Cleruno

Different specialties. Different paperwork.

Recurring drugs in one, procedures in another, workers' compensation in a third. Here's where we'd start in yours. Not every practice offers every service, and the scope is agreed in discovery.

RheumatologyNeurologyRetinaGIOrtho & spine

Rheumatology

Biologics keep patients well, and every one comes with a benefits check, an authorization and a renewal clock.

In a 2026 survey of 53 rheumatology biologics coordinators, respondents averaged about 52 prior authorizations a week, split evenly between new requests and reauthorizations.3

See a rheumatology case
  • Benefits checks across medical and pharmacy benefit, including specialty-pharmacy requirements
  • Step-therapy documentation gathered from the chart for the prescriber's review
  • Renewals opened ahead of expiry, so the next dose isn't put at risk
  • Infused drugs matched on units and dates before billing

Neurology

Infusion therapies mean recurring authorizations, payer site-of-care rules, and dose counts to track.

For neurology practices
  • Referral intake with outside imaging reports and prior treatment history
  • Diagnostic authorizations where the payer requires them
  • Infusion renewals with doses used tracked against doses approved
  • Site-of-care checks before scheduling, with the decision left to your team

Retina

Injection series run on repeat authorizations that are almost always approved, and still take real staff time.

In a study of 2,225 anti-VEGF requests at nine retina practices, median staff time was 100 minutes per request. 64% were reauthorizations, and almost none of those were denied.2

See a retina case
  • Benefits and step-therapy checks for the planned drug
  • Approved injection counts tracked against visits, per eye
  • Renewals opened before the last approved injection
  • Drug, units and eye matched before buy-and-bill claims go out

Gastroenterology

Procedures depend on complete referrals and financial clearance before the scope date. IBD patients add biologics.

See a GI case
  • Referral records such as prior procedure reports and pathology, requested and followed up
  • Endoscopy authorization where the payer requires it
  • Financial clearance confirmed before the procedure date
  • IBD biologic and infusion authorizations and renewals

Orthopedics & spine

Imaging and surgery authorizations, clearance checklists, and adjusters who don't call back.

See an orthopedic case
  • Imaging authorization requested after the clinician signs off on the order
  • Surgical clearance checklists tracked until every document is in
  • Workers' compensation claim verification and adjuster follow-up
  • Carrier billing handed off with the attachments it requires
Talk through your specialtySomeone who knows your workflows joins the review. How it worksThe responsibility split and engagement steps. PricingExample scenarios for three specialties.

Sources

  1. Time-and-motion study of 2,225 anti-VEGF prior authorization requests at nine retina practices, January–June 2022, JAMA Ophthalmology, June 27, 2024. Summary: ajmc.com
  2. Spherix Global Insights survey of 53 rheumatology biologics and reimbursement coordinators, January 7–February 4, 2026, reported by Healio, May 29, 2026. healio.com