Processing Authorization Request Responses (2024)

Approved Authorization Requests have been approved but may have additional comments from the prescriber; a prescriber can approve Authorization Requests for one prescription or multiple (a bundle).

Approved Authorization Requests are listed in the PrescribeIT® To Do tab.

To Process an Approved Authorization Request Response:

1. In the PrescribeIT® To Do tab, select the Authorization - Approved response.

2. Select the Process button. The New Prescription window opens.

3. Review the prescription and comments (if any) from the prescriber.

4. Complete the New Prescription information. Some fields will be populated based on the previous transaction processed and can be edited, review the content and enter a Qty Auth.

5. Select the Process Now button. A Duplicate Checking prompt displays.

   

6. Select on the following:

   • Refill - fills the existing prescription. The new PrescribeIT® transaction is returned to the PrescribeIT® >To Do tab for processing at a future date.

     Note: This option is not available if there are no more refills remaining on the existing prescription.

   • ReAuth - reauthorizes the existing prescription with the new PrescribeIT® transaction. This voids any refills remaining on the existing prescription and continues the audit trail. This continues to audit trail for the existing prescription.

     Note: If the incoming PrescribeIT® transaction has a different strength than the prescription that is currently on file, you will not be able toreauthorize the existing prescription. For more information, see Reauthorizing Approved or Approved withChanges transaction with a modified strength below.

   • New Rx - creates a new prescription using the new PrescribeIT® transaction. This creates a new, separate audit trail on the patient's Profile and does not link the prescription to the existing prescription.

   • Cancel - neither the existing prescription or the incoming PrescribeIT® transaction are processed. The PrescribeIT® transaction is returned to the PrescribeIT® >To Do tab.

Approved with Changes Authorization Requests have been approved but the prescriber has made one or more changes. The response will include a new transaction and may have additional comments from the prescriber.

Approved with Changes Authorization Requests are listed in the PrescribeIT® To Do tab.

To Process an Approved with Changes Authorization Request Response:

1. In the PrescribeIT® To Do tab, select the Authorization - Approved with Changes response.

2. Select the Process button.

3. A message appears indicating that the prescriber has made changes to the prescription. Click OK.

   

   Ensure you verify the changes made by the prescriber.

   The New Prescription window opens.

4. Review the changes made by the prescriber.

5. Complete the New Prescription information. Some fields will be populated based on the previous transaction processed and can be edited, review the content and enter a Qty Auth.

6. Select the Process Now button. The following prompt displays.

   

7. Select on the following:

   • Refill - fills the existing prescription. The new PrescribeIT® transaction is returned to the PrescribeIT® >To Do tab for processing at a future date.

     Note: This option is not available if there are no more refills remaining on the existing prescription.

   • ReAuth - reauthorizes the existing prescription with the new PrescribeIT® transaction. This voids any refills remaining on the existing prescription and continues the audit trail. This continues to audit trail for the existing prescription.

     See Also

     CVS Text Messaging Program - Get text alerts from CVS pharmacyWhat doctors wish patients knew about prior authorizationDelphi murders judge bans suspect’s defense from bringing up cult theory at trialFAQs for Specialty Expedite - CVS Specialty

     Note: If the incoming PrescribeIT® transaction has a different strength than the prescription that is currently on file, you will not be able toreauthorize the existing prescription. For more information, see Reauthorizing Approved or Approved withChanges transaction with a modified strength below.

   • New Rx - creates a new prescription using the new PrescribeIT® transaction. This creates a new, separate audit trail on the patient's Profile and does not link the prescription to the existing prescription.

   • Cancel - neither the existing prescription or the incoming PrescribeIT® transaction are processed. The PrescribeIT® transaction is returned to the PrescribeIT® >To Do tab.

Denied Authorization Requests have been rejected by the prescriber; a reason will accompany the denied response. The prescriber may provide a Replacement Rx if a new prescription is prescribed.

Denied Authorization Requests are listed in the PrescribeIT® To Do tab.

To Process a Denied Authorization Request Response:

1. In the PrescribeIT® To Do tab, select the Authorization - Denied response.
2. Select the Process button. The Authorization Request Response window opens.

   

   • Reason and Comments contain information from the prescriber.

   • View Order displays the original copy of the Authorization Request.

3. Click Acknowledge.

   An activity will be created in the History tab of the patient profile based on the rejected response from the prescriber. The Authorization Request moves to the completed tab of the Message Manager and is no longer available in the To Do tab.

