Waseel ASP

To perform Request EBP Pharmacy Pre-authorization Transaction, you need to follow below mentioned steps: -

Step 1: Navigate to NPHEIS -> Pre Authorization -> Request Pre Authorization page.

Step 2: Search for Beneficiary 

Note: Please register a new beneficiary if the record does not exist. Searching for a beneficiary fill the Insurance Plan drop down if the insurance information available otherwise, please add the insurance plan information to the beneficiary details.

Step 3: Enter “Pre Authorization Info” section (all fields with * are mandatory). Select the pre-authorization type as “Pharmacy”

Note: In case, you have already raised a Prescription Request and want to link that with current Pharmacy Pre-authorization. Please enter information under “Prescription Reference No.”. 

Step 4: Enter Care team.

Step 5: Enter Diagnosis Information (Field with * are mandatory) 

Note: When pre-authorization type is Optical, healthcare provider will be mandated to fill the Vision Prescription. This section will appear in between Diagnosis and Supporting info.

Step 6: Provide Supporting Info, add “Days Supply”.

Step 7: Enter Items Information (Field with * are mandatory). Use this section to add product or service information that need an authorization and corresponding pricing breakdown. Here, three additional fields will play key role as per the new EBP guidelines, you need to enter information as per the case requirement: -

Step 8: Enter accident details. It is an optional section under which Healthcare provider need to enter details, if patient encountered any accident. 

Step 9: Click on the “Request Authorization” to submit the authorization Request. After filling all the authorization request details, this is the last step to submit authorization. 

Note: While submission of Pre-Authorization request, if user missed to enter any mandatory information, then system will give details of missed.