Prior authorization,
handled before the visit.
authMD automatically monitors orders and appointments in the headacheMD network, checks existing authorizations, and opens a case only when one is actually needed — so staff work exceptions, not every chart.
The focus is on botulinum toxin pre-certification for chronic migraine, Spasmodic Torticollis and Orofacial dystonia.
How it works
- Order or appointment arrives. A toxin procedure order or toxin visit is picked up from the EHR feed.
- Existing auth is checked. Same account, same toxin, dates and units covered? Nothing to do.
- Case opens only when needed. Missing, expiring, changed toxin, or units over the approval — a case is started with the payer's criteria attached.
- The team stays in the loop. Every decision is logged; payer rules improve from real denials.
Security by design
- Minimum-necessary data: the account number is the working identifier.
- AI features are off by default and never receive identifiable patient data.
- Append-only audit trail on every authorization change.
- Encrypted in transit (TLS) and designed for HIPAA-eligible hosting.