Preparation time
Measure active staff time from case intake to a submission-ready packet. Separate document collection from time waiting for a clinician or payer.
QuickAuth · Prior authorization software
Prior authorization with a clear next action
Organize request preparation, supporting documents, submission receipts, and status follow-up. Keep staff review attached to the case and confirm the payer channels and EHR handoffs for your proposed workflow.
Need staff to perform the work? Review prior authorization services.
What is prior authorization automation?
Prior authorization automation coordinates requirement checks, documentation gathering, request preparation, submission, and follow-up. QuickAuth brings those steps into a shared case workflow, with supporting evidence and review queues for missing information or uncertain requirements. The customer confirms payer connections, clinical review responsibilities, and approved submission channels during implementation. Payer decisions and response times remain separate from the time spent preparing a request.
More about AI prior authorization
What Is AI Prior Authorization?
AI-assisted prior authorization software can help organize case information, prepare requests, and coordinate configured status and follow-up tasks. A product evaluation should distinguish a suggested action from a reviewed submission, inspect the supporting evidence, and identify the work that remains with staff.
QuickAuth is an AI prior authorization automation platform that evaluates CPT, HCPCS, and ICD-10 codes against payor-specific rules, automatically pulls clinical documentation from your EHR/PMS, submits authorization requests via APIs, RPA bots, and AI voice agents, and tracks case outcomes in a shared queue. Confirm supported payers, permissions, and review responsibilities for your deployment.
Make Authorization Handoffs Visible
Map the work between scheduling, document collection, submission, payer follow-up, and billing. Identify where your team lacks a current status, supporting evidence, or a clear next owner.
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Work to investigate
- •Measure staff time spent moving between the EHR, payer channels, and the case record
- •Identify upcoming appointments with an unresolved authorization task
- •Review authorization-related denial records with their supporting evidence
- •Record repeat data entry, unanswered requests, and follow-up assigned outside the main queue
- •Check how scheduling learns about a pending decision or missing information
Use the observed workflow as your pilot baseline.
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Workflow to demonstrate
QuickAuth workflow materials describe a shared request queue, supporting documents, submission receipts, status follow-up, and review handoffs. Confirm the available channels and the work your staff will retain during discovery.
- ✓Automatically detects if prior auth is required for specific CPT/HCPCS, diagnosis, payor, and plan
- ✓Review the patient, insurance, order, and document information available through the approved connection
- ✓Validate the permitted submission channel and inspect the resulting receipt
- ✓Inspect pending responses, additional-information requests, and assigned follow-up
- ✓Test authorization number, date, unit, and status handoffs to your retained systems
Agree who reviews exceptions, approves submissions, and confirms the next action.
Who QuickAuth Is For
Evaluate QuickAuth against the responsibilities of your provider organization, billing team, MSO, or service operation. Each group should define the cases, staff work, systems, and evidence required for its pilot.
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Single-Specialty Practices
Radiology, Cardiology, Orthopedics, Oncology, Behavioral Health, Gastroenterology, etc.
Authorization evidence
Inspect recorded authorization details and unresolved exceptions before the billing handoff.
Preparation and response time
Measure preparation separately from the time awaiting a payer decision.
Staff and scheduling handoffs
Assign missing information and communicate pending decisions to the scheduling team.
Staffing requirements
Measure review, follow-up, and exception work before estimating staffing needs.
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Multispecialty Clinics & Physician Groups
Large practices managing multiple specialties and complex payor relationships
Documented workflow scope
Agree the workflow, review responsibilities, and exceptions for each participating location.
Volume and cost planning
Test representative volumes and include customer effort, usage, and support in the cost model.
Visibility and control
Inspect recorded status, the latest source response, and the queue responsible for the next action.
Scheduling visibility
Review how an unresolved request reaches scheduling before the planned service date.
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Hospital Outpatient Departments & ASC Networks
Outpatient departments, ASCs, imaging centers, labs, and post-acute providers
Documentation readiness
Review available documents and assign missing information before an authorized submission.
