Decisions and next steps

Understand the payer's decision and how Davner handles denials and appeals.

When the payer makes a decision, we update the request and let you know. Open the request to read the explanation in Activity and find supporting correspondence in Documents.

If the request is approved

The status changes to Authorized. Review the approval details, including the authorized services, dates, quantities, and authorization number provided by the payer.

You can download the approval document from Documents or use Print request for a summary of the case.

If the request is denied

We explain why the payer denied the request and what happens next.

If we determine that the denial is based on an invalid or incorrect reason, we’ll appeal it automatically.

When a peer-to-peer is needed

If the denial can only be overturned through a peer-to-peer, we’ll let you know. Your practice arranges the peer-to-peer. We’ll provide the reason for the denial and a justification you can use to explain why it should be overturned.

If you have questions about the decision or next steps, leave a comment on the request.