Know which deadline you missed, and why
Managed care runs on three clocks set by three different parties. Attergo records the moments behind them: when the payer pended a case, when information was asked for, when each criterion was decided and by whom. Turnaround becomes a measurement instead of a status.
A status cannot tell you how long something took
A case marked pended tells you it is pended. It cannot tell you it sat there for eleven days, and eleven days is the finding. Regulatory, contractual and internal targets are set by three different parties and are routinely three different numbers. Collapse them into a single due date and a breach report can no longer name the deadline that was missed.
The mechanism behind it.
Three clocks, kept apart
Regulatory, contractual and internal targets are separate fields on the case. A breach report names the one that was missed.
Criteria decided one at a time, with reasons
Each criterion carries its outcome and the rationale behind it. A criterion marked not met without a rationale cannot be appealed, so the platform requires one before it will record the decision.
Communications logged without the clinical narrative
Every exchange with a payer, provider or member is recorded as a fact with a time and a channel. The body of it is held apart and revealed only under audit, so operations reporting carries no clinical detail.
Existing pharmacy authorizations carry on
The enterprise context decorates the prior authorization case Attergo already runs. There is no second queue and no second clock, and the workflows a pharmacy team uses today are unchanged.