Prior authorization software that stops approvals expiring before the procedure
Prior authorization is a payer requirement that a provider obtain approval before delivering certain services, procedures or drugs. CAQH industry measurement found roughly 51 percent of prior authorization transactions still conducted manually, across about 24,874 relevant establishments. Neurobird holds every request in 1 queue with its clinical packet attached and tracks expiry so an approval does not lapse before the procedure happens.
Neurobird Prior Authorization Workflow in short
- Hold every request in one queue regardless of which payer portal it went through
- Attach the clinical documentation that supports the request to the request itself
- Track expiry so an approval does not lapse before the procedure happens
- 51% Share of prior authorization transactions still conducted manually according to CAQH industry index measurement. CAQH CORE
- 24,874 Approximate US establishments where this workflow sits inside the practice rather than a payer. US Census County Business Patterns
- Pricing runs 180 to 700 US dollars per month across 3 tiers. Early access is free.
What medical practices and billing teams actually deal with
Why it stays broken
Prior authorization is a many to many document problem. Hundreds of payers, each with their own portal, form and expiry rule, and no shared status layer. So practices staff it with people and a spreadsheet, and the spreadsheet is the only thing that knows what is outstanding.
An expired authorisation on a 12,000 dollar procedure becomes a write off nobody budgeted.
Clinical documentation supporting the medical necessity of the prescription must be submitted to the Department for all prior authorization requests.
Neurobird Prior Authorization Workflow Document Automation Platform
Stop treating each payer as a separate process. One queue, one clinical packet per request, and expiry visible while there is still time to renew.
- 1Hold every request in one queue regardless of which payer portal it went through
- 2Attach the clinical documentation that supports the request to the request itself
- 3Track expiry so an approval does not lapse before the procedure happens
- 4Show a coverable audit trail when a claim is denied despite an authorisation
What changes with Neurobird Prior Authorization Workflow?
The same work, read left to right: how it runs today, and how it runs once the record is in one place.
| Today | With Neurobird Prior Authorization Workflow |
|---|---|
| Every payer wants a different form through a different portal, and none of them tell you the status | Hold every request in one queue regardless of which payer portal it went through |
| Approvals expire quietly, so a scheduled procedure is discovered uncovered on the morning it happens | Attach the clinical documentation that supports the request to the request itself |
| The work is phone calls and fax confirmations that leave no record anyone else can pick up | Track expiry so an approval does not lapse before the procedure happens |
Who is this for?
Same queue, three different pressures.
One coordinator holds it all
If that person is out, nobody knows what is pending. You need the queue to exist outside one head.
Volume moves between sites
You need workload visible across locations so a backlog at one site does not become a denial.
Denials are a reported metric
You need the pattern: which payer, which service, which reason, so the fix is systemic rather than per claim.
The authorisation queue, as your coordinator would work it
A working preview. Tick a request to file its clinical evidence.
Watch the fields extract from the document.
How does Neurobird Prior Authorization Workflow work?
Open the request once
Patient, service, payer and clinical justification form a single record no matter which portal it is destined for.
Attach the evidence
Notes, imaging reports and medical necessity documentation attach to the request, so a resubmission is not a rebuild.
Watch the clock
Expiry dates surface on the queue, so a 90 day approval does not quietly lapse before a scheduled procedure.
What the prior authorization burden actually looks like
Useful if you are staffing or defending this function. Each source links out.
Share of prior authorization transactions still conducted manually according to CAQH industry index measurement.
CAQH COREApproximate US establishments where this workflow sits inside the practice rather than a payer.
US Census County Business PatternsCMS has advanced interoperability and prior authorization rules requiring payers to support electronic processes and report metrics.
CMSStandard decision timeframe CMS has set for non urgent prior authorization requests under the interoperability rule, with 72 hours for expedited.
CMSPrior authorization workflow software questions, answered
Key terms
- What is prior authorization?
- Prior authorization is a payer requirement that a provider get approval before delivering certain services, procedures or drugs. The provider submits clinical justification, the payer decides, and without an approval on file the claim is typically denied.
Why is prior authorization so slow?
Because it is a document exchange run across dozens of separate payer portals, fax lines and phone queues, with no shared status. Around 51 percent of prior authorization transactions were still conducted manually according to CAQH industry measurement.
What happens when an authorization expires?
The approval becomes invalid and the claim is denied even though it was once approved. Expiry windows vary by payer and service, which is why tracking them matters as much as obtaining them.
Does this submit to payers automatically?
No. Payers control their own portals and many do not expose an interface. This keeps the queue, the clinical packet and the expiry tracking in one place so the submission work is fast and nothing is lost.
Why we are building this
Prior authorization is the clearest example we found of administrative work that everyone agrees is broken and nobody owns. Payers control the portals, practices carry the labour, and the patient waits.
CMS rules are now pushing payers toward electronic processes and decision timeframes, which will help. It will not remove the practice side work of assembling clinical justification and tracking what is outstanding.
We would rather build this with coordinators than guess. Tell us how your queue works, and where we have got it wrong.
Where the requirement comes from
The federal rules now reshaping prior authorization.
- CMS Interoperability and Prior Authorization final rule The rule setting decision timeframes and electronic process requirements for impacted payers.
- CAQH Index Industry measurement of manual versus electronic administrative transactions, including prior authorization.
- HHS ASPE, health IT adoption Federal research on health IT adoption and administrative burden.
- US Census County Business Patterns Establishment counts for ambulatory and practice settings.
How much does Neurobird Prior Authorization Workflow cost?
Priced per coordinator seat because that is who works the queue. Requests are unlimited.
- Unified request queue
- Clinical packet attachment
- Expiry tracking
- Denial audit trail
- Email support
- Everything in Single practice
- Cross site workload balancing
- Payer rule library
- Turnaround reporting
- Named contact
- Everything in Multi site
- EHR integration
- Role based PHI access
- Denial pattern analytics
- Onboarding and security review
Get free early access
If you work prior authorizations, tell us how you track what is outstanding today.
Straight answer on where this is: In development. Early access gets the working preview, a say in what ships first, and early access pricing. It does not get you a login today, and it does not touch PHI before a security review.
Prefer email? Write to office@neurobird.com and a person will reply. No autoresponder.