Create and Submit Authorization Requests for Review

The Authorization Intake process helps you save time and cut down on errors. You can create an authorization request of type Inpatient, Outpatient, or Concurrent review. Depending on the request type, the request creation process varies.

1. Select an Authorization Request Type
   Select either inpatient or outpatient for a new request, or concurrent review for an existing request.
2. Run an Eligibility Check for Your Care Request
   Verify members’ benefits coverage and check which care request services require an authorization.
3. Link a Concurrent Review to an Existing Request
   Ensure members continue to get timely and cost-effective care by performing concurrent reviews for an existing request during the course of a member’s treatment.
4. Add Care Request Details to the Authorization Request
   Authorizations require that you add details about the requested service. The details you enter depend on whether the care request is new or existing, and inpatient or outpatient.
5. Add Provider Details to the Authorization Request
   Enter information about the requesting provider, servicing provider, and the servicing facility where the service will occur. You can automatically see if the provider is inside or outside the payer network.
6. Upload Supporting Documents for the Authorization Request
   Authorization requests often require supporting clinical documents. In the Authorization Intake process, the Upload Clinical Documents window provides a checklist of required documents.
7. Review the Authorization Request
   Before submitting an authorization request, you see an overview where you can override the document status and add notes or observations.