Prior Authorization

Through Zaya, you can submit the information required for prior authorization to all payers. The Zaya team will use this information to obtain prior authorization and will update you with the outcome.

If you're intending to see a patient that is subject to prior authorization for the first time through Zaya, your practice will need to re-obtain prior authorization. The patient's first visit billed under Zaya is considered an EVAL visit.

Submit authorization information for a new patient

1. Navigate to the Prior Authorization page on the portal. If, during the eligibility check, the patient is determined to be Zaya billable and prior authorization is required, the patient will be listed under the Pending tab on the Prior Authorization page.

2. Press 'Submit Information' to begin completing the patient's form. Use the 'Continue' and 'Back' buttons to navigate through the form.

3. In the final step, Attestation and Completion, you must attest to submit the form to Zaya.

Note: Anthem BCBS requires additional information. For this payer, there are additional questions you need to complete.

View authorization outcomes

The Zaya team will submit the patient’s information for authorization within 24-48 business hours. Once the authorization outcome has been received from the payer, the patient will be moved from 'Submitted' to either 'Approved' or 'Denied.'

• Approved: The patient has been approved by the payer. Here, you will find the date the authorization was approved, the authorization number, the approved date range, and the approved visits/units.

• Denied: The patient has been denied by the payer. Here, you will find the date the authorization was denied.

Resubmit information to obtain reauthorization

To reobtain authorization, navigate to the ‘Approved’ tab. To ensure continuous care for your patient, it’s important to reobtain authorization before the approved date range ends or the approved visits/units are used up, whichever occurs first. Avoid waiting until the last minute to request renewals to prevent disruptions in patient care. Your EHR might track expiration dates automatically.