MarketplaceStudioActivityPrior Authorization Requirements

Create your first automation in just a few minutes.Try Studio Web

Prior Authorization Requirements

Prior Authorization Requirements

by Myndshft Inc.

StarStarStarStarStarStarStarStarStarStar

0

Activity

Downloads

<100

back button
back button
carouselImage0
next button
next button

Summary

Summary

Activity that instantly identifies if prior authorization is required for Payers across multiple CPT/HCPC codes, and determines the optimal submission route between EDI/278, fax, and payer portals

Overview

Overview

Integrates and appends your existing workflow to verify eligibility and benefits in real-time with over 600 payers, providing the prior authorization requirement for the CPT/HCPC code you provide based on the specific plan and payer. Additionally, obtain the method of submission, submission details, and the PDF guideline which states the requirement.

API keys are required to leverage this activity. 

Please reach out to Myndshft through info@myndshft.com for API Keys and contracting.

Features

Features

  1. Myndshft dynamically updates rules engines based on the actual responses and results from submitted prior authorizations. 
  2. Leveraging advanced ML/AI models, accurate PA requirements for all specialty pharmacy and diagnostics procedures are continuously extracted and updated. 
  3. Easily appends to the Member Eligibility/Benefit Verification Activity.

Additional Information

Additional Information

Dependencies

None

Code Language

C#, Visual Basic

Runtime

Windows Legacy (.Net Framework 4.6.1)

Publisher

Myndshft Inc.

Visit publisher's page

Trusted Source

License & Privacy

License Agreement

Privacy Terms

Technical

Version

1.0

Updated

January 25, 2022

Works with

Studio: 21.4 - 22.10

Certification

Silver Certified

Support

Email: help@myndshft.com

Link: https://myndshfthelp.zendesk.com/hc/en-us

Severity Level: Urgent Description: Major system failure with no workaround Response Time: Business Hours - 30 minutes via email After Hours - 1 hour via email Severity Level: High Description: Important Functions are unusable Response Time: Business Hours - 30 minutes via email After Hours - 2 hour via email Severity Level: Medium Description: System failure under unusual circumstances or minor features do not work with a low impact workaround Response Time: Business Hours - 3 hour via email Severity

Resources

Similar Listings