PAXpress User Manual
Contents
1. eMedNY offers several innovative technical and architectural features facilitating the adjudication and payment of claims and providing extensive support and convenience for its users CSC is the eMedNY contractor and is responsible for its operation The information contained within this document was created in concert by eMedNY DOH and eMedNY CSC More information about eMedNY can be found at www emedny org eMedNY PAXpress User Manual Version 2013 1 03 27 2013 272. Quantity Single Fill Please eie Me BCCTDCTI808 D8 2320 Mie in me Sa bity ha Fieste cel culate 758 oropa Gayi b Days Supply Single Fill 30 Refills A 12 exncoeGed Representative NDC 63402071101 eMedNY PAXpress User Manual Version 2013 1 03 27 2013 14 CREATING A PA REOUEST 5 6 Wildcard Drug Name Searches The wildcard character can be used in a search to substitute for one or more characters in a drug name Wildcard searches allow searches such as e Beginning With Any set of characters plus the wildcard returns all drugs that begin with those characters For example SO returns all drugs that begin with SO e Containing The wildcard plus at least two characters returns all drugs that contains the specified characters For example 10 mg returns all drugs with 10 mg somewhere in the name e Bounded A more detailed instance of containing where the first characters are specified along with characters contained in the drug name with the wildcard between them For example SO 10 returns all drugs beginning with SO and containing 10 e All returns all drugs in the PAXpress system A representative set of examples follows over the next sections eMedNY PAXpress User Manual Version 2013 1 03 27 2013 15 CREATING A PA REOUEST 5 6 1 Beginning With 1 Type SO in the drug field The search results display all active drug names beginning with an SO as
3. Dialog Box Once the Request PA button is clicked a verification display box will be displayed to request the user to confirm that the information has been entered correctly The display box contains the following requested data elements Representative NDC Label Name the calculated Units per Day Days Supply Single Fill and duration Service Dates Is this information correct Requesting 00000017690 COUMADIN 2 5 MG TABLET for 1 0000 unit s per day for 30 days s for a total duration of 30 day service Dates from 5 1 7 vyvy through 6 16 submi Click the Submit or Cancel button accordingly If submitted a message briefly displays stating that the request is being processed eMedNY PAXpress User Manual Version 2013 1 03 27 2013 13 CREATING A PA REOUEST 5 5 Validation Errors Dialog Box If the information entered in the PA request fails PAXpress initial validation rules the Validation Errors dialog box will be displayed in place of the Is This Information Correct box shown in section 5 4 Validation Errors Please ensure that all PA requirements are met before submitting CI Click the OK button The user will be returned to the previous page and the field entry or entries that failed validation in the PA details section will display with an error box as shown in the example below PA Details Prescriber DOE JOHN MO 1234567890 v Drug ALVESCO 80 MCG INHALER n
4. 877 309 9493 if further assistance is needed Drug OPTIVAR 0 05 DROPS Quantity Single Fill 30 Refilis O Refills authorized may differ from request based on clinical criteria parameters Result Request Not Approved Not Certified Reference Number 10009727346 Rejection Reason s Maximum Quantity Criteria Failure 75MO Aler fify PA Request When a PA request is denied users have the opportunity to modify the submitted PA request by clicking Modify PA Request 6 3 1 Special Reject Codes The Modify PA Request button will only display if the PA was denied with any one of the following reject codes or if any one of the following reject codes is used in conjunction with other reject codes 75UD Units Per Day or Days Supply Criteria Failure 75MQ Maximum Quantity Criteria Failure 75MD Duration Criteria Failure 75UF Units Per Fill or Units Per 30 Days Criteria Failure The button will not display for other rejection reasons such as Step Therapy Or Preferred Product Required 75AT The PA Details page will be presented as shown in section 5 3 above retaining the client prescriber and PA detail values The PA may be updated and resubmitted eMedNY PAXpress User Manual Version 2013 1 03 27 2013 24 PA CREATION RESULTS 6 4 Approved PA Results If the prior authorization reguest is approved the user receives the approval message white text on a green background below the Res
