Assemble payer-specific clinical-necessity packets from the chart, submit them, and track status and appeal deadlines across payers, escalating true denials to a physician advisor.
Nurses spend hours per case assembling clinical documentation for prior authorization by hand, and status tracking across a dozen payer portals happens in spreadsheets.
from the EHR chart
Review true denials
A prior-authorization request for a lumbar MRI was submitted to a payer and came back denied for insufficient conservative-treatment documentation. The physician advisor needs to decide whether to appeal.
Try it — same review surface your operators use, with a representative decision. Nothing here is saved or sent anywhere.
The actual medical-necessity determination, and appealing a true denial, stay with your physician advisors.
See this workflow against your own queue.
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