What We Do
Novus360 Prior Authorization
Novus360 Prior Authorization
Smarter, Simpler Prior Authorizations
Novus360's Prior Authorization (PA) solution helps streamline utilization management by ensuring medical services are medically necessary, timely, and cost-effective. From pre-checks to approvals, the process supports providers and payers in delivering the right care at the right time.
Quickly search CPT or HCPCS codes to check if a procedure needs prior authorization. This step ensures clarity right from the start and aligns care with plan requirements.
Securely submit authorization requests online—no paperwork, no delays. It's fast, trackable, and easy to use for providers.
Standard (non-urgent) requests are reviewed within 15 calendar days. Urgent cases? We get them processed within 72 hours of receipt, helping patients get timely care.
Each request is reviewed based on clinical evidence, the member's benefit plan, and medical necessity. The process is thorough yet efficient.
We believe in strong communication. Our approach brings providers and payers together to ensure patients receive the care they need, without unnecessary roadblocks.
Automation speeds things up. Our intelligent decision support tools help reduce review time while improving accuracy and compliance.
Emergencies can't wait. Provisions are always in place to bypass prior authorization for urgent care needs when delays could risk a patient's health.
Comprehensive Healthcare Systems Inc.
Ensuring Medical Necessity – Ahead of Time
Ensuring Medical Necessity – Ahead of Time
Before treatment begins, Novus360 helps verify if ambulatory care and other services require prior authorization. Our process supports:
- Ambulatory procedures
- High-tech imaging (MRI, CT, PET scans)
- Outpatient psychiatric care
- Home healthcare
- Physical, speech, and occupational therapy