5. User Manual Version 2013 1 03 27 2013 HIPAA SECURITY AND PRIVACY 2 HIPAA Security and Privacy Health Insurance Portability and Accountability Act of 1996 HIPAA is a federal law that protects health insurance coverage for workers and their families when they change or lose employment It includes the Privacy Rule enacted April 14 2003 which establishes regulations for the use and disclosure of Protected Health Information PHI the Security Rule enacted April 25 2005 which addresses electronic PHI ePHI and establishes the requirements to protect the confidentiality integrity and availability of PHI created maintained and transmitted in electronic format and Health Information Technology for Economic and Clinical Health Act of 2009 HITECH which strengthens the HIPAA regulations HIPAA is intended to Provide better access to health insurance Limit fraud and abuse Reduce the administrative costs of providing health care Standardize the content and format of electronic health care transactions and promote their use eeee Ensure privacy and security of paper and electronic PHI Under HIPAA users are to Utilize unique user id and passwords for each user Share PHI with co workers who have a need to know and the appropriate access Discuss PHI in private areas not in public areas or in telephone conversations that can be easily overheard by others Keep and protect written and electronic he
6. entries are displayed in the following format Prescriber Full Name Prescriber NPI Click the down arrow in this field to view the drop down list and use the up and down arrow keys to navigate Click to select the appropriate prescriber Note If the desired prescriber is not found enroll the prescriber into ePACES with the ETIN that is currently enrolled with the User ID eMedNY PAXpress User Manual Version 2013 1 03 27 2013 11 CREATING A PA REOUEST Drug This field is a reguired field Type at least the first three characters of the drug name or no results will be displayed A drop down list displaying associated Label Names containing the partial search seguence will appear For example typing oxy in the Drug field generates a list of drug names that begin with the letters oxy Select the appropriate drug from the list See section 5 6 for use of wildcard characters in the Drug field If applicable the Alternate Drugs list will be populated with a list of all associated Label Names for the Generic Code Number s of the Label Name entered in the Drug field The user has the option to select one of the values in the Alternate Drugs list which will replace the value of the previously selected Label Name in the Drug field Note The Representative NDC field is populated once a drug is selected in the Drug field Any modification of the value will be validated against all NDCs associated with the Label Name in the Drug fiel
7. will be displayed if any of the required fields are entered incorrectly If the client was found the message Client Found is displayed in the PA Request region under the reset button in a green box with white lettering as illustrated The next line is populated with the following client information as found in eMedNY Medicaid ID Number First and Last Name Date of Birth Gender Successful Search Results PA Reguest 03 27 2013 Service Type Pharmacy Client ID 771273457 Client Account M A Client Last Name soo Client DOB mmddiyyyy Reset Client Found 47123457 NOEN PATIENS mmiddi yyyy Male PA Details Prescriber Select a prescriber ka Drug Type to begin searching for a drug w Please select a drug to view additional alternatives Quantity Single Fill Instructions for units of use products inhalers topicals injectables etc Please enter the appropriate package size in the Quantity field Please calculate the proper days supply Frequency Quantity Duration information Days Supply Single Fill Refills Request PA Reset PA Details Representative NDC The NDC selected entered may or may not represent the NDC dispensed at the pharmacy eMedNY PAXpress User Manual Version 2013 1 03 27 2013 CREATING A PA REQUEST Unsuccessful search results indicate the incorrect field and display an error message PARS er pa request Quick Links
