Requirement detection
Services needing auth flagged automatically from the schedule and orders.
Services / Prior Authorization
Prior Authorization
Prior auth is where care slows down and revenue gets risky — a service delivered without authorization is a claim a payer can simply refuse. GetMax identifies what needs authorization, assembles the documentation, submits, and chases the payer until there's an answer — before the appointment, not after.
What's included
Documentation assembly
Clinical documentation gathered and packaged to payer requirements.
Submission & tracking
Requests submitted through payer channels and statused until resolved.
Urgent & expedited handling
Time-sensitive cases escalated through expedited payer pathways.
Denied-auth appeals
Authorization denials appealed with supporting clinical evidence.
How it works
- 01
Detect
Auth requirements identified from scheduled services and payer rules.
- 02
Submit
Complete, documentation-backed requests filed through the right channel.
- 03
Chase to answer
Statuses followed up until approval — and appealed when wrongly denied.
Questions, answered
How do you know which services need prior authorization?+
Payer rules are checked automatically against your schedule and orders — requirements are flagged before the visit rather than discovered at claim time.
What about urgent cases?+
Time-sensitive requests are routed through payers' expedited pathways and escalated by specialists when a decision stalls.
Do you appeal denied authorizations?+
Yes — denied auths are appealed with supporting clinical documentation, because an unfought auth denial usually becomes an unpaid claim.