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
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<div xmlns="http://www.w3.org/1999/xhtml"><h2>Eylea Injection Workflow</h2><ol><li><strong>Referral Received:</strong> Referral and patient information are received by the front desk.</li><li><strong>Benefits Verified:</strong> Benefits verification staff confirm the patient’s insurance coverage for Eylea injections.</li><li><strong>Prior Authorization (PA):</strong> If required, a PA is initiated and tracked through completion.</li><li><strong>Patient Scheduled:</strong> Patient is contacted and appointment is scheduled after coverage confirmed.</li><li><strong>Clinical Review:</strong> Provider reviews chart, confirms diagnosis, and documents the need for injection.</li><li><strong>Injection Visit:</strong> Injection is administered and documented in the EHR system.</li><li><strong>Charge Entry:</strong> Clinical documentation is sent to billing team for charge capture and coding.</li><li><strong>Claim Submission:</strong> Claim is submitted to the payer for reimbursement.</li><li><strong>Follow-up:</strong> Denials, if any, are appealed; payments are tracked; patient is scheduled for follow-up.</li></ol></div>
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