Prior auth built from the chart and payer policy.
Gather supporting records, answer payer questions, and draft the medical-necessity letter. Your clinician signs off; Foresight submits and tracks the decision.
Which criteria does the record satisfy?
Check the chart against the policy for the requested service. Missing or ambiguous evidence becomes a review question.
Each answer cites the chart evidence and payer-policy clause behind it.
The evidence and decision are saved together for review.
Your clinician approves the packet before any PA is submitted.
Document the prior treatment.
Pull failed trials and step-therapy history from the chart into a medical-necessity letter. Show the records supporting each statement.
- Step therapy4 failed antidepressant trials
- SeverityPHQ-9 baseline documented
- Diagnosis
F33.2recurrent MDD
Track the authorization through the treatment course.
Submit electronically where supported, or by fax, then follow up on requests and denials. For recurring treatment, compare delivered sessions with granted units and expiration dates.