MAJ OS
🏥 Prior Authorization AI
📋 Requirements Checklist
🧠 Documentation Audit
🚦 Submission Gate
💰 Revenue Protection
MAJ HEALTHCARE OS
Prior Authorization & Policy Compliance Engine
Select the payer, plan type, service category, CPT code, and diagnosis. MAJ Healthcare OS checks clinical documentation against payer-specific requirements before claim or authorization submission.
Submission Status
WAITING
STEP 1 — PAYER + SERVICE
Insurance Intelligence
Tip: include ICD-10 codes, symptom duration, red flags, failed treatment, exam findings, and why this service is medically necessary.
STEP 2 — CLINICAL DOCUMENTATION
Patient Notes
Approval Probability
0%
Denial Probability
0%
Risk Level
—
Policy Source
Not Found
Plan-Specific Warning
Commercial, Medicare Advantage, Medicaid, PPO, HMO, and employer plans may have different coverage criteria, prior authorization requirements, reimbursement policies, and exclusions. Always verify member-specific benefits before submission.
Commercial, Medicare Advantage, Medicaid, PPO, HMO, and employer plans may have different coverage criteria, prior authorization requirements, reimbursement policies, and exclusions. Always verify member-specific benefits before submission.