One Workspace. Structured Packets. Defensible Decisions.
Every stakeholder contributes directly to a single, organized case file, so insurers receive complete submissions, make faster determinations, and keep audit-ready records without the paper chase.
Structured submissions, clinics, patients, and providers upload RFAs, notes, imaging, and prior auths into one shared packet.
Faster, clearer reviews, missing fields and stale documents are visible to everyone, reducing back-and-forth.
Audit-ready compliance, role-based permissions, minimum-necessary PHI, and immutable logs.
Work from complete, standardized packets. Every stakeholder uploads their piece of the record into a structured folder: RFA, clinical notes, imaging, prior authorizations, and supporting forms, all with version history.
Cut the back-and-forth. No more chasing missing documents by email. The shared timeline shows what’s outstanding and who’s responsible.
Stay on clock, stay compliant. Cases are aligned to statutory review timelines. Your determinations are timestamped alongside the submission trail, simplifying downstream IMR or appeals.
Control access, prove compliance. Invite-only, role-scoped permissions limit exposure. Every view, download, and export is logged and exportable for QA or audit.
Scale without replacing systems. Secure links and scoped invites make it easy to layer Auth Hero on top of your existing workflow.
How It Fits Your Claims Workflow
01
Receive a Case Invite
Open a structured packet with the RFA, supporting documentation, prior auths, and related forms in one workspace.
02
Review in Context
See the case timeline at a glance, request clarifications or additional documents, and track responses without losing history.
03
Decide & Document
Enter your determination and rationale; it’s captured alongside the case record with timestamps.
04
Export When Needed
Generate a defensible UR/IMR bundle, documents + logs, in minutes.
Why It Matters
Time-boxed reviews, cleaner handoffs. Packets align with statutory review clocks. Determinations are preserved with dated traces that reduce disputes and cycle times.
Guideline-aware organization. Evidence is structured in line with review expectations, so your team focuses on medical necessity, not file formatting.
Network context built-in. Provider and network details stay attached to the case file, minimizing detours and rework.
Privacy, Security & Defensibility
HIPAA-aligned by design, role-based access, expiring invites, least-privilege defaults.
Immutable audit trails, every view, download, and permission change is logged and attributable.
Production-ready governance, consistent version history and exportable reports for audits, QA, and legal events.
Why Carriers and TPAs Choose Auth Hero
Lower admin drag, fewer incomplete packets and resubmissions.