CoverMyMeds vs Surescripts vs Availity

What these three platforms actually are

All three sit somewhere between a prescriber and a health plan in the prior authorization chain. But each solves a different problem for a different customer, and that's the first thing worth untangling before comparing anything else.

• CoverMyMeds — a submission platform prescribers' offices use directly, filling in a form on-screen and sending it to the relevant payer or PBM.
• Surescripts — a network utility that EHR systems, pharmacy software and payer systems build on top of, so the transaction moves between two other pieces of software rather than through a site staff visit themselves.
• Availity — a multi-payer portal a provider's billing team logs into to handle authorizations, and other admin tasks, for many different health plans from one place.

The distinction that causes most of the confusion is portal versus network. A portal is a destination: you log in, complete a form, and get an answer on that same site. A network utility is closer to plumbing: it carries a transaction between two systems using a shared data standard, and most people relying on it never see its name on a screen. Surescripts sits firmly in that second category. CoverMyMeds and Availity are portals first, even though both also offer behind-the-scenes connections for software vendors whose staff never need to log into a website at all.

How the three compare

The table below sets out what's actually verifiable about each platform, rather than what their marketing pages imply. Where a company hasn't published a directly comparable figure, that's noted rather than filled in with a guess, because the three measure very different things: prescription volume covered, a single transaction's speed, and a whole network's total traffic aren't interchangeable ways of describing scale.

Who owns each platform, and why it matters

McKesson Corporation, one of the largest pharmaceutical distributors in the US, bought CoverMyMeds in 2017 for a reported $1.1 billion, and has run it as a wholly owned subsidiary ever since. That matters because McKesson has commercial interests elsewhere in the drug supply chain, even though CoverMyMeds itself doesn't set formulary rules; the payer or PBM on the other end of the request still makes that call.

Availity started in 2001 as a joint venture between Blue Cross Blue Shield of Florida (now Florida Blue) and Humana. Health Care Service Corporation and Anthem, now Elevance Health, joined later as owner-payers too. The platform runs on what's sometimes called a coopetition model: rival insurers share the same infrastructure and governance, because building separate portals for every payer would cost providers more time than it saves anyone. The trade-off is that it's the payers, not the providers, who own the tool providers are asked to use.

Surescripts has a more layered history. It began life owned by pharmacy chains, PBMs and technology vendors who needed a shared network rather than dozens of private wires between each other. In October 2024, private equity firm TPG Capital became its majority investor. The National Community Pharmacists Association kept, in its own words, a significant ownership share "so we can continue to influence its growth," while full details of who else holds a stake are covered by a non-disclosure agreement. Surescripts describes its own role like this:

“Our purpose is to serve the nation through simpler, trusted health intelligence sharing, in order to increase patient safety, lower costs and ensure quality care.”

A prescriber's office: whose workflow are you actually in?

Picture a busy family medicine clinic. A patient's new prescription triggers a prior authorization flag at the pharmacy. The clinic's medical assistant doesn't pick a platform from a list; she opens whatever the clinic's electronic health record already has built in. If that record has a CoverMyMeds integration, a form pre-fills on the same screen she already uses for prescribing, and she never visits a separate website. If the patient's plan requires Availity, she might instead get a message telling her to log into Availity Essentials directly, because that payer has made it the only accepted channel. Meanwhile, if the request completes automatically using data already sitting in the record, it may have travelled over Surescripts' network in the background, with no one in the building aware that name was ever involved. Three different platforms, and the clinic's staff may only ever consciously deal with one or two of them.

Genuine limitations of each

None of these platforms is a complete answer on its own, and each carries a real trade-off worth knowing before you rely on it.

• CoverMyMeds covers a large share of prescription volume, but that still leaves payers outside its network, and some requests that start electronically still fall back to fax or a phone call to finish. It's also owned by a company with its own commercial stake in the drug supply chain, which is worth knowing even though it doesn't change the coverage decision itself.
• Availity is genuinely useful when several of your payers already treat it as their exclusive portal, but a clinic dealing with plans outside that group ends up running a second or third system anyway, rather than replacing them. Because it's owned by the payers themselves, providers have less say over how the portal changes over time than they would with a vendor they'd chosen and paid for directly.
• Surescripts can't be bought or logged into directly by a single clinic; its usefulness depends entirely on how well your specific EHR or pharmacy vendor has built on top of the network, so two practices on the same national network can have very different day-to-day experiences. Its recent shift toward majority private-equity ownership also means its long-term priorities now answer to an investor with a return to make, alongside the pharmacy and PBM stakeholders who founded it.