Simulated AIExport
Prior authorization · Pre-service

Predetermination

Voluntary pre-service reviews for plans without a prior authorization requirement

PreviewNot in this phase. Predetermination requests and payer responses. Static sample data; rows open a read-only detail.
Pending
4
awaiting payer decision
Approved (30 days)
6
incl. 1 gold-card auto-approval
Info requested
1
respond by Oct 3
Median turnaround
9 days
from send to decision

Predetermination requests

8 rows
PatientPayerSiteSentMethodStatusDecision due
Ana SobrinoBCBS TX · Blue Choice PPO (Walmart)Left breast2026-09-24Payer portalPending2026-10-08
Ivy CastellanosBCBS TX · Blue Choice PPO (American Airlines)Pediatric CNS2026-09-28Payer portalAuto-approved (gold card)—
Elena PetrovaCigna · Open Access PlusMeningioma2026-09-19FaxAdditional info requested2026-10-03
Rahul MenonBCBS TX · Blue Choice PPONasopharynx2026-09-22Payer portalPending2026-10-06
Carla JimenezAetna · Open Access PPOLeft breast2026-09-12Payer portalApproved 9/26—
Walter GravesHumana · Gold Plus HMOProstate2026-09-08Payer portalDenied 9/20—
Bea LindgrenUHC · Navigate HMOLung—DraftNot yet sent—
Omar FaroukCigna · Open Access PlusRetroperitoneal sarcoma2026-09-27Payer portalPending2026-10-11