8. Drug Utilization Review Program Frequency Quantity Duration Program Step Therapy Program Magellan Medicaid Client Last Name Administration First 4 characters or full last name if less than 4 characters BHi Aira arih Preferred Drug List eMedN Client DOB j i 3 Medicaid Formulary O j egret ro ico Communications Documents and Help PAXApress User Manual 2012 Health Information Designs LLC AN rights reserved Please contact the system administrator for any questions eMedNY PAXpress User Manual Version 2013 1 03 27 2013 10 CREATING A PA REOUEST 5 3 PA Details Section After PAXpress successfully validates the entered client information the PA Details section is displayed All fields marked with an asterisk must be populated or an error will occur PA Details Prescriber Selecta prescriber Drug pe Please selecta Crug to view accfionai aternatves Quantity Single Fill ons fap 2352 enter tne appropaa 2338 CSicuste the proper Says Suse Frequency Guantity Duration information Days Supply Single Fill Refills Request PA Reset PA Detaiis Representative HDC The NOC selected entered may or may not represent the NDC dispensed at the pharmacy 5 3 1 Fields and Buttons Prescriber This field is a required field The Prescriber drop down list displays all prescribers associated to the user name used to log into the PAXpress application List
9. ULE Days Supply Single Fil A woROCORT 100 MG VIAL Refills A METHAPRED 125 MG VIAL A METHAPRED 40 MG UNIVIAL Request PA Reset A METHAPRED 40 MG VIAL 7 ABACAVIR 300 MG TABLET ABELCET 100 MG 20 ML VIAL ABILIFY 1 MG ML SOLUTION ABILIFY 10 MG TABLET id d Page 1of5s0 b bl Quantity Single Fill Representative NDC The NDC selected entered may or may not represent the NDC dispensed at the pharmacy eMedNY PAXpress User Manual Version 2013 1 03 27 2013 20 oe ess soi CREATION RESULTS 6 PA Creation Results PAXpress performs a validation check to ensure the requested drug requires a prior authorization There are four possible outcomes detailed in the sections below PA Not Required Open PA Exists Request Denied due to Clinical Editing or Denied by eMedNY DOH and Approved PA Results In addition new PAs for the current client may be requested from any of the four results using the Request New PA for Current Client button that appears at the bottom of the Client Information area PAXpress will return to the Client Search Results section 5 2 with the current client s information already populated The Result windows contain two areas Client Information and PA Result Client Information wall ull ull ull ull ID Full name Date of birth Gender Account number Request New PA for Current Client button PA Results BE B E EE E A response message related to
10. alth information from the eyes of others who do not need the information in order to perform their assigned jobs Make sure that casual visitors cannot wander into areas in which clinical or billing information is kept Know when a person s PHI can be shared without the person s permission and when written or oral permission is required Ensure that all policies or procedures for safeguarding the confidentiality of PHI or other sensitive material are followed Investigate and report to the Compliance Officer or designee any incident where the acquisition access use or disclosure PHI is in a manner not permitted or which compromises the security or privacy of PHI Properly dispose of printed and electronic protected health information Access PHI on company owned equipment in secured locations and not in public settings such as the mall or libraries Note PAXpress users are responsible for the preservation privacy and security of data in their possession While using the application the user has access to data that contains PHI and must be guarded and disposed of appropriately if downloaded by the user As covered entities or vendors operating on behalf of a covered entity any inappropriate use or disclosure of PHI must be handled as prescribed in the above mentioned federal regulations eMedNY PAXpress User Manual Version 2013 1 03 27 2013 REQUIREMENTS FOR USING THE PAXPRESS APPLICATION 3 Requirement
