What does the Workflow Teardown cost?

It is $2,500 fixed, credited against the build if you sign within 30 days. The readout arrives 10 business days after your de-identified sample set, with a sample run on 25 documents you can compare.

Which payers are covered?

Medicare Advantage, Medicaid and CHIP, and exchange plans are the impacted payers under CMS-0057-F (CMS fact sheet, 2024-01-17). Other payers sit outside the mandate, and drug prior authorizations are not covered by it.

Rekey Desk / Guides / Automate prior auth now or later

Prior auth timing

Automate prior authorization now or wait for the payer API

Your team is booking prior auth capacity for next year while the payer API mandate starts on January 1, 2027 (CMS fact sheet, 2024-01-17). The meeting question is whether to build the keying now or wait. Waiting does nothing for the requests already stacked up this quarter.

Rekey Desk does not wait on a mandate: the Rekey Map counts today's keying, the Field Rulebook writes the rules, the Keying Build works over fax and portal channels as they are, and the Exception Queue holds what needs a person. The channels are not your constraint.

Request a sample run See a sample run

Last updated 2026-09-26. Rekey Desk is run by Mike Rodgers from Denver and works remotely with operators across the United States.

What the rule actually requires

CMS-0057-F requires impacted payers, Medicare Advantage, Medicaid and CHIP, and exchange plans, to give a specific denial reason and return urgent decisions within 72 hours and standard decisions within 7 calendar days, from January 1, 2026 (CMS fact sheet, 2024-01-17).

The FHIR Prior Authorization API is required from January 1, 2027, and decisions may still arrive by portal, fax, email, mail or phone (CMS fact sheet, 2024-01-17). The deadline moves for the API, not for your intake desk.

What the API does not cover

The mandate covers the impacted payers only, and it does not reach drug prior authorizations, so those keep arriving on the channels they use today. Payers outside the impacted list are not covered at all.

Even for impacted payers, decisions may still arrive by portal, fax, email, mail or phone (CMS fact sheet, 2024-01-17). Paper does not disappear because an API exists.

What stays manual either way

Attachments that exist only on paper, pages a scanner cannot read, and anything that needs a person judgment. Those arrive as an image, and someone still has to read it and decide where it goes.

The Exception Queue is built for them: a reason code, the source page, and a named person. Nothing is guessed, and nothing is keyed from memory.

Clinical and coding decisions stay with your clinicians, and payer submissions stay with your team in every version of this.

What to do now

Count the work that happens today, whatever channel it arrives on. Practices complete 39 prior authorization requests per physician per week, and staff spend about 13 hours a week on them (AMA, 2025-04-24); that volume does not pause for a mandate.

Automate the keying that is already happening: reading the packet, filling the form, attaching pages, keying the decision back. The channels stay the same; the retyping is what changes.

Bring your count to a teardown and get a Rekey Map and Field Rulebook that work over fax and portal today, with a fixed build quote at the end.

How to decide

If all four hold, the wait or build decision is a budget conversation, not a guess.

Check: the payer in front of you is on the impacted list or it is not, and you found out before planning.
Check: your volume count includes fax and portal requests, not only electronic ones.
Check: the build quote names the channels it keys from.
Check: exceptions carry a reason code and a named person in either case.

What correct looks like

The checks behind this page

Check: the payer in front of you is on the impacted list or it is not, and you found out before planning.
Check: your volume count includes fax and portal requests, not only electronic ones.
Check: the build quote names the channels it keys from.
Check: exceptions carry a reason code and a named person in either case.

Named owner of mistakes: Mike Rodgers. Every field your staff mark wrong is counted in the Monthly Accuracy Report, the rule behind it is fixed, and the affected records are checked again before the next batch.

Start here

Workflow Teardown, $2,500 fixed

Readout 10 business days after your de-identified sample set arrives. The $2,500 is credited in full against the Keying Build if you sign within 30 days of the readout. If the map shows the workflow is not worth automating, the readout says so, and you keep the map and the rulebook.

