Prior authorisation, submitted complete the first time

Prepares and chases approval requests to the insurer or health fund

The patient finds out sooner whether the procedure is covered

Most requests are not refused because the procedure is uncovered. They are refused because a document was missing — and you learn that two weeks later.

What you get

The file goes out complete

What is missing is flagged before submission, not after refusal.

Nothing is forgotten

Every request has a tracked deadline. Those without an answer are chased automatically.

The patient is kept informed

Notifications go out at each change of status, without anyone remembering to call.

You see what gets refused and why

Reasons are recorded, so patterns become visible and the next files go out stronger.

How it works

The flow, step by step

  1. 1. The request

    The proposed procedure determines which documents are needed, per that insurer's rules.

    • PostgreSQL

  2. 2. Completeness

    The system checks what the patient file already holds and lists exactly what is still missing.

    • OCR
    • PostgreSQL

  3. 3. Submission

    The file goes out on whatever channel the insurer accepts — portal, email or standard form.

    • n8n

  4. 4. Follow-up

    The deadline is tracked. With no answer when it falls due, the request is chased and someone is told.

    • n8n
    • Slack

  5. 5. The outcome

    Approval or refusal, with its reason, enters the file and triggers the patient notification.

    • WhatsApp Business API

Results

A 70-employee catering group with two event venues

Automatic deadline tracking and chasing of unanswered requests already runs in production, in another sector.

Automation workflows
125 63
WhatsApp errors per hour
15–30 0
Security findings
584 383
Weeks to production
— 6

Works with what you already run

  • n8n
  • PostgreSQL

Related solutions

Frequently asked questions

Do you hold security certifications?
We hold no ISO 27001 or SOC 2. If a contract or your internal policy requires them, say so in the first conversation and we will point you to a certified supplier.
Does the system decide what is covered?
No. It checks whether the file is complete against the insurer's rules. The coverage decision belongs to the insurer, and the clinical decision to the doctor.
Do you connect to the health fund's portal?
Where one is accessible, yes. Where not, we prepare the complete file and submission stays manual — the time-consuming half still disappears.
Insurer rules change. What then?
The rules are data, not code. You can update them yourselves, and if you would rather not, it falls under the managed service.
How long does it take to set up?
Four to eight weeks, depending on how many insurers and procedure types you cover.

How many of your requests are refused for missing documents?

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