Fax number and, at the bottom of the page, click Fax. This will send a coversheet letting the recipient know a prior authorization is needed and how to access the form online. It will also send them the Key information needed to access the form, including the CoverMyMeds key. Requests cannot be accessed by another healthcare professional unless they have the Key information. If you have been sent a key by a pharmacy or another healthcare professional, use the following steps to access the request 1. Go to and enter the key information For CoverMyMeds users, login to your account and click Enter key on the left panel. For non-covermymeds users, click Receive a Request? Enter Key below the login box. 2. Enter the Key, Patient s Last Name, and Patient s Date of Birth. 3. Click Enter key. For CoverMyMeds users, once you ve logged into your account and entered a key, the request will be linked to your account and accessible from your Dashboard.

5 5 CoverMyMeds User s Guide Completing the Request Once you ve selected the right PA form, complete Patient details, Prescriber details, Medical details, and Rationale sections. Be sure to click Save whenever you complete a section of the form. v Pharmacies: Only the Patient Name and Date of Birth are required to print or share the request with the prescriber. Address Books Don t see the form you need? Give CoverMyMeds a call at (866) or chat with us in the lower right corner of your screen. Our client support is available Monday- Friday from 8am to 11pm ET and Saturday from 8am to 3pm. In CoverMyMeds, address books are used to store patient, prescriber, and pharmacy information for future PA requests. To store an entry into the address book, enter information into the appropriate fields and click Save in the left panel. To store multiple entries, follow the steps below 1. Type the contact s information into the provided fields and click Save on the left panel. 2. Click Clear on the left side of the gray Address Book bar and start typing information for the next contact. 3. Repeat this process until you ve entered all desired entries. To retrieve a stored entry, begin typing into the First Name field. The address book will change to Do you mean: and list entries matching the name entered. To select the entry displayed, click the name displayed and select from the drop down menu. Click Clear to search for another entry. Alternatively, you can also retrieve a full list of entries by leaving the fields blank and clicking the gray Address Book bar. Required and Important Tags The red Required tags indicate fields used by the plan or another healthcare provider to identify the patient. These fields are also required to share the request with another healthcare professional or to send the request to the plan for review. The orange Important tags indicate fields most commonly used by the plan to make an accurate determination. We highly recommend completing these fields before sending the request to the plan.

6 6 CoverMyMeds User s Guide Sending a Request to the Plan Once the PA request is complete, click Send to Plan in the left panel. Some plans have switched to a fully-electronic process, and those will pop up a box telling you the prior authorization has been sent. For classic forms, the plan s fax number will auto-fill for most requests in CoverMyMeds. You will also be shown a preview image of the form you ve filled out as well as your own contact information. If any fields are blank, be sure to enter in the appropriate information. Some PA s require an authorized signature before they can be sent to the plan. Through CoverMyMeds, requests can be signed electronically using the mouse. From the Send Request to Plan screen, sign the request on the dotted line by holding down the left mouse button and moving the curser like a pen to form a signature. You may click Reset and re-sign until you are content with the signature. CoverMyMeds automatically stores the signature after the request is sent. The signature will be available in your Stored Signatures the next time you send a request to the plan. After confirming the office contact information and applying the signature (if needed), click the Fax button at the bottom of the page. Once a prior authorization request has been successfully sent to the plan, they will contact you directly with their determination, usually by fax. On average, it takes 1 to 5 business days to come to a determination. Sending a Request to a Provider In addition to being able to send a PA request to the plan, requests can also be sent to the prescribing physician or another healthcare professional for completion. After creating a new prior authorization form or opening an existing form, enter the patient s first and last name as well as their date of birth. Click Send to Prescriber on the left panel and select to enter the prescriber s address and share a form directly with their CoverMyMeds account, or Fax if they don t have an account. To fax, complete any empty fields on the fax screen and edit the Message text box if needed, then click Fax. You can also view or print the fax by clicking Preview.

7 7 CoverMyMeds User s Guide Downloading / Printing a Request If a physical copy of a PA request is needed, it can be downloaded and printed out for many plans. On your Dashboard, click Open on the request you would like to download/print. Click Other Actions, select Download / Print on the left panel. Then, click Download only if printing for patient s records or Download and Mark as sent to plan if printing to manually fax the request to the plan using your office fax machine. The phone and fax number for the plan are located in CoverMyMeds next to the form image. The file will open in a PDF that you can view and print. For plans that have switched to a completely electronic process, a paper form will not be available, but you ll still be able to print out the questions and any information you ve entered for the patient s records if needed using the Download / Print button. Patient Follow-up Instructions Pharmacies are able to send patient instructions that allow the patient to follow up with the prescriber to ensure the request is submitted to the plan. To print a patient instruction sheet: 1. Open an existing request or create a new request and enter at least the patient s first and last name, as well as their date of birth. Add other details as available. 2. Share the request by clicking Send to Prescriber or Download / Print. 3. Finish the process: a) Send to Prescriber After clicking Send to Prescriber and choosing Fax as the method, check Fax me instructions to give to the patient. Click Fax to send yourself an instruction sheet to give the patient. b) Download / Print Check Include patient instruction sheet. Then, click Download only or Download and Mark as sent to plan. Open the PDF and print the form with the instruction sheet.

