Your AI Prior Authorization Teammate gathers clinical data, submits authorization requests, tracks approvals, and manages appeals — cutting auth turnaround from days to hours and eliminating the #1 source of staff burnout.
From clinical data gathering to payer submission and appeals management, your AI teammate handles the entire auth lifecycle.
Automatically gathers clinical notes, diagnoses, lab results, and supporting documentation from the EHR to build complete auth packages.
Submits authorization requests to payers electronically via portal, fax, or API — with all required clinical documentation attached.
Monitors auth status in real time, sends automated follow-ups to payers, and escalates delayed authorizations before they impact care.
Analyzes denial reasons, assembles appeal documentation, and submits appeals with targeted clinical evidence to overturn denials.
Maintains and applies payer-specific auth requirements, ensuring submissions meet each payer's unique criteria on the first attempt.
Tracks approval rates, turnaround times, and denial patterns by payer — surfacing insights to optimize your auth strategy.
Designed for executives and managers responsible for revenue integrity, care access, and administrative efficiency.
Revenue cycle leaders who need to reduce auth-related denials, accelerate cash flow, and eliminate the auth backlog.
Clinical leaders who need to ensure timely care access without diverting clinical staff to administrative auth tasks.
Managers overseeing auth teams who need to handle growing volumes, reduce staff burnout, and improve turnaround times.
AI Prior Authorization directly displaces the most time-consuming, frustrating task in healthcare administration.
Every deployment is benchmarked against the metrics that matter most to healthcare revenue and operations.
Authorization turnaround drops from days to hours with automated submission and tracking.
Complete, payer-specific submissions dramatically improve first-pass approval rates.
AI handles the repetitive data gathering, submission, and follow-up tasks that consume staff time.
Payer-specific rule intelligence ensures complete submissions that meet requirements the first time.
Faster authorizations and successful appeals recover revenue that would otherwise be lost to delays and denials.
Handle growing auth volumes without hiring additional authorization staff.
Your AI teammate integrates with EHRs, payer portals, and clearinghouses you already use.
Native integration for clinical data extraction, auth status tracking, and care team notifications.
Automated submission to major payer portals including UnitedHealthcare, Aetna, Cigna, and Blue Cross.
Connects to Availity, Change Healthcare, and Trizetto for electronic auth submission and tracking.
Automated fax submission for payers that still require it, with OCR-based response processing.
Integrates with MCG, InterQual, and other CDS tools for evidence-based authorization support.
RESTful APIs and X12 278 transaction support for electronic prior authorization.
A structured deployment delivering measurable results from the first sprint.
Every submission is auditable. Every record is protected. Built for HIPAA-regulated environments.
Complex cases and peer-to-peer reviews route to clinical staff. AI handles routine auths at scale.
Full audit trails, BAA support, and compliance logging for healthcare regulatory requirements.
End-to-end encryption and data residency controls for all protected health information.
Connects to Epic, Cerner, athenahealth via HL7 FHIR and secure APIs.
See measurable results — faster authorizations, fewer denials, and recovered revenue — within your first month.