ClearAuth — Prior Authorization Packet Assembler (Demo)

1Sample Case
2Extracted Info
3Payer Requirements
4Packet Preview
5Submit & Track

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Sample Case

Patient

Jane Smith

DOB: 03/14/1968

Member ID: BCB-TX-4892017

Payer: BCBS-Texas

Provider

Ordering: Dr. Michael Torres, MD

Procedure & Diagnosis

Procedure: Rotator Cuff Repair (CPT 29827)

Diagnosis: M75.121 — Complete rotator cuff tear, right shoulder

Clinical Summary

Patient presents with 6-month history of right shoulder pain with significant functional limitation. Failed 12 weeks conservative therapy including PT and cortisone injections. MRI confirms full-thickness rotator cuff tear. Surgical intervention recommended.

What you'll see

Pre-filled patient and provider details
BCBS-TX requirements for CPT 29827
A ready-to-submit packet preview

Extracted Information

Editable — verify anything marked for review

Patient

AI Extracted High

DOB

AI Extracted High

Member ID

AI Extracted High

Payer

AI Extracted High

Procedure

AI Extracted High

Diagnosis

AI Extracted High

Ordering Provider

AI Extracted High

Referring Provider

AI Extracted High

Clinical Summary

AI Extracted Review

CPT Code Search (BCBS-TX)

Confidence guide

High confidence (spot-check)

Review suggested (read and confirm)

Submit this packet via UHC's provider portal:

Open uhcprovider.com (simulated)

Tip: Attach the combined packet PDF and include the member ID in the subject line.

12 auths this week · 83% first-pass approval rate · Avg prep time: 8 min

Patient	Procedure	Payer	Status	Submitted	Days

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Sample Case

Extracted Information

UnitedHealthcare — Outpatient Advanced Imaging

Packet Preview