The Keying Build is a fixed price quoted after the teardown, and Run and Check is a monthly price quoted with it.

Request a sample run Full offer and price

What your people still own

Your staff work the channels the payer actually uses.
Your named people decide every exception.
Clinicians decide anything clinical in every version of this.
You own the Field Rulebook, the exception log and the build configuration.

FAQ

Questions about this page

What does the Workflow Teardown cost?: It is $2,500 fixed, credited against the build if you sign within 30 days. The readout arrives 10 business days after your de-identified sample set, with a sample run on 25 documents you can compare.
Does the 2027 API mean I can stop keying?: No, the API is required from January 1, 2027, for impacted payers, and decisions may still arrive by portal, fax, email, mail or phone (CMS fact sheet, 2024-01-17). Fax and portal keying continues for everyone else.
Which payers are covered?: Medicare Advantage, Medicaid and CHIP, and exchange plans are the impacted payers under CMS-0057-F (CMS fact sheet, 2024-01-17). Other payers sit outside the mandate, and drug prior authorizations are not covered by it.
What stays manual either way?: Paper attachments, pages that cannot be read cleanly, and anything needing judgment. Those go to the Exception Queue with a reason code and the source page, and your named person decides.

Keep reading

Workflows

Prior auth packet building

Your prior auth staff pull notes, orders and prior therapy from the chart, key payer portal forms page by page, then key the decision back.

Read the page

Who it is for

Prior auth intake for health plans

Faxed prior authorization requests and clinical attachments sit outside the utilization management system until someone keys them in by hand.

Read the page

Guides

How to count re-keying

Count one workflow's re-keying before buying: documents per week, fields keyed, minutes per document and your loaded hourly cost.

Read the page

Every page on this site

Rekey Desk home: healthcare back-office automation, one workflow at a time, with prices and the method.
Referral intake keying: Referral packets wait in the fax inbox while your intake coordinator retypes the face sheet, orders and H&P before anyone can call.
Prior auth packet building: Your prior auth staff pull notes, orders and prior therapy from the chart, key payer portal forms page by page, then key the decision back.
Eligibility and benefits keying: Your front desk reads payer responses and retypes frequencies, maximums, waiting periods and deductibles into the PMS ledger at every location.
Claim status follow-up keying: Payer responses and portal screens get read, then retyped as notes in the AR work queue while staff reopen three systems to act.
Dental groups and DSOs: DSOs verify insurance and post benefits at every location without adding headcount, and onboard acquisitions without switching the PMS.
Home health and hospice intake: Referral packets, intake keying and Medicare Advantage authorizations hold up start of care while your coordinator retypes the same pages.
Prior auth intake for health plans: Faxed prior authorization requests and clinical attachments sit outside the utilization management system until someone keys them in by hand.
Specialty group back office: Your prior auth staff key requests all week while referrals move in and out and charts still have to reach payers by hand.
Healthcare PE rollouts: Every acquired site breaks the same workflow its own way; tear down one workflow at one site, then roll one rulebook across the platform.
How to count re-keying: Count one workflow's re-keying before buying: documents per week, fields keyed, minutes per document and your loaded hourly cost.
Vendor questions before data moves: Ask any automation vendor these before patient data moves: agreement, accounts you control, accuracy on your documents, exception codes.

Request a sample run

Tell us the workflow that eats the most typing

One short form. We reply by email with what we need for the sample run. No patient data in this form, please.

Workflow Teardown: $2,500 fixed
Readout 10 business days after your de-identified samples arrive
Credited in full against the build if you sign within 30 days

Automate prior authorization now or wait for the payer API

What the rule actually requires

What the API does not cover

What stays manual either way

What to do now

How to decide

The checks behind this page

Workflow Teardown, $2,500 fixed

What your people still own

Questions about this page

Related pages

Prior auth packet building

Prior auth intake for health plans

How to count re-keying

Every page on this site

Tell us the workflow that eats the most typing