MHK Interoperability Implementation Guide
0.1.0 - CI Build

MHK Interoperability Implementation Guide - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Example Basic: Eylea Injection Workflow Example

Eylea Injection Workflow

  1. Referral Received: Referral and patient information are received by the front desk.
  2. Benefits Verified: Benefits verification staff confirm the patient’s insurance coverage for Eylea injections.
  3. Prior Authorization (PA): If required, a PA is initiated and tracked through completion.
  4. Patient Scheduled: Patient is contacted and appointment is scheduled after coverage confirmed.
  5. Clinical Review: Provider reviews chart, confirms diagnosis, and documents the need for injection.
  6. Injection Visit: Injection is administered and documented in the EHR system.
  7. Charge Entry: Clinical documentation is sent to billing team for charge capture and coding.
  8. Claim Submission: Claim is submitted to the payer for reimbursement.
  9. Follow-up: Denials, if any, are appealed; payments are tracked; patient is scheduled for follow-up.