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Prior Authorization
Our Prior Authorization solution automates and simplifies this process, reducing manual effort, improving approval turnaround times, and ensuring compliance with payer requirements. By streamlining PA workflows, healthcare providers can focus on patient care while reducing the claim denials by up to 50% and maximizing revenue.
A comprehensive, real-time insurance and benefits validation system as well as an understanding of the patient’s liability for every visit, empowers healthcare organizations to confirm coverage and eligibility upfront, drastically reducing the risk of denied claims and improving the overall financial performance of the revenue cycle.
Challenges in
Prior Authorization
PA Requirement
Manual Processes
Delays in Patient Care
Lack of Real-Time Status Updates
Key Features
PA Needed
With a built-in repository as well as direct integration with payers automatically identify whether PA is needed for procedures or services.
Automated Request Submission
Automatically submit PA requests with all required documentation directly to payers, reducing manual intervention.
Real-Time Eligibility Checks
Verify patient eligibility and medical necessity before submitting PA requests to ensure faster approvals across multiple payers.
Pre-Built Payer Rules
Stay compliant with payer-specific requirements through pre-configured rules that help ensure complete and accurate PA submissions.
Integrated with EHR
Seamless integration with Electronic Health Records (EHR) allows providers to generate and track PA requests directly from patient records.
Real-Time Status Tracking
Continuous automated tracking to receive instant updates on the status of PA requests, including approvals, denials or requests for additional information.
Key Benefits
Boost Revenue Cycle Efficiency
Ensure timely approval and claim submission, accelerating reimbursement and reducing the risk of lost revenue.
Reduce Administrative Burden
Reduces time spent by staff on PA by up to 50%, thus automating the PA process frees up staff to focus on higher-value tasks, reducing burnout and operational costs.
Accelerate Patient Care
Faster PA approvals reduce delays in treatment, improving patient outcomes and satisfaction.
Improve Approval Rates
By submitting complete, accurate, and payer-compliant PA requests, your organization can minimize the risk of denials.
Ensure Compliance
Built-in rules and real-time checks ensure adherence to payer and regulatory requirements, mitigating the risk of audits or penalties.