Prior authorization

Utilization Management.

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.

Key Features
Hook - Key Features

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.

How It Works
Hook Prior Auth 01

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.

Hook Prior Auth 02

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.

Hook Prior Auth 03

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.

Hook Prior Auth 04

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