Pre-authorisation · Sample
PA-2041
Riverside Hospital to Northfield HMO
- General consultation15,000.00Approved
- MRI scan, lumbar spine85,000.00Awaiting HMO
- Branded medication12,500.00Rejected
Reason: a generic is available
Approved so far15,000.00
For HMOs and hospitals
Agree it.Approve it.Settle it.
Healthwise puts agreed prices, pre-authorisations, claims and invoices on one platform, so hospitals and HMOs work from the same record.
- Test mode
- Audit trail
- Scoped API keys
- Live updates
Between hospital and HMO, the details get lost.
- 01
Prices argued after the fact
Without an agreed price list, every bill starts a negotiation.
- 02
Approvals chased by phone
Requests wait in inboxes while patients wait for an answer.
- 03
Payments nobody can trace
Settlement happens somewhere else, and the record never catches up.
One flow, from price list to payment.
- 01
Agree prices
The hospital and the HMO agree a list of services and prices. That list is what every request is priced from.
- 02
Request pre-authorisation
The hospital submits the services it plans to deliver. The HMO approves or rejects each one, and a rejection always comes with a reason.
- 03
File the claim
An approved pre-authorisation becomes a claim for the services actually delivered. The HMO validates it or disputes it with a note.
- 04
Invoice and settle
The hospital bundles validated claims into one invoice, with service charge and tax worked out. The HMO settles it by recording a payment reference.
Built for both sides of the table.
For hospitals
Submit knowing the price is agreed.
- Services and prices agreed up front and applied automatically at submission.
- A decision on every service, with a reason for any rejection.
- Approved pre-authorisations become claims, and validated claims go on a single invoice.
For HMOs
Decide with the full picture.
- See only what has been submitted, never half-finished drafts.
- Approve or reject each service on its own, with a reason for rejections.
- Validate or dispute claims, then settle invoices with a payment reference.
Built for accountability.
Healthwise handles money and medical decisions. The controls are part of the product, not an add-on.
Test mode
Rehearse the whole flow with test data before anything goes live.
Audit trail
Organisation owners can review who did what, and what changed.
Scoped API keys
Connect your own systems with keys limited to exactly what they need.
Live updates
Decisions and status changes reach your team as they happen.
Two-step sign-in
Protect accounts with an authenticator app.
Pricing that fits your organisation.
Tell us about your hospital or HMO and we will get back to you with the details.