METHOD AND SYSTEM FOR REQUESTING PRIOR AUTHORIZATION FOR MEDICAL PRODUCTS AND SERVICES

摘要

A system and method for requesting prior authorization for a medical product and/or service includes a processor providing a user interface accessible over a network and via which to receive user input of information concerning the product and/or service, the intended recipient thereof, and the prescriber thereof. The user interface is accessible using each of a plurality of user profiles, including two or more of the prescriber, user, and provider. Login information is not required for the request generation, a recipient health plan identification being used instead. Different sequences are provided by the processor depending on the user profile used for generating the request. Request status is provided based on input of a code generated for the request and without requiring login information. The system is configured to generate and transmit to the prescriber a communication regarding the request where the request is initiated using a recipient profile.

主权项

1. A computer-implemented method for requesting prior authorization for at least one of a medical product and a medical service, comprising:
receiving, by a computer processor, a user selection of one of a plurality of stored user profiles, wherein the stored user profiles include a prescriber profile and a patient profile; performing, by the processor, a process that includes obtaining information from the user, wherein the process differs depending on which user profile was selected; and initiating, by the processor, a prior authorization request for the at least one of the medical product and the medical service based on input from the user during the process.