How to create and submit a PMG authorization

 

The Santa Cruz Health Information Exchange will allow the user to directly access the Physicians Medical Group Authorization program to create an authorization and to check authorization status with a single sign on into the SCHIE.

 

TO CREATE an Authorization Request

1. Go to the Patients tab and Search for the Patient

2. In the Patient Actions window – Select Create Auth

3. The NEW AUTHORIZATION page will appear with the patient’s name selected if they exist in the PMG Authorization System. If this is not the correct patient or if you would like to search for a different patient, remove the existing information in the Search Criteria and type in the new name and/or birthdate and /or member ID.

4. Click on the blue underlined insurance entry. If the patient is listed in the shaded area they do not have currently active insurance with PMG. Click on the Insurance ID number or Add new insurance plan under Eligibility to open the form. 4) Fill out the Authorization Request as fully as possible. Fields with red asterisks must be completed before the form can be sent. Be sure that you enter a quantity in the window before the definition of the procedure.

5. You can attach documents to the form which may be in files on your computer. If the supporting documents are available in the HIE – please enter the date, provider and document name in the Notes box. . PMG nurses will review those documents in the HIE. If the supporting documents exist only in paper form you can check the box at the bottom to indicate that you are faxing supporting documentation for the authorization request. Please do not send faxes unless absolutely necessary.

6. Click Submit

7. When your authorization has been accepted you will see the notation Authorization Request Submitted and a link which will display previous authorization requests for the patient.

8. You can Check Auth Status in the Patient Actions tab to check the status of your request.

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