RxAuth
The prior authorization process can be labor-intensive and complex. RxAUTH™ effectively integrates receipt, tracking, and decision processes for prior authorization requests. Real-time automated entry of prior authorization into RxCLAIM® from RxAUTH completes the process for an approved request.
The components and functionality of RxAUTH are:
- Prior authorization requests can be received by RxAUTH in a number of ways including web-based communication, from a rejected claim, as well as manual entry of information if desired. Other modes of input as available in the business setting can also be integrated.
- User-defined protocol rule sets determine whether a prior authorization should be granted.
- Evaluation of supporting information provided against rule sets in protocols allows RxAUTH to render an approval or denial decision.
- When integrated with appropriate document/workflow management technology, decision-dependent text housed in RxAUTH can facilitate request-related correspondence generation.
- RxAUTH automatically creates a prior authorization in the RxCLAIM system in real-time when protocol rules have been satisfied.
The features and advantages of RxAUTH are:
- Role-based security supports three levels of access: help desk, manager, and administrator.
- On-line protocols promote inter-rater reliability.
- Flexible rules facilitate customization of protocols.
- SXC’s RxTRACK® data warehouse offering supports detailed reporting on RxAUTH-related activity including timeliness of decisions.
