An ePA is an electronic prior authorization. It’s a 100% digital version of the pdf or paper prior authorizations that insurance companies often require before approving claims.
Due to their digital nature, ePAs have several benefits. ePAs are:
A message with the link to the PA will be sent to the provider’s office via email and/or fax, depending on the information we have on file. In this message, the provider will receive all instructions for accessing the PA.
Your office will receive an email or fax containing a link to www.MercalisPA.com, as well as a unique patient ID. When you visit www.MercalisPA.com, you’ll be asked to enter the NPI for the prescriber as well as the unique patient ID you just received. You’ll then be asked to verify the details we’ve pre-populated based on information we already have. Finally, you’ll be presented with the clinical questions to fill out.
The experience for HCPs is exactly the same, regardless of the payer’s ability to accept electronic PAs. That is, HCPs will submit the form on www.MercalisPA.com, and those forms that can’t be submitted electronically will automatically be transcribed and faxed to the payer.
Yes! You’ll need the unique patient ID to check the status of the prior auth after you submit it.
The form can’t be submitted until it’s complete; however, you can access the form again using the same process listed above (i.e., NPI+PIN). Any information you’d previously entered will be saved and you can pick up right where you left off.
The process is setup to fill out PAs as they come in, not in batches. So, you’ll need to go to www.MercalisPA.com each time and enter the NPI/Patient ID for each PA you want to fill out. We’re exploring the ability to see PAs for all your patients at once – we’ll make sure to share details when this becomes available.
On average, forms take a few minutes to complete; however, each form is specific to an insurance company, so it depends on the types of questions they ask and what additional documentation they might need.
Click the “edit” button, which will provide contact information for requesting changes. We’ll be able to make changes in our system and re-initiate the form. You’ll receive a new email/fax when this process is complete.
Yes! The process to access status for a patient is the same as when you accessed their form – simply visit www.MercalisPA.com, enter the prescriber’s NPI and the unique Patient ID, and you’ll see the status of the submitted prior auth.
Depending on the payer, a decision can be made and posted the same day. However, some payers take longer to make decisions, and others choose not to communicate their decisions digitally, requiring fax or mail communications directly with the provider.
Since some payers only communicate their prior authorization decisions directly to HCPs via fax or mail, our system may not be able to track those decisions in real time.
Please reach out to Mercalis ePA support – the contact information will be on the fax/email you received for this prior authorization, and our team of experts will help you with next steps.
Sometimes, the prior authorization process requires a set of follow-up questions. If this is the case, you will automatically receive another email/fax notifying you of these supplemental questions. From here, the process will be the same as with the first set of questions.
The process is designed to manage PAs as they come in, not in bulk. So, you’ll need to go to www.MercalisPA.com each time and enter the NPI/Patient ID for each PA you’d like to follow up on. We’re exploring the ability to see PAs for all your patients at once – we’ll make sure to share details when this becomes available.