Measured proof from prior-authorization teams.
AuthQuire proof is shown only where customer permission, measurement source, and publication scope are approved.
What an AuthQuire packet actually looks like.
Synthetic example. No patient data. No customer data.
The packet structure the product produces — cover, criteria map, source-cited evidence, an open gap, and the audit footer. It is an illustration, not a real submission or customer document.
Lumbar MRI without contrast — prior authorization
- Member
- AQ-EX-0001 (example)
- DOB
- 1972-04-12 (example)
- Payer
- Example Health Plan
- Plan policy
- MSK-IMG-014 v2024.3
- CPT
- 72148
- ICD-10
- M54.16
- Referring NPI
- 1234567890 (example)
- Rendering NPI
- 0987654321 (example)
- Conservative care ≥ 6 weeks documentedPT note 2026-03-14
- Failed conservative treatment, clinician's wordsProgress note 2026-04-22
- Functional impact captured (ODI 38)ROM form 2026-04-22
- Prior imaging within 12 months — date confirmedAwaiting confirmation from referring office
"Patient completed 8 weeks of supervised physical therapy with NSAID trial. Reports persistent radicular pain limiting work duties."
"Conservative measures have failed. Patient reports inability to perform overhead lifting required by occupation."
"Oswestry Disability Index 38 (moderate disability). Lumbar flexion 35°, extension 10°."
Prior imaging date (CT lumbar, est. Nov 2025) — coordinator to request from referring office before packet leaves the workspace.
This example is fictional. Identifiers, dates, and quotes do not correspond to any real patient, provider, or payer.
Mid-Atlantic Orthopedic Specialists (MAOS)
- Organization
- Mid-Atlantic Orthopedic Specialists (MAOS)
- Scale
- 14 clinics, 42 full-time providers, about 18k patient encounters/month
- Teams using AuthQuire
- Prior authorization coordinators, RCM managers, and billing specialists
- Before workflow
- Manual PDF extraction, payer-specific guideline mapping, and email or physical routing for physician signature
- Current workflow
- AuthQuire assembles PA packets from Epic clinical summaries, imaging orders, and payer requirement matrices for human review
- Operating window
- March 2025 to present
- Measurement
- Internal RCM efficiency logs and EHR timestamp audit
“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.”
AuthQuire prepares packets for staff review. It does not submit autonomously, make clinical decisions, or guarantee payer approval.
Measured across approved reporting participants
Reporting window: Jan 2025 — June 2026 · Scope: 7 organizations, 22 locations, 114 licensed users.
Representative figures may be public; raw counts are customer-specific.
Reducing days to submission for a multi-site orthopedic practice
AuthQuire connected the order to the clinical note, detected that a clinical-indication requirement was met in the note narrative, flagged conflicting pain-location language, and prepared the PA packet for coordinator review.
Outcome: Packet submitted within 4 hours of order entry, avoiding about 3 days of scheduling delay and reducing denial risk for missing clinical justification.
“The system caught the ambiguity in the clinical notes that my team usually misses until the payer rejects it three weeks later. That's the actual win.”