Prior auth.Denial appeals.End to end.
Cited drafting. Physician sign-off. Staff-controlled submission. Follow-through.
This example workflow accepts either a prior authorization or denial appeal, creates a source-cited draft, coordinates physician review and staff-controlled submission, follows deadlines, and reports the outcome.
Most denied Medicare Advantage prior authorizations are never appealed.
of denied Medicare Advantage prior-authorization requests are appealed
of appealed Medicare Advantage prior-authorization denials are partially or fully overturned
KFF analysis of 2024 CMS data · Medicare Advantage
Prior auth or appeal. One accountable workflow.
We draft and cite it. Your physician reviews it. We manage what comes next.
Prior authorizations and denial appeals use one six-step workflow: intake, source-cited drafting, physician review, staff-controlled submission, follow-up, and outcome reporting.
Your team sends it through existing channels. We track the receipt, deadline, payer decision, and—when applicable—posted payment.
Every case. Accounted for.
We agree on one workflow and its full candidate list before work starts. Nothing quietly disappears when the queue gets hard.
Worked or explained
Every eligible case is worked, or carries a documented reason why it was not.
Deadlines with teeth
A missed in-scope deadline triggers a contractual fee credit.
Approved isn’t paid
The managed report keeps the payer’s decision and posted payment separate.
We take responsibility for the work—not the insurer’s verdict.
This sample managed-service report shows six Medicare Advantage level-of-care denials with an explicit status, including one case not worked with a recorded reason, and keeps payer decisions separate from reported payment.
Start with one workflow.
Keep the systems, staff, and submission process you already have. We prove the value before asking for deeper integration.
Protect earned revenue.
Finish high-value clinical denials before they age into write-offs.
Give the time back.
Appeals plus supported prior-auth templates, without taking clinical judgment away from the physician.
Inveto prepares source-cited prior authorizations and denial appeals. Your team controls submission.
Patient data is enabled only after a customer-specific BAA and launch checks are complete.