paPAyaRx provides health plans and PBMs with tech solutions to control and refine their ePA strategy to achieve results. With paPAyaRx, you can keep your existing ePA strategy and operations, and we work behind the scene. We innovate with No New Screens, and no changes for your operations teams except less inbound work.
Let's start creating a better member experience together!
paPAyaRx: Making PA Papercuts Disappear
paPAyaRx streamlines pharmacy–payer interactions by eliminating delays, manual work, and guesswork.
We offer automated administration of the Gold Card framework and pre-approved prior authorizations (paPA✦).
Built on existing NCPDP data standards, paPAyaRx works invisibly in the background, so your team doesn't learn a new process or look at a new screen.
Most importantly, paPAyaRx realigns the interests of patients, medical staff, pharmacies and health plans into a win-win-win-win.
No New Workflows
Clinicians keep their existing systems and processes, with nothing new to learn.
No New Portals
paPAyaRxâ„¢ integrates with the tools your team already uses every day.
No Additional Data Entry
Existing information flows are used to process authorizations automatically.
No Interruptions to Care
Providers stay focused on patients while administrative tasks run silently in the background.
Why paPAyaRxâ„¢ Stands Out
Built by PBM Experts
Decades of experience in PBM, pharmacy operations, clinical pharmacy, and real-world patient needs.
Designed for All Stakeholders
Less burden for providers and pharmacists, while supporting payers' need to manage formularies. True alignment.
Reliable and Efficient
Innovative yet practical, grounded in real-world pharmacy workflows and tested operational scenarios.
Potential Impact
paPAyaRx is in its early days; as clients realize results, we will develop new metrics and case studies. We expect health plans and PBMs will see improved member satisfaction, lower trend and lower cost of operations for ePA. For pharmacies, we expect a higher fill rate, lower abandonment and greater patient satisfaction. Medical office staff should see less administrative work. Patients will get their treatments faster and with less hassle.
The result is faster access to care, fewer administrative delays, and dramatically better experiences for everyone involved—patients, providers, pharmacists, and payers.
Seamless Solutions for Prior Authorization