Prior authorization
In developmentAdminQ is in development for prior authorization in orthopedics and interventional pain. It is designed to gather the payer's requirements, the clinical documents, and a list of what is missing, so staff can review a complete packet before they submit it.
The problem
Authorization requests are often returned because a required item was missing, such as a pain scale, a record of conservative care, or imaging. For repeat injections, the documentation requirements are specific and easy to miss.
How it works
A packet with the payer's documentation requirements for the procedure, the relevant clinical documents from the chart, such as the H&P, imaging, and a medical-necessity summary, and a list of items that are missing.
Staff review the packet, fill any gaps, and decide when it is ready.
Staff submit the request to the payer. AdminQ does not submit authorizations on its own.
Availability
In developmentBeing built or evaluated. Not offered to practices yet.
Evidence
Measured
Sampled Medicare epidural steroid injection records missing a core documentation item
Limitation: A missing item is a review finding, not a denied claim or a confirmed recoupment.
Related workflows
Readiness items to resolve before the packet is built.
Planned connection. Coding for the same surgical case.