New Medical Authorizations Transaction

Health Plans: 

  • Medical Mutual of Ohio

Workflow: 

  • Medical Authorizations

Overview

NaviNet Open Medical Authorizations enables provider offices to submit and access medical authorizations in real time.

About this New Features Guide

The enhancement details in this New Features Guide are plan-specific to Medical Mutual of Ohio and include optional features implemented on behalf of the plan.

This new features guide is not meant to be a user guide. For a complete user guide that describes all functionality in detail, see the NaviNet Open Medical Authorizations User Guide.

Accessing NaviNet Open Medical Authorizations

To access this transaction, Navigate to Workflows > My Health Plans > Medical Mutual of Ohio.

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Under Workflows for this Plan, select Medical Authorizations.

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Searching for an Existing Authorization

  1. Go to Workflows > My Health Plans > Medical Mutual of Ohio.
  2. Under Workflows for This Plan, click Medical Authorizations.
  3. On the Authorizations screen, enter search criteria and click Search.
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  4. If your search returns multiple authorizations, the Search Results screen appears. Click anywhere in an authorization's row to select the desired authorization.
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  5. In the Authorizations Details screen, review the member, authorization, and provider details. Image
  6. To print or save a copy of the authorization, click View/Print as PDF in the top-right corner of the screen.

Submitting an Authorization

  1. On the Authorizations screen, click Create New Authorization
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  2. Search for and select a patient for the new authorization. Once you have entered search criteria, click Search. You can search by:
    • Member ID and Date of Birth
    • Name and Date of Birth
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  3. Review the Authorization Pre-Screening Questions and click Continue.
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  4. Fill out the Create New Authorization screen fields. Keep in mind:
    • At least one of the providers you select must be in your office.
    • When submitting inpatient authorizations, the selected requesting and servicing providers must be physicians. Use the Servicing Facility field to select a facility.
    • You can include service type, place of service, requesting and servicing providers, diagnoses, services, attachments, clinical notes, and contact information. See NaviNet Open Medical Authorizations User Guide for more help with filling out the Create New Authorization screen fields.
  5. Click Submit.
  6. If you are submitting an inpatient authorization, the Discharge Supplemental Information screen appears. Complete the questions and click Submit
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Authorizations Details Screen

When you click Submit, the Authorization Details screen appears and summarizes the information provided in your authorization submission, including a status bar with the current status of the authorization and the authorization number. For example, the status of the following authorization is "Pending".

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