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Key Points

• EHR鈥慹mbedded medication access platform: CoverMyMeds introduced expanded Specialty Access and Affordability Solutions that operate directly within the EHR, allowing care teams to manage tasks without switching systems.
• Unified prior authorization and benefits workflows: The solutions bring together medical and pharmacy prior authorization, benefits investigation and patient services enrollment into a single, automated workflow.
• Built to align with existing clinical workflows: The solutions were developed with specialty clinician and health system input.
• Automation designed to reduce administrative workloads: Real鈥憈ime health plan and PBM rules, automated data use and streamlined processes help reduce manual work and support faster therapy initiation.
• Initial focus on high鈥慶omplexity specialties: The phased rollout begins with oncology and ophthalmology, with broader availability planned for additional therapeutic areas in 2026.

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At CoverMyMeds, a belief in a more connected, clinician-friendly future is driving new, expanded Specialty Access and Affordability Solutions. Built to accelerate access from the moment a therapy is ordered, includes medical prior authorization — uniting benefits investigation, pharmacy prior authorization and patient services enrollment in a single, fully integrated, EHR-embedded experience.

An EHR鈥慐mbedded Platform That Unifies Access, Authorization and Patient Services

“We built the new solutions for specialty providers and care teams with a clear goal in mind: to remove barriers, not create new ones,” said Miranda Delatore, vice president of Product, CoverMyMeds. “Instead of adding steps, we designed the platform to consolidate the most important access activities into a single digital experience that lives directly within the existing EHR.”

Medical & Pharmacy Prior Authorization Automation

• Instantly identifies health plan and PBM rules and requirements to eliminate manual research
• Automates repetitive administrative tasks that delay authorization timelines
• Utilizes EHR data, health plan information and PBM requirements to support complex cases
• Provides real-time insights to improve scheduling and resource planning
• Reduces care coordinator workload and supports a more efficient process across health plans and PBMs

Integrated Benefits Investigation

• Automates medical benefits verification and investigation
• Surfaces payer-specific coverage details and requirements in real time
• Helps care teams understand what’s needed earlier in the workflow

Integrated Patient Services Enrollment

• Streamlines enrollment for specialty therapies within a single workflow
• Eliminates the need to navigate multiple portals or re鈥慹nter information
• Simplifies access to financial assistance and patient support programs

EHR-Embedded, End-to-end Workflow

• Allows clinicians to complete access tasks without toggling between systems, truly meeting them where they are
• Can be initiated when a therapy is ordered
• Creates consistent, predictable workflows across therapeutic areas and payer types
• Provides visibility into status throughout the process

All supported by a modern underlying architecture built for rapid EHR integration, enabling health systems to scale the platform across departments while aligning clinical and operational needs.

Built with Clinicians to Deliver Immediate Value Inside the EHR

This new offering was built with direct input from the specialty care teams closest to access work (those coordinating benefits, navigating health plan and PBM requirements, managing authorizations and ensuring patients don’t fall through the cracks) alongside health system leaders responsible for operational efficiency and sustainable use of resources.

Today’s decision鈥憁akers face several competing priorities. They must reduce administrative tasks, protect clinician wellbeing, maintain throughput and maximize reimbursement to meet financial targets, all while avoiding disruption to existing systems.

We intentionally designed these offerings to meet these expectations. It fits directly into existing EHR workflows, allowing clinicians to complete tasks in a familiar environment. It reduces repetitive work rather than adding to it. And early implementations have already shown promising improvements in efficiency and speed to therapy initiation.

Phased Rollout Starting with High鈥慍omplexity Specialties

The expanded Specialty Access and Affordability Solutions will focus on oncology and ophthalmology, where the need for speed and simplification is especially critical. These specialties face some of the highest administrative complexities, and delays in access can increase administrative work and create uncertainty for patients and care teams.

The solutions already being deployed across select use cases, with broader availability planned for late 2026 and additional therapeutic areas rolling out on an ongoing basis. As we continue to expand capabilities, we remain focused on collaborating with health systems early – so together we can shape a scalable, integrated solution that delivers meaningful clinical and operational impact from day one.

Launching a Unified Expanded Access and Affordability Platform

The launch of CoverMyMeds’ expanded Specialty Access and Affordability Solutions marks an important shift — from fragmented tools to a unified, automated access experience.

“For us, it represents a platform built to strengthen clinical relationships and help stakeholders across the health care community deliver better support programs through real-time insights,” Delatore said. “Most importantly, it helps ensure patients begin therapy faster and with fewer obstacles.”

^[1] Source: CoverMyMeds Specialty Access and Affordability Solutions, data on file. 2024.