Authorization Manager by AccuReg is a comprehensive solution designed to streamline the prior authorization process for healthcare providers. By automating traditionally manual tasks, it reduces administrative burdens, minimizes costs, and enhances patient satisfaction. The system employs intelligent automation, an adaptive rules engine, and sophisticated pattern analysis to efficiently manage and obtain authorizations, ensuring compliance with ever-changing payer requirements.
Key Features and Functionality:
- Automated Authorization Determination: Utilizes real-time Electronic Data Interchange transactions to instantly determine and retrieve authorizations for common procedures.
- Payer Rules Management: Maintains and updates authorization determination rules for all payers, ensuring accuracy and compliance.
- Real-Time Alerts and Instructions: Provides staff with immediate notifications and guidance through a centralized interface on obtaining authorizations and required documentation.
- Intelligent Monitoring: Automates the monitoring of response statuses, retrieving authorization or denial numbers along with any additional documentation requests, thereby reducing manual checks.
Primary Value and Problem Solved:
Authorization Manager addresses the inefficiencies and high costs associated with manual prior authorization processes. By automating these tasks, it significantly reduces no-authorization denials, lowers labor costs, and improves staff efficiency. This leads to expedited patient care, increased patient satisfaction, and enhanced physician contentment. Ultimately, the solution empowers healthcare providers to focus more on patient care rather than administrative tasks, ensuring a smoother and more efficient authorization process.