Skip to main content

TPA Utilization Review

This guide covers the utilization-review workflow for Authorization Requests in the Case Clinical admin portal. As a TPA reviewer you work the Authorization Numbers queue: verify each request against the medical records and guidelines, code the diagnoses and procedures, and move the request through the review workflow.

The workflow at a glance​

  1. Work the queue — open the Authorization Numbers queue, load the TPA view, sort by action date, and open a request.
  2. Review a request — open the report, then code the diagnosis codes, procedure codes, and place of service.
  3. Update the status — move the request to the right status; some statuses collect additional required information in a dialog.

Where​

EnvironmentURL
UAThttps://admin-uat.caseclinical.com/queues/authorization-numbers
Productionhttps://admin.caseclinical.com/queues/authorization-numbers
note

The screenshots and field lists in this guide match the redesigned Authorization Overview screen (July 2026). If your screen shows a left navigation drawer inside the record, you are on an older build.