PhiCure’s prior authorization software enables your medical office to more easily manage the validation of authorizations. We do this through a series of automated systems that handle validation and acquisition through an intuitive dashboard. Read the sections below to learn more about how our software works at each step of the process.
Validation:
First, the payer automatically verifies authorizations that are present on the patient’s record. This ensures that the procedure(s) and approved date ranges are accurate. Then, if an Authorization number fails validation, the system automatically looks for a valid Authorization on-file with the payer and returns that value to the user. This way the registration system can be updated.
If an alert is generated by PhiCure's knowledge rules, indicating that an Authorization is required and none is present on the patient record, the system automatically looks for a valid Authorization on-file with the payer and returns that value to the user so that the registration system can be updated. This process can be repeated at the Point-of-Service to validate the approved order has not been modified.
When your staff schedules a procedure that may require a Prior Authorization, our system automatically confirms whether or not an Authorization is required. If an authorization is not required, our system sends a notification back to you. Otherwise, the Authorization request moves on to the submission stage.
After submitting the Prior Authorization request, the system continues to monitor the payer behind the scenes until it receives notification requesting additional information or the successful submission of a completed authorization request.
When completed the practice will receive the authorization approval number “to-from” valid dates, other required data and an archived screen capture of the Authorization.
Centralized Dashboard to Manage Your Day
Reduced Labor Efforts from PhiCure's Automation
Eliminates Missed or Rescheduled Authorizations
Integrated E-Fax Solutions So All Users Have Faxing Capabilities
Auto-Post Results Back Into All Major PM / EMR Systems