What is the process once the PA request is received?
Providers may submit PAs either online or on paper. Online submission is strongly encouraged. If submitted online, the system performs validation checks to ensure that required fields are completed and certain minimum information such as provider ID, member ID, procedure code, and dates are included and are valid. PAs submitted on paper are keyed into NewMMIS by PA staff and the system performs similar checks. In both cases, the PA is also stamped with the receipt date. The PA is then forwarded to the appropriate consultant for review and decision. After a decision is made, decision letters are mailed to both the provider and the member.