Configured submission controls
Confirm permitted channels, approval steps, receipts, and staff handling when submission fails.
Specialty-specific rules
QuickAuth understands ASC, imaging, and specialty billing requirements.
Pending-case handoffs
Trace a pending request to its owner and the staff who need the next status update.
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RCM Vendors, MSOs & ACOs
Revenue cycle management companies managing prior auth for multiple clients
Workload measurement
Count completed tasks, manual touches, and unresolved cases within the agreed pilot scope.
Defined service responsibilities
Confirm customer and vendor ownership, escalation, and any response terms in the proposal.
Demonstrated workflow
Compare the same sample cases, review controls, and handoffs across proposed solutions.
Client and entity scope
Validate access boundaries, provider relationships, and reporting for the proposed client entities.
Define the scope before estimating value
Bring your authorization volume, payer mix, current preparation effort, retained systems, and review staffing to discovery. Compare a scoped software proposal with your existing process. If you need staff to perform the work, define that service responsibility separately. Suitability and financial value depend on the demonstrated scope and written terms.
QuickAuth workflow illustration
Detect → Gather → Submit
An illustration of the handoffs from requirement checks to documentation and submission. Watch the product demonstration above to inspect the interface.
Step 1
Detect
Review scheduled cases, recorded requirements, and unresolved questions with the responsible staff.
Step 2
Gather
Pull clinical notes, labs, and CPT/ICD codes from the EHR and match payer criteria automatically.
Step 3
Submit
Submit through the approved payer channel, retain the receipt, and review the latest available response.
Illustrative workflow. Confirm the available data, approved channels, staff review, and exception handling for the proposed deployment.
Explore the workflow in detail
How QuickAuth Organizes Authorization Work
This AI prior authorization automation platform transforms utilization management from a manual bottleneck into an automated background process. QuickAuth handles CPT, HCPCS, and ICD-10 code evaluation, medical necessity documentation, and authorization requests across Medicare Advantage, Medicaid, and commercial payors.
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1
Detect – Does This Service Require Prior Authorization?
As soon as a provider places an order or an appointment is scheduled, QuickAuth evaluates procedure codes, diagnoses, and site-of-service. It checks payor- and plan-specific rules and benefit documents, validates eligibility and benefits when available, and returns a clear answer: No auth needed, Auth required, or Auth recommended — with the reason and policy reference.
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2
Gather – EHR-Driven Documentation Assembly
For cases that require auth, QuickAuth automatically pulls demographics, insurance, diagnoses, and orders from your EHR/PMS. It reads clinical notes, imaging reports, and lab results to extract indications, prior treatments, and key findings. The system assembles a complete documentation packet that aligns with the payor's medical policy and checklist. Staff no longer chase clinicians for "one more note" — QuickAuth shows exactly what's missing and can often find it in existing documentation.
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3
Submit & Track – Approved Channels and Follow-up
After staff review the request, use the approved submission channel and inspect its receipt. Track the payer response and last status check, assign additional-information requests, and retain the follow-up evidence. Confirm which actions are configured and which require staff completion. Test the authorization number, dates, units, and status handoff to the retained EHR with an authorized sample, including an unsuccessful update.
Confirm the queue owner, supporting evidence, approved channel, and staff follow-up at each handoff.
Measure a QuickAuth Pilot Against Your Current Workflow
Agree on a baseline, payer and service scope, observation period, and acceptance criteria before rollout. These measures help your team evaluate the product using comparable cases.
Payer response time
Record submission and decision timestamps, the payer channel, and whether additional information was requested. Keep this separate from preparation time.
Manual touches
Count staff actions and handoffs per case, including corrections, additional-document requests, and follow-up. Compare similar payers and services.
Documentation completeness
Track the share of reviewed packets containing the required evidence at submission. Record missing items and the reviewer who resolved them.
Authorization-related denials
Use reviewed denial reasons to identify missing, invalid, or expired authorization cases. Define the denominator and distinguish them from other denial causes.
