Prepare for a Seasonal Increase in Prior Authorization Requests
Criteria Builder Benefits
Reduce Additional Outreach
Reduce follow-up to providers by using dynamic question logic to gather relevant clinical information up front.
Reduce the manual effort and redundancy associated with maintaining paper-based drug guidelines.
Implement a single source of guidelines across electronic, phone and fax channels.
Use automatically generated visual decision trees with recommended outcomes to make the PA review process easier.
Increase Speed to Therapy
Helps members get their needed therapy faster with determination logic and outcome reasons that result in a shorter approval duration.