Payer coverage
Carelon prior authorization, automated.
Docflow automates prior authorization on Carelon Medical Benefits Management (formerly AIM Specialty Health).
This is how you try Docflow: a 30-day pilot, fully refundable if you're not satisfied.
Reserve your start week.
What your team deals with on Carelon.
Carelon Medical Benefits Management, formerly AIM Specialty Health, reviews specialty services for health plans, including sleep, imaging and musculoskeletal care. Requests go through its provider portal with clinical questions for each service.
- Each service type has its own clinical question set.
- Answers have to match the documentation exactly, or the request goes to manual review.
- Case numbers have to be tracked back to the right order.
From order to decision, without your team logging in.
- 01
Build the request
Docflow reads the order and clinicals from your system and fills in everything Carelon asks for.
- 02
Submit it
Docflow signs in to Carelon with your team's login, submits the request and attaches the documents.
- 03
Follow it to a decision
Docflow checks back every 12 hours until there's a decision, and flags any request for more information to your team.
- 04
Write it back
The decision and authorization number land in your system, on the right order, with a record of every step.
Carelon questions.
Does Docflow answer Carelon's clinical questions?
Yes. Docflow answers them from the patient's records and attaches the supporting documents, and sends anything unclear to your team.
Does Docflow need its own Carelon account?
No. Docflow uses your team's login, stored encrypted, so requests are submitted under your organization like they are today.
How long does it take to get started?
Start with a 30-day pilot on your real work. If you're not satisfied, you get a full refund.
Other portals Docflow submits on.
Hand us your Carelon queue.
Start with a 30-day pilot, fully refundable if you're not satisfied.
This is how you try Docflow: a 30-day pilot, fully refundable if you're not satisfied.
Reserve your start week.
HIPAA compliant
SOC 2® Type 1Always on, always improving