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Prior Authorization

Change Healthcare Prior Authorization is a workflow tool that efficiently generates approval and denial responses at the conclusion of the prior authorization decision process. Each PA is assigned a unique ID for ease of maintenance updates, changes and tracking purposes.

Electronic prior authorization is an automated rules-based claims module that determines if claims can process or needs manual authorization and clinical review.

Avoid lost revenue by quickly determining drug pre-authorization.
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Determine Pro-Approved Drugs

Our secure, web-based platform allows efficient deployment to clients and other authorized users. Automated processes determine drugs that are approved without clinical intervention. If prescriptions require clinical review and PA processing, this solution helps manage documents by generating and tracking correspondence to prescribers through fax or mail.

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Access A Flexible Interface

Secure access is provided to claims history, PA requests, chart notes, and drug/member/provider information all in one click. Decision letters containing all relevant information are generated and distributed to the appropriate parties.

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Store Records Securely

Store all artifacts related to Prior Authorization determinations in case of appeal, audit, or consultation in the future.