Service 1 of 9
Prior authorization
Request, track and resolve authorizations without the fax-and-hold loop.
- Providers
- Payors
How it runs
AI-led: 3 of 5 steps
AI + person-led: 1 of 5 steps
Person-led: 1 of 5 steps
- Detects authorization-required rejects and orders as they arrive AI
- Assembles the request from the claim, chart notes and payer criteria AI
- Checks completeness against the payer’s criteria before submission AI + person
- Clinical judgment, peer-to-peer calls and appeals Person
- Tracks status and closes the loop with the pharmacy or practice AI
Always reserved for a person: A person submits anything that needs clinical judgment, and owns every appeal.
Who it is for
- Pharmacies hitting authorization-required rejects at the counter
- Practices and clinics waiting on payer decisions before treatment
- Payors who want complete, criteria-matched requests the first time
How it connects
- Help desk: Rejects reported by phone become authorization requests without re-keying.
- Eligibility & verification: Coverage is confirmed before a request is built.
- Denials & collections: Authorization denials feed the appeal playbook.
What gets measured
The numbers we report to you.
Targets are agreed with each client, per task. We report against them, and automation is held to historical human accuracy.
- Time to decision From the first reject or order to the payer’s answer.
- First-pass completeness Requests the payer accepts without asking for more.
- Appeal outcomes Overturned denials, tracked by payer and reason.
- Loop closure Pharmacies and practices told the outcome, and when.
Next service: Help desk →
Talk to us
Talk to us about prior authorization.
We'll show you how we'd run it: what AI would handle, where your team or ours would decide, and what we'd measure.
Talk to us- Pharmacy help desk · Workers' comp
- 844.328.2048
- Pharmacy help desk · Auto no-fault
- 844.569.8876
- helpdesk@health-lift.com
- Billing address
- PO Box 520190, Salt Lake City, UT 84152