Prior Authorizations
Automate DME prior authorization requests
Problem
Prior authorization (PAR) slows DME/HME order flow. Billing teams juggle 20+ payer portals, 30-minute submissions for multi-line CPAP and other orders, and constant status checks—creating backlog, variability, and avoidable DSO. Even approvals hide in portals until someone finds them, delaying billing and patient starts.
Docflow Solution
Docflow automates prior auth end-to-end with AI plus rules-driven automation. When an order hits the PAR step in your billing software, Docflow pulls required data, submits to the right payer portal, and checks decisions hourly. Approvals and notes post back to your billing system in real time, with full audit traceability.
Benefits of using Docflow
Faster throughput & lower DSO: Immediate PAR submission and auto-posting of decisions accelerate billing, clear backlog, and improve cash flow.
Higher accuracy & compliance: Deterministic workflows apply payer-specific rules the same way every time, minimizing denials and rework.
Tighter portal integration: Docflow logs into payer portals, monitors statuses hourly, and writes results back to your DME/HME billing system.
Operational visibility: End-to-end audit trails show exactly what was submitted, when, and why.
Future-proofing: As PAR requirements expand across DMEs/HMEs, automation absorbs the workload without adding staff.
“Prior auth used to be a bottleneck for us. Now, it runs overnight — we start the day with approvals in queue.”
— Billing Manager, National DME Provider