The authorization, from the moment something revealed it was needed
An authorization is rarely the first thing that happens. A rejection, an order, a referral or an eligibility response reveals that one is needed, and the work begins there. Attergo raises the case from that event, carries the reason forward, and measures the wait from when it started rather than from when somebody noticed.
The clock starts before anybody opens the case
A deadline measured from first touch measures how fast a team works after noticing. It does not measure the wait, which is the only number a regulator or a member cares about. Worse, regulatory, contractual and internal targets are set by three different parties and are routinely three different dates. Collapse them into one and a breach report can no longer name which promise was broken.
The mechanism behind it.
Cases are raised from the event that revealed the need
A pharmacy rejection, an order, a referral, an eligibility response or an imported file can each open a case, and the origin is recorded on it. A case with no recorded origin cannot be traced back to what caused it.
Three deadlines, kept apart
Regulatory, contractual and internal targets are separate fields. A breach names the one that was missed, because the three are set by three different parties and are not interchangeable.
Criteria decided one at a time, with reasons
Each criterion carries its own outcome and the rationale behind it. A criterion marked not met without a rationale cannot be appealed, so the platform requires one before it records the decision.
Every exchange logged, without the clinical narrative
Communications with a payer, provider or member are recorded as facts with a time and a channel. The body is held apart and revealed only under audit, so operations reporting carries no clinical detail.
The products this reaches.
What an enterprise organization additionally gets.
Managed care access
Unified work and cases
These are enterprise surfaces. How they are packaged is on the pricing page, and nothing above them requires an enterprise organization to reach.