Prior Authorization with Key
Prior Authorization with Key
|
Overview: Creating an electronic prior authorization in cover my meds (CMM) |
Audience: Front office support and prescribers |
Review: Prior authorizations are necessary when insurance does not normally cover a medication. We will submit reasoning or an ePA as to why the patient needs the medication to request insurance to cover it. Some PA requests will come in with a Key meaning the pharmacy started the ePA. This document explains what to do when there is a request with a Key.
Where
to find your PA request:
1. In your clinical inbox find the “Orders/Rx/Auths” bucket.
2. Identify the prior authorization request which is labeled “Prescription – Prior Authorization Request.”1. Open CMM in another screen and log in
2.
From the CMM
dashboard select the option “Enter Key”
3. Plug in the key code, last name, and DOB
4. Once the ePA populates fill in all the “required” fields. Toggling into the patient chart in Athena when needed.
5. Once all the required fields are filled in select “Send to plan”
6. There may be additional questions related to the patients’ health. Use the “Visits” and “Meds” tab in the chart to answer the question set to the best of your ability. IF unable to proceed with answering the question set, send the key to the provider to complete the ePA.
7. When the ePA has been submitted close the PA request in Athena by using the actions bar and selecting “Close” > “Prior authorization requested” > “Save”.
Related Articles
Prior Authorization without Key
Prior Authorization without Key Overview: Creating an electronic prior authorization in cover my meds (CMM) Audience: Front office support and prescribers Review: Prior authorizations are necessary when insurance does not normally cover a medication. ...TMS Workflow: Before Treatment
Screening If a provider refers a patient to TMS treatments an Internal Referral https://geodehealth.zohodesk.com/portal/en/kb/articles/internal-pr will be created and routed to the TMS Coordinator or Technician. The patient can also book screenings ...Spravato MA Workflow
Spravato MA Workflow Screening If a provider refers a patient to Spravato treatments an Internal Referral https://geodehealth.zohodesk.com/portal/en/kb/articles/internal-pr will be created and routed to the Spravato Coordinator. · Once the Internal ...EAP and TOVA Request Communications to Billing
Benefit Verification & Authorization Communication Requesting team members need to “Add incoming authorization” From the Quickview page, “Add Incoming authorization” to communicate to billing to check eligibility on treatment services or request an ...Epion Guide
Epion Guide Download the Epion Extension (only need to do once) 1) In the upper righthand corner of your browser, click the puzzle piece icon. 2) In the dropdown menu, select the Pin icon next to Epion Insurance Inbox. If you do not have the Epion ...