Prior Authorization Overview

Develop Health is revolutionizing the prior authorization process in healthcare. Our suite of tools, including Automated Prior Authorization, Denial Risk Alert, Inbound Fax Parsing, Omni-Channel Submission Pathways, Proactive Reauthorizations, and Regular Status Checks, streamlines and enhances the efficiency and effectiveness of prior authorizations.

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Automated Prior Authorization

Automates the assessment and processing of prior authorizations, simplifying form selection, autofilling, and submission.

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Omni-Channel Submission Pathways

Adapts to various PBM requirements by intelligently selecting the most effective submission method, supported by a unified dashboard and robust API for a seamless experience.

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Regular Status Checks

Actively monitors the status of prior authorization requests, particularly during PBM or payer delays, providing real-time updates for transparency and timely interventions.

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Inbound Fax Parsing

Transforms traditional fax communications from PBMs into digital formats, enabling automated data extraction and integration for enhanced accuracy and workflow efficiency.

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Proactive Reauthorizations

Anticipates and notifies healthcare providers of upcoming reauthorization needs, facilitating timely renewals to ensure continuous patient care without interruptions.

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Denial Risk Alert

Proactively identifies potential issues in prior authorization submissions by integrating drug label information, formulary data, and clinical decision criteria, minimizing denial risks.

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Conclusion

Develop Health’s prior authorization tools are designed to reduce administrative burdens, speed up the authorization process, and improve patient care outcomes. By leveraging advanced technology and proactive strategies, we offer healthcare providers a streamlined and effective prior authorization experience.