11. d If a value entered in this field is outside the NDC range is not numeric or if the field is left blank an Invalid NDC error message displays Ouantity Single Fill This field is a required field Type the quantity requested for a single fill Note If further guidance is needed to complete this field click the Frequency Quantity Duration Information link found beneath this field Days Supply Single Fill This field is a reguired field Type the days supply reguested for a single fill Note If further guidance is needed to complete this field click the Frequency Quantity Duration Information link found above this field Refills This field is a reguired field Type the number of refills reguested between 0 and 5 Note Requests that exceed the value associated with the Maximum Refills Allowed for the drug being requested will receive an error and will require re entry of the value See section 5 5 below Request PA Once all fields have been entered click the Request PA button Reset PA Details When the Reset PA Details button is clicked the system clears all previously entered information in the PA Details section The client information is retained by the application Note To completely cancel the current PA and create a new one click the PA Request tab at the top of the page eMedNY PAXpress User Manual Version 2013 1 03 27 2013 12 CREATING A PA REOUEST 5 4 Is This Information Correct
12. e 10 Refer to the second graphic below and compare its results with the first graphic 2 Scroll through the results for the desired drug If there are more than 20 results use the forward and back arrow buttons at the bottom of the dialog box to navigate the result pages 3 Click on the desired drug selection to populate the drug field PA Request 031212013 Service Type Pharmacy Client ID 771273457 Client Account MA Client Last Name xwx Client DOB mmdd yyyy Client Found 77123457 NOEN PATIENS mmiddfyyyy Male PA Details Prescriber NOEN MEDICUS MD 123467890 m Drug AB 10 ABELCET 100 MG 20 ML VIAL ABILIFY 10 MG TABLET ABILIFY DISCMELT 10 MG TABLET ABREVA 10 CREAM ABSORICA 10 MG CAPSULE ABSTRAL 100 MCG TAB SUBLINGUAL Quantity Single Fill F 1 of 1 gt P Days Supply Single Fill n M Refills Request PA Reset PA Details Representative NDC The NDC selected entered may or may not represent the NDC dispensed at the pharmacy eMedNY PAXpress User Manual Version 2013 1 03 27 2013 18 _ CREATING A PA REQUEST The addition of a space following the 10 in the search string limits the results compared to the results above that did not use a Space after the 10 PA Request 03212013 Service Type Pharmacy Client ID 2771273457 Client Account MA Client Last Name XXX Client DOB mmddfyyyy Client Found 47123457 NOEN PATIENS mm
13. f mA 7 r 4 fs r 4 i d x A t A a Y E i TA H i i fi t I i el f f W g A r eMedNY PAXpress User Manual Version 2013 1 03 27 2013 For questions pertaining to the PAXpress Application functionality or ePACES Enrollment call the eMedNY Call Center at 1 800 343 9000 For questions related to clinical criteria parameters requirements for drugs subject to prior authorization call Magellan Medicaid Administration at 1 877 309 9493 oes TABLE OF CONTENTS TABLE OF CONTENTS 1 PURPOSE STATEMENT ssssssssssossssssesossososssecosssssossssccossosossssesossosssssssesssssossssseosssssssssssosossossssscossssossssssesssssoosss 1 Zs TPA SECURITY AND PRIVACY seoor EEEE EE aaa 2 3 REQUIREMENTS FOR USING THE PAXPRESS APPLICATION ccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccccsoccccccs 3 4 ACCESSING THE PAXPRESS APPLICATION cccsccccsccccscvccccccscsccccscvccccccvaseccencncccccccasccsesencccccccacccsesecccsccccccccsesecccscceces 4 5 CREATING A PA REQUEST sssssssssssssssssscsssssssssssesosssssssssesosssssssssscosssssssssssossssssssssessssssssssssssssssssssscosssosssssseeoo 6 5 1 PARegu est Client Information Page isssrisosiisunacsrnni anaa ENa EEEE 7 DeLi Fields and BUON S ania EAEAN 7 52 Chent SearchResult sata cet nase E E E EEEO 9 53 PA Detaile SECON ec a E aa 11 SL Fields and BUTTONS u o en ee ee ee eee 11 S4 1S THs Information Correct Dialog BOX sises
