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Prior Authorization Customization and Flexibility

Right now I have over 100 unassigned prior authorization tasks floating around. Just because a insurance does not cover the medication at 100% does not mean we want to do a prior authorization on that medication. Our pharmacies have meds that are only $4.00 that we want to use. I think we should be able to turn the option off to automatically create Prior Auth tasks, set a threshold for how expensive a medication is before we're prompted to fill out the form, or we should be able to pick which specific medications we want to create a task for.

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Mrs Jennifer Matheny shared this idea  ·   ·  Admin →
Acknowledged  ·  Matthew Douglass responded  · 

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9 comments

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  • Dr Anace Said commented  · 

    Please create a turn off button. There is a lot of wrong prior auth that is completely unneeded.

  • Anonymous commented  · 

    This is creating hundreds of unneeded and inaccurate prior auth notices that have to be cleared from the task task.
    Please create the option to turn this off.

  • Megan commented  · 

    There are some medications that we know require a PA, if we could have the option to manually generate an electronic PA form instead of the form automatically creating a task that would be very beneficial for our practice because it would eliminate extra work for the providers.

  • Megan commented  · 

    We are a self-insured company with an in-house pharmacy, so the majority of the medications we prescribe do not require prior authorizations. There needs to be a turn off feature available!

  • Carl Flor commented  · 

    In a patient that truly needs a PA and their EHR does NOT generate a PA. I am unable to generate a 'De Novo" PA request, the TASKS section will not allow this action. This needs to be corrected.

  • Anonymous commented  · 

    It would be good if the Prior Authorization feature was not restricted to Medication only. Some insurances require prior authorization for other procedures or imagine.

  • Angel Diaz commented  · 

    We don't get to many prior auths request from pharmacies and it is taking time to clear out those tasks. I believe that features like this must have an on/off switch and those that need it will turn it on, otherwise will be off.

  • Dee Scritchfield commented  · 

    In the event the brand is required, I can see this being helpful but that is seldom the case. The script automatically says that they can substitute the generic which is the law in WV. It requires generic substitution unless otherwise stated. Although the message says prescription was not sent because a prior authorization was needed; this is not accurate. E-scribe has already sent the prescription which is why we know prior authorization is not needed in almost all situations as they automatically fill it using the generic without us having to do anything.
    That is why we want the ability to turn this feature off. This law may be different in other states so the feature may be useful to others.

  • Dee Scritchfield commented  · 

    I understand this was made to enhance our work flow but it has merely created additional work for us to clear these from the tasks. We never have this many calls from pharmacies for prior authorization.

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