How can you ensure that your patients receive the best medication for their conditions?
In the current managed care environment, an increasing number of prescriptions are being denied by plans, requiring prescribers to complete prior authorizations. This process is highly disruptive, time consuming, and often leads to a denial without any relevant clinical review.
Plans are making PA forms more complex and are changing them frequently. When a call to a plan is required, it is common for a prescriber or their staff to spend several minutes on hold before ever speaking with anyone at the plan. Nurses, practice managers, or other staff who are charged with completing and submitting PA forms find the process to be confusing, time consuming, and frustrating.
PRESCRIBER PA PROBLEMS
4.6 hrs
A CVS/Caremark study indicated that physician offices spend an average of 4.6 hours per week on prescription prior authorization.
70%
A study by Trivium Health, Inc. showed that 70 percent of denied PAs were rejected for administrative reasons such as incomplete or inaccurate information. These PAs were denied without having received any clinical review.
94%
More than 94 percent of Medical Group Practice Managers believe that the PA process is time consuming and confusing.
THE PARx PASS SOLUTION
The PARx Prior Authorization Support System (‘PASS’) is free to prescribers, helps them manage the PA process accurately and efficiently, and results in higher approval rates and less time spent on administrative hassles. Our PASS system incorporates a secure, “easy to use” web portal, with a call center staffed with healthcare professionals and reimbursement specialists to interact with managed care plans on your behalf, supporting all of your PA needs.
Ease of Use
User-friendly, HIPAA compliant portal to initiate and manage PA request incorporates pre-populated fields and “drop-down” menus
Universal PA Forms
Standardized form layout for all products and plans eliminates confusion
Commitment to Quality
100% of PA forms are reviewed to ensure accuracy and completeness
Call Center Support
Staff of pharmacy technicians, nurses, medical assistants, and reimbursement professionals available to provide assistance, and spend time interacting with plans so physician doesn’t have to
Timely Resolution
Follow up calls are made to plans if no resolution within 72 hours post PA submission
Process Transparency
Prescribers can check the status of PAs in our PASS portal at any time
FREQUENTLY ASKED QUESTIONS
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What is PASS?
The PARx Prior Authorization Support System (PASS) improves and simplifies the PA process for prescribers and staff.
- Password protected, web-based system is HIPAA compliant, ensuring privacy and security
- User-friendly across all health plans – no more hunting for forms
- Call Center support for accurate and complete PA submissions
- Rapid submission and real time reporting
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How do I register?
Registering is easy and takes only 5-10 minutes to complete. Click the “Register” button on this web site, which will take you to the Registration page. Entering the prescriber NPI will auto-populate many fields. Fill in the contact information, and then sign the Business Associate Agreement electronically; or print, sign, and fax it to PARx Solutions at (866) 725-7063.
If you sign the BAA electronically, you may begin submitting PAs right away. Faxed BAAs may take up to 24 hours for processing. PARx will communicate to you via email and a phone call that your account is active, and you can begin submitting PAs.
PARx processes each new account as quickly as possible, typically within 24 hours. Once the account is operational, PARx will communicate to you via email and a phone call that your account is active, and you can begin submitting PAs.
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How much does the PASS service cost?
The PA services are provided at no cost to prescribers.
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Can I register more than one provider under my account?
Yes. You only need to register one provider to create your account initially, and then you can add more providers at any time under your “My Account” settings. Each new provider must sign a BAA before you can submit PAs for that provider.
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What is a Business Associate Agreement, and why is it needed?
The Business Associate Agreement (BAA) confirms that all PARx services comply with HIPAA and HITECH regulations, thereby protecting both the patient and the prescriber. A BAA allows PARx to provide PA services for the prescriber, while it also assures that confidential patient health information is securely protected.
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How long does it take to complete the PA request form using PASS?
For most PA requests, it will take only a few minutes to enter the appropriate information, review the form for accuracy, and submit it to PARx.
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Can PASS be used for all health plans?
PASS can be used for virtually all health plans including commercial insurers, Medicare, Managed Medicare, Managed Medicaid, and (in most states) Medicaid. The only exceptions are for “unmanaged” Medicaid plans in California, Washington, and Wisconsin (where the PA request needs to be submitted by the dispensing pharmacy).
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What is the typical processing time for a PA request?
Most Prior Authorization requests are reviewed by PARx and submitted to the health plan within a few hours. In the majority of cases, a decision is received from the plan within 48 hours, but the process can take longer in some cases. As soon as PARx receives a decision from the health plan, that information is faxed to the prescriber’s office and the status page in the PASS portal is updated.
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How can a prescriber track the status of a Prior Authorization request?
Prescribers can track the status of a PA request by logging into their PASS account, or by calling PARx directly at 866-725-7279 (between 8AM to 8PM ET Monday through Friday).
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When can Prior Authorization requests be submitted?
The PASS system is on line 24 hours a day, seven days a week. Our healthcare professionals and reiumbursement specialists are available between 8AM to 8PM ET on weekdays to review and submit Prior Authorization requests to the health plans.
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How can PARx Solutions be contacted if there is a question about a submission or PA status?
PARx can be reached by calling 866-725-7279, or by emailing support@parxsolutions.com.
TESTIMONIALS
I am so happy I heard about your company! So easy and fast. I will let my local vision source group know about your company in our next meeting. Thanks!
PARx makes a world of difference – I love the system. I do not have to sit on the phone any longer. The site is user-friendly. I like how most of the information pre-populates. It definitely has opened up a lot of options and at the end of the day, it is helping the patient.
You’re GREAT! Thank you so much for helping us with this Managed Medicaid situation, because they are so hard to deal with. You have made our lives so much easier.
I wanted to say Thank You for helping get a patient’s diabetes medication approved. I had tried several times and whatever magic you worked, worked!
I really like your service. I do not have to worry about the PA request once I send it over to you. Thank you so much and I really appreciate your help.
You are a God send, thank you so much for putting up with the insurance companies, so we don’t have to.
Please give everyone that works there a big hug and say thank you! You are amazing and I am so glad that I do not have to process these PAs by myself. You provide a tremendous service.
I love PARx! I log in, type a bit of info and I know it is taken care of. It is so fast and easy.
I just love this program, you are all so amazing. I just love this service.