# 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.

- URL: https://neurobird.com/priorauth/
- Product: Neurobird Prior Authorization Workflow Document Automation Platform
- Niche: prior authorization workflow
- Buyer: medical practices and billing teams
- Status: in development, open for early access
- Updated: 2026-08-21

## What Neurobird Prior Authorization Workflow does

- 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
- Show a coverable audit trail when a claim is denied despite an authorisation

## How it works

1. **Open the request once** Patient, service, payer and clinical justification form a single record no matter which portal it is destined for.
2. **Attach the evidence** Notes, imaging reports and medical necessity documentation attach to the request, so a resubmission is not a rebuild.
3. **Watch the clock** Expiry dates surface on the queue, so a 90 day approval does not quietly lapse before a scheduled procedure.

## From the source material

> Clinical documentation supporting the medical necessity of the prescription must be submitted to the Department for all prior authorization requests.

Source: pa.gov, https://www.pa.gov/agencies/dhs/resources/pharmacy-services/pharmacy-prior-authorization-general-requirements

## Industry context

- **51%** Share of prior authorization transactions still conducted manually according to CAQH industry index measurement. (source: CAQH CORE, https://www.caqh.org/explorations/caqh-index)
- **24,874** Approximate US establishments where this workflow sits inside the practice rather than a payer. (source: US Census County Business Patterns, https://www.census.gov/programs-surveys/cbp.html)
- **2026** CMS has advanced interoperability and prior authorization rules requiring payers to support electronic processes and report metrics. (source: CMS, https://www.cms.gov/priorities/key-initiatives/burden-reduction/interoperability/policies-and-regulations/cms-interoperability-and-prior-authorization-final-rule-cms-0057-f)
- **7 days** Standard decision timeframe CMS has set for non urgent prior authorization requests under the interoperability rule, with 72 hours for expedited. (source: CMS, https://www.cms.gov/priorities/key-initiatives/burden-reduction/interoperability/policies-and-regulations/cms-interoperability-and-prior-authorization-final-rule-cms-0057-f)

## Pricing

- Single practice: $180 per seat, per month
- Multi site: $390 per seat, per month
- Health system: $700 per seat, per month

## Questions

### 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.

## Sources

- [CMS Interoperability and Prior Authorization final rule](https://www.cms.gov/priorities/key-initiatives/burden-reduction/interoperability/policies-and-regulations/cms-interoperability-and-prior-authorization-final-rule-cms-0057-f)
- [CAQH Index](https://www.caqh.org/explorations/caqh-index)
- [HHS ASPE, health IT adoption](https://aspe.hhs.gov/)
- [US Census County Business Patterns](https://www.census.gov/programs-surveys/cbp.html)

## Contact

- office@neurobird.com
- https://neurobird.com/