A pre-service authorization and medical necessity solution for healthcare providers that want to automate authorization workflows, reduce denials and bad debt risk, and increase efficiency.
Automate manual processes by determining if a pre-authorization is required and on file with the payer.
Monitor payers electronically for pending pre-authorization decisions with results automatically posted to your health information system.
Create a consistent workflow for manual intervention of pre-authorization follow-up to ensure mission-critical steps are not overlooked.
Help reduce authorization-related claim denials by accessing an audit trail where the authorization verification was obtained and results were stored.
Help reduce losses due to write-offs by automating Medical Necessity checking as part of registration, and perform clinical code auditing for Medicare outpatient services.
Create Advanced Beneficiary Notices with expected charges for the patient which allows them to accept liability prior to care delivery.