Knowledge Base
Find step-by-step guides and explanations for every area of GEMA. Select a category or article below to get started.
Getting Started
Sign in, navigation, and the basics.
- Welcome to GEMAAn introduction to GEMA and how to navigate the application.
- Signing In to GEMAHow to sign in with email and password, use SSO, reset your password, and what happens after you log in.
- Multi-Factor AuthenticationHow to verify your identity with MFA when signing in and how to enroll a new MFA method.
- Navigating GEMAA tour of the left navigation, the header bar, the Settings menu, and signing out.
Patients
Managing patient records, charts, and clinical data.
- Finding PatientsHow to access the Patients list, search by name or identifier, filter by business unit, and open a patient record.
- The Patient ChartA guide to the patient chart layout — the header, sidebar navigation, and each section of clinical data.
- Adding and Editing PatientsHow to add a new patient record, edit demographics, and manage notes and alerts.
- Merging Duplicate PatientsHow to identify and merge two duplicate patient records into a single survivor record.
Tasks & Prior Authorization
Working the task queue and the PA workflow.
- Working the Task QueueLearn how to access, filter, and navigate the task queue to manage prior authorization and other clinical tasks.
- The PA WorkflowUnderstand the PA Workflow Timeline, read the current workflow state, and perform manual transitions such as approve, deny, or abandon.
- PharmPix ApprovalUnderstand the PharmPix submission status on a task, and learn how to review and retry failed submissions.
- AppealsLearn how to find appeal tasks, review the appeal submission, and approve or deny an appeal.
Communications
Inbox document handling and outbound determination letters.
Guidelines & Evaluations
Configuring clinical guidelines and running batch evaluations.
- Configuring GuidelinesLearn how to add, edit, clone, and manage clinical guidelines in Guideline Manager.
- Testing Guidelines with the Rule Test RigUse the Rule Test Rig to simulate patient scenarios and verify your guideline rules before they go live.
- Running Guideline EvaluationsTrigger guideline evaluations, choose Active or Report mode, monitor progress, and review patient results.
PA Expirations
Monitoring expiring authorizations and initiating continuations.
- Monitoring PA ExpirationsRead the PA Expirations dashboard to identify prior authorizations expiring in 14, 30, or 90 days.
- Starting a Continuation EvaluationUse the three-step continuation wizard to initiate a guideline evaluation for an expiring prior authorization.
- Scheduled ReviewsPut a future prior authorization review on the calendar for one patient or a whole spreadsheet, fix rows that need a match, and start a review when it is due.
Documents & Inbox
Uploading, reviewing, and assigning incoming documents.
- Uploading Documents to the InboxNavigate to the Inbox, upload clinical documents, and understand how the system processes and tracks them.
- Reviewing and Assigning DocumentsOpen a document in the Inbox, review AI-extracted data, and assign it to the correct patient.
- Handling Unmatched DocumentsFind and resolve unmatched-document tasks in the task queue by reviewing AI extraction and assigning documents to patients.
Reporting & Dashboards
Analytics dashboards and data source configuration.
EDI Claims
Monitoring electronic medication claims.
Configuration
Formularies, ontology, NPI overrides, and letter templates.
- FormulariesView and manage drug formularies, including their linked guidelines, business units, and public formulary page.
- Ontology ManagerManage reusable clinical rule snippets, custom LOINC codes, and adopt Ethicos ontology rules and custom LOINC codes from the library.
- Prescriber ManagementSearch for providers by NPI or name, and set tenant-level phone, fax, and Direct address overrides.
- Communication LettersConfigure every letter type for each recipient, the letter signer, delivery method, and trigger a batch send.
Administration
Tenant management, users, roles, and integrations.
- Tenant ManagementCreate and manage tenants, and navigate tenant details as a global or tenant administrator.
- Users and RolesInvite users to your tenant, assign roles and abilities, and manage existing accounts.
- Business UnitsUnderstand and manage the business unit hierarchy that controls data access within your tenant.
- IntegrationsConnect your tenant to external fax providers, PharmPix pharmacy claims data, a GPG key for encrypted files, and partner systems.
- Partner API KeysGive a partner system read access to your tenant, and manage the keys it uses.
External Users
Prescriber data collection forms and appeal submissions.
- Prescriber Data Collection FormHow prescribers and providers complete the clinical data request form sent as part of a prior authorization.
- Submitting an AppealHow prescribers and providers submit a formal appeal after a prior authorization is not approved.
- Provider PortalHow prescribers use a health plan's provider portal to review clinical policies, open a published formulary page, start a prior authorization, respond to a data request, or begin an appeal.
Platform Operations
Global admin tools — EDI management, jobs, script runner.
- EDI ManagementManage EDI mappings and monitor incoming and accepted EDI files. Requires global administrator access.
- Job ManagementMonitor background jobs and manage the callback queue. Requires global administrator access.
- Script RunnerRun and monitor administrative scripts with live log streaming. Requires global administrator access.
- Generate Test PatientCreate synthetic test patients shaped around specific guidelines for verifying PA workflow scenarios, including pinning pharmacy and prescriber NPIs.