Using Electronic Prior Authorization (ePA)

SigmaMD supports ePA (Electronic Prior Authorization) through its integration with DoseSpot. This allows clinicians to efficiently complete prior authorization requests for medications directly within the prescribing workflow. Below is a step-by-step guide on how to use ePA in SigmaMD.

What is ePA?

ePA allows clinicians to request medication prior authorizations electronically, reducing delays and manual paperwork. It is available for patients with pre-populated formulary information in DoseSpot, and clinicians must have the “ePA” role enabled to use this feature.

How to Initiate an ePA Request

1. Open the Patient’s Chart

  • Begin by accessing the patient chart and navigating to the ePrescribe module.

2. Select Medication

  • Locate the medication under the “Pending Medications” list.

3. Start Prior Authorization

  • From the Actions dropdown, select Start Prior Auth.
  • You will see a popup asking how to proceed.

4. Choose ePA Request

  • Select ePA Request to begin the electronic process. Optionally, you can choose Expedite Prior Authorization to send the request as urgent.

Active Prior Authorization Requests

After initiating, the medication will move to the Active Prior Authorization Requests section. Here, you can:

  • Monitor status (Pending, Action Required, Approved, etc.)
  • View detailed logs by clicking on the status icon
  • Access Prior Authorization History for finalized outcomes

Responding to Questions

If the payer requires more information:

  • The status will show Action Required
  • Click Answer Questions from the Actions dropdown
  • Complete the question set and click Submit

If the ePA Is Approved

The prescription will move back to Pending Medications. You may now:

  • Approve and send it to the pharmacy
  • Or approve and print it

If the ePA Is Denied

If the prior auth is denied:

  • Click Appeal Prior Auth from the Actions dropdown
  • Add a comment and submit the appeal
  • If additional info is requested, repeat the question and submission process

Partial Denials

If a PA is partially denied:

  • You can accept the denial
  • Or select Cancel and Restart to edit and resubmit the prescription

ePA Notifications

SigmaMD automatically notifies the assigned care provider of any updates to the prior authorization status. There are three types of notifications:

  • Approved Prior Authorization: Sent via push notification and SMS
  • Denied Prior Authorization: Sent via push notification and SMS
  • All Other Updates: Sent via push notification only

These notifications help ensure the care provider stays informed throughout the prior authorization process.

If you experience issues using ePA, please contact our support team for assistance.