Faster Approvals to Promote Optimal Therapy for Customers

For many customers, waiting for prior authorization prescriptions to be approved can be an extra pain point in the health care process. The verification process may, in fact, delay the start of much needed therapy. However, this roadblock between customers and their prescriptions can often be avoided, thanks to advancements in data integration between Cigna’s medical and pharmacy benefits.  In the simplest terms: why ask a doctor to confirm – and make a customer wait for medical information we already have?

That's where Cigna's Rx Claim Connect program can help. It instantly verifies customer information and removes the need for a prior authorization for certain medications within seconds.¹ Built upon Cigna's fully integrated model, with medical and pharmacy linked together, the claims database is continually refreshed with customer data, enabling pharmacies to process the prescription at point of sale. This initiative helps facilitate timely approval of therapy for our customers while still providing the cost containment measure of utilization management. To date, over 52,000 customers a month have benefited from this capability.²

The program deals with the potential misuse of opioids by requiring prior authorizations which help to tightly manage risks associated with opioid use. Cigna Rx Claim Connect allows us to automatically approve coverage of therapy for people with critical illnesses like cancer and sickle cell, as well as for those who are in hospice.

Faster approvals and promoting optimal therapy helps close any gaps in care sooner, driving improved outcomes and reducing potential exacerbations and hospitalizations. Cigna Rx Claims Connect eases the overall health care experience, helping customers to start their medication right when they need it the most.  The service is available at no additional charge to our clients.

1. Administered on select drugs/drug classes.
2. Based on most recent results of program reported January 2018.