A Formulary is a list of prescription drugs covered by a health insurance plan and information on their tier or cost-sharing level. Prior authorization may be required for medications not on the formulary.
How to Prepare Your Prior Authorization Workflows for CMS-0057-F and Beyond
Our practical checklist and workflow mapping guide helps patient access leaders assess and organize their prior authorization processes before CMS-0057-F’s FHIR-based API requirements take effect in 2027.
