Introducing the Prior Authorization Navigator Subscription!Icons_ePrescribing-Prior-Auth_Iso

Point-of-Care Partners’ Prior Authorization Navigator is a succinct yet comprehensive subscription-based analysis of state and federal rules, statutes and standards governing prior authorization for prescription and medical benefit. It enables healthcare stakeholders to readily understand the varied approaches that states are taking to address the inefficiency of today’s paper/phone/fax prior authorization (PA) processes, which may include requiring timely responses to PA requests, standardizing PA forms and mandating electronic prior authorization (ePA).

In many states, laws and rules are formed by an overlapping web of government entities including insurance commissions as well as pharmacy boards. The Prior Authorization Navigator is a central source for stakeholders to understand the current environment of and future changes in the PA ecosystem.

We do the time-consuming research to deliver analysis in an easy-to-read, summarized data set for busy software product managers.

Up-To-Date Regulatory Intelligence

  • Which states require electronic submission of PAs or will require it (and when)?
  • How can the PA information be transmitted?
  • Which states have standardized their prior authorization forms? Do their rules require expert interpretation?

Attain peace of mind with comprehensive research of state-by-state rules, regulations and laws, both adopted and proposed, on prior authorization.

Who is this Meant for?

  • Payers
  • Pharmacy Benefit Managers (PBMs)
  • Health technology vendors (like EHRs)
  • Life Sciences/Pharmaceutical Manufacturers

What does the Prior Authorization Navigator cover?

Fully updated quarterly with intermittent alerts for urgent changes, the Navigator presents PA regulations for the 50 states and Washington, D.C.

  • Status of pending and active legislative initiatives with citations, summarized by feature and by individual state
  • Status of proposed and adopted rules with citations
  • Links to prior authorization forms and format requirements
  • Quarterly updates as a navigable database
  • One-click access to full text of state and federal legislation, rules and standards

How do I access the Prior Authorization Navigator?

Prior Authorization Navigator is available in an easy-to-use portal and includes:

      • A 50-state grid
      • Training & onboarding for new subscribers
      • Quarterly updates
      • Executive summary of changes each quarter
      • Access to POCP subject matter experts for content-related questions and clarifications

User-Friendly Online Platform

By subscribing, you will have access to all the state-by-state data via a user-friendly online platform, Below are some sample of the valuable information and resources available to you, including full reference citations, ensuring you have the most accurate and up-to-date data at your fingertips to make informed decisions about strategic opportunities, develop product roadmaps, and stay ahead of the curve in an evolving healthcare environment.

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Save time by using curated policy intelligence, allowing your team to focus on your core mission

Drive operational and clinical efficiencies within your organization.

 

Enhance the policy integrity of your solution.

 

Exceed client expectations by staying ahead of policy changes.

 

Identify opportunities for strategic shifts or policy influence

 

Solution Examples

Homepage PA Reports
Prior Authorization Reports (from Homepage)
PA Medical Active Summary Report
Prior Authorization Medical Active Summary Report
PA Prescription Active Summary Report
Prior Authorization Prescription Active Summary Report
PA Proposed Medical Summary Report
Prior Authorization Proposed Medical Summary Report
Prior Auth Grid (Expanded)
Prior Auth Grid (Expanded)
PA Proposed Prescription Summary Report
Prior Authorization Proposed Prescription Summary Report