Prior Authorization Submission for Medical Coding Managers with Optum CAC
The Problem
Prior auths for CDI & Coding procedures sit in 3M 360 Encompass queues for days — the patient reschedules, the surgeon's OR time goes unused, and the practice eats the margin.
What We Build in Optum CAC
AI checks payer-specific PA requirements, pulls the chart from 3M 360 Encompass, submits the PA with clinical justification, and tracks status — turnaround drops from 7 days to under 48 hours. Purpose-built for teams running Optum CAC — uses the native API or agent integration so nothing leaves the system of record.
Optum CAC Integration Approach
Audit your Optum CAC configuration
We map the specific Optum CAC objects, custom fields, and workflows the automation needs to touch for your cdi & coding practice.
Build on the Optum CAC API or agent
Integration happens inside Optum CAC — no data leaves the system, no parallel tool for your team to learn, no license changes.
Human-in-the-loop handoff
Every automation routes exceptions back to a human in Optum CAC with enough context to act — AI handles the 80%, your team owns the judgment calls.
See this running in your Optum CAC instance
30-minute call. We'll look at your actual Optum CAC setup and show exactly how this workflow fits.