AI Admin Agents for Providers and Plans

Automate
Prior Authorization on Qualifacts with AI

GenHealth can automate Prior Authorization for organizations using Qualifacts by executing workflows autonomously for actions taken over the web and fax

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Trigger

When events happen in Qualifacts

New data or events occur in Qualifacts that need to be processed.
Qualifacts

Polling for new records

Action

Automatically run Prior Authorization

GenHealth processes the Prior Authorization workflow automatically using AI.
Process Prior Authorization

Create or update records

How To Guide

How to automate Prior Authorization on Qualifacts

Follow these steps to set up automated Prior Authorization for Qualifacts using GenHealth's UMPA app. No code required.
1
Sign up for UMPA

Create your free GenHealth UMPA account to get started.

Sign up
2
Add Qualifacts integration

In UMPA, connect Qualifacts by entering your username and password.

Connect
3
Add a Prior Authorization workflow

Create a new workflow in UMPA and select Prior Authorization as the type.

Add workflow
4
Schedule the workflow

Choose your triggers or schedule (event-based or recurring) and go live.

Schedule
Start automating Prior Authorization
Benefits

Why automate Prior Authorization with Qualifacts?

Save Time

Eliminate manual data entry and reduce processing time by over 80%

Reduce Errors

AI-powered automation ensures accuracy and consistency

Keep Your Workflows

No need to replace Qualifacts - automate on top of your existing systems

Get Paid

More accurate Prior Authorization leads to faster payments with fewer denials

Details

How does it work?

1
Connect Qualifacts

GenHealth can link your Qualifacts account

2
Configure Workflow

GenHealth will setup your Prior Authorization automation rules and preferences

3
AI Takes Over

GenHealth automatically processes Prior Authorization tasks as they come in

4
Monitor Automation Reports

Track performance via reports

Get started with Qualifacts + Prior Authorization automation
App

More about Qualifacts

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Workflow

More about Prior Authorization

Assembles payer-specific packets from intake and qualification artifacts and submits via Availity, CareCentrix, Carelon, and direct payer portals. Polls for status; ingests approvals, denials, and documentation requests; routes requests back into intake; notifies the team in Slack/email/EHR; and logs auth numbers and units to the order with a complete audit trail.

View all Prior Authorization integrations
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