Using Prior Auth
Clinical context
The packet is only as good as the context behind it. Add context in step 4 of the wizard or later in the Clinical context section of the request page. There are three ways to add it.
Paste text
Paste chart notes, exam findings, correspondence or a denial letter into Clinical note (up to 20,000 characters) and choose Add note. The optional Label helps you tell notes apart, for example “Exam note 10 Oct”.
You can add as many notes as you need and remove any of them.
Structured findings
The findings tab is a short form for your specialty, with fixed options where a payer expects a specific value. Anything you fill in is used as is, so it's the most reliable way to give the draft exact facts.
| Practice type | Form sections |
|---|---|
| Dental | Presentation, Periodontal charting, History |
| Aesthetics | Assessment |
| Physiotherapy | Diagnosis and progress, Plan |
| Other types | Summary (the generic form) |
Uploaded files
Attach supporting files, such as radiographs, charts or letters. Accepted types: PDF, PNG, JPEG, TXT and DOCX, up to 10 MB each. Files are stored privately for your practice. Team members can download them again from the request page.
What makes a good note
- Findings that justify the service: what was observed, measured or imaged, and when.
- What has been tried and why it isn't enough: prior treatment, how long, and the result.
- What the payer asked for, if you know it: look at your practice's notes for that payer.
- Plain statements over summaries of opinion. The draft can only restate what you give it.
When context can be changed
Notes, findings and uploads can be added or removed while the request is Draft, Ready for review or Appeal in progress. Once the packet is locked the context is frozen, though uploaded documents can still be downloaded.
To generate the first packet you need at least one note or some structured findings. Next: generating a packet.