From clinical note to payer-ready packet in one staff review queue.
For orthopedic, imaging, and RCM authorization teams.
AuthQuire extracts the evidence payers ask for, assembles the authorization packet, tracks status, and prepares appeals when requests come back denied.
- 100% human review before submission
- BAA-supported workflows
- Built for orthopedic and imaging teams
Most denials trace back to the same four steps.
- Order placed
Provider requests a procedure or imaging study.
- Evidence scattered
Notes, labs, and prior tx history sit in different systems.
- Payer criterion missed
A payer-specific requirement is never checked off.
- Denial / rework
The request comes back denied and the queue starts over.
What the queue does before anything is sent.
Five connected stations move every request from raw note to reviewed packet.
- Station 1 · IntakePull the clinical note
Capture the most recent note that justifies the request.
- Station 2 · MapMatch payer criteria
Mark which payer requirements are satisfied and which are not.
- Station 3 · CiteAttach evidence
Each criterion links to the source chip that proves it.
- Station 4 · AssembleBuild the packet
Versioned packet ready for submission to the payer portal.
- Station 5 · ApproveStaff sign-off
A reviewer approves before anything leaves the queue.
The packet is the product.
Every authorization request leaves the queue as a single, reviewable packet — structured the way payers expect to receive it.
- Requested service
CPT/HCPCS, side, urgency, ordering provider.
- Payer criteria
Plan-specific requirements mapped one-to-one.
- Extracted evidence
Pulled from chart with citation back to source.
- Missing evidence
Flagged gaps with the exact next-step request.
- Letter / forms
Cover letter and payer forms pre-populated.
- Source trail
Every chip links to the originating document.
- Staff approval
Reviewer sign-off recorded before submission.
Used by a 14-clinic orthopedic team.
Mid-Atlantic Orthopedic Specialists uses AuthQuire to assemble prior authorization packets from Epic clinical summaries, imaging orders, and payer requirement matrices before coordinator review.
Multi-site orthopedic and rheumatology practice · Maryland & Virginia
- Scale
- 14 clinics · 42 providers · about 18k patient encounters/month
- Operating window
- March 2025 — present
“The shift wasn't about replacing the coordinator; it was about stopping the ‘search and rescue’ mission through the patient's chart. We now spend our time reviewing the packet for accuracy rather than hunting for the imaging report.”
- Conservative therapy ≥ 6 weeksPT note · 04/12
- Documented neuro deficitExam note · 05/02
- Prior imaging reviewedX-ray report · 03/28
- Failed medication trialMissing — reviewer flagged
Reviewed, scoped, and logged — by design.
Every packet passes through a named reviewer. Nothing auto-submits.
Encrypted in transit and at rest. Access scoped by role and client.
Packets, access, exports, and approvals are timestamped and queryable.
Priced against authorization volume, not seat counts.
Pick the lane that matches how your team actually works.
- One review queue
- Packet desk + appeals
- Payer portal submission
- Per-modality queues
- Payer criteria libraries
- First-pass tracking
- Per-client workspaces
- Reviewer assignments
- Roll-up reporting