What if the HCP/office prefers to do their own PA?
PhilRx can support HCP/offices that prefer to do their own PA. PhilRx will notify the HCP office via Fax (or email depending on their preference) if a PA is required. If PhilRx is not notified of the outcome of the PA based on the Business Day Rule, PhilRx will rerun the claim to determine if approved/denied or pending. If pending, PhilRx will reach out to Payer for a status update. If the claim is not approved or denied by the end of Business Day timer, then PhilRx will reach out to the HCP office to determine the next steps.
