Authorization automation that reduces your risk of denial.
Finding that optimal balance of resources needed to keep denials in check and keep up with payer update bulletins outlining new and changing authorization requirements is daunting. Payers are demanding prior authorization for more services, and tracking their complicated requirements in three-ring binders and spreadsheets just doesn’t cut it.
Do more with your resources
Authorization management is one of those elusive activities that most providers struggle with. Automating authorizations from initiating the authorization to retrieving it and submitting it will help your staff handle the increasing number of authorizations required by payers. In turn, you’ll increase yield, net revenue, and optimize resources while decreasing authorization-related denials and denial write-offs. Our Authorization-Denial Prevention, or Auth-DP™ leads the industry with 7 years of authorization automation experience in the most comprehensive platform.
Auth-DP™ has modules for initiating, statusing, notification and submission, and includes MedicalNecessity, automating the entire authorization process on one solution.
AuthInitiate™ leverages our investment in a comprehensive authorization-required rules library that we’re continuously updating, freeing up your staff to focus on other denial risk.
AuthStatus™ provides an automated confirmation note when information hasn’t been provided correctly, eliminating manual researching of authorizations.
End-to-end authorization automation
Auth-DP™ is a software suite that includes a module for every stage in the authorization process, from determining if an authorization is required and whether MedicalNecessity is required, through to initiating the authorization, retrieving the status of the authorization, notifications of inpatient admissions and authorization requests for inpatient direct admissions.
Browse the modules included in the suite in this section, or choose to automate your authorization process a la carte. We’ll work with you to determine the most appropriate product set to achieve your specific goals.
AuthStatus™ determines whether an authorization is required from our proprietary authorization library of over 700,000 rules for a service and plan, retrieving this information directly from the payer’s website.
MedicalNecessity supports the evaluation of medical necessity rules for Medicare and commercial payers, and automatically generates advance beneficiary notice or notice of non-coverage.
AuthInitiate™ automatically initiates an authorization for scheduled services through payer websites and faxing, minimizing the manual effort of credential management.
AuthNotification supports inpatient admission notification requirements for Aetna and UnitedHealthcare.
AuthSubmit supports authorization requests for inpatient direct admissions.
Work is visibly more productive. With no other changes made in the time period, it’s obvious that these improvements are a result of Recondo’s automation technology.