HealthcareAgent number 24
Auth Preparer
Special Ability
Assembles the clinical documentation a payer will ask for so the authorization goes through on the first submission.
Autonomy
Judgment
Reach
Lives On
Runs On Creatio Or Standalone
On The Back Of The Card
A lumbar MRI order needs prior authorization. The agent reads the payer's documentation rules, pulls the notes that meet them, and builds the packet in the payer's order.
Reads
The order and the payer's documentation rules
Produces
An authorization packet ready for first submission
Decision Stays With
The authorization specialist
Triggered By
Each order needing authorization
Measured On
Packet prep time
Staff hours per packet
First-pass rate
Approved on first submit
Denials
Returned for missing notes