Prior Auth & Utilization Management
UM Analyst (Demo)

Prior Authorization Request

Incoming request received via Da Vinci PAS (FHIR). Auto-adjudicated.

📥 Source: Da Vinci Prior Authorization Support (PAS) — structured FHIR bundle from Acme Medical Group

Request Summary

Auto-Approved Da Vinci PAS
PA-2024-8847291-XYZ
Rocco842 Reichel38
CPT 74181 — MRCP of Abdomen
Acme Medical Group / Dr. Jane Smith

Submitted Clinical Data (FHIR QuestionnaireResponse)

Reason for MRCP (Clinical Indication)

"Abdominal pain and jaundice with history of T2DM." (Structured provider input)

Has the patient had a recent abdominal ultrasound?

"Yes" (Structured provider input)

Why This Was Auto-Approved

This request was received as a structured FHIR bundle. The data was complete and machine-readable, allowing our rules engine to auto-approve it in seconds.

Without Da Vinci: Incomplete fax or portal upload, manual data entry, pended for clinical review, phone tag. (Days of effort.)

With Da Vinci (CRD + DTR + PAS): Complete, structured request → auto-approve. (Seconds.)