A female patient enjoying access to online resources on her laptop
A female patient enjoying access to online resources on her laptop

The First Prior Authorization Resource for Patients

Do you or your clients have specialty drug claims on group benefit plans? If so, you need to read this blog and find out about the new patient information and resources website.

Patients are the hardest hit by complexities in the claims process for specialty drugs that require prior authorization by payers, whether private or public. Although prior authorization results in an administrative burden on physicians, their staff, patient support plans and payers, patients may struggle with navigating access to healthcare and medication through processes that may be new to them, while coping with the everyday challenges of their disease.

The Simplify Prior Authorization website was developed to provide information for patients and other stakeholders on private payer prior authorization in a context that would be relevant to their experience.

The I am a Patient tab includes five sections:

  1. Group Benefits Basics and Your Coverage for Prescription Drugs
  2. When Is a Prescription Drug a Specialty Drug
  3. Why Do I Need Prior Authorization to Fill My Prescription
  4. The Prior Authorization Claims Process and You
  5. My Claim Has Been Declined by My Insurer – What Should I Do Now?

As well as the website content, a PDF and a brief video is available for each of the I am a Patient sections. The Simplify Prior Authorization website and PDFs meet accessibility standards. The website and most content is available in English and French.

Patients can also find additional sources of assistance under the Resources tab of this site. More on this in our next blog.

For more information on prior authorization, other aspects of the Simplify Prior Authorization initiative, or how to get involved or support the website, contact Denise Balch at

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Our LinkedIn Page provides useful resources and information related to Prior Authorization with resources available for patients, benefits and healthcare stakeholders, follow our LinkedIn Page to stay up to date.

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