FREE ONLINE TOOL
Payer Guidelines At Your Fingertips
We help you identify authorization and medical necessity requirements through a simple query by procedure, payer and diagnosis. The search results return only the relevant guideline sections saving you time reviewing and hunting for the information.
Get access to:
- Comprehensive radiology, cardiology, and orthopedic guidelines
- The latest up-to-date content
- Quick and easy search capabilities
- Intelligent and accurate responses
- Real-time learning and content improvement
ALLEVIATE STAFF BURDEN
Difficulties Preparing Prior Authorization Submissions
The prior authorization process is often time-consuming and cumbersome, requiring hours of preparing forms to submit to payers for approvals. This can result in delays in care, or even denial of much needed treatments.
Some of the challenges administrative staff faces include:
- Time-consuming: The process can take days to research and complete.
- Cumbersome: There is often a lot of paperwork involved which may need to be faxed.
- Can result in delays: Delays in care can occur if the requests are not completed in a timely manner.
- Can be denied: Coverage for treatments can be denied if the prior authorization requirements for care delivered is not met.
Our online clinical guidelines search tool helps staff overcome such challenges by reducing time to review commercial payer requirements when preparing prior authorization submissions.
HOW WE DO IT
How Clinical Guidelines Can Help
Clinical Guidelines can help you streamline the prior authorization process by providing quick and easy access to payer guidelines.
Identify the requirements for authorization and medical necessity through a simple query by procedure, payer and diagnosis. Our search results return only the relevant guideline sections saving you time reviewing and hunting for the information.
Our real-time learning and content improvement capabilities ensure that you always have the most up-to-date information.
Reduce Time To Research Payer Policies
Get the information you need quickly to learn what specific payers require for prior authorization submissions without having to review an entire payer’s policy.
We offer quick and easy search capabilities so you can find what you need fast. Our intelligent and accurate responses help you make better decisions about which services to provide to comply with medical necessity requirements.
Our real-time learning and content improvement system ensures that you always have access to the latest and most accurate information. So you can focus on what’s important: providing the best care for your patients.
POWERED BY NLP
Stay Ahead With Prior Authorization Technology
We leverage modern technology like artificial intelligence’s natural language processing (NLP) to help you find the right information faster. This allows us to provide you with the most accurate and up-to-date payer guidelines available.
Our platform is constantly learning and improving. We use feedback from our users to improve the accuracy of our results and to add new features and functionality.
Search algorithms are trained on radiology and orthopedic guidelines so you can be sure you’re getting the most up-to-date information. More specialties will be added soon.
Helpful Resources For Your Team
We create educational materials frequently in the form of virtual office hours, articles, white papers, webinars and podcast episodes which help our clients and peers with common patient access challenges they face. If you would like us to address a specific topic, feel free to reach out to us.