Electronic Prior Authorization Automation Software for Payers

Accelerate Access to Care While Reducing Your Cost Per Case

Experience the benefits of real-time automation when payers, providers, manufacturers and pharmacies all come together on a single platform to automate the prior authorization process.

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A Powerful Tool Built for (and with) Payers

Prior authorization requests are an important part of delivering service to your members, but manual reviews and missing information can make the process costly and frustrating for everyone. PriorAuthNow™ is creating a world where payers get the clinical information they need, securely and electronically. By combining a robust API and advanced data analytics, PriorAuthNow goes beyond simply moving data around electronically.

Payers, providers and pharmacies are no longer tied to an antiquated industry process riddled with challenges. By automating the process with data analytics and payer-driven rules engines, decisions are accelerated (often completely automated), and the cost per case is reduced. And the best part is, members receive the right care at the right time to avoid costly complications.

Why Payers Choose Us

Improved Productivity

42% increase in staff productivity thanks to smarter workflows, data-driven rules engines, and automatic adjudications

Healthier Members

9 out of 10 determinations are sent back in one day or less, reducing time-to-care and increasing the likelihood of patients receiving appropriate care

Increased Margins

Staff efficiencies lower the cost per case and advanced analytics drive better business decisions

Try it out Now.

Partner with the only platform that accelerates prior authorizations for all stakeholders

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Desktop screenshot of PriorAuthNow’s electronic prior authorization automation software for payers.
Key Features
  • Proactive Worklists: PriorAuthNow tracks the status of prior authorization requests in an intuitive, easy-to-use dashboard. A detailed audit trail is created at each stage of the process, and stakeholders are proactively notified when specific action needs to be taken—nearly doubling the number of requests processed per person per day.
  • Automated Determinations: PriorAuthNow seamlessly ensures payers receive the right information the first time, significantly reducing manual prior authorization reviews and eliminating the back-and-forth requests for missing information. Plus, payer-driven rules engines combine with data analytics to identify recurring actions and accelerate automatic decisions.
  • Advanced Business Analytics: Robust prior authorization performance data provides insight into patient adherence trends, high- and low- performing business partners, common determination issues, and more.
  • Single Platform: The PriorAuthNow platform provides an independent, central solution that was created in partnership with providers, payers and both pharmacy and medical benefit managers nationwide. It’s designed to handle all types of prior authorizations for all types of care.