This job aid describes how to:
*	Complete a previously saved, but not submitted, Prior Authorization request via the Provider Online 
Service Center.
Access Inquire/Maintain PA Request
From the Provider Online Service Center home page:
1.	Click Manage Service Authorizations.
2.	Click Prior Authorizations.
3.	Click Inquire/Maintain PA Request. The Search for Prior Authorization panel is displayed.
Search for PA Request
On the Search for Prior Authorization panel:
4.	Enter the Tracking Number or Prior Authorization Number for the request.
Note: If you don’t know the Tracking Number or Prior Authorization Number, you can perform a search 
for the request using the other search criteria on the panel.
5.	Click Search.
On the Search Results panel:
6.	Click the Tracking Number of the desired request.
Review Request
On the Base Information panel:
7.	Review the request information to ensure you have the correct request.
8.	Click the Attachments tab.
Add Attachment
On the List of Attachments panel:
9.	Click New Item. The Attachment Details panel is displayed.
On the List of Attachments panel:
10.	Select the Report Type from the drop-down list.
11.	Select the Transmission Code from the drop-down list.
12.	Enter a Control Number for the report you want to attach.
13.	In the Description field, enter a brief comment or description of the report.
14.	Click Browse.  The Choose File window is displayed.



Select File to Attach
On the Choose File window:
15.	Navigate to the file you want to attach.
16.	Click Open. The Choose File window closes and the path of the selected file is displayed in the File 
Name field.
Upload Attachment
On the Attachment Details panel:
17.	Click Add/Upload. The List of Attachments panel is displayed.
On the List of Attachments panel:
18.	Click the Confirmation tab.
Confirm and Submit Request
On the Confirmation panel:
19.	Verify that the information on the panel is correct.
20.	Click Submit. The Prior Authorization Response panel is displayed, indicating that you have 
successfully submitted the request.



Glossary of Terms
Adjudicate – There are header level PA statuses to tell where the PA request is in the process.  Adjudicated means
MassHealth has made a decision on the PA and that all lines have been finalized. Finalized is when all line statuses are 
cancelled, approved, modified, or denied.  When the PA is adjudicated, a letter is sent to the member (with right to appeal 
for denied or modified lines), PCM and FI.

Control Number – Number assigned by PCM for an attachment that will be stored at PCM office (only applies when 
Transmission Code is Available on Request at Provider Site).

Report Type – Documentation submitted with request by PCM. There are two options for PCM:
	Initial Assessment – initial request
	Patient medical History Document - reevaluation 

Status – Indicates where the request is in the process of being reviewed and adjudicated. Status options:
	Additional Information Received – Indicates information has been received that was missing from the original 
request.
	Approved – Request is approved by MassHealth.  A PA letter is generated and sent to the member, the PCM and 
the FI.
	Cancelled – Request is cancelled by MassHealth due to duplication or insufficient information.  A PA letter is 
generated and sent to the member, the PCM and the FI with a reason for the cancellation.   The PCM may resubmit 
the request as appropriate.
	Cancelled by Provider – Status used for all lines when Provider (PCM) Voids the PA Request. 
	Note:  provider can only void a PA while the PA is in Ready for Review status.
	Denied – Request has been denied by MassHealth. A PA letter is generated and sent to the member (with right to 
appeal), and to the PCM and the FI.
	In Process – Request has only been saved, and has not been submitted to MassHealth for review.
	In Review – Request has been submitted by PCM and assigned to a MassHealth reviewer. 
	Modified – Request has been altered by MassHealth reviewer either in adjudicating or as an adjustment requested 
by the PCM.  A PA letter is generated and sent to the member (with right to appeal), and to the PCM and the FI.
	Ready for Review – Request has been submitted, but has not been assigned to MassHealth reviewer.
	Testing – Request has been submitted in order to test functionality of the system.
	Void – Request has been voided by MassHealth.  A PA letter is not generated.
Tracking Number – Number assigned to PA request prior to MassHealth review.

Transmission Code – Method by which PCM transmits attachment to MassHealth. There are six code options:
	Available on Request at Provider Site
	By Fax
	By Mail
	Electronically Only
	Email
	Voice

NewMMIS Job Aid: Complete a Saved Prior Authorization 
MassHealth Provider Online Service Center	1 of 4	Revised: July 27, 2010
		v2.3
Provider Online Service Center - Submit a Referral
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