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Automate Primary Care Medication Prior Authorization
Workflow Details
For primary care patients prescribed medications that require PA, extract diagnoses, labs, encounters, medication history, and coverage details from the EHR, answer payer-specific questions, and complete the electronic PA form. Validate against payer criteria and clinical guidelines, submit, track status, and draft appeals, with an optional human review step before submission.
Interested in using this workflow? Contact the Bunkerhill Team.
What this Workflow Does
This workflow ingests EHR data across encounters, conditions, labs, medications, and insurance details to determine eligibility and complete payer-specific prior authorization forms. It submits requests electronically, monitors determinations, parses denial reasons, and drafts appeal narratives for rapid resubmission while maintaining a full audit trail. Sites can enable “review before send” and manual overrides where preferred. The value is faster turnaround, fewer avoidable denials through guideline-concordant documentation, and substantial reduction in staff time per PA request.
Use Case
Streamline prior authorization
Clinical Speciality
Primary Care
Specialty-agnostic / System-level
Data Sources
Encounters
Conditions
Labs
Medications
Messages
