Patient insurance information
Check eligibility in-force
Check Policy information for nphies deductible and max limit
Any problem in contracts shall be updated for correct nphies response.
Select nphies pre-auth type:Professional
Empty or Need intervention group
Missing nphies code,procedure group not mapped in system as per nphies requirement.
To fix this :-
You need to make sure that all products in the requested are correctly mapped with the correct CPT Code in the charge master.
And the cpt code already assigned to procedure group in the cpt 4 codes screen
Do not continue with Process:
nphies payer license not updated in Business partner.
nphies server time-out(needs to be resubmitted)
Expected or correct responses from nphies
Pending & Queued :Need to be responded to by the insurance company by approving or rejecting the pre-auth request.
To be used after a few minutes to check the HIC response for the pre-auth.
Once the pre-auth request response is polled as approved,PSO can continue with the Service order posting & billing process.