For Insurance Companies
Manage coverage decisions and healthcare requests digitally
Work with connected practices, facilities, pharmacies, and supply providers on coverage checks, prior authorisations, claims, and appeals — in one auditable workflow.
What you can do
- Receive coverage checks and prior-authorisation requests
- Review and decide claims from connected healthcare organisations
- Request additional information before deciding
- Record decisions with notes and timestamps
- Manage appeals on previous decisions
- Track payments and settlements linked to approved claims
- Maintain a complete, auditable trail of every decision
How it works
- 1
A patient or connected healthcare organisation submits a coverage, prior-authorisation, or claim request
- 2
Your team receives the request with the required information
- 3
Authorised staff review and record a decision
- 4
The requesting party is notified of the outcome
- 5
If needed, the decision can be appealed and reviewed again
How PharmiraHealth connects you
GP & medical practicesHospitalsCare facilitiesPharmaciesLaboratoriesMedical supply providersPatients