Prior Authorization

Streamline prior authorization by automating screening of authorization requirements for more than 16,000 procedure codes

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Confirm prior authorization requirements prior to service to lower administrative costs and avoid denials.

Managing prior authorization requirements is an extremely manual and time-consuming process. Registration staff members use spreadsheets, binders and sticky notes to keep track of authorization requirements and constant changes to payer rules.

Streamline this process with TransUnion’s Prior Authorization solution. The solution confirms if an authorization is required for medical procedures prior to service by accessing TransUnion’s Prior Auth LibrarySM, which contains more than 1.5 million continually updated payer-specific prior authorization rules for more than 16,000 procedure codes.

With Prior Authorization, you can:

  • Streamline the process by automating screening of prior authorization requirements
  • Standardize workflows by ensuring staff members use the same rules across facilities
  • Lower administrative costs by reducing phone calls to payers
  • Prevent denials that can result from missing prior authorizations

Find out today how you can streamline your prior authorization process and improve staff efficiency.

Product Highlights
  • Comprehensive rules library, covering 92% of insured lives

  • Regular updates to prior authorization rules, ensuring you have access to the most up-to-date and accurate requirements across payers

  • Easy access to both payer-published rules and provider’s custom rules–all in one place

  • Seamless integration with TransUnion Healthcare’s ClearIQ solution

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