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Comlete lifecycle automation
Streamline prior authorization submissions, decisions, and follow-up with targeted human oversight
Zero surprises
Requirement detection
Cross-references payer rules and procedure codes at order entry to flag authorization requirements in real time.
EHR integrated
Clinical data extraction
Pull diagnosis codes, procedure details, and clinical notes from your EHR, eliminating manual chart-to-form transcription.
FHIR API ready
Automated submission
Enable zero-touch processing by automatically bundling and submitting payer-specific authorization packages via FHIR API or portal for all standard cases.
Decision automation
Intelligent adjudication
Evaluate requests against clinical protocols and coverage rules to instantly approve eligible cases, ensuring consistent, evidence-based decisions with minimal manual intervention.
Guided review
Human-in-the-loop escalation
Route edge cases to licensed reviewers with complete case context, and documentation pre-assembled, enabling faster decisions.
Proactive alerts
Real-time status monitoring
Monitor submission status across payer systems and alerts provider staff to approvals, pending documentation requests, or denials before scheduled care is affected.
CMS compliant
Audit & compliance logging
Every submission, decision, and status update is logged with timestamps and policy references to meet CMS 2026 turnaround and audit requirements.
Continuous learning
Predictive denial prevention
Identify high-risk submissions early using historical patterns, highlighting documentation gaps and payer sensitivities before submission to reduce denial rates.
