Direct Prior Authorization

Direct Prior is a service using our Electronic Authorization and Referral modules designed to automatically manage the validation and acquisition of referrals and authorizations from Physicians (Procedures, Imaging and Surgeries) for Outpatient and Inpatient requests.

Direct Prior Authorization Dashboard

  • Validation: Authorizations that are present on the patient record are automatically verified with the payer, ensuring the procedure(s) and approved date ranges are accurate.
  • Authorization Requirement Identification: The identification process relies on an authorization / referral statistical database which is the result of an analytical process that detects data patterns.
  • Automated Authorization Acquisition: Uses the data collected from the physician’s office portal or staff at the hospital to submit the request for authorization and queries to the payer.
  • Authorization Dashboard: Communicates the result of Automated Authorization Acquisition to the hospital / facility staff through various alerts, for hospital initiated authorization requests.
  • Custom Reporting: Complete custom reporting that allows you to drill down and pivot inside your data that allows you to understand where the issues are and manage your business with better efficiency.