CL-031Authorization Management
Goal Documentation for Authorization
Clinical Experience & Provider Productivity
Recommended pathTo be confirmed with PRN
- Capability status
- To be confirmed with PRN
- Transformation phase
- To be confirmed with PRN
- Effort
- To be confirmed with PRN
Current State / What We Learned
Observed today, as captured in the corrected assessment.
PRN reports authorization risk when progress reports do not contain updated goals
Desired Future State
The target way of working PRN and Raintree are aiming for.
Reduce authorization denials tied to incomplete goal updates
Requirement / Gap
Ensure payer-required goal updates are completed before auth submission
Raintree Recommended Path
- Build workflow alerts/validation around goal review and authorization milestones
- Add custom events to validate that goal status column values are updated / reviewed in specific note types.
Dependencies / Considerations
Payer-specific requirements
Outstanding Questions / Decisions
Can this be tied to authorization due dates or payer rules?
Evidence
Evidence for this opportunity is still to be confirmed.
Source
Detailed Transformation Assessment (Corrected)Related opportunities
Related by workstream and subject matter. These are not stated dependencies unless the assessment says so.