Once a patient is enrolled in a Patient Support Program, you can begin the Prior Authorization process to submit the required forms to the payer.
Prior Authorization is the process of collecting information from the physician and patient and completing a form to be submitted to the payer (insurance providers), to determine if they will cover the cost of the medication.
Auxita has both private and public Prior Authorization forms available.
NOTE Each form’s workflow is determined by the configuration set by the program's preferences, this is reflected and seen on the reimbursement status tile.
From the Program’s Section:
- Open the Program’s Section
- On the top of the Programs overview, select Status, and then select Enrolment to filter the table
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Find the Patient with a submitted enrolment that now requires Reimbursement and click on their name to select the patient
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Click the New Prior Authorization button
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Select the Prior Authorization Form from the list of available forms
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The Prior Authorization Form will open automatically
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Fill in all details on the form and click Send for Patient Signature when complete. The reimbursement form status changes to In Progress
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The patient will receive an email notification from Auxita to sign their consent
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Once signed, the Reimbursement Status on the enrolment card shows a green check mark for Awaiting Patient Signature
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If all other requirements are complete, the status changes to Submitted to Program
NOTE Some of the fields will be pre-populated with data pulled from the Auxita platform. Make sure to complete all required fields, including signature.
TIP Like Enrolment Forms, digital Prior Authorization Forms can be saved as a draft by clicking ‘Save & Close’ within the form.
From the Patients Section:
1. Select the Patient
2. Go to the Program Overview Tab
3. Click the New Prior Authorization button
4. Select the Prior Authorization Form from the list of available forms
5. The Prior Authorization Form will open automatically
6. Complete the fields required
7. Select Send for signature or Submit in the reimbursement form to update the status
8. The patient or physician will receive a notification from Auxita to sign If required
9. Once signed, the Reimbursement Status on the enrolment card shows an update on the status of the reimbursement
10. If all other requirements are complete, the status changes to Submitted to Program
NOTE The Patient PSP Journey or Activity Table can help identify the patient‘s progress and the time stamps of when the requests were submitted.