Intuitive Prior Authorization Platform for Healthcare Providers

The GuidingCare® Authorization Portal offers an intuitive and comprehensive authorization management platform to ease the preauthorization, appeals, and messaging process for your Utilization Management staff and the providers who interface with your plan. Plans can dramatically streamline the preauthorization process and shrink turnaround times by eliminating time-consuming faxes and phone calls. The reduced administrative burden ensures more satisfied staff, providers and plan members. Best of all, the Authorization Portal integrates with the world’s most comprehensive and respected clinical guidelines.

Features

Rules and Procedures

Configure workflows and templates to meet requirements according to the plan design, line of business, regulatory requirement or quality measure. Real-time data can automatically authorize routine requests and flag those that need further medical review, reducing administrative burden and increasing provider satisfaction.

Clinical Guidance

Pre-built integrations with MCG Cite AutoAuth and InterQual Connect™, the world’s most comprehensive and respected clinical guidelines, provide confidence coverage decisions are grounded in best practices.

Messaging

Direct messaging between providers and utilization management nurses eliminates inefficient phone and fax communications.

Discharge Tracking

Track discharge plans and complete discharge assessments directly on the member’s authorization to improve care planning and coordination.

Integrated Platform

Offers seamless, end-to-end workflows when combined with GuidingCare’s Utilization Management and Appeals & Grievances solutions.