ePA from the Workflow Module Inbox

When you set up Clinical Tasking for Electronic Prior Authorization (ePA), users receive tasks in their inbox that notify them of certain ePA status changes that they need to take action on. Tasks can be routed to a provider or to a workgroup depending on the setup.

Having ePA tasks listed on the Clinical Tasking tab in Inbox helps prescribers and clinical staff monitor responses on prior authorization requests sent from NextGen® Enterprise EHR to the pharmacy benefits managers (PBMs). The responses can include status updates when a prior authorization request needs clinical questions answered or other prescriber input, as well as approvals and denials from the PBM.

Having notifications sent to the inbox improves the efficiency of the ePA process by enabling you to manage some ePA actions without opening the Medications module each time you want to check an ePA status or take action. The ePA tasks have Action Required and Approved statuses. You can go directly from the task in the inbox to the Manage ePA window, or if the task indicates the ePA status is approved, you can send the medication to the pharmacy.

Clinical Tasking displays ePA tasks with their descriptions indicating their status (such as Action Required, Approved, Denied, and Closed). You can Accept and Reject actions on ePA task types. You can also perform other default actions similar to the actions for refill tasks.

Once the status of an ePA case changes, a new task is created, and the state of the previous ePA task is automatically marked as completed. For example, if a user has a task with a status of Action Required, the user opens the Accelerator from the Manage ePA window to complete the Question Set. Once the PBM sends a response, a new ePA task is generated with status of Approved or Denied. The original Action Required task is automatically marked as Completed.