Electronic Prior Authorization Setup

NextGen® Enterprise EHR Help

Electronic Prior Authorization Setup

After you enable Electronic Prior Authorization (ePA) across the enterprise, you can control which users use it. ePA setup involves the following procedures: Enable ePA for the enterprise . Grant users permission to initiate and manage the ePA process. If necessary, modify the ePA Import processor in NextGen Communication Services. For more information, go to NextGen Healthcare Success Community, and download the latest NextGen® Communication Services Configuration Guide for NextGen ePrescribing. If you want the user to receive tasks in the Inbox when an ePA status update indicates user action is required, then in File Maintenance, select Providers master file then go to ePrescribing tab, assign a workgroup and the ePA category to the provider for the ePA Task Type. Note: When the ePA Task Type has a workgroup and the ePA task category selected, in the Provider Check window, the Workflow and Categories section displays the ePA Group and ePA Category fields. Enable Electronic Prior Auth

NextGen® Enterprise EHR Help

Enable Electronic Prior Authorization for the Enterprise

Enabling Electronic Prior Authorization (ePA) for the enterprise allows users with the proper security rights to initiate ePA for a medication and to manage the ePA process. In the System Administrator application, open the ePrescribing universal preferences, and then set the Electronic Prior Authorization (ePA) Enable preference to True. By default, the preference is set to False. When the preference is set to False, the Initiate ePA link and Manage ePA button in the Medications module and in the View menu, the Manage ePA menu item are hidden from users. Parent topic: Electronic Prior Authorization Setup

NextGen® Enterprise EHR Help

ePrescribing Setup

Before you begin Before you use the NextGen® Enterprise EHR ePrescribing feature, the following ePrescribing setup procedures must be completed: Install NextGen® Communication Services (NCS). Enable Surescripts functionality in NCS. Note: Before you attempt to set up ePrescribing, you must contact NextGen Healthcare Support to install and configure NCS. Download the Surescripts pharmacies. Map unmatched pharmacies and add unmatched pharmacies as new. Check the pharmacy service level. Enroll the providers in the Surescripts network. Set up eRx permissions for the providers. Set up ePCS (Electronic Prescriptions of Controlled Substances) for authorized providers. Set up tabs and categories for eRx refills and eRx errors in the Workflow module's task list. Set up workgroups for eRx refills and eRx errors in the Workflow module. Assign each Surescripts-enrolled provider with an eRx-specific workgroup and task list category. Set up supervising physician. Set up multiple destinations. System

NextGen® Enterprise EHR Help

Enroll Provider in ePA at the Retail Service Level

To send electronic prior authorization requests, a provider must have Retail Service Level enrollment in ePA. In File Maintenance, Providers master file, select a provider. In the Modify Provider Information window, go to the ePrescribing tab, then navigate to the Retail Level Service Level section, select ePA. Note: ePA enrollment is not required for Mail-Order Service Level. Select open menu > Retail > Enroll or Update. Modify Provider Information Parent topic: Electronic Prior Authorization Setup

NextGen® Enterprise EHR Help

Managing Electronic Prior Authorizations

An electronic prior authorizations (ePA) is automatically initiated when you accept a medication and save it to the patient chart and one of the following conditions is met: If the selected medication requires a prior authorization through a Real-Time Prescriptions Benefits (RTPB) request. Note: The patient's Pharmacy Benefits Manager (PBM) must be enrolled into Real-Time Prescriptions Benefits. If the patient's formulary file indicates that a prior authorization is required for the selected medication. Note: If the automatic ePA initiation fails, the Initiate ePA link in the medication details section becomes available. You can also manually initiate an ePA for new and renewed medications in NextGen® Enterprise EHR. Additionally, you can do the following: Complete and submit the criteria to the PBM for review. View approval or denial responses. Initiate appeals, if required. View prior authorization transactions history. Note: If a medication requires prior authorization and you attem

NextGen® Enterprise EHR Help

Managing Electronic Prior Authorizations

An electronic prior authorizations (ePA) is automatically initiated when you accept a medication and save it to the patient chart and one of the following conditions is met: If the selected medication requires a prior authorization through a Real-Time Prescriptions Benefits (RTPB) request. Note: The patient's Pharmacy Benefits Manager (PBM) must be enrolled into Real-Time Prescriptions Benefits. If the patient's formulary file indicates that a prior authorization is required for the selected medication. Note: If the automatic ePA initiation fails, the Initiate ePA link in the medication details section becomes available. You can also manually initiate an ePA for new and renewed medications in NextGen® Enterprise EHR. Additionally, you can do the following: Complete and submit the criteria to the PBM for review. View approval or denial responses. Initiate appeals, if required. View prior authorization transactions history. Note: If a medication requires prior authorization and you attem

Electronic Prior Authorization Setup

Recommendations

Electronic Prior Authorization Setup

Enable Electronic Prior Authorization for the Enterprise

ePrescribing Setup

Enroll Provider in ePA at the Retail Service Level

Managing Electronic Prior Authorizations

Managing Electronic Prior Authorizations

Electronic Prior Authorization Setup

Electronic Prior Authorization Setup

Enable Electronic Prior Authorization for the Enterprise

ePrescribing Setup

Enroll Provider in ePA at the Retail Service Level

Managing Electronic Prior Authorizations

Managing Electronic Prior Authorizations