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Patient care comes first
Navigating the world of medicine is something we specialize in.
Our Approach
If you are a provider of patient care and receive prior authorization requests from your patients' insurance, we're interested in partnering with you! One of our primary goals is for patients to receive care in a timely manner, and the existing PA processes often do not allow that. Offices that partner with us have access to the PFRx portal as well as the support staff that comes along with.
About PFRx
Founded by a licensed pharmacist enamored with providing quality patient care and a data engineer disenchanted by the current state of healthcare, PFRx is a platform striving to help streamline the process for physicians and patients struggling to navigate their PAs.
1.
Prior Authorization Request
Most physicians and patients alike have had a prescription unable to be filled initially due to a prior authorization (PA), or when the insurance requires more information before they will cover the medication.
2.
PA Submitted to PFRx
Our contracted offices have access to the PFRx portal, where the information from the insurance as well as patient charts are able to be securely uploaded.
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3.
PFRx Completes and Submits PA
Upon receipt of all pertinent patient data, the pharmacist will review the specific plan's PA request form and proceed with providing the rationale requested by the plan.
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4.
Follow-through Care
If any additional information is requested by the insurance to justify the treatment choice, we will assist with the peer-to-peer and the ilk too.
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Overview of Process
To put it simply, once the prescriber receives the PA request, they upload all important patient documents to the portal and PFRx will begin the process from there. Once we have all documents, the pharmacist will review the medication, its intended use in the patient and if it is in line with evidence-based medicine, and if appropriate, they will then craft the PA form with all appropriate rationale detailed. This will be provided to the office or directly to the payor, depending on the office preference, with our staff an email away if any further assistance is needed - because let's be real, peer-to-peer reviews also exist!
1.
PA Request Uploaded
2.
Patient Docs Uploaded
3.
RPh Reviews Request
4.
RPh Completes PA Request
5.
PA Request Submitted to Payor
