Problem Statement

Authorizations must be handled within tight payer timeframes, and doing it manually is labor-intensive, so a missed or late authorization becomes an avoidable denial. Before any of that can happen, someone has to determine whether a given visit even requires authorization, checking each upcoming visit against payer guidelines, a high-volume gating step that has to be right because a visit wrongly cleared as "no authorization needed" surfaces later as a denial. Driving this off the Epic ASA file lets the determination run across the full schedule rather than one appointment at a time.

Automation Solution

This automation evaluates whether upcoming visits require authorization by checking payer guidelines and updating the EMR tables with the authorization requirements.