First Script integrates pharmacy UR determinations and referrals eliminating the burden on claims examiners to review, interpret, or manually input UR prior authorizations. A notification indicating whether UR is recommended or required is generated for medications meeting certain formulary or jurisdictional criteria as they attempt to process. Received pharmacy UR decisions are applied at the point-of-authorization to ensure our adjudication platform contains the information needed to process the prescription as intended and adequately captures the UR prior authorization record.
How pharmacy UR integration works
Find out more about how our online interface provides visibility into pharmacy UR determinations and streamlines the referral process to improve the user experience.