Solutions · By team · Authorization
Authorized before arrival. The denial is fixed before it exists.
Fewer prior authorization denials, faster A/R and a lower cost to collect, because the revenue cycle starts at the order.
For CFOs and pre-cert leads
“We are totally caught up. We have no backlog.”
Mendy Christensen, RT(R), Executive Director, Iowa Radiology
See it work
Walkthrough: an order that needs an authorization
Walkthrough · 1:26
What changes
The same team, fewer surprises
Today
- Authorization needs found when someone gets to the order
- Progress notes chased by phone and fax
- Status checked on payer portals, one order at a time
- Patients booked before the payer is ready
With Gravity
- Coverage and authorization gaps flagged when the order is created
- The progress note requested from the order, and tracked
- Status checked every weekday on booked MR and CT orders
- Slots too early for the authorization greyed out
How it runs
How prior authorization automation works on a new imaging order
One order that needs an authorization, from creation to the booked exam. Each step names the part of Gravity that does it.
| Step | What happens | Feature | Done by | Mode |
|---|---|---|---|---|
| 01 | When the order is created, coverage, eligibility and authorization gaps are flagged before the exam. | Financial clearance | Gravity Estimate | Agentic |
| 02 | Coverage is verified before the patient arrives, without calling the payer or logging into a portal. | Eligibility and benefits checks | Gravity Estimate | |
| 03 | HMO plans are recognized, with the IPA and primary care provider, so staff know when a referral applies. | HMO and IPA plan detection | Gravity Estimate | |
| 04 | The progress note or prior authorization is requested from the referring office, from the order, and each request is tracked. | Request a missing order | Gravity Doc | Automated |
| 05 | Before the authorization is requested, an agent checks the order and progress notes against the payer's medical-necessity criteria, and flags what doesn't meet them so it's fixed before submission. | Medical necessity check | Gravity PriorAuth | Agentic |
| 06 | The request is filled in and submitted on the payer portal without retyping the order, and its status checked. | Submission and status on portals | Gravity PriorAuth | Agentic |
| 07 | Answers for the payer's clinical questions are drawn from the progress notes. | AI case assistant | Gravity PriorAuth | |
| 08 | Prior auth is started for pending orders, and status is checked on booked MR and CT orders every weekday. | Prior auth status checks | Gravity PriorAuth | Automated |
| 09 | Slots too early for the authorization are greyed out, and a move outside the authorized window is flagged. | Authorization-aware booking | Gravity Booking | |
| 10 | Orders waiting on an authorization are on a list, filtered to what each person should work next. | Orders worklist | Gravity Work |
Financial clearance, the medical necessity check and submission on portals are agentic: the agent does the work and your people handle the exceptions. For submission on portals, your center chooses whether a person reviews every run or lets it finish on its own. Status checks and missing-order requests run on their own.
Gravity today
- 80%+of Iowa Radiology's prior authorizations go through Gravity
- Day 4a backlog of about 430 orders, gone
- 0people added: two specialists keep up with four clinics
Trusted by more than 460 imaging centers across the US.
How a radiology practice in Iowa cleared its prior authorization backlog in days. Read the Iowa Radiology story
Questions
Questions about prior authorization
What is prior authorization automation for radiology?
In Gravity, the authorization work starts at the order. Financial clearance flags coverage, eligibility and authorization gaps the moment an order is created, the medical necessity check runs before the request goes out, prior auth status is checked every weekday on booked MR and CT orders, and booking never offers a slot the authorization can't cover.
Will a patient be booked before the authorization is ready?
No. Per-insurance lead times grey out slots too early for the authorization, the wait is waived once it's authorized, and a move outside the authorized window is flagged.
How do you get the progress note from the referring office?
Staff request the missing order, progress note or authorization from the order, one at a time or in bulk, and Gravity tracks each request.
Does the referring office know what an order still needs?
Yes. Referring coordinators are told what the order still needs and what is delaying care. Marketers are told when a referring office owes clinical notes or an authorization, or an exam was denied.
For CFOs, modeled
$26 of every $100A typical imaging center keeps $5 of every $100 it collects. It spends $26 getting the order, completing the exam and getting paid. Modeled.