PA Assistant works Prior Authorization and Medicare Bridge cases assigned through the documented process.
→ Patient communication should be limited to the PA or Medicare Bridge process being worked.
→ Do not take over or respond to general Client Success conversations unless specifically assigned to do so.
→ If you identify something outside the PA Assistant role, route it to the AMS Process channel in Slack rather than resolving it — even when it seems simple.
→ Escalate as a process concern, not as a specific person issue.
AMS only processes a Prior Authorization when the client has requested that AMS complete a PA.
→ A fax or email from a pharmacy or other outside party stating that a PA is needed does not trigger the PA process.
→ Do not contact the client after receiving a PA fax/email.
→ Archive emails and faxes that do not require action — do not delete.
Check #ams-playbook-improvement and #ams-process-channel.
→ Read each new update completely.
→ Add your personal emoji to show it was read.
→ If action is required, complete it and add ✅ when finished.
Normal goal: approximately 10–15 minutes. During active process/training updates, this may take longer.
→ Open the HIPAA-compliant Chrome profile associated with [email protected].
→ Password is stored in 1Password.
→ Review new/unread email.
→ Handle PA Assistant items that require action.
→ Archive items that do not require action.
→ Open Doximity (login in 1Password).
→ Review new/incoming faxes.
→ Identify anything related to an existing client-requested PA or Medicare Bridge case.
→ Handle items requiring PA Assistant action.
→ Archive items that do not require action.
→ Open GHL → Tasks.
→ Review tasks assigned to Anne Marie for clients who have requested a PA.
→ Open the client record and review the handoff/context.
→ Follow up with the client in HealthAide.
→ Complete the GHL task after the handoff has been received and the appropriate PA follow-up has been started.
→ Add the new PA into the PA Tracker (see Section 6).
→ Communicate with the client in HealthAide throughout the PA process.
→ Give clear status updates as the PA progresses:
• Waiting for insurance response
• Additional information is needed
• PA approved or denied
• Next action required, when applicable
→ Open the HIPAA-compliant drive.google.com within the [email protected] profile.
→ Open the PA Tracker.
→ Create/update the patient's PA record as the PA progresses.
• Patient Name — REQUIRED
• DOB — REQUIRED
• CMM Key — REQUIRED when initiated in CoverMyMeds
• Status — REQUIRED and kept current
• Approval Date, Approval Term, Expiration, and Start Next PA — when applicable
• Last Date Patient Notified — REQUIRED
• GHL Updated — REQUIRED
• Charted in HealthAide — REQUIRED
• Notes needed to understand or continue the case, placed in HealthAide
→ PA work hours must also be recorded on the calendar using the required format so it can be identified during the payroll sweep.
PA Assistant does not mark the PA as Paid — that is a payroll/Linda function.