14. iAddiyyyy Male PA Details Prescriber NOEN MEDICUS MD 123467890 Drug AB 10 ABILIFY 10 MG TABLET Quantity Single Fi SP HFY DISCMELT 10 MG TABLET ABSORICA 10 MG CAPSULE ik id 4 Page 1o P bi a Please calculate the proper days supply Frequency Quantity Duration information Days Supply Single Fill Refills u Reguest PA Reset PA Details Representative NDC The NDC selected entered may or may not represent the NDC dispensed at the pharmacy eMedNY PAXpress User Manual Version 2013 1 03 27 2013 19 CREATING A PA REQUEST 5 6 4 All 1 Type three wildcards The search results display all active drug names available as illustrated below 2 Scroll through the results for the desired drug If there are more than 20 results use the forward and back arrow buttons at the bottom of the dialog box to navigate the result pages 3 Click on the desired drug selection to populate the drug field PA Request 031212013 Service Type Pharmacy Client ID 771273457 Client Account MA Client Last Name xwx Client DOB mmdd yyyy Client Found 47123457 NOEN PATIENS mmiAddiyyyy Male PA Details Prescriber NOEN MEDICUS MD 1234673890 WME Drug 69 12 HOUR NASAL RELIEF SPRAY 2 DEOXY D GLUCOSE POWDER 4 AMINOPYRIDINE POWDER 5 AMINOSALICYLIC ACID POWD 5 AMINOSALICYLIC ACID POWDER 7 KETO DHEA POWDER 8 MOP 10 MG CAPS
15. icrpninaser ronko ner nsenceceiaaumeasnenaseeunnbautanccuseaniecuiamesaianosedaeneneas 13 D9 Validation Errors Dialog BOX OPER RR RKO 14 S0 VV OCA Gl Drue Name ser CNG erene E E nufsdeutdtbko 15 oL SINS N en E E E ssaceedansendeeeceancesenne 16 SO CON E E tannoteantalcovatorane 17 SSS BONI o N 18 OAE Aa A E i 20 B PA CREATION KESULI Sos 00 da sea ans sino Faon cua a AiE RENEE iNe Naana NEE aait 21 61L 9 SN oa 010 1 0 O E 22 6 2 ODen PLEXI zese A tic rura cine Aaedeiieeysietaiinetnpntinarneusieutaauer dcus cihulesukiaksedeukscu ks odesei chniskoce ib n0 23 6 3 Request Denied Due to Clinical Editing or Denied by eMedNY DOK ccccccccccccccceeeeeeeeeeesseeeceeeeeecssseeeeeeeeaaeens 24 Bigs SSC CI al SIO CU A010 ARSEN E base O O O O O 24 Eels FIOM URAR U O inbessieacesessiadoesatncsaaee eae 25 APPENDIX A MODIFICATION TRACKING csccsexessceesesosccnscoessesewesnaneneesnwe ee VKV SENSOR SG V SN SKO KV SASKO Sk 26 eMedNY PAXpress User Manual Version 2013 1 03 27 2013 eee PURPOSE STATEMENT 1 Purpose Statement PAXpress is designed for providers to request a prior approval PA from New York Medicaid This manual is designed specifically for providers to explain the following steps in using the PAXpress application Logging In Requesting a PA Understanding PA Request Results Each section includes screen shots field definitions and instructions on how to perform the various tasks eMedNY PAXpress
16. illustrated below 2 Scroll through the results for the desired drug If there are more than 20 results use the forward and back arrow buttons at the bottom of the dialog box to navigate the result pages 3 Click on the desired drug selection to populate the drug field PA Request Service Type Pharmacy Client ID 771273457 Client Account MA Client Last Name soo Client DOB mmdd yyvy Client Found 47123457 NOEN PATIENS mmiAddiyyyy Male PA Details Prescriber Select a prescriber z R Drug 50 SOCHLOR 5 EYE DROPS SOCHLOR 5 EYE OINTMENT SOD CITRATE CITRIC ACID SOLN SOD FER GLUC CPLX 62 5 MG 5 ML SOD METABISULFITE ANHYDROUS SOD METABISULFITE GRANULES SOD POLYSTYREN SULF 15 G 60 ML Days Supply Single Fill coDIUM ACETATE 2 MEQ ML VIAL F Refills SODIUM ACETATE 4 MEQ ML VIAL SODIUM ASCORBATE POWDER Request PA Reset SODIUM BENZOATE POWDER SODIUM BICARB 4 2 VIAL SODIUM BICARB 650 MG TABLET SODIUM BICARB 8 4 ABBOJECT SODIUM BICARB 8 4 SYRINGE ji d Page Vos b H Quantity Single Fill Representative NDC The NDC selected entered may or may not represent the NDC dispensed at the pharmacy eMedNY PAXpress User Manual Version 2013 1 16 03 27 2013 5 6 2 Containing 1 Type 200 in the drug field The search results display all active drugs containing 200 CREATING A PA REQUEST 2 Scroll through the results for the desired drug If there are mo
