Prior authorization
Utilization Management.
Re-imagined.
Hook is taking the pain out of prior authorization by automating the entire end-to-end process in seconds, saving time and costs.
Re-engineering the prior authorization process
Hook into the future of Prior Authorization
Hook is the first prior authorization solution specifically designed to follow the DaVinci implementation guide, using CDS Hooks, FHIR, SMART on FHIR and CQL. It integrates seamlessly into existing workflows to automate the prior authorization process end-to-end. Hook can save up to 17 minutes per transaction, while eliminating the need for payer portals, back and forth phone calls, and faxing forms... ultimately generating valuable time savings and eradicating redundant paperwork.
Automated Prior Auth Check
Using CDS hooks, Hook’s CQL engine retrieves and processes prior authorization rules, immediately determining if prior authorization is required.
EHR Connectivity
Hook initiates prior auths from the EMR - right in the workflow of placing an order - and pre-populates the SMART on FHIR form by pulling patient data directly from the EMR.
Real-Time Approval
Using the CQL engine, Hook automates the approval process by cross-checking medical necessity rules and requirements from payers.
STEP 01: Prior Auth Automated Check
Hook automatically checks with payors if prior auth is needed, eliminating manual portal checks and phone calls. Whenever a doctor places an order in the EMR, Hook's engine instantly retrieves and processes prior authorization rules from payors and automatically determines if prior authorization is required.
STEP 02: Prior Auth automatically initiated and pre-populated
When prior authorization is required, the CDS card directs the doctor to the SMART on FHIR PA form. Hook retrieves rules and requirements from payers to identify the appropriate clinical documentation, and the questionnaire is automatically pre-populated with patient information – pulled directly from EMR data.
STEP 03: Prior Auth form review
While in the app, doctors can modify answers and select the correct data. Providers can also access the patient information they need through HOOK’s comprehensive clinical dashboard, which provides real-time, longitudinal patient records across 3,000 hospitals in the US - through FHIR and HL7, as well as proprietary APIs.
STEP 04: Prior Auth submission
and real-time approval
When submitting the request, our CQL engine saves valuable time by automating the approval process. HOOK’s engine retrieves medical necessity rules from payers, accelerating an automated approval, so that providers no longer have to wait days – or weeks – for manual reviews.
Provider Benefits
Speed up submissions
Facilitate submissions by pre-populating prior authorization forms with EHR data
Reduce care delays
Help reduce care delays and write-offs with faster turnaround times
Increases rates of approval
Guarantee real-time approvals with retrievals of payers’ rules instantly
Payer Benefits
Automated review
Remove the need for manual reviews by payers' admin, to streamline a frictionless approval process
Faster approvals
Get approval right at the point-of-care to increase customer satisfaction
Simpler Utilization Management
Access comprehensive patient records including Notes, Labs, and Imaging right in the app