Priority Health - Prior Authorization Option for Pharmacy

September 2, 2020

You now have the option to submit pharmacy prior authorizations for Priority Health members electronically.


Save time and get faster pharmacy decisions

We know you spend substantial time on prior authorizations and that it’s a common pain-point for many practices. That’s why we’ve partnered with Surescripts to implement an electronic prior authorization (ePA) solution for Rx drugs that will eliminate the need for time-consuming paper forms, faxes and phone calls, and allow us to return faster decisions to you.

You won’t be required to submit prior authorizations electronically. We’ll continue to process pharmacy prior authorizations submitted via paper fax or by phone.


What are the benefits?

ePA streamlines the prior authorization process for both you and Priority Health. As a provider, you can save time and increase efficiency, as well as reduce administrative costs associated with faxing (or calling-in) prior authorizations. In addition to submitting requests electronically you can also check on request status without having to call us. It also helps our pharmacy team streamline coverage decisions, so your requests can be completed faster. In turn, this creates a positive patient/member experience that can increase medication adherence and improve outcomes.


How does it work?

There are two solutions for using ePA:

  • Prior Authorization Portal – (Coming mid-September)  You can use this option if your EHR doesn’t have Surescripts Prior Authorization enabled. Using the portal, you can respond to prior authorizations requests or process requests prospectively. Within the portal, you’ll be able to complete question sets and route them to Priority Health for approval. Learn more about how the Surescripts Prior Authorization portal works.