HEALTHCARE USE CASE

Prior Authorization Management

Stop burning coordinator hours on phone holds, fax machines, and payer portals.


THE PROBLEM

Prior auths are a bottleneck that delays care and drains staff.

Checking status with multiple payers, tracking expirations, resubmitting denials — all manual, across phone, fax, and portals.

STATUS CHECKS

Staff calls payers, sits on hold, logs into portals one by one. A single auth check can take 20–30 minutes. Multiply that by dozens per day.

EXPIRATIONS

Authorizations expire silently. Nobody tracks the dates until a claim gets denied. Procedures get delayed. Patients reschedule or leave.

DENIALS

Auth denials require manual appeal — gather documentation, write the letter, resubmit. Weeks pass. Some never get resubmitted.


THE SOLUTION

Automated status checks, expiration alerts, and instant resubmission.

AI monitors every authorization across every payer — checking status, flagging expirations, and resubmitting denials without staff intervention.

Automated Status Checks

AI checks payer portals and phone systems automatically. Status updates flow into your workflow in real time. No more hold music.

Expiration Alerts

Every authorization tracked with expiration dates. Staff gets alerts before auths lapse. Procedures stay on schedule. Zero surprises.

Auto-Resubmission

Denied auths get corrected and resubmitted automatically. Documentation gathered, appeal letters generated. Staff notified when auths clear.


RESULTS
40% Faster auth resolution
90%+ Auto-check rate
8 hrs Saved per coordinator per week

Typical results based on industry benchmarks. Individual outcomes vary.


Ready to take prior auths off your team's plate?

Whether you have a question, need a quote, or just want to learn more about how we work, we're here. We respond within a day, every time.

Or reach us directly at max@constanceit.com