Utilization review and authorizations

Make the clinical record work for utilization review

Rewire Clinical manages initial and concurrent authorizations beside the care they cover. UR staff pull medical-necessity support from notes, treatment plans, level-of-care history, and outcome measures without chasing clinicians for a second version of the record.

Authorization control

Know what is approved, what expires next, and what needs review

Track requested and approved dates, units or days, payer contacts, reference numbers, submission history, decisions, and next-review requirements. Expiration alerts surface cases before an authorization lapses.

Initial review starts with intake and assessment data. Concurrent review uses current notes, participation, risk, medications, discharge barriers, level-of-care detail, and measurable change from the same chart.

Initial authorization

Organize eligibility, admission findings, level-of-care criteria, and the first payer submission.

Concurrent review

Prepare continued-stay support from current documentation and track every payer exchange.

Expiration alerts

See remaining days or units, next review dates, overdue work, and cases at risk.

Medical necessity

Use the documentation clinicians already create

UR staff can pull signed notes, treatment plan progress, outcome measures, functional change, risks, and discharge planning directly from the chart. Clinicians see missing or stale documentation before it becomes a payer problem.

That keeps medical-necessity support grounded in the actual course of care. It also cuts down on duplicate narratives that drift away from the clinical record.

From care to payment

Strong documentation shortens the path to payment

Authorization dates and level-of-care decisions remain visible to billing, reducing claims that go out without matching coverage. When a payer pushes back, staff can trace the request, clinical support, decision, and claim impact in one place.

Rewire Clinical for facilities

Give UR a current clinical story, not a scavenger hunt

See how authorizations, documentation, census, and billing stay aligned in Rewire Clinical.

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