Scheduled-procedure prior authorization with the payer: built from the EHR order, the payer's required documents checked before sending
Provable in pilot
- Area
- Prior authorization
- Stage
- Handoff
- Moves
- prefill, chase and verify, decide, write back
- Customers
- None named yet
Controls enforced
- Payer document checks
- clock tied to the procedure date
- cases at risk escalated
Evidence produced
- Approval or denial written to the EHR
Claims
Callvu requests missing documents from the right party on a clock, reads them on arrival (OCR) and checks each against what the case needs.
A process can run a timer that tracks a regulatory clock, such as a response or disclosure deadline, and act when it runs out.