Pre-authorisation workflow
Raise and track pre-authorisation requests against the same patient record the care team is already working from.
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Payer Management
Pre-authorisation shouldn't run separately from care.
Payer Management brings pre-authorisations, claims, and payer communication into a single, transparent workflow, so an admission, a procedure, or a discharge doesn't wait on a parallel paperwork process nobody can see the status of. Built on top of your existing HIS.
40%
reduction in claim denials
35%
faster pre-auth turnaround
30%
ARPOB through fewer delayed claims
Insurance status is often the least visible part of an inpatient stay.
Pre-authorisation status is invisible to the care team.
Whether a procedure is actually approved often isn't visible to the people deciding when to proceed with it.
Payer communication happens over email and phone.
Requests for additional documentation or clarification get lost in threads, adding days to an approval that was otherwise ready.
Claims wait behind manual paperwork.
A claim can't go out until the right documentation is assembled, and assembling it is often a manual, late-stage task.
Denials surface after the fact.
A rejected claim or a denied pre-auth often isn't discovered until well after the care decision it was tied to has already happened.
How it Works
Prodoc · Payer Management
Pre-authorisation request
Knee arthroscopy · Star Health
Raised against patient record · Ananya Desai · 11 Sept
Submitted
Policy numberSH-482910
Treating doctorDr. Iyer · Ortho
Estimated stay2 days · OT-3
Documents attached4 of 4
Expected payer response24–48 hours
The care team and the finance team see the same payer picture.
Unified payer communication
Every request for documentation or clarification lives in one workspace, instead of scattered across email and phone.
Claims assembly as the stay progresses
Documentation builds throughout the stay, so claims don't have to be assembled from scratch at discharge.
Status visibility for care and finance teams
See where a pre-authorisation or claim actually stands, without a call to the insurance desk.
The care team and the finance team see the same payer picture.
Pre-auth
35%
faster pre-authorisation turnaround
Denials
40%
reduction in claim denials
ARPOB
30%
ARPOB through fewer lost claims
Communication
50%
less time on payer follow-up
01
Faster pre-authorisation turnaround
Requests move faster when documentation gaps are visible early, rather than discovered after a delay.
02
Fewer claim denials
Claims built from a continuously assembled record are more complete, reducing the errors that lead to denial.
03
Less time on payer communication
Requests and responses are tracked in one place, rather than chased across email and phone.
Frequently asked questions
No. It gives your insurance desk a shared workflow to manage pre-authorisations and claims in, the relationships and negotiations with payers stay with your team.
Insurance status shouldn't be the part of the stay nobody can see.
Book a demo and we'll show you how it runs on your payer mix and your existing systems.