Your providers submit requests to us online or over the phone.
Our automated platform reviews the requests in real time.
Requests that meet clinical criteria are immediately approved. Our clinical reviewers, including specialty-matched physicians and nurses, are available to consult with your providers about any requests that don’t meet our clinical guidelines.
If included in your program design, we redirect services to high-value sites of care when clinically appropriate.
Review request data is shared with your system(s) for claims, care management, and/or reporting purposes.