RxResults monitors the use of certain medications to ensure members receive appropriate and cost-effective drug therapies with the best possible therapeutic outcomes. These medications may require prior authorization or step therapy. Prior authorization means certain clinical criteria must be met for the drug to be covered for the patient or member. Step therapy requires members to try and fail first-line therapies before coverage approval for certain medications. If first-line therapies have not been met, the medication will require a prior authorization.
The criteria for prior authorization and step therapy are based on current non-biased clinical peer-reviewed literature and the related recommendations of the Evidence Based Prescription Drug Program (EBRx) within the College of Pharmacy at the University of Arkansas for Medical Sciences (UAMS). The EBRx Pharmacy and Therapeutics (P&T) Committee members are physicians, pharmacists, and other healthcare professionals.
Click here for RxResults' criteria for prior authorization and step therapy
RxResults uses CoverMyMeds (CMM) for ePA. Using ePA can:
- Eliminate wait time on the phone or the need to use manual fax forms
- Reduce disruptions to care
- Allow renewals to be created from a previous request
- Reduce paperwork
- Provide secure transmission of protected health information using the National Council for Prescription Drug Programs (NCPDPD) SCRIPT standard
Submit an ePA using CMM: CoverMyMeds Log In
BIN: 025276
Group: RxR
Plan or PBM name: RxResults
ePA portal support: CoverMyMeds Support
If you have any questions or encounter issues with ePA you can contact RxResults Prescription Services at 1-844-853-9400, Monday through Friday, 7:00 am – 7:00 pm CST