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 and diagnosis type.

03

Get your gap report and fix it

Receive an authorization readiness score, dimensional assessment, and AI-drafted remediation language — specific clinical sentences your team can add to the note in minutes.

Payer coverage

14 payers. Every major Florida Medicaid plan and national commercial insurer.

Sunshine Health Aetna Better Health FL Molina Healthcare FL Simply Healthcare FL Humana Medicaid FL UHC Community FL BCBS Florida Cigna Behavioral Health Aetna Commercial UnitedHealthcare Humana Commercial Magellan Health Carelon / Beacon TRICARE Traditional Medicare Medicare Advantage

Green = Florida Medicaid Managed Care  ·  Additional payers added regularly

Features

Everything your UR team needs.
Nothing they don't.

⚖️

MH vs SUD framework detection

Auto-detects whether ASAM or InterQual applies based on primary diagnosis. Critical for Sunshine Health and others that use different frameworks for MH vs substance use.

🔄

Concurrent stay review

Compare your initial auth note against a current progress note to identify documentation gaps before submitting for continued stay reauthorization.

📋

Batch review

Analyze up to 8 patient documents simultaneously with a summary dashboard. Ideal for high-volume UR teams managing multiple concurrent authorizations.

✍️

AI remediation drafting

AuthAlly drafts the specific clinical language your provider needs to add — written in the style of a progress note addendum, ready to copy and paste directly.

📄

PDF upload from any EHR

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

📊

Exportable gap reports

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

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

See AuthAlly analyze your documentation in 30 seconds.

Enter your email and we'll set up a live demo using a de-identified note from your team against your actual payer. No pitch. Just results.

No commitment required. Response within one business day.