Supports authorization requirement checks, documentation gathering, submission, status follow-up and routine exception handling.
All clinical and coverage decisions. Any authorization request that falls outside defined parameters, including unusual coding, missing clinical justification or a payer response the worker cannot interpret, is escalated to a named human owner rather than resolved automatically. Final sign-off on any submission or appeal affecting patient care or payment remains with your team.
Whether the worker matches how prior authorization is actually performed in your organisation, including payer mix and specialty variation.
Accuracy and completeness of submissions, follow-up timeliness, and behaviour on incomplete or ambiguous documentation.
How PHI is accessed, transmitted, retained and logged, and whether that satisfies your own control framework.
Where the worker stops, what it escalates, and whether every exception reaches a named human owner.
Connections to your EHR, payer portals and document stores, and the permissions each one requires.
Whether every action, decision and escalation leaves a reviewable record your auditors can follow.
Deployment requires integration with your existing systems of record and agreement on escalation paths before go-live. Perentis defines these conditions as part of the assessment, while implementation is completed by your team or an approved delivery partner.
Tell us how prior authorization runs in your organisation today. We’ll walk through the assessment, what it found, and the conditions a deployment would need to meet.