Editing Task Prescription is Rejected for Prior Authorization

Global Elements

Name	Value
Task Name
Task Type
taskTitle	Prescription is Rejected for Prior Authorization
scenarioText	Duane’s Venlafaxine tablet prescription was rejected because it wasn’t covered by insurance. In response, his doctor sent over an E-script for Wellbutrin as a replacement. The new prescription was processed, but unfortunately requires a prior authorization (PA). To handle this situation, you’ll need to void the Venlafaxine, confirm the reason for the Wellbutrin rejection, submit a PA to CoverMyMeds and void the Wellbutrin while the PA processes.
whyImportant	Initiating PAs is a large part of your responsibilities at Genoa. Our service goes above and beyond to ensure our consumers receive their medications. It’s important to void any prescriptions that are awaiting PA so our current inventory remains accurate.
conclusion	Congratulations! You successfully initiated Duane’s Wellbutrin PA in CoverMyMeds, and voided all related prescriptions that cannot yet be filled. This will speed up the process for getting Duane his medication, and ensure an accurate inventory in the meantime. You may now exit this course.

Task Steps

Order	Step Text	Edit
↑ 1 ↓	Before you process the Wellbutrin E-script, you need to void the Venlafaxine claim. Open the Batch Bill, then locate and view the rejected claim.	Edit
↑ 2 ↓	Since Duane’s Venlafaxine tablet prescription was rejected, you’ll need to place it on file and return the quantity to inventory. Using the knowledge from the previous PROscript tutorial, void the Venlafaxine prescription. Remember, this claim was rejected because the medication was not covered by insurance.	Edit
↑ 3 ↓	Notice that completing the Venlafaxine void in the batch bill returns you to the claims list. You can see here that Duane’s new prescription for Wellbutrin was also rejected. Open the claim and read the rejection thoroughly to find out why, then pull up your options for managing the rejection.	Edit
↑ 4 ↓	You now know this prescription was rejected because it requires prior authorization (PA). Fortunately, you can send the PA request directly to CoverMyMeds from this rejection screen with the click of a single button. Do this now.	Edit
↑ 5 ↓	Notice the CoverMyMeds window has opened in your internet browser. If all information is complete, you’ll see a “no further action required” message indicating that the PA has been successfully submitted. For this example, enter the prescriber's fax number into the appropriate field to complete the request. Once the PA has been sent, you can close the browser window.	Edit
↑ 6 ↓	Because the Wellbutrin prescription is awaiting prior authorization, we cannot fill the medication at this time. It will need to be voided so it can be placed on file and added back to inventory. Complete the void the same way you did earlier, but remember to use the correct void reason for this prescription.	Edit

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