Authorizations secured before the appointment, not chased after.
Dedicated prior authorization specialists tracking every payer's specific requirements in real time.
0%
First-submission approval rate
0%
Authorization-related denials
0 days
Average determination turnaround
How Sevynox approaches prior authorization
Prior authorization requirements change constantly and vary by payer, plan, and procedure — which makes them one of the most common avoidable denial causes. Sevynox authorization specialists track requirements continuously and submit requests with the documentation payers actually need.
Every authorization is tracked to a confirmed determination before the date of service, with escalation built in when a payer is slow to respond.
What changes once this is running.
Fewer authorization denials
Requests are built with the exact documentation each payer requires.
Faster determinations
Proactive submission and follow-up shortens the wait for approval.
Real-time requirement tracking
Payer rules are monitored continuously, not looked up ad hoc.
Scheduling protection
Procedures aren't scheduled until authorization status is confirmed.
How an engagement actually runs.
Requirement verification
Current payer-specific authorization requirements are confirmed for the planned service.
Documentation assembly
Clinical documentation supporting medical necessity is compiled and submitted.
Submission & tracking
Requests are tracked continuously through payer portals and phone review.
Escalation & appeal
Delayed or denied requests are escalated or appealed immediately.
What's included.
Payer requirement database
Continuously updated authorization rules by payer, plan, and procedure.
Peer-to-peer coordination
Scheduling and preparation support when a peer-to-peer review is required.
Status tracking dashboard
Real-time visibility into every authorization in progress.
Retroactive authorization support
Handling urgent and emergent cases requiring after-the-fact authorization.
The AI layer behind this service.
Payer rules engine
Authorization requirements are tracked and updated continuously across payers and plans.
Automated status polling
Payer portals are checked continuously so nothing waits on a manual callback.
Medical necessity documentation matching
Clinical documentation is matched against payer-specific criteria before submission.
Orthopedic specialty group, 30 providers
Challenge — An orthopedic group was losing scheduled surgical volume to same-week cancellations caused by authorizations that hadn't cleared in time.
Approach — Sevynox implemented proactive authorization tracking beginning at the point of scheduling, with automatic escalation for any request approaching the procedure date.
0%
First-submission approval rate
0
Case cancellations due to pending authorization
0.0 days
Average determination turnaround
Questions we hear most.
See what prior authorization looks like on your own claims.
A working session with our team, scoped to your specialty mix and payer contracts — not a generic slide deck.