Features

Prior-Authorizations

Platform Features

Prior-Authorizations

Wise consolidates prior authorization tasks and status in a single, transparent workflow. When medications require PA, the system notifies the right users, organizes documentation, and lets your team track progress without juggling multiple inboxes and portals.

Hospice impact overview

Make PA work visible, owned, and easier to move

In most hospices, prior authorizations are everyone’s problem and no one’s job. A reject comes back from the pharmacy, someone leaves a message, a spreadsheet gets updated later, and the patient waits.

Wise doesn’t change payer rules, but it does make the work manageable. When a medication rejects with a PA requirement, Wise creates a clear task, notifies the users who handle PAs, and keeps status visible alongside the order. Nurses can re-ping PA users when something stalls, and leaders can see where volume and delays are building up.

Key Outcomes

Less chasing: Each PA request lives in one place with an owner, status, and next step, instead of scattered across inboxes and notes.
Fewer preventable delays: The information and attachments your team needs for PA review are captured in a single workflow, so requests don’t stall because something basic was missed.
Cleaner decision documentation: approvals, denials, and rationale are recorded consistently instead of living in inboxes

Strategic Impact

Our Prior Authorization workflow gives you one trackable path from “PA required” to submission, follow-up, and decision. Every request has an owner, a status, and a record you can trust later.

For hospice executive leaders

Turn prior auth into a governed, trackable process across every location.

Prior authorizations will never disappear, but the chaos around them can. Instead of PA work living in email and phone notes, Wise gives you a defined workflow with clear ownership and reporting. That means fewer surprises when a patient can’t get a medication on time and fewer “we didn’t know this was stuck” moments.

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Key Outcomes

Defined PA workflow instead of ad hoc fixes: Requests, documentation, and decisions live in one place, not scattered across systems and spreadsheets.
Clear ownership: PA tasks route to the users who handle them, so responsibility is explicit instead of implied.
Visibility into bottlenecks: Leadership can see PA volume and where requests tend to stall, making it easier to address process issues instead of guessing.

Executive Strategic Impact

Our Prior Authorization workflow standardizes how requests move across locations while preserving local role structure, escalation paths, and accountability.

For hospice clinical leaders

Protect start-of-care momentum when coverage timing threatens the plan

For clinicians, PA problems show up as delays and callbacks: “Did the PA get sent? Did it come back? Can I move this patient to something that’s covered?” Wise doesn’t add more forms. It makes PA work visible and keeps the clinical team in the loop.

Key Outcomes

Actionable notifications, not buried messages: When a PA is required, hospice staff with PA authority receive push notifications so the work doesn’t sit unnoticed through shift changes or weekends.
Re-ping when something’s stuck: Nurses and other team members can nudge PA users on a specific medication if a decision hasn’t moved, instead of starting over with new messages.
Status tied to the order: Clinicians can see whether a PA is pending, approved, or denied from within Wise, reducing back-and-forth just to find out “where things stand.”

Clinical Strategic Impact

A centralized PA workflow makes it clear when a request is needed, who owns it, and where it stands, so clinicians only get pulled in when their input is actually needed to move things forward.

For hospice financial leaders

Turn prior auth outcomes into finance-grade signal: denial reasons, volume, and exception trends

Finance feels PA problems in denials, write-offs, and unplanned exceptions. When PA work is opaque, it’s hard to separate “inevitable payer behavior” from issues that can be fixed. Wise helps by centralizing PA activity and tying it directly to medications and claims.

Key Outcomes

Visibility into cost-impacting exceptions: When PAs are required for medications outside your formulary or preferred agents, Wise captures those requests and outcomes, giving finance a clear view of where cost variation is entering the system.
A clearer link between clinical decisions and pharmacy spend: PA activity tied to specific medications makes it easier to see which exceptions are clinically appropriate and which patterns are driving avoidable spend.
Better formulary management over time: Consistent PA tracking shows where your formulary is working as intended and where refinements may reduce unnecessary brand or non-preferred utilization.

Financial Strategic Impact

The prior authorization workflow structures PA outcomes, giving finance clear insight into which exceptions drive cost and where tightening process or formulary would have impact.

FAQ

Common Questions

Complex workflows shouldn’t require guesswork. We’re committed to explaining how our solutions work—and why they matter—in terms that help leaders make decisions with confidence. When you need clarity, we’re here, no friction and no fluff.

Every decision is logged with timestamp, user, rationale, and related documents, producing a complete audit history.

Rich metrics cover off‑formulary → authorization rates, approval/denial reasons, cycle time, aging, and downstream cost impact—filterable by prescriber, team, site, and drug class.

Yes. Rules can factor medication, diagnosis, cost thresholds, prescriber, team, or site.

Built‑in alerts notify the responsible user (and backups if configured) when an item needs action or approaches expiration.

Yes. All prior authorizations are submitted electronically through the platform; staff do not need to log into payer portals or send faxes.

Your hospice does. You grant initiation/approval authority to any staff role and can reassign ownership at any time.

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