Prior Authorization

Real-time Prior Authorization Guidance and Decision at the Point of Care

The Prior Authorization (PA) Module is an end-to-end PA solution for providers and payers. Our tool streamlines PA submissions and decision processes, saving valuable time for users.
Our Prior Authorization module enables providers to validate a PA request against payer guidelines, automatically submit it, and then to receive instant decisions from the payer. Similarly, it enables payers to automate PA decisions and serves as a decision support engine to help streamline complex utilization management processes.

The solution can integrates seamlessly with a provider’s EMR and a payer’s utilization management system by leveraging the Fast Healthcare Interoperability Resources standards (FHIR), or it can be accessed via a web-based application. Call us today to talk about integrations!

Features

Automated PA
PA Requirements Identification and Determination
Providers PA Submission
Payers Clinical Decision Support Tool and Automated Approvals

Benefits