17. link to the PAXpress User Manual Announcements related to the PAXpress application such as program modifications and additions of new criteria will be displayed in the middle of the page Version 2013 1 eMedNY PAXpress User Manual 03 27 2013 CREATING A PA REOUEST 3 Creating a PA Reguest To create a PA request click the PA Request link at the top of the PAXpress home page The application will display the PA Reguest login PAIZRZSS Username Password Agreement 7 i have read and I agree to the Medicaid Confidentiality Regulations Please Note Medicaid recipient level data is confidential and is protected by state and federal laws and regulations It can be used only for the purposes directly connected to the administration of the Medicaid program You are required to read understand and comply with these regulations There are significant state civil and federal criminal penalties for violations View Medicaid Confidentiality Regulations Agree Logon If you are having trouble logging on please call 800 343 9000 2012 Health Information Designs LLC All rights reserved Please contact the system administrator for any questions 1 Enter the ePACES USERID in the Username field and password in the Password field Only ePACES User IDs that are attached to a prescribing provider can be used to enter prior approval requests via PAXpress Select the check box to indicate adherence to Medicaid c
18. onfidentiality regulations Click the Agree Logon button The PA Request Client Information page displays Note The Medicaid confidentiality check box must be selected before clicking Agree Logon PAXpress will retain the username if this check box is not selected however the password must be re entered into the Password field Contact the eMedNY Call Center at 800 343 9000 if you encounter trouble logging into the PAXpress system eMedNY PAXpress User Manual Version 2013 1 03 27 2013 CREATING A PA REOUEST 5 1 PA Request Client Information Page The PA Request Client Information page accepts client information required for a PA Request All fields marked with an asterisk must be populated PA Request 03 27 2013 Service Type Pharmacy Client ID Client Account Client Last Name First 4 characters or full last name if less than 4 characters Client DOB E MMDOYYYY Client Search Reset If any of the required fields are left blank fail field validations or do not match the system information found for the client error messages are displayed to the left side of the corresponding field as shown in the example below PA Request 031272013 Service Type Pharmacy Client ID Cien ID is required Client Account Client Last Name ABCD First 4 characters or full last name if less than 4 characters Ak Last name mismatch Client DOB nd Client Search Reset 5 1 1 Field
19. re than 20 results use the forward and back arrow buttons at the bottom of the dialog box to navigate the result pages 3 Click on the desired drug selection to populate the drug field PA Request Service Type Pharmacy Client ID 771273457 Client Account MA Client Last Name xwx ClientDOB mmddiyyyy Client Found 47123457 NOEN PATIENS mmiAddiyyyy Male PA Details Prescriber NOEN MEDICUS MD 1234673890 m De ABSTRAL 200 MCG TAB SUBLINGUAL a ACEBUTOLOL 200 MG CAPSULE ACTIQ 1 200 MCG LOZENGE ACTIO 200 MCG LOZENGE ACYCLOVIR 200 MG CAPSULE ACYCLOVIR 200 MG 5 ML SUSP ADRIAMYCIN 200 MG 100 ML VIAL Days Supply Single Fil an vaTe 200 400 UNITS VIAL Refills ADVATE 801 1 200 UNITS VIAL ADVIL 200 MG CAPLET Request PA Reset ADVIL 200 MG GEL CAPLET ADVIL 200 MG LIQUI GEL CAPSULE ADVIL 200 MG TABLET AGGRENOX 25 MG 200 MG CAPSULE ALBENZA 200 MG TABLET 4 d Page Vo is P bo Quantity Single Fill Representative NDC The NDC selected entered may or may not represent the NDC dispensed at the pharmacy eMedNY PAXpress User Manual Version 2013 1 17 03 27 2013 m CREATING A PA REOUEST 5 6 3 Bounded 1 Type AB 10 in the drug field The search results display all drugs that begin with AB and have 10 anywhere beyond the AB NOTE Type AB 10 space and the search results change to include only drugs beginning with AB where a space follows th
