Migraine Care

Capture and structure the clinical data your billing team needs for rapid migraine prior-auth filing

Prior authorization for migraine preventives and newer injectables requires detailed medication history and failed trials. Our AI captures this evidence on intake and escalation calls, returning a structured summary that your billing team uses to file prior-auth quickly—reducing treatment delays.

Medication trial history captured: name, dose, duration, efficacy, reason for discontinuation for each prior preventive
Frequency documentation: migraine days per month or attacks per week for the past 90 days establishes need for escalation therapy
Baseline and treatment response: captured for each trial to demonstrate adequate dosing and adequate duration before escalation
Comorbidity context: depression, anxiety, hypertension documented to inform medication choice and justify therapy selection
Insurance guidelines screening: AI flags therapy choice against common prior-auth criteria so your billing team files with confidence
Structured summary returned for chart review; your billing team compiles prior-auth packet with provider signature

How it pays back

Evidence ready on day one

Instead of calling patients to gather trial history for prior-auth, your billing team gets a complete narrative from the intake call.

Faster insurance approval turnaround

Prior-auth packets filed with complete medication trial and frequency documentation reduce insurance requests for more information.

Fewer approval denials

Structured evidence of prior therapeutic failure meets insurance criteria upfront, reducing denials and appeals.

Patient therapy starts sooner

Faster prior-auth approval means patients begin preventive or injectable therapy without weeks of delay.

Medication trials, dosages, durations, and efficacy

Captured on first call for prior-auth evidence

Frequency documentation

Migraine days per month establishing medical necessity

Insurance criteria cross-reference

AI flags therapy choice against common prior-auth guidelines

Structured billing packet

Staff compiles prior-auth with complete clinical evidence and provider approval

Frequently asked questions

What medication trial information does the AI capture for prior-auth?

The AI captures medication name, dose, duration of trial, dates started and stopped, perceived efficacy by the patient, side effects, and reason for discontinuation (e.g., 'ineffective,' 'intolerable side effect'). This evidence is returned as a structured summary for your team to review and use to meet most prior-auth requirements for failed sequential therapy.

How does the AI document 'failed trial'—does it require a certain duration?

The AI captures what the patient reports: duration on the medication and their perception of efficacy. Your clinician and billing team then verify against standard therapy windows (e.g., 4 weeks minimum for topiramate, 8 weeks for propranolol) before submitting prior-auth.

Can the AI identify insurance plan-specific prior-auth criteria?

The system captures the patient's insurance during intake. Your billing team can configure common prior-auth rules for major plans (e.g., 'CGRP inhibitor requires 2 failed preventives'). The AI flags when evidence meets or falls short of those criteria.

Does the call capture help with appeals if an initial prior-auth is denied?

Yes. The structured call summary with full medication trial history and frequency data is saved for your team's review. If an initial prior-auth is denied, your appeals team uses the call summary to rebuild the case with additional clinical context or peer-to-peer discussion.

What if a patient didn't try any prior preventives—are they eligible for a CGRP inhibitor?

That depends on the insurance plan and your clinic's protocol. The AI captures the patient's prior history accurately; your clinician and billing team then consult the insurance guidelines and may request an exception or alternative therapy path.