Retrospective ePA is available now. Auto-Start ePA (real-time, prospective PA initiation at the point of prescribing is not yet available. If you're interested in enabling Auto-Start ePA please contact DrChrono Support.
Overview | Retrospective ePAs | Validations & Exceptions | Patient not Found | Complete a Prior Authorization | View Payer Responses | View Existing Prior Authorizations |
Overview
Retrospective ePA streamlines the prior authorization process by replacing many fax-based pharmacy requests with an electronic workflow. When a pharmacy identifies that a medication requires prior authorization, the request is sent electronically through CoverMyMeds and delivered directly to DrChrono for review and completion. Providers and staff can manage the entire request from within DrChrono, keeping prior authorization activity organized in the Message Center and the patient's Authorizations tab.
Key Benefits
- Reduce manual work by replacing many fax-based prior authorization requests with an electronic work flow.
- Manage requests in one place by reviewing, completing, and tracking prior authorizations directly in DrChrono.
- Stay informed with electronic notifications and payer responses available in the Message Center.
How Retrospective ePA Works
- A pharmacy determines that a medication requires prior authorization.
- CoverMyMeds sends the prior authorization request electronically to DrChrono.
- DrChrono validates the request by confirming the medication, patient, prescriber, and checking for existing prior authorizations.
- If validation is successful, the request becomes available for completion within DrChrono.
- If additional information is required, providers complete the requested questions and submit the prior authorization electronically.
- Payer responses (Approved, Denied, or More Information Needed) are returned directly to DrChrono.
Validation & Exceptions
Each incoming prior authorization request is automatically validated before it becomes available.
Common validation checks include:
| Validation | What Happens |
| Medication not found | Provider receives a notification |
| Prescriber not matched | Provider receives a notification |
| Duplicate PA already exisits | Provide is notified that a request is already in progress |
| Patient cannot be matched | Provider must either attach the patient to a chart or deny the request |
Patient Not Found
If DrChrono cannot match the patient to an existing chart, the request is placed on hold until action is taken.
Choose one of the following:
Option 1: Deny the Request | Option 2: Attach the Patient |
|
|
Completing a Prior Authorization
 |  |
You can complete a prior authorization from either location:
| Message Center | Patient Chart |
|
|
Payer updates typically appear within a few minutes after submission, although timing may vary by payer.
Viewing Payer Responses
- To review the payer's decision:
- Open Message Center.
- Navigate to ERX > Prior Authorization.
- Select the patient's request.
Possible responses include:
- Approved
- Denied
- Complete More Questions
If additional information is requested, select Complete More Questions, answer the requested items, and submit the prior authorization again.
Viewing Existing Prior Authorizations
To view all prior authorization requests:
- Open the patient chart.
- Navigate to Demographics > Authorizations.
Available statuses include:
- Initiated
- Open
- Requested
- Approved
- Denied
- Expired
From the Action menu, you can:
- Send a PA
- Cancel a request
- Archive a request
- View the payer response