Expiration and renewal work
Track cases approaching their recorded expiration date, renewal actions, unresolved exceptions, and handoffs to scheduling and billing.
Assign an operations owner to review the results and exception records. A product demonstration shows the workflow; measured outcomes require a defined sample and verified observations from that deployment.
Payer-specific onboarding
Documentation and status workflows
Designed for providers, RCM vendors, and MSOs
Compare Authorization Workflow Responsibilities
Use these questions to compare your current process, a proposed automation tool, and QuickAuth. Confirm each implementation against your actual payer and EHR requirements.
| Capability | Status quo manual | Generic RPA | QuickAuth |
|---|---|---|---|
| Multi-channel submission | Phone + fax + portal logins | Confirm supported channels and maintenance ownership | Confirm approved API, portal, or voice channels |
| EHR write-back | Staff retypes auth # into EHR | Confirm whether write-back is in scope | Validate auth number, units, and date write-back |
| AI-drafted appeals | Staff prepares and reviews supporting evidence | Confirm document gathering and reviewer handoff | Drafts with source context for human review |
| Renewal Calendar | Staff maintains an expiration tracker | Confirm monitoring and alert capabilities | Expiration queues and configurable review handoffs |
| Pricing model | FTE salary + benefits per specialist | Request license, maintenance, and support terms | Request a quote for volume, scope, and integrations |
| Implementation speed | Document the current process and training needs | Confirm configuration, testing, and access requirements | Agree on payer scope, testing, review, and rollout |
Appeal win-rate and renewal-lapse figures reflect aggregate customer outcomes; individual results vary by specialty and payer mix.
Built for Real-World Operations and RCM Workflows
Use the demonstration to trace case preparation, submission, response review, and the next-team handoff. Validate each proposed connection and name the staff responsible for approvals and unresolved work.
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Automated Prior Auth Detection
Evaluates procedure codes, diagnoses, and site-of-service against payor- and plan-specific rules to determine if prior auth is required, recommended, or not needed.
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Intelligent Documentation Gathering
Organize the case information and supporting documents available through the approved EHR connection or upload. Review missing items before submission.
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Multi-Channel Submission
Confirm the available electronic, portal, fax, or staff-assisted submission route for each payer and plan. Validate permissions, attachments, receipts, and fallback ownership.
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Automated Status Tracking
Review recorded submission and payer-response states, the latest check, and outstanding information requests. Confirm status-check frequency and escalation during setup.
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Proactive Follow-Up
Assign pending responses and additional-document requests to a queue owner. Inspect unresolved items and the evidence recorded after follow-up.
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EHR/PMS Integration
Validate authorization numbers, dates, units, and status handoffs against the proposed EHR fields. Define how staff resolve failed or incomplete updates.
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Smart Queues & Prioritization
Review queues for pending decisions, missing information, approaching service dates, and appeal work. Confirm priority rules, source deadlines, and escalation ownership.
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AI + Human Review
Agree which configured tasks can run, which require approval, and which stay with staff. Demonstrate an exception, a rejected action, and the next review handoff.
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Case and Action History
Inspect source responses, submission receipts, document versions, and reviewer actions in a sample case. Confirm available exports and retention in the proposed deployment.
Keep the recorded payer response, supporting documents, and next action attached to the case. Confirm how scheduling, clinical reviewers, and billing receive the information relevant to their work.
Renewal Calendar
Review expiring authorizations and renewal work
The Renewal Calendar organizes authorizations by recorded expiration date so staff can prepare renewal drafts, review documentation, and follow up on unresolved cases. The windows below are queue filters from the workflow documentation, not payer turnaround commitments.
For a specialty example that keeps approved units, treatment-plan evidence, and renewal dates distinct, review ABA authorization unit and renewal tracking.
≤ 7 daysRed
Review the recorded expiration and next service date; assign the missing information and payer follow-up to an owner.
Examples: Behavioral health weekly sessions, chemo cycles already on the calendar.
8–14 daysAmber
Plan the renewal work and confirm the applicable submission requirements and response expectations with the payer.
