Electronic Prior Authorizations

This page will walk the user through the Electronic Prior Authorization (EPA) module of the NEMORx application.

When prescribing a medication that requires a Prior Auth user will have the ability to:

  • Send the Rx and have the Prior Auth handled by phone/fax
    • When doing this the user should not click the Send Prior Authorizations button and simply click the send or print Rx buttons
  • Send the EPA and save the medication until the prior auth results have been completed.
    • When taking this route the user will need to click the "Send Prior Authorization" button which will initiate the prior auth.
    • Once this has been sent you will receive a message stating that you must complete the prior auth using the EPA module.
      • InitiatePriorAuth.png
    • This will also open the Surescripts Accelerator enabling you to respond back and forth with the insurance company.
      • In this module, you may have to answer questions and upload documents to obtain approvals (NOTE: If you send a Dx with your EPA the insurance company may approve the medication without additional questions)
Now that you have sent your prior auth and have gone through the approval process you can send, cancel or cancel with a new script from the EPA module.
  • Approved Medications
    • If your medication has been approved simply click the send button and NEMORx will send the Rx with the authorization status to the Pharmacy.
      • ApprovedMedication.png
  • Denied Medications
    • If your medication has been denied you can send the Rx, cancel the Rx, or Cancel with a new Rx.
    • If you chose to send or cancel with a new Rx, the denial status will be sent to the pharmacy so they do not attempt to obtain a prior auth.
  • Partially Denied Medications
  • If your medication has been partially denied you will see notes and the approved amounts within this module. From here you have the ability to:
    • Cancel the Rx
    • Send the medication as is
    • Cancel with Rx
      • This will enable you to write Rx with the updated Amounts/Days supplied. When sending this Rx it will send the Authorization Number to the pharmacy.
Unless otherwise stated, the content of this page is licensed under Creative Commons Attribution-ShareAlike 3.0 License