   Note: Selecting Cancel will bring the rejected Authorization Request Response back into the PrescribeIT® To Do tab.

Warning This feature is only available in a limited number of New Brunswick stores on PharmaClik Rx 2.7.

A prescriber may choose to respond to an Authorization Request by denying the requested medication and replacing it with another. This is referred to as a Deny and Replace. Up to 5 replacement medications can be received in a response to an Authorization Request.

1. In the PrescribeIT® To Do tab, two activities appear for the response:

   • Authorization - Denied

   • New Rx Request

   Select either activity.

2. Select Process. The Authorization Request Response window opens.

   

   • Reason and Comments contain information from the prescriber.

   • View Order displays the original copy of the Authorization Request.

   • Skip closes the Authorization Request Response window and the New Prescription window.

   • Replacement Rx displays the replacement medications that were prescribed

     Tip: You can see the full list of medications that the prescriber by hovering over the Replacement Rx field.

3. Select Acknowledge. The New Prescription window opens.

   Note: If Cancel is selected, the Authorization Request Response window closes. The Denied response must be handled before the New Rx Request can be processed.

4. Proceed with processing the PrescribeIT® prescription as per usual process.

   

When a prescriber is waiting on lab results or an appointment with the patient prior to authorizing a prescription, they may respond to an AuthorizationRequest with an Under Review Response. A reason and comments will accompany an Under Review response.

Under Review Authorization Requests are listed in the PrescribeIT® To Do tab.

1. In the PrescribeIT® To Do tab, select the Authorization - Under Review response.
2. Select the Process button. The Authorization Request Response window opens.

   

   • Reason and Comments contain information from the prescriber.

   • View Order displays the original copy of the Authorization Request.

3. Click Acknowledge. The following will occur:

   • An activity will be created in the History tab of the patient profile based on the response from the prescriber.

   • The order moves to the completed tab of the Message Manager and is no longer available in the To Do tab.

     Note: Selecting Cancel will bring the rejected Authorization Request Response back into the PrescribeIT® To Do tab.

   • If the prescriber's EMR supports PrescribeIT® v5.0 or later:

     • The Authorization Request in the Sent tab is updated from Response Received to Under Review.

     • Once the prescriber sends an approved or denied response to the Authorization Request, the response will appear in the PrescribeIT® To Do tab for processing and the status of the Authorization Request in the Sent tab will be updated to Response Received.

   • If the prescriber's EMR supports a version of PrescribeIT® earlier than v5.0:

     • The status for the Authorization Request remains as Response Received and the prescriber cannot send further updates to change the status to Under Review.

If you are attempting to select the ReAuth button for an Approved or Approved withChanges PrescribeIT® transaction and the existing prescription has a different strength, the following prompt appears.

You are unable to reauthorize an existing prescription with a PrescribeIT® transaction if the PrescribeIT® transaction has a different strength as the medications are not considered interchangeable.

To process an Approved or Approved withChanges PrescribeIT® that has a modified strength select New Rx from the prompt.

This creates a new prescription that is not linked to the existing prescription and has a separate audit trail.

It is up to your discretion if you want to inactivate or discontinue the existing prescription with the previous strength.

If you receive a PrescribeIT® transaction with a future Written Rx Date, you are not able to process the prescription and will receive the following prompt.

The future WrittenRx Date needs to be modified to the current date to be processed.

To modify theWrittenRx Date:

1. In the Rx Detail window, select the Extended tab.

2. In the WrittenRx Date field, enter today's date.

   

3. Process the prescription as usual.

1. Select the Failed or Rejected Authorization Request response.

2. Select Detail to view the reason for the rejection. The Rejection Message window opens.

   

   • The Rejection Reason displays the reason for the rejection or failure.

   • The number of Retry Attempts is displayed on the bottom.

3. Select Retry to re-transmit the Authorization Request to the prescriber. After 3 failed attempts you may be prompted to contact the doctor.

   Note: If the failure reason was due to a network communication error, there is no limit on the retry attempts.

4. Select OK to return to the PrescribeIT® Sent tab.

1. Select the Failed or Rejected Authorization Request response.

2. Select Void. The Void window opens.

   

3. Enter a reason for voiding the transaction.

   Note: The reason can be viewed in the PrescribeIT® Sent tab and patient's profile History tab by hovering you cursor over the voided transaction. A pop-up will display the reason why the transaction was voided and who set the transaction to void.

   

4. Select Yes.

   The status of the Authorization Request is set to Void in the PrescribeIT® Sent tab. You will no longer be able to Detail the Authorization Request.