Prior authorization: fewer hours on hold, fewer windows missed.
Every payer wants different paperwork, and every deadline is easy to lose in a busy week. We build the prior authorization automation that holds the requirements, assembles the documents, and warns your team before a window closes.
Who this is for
- Practices whose staff spend hours a week on hold and on payer portals
- Clinics that track authorizations in a spreadsheet or in someone's head
- Practices that have had claims denied because an authorization lapsed
- Behavioral health and other ongoing-care practices that renew authorizations often
- Medical, dental, and behavioral health practices billing several payers
What makes a prior authorization tracker actually get used.
Built in-house around your EHR and your payers, so your team keeps working the way it already does.
Every payer wants something different?
A tracker that holds each payer's requirements, so staff check one place instead of a stack of PDFs and portal pages.
Assembling the paperwork takes the longest?
Supporting documents are assembled from your EHR into the packet each payer expects, so your team reviews and sends instead of retyping.
Authorization expiring before anyone notices?
Alerts before an authorization window closes, sent to the person who owns it, with the renewal packet already prepared.
No idea where a request stands?
A status board showing every open request, its payer, its deadline, and who is responsible for it.
Software your team works in, connected to your systems
We build alongside your EHR rather than replacing it. The tracker supports your staff, and your team still makes every decision and sends every request. We have worked with platforms including Medplum and OpenEMR, and we build custom tools around your requirements.
- Practice Operations: denials, prior authorization, no-shows, and compliance systems
- Denial management: what happens when an authorization or claim is refused
- Medical practices, dental practices, and behavioral health practices
- Florida clinics: state rules and Medicaid managed care
- Security and Compliance: how we protect patient data
Prior authorization FAQ
Didn't answer yours? Ask us directly. The form is right below.
Prior authorization, also called pre-authorization or prior approval, is a health plan's requirement that a provider get approval before delivering certain services, medications, or procedures. Without it, the plan may refuse to pay. Each plan sets its own list of services and its own rules.
A 2024 AMA physician survey found physicians and their staff spend an average of 13 hours a week on prior authorization. Your own figure depends on your payers and services, so we start by mapping where the time goes in your practice.
Some steps can be automated and some cannot, and it varies by payer. We build the tracker, the document assembly, and the alerts around your workflow, and your staff make the decisions and send each request as the payer requires. We tell you plainly which steps can be automated for your payers.
It is software that takes over the repeatable parts of the process: tracking each payer's requirements, assembling supporting documents from the record, watching deadlines, and showing the status of every open request. The parts that need judgment stay with people. Your clinicians document why the service is needed, and the payer makes the decision.
AI can help with some of the work, such as spotting a missing document or drafting a request for a person to check, but it does not make the decision. The payer does, and your staff review and send every request. Our trackers and alerts follow rules built around your workflow. If an AI step would help, we scope it with you first, it runs in your own cloud account under a Business Associate Agreement, and patient information does not go into consumer AI tools.
Yes, for health plans. CMS's Interoperability and Prior Authorization final rule (CMS-0057-F) requires covered payers to decide requests within 72 hours for expedited requests and seven calendar days for standard ones, starting January 1, 2026, and to have a Prior Authorization API in place by January 1, 2027. It covers Medicare Advantage, state Medicaid and CHIP fee-for-service programs, Medicaid managed care, CHIP managed care, and Qualified Health Plan issuers on the federally facilitated exchanges. It does not apply to providers, and it covers only those payer types, so your other payers' own rules still apply.
Usually, yes. We build alongside the system you already use, reading from it and writing back, rather than asking you to migrate. We have worked with EHR and EMR platforms including Medplum and OpenEMR, as well as custom-built systems.
Prior authorization involves protected health information, so we sign a Business Associate Agreement before we touch any of it. The tracker runs in your own cloud account (AWS, Azure, or Google Cloud), with access controls and audit logging. See Security and Compliance.
Weeks, not the many months a traditional build can take. Once the plan is agreed, you see a working prototype before you commit to the full build. Your exact timeline is fixed in writing with the scope.
Tell us how prior auth works in your practice today. We'll tell you if a tracker would help.
One email or a 30-minute call. No pitch deck, no pressure, and a straight answer within one business day.
We'll get back to you within one business day.
Prefer email? hello@atlantixlabs.comPlease don't send patient information by email.