20. s and Buttons Client ID This field is a reguired field Enter the Medicaid identification number found on the client s Medicaid card in the following format AA12345A 2 Alpha 5 Numeric 1 Alpha Client Account This field is an optional field If known enter the Client s Account Number This is an internal office number used to identify the client the PA is for Up to 50 alphanumeric characters are allowed in this field eMedNY PAXpress User Manual Version 2013 1 03 27 2013 CREATING A PA REQUEST Client Last Name This field is a required field Enter either the first four alpha characters or the full last name of the client if less than four characters Client DOB This field is a required field Enter the date of birth of the client in mm dd yyyy format or select a specific date from the date selection picker A drop down list for the month and year will be available for selection April2112 S M T W T F S S W 4 6 c _ 5 d Today Client Search When the Client Search button is clicked the system validates a client by determining if a matching client is found in the system based on the specified client information Reset The Reset button clears all previously entered client information eMedNY PAXpress User Manual Version 2013 1 03 27 2013 CREATING A PA REOUEST 5 2 Client Search Results A valid client must be found in order to create a PA Errors
21. s for Using the PAXpress Application The New York State Department of Health NYS DOH requires that all providers have an active account with the electronic Provider Assisted Claim Entry System ePACES a component of the electronic Medicaid system of New York eMedNY Note An Electronic Transmitter Identification Number ETIN must be obtained prior to enrollment The reguirements for using ePACES and PAXpress include Internet browser that supports 128 bit encryption with JavaScript and cookies enabled Internet Explorer 7 and above Firefox v 14 and above Chrome v 21 and above or Safari v 5 and above Operating systems Microsoft Windows Mac OS or Linux To take advantage of ePACES providers need to follow an enrollment process Additional enrollment information is available at www emedny org or by clicking on the link to the web page below https www emedny org HIPAA QuickRefDocs ePACES Enrollment Overview pdf eMedNY PAXpress User Manual Version 2013 1 03 27 2013 ACCESSING THE PAXPRESS APPLICATION 4 Accessing the PAXpress Application To access the application from eMedNY org 1 Goto www emedny org Z TST INV E gt ider z What s New _ Information va Provider Manuals Training Contacts CERNE APA eMedNY lt Program Enrollment Support Tools Center 3 Login ePACES SPACES Information we lco m to gt Login eXchange Enter Facilities Practitioner s NPIS eMedNY LISTSERV Submit
22. ter Dashboard Dashboard Information Test Environment Kx MEIPASS notice LOGIN 1 Important Provider Satisfaction Survey m A PAXpress 77 December 18 2012 Reminder Medicaid to require Electronic Funds Transfer EFT for provider payments and Electronic Remittance Advice ERA or PDF version of paper remittances Click here to Go Green K Medicaid Updates Click to View Electronic PDF Remit Applications 2 Click the PAXpress button on the right side of the page Additionally PAXpress may be accessed by the following links https newyork fhsc com select the PAXpress link from the Quick Links menu tab https paxpress nypa hidinc com eMedNY PAXpress User Manual Version 2013 1 03 27 2013 ACCESSING THE PAXPRESS APPLICATION The PAXpress home page will appear as shown below home Quick Links There are currently no new announcements Drug Utilization Review Program Frequency Quantity Duration Program Step Therapy Program Magellan Medicaid Administration Preferred Drug List eMedNY Medicaid Formulary Important Provider Communications Documents and Help e PAXpress User Manual 2012 Health Information Designs LLC All rights reserved Please contact the system administrator for any questions The page contains three main sections Quick Links this section contains links to sites of interest for pharmacy providers Documents and Help this section contains a
