How to Use the Pre-Auth Module?

Oncology > Patient > Pre-Auth

The following sections and functionalities have been added in the Pre-Auth Module:

1)      Document Pre-Auth number in a Pre-Auth request

The user will navigate to the “Pre-Auth” screen. The pre-auth number can be documented in the field “Pre-Auth number”.

Pre-Auth Number

2)      Associate diagnoses with a Pre-Auth request

The user will navigate to the “Pre-Auth” screen. The diagnoses present in the patient’s profile will load by default when a pre-auth request is created.

Diagnosis

3)      Associate cancer stage with a Pre-Auth request

The user will navigate to the “Pre-Auth” screen. The stages documented with the selected patient will populate in the “Stage” field.

Stage

User can select the desired stages which would become a part of the pre-auth request.

Stage

4)      Attach document in a Pre-auth request

The user will navigate to the “Pre-Auth” screen. In order to associate documents with the pre-auth request, the user will have to press the “Add” button in the “Documents” section which would display the list of documents added in the “Document Manager” of that patient.

Document Manager

The user will have to select the desired document(s) and then press the “Done” button to associate these document(s) with the pre-auth request.

Documents

5)      Associate procedures with a Pre-Auth request

The user will go the “Pre-Auth” screen. By default, the list of configured procedures will be populated in the “Procedures” section. The user can either select the desired procedure(s) from the list or can search for other procedure(s) in the “Search” field. Upon selection, 1 unit will be selected for that procedure.

Procedures

6)      Updates in the “Ordered Drugs” section

The “Chemo Rx Order” section has been renamed as “Ordered Drugs”. The updated screen can be seen below:

Ordered Drugs
  • Auth Required” checkbox has been added to specify whether pre-authorization of that specific drug is required or not.
  • The “Drug” column will contain the information of drug including its name, unit dose, total dose, route, mixing instructions etc.
  • The infusion time of the drug will be populated in the “Duration” field.
  • Available billing codes of the drug will be seen in the “JCode” field.
  • NDC” field has been added to document the NDC as well. Based on the total dose and the selected NDC, the “Billed” and “Wasted” units will be calculated which would thereby calculate the “Total Units”.
  • NB” option has been added to mark a drug as non-billable.

NOTE:

  1. Wasted” units will only be calculated if the selected NDC is a Single Use Vial.
  2. The “Total Units” will be the units of the drug for the whole therapy i.e. the billed and wasted units would be added and then multiplied with the total number of ‘Times’ the drug is to be given in the whole therapy. As shown in the example above, the billed units and wasted units for Doxorubicin are 12 and 3 respectively, so the system will add them and then multiply it with the total number of times Doxorubicin is to be given in the whole therapy i.e. 15 * 6 = 90 are the total units.

7)      Attach provider notes in a Pre-auth request

The user will navigate to the “Pre-Auth” screen. In order to associate provider notes with the pre-auth request, the user will have to press the “Add” button in the “Provider Notes” section which would display the list of the available provider notes of that patient.

Provider Note

The user will have to select the desired provider note(s) and then press the “Done” button to associate these provider note(s) with the pre-auth request.

Provider Note

8)      Associate administrations with a Pre-Auth request

The user will navigate to the “Pre-Auth” screen. In order to associate administrations with the pre-auth request, the user will have to press the “Add” button in the “Administrations” section which would display the list of the signed administrations of that patient.

Administration

The user will have to select the desired administration(s) and then press the “Done” button to associate these administration(s) with the pre-auth request.

Administration

9)      Associate lab results with a Pre-Auth request

The user will go the “Pre-Auth” screen. In order to associate lab results with the pre-auth request, the user will have to press the “Add” button in the “Labs” section which would display the available lab results for that patient.

Lab Results

The user will have to select the desired lab result(s) and then press the “OK” button to associate these lab result(s) with the pre-auth request.

10)      Add comments in a Pre-Auth request

The user will go the “Pre-Auth” screen. The user can write any comments in the “Comments” section.

Comments

11)      Updates in the Pre-Auth reports criteria screen and Pre-Auth reports

The Pre-Auth report criteria screen has been updated. User can learn about these updates by clicking here.