ARE PRIOR AUTHORIZATIONS GIVING YOU A HEADACHE AND COSTING YOU TIME AND MONEY?

 

WE CAN RECOVER APPROXIMATELY 40% OF YOUR DENIED CLAIMS!

 

WE CAN REDUCE YOUR PRIOR AUTHORIZATIONS FROM MANY HOURS TO ONLY 1 MINUTE, SAVING YOU $80.00 per PA, ON AVERAGE! AMA

 

Health plans, employers and government-sponsored health care programs are focusing their attention on optimizing patient outcomes with medications that have established evidence of efficacy and safety, while providing the highest value. Implementation of a well-designed, evidence-based prior authorization program optimizes patient outcomes by ensuring that patients receive the most appropriate medications while reducing waste, error and unnecessary prescription drug use and cost. PRIOR AUTHORIZATION SOFTWARE (PA) is an essential tool that QCP uses to ensure that drug benefits are administered as designed and that plan members receive the medication therapy that is safe, effective for their condition, and provides the greatest value.

QCP

Prior authorization requires the prescriber to receive pre-approval for prescribing a particular drug in order for that medication to qualify for coverage under the terms of the pharmacy benefit plan. Guidelines and administrative policies for prior authorization are developed by pharmacists and other qualified health professionals.  Each managed care organization develops guidelines and coverage criteria that are most appropriate for their specific patient population and makes its own decisions about how they are implemented and used. Well-designed prior authorization programs consider the workflow impact on health care system users and minimize inconvenience for patients and providers.

Prior authorization can be used for medications that have a high potential for misuse or inappropriate use. For some categories, health plans may limit the coverage of drugs to FDA approved uses and require a prior authorization for off-label indications. An example of an off label use could be a physician prescribing a powerful opiate that has only been approved by the FDA to treat breakthrough cancer pain, in a patient that has chronic back pain. In this case, there is insufficient clinical evidence supporting the use of the medication for non-cancer purposes and prescribing such a medication could pose a serious safety risk for the patient. Prior authorization would be used to limit coverage in this situation to those patients where safety and appropriate use has been documented.

QCP Response From CEO Mike Holmes To COVID-19

March 17, 2020

Greetings,

We have a unique responsibility to support our customers and their patients during this public healthcare crisis.

With a critical role supplying the pharmaceuticals urgently needed to respond to coronavirus, as well as to our pharmacies and clinics who dispense acute and chronic medications that their patients also need, QCP has held multiple meetings over the last few weeks to ensure that our customers needs are met in a safe and timely manner, and that our Employees stay safe and healthy.

No slowdown in service has occurred, and none is expected.

QCP’s office workers began working remotely from home last week and will continue to do so until the threat subsides. Workers at our healthcare repackaging, distribution and CSR center continue to report to work.

Thankfully, no employees have been diagnosed with COVID-19, the respiratory disease caused by the novel strain of the virus, and in fact only 1person has been diagnosed in all of Lucas County, at the time of this writing.

QCP has enacted a pre-established plan for responding to a pandemic based on guidelines passed down to us through our lobbying group, Healthcare Distributors Association, from the Centers for Disease Control and Prevention, and the U.S. Department of Health and Human Services, who view the role of QCP and other pharmaceutical Wholesalers as critical to the health and well-being of all Americans.

QCP’s goal has always been to maintain a 3-month supply of over 90% of its’ fast-moving pre-packaged medications. Still, in light of the pandemic, we have increased our supplies of multiple medications and, while we’ve experienced a slight increase in orders as some customers expect that supply chains could be interrupted, we’ve been able to maintain our inventory levels. To date, QCP has experienced zero issues, and the FDA said only 1 medication is in short-supply due to COVID 19. While the possibility of supply disruptions in the future exists, we are communicating with suppliers and customers, and will exhaust all efforts to mitigate any issues that may occur.