Prior Authorization Management

Streamline your prior authorization process with our comprehensive workflow management system designed specifically for healthcare providers.

Initial Referral and Eligibility

Complete workflow for managing patient referrals and insurance eligibility

  • Capture doctor referrals with intake date
  • Record patient demographics and physician information
  • Process insurance cards and verify coverage
  • Special handling for MassHealth 30-visit threshold
  • Automated eligibility verification results

Prior Authorization Initiation

Streamlined process for initiating and managing prior authorizations

  • Automated PA request creation
  • Document upload and storage
  • Tracking system with unique identifiers
  • Status monitoring (Submitted, In Review, etc.)
  • Additional information request handling

Authorization Monitoring

Comprehensive tracking of approved prior authorizations

  • Track start and end dates
  • Monitor approved services and quantities
  • Automated expiration alerts
  • Renewal process management
  • Special conditions tracking

Daily Process Tracking

Daily management and monitoring of authorizations

  • Daily eligibility checks
  • PA status reporting
  • Real-time dashboard updates
  • Automated staff notifications
  • Comprehensive reporting capabilities

Ready to Streamline Your Prior Authorization Process?

Join healthcare providers who are already benefiting from our automated solution.