TELUS Health, Canada Life and Innomar Strategies Pilot The First Electronic Prior Authorization Solution In Canada

TELUS Health, Canada’s largest health IT company; along with Canada Life, a leading insurance, wealth management, and benefits provider; and Innomar Strategies, a leading patient support service provider; together announced the launch of Canada’s first electronic drug prior authorization (ePA) solution. In a pilot program that will assess the value and potential benefits for users, the companies will test the digitized process to fulfill prior authorization submissions for real prescription cases and evaluate its impact on process efficiency, consistency of adjudication results and the overall plan sponsor and member experience.

How it works

Prior authorization is applied to certain prescription medications to determine if a benefits plan member is approved to receive coverage for that specific drug. Digital ePA solutions, which are available in other countries, help to unlock system efficiencies and productivity gains, resulting in decreased time spent fulfilling prior authorization submissions. With submissions in Canada expected to grow due to the increased utilization of specialty medicines, and even more coming to market, the TELUS Health ePA solution is set to make a significant impact across the country’s health benefits industry.

With the new TELUS Health ePA solution, physicians and patient support program staff can easily initiate the prior authorization process through a web portal, allowing them to complete all necessary forms, secure electronic signatures and deliver digital outputs directly to insurance providers and payors. This ensures complete information is submitted for processing and helps prevent delays as well as substantial back and forth between stakeholders.

The ePA solution supports:

  • Benefits plan sponsors and members by providing a more efficient and expedited prior authorization process, ensuring more timely access to medications and offering a simpler overall benefits experience;
  • Physicians and their staff, by reducing time spent managing forms, as well as delays in treatment, allowing more time to be spent with patients;
  • Insurance providers and payors, by making the adjudication process faster and more efficient, all while producing consistent results that lead to fewer inquiries to call centres and delivering a better experience for plan sponsors and their members; and
  • Patient support program providers, by streamlining processes which have the potential to increase efficiency of workflows and provide access to reported trends and metrics, improving the customer experience.

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