Private clinics without an internal revenue cycle team lose paid revenue to denied or missing pre-authorizations, not because the care was wrong, but because the request was never filed, filed late, or filed against the wrong plan rule. This tool gives a fast read before you submit.
Free and anonymous. No patient details, member IDs, or files are entered here. The tool runs entirely in your browser and sends nothing to a server.
Pick the procedure category, the payer type, and the country. You will get a readiness indicator, a submission checklist, and the denial reasons that most often follow this combination.
The free tool tells you the general pattern. These two paths cover the work a clinic without a revenue cycle team cannot easily do alone.
Send the procedure and payer details, no patient identifiers. The submission gets prepared, tracked to a decision, and chased before it ages into a denial. Built for clinics that do not have staff dedicated to authorization tracking.
Ask about the managed serviceThe complete procedure by payer pre-authorization list for your market, kept current on a refresh schedule, instead of the general pattern the free tool shows.
Ask about the rules libraryThe denial reasons shown are drawn from the X12 Claim Adjustment Reason Code set, the code list payers use on a remittance to say why a line was reduced or denied. The authorization-specific codes and the general readiness pattern above them are revenue cycle guidance, not official X12 text. Source: x12.org/codes.
The readiness checklist is standard pre-authorization submission practice: eligibility verification, code and diagnosis alignment, medical necessity documentation, referral requirements, benefit limits, submission lead time, and authorization number matching. It is not specific to any named payer.