Prior Authorization Submission for Prior Authorization Specialists with Change Healthcare
Run prior authorization submission on autopilot inside Change Healthcare.
The Problem
Prior auths for Utilization Management procedures sit in CoverMyMeds queues for days — the patient reschedules, the surgeon's OR time goes unused, and the practice eats the margin.
What We Build in Change Healthcare
AI checks payer-specific PA requirements, pulls the chart from CoverMyMeds, submits the PA with clinical justification, and tracks status — turnaround drops from 7 days to under 48 hours. Purpose-built for teams running Change Healthcare — uses the native API or agent integration so nothing leaves the system of record.
Change Healthcare Integration Approach
Audit your Change Healthcare configuration
We map the specific Change Healthcare objects, custom fields, and workflows the automation needs to touch for your utilization management practice.
Build on the Change Healthcare API or agent
Integration happens inside Change Healthcare — no data leaves the system, no parallel tool for your team to learn, no license changes.
Human-in-the-loop handoff
Every automation routes exceptions back to a human in Change Healthcare with enough context to act — AI handles the 80%, your team owns the judgment calls.
Frequently asked
Does this prior authorization submission automation work natively in Change Healthcare?+
Yes — we build directly on Change Healthcare's API or agent integration. Your data stays in Change Healthcare, your prior authorization specialists keep the same login and UI, and there's no parallel system for the team to learn.
What Change Healthcare configuration do we need before deployment?+
We work with your existing Change Healthcare setup. During discovery we map the specific objects, custom fields, and workflows the automation touches — no rip-and-replace required for utilization management teams.
Can Change Healthcare handle prior authorization submission on its own?+
Change Healthcare handles configuration; AI handles judgment. Native Change Healthcare workflows route deterministic tasks; our automation layer adds the AI judgment Change Healthcare doesn't ship out of the box — document classification, exception triage, drafting.
Is Change Healthcare the right tool for prior authorization submission for prior authorization specialists?+
Change Healthcare is widely used among utilization management teams precisely because of its data model around prior authorization submission. We've deployed this workflow on Change Healthcare for similar firms and the integration is well-trodden.
What's the typical ROI of prior authorization submission automation in Change Healthcare?+
For utilization management firms running Change Healthcare, automation typically pays back inside the first quarter — measured against the loaded cost of the prior authorization specialist hours absorbed. Higher volumes deploy faster.
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See this running in your Change Healthcare instance
30-minute call. We'll look at your actual Change Healthcare setup and show exactly how this workflow fits.