23. the result type Drug Ouantity single fill Refills Result Reference number Rejection reason s for denied duplicate and non required PAs only eMedNY PAXpress User Manual Version 2013 1 21 03 27 2013 PA CREATION RESULTS 6 1 PA Not Required If the drug does not require a prior authorization a display in red text below Reference Number in the PA Results section will identify the rejection reason as Drug does not require a prior authorization Client Information ChentiD 77123452 Client Full Name NOEN PATIENS Client DOB mm dd yyyy Client Gender Male Client Account N A Request New PA for Current Client J PA Results The drug being requested requires additional information Please call the New York State Medicaid Pharmacy Prior Authorization Call Center at 1 877 309 9493 if further assistance is needed Drug OPTIVAR 0 05 DROPS Quantity Single Fill 30 Refills 0 Refills authorized may differ from request Dased on clinical criteria parameters Result Request Not Approved Not Certified Reference Number 10009727346 Rejection Reason s Maximum Quantity Criteria Failure 75MO Modify PA Request eMedNY PAXpress User Manual Version 2013 1 03 27 2013 22 PA CREATION RESULTS 6 2 Open PA Exists If the prior authorization request already exists or is a duplicate PA for the drug being requested for the client a display in red text below Reference Number in the PA Results section
24. ult field in the PA Results section Client Information ClientiD Z712345Z Client Full Name NOEN PATIENS Client DOB mmidd yyyy Client Gender Male ChentAccount N A Request New PA for Current Client PA Results 00075150616 NASACORT AQ NASAL SPRAY for 17 unit s Service Dates from 07 02 yyyy through 07 02 yyyy Drug NASACORT AQ NASAL SPRAY Quantity Single Fill 17 Refills O Refills authorized may difer from request Da0d0 on Clinical criteria parameters Result Request Approved Certified The drug being requested has been approved The NDC selected may or may not represent the NDC dispensed at the pharmacy Reference Number 12222222222 PA Start Date 07 02 yyyy PA End Date 07 02 yyyy For an approved PA the Prescriber may advise clients that the drug has been approved for fill at a Medicaid enrolled pharmacy of their choice eMedNY PAXpress User Manual Version 2013 1 03 27 2013 25 APPENDIX A MODIFICATION TRACKING APPENDIX A MODIFICATION TRACKING 9 6 2012 Version 2012 1 Initial publication of the PAXpress User Manual 3 27 2013 Version 2013 1 Added Wildcard Drug Name Searches section 5 6 eMedNY PAXpress User Manual Version 2013 1 03 27 2013 26 oe ess EMEDNY INFORMATION eMedNY is the name of the electronic New York State Medicaid system The eMedNY system allows New York Medicaid providers to submit claims and receive payments for Medicaid covered services provided to eligible clients
25. will identify the rejection reason as Existing Open PA Client information ClientiD 77123452 Client Full Name NOEN PATIENS Client DOB mm dd yyyy Client Gender Male ClientAccount N A Reguest New PA for Current Client PA Results The client has an existing open prior authorization for the requested drug Please call the New York State Medicaid Pharmacy Prior Authorization Call Center at 1 877 309 9493 if further assistance is needed Drug VICODIN 5 500 TABLET Quantity Single Fill 30 Refills O Refills authorized may differ from request based on clinical criteria parameters Result Request Not Approved Not Certified Reference Number 10009727345 Rejection Reason s Existing open PA E gt eMedNY PAXpress User Manual Version 2013 1 03 27 2013 23 PA CREATION RESULTS 6 3 Request Denied Due to Clinical Editing or Denied by eMedNY DOH If the prior authorization request is denied the rejection reason s with associated reject code will display in red text below Reference Number in the PA Results section will identify the rejection reason as Maximum Quantity Criteria Failure 75MQ Client Information Client ID 7712345Z Client Full Name NOEN PATIENS Client DOB mmiddiyyyy Client Gender Male Client Account N A Request New PA for Current Client PA Results The drug being requested requires additional information Please call the New York State Medicaid Pharmacy Prior Authorization Call Center at 1
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