What is MRE validation in Pre-authorization Transaction? ماهو MRE

Pre-authorization transaction can be sent to MRE (Medical Rule Engine) for clinical validation. Only following types of product or services are covered for MRE validation: -

•          Procedure

•          Laboratory

•          Transportation SRCA

•          Imaging

•          Services

•          Dental 

Note: This is a configuration-based feature. It will only be visible to any provider, if Waseel Admin have enabled MRE Configuration for you.

To perform MRE validation, provider need to follow below mentioned steps: -

Step 1: Create Pre-Authorization request, navigate to NPHEIS -> Pre Authorization -> Request Pre Authorization page.

Step 2: Enter “Pre Authorization Info” section (all fields with * are mandatory)

Step 3: Enter Care team.

Step 4: Enter Diagnosis Information (Field with * are mandatory) 

Step 5: Provide Supporting Info. (optional)

Step 6: Enter Items Information (Field with * are mandatory). For PBM please add items out of mentioned categories (Procedure, Laboratory, Transportation SRCA, Imaging, Services

& Dental). 

Step 7: Enter accident details. It is an optional section under which Healthcare provider need to enter details, if patient encountered any accident. 

Step 8: 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. 

Step 9: Click upon request MRE button. PBM response will appear on screen

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