Behavioral Health Prior Authorization

Your documentation.
Their criteria.
No surprises.

AuthAlly reviews clinical notes against payer-specific ASAM and InterQual criteria before you submit — so your team catches denial risks before the payer does.

Request a Demo See How It Works

14 Payers  ·  Full ASAM Continuum  ·  MH + SUD Frameworks  ·  PDF Upload

Authorization readiness — PHP / ASAM 2.5
Likely denied — 38%
38%

Sunshine Health · PHP

3 critical gaps in ASAM
dimensional criteria

Withdrawal / monitoring needGap
Relapse risk / Dimension 5Partial
Recovery environment / Dim. 6Gap
Biomedical conditionsMet
Psychiatric / emotional stabilityMet
Remediation drafted
"Patient's current home environment presents significant relapse risk due to active substance use by household members and proximity to prior using locations, making IOP-level care clinically contraindicated..."
15–30%
of behavioral health prior auth requests are denied — most due to documentation gaps, not clinical appropriateness
$3k+
average revenue lost per denied authorization before accounting for UR staff time on appeals
4hrs
average UR staff time per prior auth submission and subsequent appeal process

How AuthAlly Works

From clinical note to authorization-ready in seconds.

AuthAlly doesn't replace your clinical team — it makes their documentation payer-proof before it leaves your facility.

01

Upload Your Documentation

Paste text or upload a PDF directly from Kipu, TIER, or any EHR. AuthAlly reads progress notes, H&Ps, assessments, and discharge summaries in seconds.

02

Select Payer and Level of Care

Choose from 14 payers and 10 levels of care. AuthAlly applies the exact criteria framework — ASAM or InterQual — that payer uses for that specific level of care.

03

Review Gaps and Submit with Confidence

AuthAlly surfaces missing criteria and drafts clinical language to address each gap. Your team adds it to the note, then submits — ready for approval.

Supported Payers

Built for Florida's major payers — expanding nationally.

Sunshine HealthFlorida BlueMolina HealthcareHumanaAetnaCignaUnited HealthcareSimply HealthcareBCBSWellCareMagellanBeacon HealthOptum+ More

Platform Features

Everything you need to stop denials before they happen.

AuthAlly brings clinical intelligence and payer-specific criteria into one platform built specifically for behavioral health and addiction treatment.

🧠

ASAM Dimensional Screening

Screens progress notes against all 6 ASAM dimensions for the selected level of care, identifying gaps that commonly trigger denials.

📋

Payer-Specific Criteria Engine

Each payer uses different criteria — some use ASAM, others InterQual, some hybrid. AuthAlly applies the right framework automatically.

✍️

AI Remediation Drafting

Doesn't just flag gaps — drafts the clinical language needed to address each gap. Providers add it to the note in under two minutes.

📄

PDF Upload from Any EHR

Upload directly from Kipu, TIER, or any EHR-exported PDF. No copy-paste required. AuthAlly extracts and analyzes automatically.

📊

Exportable Gap Reports

Print-ready authorization gap reports for prior auth submissions or denial appeals, including dimensional assessment and payer-specific findings.

🔒

HIPAA Compliant

Built to meet healthcare data privacy and security standards. All clinical documentation handled with enterprise-grade security.

Return on Investment

What does one prevented denial actually cost?

Most facilities see ROI within their first week. Adjust the sliders to estimate the revenue impact at your facility.

Monthly auth requests40
Current denial rate20%
Monthly denials8
Revenue at risk / month$24,000
Denials prevented (est.)4–5
Monthly revenue protected$12,000–$15,000
1040200
5%20%40%
$1k$3,000$12k
Estimated annual revenue protected
$108,000
Based on ~50% denial reduction estimate

Early Results

Built with behavioral health UR teams, for behavioral health UR teams.

We were losing 3–4 PHP auths per month with Sunshine Health. AuthAlly showed us exactly why — we were never addressing Dimension 6. That one change turned our denial rate around.
Director of Utilization Review
Residential treatment center, Florida
Beta User
I didn't know Sunshine used InterQual for mental health and ASAM for SUD until AuthAlly flagged it. We had been submitting every dual-diagnosis case under ASAM. No wonder they kept getting denied.
UR Coordinator
Dual diagnosis facility, Tampa FL
Beta User
The remediation drafting is what sold me. It doesn't just tell you what's missing — it writes the clinical language for you. Our providers add it to the note in under two minutes.
Revenue Cycle Director
Multi-site behavioral health group
Beta User

Get Started

See AuthAlly analyze your documentation in 30 seconds.

Request a personalized demo using a de-identified note from your team against your actual payer. No pitch. Just results.

Request a Demo See How It Works

No commitment required. We'll reach out within 1 business day.