Examples: PT visit packs, infusion series, recurring durable medical equipment.
15–30 daysYellow
Prepare a renewal draft and identify the documentation that the reviewer still needs.
Examples: Specialty pharmacy refills, ongoing radiation treatment plans.
Evaluate a batch of renewal drafts
Illustrative workflowUse an authorized sample of expiring requests to inspect draft creation, updated information, validation, and submission receipts. Include a request with a missing document and a channel that requires staff completion. This illustrates the process; it is not a customer result.
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Filter the calendar
Open the Renewal Calendar from the Prior Auth navigation and filter by service type (e.g. PT) and "expires in 30 days."
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Bulk Renew Selected
QuickAuth clones every selected PA into a draft with the same patient, payer, CPT/ICD-10, and prior supporting docs.
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Refresh dates and units
Update the Service Date Range to the next coverage window and the Units Requested to match the new treatment plan.
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Validate and Submit Batch
Review the available documents, resolve validation findings, and submit through the approved channel. Check each submission receipt and route failed or pending items to an owner.
What to verify: Record preparation time, missing information, staff review, submission evidence, and the next follow-up separately for each request. A submitted renewal does not establish payer approval or uninterrupted coverage.
Workflow basis: QuickRCM Prior Authorization training material on renewal drafts and batch submission. Its example timings and results are not independently verified customer evidence. Confirm recorded authorization dates, the payer response, and staff responsibilities for the proposed deployment.
Appeals Workspace
Prepare Authorization Appeals with Evidence and Review
When a PA comes back deniedor partially approved, the Appeals Workspace owns the next move: AI-drafted letter, P2P scheduling, deadline tracking, and the applicable escalation stages in one queue. Confirm the appeal route from the denial notice and the payer or program requirements.
AI-drafted appeal letter
QuickAuth pre-generates the appeal letter from the denial reason and the original packet, citing payer policy by name. Edit inline; the clinical claims stay traceable to the chart.
Peer-to-peer scheduler
When the denial letter offers a P2P, capture the payer phone number, time window, and ordering provider in one click. Outcomes — approved, denied, no-show — log to a peer-to-peer review record on the appeal.
Filing-deadline banner
Record the applicable deadline and its source for each case. Confirm whether the payer uses calendar or business days and route approaching deadlines to the queue owner.
Illustrative interface example. Confirm the deadline and route for the actual case.
Appeal Filing Deadline — 7 business days remaining
Aetna First-level reconsideration · denial reason: missing documentation of failed conservative therapy · payer window 60 days.
Submit AppealSchedule P2P
Escalation ladder: First-level review → Second-level review → External review → ALJ
Tracked end-to-endReview the original packet, supporting documents, peer-to-peer notes, and prior responses before preparing an escalation. Confirm the applicable route and deadline from the case evidence, and assign the next action to a responsible reviewer.
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First-level review — Reconsideration
First written appeal back to the payer. AI-drafted letter cites the original packet, the payer's denial reason, and any LCD/NCD policy that supports coverage.
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Second-level review — Second-level review
Independent payer review when First-level review is upheld. QuickAuth carries forward every document and adds a fresh clinical narrative.
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External review — External review
Third-party medical reviewer (state DOI or federal IRO). Deadline tracker switches to the external reviewer's clock automatically.
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ALJ — Administrative Law Judge
A program-specific escalation stage when an administrative review route applies. Confirm eligibility and required documents before preparing a packet.
Source: QuickRCM Prior Authorization training manual, § "How to: File an appeal on a denied PA" and § "Schedule a peer-to-peer (P2P) review." Status flow: denied → appealed → appeal approved or escalate to the next level.
- Aetna
- Anthem
- BCBS
- Cigna
- Humana
- UnitedHealthcare
- Kaiser
- Centene
- Molina
- Medicare
- Medicaid
- Tricare
Bring your commercial and government payer mix to the demo. Confirm the supported plan, transaction, and submission channel for each payer in your rollout.
