How do I find the correct form?
Click “new prior authorization request” and enter the search information. ApproveRx reviews our library of thousands of forms for you and returns to you the form you need.

How can I be sure that the right form is returned to me?
Prior authorization forms can change from time to time. ApproveRx conducts ongoing reviews of all forms to help ensure our system provides you with the most up-to-date forms for each plan.

What should I do if I cannot locate the form I need?
ApproveRx contains thousands of prior authorization forms from health insurance and prescription benefit companies (PBMs) across the U.S., so it is unlikely that you won’t find the form you need. However, if this does happen, simply click the “Don't see the form you need?” link and complete the inquiry fields. ApproveRx will notify you by e-mail when we have uploaded the form to the system.

What parts of the forms should I complete?
You should try to complete as much of each form as possible in order to expedite the approval process, but there are several fields that must be completed in order to process the authorization request. Required fields include the patient’s first and last name, and the physician’s name and zip code.

Can I save or archive a form so that I may complete it later?
Click the “Save and complete later” button. To finish filling out the form, go to the “Open Prior Authorizations” link. After you submit the form, a copy will automatically be saved and available for you to view later under the “Submitted Prior Authorizations” section.

How do I view a submitted form?
Simply go to the "Submitted Prior Authorizations" link to view all submitted requests.

Why should I use ApproveRx?
ApproveRx is designed to help pharmacies and healthcare professionals find and submit prior authorization approval forms quickly and efficiently. ApproveRx can help streamline the prior authorization process and improve patient care. The site also allows you to manage and view the prior authorization requests you submitted. In addition, you can cut down on paper faxes with the ApproveRx e-fax capability.

Who runs the ApproveRx website?
ApproveRx is managed by Asembia Technology, LLC, which provides specialty pharmaceutical contracts, programs and information management services for national, regional, and local pharmacy providers. Asembia, its member pharmacies and Pharma/Biotech partners are leading the way in continuing to define the specialty pharmacy channel.

What should I do if I forgot my password?
Simply click on the "Forgot Password" link in the login box. Follow the password retrieval process.

Why should I use the “address book” feature?
The address book feature allows you to pre-populate certain information to make completing the prior authorization form faster and easier.

What is the “notes” function and why should I use it?
The notes functionality can help you manage your prior authorization requests. Each time a prior authorization request is submitted, a “note” is logged with the date and time the request is submitted to the party.

Does ApproveRx fax my prior authorization request for me? Yes, ApproveRx faxes your request using our secure fax server. All you need to do is click on the “fax form” button and complete the fax details page.

What will the fax recipient receive when I fax a request to them? The recipient will receive a fax cover page with the information you specified and the prior authorization request. You may choose to attach PDF’s or documentation and in that case that will be received, as well.

How do I know that the fax I sent went through? You will receive an email indicating that your fax was sent. Additionally, a “fax sent” message will also appear in your submitted prior authorizations under the Status.

How does the recipient of the fax know who to respond to? The fax details page allows you to customize this information and input your fax # which the recipient should use when responding.

How long does a fax take to go through, using ApproveRx? The ApproveRx fax server is similar to other fax services. The fax will be submitted as soon as you click the submit button. From that time, the fax should be submitted within a minute or two.

How do I know what insurance plan my patient has?
The pharmacy commonly has the PBM name, plan name, BIN, and PCN. The plan name is typically located on the patient's insurance card. Enter the drug name and any combination of the BIN, PCN, or plan name to return the appropriate prior authorization form.

What if a patient has more than one insurance plan?
You can only submit a prior authorization to one insurance plan at a time. You should submit the prior authorization request to the patient's primary insurance plan.

Will I be notified of the plan's decision (if the prior authorization was approved or denied)?
The health plan typically contacts the prescriber (via phone or fax) within 3 days. It is up to the prescriber to call the pharmacy and communicate the decision. If you are a pharmacy, you should follow up with the prescriber within 3 days from when the request was submitted.

What should I do if I do not receive a response from the health plan?
To increase health plan response times, be sure to call the health plan to let it know that you submitted a request for an approval via fax.

What should I do if I receive a denial from the health plan?
You are able to appeal the health plan's decision. Typically, the health plan will communicate the appeal process in their denial letter.  Most often, the prescriber must write a letter to the plan in order to appeal the decision.

Does ApproveRx help with the appeals process?
ApproveRx provides standard letter templates that you can easily customize to initiate the appeals process with a health plan or PBM. Typically, each plan requests that the prescriber write a letter and provide documentation regarding why the patient needs the medication. The appeals letters can be accessed by clicking on the Appeal Letters tab within the navigation on the left side of your page when you log in.

What is the FAX CODE feature?
ApproveRx’s unique FAX CODE feature helps streamline communication between pharmacies and their physician partners, resulting in expedited prior authorization approvals. When a pharmacy submits a request to a prescriber using ApproveRx, a unique code is automatically generated and included on the fax cover page. Prescribers can enter the FAX CODE in ApproveRx to complete and sign the pre-populated PA form sent by the pharmacy. In addition, when prescribers update the status of a PA in ApproveRx, the pharmacy is automatically notified of an approval or denial.

How do I know that the patient information I enter is kept secure?
By using the website, you agree to permit the information you submit to be shared with other health care professionals and payors to determine coverage.

Does ApproveRx share my patient data?
ApproveRx does not share or sell patient data. ApproveRx can be used within HIPAA compliant systems to ensure patient confidentiality.

Does ApproveRx offer medical advice?
ApproveRx does not offer medical advice or act as a physician in any way. The content of ApproveRx should not be used during a medical emergency or to diagnose or treat a patient. ApproveRx does not take the place of patient examinations or counseling. ApproveRx does not endorse certain products, pharmacies or physicians.

Is faxing prior authorization requests through ApproveRx HIPAA compliant? Yes, ApproveRx uses its own fax servers. We do not use a third party fax server so our process is fully HIPAA compliant.