Step Click the New Request button (located at the bottom of the home screen). 1 Step Search for member by: 2 Member ID OR Last Name Date of Birth Click the Search button. Step Select the Member from the search results by clicking on the Select link. 3 Step Verify member information and click the New Request button. 4 Select request type (Inpatient or Outpatient) and click Create Request. Step Enter Patient Detail. 5 Click either the next section link or the Next button to continue through the Inpatient Service Request process. Step Enter Requesting Provider Information. 6 Click Next to continue. Step Enter Facility information. 7 To search for facility information, click the search button. Type in a keyword in the Facility Name field and click Find. Select the facility from the search results. Facility information will populate the fields from the search selection. Step Select the appropriate service detail using the corresponding drop down menus and fields. 8 Click Next to continue. Step Add CPT Code by clicking the Add New Code button searching and selecting from the search 9 results. Select the requested date of the procedure by click the appropriate date on the dropdown optional calendar. To add a new code, click the Add New Code button and select from the search results. Click Next to continue. Step At least one diagnosis code must be attached to the case. If there are more than one, one must be 10 selected as the primary. To add a new code, click the Add New Code button and select from the search results. Click to continue. Next Step Enter any clinical notes in the text field. 11 Click Next to continue. Step Attach clinical documentation by clicking the browse button. 12 Browse and find the file and click Open to attach. Once attached, click Submit. Step Questionnaires (if applicable) 13 Step Click the checkbox at the bottom of the page and click either Save for Later or Submit. 14 Step A Request Overview is displayed. 15
Step 1 Click the New Request button (located at the bottom of the home screen). Step 2 Search for member by: Member ID OR Last Name Date of Birth Click the Search button. Step 3 Select the Member from the search results by clicking on the Select link. Step 4 Verify member information and click the New Request button. Select request type (Inpatient or Outpatient) and click Create Request. Step 5 Enter Patient Detail. Click either the next section link or the Next button to continue through the Inpatient Service Request process. Step 6 Enter Requesting Provider Information. Click Next to continue. Step 7 Enter Facility information. To search for facility information, click the search button. Type in a keyword in the Facility Name field and click Find. Select the facility from the search results. Facility information will populate the fields from the search selection. Step 8 Select the appropriate service detail using the corresponding drop down menus and fields. Click Next to continue. Step 9 optional Add CPT Code by clicking the Add New Code button searching and selecting from the search results. Select the requested date of the procedure by click the appropriate date on the dropdown calendar. To add a new code, click the Add New Code button and select from the search results. Click Next to continue. Step 10 At least one diagnosis code must be attached to the case. If there are more than one, one must be selected as the primary. To add a new code, click the Add New Code button and select from the search results. Click Next to continue. Step 11 Enter any clinical notes in the text field. Click Next to continue. Step 12 Attach clinical documentation by clicking the browse button. Browse and find the file and click Open to attach. Once attached, click Submit. Step 13 Questionnaires (if applicable) Step 14 Click the checkbox at the bottom of the page and click either Save for Later or Submit. Step 15 A Request Overview is displayed.
PriorAuthorizationInpatientSummary.docx