An employee that submits the prior auth and chases it to approval
It assembles the documentation, submits the prior authorization to the payer, then follows up by portal and phone until it's approved - or hands the appeal to staff with everything attached, so procedures don't stall waiting on an auth.
The actual employee, on the phone with the payer.
Submitted. Chased. Approved.
How it works
Assembles the documentation
Pulls the order and the supporting clinical documents the payer requires, and checks the request is complete before anything is sent.
Submits to the payer
Files the prior authorization in the payer portal, attaches the documentation, and logs the reference number back to the chart.
Chases to a decision
Follows up by portal and phone until it's approved, identifies exactly what's missing when it stalls, and hands appeals to staff with the full file.
From order to submitted, end to end
It reads the order, gathers the clinical documentation the payer requires, submits the prior authorization in the portal, and logs the reference number - then takes over the status chase.
Works in the tools you already use
Availity
Change Healthcare
Epic
athenahealth
Waystar
SlackFrequently asked
No. It assembles the documentation the ordering provider and payer require, submits it, and chases the status - but the clinical justification and any appeal argument stay with your staff. It handles the logistics, not the medicine.
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