How to process Electronic Prior Authorization (EPA)?

How to Process EPA?

  • When the payer responds to the initialized request with a few questions the status will change.
  • Then PA status will change from In Progress-initialized to In Progress-Open. 

  • Click on status to view the EPA record details
  • And then click the Close button.

  • Click the Open Accelerator button.
  • Through the accelerator, the prescriber will answer the questions and provide the details on behalf of the patient. 
  • Click on the notes View to see the payer Response Note.

  • Click on Complete Prior Auth Criteria to get the payer’s questions.

  • Click the START button to answer the payer’s questions.

  • Fill out the questions one by one and attach the required document in PDF format.
  • Click the SUBMIT button. 
  • These details will be submitted to the payer.

  • Once the prescriber submits the answers, the payer will approve the prescriber’s answers through Surescripts.
  • Then PA status will change from InProgress-Open to InProgress-Approved.

  • The prescriber must acknowledge the payer’s response via Accelerator
  • Click the ACKNOWLEDGE button.

  • Once the prescriber acknowledges the payer’s response, the PA status will change from InProgress-Approved to Complete-Approved.

  • When the status is “Complete-Approved,” the prescription will automatically move to the pharmacy. This process is referred to as an auto-release process.
  • The Complete-Approved record will be released to EPA worklist automatically. 
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