Resubmit prior request

Sometimes a payer denies the initial prior request for various reasons (wrong diagnoses, missing medications, unknown insurance card, etc.). In this case, the user can resubmit the request with the corrected data. Request resubmission is available from Find Prior Requests and Electronic Prior Request forms.

Request resubmission is performed with Resubmit Request button on Find Prior Requests form or Resubmit request link on Electronic Prior Request form. This action is available if the following conditions are met:

• Type = Authorization;

• Resubmission = No

• Status = Approved, Partly Approved or Rejected;

• The request is not dispensed.
  
  

Step 1. Click Find Prior Requests below the menu. 
       Find Prior Requests form opens.

Step 2. Set a search value and click Search. 
       The search results grid appears.

Step 3. Select a request with Type = Authorization, Resubmission = No, Status = Partly Approved.
       Resubmit Request button becomes enabled for the selected request. 

Step 4. Click Resubmit Request.
       Resubmit Prior Request dialog appears. 

Step 5. Click Yes.
        Electronic Prior Request and Prior Request Resubmission dialogs close. New Electronic Prior Request - Authorization form opens. Patient Details tab is active. There are new controls Resubmission comments and Add attachment.

• Data from the request is copied to the new form including date values (Order Date, Visit Start, Visit End, Start Date, etc.).

• Data received from the payer is not copied to the new form.

• Data is available for editing.

Step 6. Enter Resubmission Comments (mandatory), click Add attachment, select a .pdf file if needed.

Step 7. Click Save as Draft.
       An information dialog appears saying that the request is saved into the database as a draft. 

Step 8. Click OK.
     Electronic Prior Request form closes. 

Step 9. Check the request on FInd Prior Requests form
       Status = Draft, Resubmission = Yes for the resubmitted request. 

ALTERNATIVE WORKFLOWS

Resubmit authorization request from Electronic Prior Request form (send to Post Office)

1. Click Find Prior Requests. 
   Find Prior Requests form opens.

2. Set a search value and click Search. 
   The search results grid appears.

3. Select a request with Type = Authorization, Resubmission = No, Status = Rejected and click View.
   Electronic Prior Request - Authorization form opens.

4. Click Resubmit request.
    Resubmit Prior Request dialog appears. 

5. Click Yes.
   Electronic Prior Request and Prior Request Cloning dialogs close. New Electronic Prior Request - Authorization form opens.
6. Enter Resubmission Comments, click Add attachment, select a .pdf file if needed.

7. Click Save & Send.
   A warning dialog appears informing that the request is sent to Shafafiya.

8. Click OK.
   Electronic Prior Request form closes.