Marcus Williams·Prior Authorization Coordinator
Catch missing prior-auth requirements before submission
See what documentation each payer requires for prior authorization so incomplete packets are flagged before they create delays.
Requirements differ by payer, plan, and procedure
Prior auth requirements aren't standardized. What one payer requires for a procedure, another doesn't. Miss a required document and the submission gets kicked back.
Common pain points
- Each payer publishes requirements in different formats and locations
- Requirements change, sometimes mid-quarter
- Incomplete submissions mean delays and rework
- No single source shows requirements across your payer mix
Pre-submission requirement validation
Check a procedure and payer combination before submission. Verity returns documented requirements including clinical criteria, required forms, submission details, evidence, and known gaps where available.
Requirements by payer and code
Enter a CPT code and payer. See prior auth requirements pulled from that payer's published guidelines.
Clinical criteria
View medical necessity criteria that determine approval. Useful for confirming documentation before submission.
Forms and submission info
Where payers publish specific forms or submission channels, Verity surfaces them alongside requirements.
Requirement-change alerts
Get notified when requirements change for procedures you search frequently.
What to expect
Verity consolidates prior auth requirements that would otherwise require checking each payer separately. Coverage varies, and not all payers publish detailed requirements, so incomplete evidence is clearly marked for manual review.