Prior Authorization Administrative Support
Structured administrative support for preparation, submission, tracking and payer follow-up of authorization requests using client-approved information and workflows.
Support May Include
Depending on your agreed scope, support may include:
- Administrative preparation of requests using client-approved information.
- Submission through approved processes and systems.
- Status tracking of submitted requests.
- Administrative payer follow-up.
- Documentation of authorization outcomes.
- Escalation when client or provider action is required.
Service Boundary
Clinical responsibility remains with qualified professionals.
- Requests requiring clinical judgment are escalated.
- Coding decisions remain with qualified professionals.
- Provider action is escalated back to the client.
- Approval is never represented as guaranteed.
- Medical necessity decisions remain outside Maono's scope.
Common questions.
What information is needed to start an authorization?
Maono works from the documentation and information supplied or approved by the client.
Can your team make clinical determinations?
No. Anything requiring clinical judgment is escalated to the appropriate qualified professional.
How are authorization statuses tracked?
Status is documented through the approved systems and workflow agreed during implementation.
Do you guarantee payer approval?
No. Authorization approval remains subject to the payer's requirements and decision.
What happens when additional documentation is requested?
The request is documented and routed or escalated according to the client's process.
Can you follow up with payers?
Administrative payer follow-up can be included through approved communication channels.