# Referral Management & Loop Closure for Prior Authorization Specialists with Change Healthcare

> AI triages incoming referrals by acuity, schedules them into open slots in CoverMyMeds, and chases outgoing referral loop closure with consulting providers — no referral gets lost. Purpose-built for teams running Change Healthcare — uses the native API or agent integration so nothing leaves the system of record.

- **Tool:** [Change Healthcare](https://calish.com/workflows/tool/change-healthcare/)
- **Role:** [Prior Authorization Specialist](https://calish.com/workflows/for/prior-authorization-specialist/)
- **Specialty:** Utilization Management
- **Category:** Communication & Outreach
- **Canonical URL:** https://calish.com/workflows/with/referral-management-and-loop-closure-for-prior-authorization-specialist-with-change-healthcare/

## The Problem

Incoming Utilization Management referrals sit in fax queues and CoverMyMeds work lists, and outgoing referrals die without loop closure — both cost the practice revenue and clinical quality.

## What We Build in Change Healthcare

AI triages incoming referrals by acuity, schedules them into open slots in CoverMyMeds, and chases outgoing referral loop closure with consulting providers — no referral gets lost. Purpose-built for teams running Change Healthcare — uses the native API or agent integration so nothing leaves the system of record.

## Change Healthcare Integration Approach

1. **Audit your Change Healthcare configuration.** We map the specific Change Healthcare objects, custom fields, and workflows the automation needs to touch for your utilization management practice.
2. **Build on the Change Healthcare API or agent.** Integration happens inside Change Healthcare — no data leaves the system, no parallel tool for your team to learn, no license changes.
3. **Human-in-the-loop handoff.** Every automation routes exceptions back to a human in Change Healthcare with full context — AI handles the 80%, your team owns the judgment calls.

## About This Workflow

- [Referral Management & Loop Closure for Prior Authorization Specialists](https://calish.com/workflows/referral-management-and-loop-closure-for-prior-authorization-specialist/)
- AI triages incoming referrals by acuity, schedules them into open slots in CoverMyMeds, and chases outgoing referral loop closure with consulting providers — no referral gets lost.

## Other Change Healthcare Automations

- [Telehealth Visit Follow-up for Radiology Practice Managers](https://calish.com/workflows/with/telehealth-visit-follow-up-for-radiology-practice-manager-with-change-healthcare/)
- [Provider Credentialing & Payer Enrollment for Radiology Practice Managers](https://calish.com/workflows/with/provider-credentialing-and-payer-enrollment-for-radiology-practice-manager-with-change-healthcare/)
- [Daily Denial Worklist Triage for Radiology Practice Managers](https://calish.com/workflows/with/daily-denial-worklist-triage-for-radiology-practice-manager-with-change-healthcare/)
- [Claim Denial Appeal for Medical Billing Managers](https://calish.com/workflows/with/claim-denial-appeal-for-medical-billing-manager-with-change-healthcare/)
- [Daily Denial Worklist Triage for Medical Billing Managers](https://calish.com/workflows/with/daily-denial-worklist-triage-for-medical-billing-manager-with-change-healthcare/)
- [Insurance Eligibility Verification for Medical Billing Managers](https://calish.com/workflows/with/insurance-eligibility-verification-for-medical-billing-manager-with-change-healthcare/)
- [Prior Authorization Submission for Medical Billing Managers](https://calish.com/workflows/with/prior-authorization-submission-for-medical-billing-manager-with-change-healthcare/)
- [New Patient Intake & Chart Prep for Medical Billing Managers](https://calish.com/workflows/with/new-patient-intake-and-chart-prep-for-medical-billing-manager-with-change-healthcare/)

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