Confirm Payer Channels and EHR Data Handoffs
Start with a written payer and plan scope, the available submission channels, and the data your EHR can exchange. Validate credentials, permissions, attachments, status responses, and write-back with representative cases before rollout.
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Payer and Plan Connectivity
List the payer, plan, service, provider entity, and required transaction for each workflow. Ask for the currently supported channel and demonstrate submission, response tracking, and an unavailable-channel fallback.
- •National and regional payors
- •Medicare Advantage plans
- •Medicaid MCOs
- •Commercial insurance plans
- •Specialty payors (radiology, oncology, behavioral health, home health, DME)
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EHR/PMS Connection Review
Identify the permitted interface for your retained EHR or practice-management system. Confirm fields, attachments, access roles, read and write permissions, fees, and the owner of failed updates.
- •FHIR and HL7 interfaces
- •REST APIs
- •Flat-file and SFTP pipelines
- •RPA-based screen automation
- •Locations, NPIs, TINs, and provider entities in the proposed scope
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File and Case-Entry Evaluation
The workflow documentation includes case entry and bulk upload. Evaluate the required fields, supporting documents, validation results, and staff work using a representative sample before choosing a starting configuration.
- •Proposed case-entry workflow
- •File upload capabilities
- •Manual case entry option
- •Dependencies for a later integration phase
- •Measured preparation and review effort
Source Data to Validate
- Patient demographics and insurance coverage
- Diagnoses, problem lists, medications, and prior procedures
- Orders, encounters, clinical notes, imaging, and labs
- Scanned documents and uploads
Return Fields to Validate
- Auth number, type (initial, concurrent, extension)
- Effective and expiration dates, units authorized
- Summary notes and key payor conditions
- Denial reasons and next steps for downstream RCM
If a required connection is unavailable, record that gap, assign a staff process, and confirm whether additional implementation work is proposed. An integration option or future plan is not evidence of a currently working connection.
Review Security and Deployment Responsibilities
Bring your privacy, security, operations, and integration requirements to the evaluation. Confirm the controls and responsibilities for the deployment your organization is purchasing.
Data handling
Confirm the information exchanged with the EHR and payer channels, where it is processed, and the applicable encryption and retention documentation.
Access and permissions
Review staff roles, service accounts, payer credentials, tenant access, and who can approve submissions or change workflow settings.
Audit evidence
Inspect a representative case history showing request preparation, reviewer actions, submission status, exceptions, and downstream updates.
Contracting
Review applicable business associate terms, support responsibilities, subprocessors, and the evidence required by your procurement team.
Human review
Assign owners for uncertain requirements, missing documentation, clinical justification, denial escalation, and approval of external actions.
Deployment acceptance
Test data access and write-back in the proposed environment. Record accepted behavior, remaining dependencies, and escalation contacts before rollout.
Frequently Asked Questions
Explore the documented workflow, proposed implementation scope, and questions to resolve during a QuickAuth evaluation.
Search covers every category. Choose a topic to narrow the results.
5 answers in General FAQs
QuickAuth is prior authorization workflow software for case preparation, supporting documents, submission, status review, and follow-up. Its workflow materials describe a shared queue, validation, receipts, renewal drafts, and appeal handoffs. Confirm the payer and EHR scope, configured tasks, required staff review, and available channels for the deployment being proposed.
Evaluate QuickAuth for a provider authorization team, practice group, health system, MSO, or RCM service operation. Bring the participating locations, provider entities, payer and service mix, retained systems, and staff responsibilities to discovery. A listed audience does not establish a validated deployment for every specialty or organization.
The workflow addresses case information spread across systems, missing-document follow-up, unclear request status, and renewal or appeal work awaiting an owner. Use a scoped pilot to measure preparation, manual touches, unresolved cases, and staff handoffs. These workflow descriptions do not establish a reduction in denials, cancellations, or cost.
Compare the same case sample across your current process and each proposed tool. Inspect available source information, submission permissions, receipts, status evidence, exception handling, reviewer actions, and the next-team handoff. Identify staff work and connection maintenance on each side. A named automation approach alone does not establish better coverage, accuracy, or outcomes.
