Electronic Prior Authorization workflow mockup streamlining medication approval between prescribers and health plans.
Overview
The ePA (electronic Prior Authorization) Solution is an interactive mockup demonstrating a modern workflow system for processing prescription prior authorization requests. This demo showcases the user interface and experience for healthcare organizations managing PA requests electronically, replacing traditional phone calls and faxes with a streamlined digital workflow.
Key Concepts
Request
A Request is a single, specific prior authorization submission for a particular medication.
- Organization: Requests appear in a dashboard or list format, showing the status of each individual submission to the health plan
- Workflow: A new request is started when a patient needs a PA for a specific prescription, guiding users through entering patient, prescriber, and medication details
- Tracking: Real-time status and determination (approved/denied) can be tracked for each PA request
Case
A Case is a comprehensive, patient-centric view that groups all prior authorization activities for an individual patient.
- Organization: The Cases dashboard is organized by patient name, date of birth, and demographic information
- Workflow: Within a patient's case, you can see multiple requests across different medications or time periods
- Tracking: Provides a holistic picture of all the patient's medication access needs in one place
Demo Features
Dual Navigation — Switch between Requests view (individual PA submissions) and Cases view (patient-centric grouping).
Request Queue Management — View and manage PA requests with Current and Sent to Plan subtabs, each with real-time counts.
Search & Filter — Quickly find requests by patient name, request ID, drug name, or provider.
Expandable Cases — Click a patient case to reveal all associated requests with their statuses.
Detailed Review Panel — Click any request to open a comprehensive side panel with patient info, prescription details, provider data, diagnosis codes, and clinical notes.
Status Workflow — Visual flowcharts showing the complete PA and Appeal workflows with color-coded status badges.
Healthcare Context
Prior Authorization (PA) is a requirement from health insurance companies that healthcare providers obtain approval before a specific medication will be covered. Electronic Prior Authorization (ePA) solutions streamline this process by:
- Replacing manual paperwork and fax-based workflows
- Providing real-time status visibility
- Enabling faster turnaround times (sometimes minutes instead of days)
- Improving communication between providers and payers
Technical Implementation
This mockup is built with modern web technologies to demonstrate responsive UI patterns suitable for enterprise healthcare applications. The interface supports both light and dark modes and is designed with accessibility in mind.
Status Workflow
Prior Authorization Flow
The standard PA workflow follows this progression:
Appeal Flow
If a PA is denied, providers can submit an appeal:
Status Reference
Request created, awaiting submission
Location: Current
Initial PA submitted to payer
Location: Sent to Plan
Payer questions need provider response
Location: Current
PA question responses submitted
Location: Sent to Plan
PA approved by payer
Location: Sent to Plan
PA denied by payer
Location: Sent to Plan
Appeal submitted after PA denial
Location: Sent to Plan
Appeal question responses submitted
Location: Sent to Plan
Appeal approved
Location: Sent to Plan
Appeal denied (final determination)
Location: Sent to Plan
Key Features
- •Requests & Cases dual navigation
- •Patient-centric case grouping
- •Real-time search and filtering
- •Expandable case rows with request details
- •Status workflow (New → Request Submitted → Question Respond → Answers Submitted → Approved/Denied)
- •Detailed request review panel