Utilization Management Automation that Simplifies Workflows

Streamline prior authorization routing, notifications, and compliance tracking—so you can focus on patient care, not paperwork.

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Nova’s Utilization Management automation tools reduce administrative bottlenecks and improve turnaround times. Designed for IPAs and health plans, Nova integrates data, automation, and policy controls to deliver accuracy and speed with full audit visibility.

Capabilities

  • Prior Authorization Routing & Assignment

    Automatically categorizes and routes incoming authorization requests based on plan rules, service type, and specialty, ensuring timely review and balanced workloads across teams.

  • Member Notification Automation

    Generates and sends compliant approval, denial, or modification letters automatically, with full audit trails and electronic delivery tracking to meet regulatory requirements.

  • Regulated Templates and Document Tracking

    Stores and maintains plan-specific templates for NOA and determination letters, applying the correct version automatically to minimize errors and maintain compliance.

  • Turnaround Time and Performance Dashboards

    Real-time dashboards track utilization volumes, approval rates, and processing times—offering leadership transparent insight into operational performance and compliance status.

How it Works

Nova integrates with your existing UM data feeds, plan templates, and authorization logs. Each new request and determination triggers automated classification, letter generation, and tracking. Supervisors retain full control for final review, ensuring accuracy and accountability.

UM Data Integration

  • Secure Web Portal
  • Secure File Transfer (SFTP)
  • Secure API Integration
  • Direct Database Connection

Referral Intake

  • Centralized in a database
  • Automatic timeliness ordering
  • Routed to dedicated systems
  • Reconciliation reports generated

Automated Systems

  • Auto-Approval Recommendations
  • Smart Referral Routing to Responsible Teams
  • Member Notification Generation
  • Patient and Provider-Related Alerts

Monitoring and Tracking

  • Standardized audit-ready reporting
  • Automation performance monitoring
  • Exception alerts and resolution tracking
  • Real-time dashboard visibility

Nova’s UM automation operates strictly within administrative scope and never performs clinical determinations.

Benefits

  • Less manual work with less room for error
  • Faster determinations and better outcomes
  • Transparent reporting for strategic decision-making
  • Stronger plan-provider coordination to ensure compliance
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