Prior authorization is a health plan process that requires providers to get approval from a health plan before a service is provided so that the patient can receive payment coverage. Hint delivers this service through Dose Spot.
You may see a prior authorization (ePA) prompt when prescribing certain medications. This enhancement is designed to streamline the prior
authorization process while maintaining flexibility and ease in the prescribing experience.
Follow your standard ePrescribing workflow (instructions here). When submitting prescriptions for select NDCs, prescribers might be prompted to initiate a prior authorization
If a prior authorization is needed, it'll be displayed in the status section of the prescription to initiate the prior authorization.
When you select that prescription to approve and send, you'll see a prompt at the bottom left to initiate the prior authorization. If you attempt to send the prescription without the prior authorization, you will be notified on the "actions
before sending" page and given another opportunity to initiate it directly from there.
To send the request to the payer electronically, select EPA. Once initiated,
the request will appear in the prior authorization section of the patient landing page. Here you can review prescription details.
Check the status of each prior authorization, and view a detailed history log. In the history log. You may find a prior authorization detail link when clicked.
This will redirect you to a webpage with more information. However, not every request will contain this link.
If you see an action required status, this means that the payer needs additional information from you. Select the prescription from the list and click "Process" to complete the necessary steps.
These actions may include uploading additional documents or answering extra question sets. For question sets, click the "start form" button. To begin, the number of questions will vary based on your responses. Be sure to answer all the questions and carefully review your answers before submitting.
Once submitted, you'll receive a confirmation that your action was successful, and you can continue to monitor the status of the prior authorization.
If a prior authorization request is approved, the prescription will be moved to the patient's pending prescription section. From there, it can be approved and sent to the pharmacy
