TransparentPA

Prior Authorization and
Pre-Certification Portal

TransparentPA is a web-based self-service Prior Authorization Portal that allows members, physicians, and health plans to submit and manage prior authorization requests or renewals. It is hosted on the Google Cloud infrastructure. TransparentPA provides end-to-end encryption and is HIPAA compliant.

Before you get started, in addition to the insurance card, you will need the following information. Members can check the formulary to determine if their medication requires a prior authorization.

For Prescription Drugs:

  • Name of drug/medication
  • Strength of the drug (example 5 mg)
  • Quantity being prescribed
  • Days Supply

For Medical Services:

  • Description of service
  • Start date of service
  • End date of service
  • Service code if available (HCPCS/CPT)

How To Get Started

  • If you don't already have one, create a Gmail (required) account for office use. It is secure, HIPPA compliant, and expedites processing. The electronic PA response will be sent to the email address of your choice.
  • Click on NEW PRIOR AUTHORIZATION.
  • Use the NEW PRIOR AUTHORIZATION drop down to select the specific prescription drug pertaining to the request.
  • If there is no PA form specific to the prescription drug pertaining to the request, select the General PA form. Selecting the General PA form when there is a drug specific form available will delay the review.
  • Complete the criteria regarding the patient’s prior authorization request. The form is automatically saved for easy retrieval.
  • The questions will use skip logic so that only applicable questions are required.
  • If you have any supporting documents, attach those documents in the form. TransparentPA provides end-to-end encryption and is HIPAA compliant.
  • The prescriber will be notified via email to check the status of the PA request upon completion of our review.