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Prior Auth

Marcus Williams·Prior Authorization Coordinator

Look up prior auth requirements before you submit

See what documentation each payer requires for prior authorization. Reduces back-and-forth from incomplete submissions.

The Challenge

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 your 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
The Solution

Requirements lookup by payer and procedure

Search Verity for a procedure and payer combination. See documented requirements including clinical criteria, required forms, and submission details where available.

Requirements by payer

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 updates

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.

Check requirements before submission instead of after rejection
Reduce incomplete submissions that require rework
One search instead of navigating multiple payer portals

Ready to see it in action?

Start with 500 free lookups. No credit card required.

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