Create authorization request

Prior Authorization is a request to payer for approval of coverage for elective services / activities before the service is delivered. As well as eligibility request, authorization may be sent it to Post Office right away or saved to draft before sending.

Step 1. Click on Create New Prior Request button (or select E-Prior Requests > New Authorization from the menu). 
       Electronic Prior Request - Authorization form opens. Patient Details tab is active.

Step 2. Select patient using Find Patient field.

 
Step 3. Go to Request Details tab and enter visit details (learn /wiki/spaces/GF/pages/4194376).

Step 4. Go to Procedure Details tab and enter activities details (learn /wiki/spaces/GF/pages/4194348).

Step 5. Click on Save & Send button.
       A warning dialog appears informing that the request is sent to Shafafiya. 

Step 6. Click on OK button.

       Electronic Prior Request form closes. Menu panel shows if there are new transactions to download.

Step 7. After the files the payer replied with are downloaded, click on See today's authorizations.

       Find Prior Authorization Requests form opens. 

Step 8. Select the request and click on View button.
       All data becomes disabled on Electronic Prior Request form. Payer reply section appears on Request Details and Procedure Details tabs. Summary tab adds at the end. 

Step 9. Go to Summary tab.
       There are two sections: (1) provider request summary and (2) payer reply summary showing the following information:

• • transaction date;
  • transaction file name;
  • link to the file content.

 
Note: Payer reply section shows no information if request status is Waiting for approval as the reply hasn't been received yet.

ALTERNATIVE WORKFLOWS

Save authorization request as draft

1. Click on Create New Prior Request button.
   Electronic Prior Request - Eligibility form opens. Patient Details tab is active.
2. Select patient using Find Patient field.
3. Go to Request Details tab and enter visit details.
4. Go to Procedure Details tab and enter activities details.
5. Click on Save as Draft button.
   An information dialog appears saying that the request is saved into the database.
6. Click on OK button.
   Electronic Prior Request form closes.

Create authorization request from Find Prior Authorization Requests form

1. Click on Find Prior Requests button. 
   Find Prior Authorization Requests form opens.
2. Click on Add button.
   Electronic Prior Request - Authorization form opens. Patient Details tab is active.
3. Select patient using Find Patient field.
4. Go to Request Details tab and enter visit details.
5. Go to Procedure Details tab and enter activities details.
6. Click on Save & Send button.
   A warning dialog appears informing that the request is sent to Shafafiya.
7. Click on OK button.
   Electronic Prior Request form closes.