This job aid describes how to:
*	Inquire on a previously 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 Member ID associated with the request.
5.	Select the Status from the drop-down list (Optional)
6.	Select the Requesting Provider from the drop-down list.
7.	Select the Assignment Code from the drop-down list (Optional)
8.	In the From Date and To Date fields, enter a date range for the search.
9.	Click Search.
On the Search Results panel:
10.	Click the Tracking Number of the desired request.

Review Request
On the Base Information panel:
11.	Review the request information.  When you have finished reviewing the request, you can do one of the 
following:
*	Click Close to go back to the Search for Prior Authorization panel, where you can start a new 
search for a request.
*	Click Return to Search Results to go back to the Search Results panel, where you can select 
another request matching the current search criteria.





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: Inquire on a Prior Authorization 
MassHealth Provider Online Service Center	1 of 3	Revised: August 4, 2010
		v2.2
Provider Online Service Center - Submit a Referral
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