All medication prior authorizations are automatically started when you order the medication in Epic (this is called electronic prior auth or EPA) The AA's monitor these PA's and will contact you when there is a decision or more information is needed. If you have questions about a PA, send an Epic staff message to the AA pool ("p ima medication prior-auth req") and attach the patient's chart.
If you need to provide clinical information to the AA's via staff message, use the following dotphrases
For Inhalers: .IMAPRIORAUTHINHALERS
For Pregabalin: .IMAPRIORAUTHPREGABALIN
For PPIs: .IMAPRIORAUTHPPI
For Testosterone Gel: .IMAPRIORAUTHTESTOSTERONEGEL
For Lidocaine Patches (Post-Herpetic Neuralgia Only): .IMAPRIORAUTHLIDOCAINE
For Opiates: .IMAPRIORAUTHOPIATES For a 1 year prior auth: Through NYRx for Patients with Medicaid: - NYRx now allows a PA exemption request for patients who have been on the same opioid dose/frequency for at least 365 days. - This allows the provider to obtain just one PA per year for patients on a stable opioid regimen, instead of a PA every 3 months. - A PA every 3 months is still required for patients who have not yet been on the same opioid regimen for 365 days. - Please call NYRx to obtain the exemption at 877-309-9493, they are available 24/7. - If NYRx call center is busy, please try NYRx Education and Outreach at 1-833-967-7310 between 8:00AM and 5:00PM ET Monday through Friday, excluding holidays, or by email at NYRxEO@primetherapeutics.com *- Any issues please contact Linda Wang: linda.wang2@mountsinai.org
FOR ANY OTHER MEDICATION: .IMAPRIORAUTHMEDICATIONS
Mount Sinai Health System Electronic Prior Authorization (ePA) Tip sheet
For Ensure and Enteral Formula, the Epic dotphrase .ENSURE taken from Johsand Villegas should be completed and documented.