Today's insurers are sticklers for making sure medical providers don't prescribe costly medications or treatments that could be substituted by generics or lower cost alternatives.
The result is "prior authorization," a set of rules and procedures that can make for a complicated and paper-intensive process for doctors, pharmacists and other professionals who must deal with a large number of insurers and a large number of forms.
CoverMyMeds has set its sites on eliminating hard-copy paperwork related to prior authorization of pharmaceuticals. The year-old company, based in Twinsburg with operations in Columbus, rolled out its solution last April. Sam Rajan, one of the company's founders, says since then thousands of clients all over the country have embraced the new online procedure that reduces time on task by as much as 75 percent.
Until now, prior authorization has been "a very manual paper process," Rajan says. "Any time there's paper involved, the work flow is disrupted and work stops. There are a couple of studies out there that show patients -- a good number of them -- can go without therapy if these prior authorizations aren't completed. That's primarily due to the provider not knowing where to go to look for the proper forms, the rules and how to get the ball rolling."
CoverMyMeds allows a provider to go online, find the right form, share it with another healthcare professional, fill it out and e-fax it to the insurer -- all in under five minutes, compared the traditional 15 to 25 minutes.
The firm has caught the attention of JumpStart, which recently invested $250,000 in the company. The funds will be used for additional technology infrastructure and personnel as the company further develops its capabilities, Rajan says.
CoverMyMeds has 11 employees and expects near-term growth to push that number up by about 50 percent.
Source: Sam Rajan, CoverMyMeds
Writer: Gene Monteith