Prior Authorization System
A novel method to obtain prior authorization from an insurance provider is the Cortex Prior Authorisation system. One of the main issues hospitals, clinics, and pharmacies encounter when interacting with their insurance providers is prior authorization. Prior permission from insurance companies is made easier for clinics and pharmacies with the aid of Cortex prior authorization. International standards are used in the previous authorisation software called Cortex. Cortex will assist doctors and pharmacists with get prior authorization for their patients using the appropriate procedure codes. An improved system for patient registration will keep track of all the patient's information, assist in creating a prior approval xml file with the correct procedure code depending on the diagnosis, and allow the attachment of supporting documentation to the xml file. Through a webservice, the relevant insurance provider will connect, authorize the processes, and send a response with information about the prior approval, after which cortex will capture the specifics from the answer details. Additionally, Cortex will keep track of the insurance companies' response codes and permit the doctors to resubmit the request for a procedure authorization. The entirety of the earlier authorization-related activities will be stored in a database that can be used as a resource in the future. Prior authorization using Cortex can be used independently or connected with any type of clinical, hospital, or pharmacy management system. Cortex can be accessed from any location in the world because it is a web-based program. Cortex is a master-based system, thus it will guarantee that the doctors send requests without mistakes.