Medmonk
Workflow Overview

Multi-Point Referral
Intake via Hub

A fully branded, end-to-end workflow covering referral intake, benefits investigation, prior authorization, copay processing, and real-time analytics — all through one unified hub.

Fully Branded Real-Time Analytics Automated PA ACH Payments
Medmonk

Complete Workflow Overview

📋
Prescriber Sends Referral
↓
eScribe
EMR
Via Pharmacy
Direct
Prescriber Portal
Web-based
Hub
Phone & Fax
↓
Medmonk
Branded Hub • All channels unified
↓
BI
Benefits Investigation
↓
Provider Pinged
Portal updates
Welcome Call
4–6 hours
Opt-In SMS
Patient consent
↓
Automated PA
Auto-generated LMN
↓
👤
Patient
Opt-In
If not: Support calls at 24hr, 48hr, 72hr
✓
PA
Approved
If not: Follow-up or appeal
↓
Patient Packet
Portal upload
Manufacturer Portal
Real-time analytics
↓
Pharmacy Copay
NCPDP <3 sec
↓
Medical Copay
EOB / 835
↓
Real-Time Analytics
Timestamps tracked

📋 Step 1: Referral Intake

📋
Prescriber Sends Referral
↓
eScribe
EMR
Via Pharmacy
Direct
Prescriber Portal
Web-based
Hub (Phone & Fax)
Direct intake
↓
Medmonk
Branded Hub • All channels unified

⚡ Step 2: Parallel Actions Fire

Medmonk
Branded Hub
↓
Benefits Investigation
Electronic/Manual BI
Provider Pinged
New patient alert
Welcome Call
Within 4–6 hours
Opt-In SMS
Patient consent text
↓
👤
Patient
Opt-In
If not: Support calls at 24hr, 48hr, 72hr intervals

✓ Step 3: Prior Authorization

Benefits Investigation
Coverage confirmed
↓
Automated PA Initiation
Auto-generated LMN based on DX & payor guidelines
Unique Prescriber Link
Review, approve, eSubmit to primary payor
↓
✓
PA
Approved?
If not: Follow-up or appeal
↓
✓ Approved
Continue workflow

📦 Step 4: Post-Approval Actions

✓
PA
Approved
↓
📦
Patient Packet Uploaded
On provider portal
📊
Manufacturer Portal
Real-time analytics: BI, PA, dispensing, refills, prescribers, copay

💳 Step 5: Copay Claims Processing

📦
Patient Packet Uploaded
↓
Pharmacy Copay Claim
NCPDP Secondary Payor
Provider processes to Medmonk as secondary payor via NCPDP in <3 seconds
Medical Copay Claim
Provider uploads EOB or receives 835 via clearinghouse

📊 Step 6: Real-Time Analytics

📊
Real-Time Analytics Dashboard
Timestamps tracked across entire workflow
↓
BI Timeline
PA Status
Dispensing
Refills
Prescribers
Copay

💰 Step 7: ACH Payment & Remittance

Medical Copay
EOB / 835 from clearinghouse
↓
💰
Process ACH Payments
Automated payment processing
↓
📄
Post Remittance on Provider Portal
Complete financial loop closure
Medmonk

Workflow Complete

End-to-end automated workflow from referral to payment, fully branded to manufacturer.

🎯
One Hub
Single branded entry
✨
Fully Branded
All portals & comms
💊
Dual Claims
Pharmacy + Medical
💰
ACH Closed Loop
Referral → Payment

*All portals branded to manufacturer
*Provider represents Specialty Pharmacy and Buy & Bill Facilities

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