Page Comparison

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• Beneficiary identifier

• Provider identifier

• Benefits class

• Benefit plan

• Clinical information

• Supporting documents

• Treatment plan

• Fee schedule

• Diagnosis

Output

• Approval with cost, service or unit boundaries or rejection

• Approval/ provisional approval (services can proceed but services may not be covered) disapproval

• Approval percentage (percentage of requests that are approved)

• Analysis of which services are being rejected (what provider, what services)

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