8 8 CoverMyMeds User s Guide Renewing a Request The Renew feature allows you to quickly create new PA requests using imported information from existing requests. With a click of a button, you are automatically given the most up-to-date form, with all the information from the previous request replicated onto a new request. To begin, open an existing request and click Other Actions, then select Renew on the left panel. On Archived requests, open the existing request and click Renew on the left panel. A pop-up box will appear with information from the previously submitted form. You should confirm that the drug dosage, prescription insurance coverage noted in the form title, and patient still reflect the information you need to create your renewal. When you are ready to renew the PA, click Create Renewal. A new form will be generated with information from the previous form. You will be required to review each section of the request and verify that all patient, prescriber, and medical information is up-to-date. Do this by clicking the blue confirmation boxes along the right side of the screen. All boxes must be checked before a renewed prior authorization can be submitted to the plan. Be sure to look for blank fields, in case a form has been updated. Once each box has been checked, click Send to Plan in the left panel and submit as normal.

9 9 CoverMyMeds User s Guide Notes and Reminders Notes and Reminders help you manage and track the activity of a PA. The system automatically records Notes for events like sending and sharing a request. You will also be able to find fax statuses and confirmations in the Notes section. To Access the notes for a PA: 1. Open the request you would like to view. 2. Click the Notes tab in the left panel. 3. View the request history, including date, time, and action taken. 4. Click All at the bottom of the Notes to find and print a fax confirmation sheet and view fax transmission statuses. 5. Add your own notes by entering information in the text field at the bottom of the left panel and clicking Add. To add a reminder: 1. Open the request you would like to view. 2. Click in the text block at the bottom of the left panel. 3. Enter information for follow-up. 4. Check Set reminder and use the drop down to choose a date. 5. Click Add. You are also prompted to add a Reminder after sending a request. To be ed about overdue reminders, go to Your preferences at the top of the screen and select Yes to Do you want to be ed about overdue reminders? Dashboard All PA requests created in CoverMyMeds are stored on the Dashboard. The Dashboard can be located by clicking the house in the upper left corner of your screen. There are three tabs on your Dashboard: 1. Current: Contains requests that have not been sent to the plan. 2. Sent to Plan: Contains requests that have been sent to the plan and are awaiting a determination. 3. Search: Search for both Open and Archived requests by patient, drug, people sharing or your identifier

10 10 CoverMyMeds User s Guide Shared and Received Tags Whenever a request is shared, one of two tags will appear next to it on your Dashboard. The Shared tag indicates you have either faxed or ed a request to another healthcare professional. This tag will not appear when the request has been sent to the plan. If the box next to Shared is empty, it means it hasn t been accessed by the recipient through CoverMyMeds. If it is checked, it means they have. The Received tag indicates you ve received a request from a pharmacy or other healthcare professional. PA s marked with this tag were not started by you, but were sent to you for completion. Using Archive & Notify Prescribers should archive requests when the plan has sent notification of the determination. Pharmacies should archive requests when the prescriber has sent notification of the determination or when the related claim has been successfully adjudicated. To Archive a form: Option1: 1. Go to your Dashboard and find the request you want to archive. 2. Click the Archive link. 3. Choose an outcome of Approved, Denied, Not sent to plan, or Don t know outcome. If Denied is chosen, a dropdown menu will appear to select the reason for the denial. If the given reasons aren t sufficient, you may type the reason in the Other field. A dropdown menu will also appear when Not sent to plan is selected. Option 2: 1. Open existing request. 2. Click Archive on the left panel. After archiving a request, it is removed from your Dashboard and an is sent to all users with access to the request. For Approved or Denied request, the shared user(s) receives an notifying them of the determination. For Not sent to plan or Don t know outcome requests, the user(s) receives an notifying them that the request has been removed from their Dashboard. To view an archived request, use the Search tab. You can filter your search results by Open Requests Only, Archived Requests Only, or both Open and Archived Requests.

11 11 CoverMyMeds User s Guide Prescriber Verification Prescriber verification allows access to two benefits within CoverMyMeds: epa is a completely electronic prior authorization process offered by select plans, some of which require verification to access. With epa, determinations are often received faster than traditional PA requests. Some plans will deliver the determination through CoverMyMeds instead of by fax or phone. Thousands of pharmacies use CoverMyMeds to load PA requests directly into your Dashboard without the need for you to enter a key or create the form yourself. To verify a prescriber, click Prescribers at the top of your screen and follow these steps: 1. Enter the prescriber s NPI or name and select them from drop down list 2. You will be given a list of fax numbers, including the one the prescriber has on file with the NPI registry. a. If you have access to one of those fax numbers, select it and click Add Prescriber. Repeat until all prescribers have been located. b. If you don t have access to those fax numbers or no fax numbers are displayed, click I don t have access to the above fax numbers. Enter the best contact phone number and additional instructions on how we can reach you. 3. Click Initiate Verification a. If you have access to the fax number, CoverMyMeds will send an alphanumeric code via that fax. When you receive the verification code, go back to the Prescriber screen and click the Enter Code button to input that verification code. From there, your prescriber will be verified. b. If you don t have access to the fax number, CoverMyMeds will attempt to verify the prescriber using other sources. If we need additional information, we will contact you at the phone number you provided. You will be sent an notification when this is complete. At any time, click the house in the upper left corner to return to your Dashboard.

12 12 CoverMyMeds User s Guide Passwords If you ve forgotten your password: 1. Go to and click on Trouble logging in? CLICK HERE. 2. Enter your address and click Recover. 3. Check the address associated with your CoverMyMeds account and follow the link to reset your password. If you d like to change your password: 1. Log in to your CoverMyMeds account and click Your preferences. 2. Scroll down to Account management. 3. Enter your current password, the new password, and confirm it. 4. Click Save and Return to Dashboard Tell a Colleague If you know a provider that would benefit from CoverMyMeds, click Tell a colleague at the top of any page to send an automated or recommend one of the following: 1. Go to and Create an account. 2. Call us at us at

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