1 • CoverMyMeds • User’s Guide
User’s Guide
Site: http://www.covermymeds.com • Email: [email protected] • Phone: 866-452-5017
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 Site: http://www.covermymeds.com • Email: [email protected] • Phone: 866-452-5017
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.
Site: http://www.covermymeds.com • Email: [email protected] • Phone: 866-452-5017
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 Email.
If you select Email, enter the email address on the
recipient’s CoverMyMeds account and click Send. This will
share the form with the user’s account and send them an
email 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 http://www.covermymeds.com 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.
Site: http://www.covermymeds.com • Email: [email protected] • Phone: 866-452-5017
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.
Don’t see the form you need? Give CoverMyMeds a call at (866) 452-­‐
5017 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. Address Books
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.
Site: http://www.covermymeds.com • Email: [email protected] • Phone: 866-452-5017
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 Email to enter the prescriber’s email 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.
Site: http://www.covermymeds.com • Email: [email protected] • Phone: 866-452-5017
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.
Site: http://www.covermymeds.com • Email: [email protected] • Phone: 866-452-5017
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.
Site: http://www.covermymeds.com • Email: [email protected] • Phone: 866-452-5017
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 emailed about overdue
reminders, go to Your preferences at the top of the screen and select Yes to “Do you want to be
emailed 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
Site: http://www.covermymeds.com • Email: [email protected] • Phone: 866-452-5017
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 emailed 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 email is sent to all users with access to the request. For Approved or Denied request, the shared user(s)
receives an email notifying them of the determination. For Not sent to plan or Don’t know outcome
requests, the user(s) receives an email 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.
Site: http://www.covermymeds.com • Email: [email protected] • Phone: 866-452-5017
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 email notification when this is complete.
At any time, click the house in the upper left corner to return to your Dashboard.
Site: http://www.covermymeds.com • Email: [email protected] • Phone: 866-452-5017
12 • CoverMyMeds • User’s Guide
Passwords
If you’ve forgotten your password:
1.
2.
3.
Go to http://www.covermymeds.com and click on Trouble logging in? CLICK HERE.
Enter your email address and click Recover.
Check the email address associated with your CoverMyMeds account and follow the link to
reset your password.
If you’d like to change your password:
1.
2.
3.
4.
Log in to your CoverMyMeds
account
and
click
Your
preferences.
Scroll
down
to
Account
management.
Enter your current password, the
new password, and confirm it.
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 email or recommend one of the following:
1. Go to www.covermymeds.com and Create an account.
2. Call us at 866-452-5017.
3. Email us at [email protected].
Site: http://www.covermymeds.com • Email: [email protected] • Phone: 866-452-5017