Help Accelerate Prior Authorization: - Automate manual processes by determining if a pre-authorization is required and on file with the payer. - Create a consistent workflow for manual intervention of pre-authorization follow-up to ensure mission-critical steps are not overlooked. - Help reduce losses due to write-offs by automating Medical Necessity checking as part of registration, and perform clinical code auditing for Medicare outpatient services. - Monitor payers electronically for pending pre-authorization decisions with results automatically posted to your health information system. - Help reduce authorization-related claim denials by accessing an audit trail where the authorization verification was obtained and results were stored. - Create Advanced Beneficiary Notices with expected charges for the patient which allows them to accept liability prior to care delivery.

Change Healthcare is inspiring a better healthcare system. We are a leading independent healthcare company that provides data and analytics-driven solutions to improve clinical, financial and patient engagement outcomes in the U.S. healthcare system. Our comprehensive suite of software, analytics, technology-enabled services and network solutions take costs out of the healthcare system by driving improved results in the complex workflows of payers and providers by enhancing clinical decision-making and simplifying billing, collection and payment processes, and enabling a better patient experience. We are creating a stronger and more efficient healthcare system that enables better patient care, choice, and outcomes at scale.

efficientC is a comprehensive decision support and claims management technology platform. It combines powerful denial analytics, claim scrubber and clearinghouse technologies, to deliver the finest denial prevention tool on the market today. efficientC’s Insights, is a predictive analytics solution that leverages machine learning to provide actionable intelligence to help keep denials at bay. Built on the backbone of its proprietary and powerful claim scrubber and stellar support team, the efficientC platform delivers the best possible results to hospital revenue cycle teams.