Free Market Health is a new innovative specialty pharmacy model that aligns resources, risk, and accountabilities for pharmacy referrals and reimbursement. Our partnership with Free Market Health will allow all in-network specialty pharmacy providers to service member’s needs from both a drug cost and patient care service perspective.
The Free Market Health program is divided up into the following components:
- Real Time Authorization (RTA)
*List of drugs included in the FMH program
REAL TIME AUTHORIZATION
The RTA component is the intake gateway providers will use to initiate the FMH process. RTA will help shorten the time it takes for drug authorizations and referrals to go through, reducing member wait times from days/weeks to hours.
Providers billing under the medical benefit for drugs on the FMH drug list can use the RTA platform either directly through the RTA platform provided to them or via a link through NaviNet®.
- Sign in to NaviNet
- Hover over Authorization Submission
- Select Free Market Health
- Log into Free Market Health
Instead of having an exclusive arrangement with one pharmacy, the FMH platform uses a marketplace where contracted specialty pharmacies will be able to bid on authorizations. This allows dynamic pricing on specialty pharmacy drugs and provides the best pricing for high-cost specialty drugs in real-time. Any specialty pharmacy that is contracted with FMH can bid on a member’s authorization. This may result in different pharmacies outside of who you typically use reaching out to you for prescriptions.
If you are interested in the Free Market Health platform and do not have access to it or have questions or issues when using the platform, contact Free Market Health at firstname.lastname@example.org.
Your request will be processed Monday – Friday 9am – 6pm EST.
Last updated on 12/1/2021