The documented workflow includes draft creation, document attachment, validation, submission, response tracking, renewal preparation, and appeal handoffs. Agree which tasks are enabled, which require approval, and which remain manual. Demonstrate both a successful case and a failed channel or missing-document case before accepting the proposed scope.
Still have questions?
Our team is here to help. Book a discovery call to see QuickAuth in action and get answers to your specific questions.
Book a 30-Min DemoCheck Medicare coverage before you request authorization
Original Medicare decides medical necessity through national and local coverage policies; these pages show which one applies.
- Original Medicare prior authorization codes and WISeR states
Hospital OPD, DMEPOS, WISeR, ASC and ambulance lists with dates.
- How to find the LCD for a service
- National Coverage Determinations explained
- Active LCDs by contractor and topic
Complete Your RCM Automation
QuickIntell — AI Eligibility Verification
Run eligibility upstream of prior auth — the same coverage check surfaces which visits need authorization, so PA detection is triggered automatically.
QuickVoice — AI Voice Agents
Evaluate permitted payer-call workflows, required staff handoffs, recorded outcomes, and the scope included in the proposal.
QuickRCM — End-to-End AI RCM
Coordinate the revenue cycle from eligibility through payment posting, with configurable review and exception queues.
QuickERA — Payment Posting Automation
Convert EOBs into 835 ERAs and review posting exceptions before reconciliation.
AI in Revenue Cycle Management Guide
Learn how AI is transforming healthcare RCM — from automated prior auth and coding to predictive denial management.
Compare QuickAuth
Review Your Authorization Workflow
Bring your payer mix, representative cases, current handoffs, and retained systems to the discussion.
Review requirement checks, documentation readiness, submission channels, and follow-up in a QuickAuth product demonstration tailored to your payer mix.
Scoped workflow discussion
Security and deployment review
Implementation dependencies
Pilot scope and acceptance criteria
Evaluate prior authorization software for your team
Authorization and scheduling teams coordinating requirement checks, clinical packets, payer submission, status, and renewals.
What to review in a product demo
Trace a request through payer requirement review, packet completeness, authorized submission, acknowledgment, additional information, decision, and renewal. Inspect scheduling handoffs and partial approvals.
Connections to your current systems
Confirm how orders and supporting documents arrive from your systems, which payer channels apply, and how decisions and expirations return to staff. Requirement checks should preserve plan, service, and date context.
Human review and release controls
Clinicians approve clinical rationale and required attestations. Staff resolve packet gaps and escalate urgent or adverse decisions. Submission does not establish approval or determine treatment.
Implementation and validation
Start with one specialty and representative payers. Establish packet requirements, approval controls, urgency criteria, status follow-up, and renewal ownership before broadening the queue.
Pricing and quotation
Quote request volume, specialties, payer connectivity, clinical packet complexity, users, onboarding, renewals, and support.
Software and managed delivery
Use software when your staff will operate this workflow. Review managed service scope when you want Quickintell to perform the agreed work.
Book a product demoFrom requirement check to renewal
Prepare the request
Start with the scheduled service, coverage, provider, location, and supporting clinical documents. Resolve missing information before release. Record the source and date of the requirement check so staff can revisit it when the service or plan changes.
Choose and confirm the submission channel
Confirm which electronic, portal, or fax channels are supported for the payers in scope. Keep the submitted packet and acknowledgment together. An attempted transmission needs follow-up when no acknowledgment arrives.
Track decisions and recurring care
Review pending requests, additional-information requests, partial approvals, and expiration dates. Carry the approved scope and dates to scheduling and billing. Route clinical questions and peer-to-peer discussions to the clinician; assign renewal ownership for recurring care.
Handle volume and exceptions
In the demonstration, inspect batch validation, urgent-request escalation, portal failures, role permissions, and the work returned to your current system. Agree status-check cadence and fallback responsibilities for the specific payer channels your organization uses.