Are you a plan sponsor or advisor? Do your plan members have claims for specialty drugs?
If so, it’s likely that plan members have questions regarding the prior authorization process, a process common for the reimbursement of specialty drugs. The complexities of the prior authorization process can be difficult to navigate for both plan sponsors/advisors, and plan members as insurers requirements, forms, and submission processes may vary.
The Simplify Prior Authorization website was developed to provide information for plan sponsors and advisors, and other stakeholders on private payer prior authorization in a context that would be relevant to their experience.
The I am a Plan Sponsor tab includes four sections:
As well as the website content, a PDF is available for each of the I am a Plan Sponsor or Advisor sections. The Simplify Prior Authorization website and PDFs meet accessibility standards. The website and most content is available in English and French.
Plan sponsors and advisors can also find additional sources of assistance under the Resources tab of this site, that may be useful to direct plan members to.
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 info@simplifypriorauth.ca.
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.
Since 2020, the conversation around improving the prior authorization process and experience has been gaining traction in Canada. However, there has been much more than discussion in the U.S. Learn what Canadian stakeholders can take away from American developments.
Are you a physician, pharmacist, or other prescriber that has patients with a prescription for specialty medications? If you are, it’s likely that your patients have a prescription for a therapy or medication that requires prior authorization, and they probably have questions about it.
Do you represent a patient support/assistance program (PSP/PAP)? If you do, it’s likely that the patients you help have a prescription for a therapy or medication that requires prior authorization, and they probably have questions about it.
The Simplify Prior Authorization initiative is an advocate for education about prior authorization (PA) and improvement in current prior authorization practices and processes. If your organization is interested in finding out more, getting involved, or in sponsorship of this important initiative, please contact us via the link below.
